Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients.

PubMed

Mica, L; Furrer, E; Keel, M; Trentz, O

2012-12-01

Systemic inflammatory response syndrome (SIRS) and sepsis as causes of multiple organ dysfunction syndrome (MODS) remain challenging to treat in polytrauma patients. In this study, the focus was set on widely used scoring systems to assess their diagnostic quality. A total of 512 patients (mean age: 39.2 ± 16.2, range: 16-88 years) who had an Injury Severity Score (ISS) ≥17 were included in this retrospective study. The patients were subdivided into four groups: no SIRS, slight SIRS, severe SIRS, and sepsis. The ISS, New Injury Severity Score (NISS), Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and prothrombin time were collected at admission. The Kruskal-Wallis test and χ(2)-test, multinomial regression analysis, and kernel density estimates were performed. Receiver operating characteristic (ROC) analysis is reported as the area under the curve (AUC). Data were considered as significant if p < 0.05. All variables were significantly different in all groups (p < 0.001). The odds ratio increased with increasing SIRS severity for NISS (slight vs. no SIRS, 1.06, p = 0.07; severe vs. no SIRS, 1.07, p = 0.04; and sepsis vs. no SIRS, 1.11, p = 0.0028) and APACHE II score (slight vs. no SIRS, 0.97, p = 0.44; severe vs. no SIRS, 1.08, p = 0.02; and sepsis vs. no SIRS, 1.12, p = 0.0028). ROC analysis revealed that the NISS (slight vs. no SIRS, AUC 0.61; severe vs. no SIRS, AUC 0.67; and sepsis vs. no SIRS, AUC 0.77) and APACHE II score (slight vs. no SIRS, AUC 0.60; severe vs. no SIRS, AUC 0.74; and sepsis vs. no SIRS, AUC 0.82) had the best predictive ability for SIRS and sepsis. Quick assessment with the NISS or APACHE II score could preselect possible candidates for sepsis following polytrauma and provide guidance in trauma surgeons' decision-making.

Characterization of Mediators of Cardiac And Renal Development in Response to Increased Prenatal Testosterone

DTIC Science & Technology

2008-08-01

II diabetes, dyslipidemia , and obesity, the combination of which is more commonly referred to as the metabolic syndrome, and various reproductive...insulin resistance, cardiovascular disease, hypertension, and dyslipidemia (Sir-Petermann et al. 2002a; Sir-Petermann et al. 2005; Orio et al. 2006). Up...resulting in dyslipidemia and oxidative stress (Bansilal et al. 2007). The combination of dyslipidemia and oxidative stress then leads to

Profound systemic inflammatory response syndrome following non-emergent intestinal surgery in children.

PubMed

Chawla, Bhani K; Teitelbaum, Daniel H

2013-09-01

Systemic inflammatory response syndrome (SIRS) is an uncommon but severe complication in surgical patients. While SIRS is well known, it is poorly described in the pediatric population. The goal of this study was to describe the incidence of profound SIRS following non-emergent intestinal surgery in children and to identify potential risk factors. A retrospective review was conducted for patients 0-19 years of age following intestinal surgery and/or lysis of adhesions from 01/01/1999-02/28/2012. Children were excluded for preoperative instability or frank bowel perforation. Patients were then placed in a post-operative SIRS or non-SIRS group as defined by the 2005 International Pediatric Sepsis Consensus Conference Guidelines (6. B. Goldstein, B. Giroir, A. Randolph, and Sepsis International Consensus Conference on Pediatric, 'International Pediatric Sepsis Consensus Conference: Definitions for Sepsis and Organ Dysfunction in Pediatrics', Pediatr Crit Care Med, 6 (2005), 2-8.). SIRS was identified in 17 of the 381 patients. Logistic regression analysis was performed and showed heart disease, kidney disease, PN dependence, and intestinal obstruction to be predictive of post-operative SIRS. This study represents one of the first reports to identify a previously poorly described process of significant SIRS after intestinal surgery in children. Both systemic organ failure and intestinal dysfunction are strong risk factors for post-operative SIRS in children. Potentially, these pre-existing conditions may lead to disruption of normal intestinal flora or barrier function, which in turn may predispose these children to dramatic SIRS episodes after intestinal surgery. Understanding how these factors lead to SIRS will be critical to developing prevention strategies. © 2013 Elsevier Inc. All rights reserved.

Circulating Plasma microRNAs can differentiate Human Sepsis and Systemic Inflammatory Response Syndrome (SIRS).

PubMed

Caserta, Stefano; Kern, Florian; Cohen, Jonathan; Drage, Stephen; Newbury, Sarah F; Llewelyn, Martin J

2016-06-20

Systemic inflammation in humans may be triggered by infection, termed sepsis, or non-infective processes, termed non-infective systemic inflammatory response syndrome (SIRS). MicroRNAs regulate cellular processes including inflammation and may be detected in blood. We aimed to establish definitive proof-of-principle that circulating microRNAs are differentially affected during sepsis and non-infective SIRS. Critically ill patients with severe (n = 21) or non-severe (n = 8) intra-abdominal sepsis; severe (n = 23) or non-severe (n = 21) non-infective SIRS; or no SIRS (n = 16) were studied. Next-generation sequencing and qRT-PCR were used to measure plasma microRNAs. Detectable blood miRNAs (n = 116) were generally up-regulated in SIRS compared to no-SIRS patients. Levels of these 'circulating inflammation-related microRNAs' (CIR-miRNAs) were 2.64 (IQR: 2.10-3.29) and 1.52 (IQR: 1.15-1.92) fold higher for non-infective SIRS and sepsis respectively (p < 0.0001), hence CIR-miRNAs appeared less abundant in sepsis than in SIRS. Six CIR-miRNAs (miR-30d-5p, miR-30a-5p, miR-192-5p, miR-26a-5p, miR-23a-5p, miR-191-5p) provided good-to-excellent discrimination of severe sepsis from severe SIRS (0.742-0.917 AUC of ROC curves). CIR-miRNA levels inversely correlated with pro-inflammatory cytokines (IL-1, IL-6 and others). Thus, among critically ill patients, sepsis and non-infective SIRS are associated with substantial, differential changes in CIR-miRNAs. CIR-miRNAs may be regulators of inflammation and warrant thorough evaluation as diagnostic and therapeutic targets.

Usefulness of elevated red cell distribution width for predicting systemic inflammatory response syndrome after extracorporeal circulation.

PubMed

Özeren, M; Aytaçoğlu, B; Vezir, Ö; Karaca, K; Akın, R; Sucu, N

2015-10-01

Cardiac surgical operations performed by using extracorporeal circulation (ECC) lead to a systemic inflammatory response (SIR). Sometimes SIR may turn into a severe state, the systemic inflammatory response syndrome (SIRS) that usually has a poor outcome with no specific clinical tools described for its prediction. Red cell distribution width (RDW) is a routine hematological parameter. It has been proposed as a marker of morbidity and mortality in various clinical conditions. We aimed to investigate the relationship between high RDW and SIRS which is triggered by ECC. Eleven hundred consecutive patients who underwent elective heart surgery with the use of ECC were retrospectively analyzed. A total of 19 patients fulfilled the described SIRS criteria and 20 consecutive patients were selected as the control group. RDW and other laboratory parameters, preoperative clinical status, operative data and postoperative data were compared between the SIRS and the control groups. Baseline characteristics of the patient groups were similar. Significant mortality was found in the SIRS group; 18 (94.73%) patients and 2 (10%) patients in the control group (p < 0.002). RDW was found to be significantly higher in the SIRS group vs the control group (15.02 ± 2.03 vs 13.01 ± 1.93, respectively, p < 0.003). Multiple logistic regression analyses showed an association between high RDW levels and SIRS development (OR for RDW levels exceeding 13.5%; 95% confidence limits of 1.0-1.3; p < 0.04). Total operation time and the need for inotropic support were also found to be significant against the SIRS group (p = 0.049). Increased RDW was significantly associated with increased risk of SIRS after ECC. The results of this study suggest that paying attention to RDW might provide valuable clinical information for predicting SIRS development among patients who are candidates for open heart surgery, without incurring additional costs. © The Author(s) 2015.

[Comment on “The Paradigm: Thomas Kuhn and the Trojan horse”] Comment: The finer points of mythology and science; Reply: Ajax, Hector, and Pandarus

NASA Astrophysics Data System (ADS)

Advocate, Dev L.

Kingsley Amis once (or perhaps twice) observed, “If you can't annoy somebody with what you write I think there is little point in writing.” Ajax L. East gives some very sound advice: “always verify your references.” This quote is not quite right and is taken out of context. Dr. Routh, when asked for some advice by a young man, replied, “I think, sir, since you care for the advice of an old man sir, you will find it a very good practice always to verify your references, sir.” This advice was offered thoughtfully and not gratuitously, out of the blue, or whatever color cyberspace is. So, it is good to verify your references. Ironically, in my account of the Trojan War, I did not refer to Homer, or the Iliad, and certainly not to an English translation or the long lost Nostoi. My sources were more eclectic and original, not that I have anything against Homer or Lattimore. Students of the Trojan War must distinguish between myth, legend, history, archeology, metaphor, parable, allegory, and geophysics. Homer, of course, takes liberties. Chieftains ride up to battle in chariots, dismount, and exchange quite long speeches before engaging in gruesome hand-to-hand combat.

An Intention-Driven Semi-autonomous Intelligent Robotic System for Drinking.

PubMed

Zhang, Zhijun; Huang, Yongqian; Chen, Siyuan; Qu, Jun; Pan, Xin; Yu, Tianyou; Li, Yuanqing

2017-01-01

In this study, an intention-driven semi-autonomous intelligent robotic (ID-SIR) system is designed and developed to assist the severely disabled patients to live independently. The system mainly consists of a non-invasive brain-machine interface (BMI) subsystem, a robot manipulator and a visual detection and localization subsystem. Different from most of the existing systems remotely controlled by joystick, head- or eye tracking, the proposed ID-SIR system directly acquires the intention from users' brain. Compared with the state-of-art system only working for a specific object in a fixed place, the designed ID-SIR system can grasp any desired object in a random place chosen by a user and deliver it to his/her mouth automatically. As one of the main advantages of the ID-SIR system, the patient is only required to send one intention command for one drinking task and the autonomous robot would finish the rest of specific controlling tasks, which greatly eases the burden on patients. Eight healthy subjects attended our experiment, which contained 10 tasks for each subject. In each task, the proposed ID-SIR system delivered the desired beverage container to the mouth of the subject and then put it back to the original position. The mean accuracy of the eight subjects was 97.5%, which demonstrated the effectiveness of the ID-SIR system.

Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome.

PubMed

Arkader, R; Troster, E J; Lopes, M R; Júnior, R R; Carcillo, J A; Leone, C; Okay, T S

2006-02-01

To evaluate whether procalcitonin (PCT) and C reactive protein (CRP) are able to discriminate between sepsis and systemic inflammatory response syndrome (SIRS) in critically ill children. Prospective, observational study in a paediatric intensive care unit. Kinetics of PCT and CRP were studied in patients undergoing open heart surgery with cardiopulmonary bypass (CPB) (SIRS model; group I1) and patients with confirmed bacterial sepsis (group II). In group I, PCT median concentration was 0.24 ng/ml (reference value <2.0 ng/ml). There was an increment of PCT concentrations which peaked immediately after CPB (median 0.58 ng/ml), then decreased to 0.47 ng/ml at 24 h; 0.33 ng/ml at 48 h, and 0.22 ng/ml at 72 h. CRP median concentrations remained high on POD1 (36.6 mg/l) and POD2 (13.0 mg/l). In group II, PCT concentrations were high at admission (median 9.15 ng/ml) and subsequently decreased in 11/14 patients who progressed favourably (median 0.31 ng/ml). CRP levels were high in only 11/14 patients at admission. CRP remained high in 13/14 patients at 24 h; in 12/14 at 48 h; and in 10/14 patients at 72 h. Median values were 95.0, 50.9, 86.0, and 20.3 mg/l, respectively. The area under the ROC curve was 0.99 for PCT and 0.54 for CRP. Cut off concentrations to differentiate SIRS from sepsis were >2 ng/ml for PCT and >79 mg/l for CRP. PCT is able to differentiate between SIRS and sepsis while CRP is not. Moreover, unlike CRP, PCT concentrations varied with the evolution of sepsis.

High concentrations of N-BNP are related to non-infectious severe SIRS associated with cardiovascular dysfunction occurring after off-pump coronary artery surgery.

PubMed

Kerbaul, F; Giorgi, R; Oddoze, C; Collart, F; Guidon, C; Lejeune, P J; Villacorta, J; Gouin, F

2004-11-01

Procalcitonin (PCT) blood concentrations are known to be an appropriate marker of severe systemic inflammatory response syndrome (SIRS) induced by coronary artery surgery with and without cardiopulmonary bypass. Pro-brain natriuretic peptide (N-BNP) is a newly described cardiac hormone considered to be an effective marker of severity and prognosis of acute coronary syndromes and congestive heart failure. We evaluated the perioperative time courses of PCT and N-BNP and investigated their role as early markers of severe SIRS (SIRS with cardiovascular dysfunction) induced by off-pump coronary artery bypass (OPCAB). Sixty-three patients were prospectively included. The American College of Chest Physicians Classification was used to diagnose SIRS and organ system failure to define severe SIRS. Serum concentrations of PCT and N-BNP were determined before, during and after surgery. Receiver operating characteristic curves and cut-off values were used to assess the ability of these markers to predict postoperative severe SIRS. SIRS occurred in 25 (39%) patients. Nine of them (14%) showed severe SIRS. Significantly higher serum concentrations of N-BNP and PCT were found in patients with severe SIRS with peak concentrations respectively at 8887 pg ml(-1) (range 2940-29372 pg ml(-1)) for N-BNP and 9.50 ng ml(-1) (range 1-65 ng ml(-1)) for PCT. The area under the curve using N-BNP to detect postoperative severe SIRS was 0.799 before surgery (0.408 for PCT; P<0.01) and 0.824 at the end of surgery (0.762 for PCT; P<0.05). N-BNP may be an appropriate marker indicating the early development of non-infectious postoperative severe SIRS after OPCAB.

Incidence of cancer in the area around Amsterdam Airport Schiphol in 1988–2003: a population-based ecological study

PubMed Central

Visser, Otto; van Wijnen, Joop H; van Leeuwen, Flora E

2005-01-01

Background Amsterdam Airport Schiphol is a major source of complaints about aircraft noise, safety risks and concerns about long term adverse health effects, including cancer. We investigated whether residents of the area around Schiphol are at higher risk of developing cancer than the general Dutch population. Methods In a population-based study using the regional cancer registry, we estimated the cancer incidence during 1988–2003 in residents of the area surrounding Schiphol. We defined a study area based on aircraft noise contours and 4-digit postal code areas, since historical data on ambient air pollution were not available and recent emission data did not differ from the background urban air quality. Results In residents of the study area 13 207 cancer cases were diagnosed, which was close to the expected number, using national incidence rates as a reference (standardized incidence ratio [SIR] 1.02). We found a statistically significantly increased incidence of hematological malignancies (SIR 1.12, 95% confidence interval [CI]: 1.05, 1.19), mainly due to high rates for non-Hodgkin lymphoma (SIR 1.22, 95% CI: 1.12, 1.33) and acute lymphoblastic leukemia (SIR 1.34, 95% CI: 0.95, 1.83). The incidence of cancer of the respiratory system was statistically significantly decreased (SIR 0.94, 95% CI: 0.90, 0.99), due to the low rate in males (SIR 0.89). In the core zone of the study area, cancer incidence was slightly higher than in the remaining ring zone (rate ratio of the core zone compared to the ring zone 1.05, 95% CI 1.01, 1.10). This was caused by the higher incidence of cancer of the respiratory system, prostate and the female genital organs in the core zone in comparison to the ring zone. Conclusion The overall cancer incidence in the Schiphol area was similar to the national incidence. The moderately increased risk of hematological malignancies could not be explained by higher levels of ambient air pollution in the Schiphol area. This observation warrants further research, for example in a study with focus on substances in urban ambient air pollution, as similar findings were observed in Greater Amsterdam. PMID:16332253

Systemic inflammatory response syndrome criteria in defining severe sepsis.

PubMed

Kaukonen, Kirsi-Maija; Bailey, Michael; Pilcher, David; Cooper, D Jamie; Bellomo, Rinaldo

2015-04-23

The consensus definition of severe sepsis requires suspected or proven infection, organ failure, and signs that meet two or more criteria for the systemic inflammatory response syndrome (SIRS). We aimed to test the sensitivity, face validity, and construct validity of this approach. We studied data from patients from 172 intensive care units in Australia and New Zealand from 2000 through 2013. We identified patients with infection and organ failure and categorized them according to whether they had signs meeting two or more SIRS criteria (SIRS-positive severe sepsis) or less than two SIRS criteria (SIRS-negative severe sepsis). We compared their characteristics and outcomes and assessed them for the presence of a step increase in the risk of death at a threshold of two SIRS criteria. Of 1,171,797 patients, a total of 109,663 had infection and organ failure. Among these, 96,385 patients (87.9%) had SIRS-positive severe sepsis and 13,278 (12.1%) had SIRS-negative severe sepsis. Over a period of 14 years, these groups had similar characteristics and changes in mortality (SIRS-positive group: from 36.1% [829 of 2296 patients] to 18.3% [2037 of 11,119], P<0.001; SIRS-negative group: from 27.7% [100 of 361] to 9.3% [122 of 1315], P<0.001). Moreover, this pattern remained similar after adjustment for baseline characteristics (odds ratio in the SIRS-positive group, 0.96; 95% confidence interval [CI], 0.96 to 0.97; odds ratio in the SIRS-negative group, 0.96; 95% CI, 0.94 to 0.98; P=0.12 for between-group difference). In the adjusted analysis, mortality increased linearly with each additional SIRS criterion (odds ratio for each additional criterion, 1.13; 95% CI, 1.11 to 1.15; P<0.001) without any transitional increase in risk at a threshold of two SIRS criteria. The need for two or more SIRS criteria to define severe sepsis excluded one in eight otherwise similar patients with infection, organ failure, and substantial mortality and failed to define a transition point in the risk of death. (Funded by the Australian and New Zealand Intensive Care Research Centre.).

Deaths and tumours among workers grinding stainless steel: a follow up.

PubMed Central

Jakobsson, K; Mikoczy, Z; Skerfving, S

1997-01-01

OBJECTIVE: To study cause specific mortality and cancer morbidity in workers exposed to the dust of grinding materials, grinding agents, and stainless steel, especially with regard to a possibly increased risk of respiratory, stomach, and colorectal cancer. METHODS: Retrospective cohort study, using reference cohorts of blue collar workers and population rates for comparison. The exposed cohort comprises workers with at least 12 months employment time at two plants, producing stainless steel sinks and saucepans (n = 727). Also, reference cohorts of other industrial workers (n = 3965) and fishermen (n = 8092) were analysed. The observation period began 15 years after the start of employment. Standardised mortality or incidence ratios (SMRs, SIRs; county reference rates) were calculated for cause-specific mortality between 1952 and 1993, and for cancer morbidity between 1958 and 1992. RESULTS: In the exposed cohort, overall mortality, cardiovascular mortality, and all malignant mortality and morbidity were slightly lower than expected. Also, the risk estimates for cancer in the upper and lower respiratory tracts and for stomach cancer were lower than expected. There was an increase in morbidity from colon cancer, which was explained by an excess of tumours in the sigmoid part only. Here, the risk estimates were higher in workers with long employment time (1-14 years: four observed cases, SIR 1.7, 95% confidence interval (95% CI) 0.4 to 4.5; > or = 15 years: three observed cases, SIR 4.3, 95% CI 0.9 to 13) and the increased risk was especially pronounced among those first employed before 1942. A slight nominal excess of rectal cancers (nine observed cases, SIR 1.4, 95% CI 0.6 to 2.6), and a significant excess of prostate cancer morbidity (36 observed cases, SIR 1.7, 95% CI 1.2 to 2.4) were found. These risk estimates did not, however, increase with employment time. CONCLUSIONS: The finding of an increased risk of cancer in the sigmoid part of the colon, which was not found in the reference cohorts, and with indication of a relation between duration of employment and response, is consistent with a causal relation. The limited size of the exposed cohort makes a detailed exposure-response analysis unstable, and the confidence limits are wide. Albeit slightly raised, the risk estimate for rectal cancer in the exposed cohort was not different from the estimate among the other industrial workers. PMID:9538356

Risk of coronary heart disease in patients with cancer: a nationwide follow-up study from Sweden.

PubMed

Zöller, Bengt; Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

2012-01-01

Risk of coronary heart disease (CHD) in cancer patients has not been thoroughly investigated. The aim of the present study was to examine whether there is an association between cancer and first hospitalisation for CHD. All individuals in Sweden with a diagnosis of cancer between 1st January 1987 and 31st December 2008 were followed for first hospitalisation for CHD. The reference population was the total population of Sweden without cancer. Standardised incidence ratios (SIRs) for CHD were calculated. The overall CHD risk during the first 6 months after diagnosis of cancer was 1.70 (95% confidence interval (95% CI) 1.66-1.75). For 26 of the 34 cancers studied, the risk of CHD was increased during the first 6 months after diagnosis of cancer. The overall CHD risk decreased rapidly, but remained slightly elevated, even 10+years after diagnosis of cancer (SIR 1.07; 95% CI 1.04-1.11). The cancer sites/types for which risk of CHD was highest during the first 6 months were small intestine (SIR 2.88; 95% CI 2.02-3.99), leukaemia (SIR 2.84; 95% CI 2.37-3.37), kidney (SIR 2.65; 95% CI 2.30-3.04), lung (SIR 2.56; 95% CI 2.35-2.80) and liver (SIR 2.28; 95% CI 1.91-2.71). Metastases were associated with an increased risk of CHD (SIR 1.46; 95% CI 1.28-1.65). Most cancers were associated with an increased risk of CHD during the first 6 months after diagnosis. CHD risk was related to the presence of metastates. Cancer patients may need a more aggressive treatment of classical CHD risk factors. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cancer incidence among workers exposed to softwood dust in Lithuania.

PubMed

Smailyte, Giedre

2012-06-01

The aim of this study was to assess cancer incidence in a cohort of woodworkers exposed to softwood dust in a Lithuanian wooden joinery products factory. The study population consisted of 1518 workers (1080 men and 438 women) employed in the factory for at least 1 year between 1947 and 1996 and living in Lithuania on 1 January 1978, when the follow-up for cancer incidence began. The follow-up period for cancer was 1978-2007. Cancer risk was assessed by standardised incidence ratios (SIR) with reference to the national population. Overall cancer incidence was not increased among woodworkers. However, the number of mouth and pharynx cancer cases among male woodworkers was significantly increased compared with expected numbers (SIR 2.19, 95% CI 1.17 to 3.74). A higher risk was found for cancer of the buccal cavity than for pharyngeal cancer (SIRs 2.83 and 1.45, respectively). The SIR for larynx cancer was also elevated (SIR 1.39, 95% CI 0.64 to 2.64) among men, while the number of lung cancer cases was higher than expected only among women (SIR 2.07, 95% CI 00.57 to 5.31). This results of this study support the hypothesis that exposure to softwood dust may increase the risk of oral and pharyngeal cancer. No support was found for an increased risk of other respiratory cancers among workers exposed to softwood dust.

Clinical Epidemiology of SIRS and Sepsis in Newly Admitted Children.

PubMed

Ganjoo, Sheetal; Ahmad, Kaisar; Qureshi, Umar Amin; Mir, Zahed Hussain

2015-08-01

To assess the clinical and demographic profile of Systemic Inflammatory Response Syndrome (SIRS) and sepsis, among newly admitted children in different age groups in a hospital in North India. This prospective study was conducted at a referral care centre in Northern India. All children, age group 0 to <18 y, admitted on days selected for study were screened and those with abnormal temperature and abnormal leukocyte count were included for further assessment. A total of twenty "24 h" periods were randomly chosen during the study period. Patients were assessed according to age specific vital signs and laboratory values to diagnose Systemic Inflammatory Response Syndrome (SIRS) and sepsis and to gain clinical and demographic data. The criteria laid at International consensus conference, 2002, were used to define patients as SIRS, Sepsis, Severe sepsis and Septic shock. During the study period, a total of 865 patients were screened for SIRS. Prevalence of SIRS amongst hospitalised children was 23 % (n = 201). Seventy nine percent (n = 159) of patients had infection associated SIRS and 21 % (42) had non-infective SIRS. Sixty four percent (n = 129) SIRS patients had uncomplicated sepsis, 15 % (n = 30) patients fulfilled criteria for severe sepsis. Out of the latter 30, 19 had septic shock. Organ dysfunction in SIRS was noted in 25 % (n = 51). 37.25 % (n = 19) had multiple organ dysfunction syndrome (MODS). The most common organism isolated was Staphylococcus aureus (n = 9). Focus of infection in majority was pulmonary (44 %). Mean duration of antibiotic therapy and hospital stay in the SIRS group were 6.4 and 6.5 d respectively. In the group without SIRS, mean duration were 2.44 d and 3.07 d respectively The differences were statistically significant. In conclusion, the proportion of sepsis contributing to SIRS is high in a tertiary care hospital. Therefore rapid recognition of SIRS is essential. Goal directed treatment of sepsis is also important so that high mortality associated with severe sepsis and septic shock are prevented.

Cancer risks in first-generation immigrants to Sweden.

PubMed

Hemminki, Kari; Li, Xinjun; Czene, Kamila

2002-05-10

We used the nationwide Swedish Family-Cancer Database to analyse cancer risks in 613,000 adult immigrants to Sweden. All the immigrants had become parents in Sweden and their median age at immigration was 24 years for men and 22 years for women. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for 18 cancer sites using native Swedes as a reference. Data were also available from compatriot marriages. All cancer was decreased by 5% and 8% for immigrant men and women, respectively. However, most of the male increase was due to lung cancer for which male immigrants showed a 41% excess. Among individual cancer sites and immigrant countries, 110 comparisons were significant, 62 showing protection and 48 an increased risk. Most of the differences between the rates in immigrants and Swedes could be ascribed to the variation of cancer incidence in the indigenous populations. Some high immigrant SIRs were 5.05 (n = 6, 95% CI 1.82-11.06) for stomach cancer in Rumanian women and 2.41 (41, 1.73-3.27) for lung cancer in Dutch men. At some sites, such as testis, prostate, skin (melanoma), kidney, cervix and nervous system, the SIRs for immigrants were decreased; in some groups of immigrants SIRs were about 0.20. The highest rates for testicular cancer were noted for Danes and Chileans. Women from Yugoslavia and Turkey had an excess of thyroid tumours. All immigrant groups showed breast, endometrial and ovarian cancers at or below the Swedish level but the differences were no more than 2-fold. Copyright 2002 Wiley-Liss, Inc.

Sir William Osler's perceptions of urolithiasis and the case of the indigo calculus.

PubMed

Moran, Michael E; Das, Sakti; Rosenberg, Stuart A

2005-12-01

Sir William Osler published his textbook, The Principles and Practice of Medicine, in 1892. It became the definitive treatise on a wide variety of diseases. The section on nephrolithiasis clearly presents the etiology, pathology, symptoms, diagnosis, and treatments. What remains a mystery is the mention, under rare forms of human stones, of a type called "indigo." A search of Index Medicus starting from 1909 backward to its inception in 1879 was performed for key words "indigo," "calculus," "renal" or "bladder stones" and "indicanuria." Twelve textbooks of urology published before 1940 were scrutinized for references to indigo calculi. Only two references to indigo were found, both related to its use for treating constipation (1887 and 1891). Of the 12 textbooks, only 4 make passing reference to "indigo stones." They all mention that such calculi are very rare, but direct references to cases are lacking. One textbook references a study of blue stones from Egyptian mummies. It is unlikely that Osler's reference to an indigo calculus was taken lightly during his writing of The Principles and Practice of Medicine. The case of the indigo calculus is fascinating and perhaps enlightening if only for the source of Osler's intrigue.

Platelet-to-Lymphocyte Ratio: A New Factor for Predicting Systemic Inflammatory Response Syndrome after Percutaneous Nephrolithotomy.

PubMed

Cetinkaya, Mehmet; Buldu, Ibrahim; Kurt, Omer; Inan, Ramazan

2017-08-29

The first purpose of this study was to reveal factors affecting the postoperative development of systemic inflammatory response syndrome (SIRS) in patients undergoing standard percutaneous nephrolithotomy (PNL) for renal stones. The second purpose was to determine the role of the preoperative platelet-to-lymphocyte ratio (PLR) and the neutrophil-to-lymphocyte ratio (NLR) in the prediction of SIRS.Matarials and Methods: In total, 192 patients who had undergone conventional PNL for renal stones from 2013 to 2015 were included in the study. SIRS developed postoperatively in 41 (21.3%) patients. The patients were divided into SIRS and non-SIRS groups, and the effects of the PLR, NLR, and other demographic and operative data were investigated to predict the development of SIRS. Variables significant in the univariate analysis were evaluated using a multiple logistic regression model to determine the independent risk factors for developing SIRS after PNL. Univariate analysis revealed significant differences in the preoperative PLR (P < .001), preoperative NLR (P = .018), number of access sites (P < .001), mean renal parenchymal thickness (P = .02), operative time (P < .001), decrease in hemoglobin (P = .016), length of hospital stay (P < .001), stone-free status (P = .023), and complication rate between the two groups of patients. However, multivariate analysis showed that only the PLR and the number of access sites were independent factors affecting the development of SIRS. When the PLR cut-off value was 114.1, development of SIRS was predicted with 80.4% sensitivity and 60.2% specificity. The preoperative PLR is an effective and inexpensive biomarker with which to predict SIRS after PNL. In particular, we recommend close monitoring of patients with a PLR of >114.1 because of the possibledevelopment of serious complications.

Sepsis biomarkers in neutropaenic systemic inflammatory response syndrome patients on standard care wards.

PubMed

Ratzinger, Franz; Haslacher, Helmuth; Perkmann, Thomas; Schmetterer, Klaus G; Poeppl, Wolfgang; Mitteregger, Dieter; Dorffner, Georg; Burgmann, Heinz

2015-08-01

Neutropaenic patients are at a high risk of contracting severe infections. In particular, in these patients, parameters with a high negative predictive value are desirable for excluding infection or bacteraemia. This study evaluated sepsis biomarkers in neutropaenic patients suffering from systemic inflammatory response syndrome (SIRS). Further, the predictive capacities of evaluated biomarkers in neutropaenic SIRS patients were compared to non-neutropaenic SIRS patients. In this prospective observational cohort study, patients with clinically suspected sepsis were screened. The predictive capacities of procalcitonin (PCT), C-reactive protein and lipopolysaccharide-binding protein (LBP) in neutropaenic SIRS patients were evaluated in terms of their potential to identify infection or bacteraemia and were compared to results for non-neutropaenic SIRS patients. To select an appropriate control cohort, propensity score matching was applied, balancing confounding factors between neutropaenic and non-neutropaenic SIRS patients. Of 3370 prospectively screened patients with suspected infection, 51 patients suffered from neutropaenic SIRS. For the identification of infection, none of the assessed biomarkers presented a clinically relevant discriminatory potency. Lipopolysaccharide-binding protein and PCT demonstrated discriminatory capacity to discriminate between nonbacteraemic and bacteraemic SIRS in patients with neutropaenia [receiver-operating characteristics-area under the curves (ROC-AUCs): 0.860, 0.818]. In neutropaenic SIRS patients, LBP had a significantly better ROC-AUC than in a comparable non-neutropaenic patient cohort for identifying bacteraemia (P = 0.01). In neutropaenic SIRS patients, none of the evaluated biomarkers was able to adequately identify infection. LBP and PCT presented a good performance in identifying bacteraemia. Therefore, these markers could be used for screening purposes to increase the pretest probability of blood culture analysis. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

Biomarkers in critically ill patients with systemic inflammatory response syndrome or sepsis supplemented with high-dose selenium.

PubMed

Brodska, Helena; Valenta, Jiri; Malickova, Karin; Kohout, Pavel; Kazda, Antonin; Drabek, Tomas

2015-01-01

Low levels of selenium (Se) and glutathione peroxidase (GSHPx), a key selenoenzyme, were documented in systemic inflammatory response syndrome (SIRS) and sepsis, both associated with high mortality. Se supplementation had mixed effects on outcome. We hypothesized that Se supplementation could have a different impact on biomarkers and 28-day mortality in patients with SIRS vs. sepsis. Adult patients with SIRS or sepsis were randomized to either high-dose (Se+, n = 75) or standard-dose (Se-, n = 75) Se supplementation. Plasma Se, whole blood GSHPx activity, C-reactive protein (CRP), procalcitonin (PCT), prealbumin, albumin and cholesterol levels were measured serially up to day 14. There was no difference in mortality between Se- (24/75) vs. Se+ group (19/75; p = 0.367) or between SIRS and septic patients (8/26 vs. 35/124; p = 0.794). There was a trend to reduced mortality in SIRS patients in the Se+ vs. Se- group (p = 0.084). Plasma Se levels increased in the Se+ group only in patients with sepsis but not in patients with SIRS. Plasma Se levels correlated with GSHPx. In SIRS/Se+ group, Se correlated only with GSHPx. In SIRS/Se- group, Se correlated with cholesterol but not with other biomarkers. In sepsis patients, Se levels correlated with cholesterol, GSHPx and prealbumin. Cholesterol levels were higher in survivors in the Se- group. Se levels correlated with GSHPx activity and other nutritional biomarkers with significant differences between SIRS and sepsis groups. High-dose Se supplementation did not affect mortality but a strong trend to decreased mortality in SIRS patients warrants further studies in this population. Copyright © 2015 Elsevier GmbH. All rights reserved.

[Establishment of the rapid, hypersensitive testing systems for sepsis/SIRS].

PubMed

Kitajima, Isao; Niimi, Hideki

2012-01-01

We developed a new infectious disease diagnostic system in order to raise the lifesaving rate in systemic inflammatory reactive syndrome, SIRS. Using eukaryote-derived thermostable DNA polymerase, the sensitive and reliable detection of bacteria becomes feasible for large fields, thereby making the development of a wide range of powerful applications possible. Further, we have established a novel measurement system for NF-kappaB activity using fluorescence correlation spectroscopy(FCS) because the elevation of NF-kappaB activity reflects acute inflammation. NF-kappaB activity measurement in patients with SIRS may provide a useful inflammatory marker.

The practicality of including the systemic inflammatory response syndrome in the definition of polytrauma: experience of a level one trauma centre.

PubMed

Butcher, Nerida E; Balogh, Zsolt J

2013-01-01

The systemic inflammatory response syndrome (SIRS) has been advocated as a significant predictor of outcome in trauma. Recent trauma literature has proposed SIRS as a surrogate for physiological derangements characteristic of polytrauma with some authors recommending its inclusion into the definition of polytrauma. The practicality of daily SIRS collection outside of specifically designed prospective trials is unknown. The purpose of this study was to assess the availability of SIRS variables and its appropriateness for inclusion into a definition of polytrauma. We hypothesised SIRS variables would be readily available and easy to collect, thus represent an appropriate inclusion into the definition of polytrauma. A prospective observational study of all trauma team activation patients over 7-months (August 2009 to February 2010) at a University affiliated level-1 urban trauma centre. SIRS data (temperature>38°C or <36°C; Pulse >90 bpm; RR>20/min or a PaCO(2)<32 mmHg; WCC>12.0×10(9)L(-1), or <4.0×10(9)L(-1), or the presence of >10 immature bands) collected from presentation, at 24 h intervals until 72 h post injury. Inclusion criteria were all patients generating a trauma team activation response age >16. 336 patients met inclusion criteria. In 46% (155/336) serial SIRS scores could not be calculated due to missing data. Lowest rates of missing data observed on admission [3% (11/336)]. Stratified by ISS>15 (132/336), in 7% (9/132) serial SIRS scores could not be calculated due to missing data. In 123 patients ISS>15 with complete data, 81% (100/123) developed SIRS. For Abbreviated Injury Scale (AIS)>2 in at least 2 body regions (64/336) in 5% (3/64) serial SIRS scores could not be calculated, with 92% (56/61) of patients with complete data developing SIRS. For Direct ICU admissions [25% (85/336)] 5% (4/85) of patients could not have serial SIRS calculated [mean ISS 15(±11)] and 90% (73/81) developed SIRS at least once over 72 h. Based on the experience of our level-1 trauma centre, the practicability of including SIRS into the definition of polytrauma as a surrogate for physiological derangement appears questionable even in prospective fashion. Copyright © 2012 Elsevier Ltd. All rights reserved.

Circulating levels of FAS/APO-1 in patients with the systemic inflammatory response syndrome.

PubMed

Torre, Donato; Tambini, Roberto; Manfredi, Mariangela; Mangani, Valerio; Livi, Paola; Maldifassi, Viviana; Campi, Paolo; Speranza, Filippo

2003-04-01

Resolution of inflammation/infection involves removal of neutrophils and other inflammatory cells by the induction of apoptosis. Fas/Apo-1 is a widely occurring apoptotic signal receptor molecule expressed by almost any type of cell, which is also released in a soluble circulating form. In this study we investigated the role of circulating Fas/Apo-1 in patients with systemic inflammatory response syndrome (SIRS). We evaluated 57 critically ill patients, 34 with infectious SIRS (sepsis and septic shock), and 23 patients with noninfectious SIRS. Circulating Fas/Apo-1 was determined by a commercially available immunoassay. Our results clearly show that levels of Fas/Apo-1 were significantly elevated in patients with infectious and noninfectious SIRS (10.4 +/- 8.1 pg/mL, controls: 5.0 +/- 0.7 pg/mL; p < 0.0001). In addition, Fas/Apo-1 levels were not able in predicting in predicting poor outcome of patients with SIRS. In conclusion, these results show that increased levels of Fas/Apo-1 from patients with SIRS is a mechanism which contribute to inflammatory response through accumulation of neutrophils at sites of inflammation/infection.

Serum selenium and glutathione peroxidase-3 activity: biomarkers of systemic inflammation in the critically ill?

PubMed

Manzanares, William; Biestro, Alberto; Galusso, Federico; Torre, Maria H; Mañay, Nelly; Pittini, Gustavo; Facchin, Gianella; Hardy, Gil

2009-05-01

To confirm the influence of systemic inflammatory response syndrome (SIRS) on selenium (Se) levels and prospectively evaluate the relationship between serum Se concentration [Se], glutathione peroxidase activity [GPx-3] and injury severity in patients at the time of intensive care unit (ICU) admission. Prospective, observational study. Multidisciplinary University Hospital ICU. A total of 36 ICU patients and 23 healthy volunteer subjects (HVS). Healthy volunteer subjects were designated as controls (Group 1). ICU patients were divided into three groups: without SIRS (Group 2); with SIRS (Group 3); with SIRS and multiple organ dysfunction syndrome (MODS) (Group 4). The latter groups had APACHE II scores >15. [GPx-3] and [Se] were determined by standard methods within the first 48 h of admission to ICU. Kruskal-Wallis and Mann-Whitney U test were used for analysis of non-parametric continuous variables. The predictive value of [Se] and [GPx-3] for SIRS was calculated using a receiver operating characteristics (ROC) analysis. In SIRS and MODS patients [GPx-3] and [Se] decreased significantly (P = 0.0001 and P = 0.002, respectively). After ICU admission [GPx-3] and [Se] had a predictive value for SIRS ([GPx-3] sensitivity: 90%, specificity: 86.2% (cut-off value: 0.5 U/mL); [Se]: sensitivity 90%, specificity 72.4% (cut-off value: 60 microg/L). [Se] had predictive value for ICU mortality (P = 0.034). Systemic inflammatory response syndrome and MODS were associated with early decreases in [Se] and [GPx-3]. Low [Se] and [GPx-3] after ICU admission had a predictive value for SIRS, which may aid future selection of patients who could benefit from Se supplementation.

Myeloperoxidase can differentiate between sepsis and non-infectious SIRS and predicts mortality in intensive care patients with SIRS.

PubMed

Schrijver, Irene T; Kemperman, Hans; Roest, Mark; Kesecioglu, Jozef; de Lange, Dylan W

2017-09-15

Systemic inflammatory response syndrome (SIRS) is a clinical syndrome following inflammation. Clinically, it is difficult to distinguish SIRS following an infection, i.e., sepsis, from non-infectious SIRS. Myeloperoxidase is a hemeprotein stored in the neutrophil azurophilic granules and is one of the main pillars of neutrophil attack. Therefore, we hypothesized that myeloperoxidase can differentiate between sepsis and non-infectious SIRS in patients with systemic inflammatory response syndrome in the intensive care unit (ICU). An observational single-center cohort study was conducted measuring myeloperoxidase in patients with SIRS in the first 48 h after admission. The outcomes were established using predefined definitions. Thirty-day mortality was retrospectively assessed. We found significantly higher levels of myeloperoxidase in patients with sepsis and septic shock compared to patients without sepsis (60 ng/ml versus 43 ng/ml, P = 0.002). Myeloperoxidase levels were related to 30-day mortality (P = 0.032), and high MPO levels on top of a high APACHE IV score further increased mortality risk. We show that myeloperoxidase is a potentially novel biomarker for sepsis in the ICU. Myeloperoxidase could eventually help in diagnosing sepsis and predicting mortality. However, more research is necessary to confirm our results.

Incidence of cardiovascular disease in a historical cohort of Danish firefighters.

PubMed

Pedersen, Julie Elbæk; Ugelvig Petersen, Kajsa; Ebbehøj, Niels Erik; Bonde, Jens Peter; Hansen, Johnni

2018-05-01

Firefighters are exposed to multiple cardiovascular hazards, but few epidemiological studies have addressed their cardiovascular morbidity. The objective of this study was therefore to examine the incidence of cardiovascular diseases (CVD) in Danish firefighters. We used individual historical employment records on 11.691 male Danish firefighters supplied by trade unions and fire agencies. The Supplementary Pension Fund Register was used to establish two occupational reference groups (a random sample from the male employed population and military employees). Information on CVD incidence was retrieved from the nationwide Danish National Patient Registry. SIRs and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs. In comparison with the population sample, the age-adjusted and calendar time-adjusted SIR for all CVDs combined was increased in firefighters (SIR=1.10, 95% CI 1.05 to 1.15). The risk was also elevated for the most frequent outcomes, including angina pectoris (SIR=1.16, 95% CI 1.08 to 1.24), acute myocardial infarction (SIR=1.16, 95% CI 1.06 to 1.26), chronic ischaemic heart disease (SIR=1.15, 95% CI 1.06 to 1.24) and atrial fibrillation/flutter (SIR=1.25, 95% CI 1.14 to 1.36). This analysis showed the most elevated SIRs for CVD in full-time firefighters compared with part-time/volunteer firefighters. Both types of firefighters employed <15 years had an increased risk of CVD. Similar risk patterns appeared in comparisons with the military. Internal analysis supported external findings. The risk of overall CVD, including the most frequent subtypes was modestly increased in Danish firefighters and was most elevated in full-time firefighters compared with other male employees. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Religious Studies: The Shaping of a Field and a Guide to Reference Resources.

ERIC Educational Resources Information Center

Lippy, Charles H.

1992-01-01

Discusses the development of religious studies as an academic discipline. Examines the work of leading thinkers in the field, including anthropologists Sir James Fraser and Edward Burnett Taylor, sociologist Max Weber, and psychologist Erik Erikson. Identifies some of the many reference works that deal with religious studies. (SG)

Trauma-induced systemic inflammatory response versus exercise-induced immunomodulatory effects.

PubMed

Fehrenbach, Elvira; Schneider, Marion E

2006-01-01

Accidental trauma and heavy endurance exercise, both induce a kind of systemic inflammatory response, also called systemic inflammatory response syndrome (SIRS). Exercise-related SIRS is conditioned by hyperthermia and concomitant heat shock responses, whereas trauma-induced SIRS manifests concomitantly with tissue necrosis and immune activation, secondarily followed by fever. Inflammatory cytokines are common denominators in both trauma and exercise, although there are marked quantitative differences. Different anti-inflammatory cytokines may be involved in the control of inflammation in trauma- and exercise-induced stress. Exercise leads to a balanced equilibrium between inflammatory and anti-inflammatory responses. Intermittent states of rest, as well as anti-oxidant capacity, are lacking or minor in trauma but are high in exercising individuals. Regular training may enhance immune competence, whereas trauma-induced SIRS often paves the way for infectious complications, such as sepsis.

The Utility of the Systemic Inflammatory Respsonse Syndrome Score on Admission in Children With Acute Pancreatitis.

PubMed

Grover, Amit S; Kadiyala, Vivek; Banks, Peter A; Grand, Richard J; Conwell, Darwin L; Lightdale, Jenifer R

2017-01-01

Pediatric patients with acute pancreatitis (AP) may meet criteria at admission for the systemic inflammatory response syndrome (SIRS). Early SIRS in adults with AP is associated with severe disease. Our aim was to evaluate the importance of SIRS in children presenting with AP on various outcomes. This is a retrospective cohort study of children hospitalized with AP at Boston Children's Hospital in 2010. Increased length of stay (LOS) and/or admission to the intensive care unit (ICU) served as the primary outcomes. Statistical analyses of measures studied included the presence of SIRS, demographic, and clinical information present on admission. Fifty encounters, in which AP was the primary admitting diagnosis, were documented. Patients had a median LOS of 4.5 (interquartile range, 2-9) days. Systemic inflammatory response syndrome was present in 22 (44%) of 50 patients at admission. Systemic inflammatory response syndrome at admission was an independent predictor of increased LOS (odds ratio, 7.99; P = 0.045) as well as admission to the ICU (odds ratio, 12.06; P = 0.027). The presence of SIRS criteria on admission serves as a useful and easy-to-calculate predictor of increased LOS and admission to ICU in children with AP.

Estimates of Monthly Ground-Water Recharge to the Yakima River Basin Aquifer System, Washington, 1960-2001, for Current Land-Use and Land-Cover Conditions

USGS Publications Warehouse

Vaccaro, J.J.; Olsen, T.D.

2007-01-01

Unique ID grid with a unique value per Hydrologic Response Unit (HRU) per basin in reference to the estimated ground-water recharge for current conditions in the Yakima Basin Aquifer System, (USGS report SIR 2007-5007). Total 78,144 unique values. This grid made it easy to provide estimates of monthly ground-water recharge for water years 1960-2001in an electronic format for water managers, planners, and hydrologists, that could be related back to a spatially referenced grid by the unique ID.

Inhibitors of Trypanosoma cruzi Sir2 related protein 1 as potential drugs against Chagas disease

PubMed Central

KongThoo Lin, Paul; Costa, David M.; Perez-Cabezas, Begoña; Tavares, Joana; Roura-Ferrer, Meritxell; Ramos, Isbaal; Ronin, Céline; Major, Louise L.; Ciesielski, Fabrice; Pemberton, Iain K.; MacDougall, Jane; Ciapetti, Paola; Cordeiro-da-Silva, Anabela

2018-01-01

Chagas disease remains one of the most neglected diseases in the world despite being the most important parasitic disease in Latin America. The characteristic chronic manifestation of chagasic cardiomyopathy is the region’s leading cause of heart-related illness, causing significant mortality and morbidity. Due to the limited available therapeutic options, new drugs are urgently needed to control the disease. Sirtuins, also called Silent information regulator 2 (Sir2) proteins have long been suggested as interesting targets to treat different diseases, including parasitic infections. Recent studies on Trypanosoma cruzi sirtuins have hinted at the possibility to exploit these enzymes as a possible drug targets. In the present work, the T. cruzi Sir2 related protein 1 (TcSir2rp1) is genetically validated as a drug target and biochemically characterized for its NAD+-dependent deacetylase activity and its inhibition by the classic sirtuin inhibitor nicotinamide, as well as by bisnaphthalimidopropyl (BNIP) derivatives, a class of parasite sirtuin inhibitors. BNIPs ability to inhibit TcSir2rp1, and anti-parasitic activity against T. cruzi amastigotes in vitro were investigated. The compound BNIP Spermidine (BNIPSpd) (9), was found to be the most potent inhibitor of TcSir2rp1. Moreover, this compound showed altered trypanocidal activity against TcSir2rp1 overexpressing epimastigotes and anti-parasitic activity similar to the reference drug benznidazole against the medically important amastigotes, while having the highest selectivity index amongst the compounds tested. Unfortunately, BNIPSpd failed to treat a mouse model of Chagas disease, possibly due to its pharmacokinetic profile. Medicinal chemistry modifications of the compound, as well as alternative formulations may improve activity and pharmacokinetics in the future. Additionally, an initial TcSIR2rp1 model in complex with p53 peptide substrate was obtained from low resolution X-ray data (3.5 Å) to gain insight into the potential specificity of the interaction with the BNIP compounds. In conclusion, the search for TcSir2rp1 specific inhibitors may represent a valuable strategy for drug discovery against T. cruzi. PMID:29357372

Inhibitors of Trypanosoma cruzi Sir2 related protein 1 as potential drugs against Chagas disease.

PubMed

Gaspar, Luís; Coron, Ross P; KongThoo Lin, Paul; Costa, David M; Perez-Cabezas, Begoña; Tavares, Joana; Roura-Ferrer, Meritxell; Ramos, Isbaal; Ronin, Céline; Major, Louise L; Ciesielski, Fabrice; Pemberton, Iain K; MacDougall, Jane; Ciapetti, Paola; Smith, Terry K; Cordeiro-da-Silva, Anabela

2018-01-01

Chagas disease remains one of the most neglected diseases in the world despite being the most important parasitic disease in Latin America. The characteristic chronic manifestation of chagasic cardiomyopathy is the region's leading cause of heart-related illness, causing significant mortality and morbidity. Due to the limited available therapeutic options, new drugs are urgently needed to control the disease. Sirtuins, also called Silent information regulator 2 (Sir2) proteins have long been suggested as interesting targets to treat different diseases, including parasitic infections. Recent studies on Trypanosoma cruzi sirtuins have hinted at the possibility to exploit these enzymes as a possible drug targets. In the present work, the T. cruzi Sir2 related protein 1 (TcSir2rp1) is genetically validated as a drug target and biochemically characterized for its NAD+-dependent deacetylase activity and its inhibition by the classic sirtuin inhibitor nicotinamide, as well as by bisnaphthalimidopropyl (BNIP) derivatives, a class of parasite sirtuin inhibitors. BNIPs ability to inhibit TcSir2rp1, and anti-parasitic activity against T. cruzi amastigotes in vitro were investigated. The compound BNIP Spermidine (BNIPSpd) (9), was found to be the most potent inhibitor of TcSir2rp1. Moreover, this compound showed altered trypanocidal activity against TcSir2rp1 overexpressing epimastigotes and anti-parasitic activity similar to the reference drug benznidazole against the medically important amastigotes, while having the highest selectivity index amongst the compounds tested. Unfortunately, BNIPSpd failed to treat a mouse model of Chagas disease, possibly due to its pharmacokinetic profile. Medicinal chemistry modifications of the compound, as well as alternative formulations may improve activity and pharmacokinetics in the future. Additionally, an initial TcSIR2rp1 model in complex with p53 peptide substrate was obtained from low resolution X-ray data (3.5 Å) to gain insight into the potential specificity of the interaction with the BNIP compounds. In conclusion, the search for TcSir2rp1 specific inhibitors may represent a valuable strategy for drug discovery against T. cruzi.

The prevalence and diagnostic utility of systemic inflammatory response syndrome vital signs in a pediatric emergency department.

PubMed

Scott, Halden F; Deakyne, Sara J; Woods, Jason M; Bajaj, Lalit

2015-04-01

This study sought to determine the prevalence, test characteristics, and severity of illness of pediatric patients with systemic inflammatory response syndrome (SIRS) vital signs among pediatric emergency department (ED) visits. This was a retrospective descriptive cohort study of all visits to the ED of a tertiary academic free-standing pediatric hospital over 1 year. Visits were included if the patient was <18 years of age and did not leave before full evaluation or against medical advice. Exclusion criteria were trauma diagnoses or missing documentation of vital signs. Data were electronically extracted from the medical record. The primary predictor was presence of vital signs meeting pediatric SIRS definitions. Specific vital sign pairs comprising SIRS were evaluated as predictors (temperature-heart rate, temperature-respiratory rate, and temperature-corrected heart rate, in which a formula was used to correct heart rate for degree of temperature elevation). The primary outcome measure was requirement for critical care (receipt of a vasoactive agent or intubation) within 24 hours of ED arrival. There were 56,210 visits during the study period; 40,356 met inclusion criteria. Of these, 6,596 (16.3%) visits had fever >38.5°C, and 6,122 (15.2% of included visits) met SIRS vital sign criteria. Among included visits, those with SIRS vital signs accounted for 92.8% of all visits with fever >38.5°C. Among patients with SIRS vital signs, 4993 (81.6%) were discharged from the ED without intravenous (IV) therapy and without 72-hour readmission. Critical care within the first 24 hours was present in 99 (0.25%) patients: 23 patients with and 76 without SIRS vital signs. Intensive care unit (ICU) admission was present in 126 (2.06%) with SIRS vital signs and 487 (1.42%) without SIRS vital signs. SIRS vital signs were associated with increased risk of critical care within 24 hours (relative risk [RR] = 1.69, 95% confidence interval [CI] = 1.06 to 2.70), ICU admission (RR = 1.45, 95% CI = 1.19 to 1.76), ED laboratory tests (RR = 1.41, 95% CI = 1.37 to 1.45), ED IV medication/fluid administration (RR = 2.54, 95% CI = 2.29 to 2.82), hospital admission (RR = 1.52, 95% CI = 1.42 to 1.63), and 72-hour readmission (RR = 1.31, 95% CI = 1.01 to 1.69). SIRS vital signs were not associated with 30-day in-hospital mortality (RR = 0.37, 95% CI = 0.05 to 2.82). SIRS vital signs had a low sensitivity for critical care requirement (23.2%, 95% CI = 15.3% to 32.8%). The pair of SIRS vital signs with the strongest association with critical care requirement was temperature and corrected heart rate (positive likelihood ratio = 2.74, 95% CI = 1.87 to 4.01). Systemic inflammatory response syndrome vital signs are common among medical pediatric patients presenting to an ED, and critical illness is rare. The majority of patients with SIRS vital signs were discharged without IV therapy and without readmission. Patients with SIRS vital signs had a statistically significant increased risk of critical care requirement, ED IV treatment, ED laboratory tests, admission, and readmission. However, SIRS vital sign criteria did not identify the majority of patients with mortality or need for critical care. SIRS vital signs had low sensitivity for critical illness, making it poorly suited for use in isolation in this setting as a test to detect children requiring sepsis resuscitation. © 2015 by the Society for Academic Emergency Medicine.

Association of Systemic Inflammatory Response Syndrome with Clinical Outcomes of Pediatric Patients with Pneumonia.

PubMed

Frazier, Steven Barron; Sepanski, Robert; Mangum, Christopher; Bovat, Christine; Zaritsky, Arno; Godambe, Sandip

2015-11-01

Systemic inflammatory response syndrome (SIRS) may complicate pneumonia. When present, it suggests that the patient's pneumonia is more severe. As such, recognition of SIRS among patients with pneumonia may be helpful in identifying those requiring more careful evaluation. Our objective was to examine the relation between the presence of SIRS and adverse clinical outcomes among children with pneumonia seen in the emergency department (ED). A retrospective chart review was performed on children diagnosed as having community-acquired pneumonia who presented to a children's hospital ED during a 3-month period. SIRS was determined by using a modification of the International Consensus Conference on Pediatric Sepsis criteria. Specifically, the SIRS criteria require an abnormal temperature-corrected heart rate or respiratory rate and either an abnormal temperature or white blood cell count. The threshold for abnormal vital signs and white blood cell counts used to determine SIRS was adjusted based on the patient's age. Morbidity endpoints included progression to inpatient or observation status or subsequent return to the ED for pneumonia, need for video-assisted thoracoscopic surgery, and total hospital length of stay as measured from ED triage assessment to final discharge from the hospital (ED, observation, or inpatient), and the need for mechanical ventilation. A total of 276 children were included in the analysis. Pneumonia patients with SIRS (n = 38) had a greater rate of hospital admission or ED return compared with SIRS-negative patients (n = 238; 79% vs 34.5%, respectively; P < 0.0001). Children with SIRS-positive pneumonia were at greater risk of requiring video-assisted thoracoscopic surgery (18.4% vs 0.8%; P < 0.0001). In addition, pneumonia patients with SIRS had a significantly longer median length of stay compared with pneumonia patients without SIRS (2.7 vs 0.19 days, P < 0.0001) and also had a significantly higher risk of mechanical ventilation (10.5% vs 0.8%). SIRS in children with community-acquired pneumonia is associated with a significantly higher likelihood of experiencing a more adverse outcome. Based on these observations, a sepsis screening tool in the ED that identifies SIRS in children with pneumonia has the potential to identify those children needing more intense monitoring and treatment.

Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm

PubMed Central

Baek, Jong Kwan; Kwon, Hyunwook; Ko, Gi-Young; Kim, Min Joo; Han, Youngjin; Chung, Young Soo; Park, Hojong; Kwon, Tae-Won

2015-01-01

Purpose The present study aimed to evaluate the risk factors and the role of graft material in the development of an acute phase systemic inflammatory response, and the clinical outcome in patients who undergo endovascular aneurysm repair (EVAR) or open surgical repair (OSR) of an abdominal aortic aneurysm (AAA). Methods We retrospectively evaluated the risk factors and the role of graft material in an increased risk of developing systemic inflammatory response syndrome (SIRS), and the clinical outcome in patients who underwent EVAR or OSR of an AAA. Results A total of 308 consecutive patients who underwent AAA repair were included; 178 received EVAR and 130 received OSR. There was no significant difference in the incidence of SIRS between EVAR patients and OSR patients. Regardless of treatment modality, SIRS was observed more frequently in patients treated with woven polyester grafts. Postoperative hospitalization was significantly prolonged in patients that experienced SIRS. In multivariate analyses, the initial white blood cell count (P = 0.001) and the use of woven polyester grafts (P = 0.005) were significantly associated with an increased risk of developing SIRS in patients who underwent EVAR. By contrast, the use of woven polyester grafts was the only factor associated with an increased risk of developing SIRS in patients who underwent OSR, although this was not statistically significant (P = 0.052). Conclusion The current study shows that the graft composition plays a primordial role in the development of SIRS, and it leads to prolonged hospitalization in both EVAR and OSR patients. PMID:25553321

Systemic inflammatory response and serum lipopolysaccharide levels predict multiple organ failure and death in alcoholic hepatitis.

PubMed

Michelena, Javier; Altamirano, José; Abraldes, Juan G; Affò, Silvia; Morales-Ibanez, Oriol; Sancho-Bru, Pau; Dominguez, Marlene; García-Pagán, Juan Carlos; Fernández, Javier; Arroyo, Vicente; Ginès, Pere; Louvet, Alexandre; Mathurin, Philippe; Mehal, Wajahat Z; Caballería, Juan; Bataller, Ramón

2015-09-01

Alcoholic hepatitis (AH) frequently progresses to multiple organ failure (MOF) and death. However, the driving factors are largely unknown. At admission, patients with AH often show criteria of systemic inflammatory response syndrome (SIRS) even in the absence of an infection. We hypothesize that the presence of SIRS may predispose to MOF and death. To test this hypothesis, we studied a cohort including 162 patients with biopsy-proven AH. The presence of SIRS and infections was assessed in all patients, and multivariate analyses identified variables independently associated with MOF and 90-day mortality. At admission, 32 (19.8%) patients were diagnosed with a bacterial infection, while 75 (46.3%) fulfilled SIRS criteria; 58 patients (35.8%) developed MOF during hospitalization. Short-term mortality was significantly higher among patients who developed MOF (62.1% versus 3.8%, P < 0.001). The presence of SIRS was a major predictor of MOF (odds ratio = 2.69, P = 0.025) and strongly correlated with mortality. Importantly, the course of patients with SIRS with and without infection was similar in terms of MOF development and short-term mortality. Finally, we sought to identify serum markers that differentiate SIRS with and without infection. We studied serum levels of high-sensitivity C-reactive protein, procalcitonin, and lipopolysaccharide at admission. All of them predicted mortality. Procalcitonin, but not high-sensitivity C-reactive protein, serum levels identified those patients with SIRS and infection. Lipopolysaccharide serum levels predicted MOF and the response to prednisolone. In the presence or absence of infections, SIRS is a major determinant of MOF and mortality in AH, and the mechanisms involved in the development of SIRS should be investigated; procalcitonin serum levels can help to identify patients with infection, and lipopolysaccharide levels may help to predict mortality and the response to steroids. © 2015 by the American Association for the Study of Liver Diseases.

SIR/CAR Analysis Technique for Voluntary School Sport or Amateur Athletic Organizations. A SIR/CAR Application.

ERIC Educational Resources Information Center

Moriarty, Dick; Zarebski, John

This paper delineates the exact methodology developed by the Sports Institute for Research/Change Agent Research (SIR/CAR) for applying a systems analysis technique to a voluntary mutual benefit organization, such as a school or amateur athletic group. The functions of the technique are to compare avowed and actual behavior, to utilize group…

[Procalcitonin as a diagnostic marker in systemic inflammatory response syndrome (SIRS) and sepsis].

PubMed

Hryckiewicz, Katarzyna; Juszczyk, Jacek; Samet, Alfred; Arłukowicz, Elzbieta; Sledzińska, Anna; Bolewska, Beata

2006-01-01

Evaluation the value of procalcitonin as a diagnostic and prognostic marker in septic patients and patients with systemic inflammatory response syndrome (SIRS). 126 patients were included into the study. The patients were divided into four groups: 1--septic patients with positive blood cultures, 2--septic patients with negative blood cultures, 3--patients with SIRS, 4--patients without sepsis and SIRS. PCT level was measured by imunoluminometric assay (LUMItest) and immunochromatographic assay (PCT-Q). PCT level is higher in patients with sepsis than in patients with SIRS. PCT level is only slightly elevated in patients without sepsis and SIRS. The highest PCT level is found in patients with septic shock. In patients with the clinical improvement the frequency of PCT level increase is approximately twice lower than in patients who died. Measurement of PCT level on the first, second and third day of hospitalization has no prognostic value. There is no significant difference in PCT level in sepsis caused by Gram positive and Gram negative bacteria. PCT is a useful marker in diagnosis of sepsis but its role in monitoring the severity of sepsis requires more clinical studies.

Soluble CD14 subtype (sCD14-ST) presepsin in premature and full term critically ill newborns with sepsis and SIRS.

PubMed

Mussap, Michele; Puxeddu, Elisabetta; Puddu, Melania; Ottonello, Giovanni; Coghe, Ferdinando; Comite, Paola; Cibecchini, Francesco; Fanos, Vassilios

2015-12-07

Neonatal sepsis still remains a major cause of morbidity and mortality in neonatal intensive care unit (NICU). Recently, soluble CD14 subtype (sDC14-ST) also named presepsin, was proposed as an effective biomarker for diagnosing, monitoring, and assessing the risk of neonatal sepsis and septic shock. The aim of this study was to investigate the diagnostic accuracy of sCD14-ST presepsin in diagnosing neonatal bacterial sepsis and in discriminating non-bacterial systemic inflammatory response syndrome (SIRS) from bacterial sepsis. This study involved 65 critically ill full-term and preterm newborns admitted to the neonatal intensive care unit (NICU), divided into three groups: 25 newborns with bacterial neonatal sepsis (group A); 15 newborns with a diagnosis of non-bacterial SIRS and with no localizing source of bacterial infection (group B); and 25 babies with no clinical or bacteriological signs of systemic or local infection receiving routine NICU care, most of them treated with phototherapy for neonatal jaundice (group C). A total of 102 whole blood samples were collected, 40 in group A, 30 in group B and 32 in group C. In 10 babies included in group A, sCD14-ST presepsin was also measured in an additional second blood sample collected 3 days after the start of antibiotic treatment. sCD14-ST presepsin was measured by a commercially available chemiluminescent enzyme immunoassay (CLEIA) optimized on an automated immunoassay analyzer. Statistical analysis was performed by means of MedCalc® statistical package; receiver operating characteristic (ROC) analysis was computed, and the area under the ROC curve (AUC) was used to evaluate the ability of sCD14-ST to discriminate neonatal bacterial sepsis from non-bacterial SIRS. Blood sCD14-ST presepsin levels were found significantly higher in bacterial sepsis when compared with controls (p<0.0001); similarly, they were higher in non-bacterial SIRS when compared with controls (p<0.0001). However, no statistically significant difference was found between bacterial sepsis and non-bacterial SIRS (p=0.730). In our population, CRP and sCD14-ST did not correlate with each other. ROC analysis revealed that sCD14-ST presepsin has an area under the curve (AUC) of 0.995 (95% C.I.: 0.941-1.00) greater than that of CRP (0.827; 95% C.I.: 0.72-0.906). Similarly, in the group of babies with non-infectious SIRS, sCD14-ST AUC was greater than CRP AUC (0.979; 95% C.I.: 0.906-0.999 versus 0.771; 95% C.I.: 0.647-0.868). In controls, preliminary reference intervals for sCD14-ST ranged 223.4-599.7 ng/L, being significantly different from those previously published elsewhere. In conclusion, sCD14-ST presepsin could be introduced in clinical practice as a diagnostic tool for improving the management of neonatal sepsis and non-bacterial SIRS. Copyright © 2015 Elsevier B.V. All rights reserved.

Evaluation of usefulness of myeloperoxidase index (MPXI) for differential diagnosis of systemic inflammatory response syndrome (SIRS) in the emergency department.

PubMed

Cha, Yong Sung; Yoon, Jeong Min; Jung, Woo Jin; Kim, Yong Won; Kim, Tae Hoon; Kim, Oh Hyun; Cha, Kyoung Chul; Kim, Hyun; Hwang, Sung Oh; Lee, Kang Hyun

2015-04-01

The myeloperoxidase index (MPXI) is elevated in infection. We ascertained whether MPXI might be useful in differentiation of sepsis versus non-infectious systemic inflammatory response syndrome (SIRS) in emergency department (ED). After exclusion of patients with an age of <18 years, trauma, haematological disease and on anticancer chemotherapy, 444 consecutive cases with SIRS (sepsis: 224, 50.3%; and non-infectious SIRS: 220, 49.7%) diagnosed and treated at the ED of The Wonju Severance Christian Hospital from May 2012 to June 2012 were retrospectively reviewed. Median MPXI was higher in sepsis versus non-infectious SIRS (0.1 (IQR: -3.1 to 2.5) vs -1.2 (-4.1 to 1.6), respectively, p=0.020). Median white cell count, neutrophil percentage, C reactive protein level and δ neutrophil index were also higher. However, MPXI resulted as not statistically useful for differential diagnostic parameter in analysis. MPXI is higher in sepsis than in non-infectious SIRS. However, there is currently no evidence that the MPXI adds any additional benefit to differentiate sepsis from non-infectious SIRS in the ED. Therefore, further study will be needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Terlipressin Improves Renal Function and Reverses Hepatorenal Syndrome in Patients With Systemic Inflammatory Response Syndrome.

PubMed

Wong, Florence; Pappas, Stephen Chris; Boyer, Thomas D; Sanyal, Arun J; Bajaj, Jasmohan S; Escalante, Shannon; Jamil, Khurram

2017-02-01

Patients with systemic inflammatory response syndrome (SIRS) along with decompensated cirrhosis and renal dysfunction have a poor prognosis and a lower response to treatment. We evaluated the effect of SIRS on the response of hepatorenal syndrome type 1 (HRS-1) to terlipressin. We performed a retrospective study of data from a trial of the effects of terlipressin (1 mg every 6 hours or placebo with concomitant albumin) in 198 patients with HRS-1, performed at 50 investigational sites in the United States and 2 in Canada from October 2010 through February 2013. We identified patients with 2 or more criteria for SIRS, without untreated infections (28 received terlipressin and 30 received placebo), and patients with less than 2 criteria for SIRS (control subjects). Primary endpoints included HRS reversal (a decrease in serum level of creatinine to ≤1.5 mg/dL), confirmed HRS reversal (defined as 2 serum creatinine levels ≤1.5 mg/dL, ≥ 48 hours apart), and survival for 90 days after treatment. Baseline characteristics were similar between groups, apart from slightly higher white blood cell counts and heart rates, and slightly lower serum levels of bicarbonate in patients with SIRS versus without SIRS. HRS was reversed in 42.9% of patients who received terlipressin with SIRS (12/28) versus 6.7% of patients who received placebo (2/30) (P = .0018); confirmed HRS reversal occurred in 32.1% of patients who received terlipressin with SIRS (9/28) versus 3.3% who received placebo (1/30) (P = .0048). A larger proportion of patients with SIRS who received terlipressin survived for 90 days without a transplant (13/28; 46.4%) than patients with SIRS who received placebo (7/30; 23.3%) (P = .076). In an analysis of data from a placebo-controlled study, we found that terlipressin improved renal function and reversed HRS in a higher proportion of patients with HRS-1 and SIRS than patients who received albumin plus placebo. ClincialTrials.gov, number NCT 01143246. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Serum soluble ST2 as diagnostic marker of systemic inflammatory reactive syndrome of bacterial etiology in children.

PubMed

Calò Carducci, Francesca Ippolita; Aufiero, Lelia Rotondi; Folgori, Laura; Vittucci, Anna Chiara; Amodio, Donato; De Luca, Maia; Li Pira, Giuseppina; Bergamini, Alberto; Pontrelli, Giuseppe; Finocchi, Andrea; D'Argenio, Patrizia

2014-02-01

Accurate and timely diagnosis of community-acquired bacterial versus viral infections in children with systemic inflammatory response syndrome (SIRS) remains challenging both for clinician and laboratory. In the quest of new biochemical markers to distinguish bacterial from viral infection, we have explored the possible role of the soluble secreted form of ST2 (sST2). This explorative prospective cohort study included children with SIRS who were suspected of having community-acquired infections. Plasma samples for sST2 measurement were obtained from 64 hospitalized children, 41 of whom had SIRS of bacterial etiology and 23 SIRS of viral etiology, and from 20 healthy, age- and sex-matched control children. sST2 measurement was carried out by enzyme-linked immunosorbent assay in parallel with standard measurements of procalcitonin (PCT) and C reactive protein (CRP). Our findings demonstrate that children with SIRS associated with bacterial infection present significantly increased levels of sST2, when compared with patients with SIRS of viral etiology and healthy children. More important, receiver operating characteristic curve analysis indicated that sST2 has a significant diagnostic performance with respect to early identification of SIRS of bacterial etiology, which was similar to that of PCT and greater than that of CRP. Finally, the combination of sST2 plus PCT and/or CRP, and PCT plus CRP increased their sensitivity and negative predictive value compared with sST2, PCT and CRP alone. In conclusion, sST2 level may prove useful in predicting bacterial etiology in children with SIRS.

New Processing of Spaceborne Imaging Radar-C (SIR-C) Data

NASA Astrophysics Data System (ADS)

Meyer, F. J.; Gracheva, V.; Arko, S. A.; Labelle-Hamer, A. L.

2017-12-01

The Spaceborne Imaging Radar-C (SIR-C) was a radar system, which successfully operated on two separate shuttle missions in April and October 1994. During these two missions, a total of 143 hours of radar data were recorded. SIR-C was the first multifrequency and polarimetric spaceborne radar system, operating in dual frequency (L- and C- band) and with quad-polarization. SIR-C had a variety of different operating modes, which are innovative even from today's point of view. Depending on the mode, it was possible to acquire data with different polarizations and carrier frequency combinations. Additionally, different swaths and bandwidths could be used during the data collection and it was possible to receive data with two antennas in the along-track direction.The United States Geological Survey (USGS) distributes the synthetic aperture radar (SAR) images as single-look complex (SLC) and multi-look complex (MLC) products. Unfortunately, since June 2005 the SIR-C processor has been inoperable and not repairable. All acquired SLC and MLC images were processed with a course resolution of 100 m with the goal of generating a quick look. These images are however not well suited for scientific analysis. Only a small percentage of the acquired data has been processed as full resolution SAR images and the unprocessed high resolution data cannot be processed any more at the moment.At the Alaska Satellite Facility (ASF) a new processor was developed to process binary SIR-C data to full resolution SAR images. ASF is planning to process the entire recoverable SIR-C archive to full resolution SLCs, MLCs and high resolution geocoded image products. ASF will make these products available to the science community through their existing data archiving and distribution system.The final paper will describe the new processor and analyze the challenges of reprocessing the SIR-C data.

Cancer incidence and mortality among Swedish leather tanners.

PubMed Central

Mikoczy, Z; Schütz, A; Hagmar, L

1994-01-01

OBJECTIVES--The aim was to study the incidence of cancer among Swedish leather tanners. METHODS--A cohort of 2026 subjects who had been employed for at least one year between 1900 and 1989 in three Swedish leather tanneries, was established. The cancer incidence and mortality patterns were assessed for the periods 1958-89 and 1952-89 respectively, and cause-specific standardised incidence and mortality ratios (SIRs and SMRs) were calculated. RESULTS--A significantly increased incidence of soft tissue sarcomas (SIR 4.27, 95% confidence interval (95% CI) 1.39-9.97) was found, based on five cases. Excesses, (not statistically significant) was also found for multiple myelomas (SIR 2.54, 95% CI 0.93-5.53), and sinonasal cancer (SIR 3.77, 95% CI 0.46-13.6). CONCLUSIONS--The increased incidence of soft tissue sarcomas adds support to previous findings of an excess mortality in this diagnosis among leather tanners. A plausible cause is exposure to chlorophenols, which had occurred in all three plants. The excess of multiple myelomas may also be associated with exposure to chlorophenol. The association between incidence of cancer and specific chemical exposure will be elucidated in a cohort-based case-referent study. PMID:7951777

Sir Real. Cover Story.

ERIC Educational Resources Information Center

Greenman, Geri

2000-01-01

Describes an art assignment that focuses on surrealist composition. Students learn about Sigmund Freud, artists of the Surrealist movement, and characteristics of Surrealism. The produce thumbnail sketches, locate photographic images to use as references, and then create Surrealist artworks. (CMK)

Plasma levels of F-actin and F:G-actin ratio as potential new biomarkers in patients with septic shock.

PubMed

Belsky, Justin B; Morris, Daniel C; Bouchebl, Ralph; Filbin, Michael R; Bobbitt, Kevin R; Jaehne, Anja K; Rivers, Emanuel P

2016-01-01

To compare plasma levels of F-actin, G-actin and thymosin beta 4 (TB4) in humans with septic shock, noninfectious systemic inflammatory response syndrome (SIRS) and healthy controls. F-actin was significantly elevated in septic shock as compared with noninfectious SIRS and healthy controls. G-actin levels were greatest in the noninfectious SIRS group but significantly elevated in septic shock as compared with healthy controls. TB4 was not detectable in the septic shock or noninfectious SIRS group above the assay's lowest detection range (78 ng/ml). F-actin is significantly elevated in patients with septic shock as compared with noninfectious SIRS. F-actin and the F:G-actin ratio are potential biomarkers for the diagnosis of septic shock.

The SIR-B science investigations plan

NASA Technical Reports Server (NTRS)

1984-01-01

Shuttle Imaging Radar-B (SIR-B) is the second synthetic aperture radar (SAR) to be flown on the National Aeronautics and Space Administration's Space Transportation System (Shuttle). It is the first spaceborne SAR to feature an antenna that allows acquisition of multiincidence angle imagery. An international team of scientists will use SIR-B to conduct investigations in a wide range of disciplines. The radar, the mission, and the investigations are described.

Serum inflammatory markers in the elderly: are they useful in differentiating sepsis from SIRS?

PubMed

Talebi-Taher, Mahshid; Babazadeh, Shahin; Barati, Mitra; Latifnia, Maryam

2014-01-01

Differentiating sepsis from other noninfectious causes of systemic inflammation is often difficult in the elderly. The aim of this study was to evaluate the ability of C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), procalcitonin (PCT), and Interleukin-6 (IL-6) to identify elderly patients with sepsis. In this single center prospective observational study, we included all consecutive elderly patients admitted with suspected sepsis and systemic inflammatory response syndrome (SIRS) in an emergency department. Blood samples for measuring CRP, PCT, IL-6, ESR and white blood cells (WBC) count were taken at first day of admission. Sensitivity, specificity, positive and negative predictive values were calculated for each inflammatory markers being studied. A total of 150 elderly patients aged 65 and older, 50 with sepsis and 50 with SIRS, and fifty individuals in a normal health status were included. CRP exhibited the greatest sensitivity (98%) and negative predictive value (98.6%) and performed best in differentiating patients with sepsis from those with SIRS. In a receiver operating characteristic curve analysis, IL-6 performed best in distinguishing between SIRS and the control group (AUC 0.75, 95% CI). On the other hand, both CRP and ESR appeared to be a more accurate diagnostic parameter for differentiating sepsis from SIRS among elderly patients.

The systemic inflammatory response syndrome (SIRS) to identify infected patients in the emergency room.

PubMed

Jaimes, Fabián; Garcés, Jenny; Cuervo, Jorge; Ramírez, Federico; Ramírez, Jorge; Vargas, Andrea; Quintero, Claudia; Ochoa, Jorge; Tandioy, Fabio; Zapata, Láder; Estrada, Juan; Yepes, Maria; Leal, Hiulber

2003-08-01

Evaluation of the usefulness of criteria for systemic inflammatory response syndrome (SIRS) compared with the final diagnosis of infection in patients admitted to the emergency room of two university-based hospitals. Longitudinal cohort study. Hospital Universitario San Vicente de Paul and Hospital General de Medellín, Medellín, Colombia. PATIENTS. Seven hundred thirty-four patients with suspected infection as main diagnosis for admittance into the emergency room. Sensitivity, specificity, predictive values and likelihood ratios (LR) of SIRS criteria at admission were determined using, as gold standards, the diagnosis at the time of discharge based on clinical history and evolution, and microbiological confirmation of infection. SIRS criteria were met by 503 patients (68.5%); the discharge diagnosis of infection was found in 657 (89.4%) and 276 (37%) had microbiological confirmation. SIRS criteria exhibited a sensitivity of 69%, specificity of 35%, positive predictive value (PPV) of 90%, negative predictive value (NPV) of 12% and positive LR of 1.06. There were no differences between the two gold standards. The finding of two or more SIRS criteria was of little usefulness for diagnosis of infection. It is necessary to work with new criteria and probably with biological markers, in order to obtain a simple, precise and operative definition of the sepsis phenomenon.

Obstructive Sleep Apnea Syndrome in Siblings: An 8-Year Swedish Follow-Up Study

PubMed Central

Sundquist, Jan; Li, Xinjun; Friberg, Danielle; Hemminki, Kari; Sundquist, Kristina

2008-01-01

Background: Understanding the genetic transmission of obstructive sleep apnea syndrome (OSAS) will help clinicians identify patients at risk and offer opportunities for intervention and treatment at specialist clinics. Objective: To estimate familial risk of hospitalization for OSAS in the adult population of Sweden, and to determine if there are any differences by age and sex. Design, Setting, and Participants: Using the MigMed database at the Karolinska Institute, we divided the population of Sweden into sibling groups based on a shared mother and father and ascertained the presence or absence of a primary hospital diagnosis of OSAS in each individual during the follow-up period, 1997 to 2004. Individuals were categorized as having or not having a sibling with OSAS, based on the presence or absence of the disorder in at least 1 of their siblings. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated for men and women with a sibling with OSAS, compared with men and women in the reference group (SIR = 1). Results: After accounting for socioeconomic status, age, geographic region, and period of diagnosis, men with at least 1 sibling who had OSAS had a SIR of 3.42 (95% CI, 2.18–5.36); the corresponding SIR in women was 3.25 (95% CI, 1.84–5.65). Conclusions: Our results indicate that physicians should consider family history of OSAS when deciding whether to refer a patient for further sleep examinations. Citation: Sundquist J; Li X; Friberg D; Hemminki K; Sundquist K. Obstructive sleep apnea syndrome in siblings: an 8-year Swedish follow-up study. SLEEP 2008;31(6):817-823. PMID:18548826

[Value of indoleamine 2,3-dioxygenase in diagnosis of systemic inflammatory response syndrome after cardiopulmonary bypass in children with congenital heart disease].

PubMed

Wang, Xin; Li, Zong-Xiao; Wen, Yu-Peng; Chang, Cheng

2018-01-01

To study the value of indoleamine 2,3-dioxygenase (IDO) in the early diagnosis of systemic inflammatory response syndrome (SIRS) after cardiopulmonary bypass in children with congenital heart disease. A total of 90 children with congenital heart disease who underwent cardiopumonary bypass surgery between May 2012 and January 2016 were enrolled. According to the prsence or absence of SIRS after surgery, they were divided into SIRS group (n=43) and control group (n=47). Peripheral blood samples were collected before surgery, during surgery, and after surgery. Serum levels of IDO, C-reactive protein (CRP), and interleukin-6 (IL-6) were measured and compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate their diagnostic efficiency. Compared with the control group, the SIRS group had higher serum CRP levels at 72 hours after surgery, higher IL-6 levels during surgery and at 72 hours after surgery, and higher IDO levels at 24 and 72 hours after surgery. IDO had a certain value in the diagnosis of SIRS at 24 hours after surgery with an area under the ROC curve (AUC) of 0.793, a specificity of 100%, and a sensitivity of 58.14%. CRP, IL-6, and IDO had a certain value in the diagnosis of SIRS at 72 hours after surgery. IDO had the highest diagnostic efficiency with an AUC of 0.927, a specificity of 95.74%, and a sensitivity of 76.74% at 72 hours after surgery. IL-6, CRP, and IDO have a certain value in the diagnosis of SIRS after surgery for congenital heart disease, and IDO has a higher diagnostic efficiency. IDO can predict the development of SIRS in children after surgery for congenital heart disease earlier.

Diagnostic accuracy of presepsin (soluble CD14 subtype) for prediction of bacteremia in patients with systemic inflammatory response syndrome in the Emergency Department.

PubMed

Romualdo, Luis García de Guadiana; Torrella, Patricia Esteban; González, Monserrat Viqueira; Sánchez, Roberto Jiménez; Holgado, Ana Hernando; Freire, Alejandro Ortín; Acebes, Sergio Rebollo; Otón, María Dolores Albaladejo

2014-05-01

Bacteremia is indicative of severe bacterial infection with significant mortality. Its early diagnosis is extremely important for implementation of antimicrobial therapy but a diagnostic challenge. Although blood culture is the "gold standard" for diagnosis of bacteremia this method has limited usefulness for the early detection of blood-stream infection. In this study we assessed the presepsin as predictor of bacteremia in patients with systemic inflammatory response syndrome (SIRS) on admission to the Emergency Department and compare it with current available infection biomarkers. A total of 226 patients admitted to the Emergency Department with SIRS were included. In 37 patients blood culture had a positive result (bacteremic SIRS group) and 189 had a negative blood culture result (non-bacteremic SIRS group). Simultaneously with blood culture, presepsin, procalcitonin (PCT) and C-reactive protein (CRP) were measured. Receiver operating characteristic (ROC) curve analysis was performed for each biomarker as predictor of bacteremia. Presepsin values were significantly higher in bacteremic SIRS group when compared with non-bacteremic SIRS group. ROC curve analysis and area under curve (AUC) revealed a value of 0.750 for presepsin in differentiating SIRS patients with bacteremia from those without, similar than that for PCT (0.787) and higher than that for CRP (0.602). The best cut-off value for presepsin was 729pg/mL, which was associated with a negative predictive value of 94.4%. Presepsin may contribute to rule out the diagnosis of bacteremia in SIRS patients admitted to the Emergency Department. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Expression of CD11c and EMR2 on neutrophils: potential diagnostic biomarkers for sepsis and systemic inflammation.

PubMed

Lewis, S M; Treacher, D F; Edgeworth, J; Mahalingam, G; Brown, C S; Mare, T A; Stacey, M; Beale, R; Brown, K A

2015-11-01

There is a need for cellular biomarkers to differentiate patients with sepsis from those with the non-infectious systemic inflammatory response syndrome (SIRS). In this double-blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)-like molecule containing mucin-like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non-infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0.001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0.05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively. © 2015 British Society for Immunology.

Systemic Inflammatory Response Syndrome After Major Abdominal Surgery Predicted by Early Upregulation of TLR4 and TLR5.

PubMed

Lahiri, Rajiv; Derwa, Yannick; Bashir, Zora; Giles, Edward; Torrance, Hew D T; Owen, Helen C; O'Dwyer, Michael J; O'Brien, Alastair; Stagg, Andrew J; Bhattacharya, Satyajit; Foster, Graham R; Alazawi, William

2016-05-01

To study innate immune pathways in patients undergoing hepatopancreaticobiliary surgery to understand mechanisms leading to enhanced inflammatory responses and identifying biomarkers of adverse clinical consequences. Patients undergoing major abdominal surgery are at risk of life-threatening systemic inflammatory response syndrome (SIRS) and sepsis. Early identification of at-risk patients would allow tailored postoperative care and improve survival. Two separate cohorts of patients undergoing major hepatopancreaticobiliary surgery were studied (combined n = 69). Bloods were taken preoperatively, on day 1 and day 2 postoperatively. Peripheral blood mononuclear cells and serum were separated and immune phenotype and function assessed ex vivo. Early innate immune dysfunction was evident in 12 patients who subsequently developed SIRS (postoperative day 6) compared with 27 who did not, when no clinical evidence of SIRS was apparent (preoperatively or days 1 and 2). Serum interleukin (IL)-6 concentration and monocyte Toll-like receptor (TLR)/NF-κB/IL-6 functional pathways were significantly upregulated and overactive in patients who developed SIRS (P < 0.0001). Interferon α-mediated STAT1 phosphorylation was higher preoperatively in patients who developed SIRS. Increased TLR4 and TLR5 gene expression in whole blood was demonstrated in a separate validation cohort of 30 patients undergoing similar surgery. Expression of TLR4/5 on monocytes, particularly intermediate CD14CD16 monocytes, on day 1 or 2 predicted SIRS with accuracy 0.89 to 1.0 (areas under receiver operator curves). These data demonstrate the mechanism for IL-6 overproduction in patients who develop postoperative SIRS and identify markers that predict patients at risk of SIRS 5 days before the onset of clinical signs.

Cancer Incidence in First- and Second-Degree Relatives of BRCA1 and BRCA2 Mutation Carriers.

PubMed

Streff, Haley; Profato, Jessica; Ye, Yuanqing; Nebgen, Denise; Peterson, Susan K; Singletary, Claire; Arun, Banu K; Litton, Jennifer K

2016-07-01

Mutations in the BRCA1 and BRCA2 genes are associated with increased risk of breast, ovarian, and several other cancers. The purpose of the present study was to evaluate the incidence of cancer in first- and second-degree relatives of BRCA mutation carriers compared with the general population. A total of 1,086 pedigrees of BRCA mutation carriers was obtained from a prospectively maintained, internal review board-approved study of persons referred for clinical genetic counseling at the University of Texas MD Anderson Cancer Center. We identified 9,032 first- and second-degree relatives from 784 pedigrees that had demonstrated a clear indication of parental origin of mutation. Standardized incidence ratios (SIRs) were used to compare the observed incidence of 20 primary cancer sites to the expected incidence of each cancer based on the calculated risk estimates according to each subject's age, sex, and ethnicity. BRCA1 families had increased SIRs for breast and ovarian cancer (p < .001) and decreased SIRs for kidney, lung, prostate, and thyroid cancer and non-Hodgkin's lymphoma (p < .001). BRCA2 families had increased SIRs for breast, ovarian, and pancreatic cancer (p < .001) and decreased SIRs for kidney, lung, thyroid, and uterine cancer and non-Hodgkin's lymphoma (p < .0025). Analysis of only first-degree relatives (n = 4,099) identified no decreased SIRs and agreed with the increased SIRs observed in the overall study population. We have confirmed previous reports of an association between breast, ovarian, and pancreatic cancers with BRCA mutations. Additional research to quantify the relative risks of these cancers for BRCA mutation carriers can help tailor recommendations for risk reduction and enhance genetic counseling. BRCA gene mutations have been well described to carry an increased risk of both breast and ovarian cancer. However, the implications and risks of other cancers continues to be investigated. Evaluating the risks for other cancers further is key in identifying and managing risk reduction strategies. ©AlphaMed Press.

Two Suspected Worksite or Occupational Cancer Clusters Investigated Using the Cancer Data Registry and Multiple Primary Standardized Incidence Ratios in SEER *Stat-Idaho, 2013-2014.

PubMed

Rosenthal, Mariana; Johnson, Christopher J; Scoppa, Steve; Carter, Kris

2016-01-01

Investigations of suspected cancer clusters are resource intensive and rarely identify true clusters: among 428 publicly reported US investigations during 1990-2011, only 1 etiologic cluster was identified. In 2013, the Cancer Data Registry of Idaho (CDRI) was contacted regarding a suspected cancer cluster at a worksite (Cluster A) and among an occupational cohort (Cluster B). We investigated to determine whether these were true clusters. We derived investigation cohorts for Cluster A from facility-provided employee records and for Cluster B from professional licensing records. We used Registry PlusTM Link Plus to conduct probabilistic linkage of cohort members to the CDRI registry and completed matching through manual review by using LexisNexis®, Accurint®, and the Social Security Death Index. We calculated standardized incidence ratios (SIR) using the MP-SIR session type in SEER*Stat and Idaho and US referent populations. For Cluster A, we identified 34 cancer cases during 9,689 person-years; compared with Idaho and US rates, 95 percent CIs for SIRs included 1.0 for 24 of 24 primary site categories. For Cluster B, we identified 78 cancer cases during 15,154 person-years; compared with Idaho rates, 95 percent CI for SIRs included 1.0 for 23 of 24 primary site categories and was less than 1.0 for lung and bronchus cancers, and compared with US rates, 95 percent CI for SIRs included 1.0 for 22 of 24 primary site categories and was less than 1.0 for lung and bronchus and colorectal cancers. We identified no statistically significant excess in cancer incidence in either cohort. SEER*Stat's MP-SIR is an efficient tool for performing SIR assessments, a Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists-recommended step when investigating suspected cancer clusters.

Circulating sICAM-1 and sE-Selectin as biomarker of infection and prognosis in patients with systemic inflammatory response syndrome.

PubMed

de Pablo, Raúl; Monserrat, Jorge; Reyes, Eduardo; Díaz, David; Rodríguez-Zapata, Manuel; de la Hera, Antonio; Prieto, Alfredo; Álvarez-Mon, Melchor

2013-03-01

Vascular endothelium activation is a key pathogenic step in systemic inflammatory response syndrome (SIRS) that can be triggered by both microbial and sterile proinflammatory stimuli. The relevance of soluble adhesion molecules as clinical biomarkers to discriminate between infectious and non-infectious SIRS, and the individual patient prognosis, has not been established. We prospectively measured by sandwich ELISA, serum levels of soluble E-Selectin (sE-Selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble intercellular adhesion molecule-2 (sICAM-2) at ICU admission and at days 3, 7, 14 and 28 in patients with sepsis and at days 3 and 7 in patients with non-infectious SIRS. At ICU admission, sE-Selectin, sVCAM-1 and sICAM-1 in patients with infectious SIRS were significantly higher than those found in patients with non-infectious SIRS. ROC analysis revealed that the AUC for infection identification was best for sICAM-1 (0.900±0.041; 95% CI 0.819-0.981; p<0.0001). Moreover, multivariate analysis showed that 4 variables were significantly and independently associated with mortality at 28 days: male gender (OR 15.90; 95% CI, 2.54-99.32), MODS score (OR 5.60; 95% CI, 1.67-18.74), circulating sE-Selectin levels (OR 4.81; 95% CI, 1.34-17.19) and sVCAM-1 concentrations (OR 4.80; 95% CI, 1.34-17.14). Patients with SIRS secondary to infectious or non-infectious etiology show distinctive patterns of disturbance in serum soluble adhesion molecules. Serum ICAM-1 is a reliable biomarker for classifying patients with infectious SIRS from those with non-infectious SIRS. In addition, soluble E-Selectin is a prognostic biomarker with higher levels in patients with SIRS and fatal outcome. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Performance of the SIR-B digital image processing subsystem

NASA Technical Reports Server (NTRS)

Curlander, J. C.

1986-01-01

A ground-based system to generate digital SAR image products has been developed and implemented in support of the SIR-B mission. This system is designed to achieve the maximum throughput while meeting strict image fidelity criteria. Its capabilities include: automated radiometric and geometric correction of the output imagery; high-precision absolute location without tiepoint registration; filtering of the raw data to remove spurious signals from alien radars; and automated catologing to maintain a full set of radar and image production facility in support of the SIR-B science investigators routinely produces over 80 image frames per week.

Cancer incidence among priests: 45 years of follow-up in four Nordic countries.

PubMed

Stang, Andreas; Martinsen, Jan Ivar; Kjaerheim, Kristina; Weiderpass, Elisabete; Sparén, Pär; Tryggvadóttir, Laufey; Pukkala, Eero

2012-02-01

Previously published studies on the risk of cancer among male priests have been based on cancer mortality with the exception of one case-control study. The aim of this study was to present estimates of cancer incidence among Nordic male priests. The study cohort for our analyses consisted of 6.5 million men aged 30-64 years old who had participated in any computerised population census in four Nordic countries in 1990 or earlier. Follow-up was done by drawing linkages with the national population and cancer registries. 13,491 priests were identified by their job title codes. We estimated the standardised incidence ratio (SIR) and 95% confidence intervals (95% CI) for the priests using the male population as a reference. Priests had a lower cancer incidence than the general population (overall SIR 0.85, 95% CI: 0.82-0.88). The majority of smoking- and alcohol-related cancers were associated with decreased SIR estimates. Increased risks were observed for skin melanoma (SIR 1.34, 95% CI: 1.11-1.62), acute myeloid leukemia (SIR 1.75, 95% CI: 1.20-2.47) and thyroid cancer (SIR 1.86, 95% CI: 1.22-2.73). This is the first cohort study regarding the incidence of cancer among priests. The lower incidence of smoking and alcohol-related cancers among Nordic male priests can be explained by their lower exposure to cigarettes and alcohol when compared to the general population. A greater risk of melanoma is typical of highly-educated people, but it is unclear why priests should have an increased risk of acute myeloid leukemia or thyroid cancer.

Performance of the definitions of the systemic inflammatory response syndrome and sepsis in neonates.

PubMed

Hofer, Nora; Zacharias, Eva; Müller, Wilhelm; Resch, Bernhard

2012-09-01

The aim of this study was to examine the applicability of the definitions of the systemic inflammatory response syndrome (SIRS) and sepsis to neonates during the first 3 days of life. This is a retrospective study of all term neonates hospitalized within the first 24 h of life from 2004 to 2010 at our neonatal intensive care unit. Of 476 neonates, 30 (6 %) had a diagnosis of culture-proven early-onset sepsis (EOS) and 81 (17 %) had culture-negative clinical EOS or suspected EOS. SIRS and sepsis criteria were applied to 116 (24 %) and 61 (13 %) neonates, respectively. Of 30 neonates with culture proven, EOS 14 (53 %) fulfilled SIRS and sepsis criteria. The single diagnostic criterion of SIRS applied to 20 % (hypothermia or fever), 43 % (white blood cell count/immature-to-total neutrophil ratio), 87 % (respiratory symptoms), and 33 % (cardiocirculatory symptoms) of all neonates with culture-proven EOS. The definitions of SIRS and sepsis did not apply to about half of all cases of culture-proven EOS. An evidence-based approach to find the appropriate criteria for defining EOS in the neonate is needed.

Performance Comparison of Systemic Inflammatory Response Syndrome with Logistic Regression Models to Predict Sepsis in Neonates

PubMed Central

Thakur, Jyoti; Pahuja, Sharvan Kumar; Pahuja, Roop

2017-01-01

In 2005, an international pediatric sepsis consensus conference defined systemic inflammatory response syndrome (SIRS) for children <18 years of age, but excluded premature infants. In 2012, Hofer et al. investigated the predictive power of SIRS for term neonates. In this paper, we examined the accuracy of SIRS in predicting sepsis in neonates, irrespective of their gestational age (i.e., pre-term, term, and post-term). We also created two prediction models, named Model A and Model B, using binary logistic regression. Both models performed better than SIRS. We also developed an android application so that physicians can easily use Model A and Model B in real-world scenarios. The sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) in cases of SIRS were 16.15%, 95.53%, 3.61, and 0.88, respectively, whereas they were 29.17%, 97.82%, 13.36, and 0.72, respectively, in the case of Model A, and 31.25%, 97.30%, 11.56, and 0.71, respectively, in the case of Model B. All models were significant with p < 0.001. PMID:29257099

The General Medical Council: frame of reference or arbiter of morals?

PubMed Central

Hill, D

1977-01-01

Many members of the public think of the General Medical Council (GMC) as the body which tries doctors: the doctors' law courts, as it were. And, except in the more sober of newspapers and news reports, the 'offences ' which receive the most publicity are those concerning alleged improper relations between doctors and patients. Professor Sir Denis Hill, in the following paper, which he read in the spring of this year to the annual conference of the London Medical Group devoted to a discussion of human sexuality, chose to examine the whole function of the General Medical Council as a frame of moral reference for doctors. Judging allegations of professional misconduct by doctors is the function of the Council's Disciplinary Committee. Judging sexual misconduct forms only a small part of their work. The GMC's responsibility covers the whole notion of morals and morality as it concerns doctors in their professional work. Sir Denis Hill stresses the modern thinking that morality must be learned and that attitudes are always shifting as society alters its norms of what is moral conduct. That is not to say that all that was previously considered not to be moral has now become acceptable but rather that other concepts have entered the field of moral debate. Therefore the GMC must constantly review the frame of reference it offers to doctors and the public may be surprised to learn that that process is never static. Sir Denis Hill in this paper is speaking personally and not as a member of the General Medical Council or of any of that body's special committees. PMID:926129

Development of SIR-C Ground Calibration Equipment

NASA Technical Reports Server (NTRS)

Freeman, A.; Azeem, M.; Haub, D.; Sarabandi, K.

1993-01-01

SIR-C/X-SAR is currently scheduled for launch in April 1994. SIR-C is an L-Band and C-Band, multi-polarization spaceborne SAR system developed by NASA/JPL. X- SAR is an X-Band SAR system developed by DARA/ASI. One of the problems involved in calibrating the SIR-C instrument is to make sure that the horizontal (H) and vertical (V) polarized beams are aligned in the azimuth direction, i.e.. that they are pointing in the same direction. This is important if the polarimetric performance specifications for the system are to be met. To solve this problem, we have designed and built a prototype of a low-cost ground receiver capable of recording received power from two antennas, one H-polarized, the other V-polarized. The two signals are mixed to audio then recorded on the left and right stereo channels of a standard audio cassette player. The audio cassette recording can then be played back directly into a Macintosh computer, where it is digitized. Analysis of.

A Survey of Attitudes towards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer.

PubMed

Watt, David G; Roxburgh, Campbell S; White, Mark; Chan, Juen Zhik; Horgan, Paul G; McMillan, Donald C

2015-01-01

The systemic inflammatory response (SIR) plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems. An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer. Of those invited by the survey (n = 238), 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS) and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia. The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.

Hydraulische Optimierung des Reaktionsraumes um einen Infiltrationsbrunnen zur unterirdischen Enteisenung. Durchführung eines Feldversuchs mit Infiltrationssteuerung (Teil 2/2) Hydraulic optimization of the reaction zone around an injection well during subsurface iron removal (SIR)

NASA Astrophysics Data System (ADS)

Bartak, Rico; Macheleidt, Wolfgang; Ahrns, Johannes; Grischek, Thomas

2017-11-01

In subsurface iron removal (SIR), oxygen-enriched water is injected into an aquifer to create a reaction zone. Ahrns et al. (2017) simulated a doubling of the efficiency coefficient by the inactivation of well screen sections during injection for a vertical SIR pilot well penetrating an aquifer with varying dissolved iron concentrations. The optimized injection regime was adopted conceptually in a pilot SIR test. An inflatable packer was used to manipulate the outflow distribution. The packer was inflated before the injection phase then evacuated with a vacuum pump before pumping while remaining inside the casing. Cycles with conventional injection were performed first and iron breakthrough was monitored in the pumped water. Subsequently when the packer was used, iron removal increased by 25% and the efficiency coefficient by 50% for an adopted reference value of 5.0 mg/l. Although the study site was unfavorable for SIR because of the unfavorable low alkalinity (pH in the re- and infiltrate decreased down to 4.2), the injectant could have been pretreated by the addition of alkalis prior to injection. This was not considered in the simulation and iron concentrations were above the limits commonly used in practice. However, the overall use of an optimized injection will still be presented.

Systemic and splanchnic metabolic response to exogenous human growth hormone.

PubMed

Dahn, M S; Lange, M P

1998-05-01

Evidence exists indicating that growth hormone (GH) resistance in some disease states such as hypercatabolic conditions may limit the metabolic benefit associated with recombinant human growth hormone (rhGH) administration. It was the purpose of this study to compare the systemic and splanchnic effects of rhGH in patients with sepsis exhibiting systemic inflammatory response syndrome (SIRS) with the response observed in normal volunteers. Because insulin-like growth factor I (IGF-I) is believed to be the dominant factor responsible for the anabolic effects of rhGH, particular attention was given to this secondary effector. The systemic and splanchnic effects of rhGH (0.15 mg/kg/day) were studied in normal volunteers (n = 5), critically ill patients with sepsis exhibiting SIRS (n = 6), and patients with sepsis exhibiting SIRS while receiving total parenteral nutrition (n = 6). Basal and end study IGF-I, urinary urea excretion, hepatic blood flow, hepatic venous oxygen content, and splanchnic oxygen exchange were measured after a 48-hour course of rhGH. Fasting basal IGF-I concentrations were reduced by 75% to 83% in patients with sepsis/SIRS relative to normal control subjects. After 48 hours of rhGH, peak IGF-I concentrations were 74% and 76% lower in patients in the Sepsis/SIRS and Sepsis/SIRS + Nutrition groups, respectively, compared with normal control subjects. Despite the attenuated IGF-I rise in patients, urea excretion declined by a similar magnitude in all three groups. Hepatic blood flow remained unaffected, but rhGH administration increased splanchnic oxygen consumption in all groups (control, +57%*; Sepsis/SIRS, +13%; Sepsis/SIRS + Nutr +42%*; *p < 0.05 relative to corresponding basal) resulting in a decline of basal to end therapy hepatic venous oxygen saturation (control, 67 +/- 4% to 62 +/- 11%; Sepsis/SIRS, 51% +/- 14% to 43% +/- 14%*; Sepsis/SIRS + Nutr, 62% +/- 11% to 55% +/- 16%; *p < 0.05 relative to corresponding control value), suggesting that rhGH may induce centrilobular hepatic hypoxia, which may contribute to the diminished IGF-I response. Although critically ill patients exhibit an IGF-I increase in response to exogenous rhGH, the rise is markedly attenuated compared with healthy volunteers, indicating the presence of GH resistance. Unexpectedly, the changes in the anabolic hormone IGF-I did not appear to be related to the reduction in urea excretion. This may provide some additional evidence for IGF-I resistance. Finally, rhGH is associated with an augmented splanchnic oxygen consumption but no corresponding increase in regional blood flow. As a result, regional tissue hypoxia may arise and contribute to the impaired or suboptimal IGF-I response pattern.

KEY COMPARISON Update of the BIPM.RI(II)-K1.Tc-99m comparison of activity measurements for the radionuclide 99mTc to include new results for the LNE-LNHB and the NPL

NASA Astrophysics Data System (ADS)

Michotte, C.; Courte, S.; Ratel, G.; Moune, M.; Johansson, L.; Keightley, J.

2010-01-01

In 2007 and 2008 respectively, the Laboratoire national de métrologie et d'essais-Laboratoire national Henri Becquerel (LNE-LNHB), France and the National Physical Laboratory (NPL), UK, submitted ampoules with between 10 MBq and 130 MBq activity of 99mTc to the International Reference System (SIR), to update their results in the BIPM.RI(II)-K1.Tc-99m comparison. Together with the four other national metrology institutes (NMI) that are participants, thirteen samples have been submitted since 1983. The key comparison reference value (KCRV) has been recalculated to include the latest primary results of the PTB and the LNE-LNHB as this makes the evaluation more robust. The degrees of equivalence between each equivalent activity measured in the SIR are given in the form of a matrix for all six NMIs. A graphical presentation is also given. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI Section II, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

Update of the BIPM comparison BIPM.RI(II)-K1.Cu-64 of activity measurements of the radionuclide 64Cu to include the 2009 results of the CMI-IIR (Czech Rep.) and the NPL (UK), the 2010 result of the LNE-LNHB (France) and the 2011 result of the ENEA-INMRI (Italy)

NASA Astrophysics Data System (ADS)

Michotte, C.; Ratel, G.; Courte, S.; Sochorovà, J.; Auerbach, P.; Keightley, J.; Johansson, L.; Bakhshandeiar, E.; Cassette, P.; Moune, M.; Capogni, M.; De Felice, P.

2013-01-01

Since 2009, four national metrology institutes (NMI) have submitted four samples of known activity of 64Cu to the International Reference System (SIR) for activity comparison at the Bureau International des Poids et Mesures (BIPM), with comparison identifier BIPM.RI(II)-K1.Cu-64. The values of the activity submitted were between about 3 MBq and 260 MBq. There are now five results in the BIPM.RI(II)-K1.Cu-64 comparison. A key comparison reference value (KCRV) has been calculated for the first time for this nuclide. The degrees of equivalence between each equivalent activity measured in the SIR and the KCRV have been calculated and the results are given in the form of a table. A graphical presentation is also given. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Protective Effects of Emodin-Induced Neutrophil Apoptosis via the Ca2+-Caspase 12 Pathway against SIRS in Rats with Severe Acute Pancreatitis.

PubMed

Wang, Gui-Jun; Wang, Yue; Teng, Yong-Sheng; Sun, Fa-Lv; Xiang, Hong; Liu, Jian-Jun; Xia, Shi-Lin; Zhang, Gui-Xin; Chen, Hai-Long; Shang, Dong

2016-01-01

Severe acute pancreatitis (SAP) results in high mortality. This is partly because of early multiple organ dysfunction syndromes that are usually caused by systemic inflammatory response syndrome (SIRS). Many studies have reported the beneficial effects of emodin against SAP with SIRS. However, the exact mechanism underlying the effect of emodin remains unclear. This study was designed to explore the protective effects and underlying mechanisms of emodin against SIRS in rats with SAP. In the present study, cytosolic Ca 2+ levels, calpain 1 activity, and the expression levels of the active fragments of caspases 12 and 3 decreased in neutrophils from rats with SAP and increased after treatment with emodin. Delayed neutrophil apoptosis occurred in rats with SAP and emodin was able to reverse this delayed apoptosis and inhibit SIRS. The effect of emodin on calpain 1 activity, the expression levels of the active fragments of caspases 12 and 3, neutrophil apoptosis, and SIRS scores were attenuated by PD150606 (an inhibitor of calpain). These results suggest that emodin inhibits SIRS in rats with SAP by inducing circulating neutrophil apoptosis via the Ca 2+ -calpain 1-caspase 12-caspase 3 signaling pathway.

Protective Effects of Emodin-Induced Neutrophil Apoptosis via the Ca2+-Caspase 12 Pathway against SIRS in Rats with Severe Acute Pancreatitis

PubMed Central

Wang, Gui-Jun; Wang, Yue; Teng, Yong-Sheng; Sun, Fa-Lv; Xiang, Hong; Liu, Jian-Jun; Xia, Shi-Lin; Zhang, Gui-Xin

2016-01-01

Severe acute pancreatitis (SAP) results in high mortality. This is partly because of early multiple organ dysfunction syndromes that are usually caused by systemic inflammatory response syndrome (SIRS). Many studies have reported the beneficial effects of emodin against SAP with SIRS. However, the exact mechanism underlying the effect of emodin remains unclear. This study was designed to explore the protective effects and underlying mechanisms of emodin against SIRS in rats with SAP. In the present study, cytosolic Ca2+ levels, calpain 1 activity, and the expression levels of the active fragments of caspases 12 and 3 decreased in neutrophils from rats with SAP and increased after treatment with emodin. Delayed neutrophil apoptosis occurred in rats with SAP and emodin was able to reverse this delayed apoptosis and inhibit SIRS. The effect of emodin on calpain 1 activity, the expression levels of the active fragments of caspases 12 and 3, neutrophil apoptosis, and SIRS scores were attenuated by PD150606 (an inhibitor of calpain). These results suggest that emodin inhibits SIRS in rats with SAP by inducing circulating neutrophil apoptosis via the Ca2+-calpain 1-caspase 12-caspase 3 signaling pathway. PMID:28078280

Space Shuttle Columbia views the world with imaging radar: The SIR-A experiment

NASA Technical Reports Server (NTRS)

Ford, J. P.; Cimino, J. B.; Elachi, C.

1983-01-01

Images acquired by the Shuttle Imaging Radar (SIR-A) in November 1981, demonstrate the capability of this microwave remote sensor system to perceive and map a wide range of different surface features around the Earth. A selection of 60 scenes displays this capability with respect to Earth resources - geology, hydrology, agriculture, forest cover, ocean surface features, and prominent man-made structures. The combined area covered by the scenes presented amounts to about 3% of the total acquired. Most of the SIR-A images are accompanied by a LANDSAT multispectral scanner (MSS) or SEASAT synthetic-aperture radar (SAR) image of the same scene for comparison. Differences between the SIR-A image and its companion LANDSAT or SEASAT image at each scene are related to the characteristics of the respective imaging systems, and to seasonal or other changes that occurred in the time interval between acquisition of the images.

Cancer Among Children With Perinatal Exposure to HIV and Antiretroviral Medications--New Jersey, 1995-2010.

PubMed

Ivy, Wade; Nesheim, Steve R; Paul, Sindy M; Ibrahim, Abdel R; Chan, Miranda; Niu, Xiaoling; Lampe, Margaret A

2015-09-01

Concerns remain regarding the cancer risk associated with perinatal antiretroviral (ARV) exposure among infants. No excessive cancer risk has been found in short-term studies. Children born to HIV-infected women (HIV-exposed) in New Jersey from 1995 to 2008 were identified through the Enhanced HIV/AIDS Reporting System and cross-referenced with data from the New Jersey State Cancer Registry to identify new cases of cancer among children who were perinatally exposed to ARV. Matching of individuals in the Enhanced HIV/AIDS Reporting System to the New Jersey State Cancer Registry was conducted based on name, birth date, Social Security number, residential address, and sex using AutoMatch. Age- and sex-standardized incidence ratio (SIR) and exact 95% confidence intervals (CIs) were calculated using New Jersey (1979-2005) and US (1999-2009) cancer rates. Among 3087 children (29,099 person-years; median follow-up: 9.8 years), 4 were diagnosed with cancer. Cancer incidence among HIV-exposed children who were not exposed to ARV prophylaxis (22.5 per 100,000 person-years) did not differ significantly from the incidence among children who were exposed to any perinatal ARV prophylaxis (14.3 per 100,000 person-years). Furthermore, the number of cases observed among individuals exposed to ARV did not differ significantly from cases expected based on state (SIR = 1.21; 95% CI: 0.25 to 3.54) and national (SIR = 1.27; 95% CI: 0.26 to 3.70) reference rates. Our findings are reassuring that current use of ARV for perinatal HIV prophylaxis does not increase cancer risk. We found no evidence to alter the current federal guidelines of 2014 that recommend ARV prophylaxis of HIV-exposed infants.

Sir2/Sirt1 Links Acute Inebriation to Presynaptic Changes and the Development of Alcohol Tolerance, Preference, and Reward.

PubMed

Engel, Gregory L; Marella, Sunanda; Kaun, Karla R; Wu, Julia; Adhikari, Pratik; Kong, Eric C; Wolf, Fred W

2016-05-11

Acute ethanol inebriation causes neuroadaptive changes in behavior that favor increased intake. Ethanol-induced alterations in gene expression, through epigenetic and other means, are likely to change cellular and neural circuit function. Ethanol markedly changes histone acetylation, and the sirtuin Sir2/SIRT1 that deacetylates histones and transcription factors is essential for the rewarding effects of long-term drug use. The molecular transformations leading from short-term to long-term ethanol responses mostly remain to be discovered. We find that Sir2 in the mushroom bodies of the fruit fly Drosophila promotes short-term ethanol-induced behavioral plasticity by allowing changes in the expression of presynaptic molecules. Acute inebriation strongly reduces Sir2 levels and increases histone H3 acetylation in the brain. Flies lacking Sir2 globally, in the adult nervous system, or specifically in the mushroom body α/β-lobes show reduced ethanol sensitivity and tolerance. Sir2-dependent ethanol reward is also localized to the mushroom bodies, and Sir2 mutants prefer ethanol even without a priming ethanol pre-exposure. Transcriptomic analysis reveals that specific presynaptic molecules, including the synaptic vesicle pool regulator Synapsin, depend on Sir2 to be regulated by ethanol. Synapsin is required for ethanol sensitivity and tolerance. We propose that the regulation of Sir2/SIRT1 by acute inebriation forms part of a transcriptional program in mushroom body neurons to alter presynaptic properties and neural responses to favor the development of ethanol tolerance, preference, and reward. We identify a mechanism by which acute ethanol inebriation leads to changes in nervous system function that may be an important basis for increasing ethanol intake and addiction liability. The findings are significant because they identify ethanol-driven transcriptional events that target presynaptic properties and direct behavioral plasticity. They also demonstrate that multiple forms of ethanol behavioral plasticity that are relevant to alcoholism are initiated by a shared mechanism. Finally, they link these events to the Drosophila brain region that associates context with innate approach and avoidance responses to code for reward and other higher-order behavior, similar in aspects to the role of the vertebrate mesolimbic system. Copyright © 2016 the authors 0270-6474/16/365241-11$15.00/0.

Urinary neutrophil gelatinase-associated lipocalin, a biomarker for systemic inflammatory response syndrome in patients with nephrolithiasis.

PubMed

Zhu, Wei; Liu, Min; Wang, Guang-Chun; Che, Jian-Ping; Xu, Yun-Fei; Peng, Bo; Zheng, Jun-Hua

2014-03-01

The objective of this study was to determine the diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL), C-reactive protein (CRP), and procalcitonin (PCT) in the prognosis of patients presenting with the systemic inflammatory response syndrome (SIRS) with nephrolithiasis. Urine NGAL protein levels were measured by enzyme-linked immunosorbent assay in 87 patients presenting with nephrolithiasis who were diagnosed as SIRS. Additionally, 52 patients presenting with nephrolithiasis but without urinary tract infection and 30 healthy controls were also included in the study. Levels of serum CRP and PCT were also taken into consideration. Median urinary NGAL levels were significantly increased in the SIRS cohorts compared with nephrolithiasis without urinary tract infection patients (4.28 ng/mL versus 2.69 ng/mL, P < 0.001), and NGAL was markedly elevated even in the early stage of SIRS (3.23 ng/mL versus 2.69 ng/mL, P < 0.001). According to the receiver-operating characteristic analysis, NGAL demonstrated a high diagnostic value compared with either PCT or CRP. In the later stage of SIRS, NGAL remained a highly sensitive (76.8%) and specific (86.5%) diagnostic marker compared with either PCT or CRP. Moreover, the area under the curves of NGAL (0.822) were also superior to those seen in either PCT (0.657) or CRP (0.761). Urinary NGAL is a highly sensitive and specific predictor of SIRS for patients presenting with nephrolithiasis. Further study of NGAL as a reliable biomarker of SIRS is required. Copyright © 2014 Elsevier Inc. All rights reserved.

Knowledge and recognition of SIRS and sepsis among pediatric nurses.

PubMed

Jeffery, Alvin D; Mutsch, Karen Steffen; Knapp, Lisa

2014-01-01

A large amount of research demonstrates the importance of key interventions in reducing mortality rates of pediatric patients with sepsis (Dellinger et al., 2008). Assessment and recognition of declining status must occur for interventions to be initiated. Of health care practitioners, nurses typically spend the most time with patients, and they must be knowledgeable in recognizing the systemic inflammatory response syndrome and sepsis while also being aware of the importance of prompt intervention. The literature does not discuss pediatric nurses' knowledge of systemic inflammatory response syndrome (SIRS)/sepsis recognition. The purpose of this study was to assess the knowledge of acute and critical care pediatric nurses of SIRS diagnostic criteria, sepsis guidelines, and the importance of SIRS recognition. This cross-sectional, quantitative, correlational descriptive study included 242 acute and critical care pediatric nurses at a 490-bed urban pediatric hospital. Participants completed an original questionnaire with face and content validity regarding SIRS criteria, sepsis guidelines, priority interventions, and attitude toward the importance of SIRS recognition. Findings demonstrated a significant knowledge deficit among participants in several key areas of SIRS/sepsis recognition. The mean score was 60.8% ± 7.4%. Item analyses demonstrated nurses easily recognize septic shock but have difficulty recognizing patients in earlier stages of the sepsis continuum. Significant confusion was evident regarding the role of blood pressure and serum lactic acid levels in diagnosing sepsis. It is recommended that an educational intervention be created for acute and critical care pediatric nurses to aid them in recognizing sepsis in its earlier stages.

Incident ESRD among participants in a lead surveillance program.

PubMed

Chowdhury, Ritam; Darrow, Lyndsey; McClellan, William; Sarnat, Stefanie; Steenland, Kyle

2014-07-01

Very high levels of lead can cause kidney failure; data about renal effects at lower levels are limited. Cohort study, external (vs US population) and internal (by exposure level) comparisons. 58,307 men in an occupational surveillance system in 11 US states. Blood lead levels. Incident end-stage renal disease determined by matching the cohort with the US Renal Data System (n=302). Blood lead categories were 0-<5, 5-<25, 25-<40, 40-51, and >51 μg/dL, defined by highest blood lead test result. One analysis for those with data for race (31% of cohort) and another for the whole cohort after imputing race. Median follow-up was 12 years. Among those with race information, the end-stage renal disease standardized incidence ratio (SIR; US population as referent) was 1.08 (95% CI, 0.89-1.31) overall. The SIR in the highest blood lead category was 1.47 (95% CI, 0.98-2.11), increasing to 1.56 (95% CI, 1.02-2.29) for those followed up for 5 or more years. For the entire cohort (including those with race imputed), the overall SIR was 0.92 (95% CI, 0.82-1.03), increasing to 1.36 (95% CI, 0.99-1.73) in the highest blood lead category (SIR of 1.43 [95% CI, 1.01-1.85] in those with ≥5 years' follow-up). In internal analyses by Cox regression, rate ratios for those with 5 or more years' follow-up in the entire cohort were 1.0 (0-<5 and 5-<25 μg/dL categories combined) and 0.92, 1.08, and 1.96 for the 25-<40, 40-51, and >51 μg/dL categories, respectively (P for trend=0.003). The effect of lead was strongest in nonwhites. Lack of detailed work history, reliance on only a few blood lead tests per person to estimate level of exposure, lack of clinical data at time of exposure. Data suggest that current US occupational limits on blood lead levels may need to be strengthened to avoid kidney disease. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Treatment of post-cardiopulmonary bypass SIRS by hemoadsorption: a case series.

PubMed

Träger, Karl; Fritzler, Daniel; Fischer, Guenther; Schröder, Janpeter; Skrabal, Christian; Liebold, Andreas; Reinelt, Helmut

2016-05-16

The use of cardiopulmonary bypass (CPB) in cardiothoracic surgery results in a well-known activation of the immunologic response. In some cases, however, this triggered immunologic response may be excessive, leading to a severe systemic inflammatory response syndrome (SIRS) and induced organ dysfunction. For example, patients frequently develop hemodynamic instability with hypotension and low systemic vascular resistance. To date, different therapeutic approaches, such as steroids, have been tried to control this maladaptive postoperative SIRS response, yet definitive proof of clinical efficacy is missing. A new cytokine adsorber device (CytoSorb; CytoSorbents) may be a useful approach to control hyperinflammatory systemic reactions by reducing a broad range of proinflammatory cytokines and other inflammatory mediators. This may, in turn, help to reestablish a physiologic immune response and help to restore deranged clinical parameters in these patients. In this retrospective case series study, we describe 16 cardiac surgery patients following prolonged CPB with post-CPB SIRS and subsequent acute kidney injury, who were then treated with hemoadsorption using CytoSorb in combination with continuous renal replacement therapy (CRRT). Treatment of patients with CytoSorb who presented with severe post-CPB SIRS resulted in a reduction of elevated cytokine levels, which was associated with a clear stabilization of deranged hemodynamic, metabolic, and organ function parameters. Treatment was well tolerated and safe, with no device-related adverse events occurring. CytoSorb therapy combined with CRRT is a potentially promising new treatment approach to achieve hemodynamic stability, cytokine reduction, and improved organ function in cardiac surgery patients who develop post-CPB SIRS.

The Effects of Aging on Pulmonary Oxidative Damage, Protein Nitration and Extracellular Superoxide Dismutase Down-Regulation During Systemic Inflammation

PubMed Central

Starr, Marlene E; Ueda, Junji; Yamamoto, Shoji; Evers, B. Mark; Saito, Hiroshi

2011-01-01

Systemic inflammatory response syndrome (SIRS), a serious clinical condition characterized by whole body inflammation, is particularly threatening for elderly patients who suffer much higher mortality rates than the young. A major pathological consequence of SIRS is acute lung injury caused by neutrophil-mediated oxidative damage. Previously, we reported an increase in protein tyrosine nitration (a marker of oxidative/nitrosative damage), and a decrease in antioxidant enzyme, extra-cellular superoxide dismutase (EC-SOD), in the lungs of young mice during endotoxemia-induced SIRS. Here we demonstrate that during endotoxemia, down-regulation of EC-SOD is significantly more profound and prolonged, while up-regulation of iNOS is augmented in aged compared to young mice. Aged mice also showed 2.5-fold higher protein nitration levels, compared to young mice, with particularly strong nitration in the pulmonary vascular endothelium during SIRS. Additionally, by 2-dimensional gel electrophoresis, Western blotting and mass spectrometry, we identified proteins which show increased tyrosine nitration in age- and SIRS-dependent manners; these proteins (profilin-1, transgelin-2, LASP 1, tropomyosin and myosin) include components of the actin cytoskeleton responsible for maintaining pulmonary vascular permeability. Reduced EC-SOD in combination with increased oxidative/nitrosative damage and altered cytoskeletal protein function due to tyrosine nitration may contribute to augmented lung injury in the aged with SIRS. PMID:21092756

Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection.

PubMed

Williams, Julian M; Greenslade, Jaimi H; McKenzie, Juliet V; Chu, Kevin; Brown, Anthony F T; Lipman, Jeffrey

2017-03-01

A proposed revision of sepsis definitions has abandoned the systemic inflammatory response syndrome (SIRS), defined organ dysfunction as an increase in total Sequential Organ Function Assessment (SOFA) score of ≥ 2, and conceived "qSOFA" (quick SOFA) as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare the diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in ED patients with infection. Consecutive ED patients admitted with presumed infection were prospectively enrolled over 3 years. Sufficient observational data were collected to calculate SIRS, qSOFA, SOFA, comorbidity, and mortality. We enrolled 8,871 patients, with SIRS present in 4,176 (47.1%). SIRS was associated with increased risk of organ dysfunction (relative risk [RR] 3.5) and mortality in patients without organ dysfunction (OR 3.2). SIRS and qSOFA showed similar discrimination for organ dysfunction (area under the receiver operating characteristic curve, 0.72 vs 0.73). qSOFA was specific but poorly sensitive for organ dysfunction (96.1% and 29.7%, respectively). Mortality for patients with organ dysfunction was similar for Sepsis-2 and Sepsis-3 (12.5% and 11.4%, respectively), although 29% of patients with Sepsis-3 organ dysfunction did not meet Sepsis-2 criteria. Increasing numbers of Sepsis-2 organ system dysfunctions were associated with greater mortality. SIRS was associated with organ dysfunction and mortality, and abandoning the concept appears premature. A qSOFA score ≥ 2 showed high specificity, but poor sensitivity may limit utility as a bedside screening method. Although mortality for organ dysfunction was comparable between Sepsis-2 and Sepsis-3, more prognostic and clinical information is conveyed using Sepsis-2 regarding number and type of organ dysfunctions. The SOFA score may require recalibration. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Serum levels of osteopontin are increased in SIRS and sepsis.

PubMed

Vaschetto, Rosanna; Nicola, Stefania; Olivieri, Carlo; Boggio, Elena; Piccolella, Fabio; Mesturini, Riccardo; Damnotti, Federica; Colombo, Davide; Navalesi, Paolo; Della Corte, Francesco; Dianzani, Umberto; Chiocchetti, Annalisa

2008-12-01

In sepsis, dysregulation of the immune response leads to rapid multiorgan failure and death. Accurate and timely diagnosis is lifesaving and should discriminate sepsis from the systemic inflammatory response syndrome (SIRS) caused by non-infectious agents. Osteopontin acts as an extracellular matrix component or a soluble cytokine in inflamed tissues. Its exact role in immune response and sepsis remains to be elucidated. Therefore, we investigated the role of osteopontin in SIRS and sepsis. Prospective, observational study. Intensive care unit of a university hospital. Fifty-six patients with SIRS or sepsis and 56 healthy subjects were enrolled. We analyzed the serum levels of osteopontin and TH1-TH2 cytokines and investigated the role of osteopontin on interleukin 6 secretion by monocytes. Serum osteopontin levels were strikingly higher in patients than in controls and in sepsis than in SIRS, and decreased during the resolution of both the disorders. Receiver operating characteristic curves showed that osteopontin levels have discriminative power between SIRS and sepsis with an area under the curve of 0.796. Osteopontin levels directly correlated with those of interleukin 6 and in vitro, recombinant osteopontin increased interleukin 6 secretion by monocytes in both the absence and presence of high doses of lipopolysaccharide. These data suggest that osteopontin might be a mediator involved in the pathogenesis of SIRS and sepsis, possibly by supporting interleukin 6 secretion. 45. SIRS/Sepsis: clinical studies.

PALEODRAINAGES OF THE EASTERN SAHARA - THE RADAR RIVERS REVISITED (SIR - A/B IMPLICATIONS FOR A MID - TERTIARY TRANS - AFRICAN DRAINAGE SYSTEM).

USGS Publications Warehouse

McCauley, John F.; Breed, Carlos S.; Schaber, Gerald G.; McHugh, William P.; Issawi, Bahay; Haynes, C. Vance; Grolier, Maurice J.; El Kilani, Ali

1986-01-01

A complex history of Cenozoic fluvial activity in the presently hyperarid eastern Sahara is inferred from Shuttle Imaging Radar (SIR) data and postflight field investigations in southwest Egypt and northwest Sudan. SIR images were coregistered with Landsat and existing maps as a guide to exploration of the buried paleodrainages (radar rivers) first discovered by SIR-A. Field observations explain the radar responses of three types of radar rivers: RR-1, RR-2, and RR-3. A generalized model of the radar rivers, based on field studies and regional geologic relations, shows apparent changes in river regimen since the large valleys were established during the late Paleogene-early Neogene eras. SIR-based mapping of these paleodrainages, although incomplete, reveals missing links in an area once thought to be devoid of master streams.

C. elegans sirtuin SIR-2.4 and its mammalian homolog SIRT6 in stress response.

PubMed

Jedrusik-Bode, Monika

2014-01-01

Stress is a significant life event. The immediate response to stress is critical for survival. In organisms ranging from the unicellular Saccharomyces cerevisiae to protozoa (Trypanosoma brucei) and metazoan (such as Caenorhabditis elegans, Homo sapiens) stress response leads to the formation of cytoplasmic RNA-protein complexes referred to as stress granules (SGs). SGs regulate cell survival during stress by the sequestration of the signaling molecules implicated in apoptosis. They are a transient place of messenger ribonucleoproteins (mRNPs) remodeling for storage, degradation, or reinitiation of translation during stress and recovery from stress. Recently, we have identified chromatin factor, the sirtuin C. elegans SIR-2.4 variant and its mammalian homolog SIRT6 as a regulator of SGs formation. SIRT6 is highly conserved NAD(+)-dependent lysine deacetylase and ADP-ribosyltransferase impacting longevity, metabolism, and cancer. We observed that the cellular formation of SGs by SIRT6 or SIR-2.4 was linked with the cell viability or C. elegans survival and was dependent on SIRT6 enzymatic activity. Here, we discuss how SIR-2.4/SIRT6 influences SGs formation and stress response. We suggest possible mechanisms for such an unanticipated function of a chromatin regulatory factor SIRT6 in assembly of stress granules and cellular stress resistance.

Procalcitonin, C-reactive protein and serum lactate dehydrogenase in the diagnosis of bacterial sepsis, SIRS and systemic candidiasis.

PubMed

Miglietta, Fabio; Faneschi, Maria Letizia; Lobreglio, Giambattista; Palumbo, Claudio; Rizzo, Adriana; Cucurachi, Marco; Portaccio, Gerolamo; Guerra, Francesco; Pizzolante, Maria

2015-09-01

The aim of this study was to evaluate procalcitonin (PCT), C-reactive protein (CRP), platelet count (PLT) and serum lactate dehydrogenase (LDH) as early markers for diagnosis of SIRS, bacterial sepsis and systemic candidiasis in intensive care unit (ICU) patients. Based on blood culture results, the patients were divided into a sepsis group (70 patients), a SIRS group (42 patients) and a systemic candidiasis group (33 patients). PCT, CRP, LDH and PLT levels were measured on day 0 and on day 2 from the sepsis symptom onset. PCT levels were higher in Gram negative sepsis than those in Gram positive sepsis, although the P value between the two subgroups is not significant (P=0.095). Bacterial sepsis group had higher PCT and CRP levels compared with the systemic candidiasis group, whereas PLT and LDH levels showed similar levels in these two subgroups. The AUC for PCT (AUC: 0.892, P <0.001) was larger than for CRP (AUC: 0.738, P <0.001). The best cut-off values for PCT and CRP were 0.99 ng/mL and 76.2 mg/L, respectively. Diagnostic sensitivity and specificity for PCT were 84.3% and 81.8% whereas CRP showed a sensitivity of 77.2% and a specificity of 63.6%. However, PCT was unable to discriminate between SIRS and systemic candidiasis groups (P=0.093 N.S.). In conclusion, PCT can be used as a preliminary marker in the event of clinical suspicion of systemic candidiasis; however, low PCT levels (<0.99 ng/mL) necessarily require the use of other specific markers of candidaemia to confirm the diagnosis, due to great uniformity of PCT levels in systemic candidiasis and SIRS groups.

Plasma iron, C-reactive protein, albumin, and plasma fibrinogen concentrations in dogs with systemic inflammatory response syndrome.

PubMed

Torrente, Carlos; Manzanilla, Edgar G; Bosch, Luis; Fresno, Laura; Rivera Del Alamo, Montserrat; Andaluz, Anna; Saco, Yolanda; Ruiz de Gopegui, Rafael

2015-01-01

To investigate the diagnostic and prognostic value over time of plasma iron compared with the inflammatory markers albumin, C-reactive protein (CRP), and fibrinogen in dogs with systemic inflammatory response syndrome (SIRS). Prospective observational study of sequentially enrolled dogs. ICU of a veterinary teaching hospital. One hundred and sixteen client-owned dogs: 54 dogs with SIRS or sepsis, 42 with focal inflammation, and 20 clinically healthy dogs. Blood samples were obtained on admission in all study groups, and then on alternate days until discharge or death in both inflammation groups. On admission, dogs with SIRS had significantly lower plasma iron (65 ± 5.8 μg/dL, P = 0.001) concentrations than dogs with focal inflammation (89.5 ± 6.2 μg/dL, P = 0.001). Plasma iron, albumin, and CRP effectively discriminated the SIRS/sepsis group from those presenting with focal inflammation with areas under the curve for the receiver operating curves of 0.679, 0.834, and 0.704, respectively. The admission values for these variables did not discriminate survivors from nonsurvivors within the SIRS/sepsis group. However, the magnitude of increase in iron concentration and the decrease in CRP concentration from admission to hospital discharge was higher in survivors than in nonsurvivors within the SIRS/septic group (22.8 vs. 2.51 μg/dL, respectively, P = 0.021 for iron; -67.1 vs. -4.1 mg/L, respectively, P = 0.002 for CRP), resulting in iron and CRP concentrations at hospital discharge for survivors similar to those in the focal inflammation group. Hypoferremia is a sensitive marker of systemic inflammation in dogs. In this study, the increase in iron concentrations during the hospitalization period of SIRS/septic dogs was associated with a better prognosis, suggesting that plasma iron in combination with CRP and albumin concentrations might be used to monitor dogs with inflammatory disease processes. © Veterinary Emergency and Critical Care Society 2015.

Reduced frequency of CD56 dim CD16 pos natural killer cells in pediatric systemic inflammatory response syndrome/sepsis patients.

PubMed

Halstead, E Scott; Carcillo, Joseph A; Schilling, Bastian; Greiner, Robert J; Whiteside, Theresa L

2013-10-01

Sepsis continues to be a leading cause of death in infants and children. Natural killer (NK) cells serve as a bridge between innate and adaptive immunity, yet their role in pediatric sepsis has not been well characterized. We tested the hypothesis that decreased NK cell cytotoxicity is a common feature of pediatric systemic inflammatory response syndrome (SIRS)/sepsis patients by measuring, using flow cytometry, NK cell cytotoxicity and cell surface phenotype in the peripheral blood of 38 pediatric intensive care patients who demonstrated signs and symptoms of SIRS and/or sepsis. NK cell cytotoxicity was significantly reduced in peripheral blood mononuclear cells (PBMCs) of pediatric SIRS/sepsis patients as compared with healthy controls, and the percentage of CD56(dim) CD16(+) cytotoxic NK cells in PBMCs was lower in patients with SIRS/sepsis than in normal donors. However, on a per cell basis, CD56(dim) CD16(+) NK cells in patients mediated cytotoxicity as well as those in normal donors. The NK cell dysfunction in pediatric SIRS/sepsis patients reflects a quantitative rather than a qualitative difference from healthy controls.

Relationship between High Red Cell Distribution Width and Systemic Inflammatory Response Syndrome after Extracorporeal Circulation.

PubMed

Seth, Harsh Sateesh; Mishra, Prashant; Khandekar, Jayant V; Raut, Chaitanya; Mohapatra, Chandan Kumar Ray; Ammannaya, Ganesh Kumar K; Saini, Jaskaran Singh; Shah, Vaibhav

2017-01-01

Cardiac surgical operations involving extracorporeal circulation may develop severe inflammatory response. This severe inflammatory response syndrome (SIRS) is usually associated with poor outcome with no predictive marker. Red cell distribution width (RDW) is a routine hematological marker with a role in inflammation. We aim to determine the relationship between RDW and SIRS through our study. A total of 1250 patients who underwent cardiac surgery with extracorporeal circulation were retrospectively analyzed out of which 26 fell into the SIRS criteria and 26 consecutive control patients were taken. RDW, preoperative clinical data, operative time and postoperative data were compared between SIRS and control groups. The demographic profile of the patients was similar. RDW was significantly higher in the SIRS versus control group (15.5±2.0 vs. 13.03±1.90), respectively with P value <0.0001. There was significant mortality in the SIRS group, 20 (76.92%) as compared to 2 (7.6%) in control group with a P value of <0.005. Multiple logistic regression analysis revealed that there was significant association with high RDW and development of SIRS after extracorporeal circulation (OR for RDW levels exceeding 13.5%; 95% CI 1.0-1.2; P<0.05). Increased RDW was significantly associated with increased risk of SIRS after extracorporeal circulation. Thus, RDW can act as a useful tool to predict SIRS in patients undergoing cardiac surgery with extracorporeal circulation. Hence, more aggressive measures can be taken in patients with high RDW to prevent postoperative morbidity and mortality.

Outbreak statistics and scaling laws for externally driven epidemics.

PubMed

Singh, Sarabjeet; Myers, Christopher R

2014-04-01

Power-law scalings are ubiquitous to physical phenomena undergoing a continuous phase transition. The classic susceptible-infectious-recovered (SIR) model of epidemics is one such example where the scaling behavior near a critical point has been studied extensively. In this system the distribution of outbreak sizes scales as P(n)∼n-3/2 at the critical point as the system size N becomes infinite. The finite-size scaling laws for the outbreak size and duration are also well understood and characterized. In this work, we report scaling laws for a model with SIR structure coupled with a constant force of infection per susceptible, akin to a "reservoir forcing". We find that the statistics of outbreaks in this system fundamentally differ from those in a simple SIR model. Instead of fixed exponents, all scaling laws exhibit tunable exponents parameterized by the dimensionless rate of external forcing. As the external driving rate approaches a critical value, the scale of the average outbreak size converges to that of the maximal size, and above the critical point, the scaling laws bifurcate into two regimes. Whereas a simple SIR process can only exhibit outbreaks of size O(N1/3) and O(N) depending on whether the system is at or above the epidemic threshold, a driven SIR process can exhibit a richer spectrum of outbreak sizes that scale as O(Nξ), where ξ∈(0,1]∖{2/3} and O((N/lnN)2/3) at the multicritical point.

Systemic Grammar in Computation. The Nigel Case.

DTIC Science & Technology

1984-02-01

Had Sir Christopher Wren been going to build a cathedral ever since his youth?. as a way of illustrating and organizing the discussion. 2. THE TEXT...arisen, In a conversation about Sir Christopher Wren . the need arises to know whether there was a plan for him to build a cathedral sometime after the time...of the clause. Sir Christopher Wren is the ACTOR of the clause, built the PROCESS, and this cathedral is the GOAL. (ii) Tense, i.e., the organization

Risk factors for systemic inflammatory response after congenital cardiac surgery.

PubMed

Güvener, Murat; Korun, Oktay; Demirtürk, Orhan Saim

2015-01-01

This study aims to assess the frequency of systemic inflammatory response syndrome (SIRS) following congenital heart surgery and risk factors associated with this clinical syndrome. Charts of all patients undergoing surgery for congenital heart disease in a single institution over a five-year period were analyzed retrospectively. The presence of SIRS was evaluated based on the criteria of the International Pediatric Sepsis Consensus Conference. Of the 246 patients included in the study 22 (8.9%) had clinical parameters indicating SIRS. The patients in the SIRS group had significantly longer cardiopulmonary bypass time (105.14 ± 27.27 vs. 66.86 ± 26.64 min; p < 0.01), aortic cross clamp time (69.36 ± 21.52 vs. 44.30 ± 24.27 min; p < 0.01), higher postoperative alanine aminotransferase (1419.00 ± 3260.99 vs. 81.95 ± 808.61 U/L; p < 0.01) and aspartate aminotransferase (2137.14 ± 4905.40 vs. 171.33 ± 1303.21 U/L; p < 0.01), white blood cell counts (20,827 ± 3603 vs. 12,242 ± 3782/µL; p < 0.01) and lower body surface area (0.52 ± 0.32 vs. 0.71 ± 0.36 m(2) ; p < 0.05) compared to patients in the no-SIRS group. Binary logistic regression revealed cardiopulmonary bypass time (OR: 1.05, p < 0.05), low body weight (<10 kg) (OR: 2.44; p < 0.05), and preoperative diagnosis of right to left shunt congenital heart disease (OR: 8.06; p < 0.01) as independent predictors of SIRS. SIRS was also found to be a strong independent predictor of mortality (OR: 10.13, p < 0.01). SIRS after congenital heart surgery is associated with increased mortality. Independent risk factors for SIRS in the patient population of the study were cardiopulmonary bypass time, body weight below 10 kg and preoperative diagnosis of right to left shunt congenital heart disease. © 2014 Wiley Periodicals, Inc.

The influence of percutaneous nephrolithotomy on human systemic stress response, SIRS and renal function.

PubMed

Shen, Pengfei; Wei, Wuran; Yang, Xiaochun; Zeng, Hao; Li, Xiong; Yang, Jie; Wang, Jia; Huang, Jiaoti

2010-10-01

The objective of this study is to investigate the influences of percutaneous nephrolithotomy (PNL) and open surgery nephrolithotomy on the systemic stress response, SIRS and renal function. Forty patients with kidney calculi were enrolled in the study. Twenty cases were randomized to the PNL group and the other twenty cases to the open surgery group. Levels of C-reactive protein (CRP), interleukin-6(IL-6), β(2)-microglobulin (β(2)-MG), respiration rate, heart rate, body temperature and white blood cell counts were examined. CRP and IL-6 were measured in all patients pre-operatively and on post-operative days 1, 3 and 6, respectively. There was significant difference in their pre- and post-operation levels (P < 0.05), with the peak of CRP and IL-6 observed at post-operative days 3 and 1, respectively. There was significant difference in both CRP and IL-6 between the two groups (P < 0.05). At post-operative day 1, there were 5 cases of SIRS in PNL group and 12 cases in open surgery group; there was significant difference between the two groups (P < 0.05). Serum β(2)-MG levels were measured as the same time as CRP and no significant changes were observed within or between the groups (P > 0.05). Urine β(2)-MG levels were also measured. There was significant difference between pre- and the first day post-PNL (P < 0.05); there was no significant difference between pre- and the third and sixth day post-PNL (P > 0.05). There was significant difference between pre- and first and third day post-open surgery (P < 0.05); but there was no significant difference between pre- and the sixth day post-open surgery (P > 0.05). There was significant difference between two groups at the first, third and sixth days (P < 0.05). The systemic stress response is activated both in PNL group and open surgery group to some extent. The degree of stress response of PNL is lower than that of open surgery, proving the advantages of PNL with reference to serum immunology. There were cases in both the groups with SIRS, but the degree of SIRS in PNL group was lesser than the other group. Both the groups have no obvious effect on glomerular filtration function after operation and have effect on renal tubular reabsorption in the early stage after operation; but the recovery of the PNL group is faster than the open surgery group. It is thus shown that PNL is much safer and more feasible and has lesser effect on renal function.

Serum cytochrome c level as a prognostic indicator in patients with systemic inflammatory response syndrome.

PubMed

Adachi, Naoto; Hirota, Masahiko; Hamaguchi, Masamichi; Okamoto, Kazufumi; Watanabe, Keisuke; Endo, Fumio

2004-04-01

Apoptosis may play an important role in the development of systemic inflammatory response syndrome (SIRS) and progression to multiple organ dysfunction syndrome (MODS). To quantify the extent of apoptosis in these morbidities, we developed a sandwich ELISA system to measure serum cytochrome c (cyt-c) levels and we investigated the prognostic significance of cyt-c concentration in SIRS/MODS patients. Cyt-c concentrations in patients with SIRS (n=53) with or at risk for MODS were measured and compared with those of control subjects (n=14). Cyt-c concentrations in SIRS/MODS patients increased (0.24-210 ng/ml), whereas those in control subjects were under detection limits (0.1 ng/ml). Cyt-c concentrations in non-survivors increased significantly compared with those in survivors both on the day of admission and on the fifth hospital day. A significant positive correlation was found between cyt-c concentration and two representative organ dysfunction scores, APACHE II and multi-organ failure (MOF) score. Cyt-c concentrations increased earlier than MOF score during the exacerbation phase and rapidly decreased during the convalescence phase in a survivor, but the level continued to be high in a non-survivor. Determination of serum cyt-c concentrations may be useful to assess the severity of organ dysfunction and to predict the prognosis of SIRS/MODS patients.

Can mean platelet volume and mean platelet volume/platelet count ratio be used as a diagnostic marker for sepsis and systemic inflammatory response syndrome?

PubMed Central

Ates, Selma; Oksuz, Hafıze; Dogu, Bırsen; Bozkus, Fulsen; Ucmak, Hasan; Yanıt, Fadime

2015-01-01

Objectives: To determine whether the mean platelet volume (MPV) and MPV/platelet (PLT) values can be used in the study of sepsis and systemic inflammatory response syndrome (SIRS). Methods: In this retrospective case-controlled study, 69 sepsis, 69 SIRS patients, and 72 control group who were treated in the years 2012-2013 were reviewed, and both the MPV and MPV/PLT rates were evaluated in all groups at Kahramanmaras Sutcu Imam University Intensive Care Unit, Kahramanmaras, Turkey. Results: Statistically significant difference was found between sepsis, SIRS, and control groups when comparing the MPV and MPV/PLT ratio (p<0.05), and no significant difference was found between sepsis and SIRS groups in terms of MPV and MPV/PLT ratio (p>0.05). Mean platelet volume values for sepsis and control groups was 10.07/8.731 femtoliter (fL) (p=0.000), and 9.45/8.731 fL (p=0.000) for SIRS and control groups. In the group of sepsis patients, the MPV was found to be at cut-off 8.915, sensitivity 71%, and specificity 63.9%. In the group of patients with SIRS, MPV was found to be at cut-off 8.85, sensitivity 69.6%, and specificity 62.5%. For the MPV/PLT values, the specificity and sensitivity were found to be insignificant. Conclusion: This study shows that although there was no significant reduction in the PLT values between the sepsis and SIRS patients, the MPV and MPV/PLT ratio values were found to have significant differences. However, the specificity and sensitivity of the values were not reliable standard to be used as a test. PMID:26446329

Serum decoy receptor 3, a potential new biomarker for sepsis.

PubMed

Hou, Yan-Qiang; Xu, Ping; Zhang, Mei; Han, Deping; Peng, Liang; Liang, Dong-Yu; Yang, Shanmin; Zhang, Zhenhuan; Hong, Jinsheng; Lou, Xiao-Li; Zhang, Lurong; Kim, Sunghee

2012-04-11

Sepsis, a common deadly systemic infection caused by a variety of pathogens, has some clinical symptoms similar to the systemic inflammatory response syndrome (SIRS), a whole-body non-infectious inflammatory reaction to severe insults, such as burn, trauma, hypotensive shock and so on. Treatment of sepsis depends mainly on anti-microbial, while remedy for SIRS might require steroids that could possibly enhance the spread of microbes. Unfortunately, it is very difficult to distinguish these two completely different serious conditions without blood culture, which takes days to grow and identify causative pathogens. We examined a biomarker, serum decoy receptor 3 (DcR3), was evaluated for its utility in the differential diagnosis between sepsis and SIRS. Serum DcR3 level in 118 healthy controls, 24 sepsis patients and 43 SIRS patients, was quantitatively measured by enzyme-linked immunosorbent assay (ELISA). The serum DcR3 was significantly increased in sepsis patients compared with SIRS patients and healthy controls (6.11±2.58 ng/ml vs 2.62±1.46 ng/ml, and 0.91±0.56 ng/ml, respectively, p<0.001). The areas under the receiver operating characteristic curve of DcR3 for the normal vs. SIRS, normal vs. sepsis and SIRS vs. sepsis were 0.910 (0.870-0.950), 0.992 (0.984-1.000) and 0.896 (0.820-0.973), respectively. In addition, the DcR3 exhibited a positive correlation coefficient with APACHE II score, a most commonly used index for the severity of sepsis (r=0.556, p=0.005). The serum DcR3 has a potential to serve as a new biomarker for sepsis with its high specificity and sensitivity. Copyright © 2012 Elsevier B.V. All rights reserved.

Plasma Neutrophil Gelatinase-Associated Lipocalin diagnosed acute kidney injury in patients with systemic inflammatory disease and sepsis.

PubMed

Md Ralib, Azrina; Mat Nor, Mohd Basri; Pickering, John W

2017-05-01

Sepsis is the leading cause of intensive care unit (ICU) admission. Plasma Neutrophil Gelatinase Associated-Lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI) detection; however, it is also increased with inflammation and few studies have been conducted in non-Caucasian populations and/or in developing economies. Therefore, we evaluated plasma NGAL's diagnostic performance in the presence of sepsis and systemic inflammatory response syndrome (SIRS) in a Malaysian ICU cohort. This is a prospective observational study on patients with SIRS. Plasma creatinine (pCr) and NGAL were measured on ICU admission. Patients were classified according to the occurrence of AKI and sepsis. Of 225 patients recruited, 129 (57%) had sepsis of whom 67 (52%) also had AKI. 96 patients (43%) had non-infectious SIRS, of whom 20 (21%) also had AKI. NGAL concentrations were higher in AKI patients within both the sepsis and non-infectious SIRS cohorts (both P < 0.0001). The diagnostic area under curve for AKI was 0.81 (95%CI: 0.74 to 0.87). The optimal cut-off was higher in sepsis compared to non-infectious SIRS patients (454 versus 176 ng/mL). Addition of NGAL to a clinical model comprising age, pCr, medical admission category and SAPS II score increased the mean risk of those with AKI by 4% and reduced the mean risk of those without AKI by 3%. Acute kidney injury is more common with sepsis than non-infectious SIRS. Plasma NGAL was diagnostic of AKI in both subgroups. The optimal cut-off for diagnosing AKI was higher in sepsis than in non-infectious SIRS. Addition of plasma NGAL improved the clinical model used to diagnose AKI. © 2016 Asian Pacific Society of Nephrology.

Procalcitonin and C-reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome.

PubMed

Simon, Liliana; Saint-Louis, Patrick; Amre, Devendra K; Lacroix, Jacques; Gauvin, France

2008-07-01

To compare the accuracy of procalcitonin and C-reactive protein as diagnostic markers of bacterial infection in critically ill children at the onset of systemic inflammatory response syndrome (SIRS). Prospective cohort study. Tertiary care, university-affiliated pediatric intensive care unit (PICU). Consecutive patients with SIRS. From June to December 2002, all PICU patients were screened daily to include cases of SIRS. At inclusion (onset of SIRS), procalcitonin and C-reactive protein levels as well as an array of cultures were obtained. Diagnosis of bacterial infection was made a posteriori by an adjudicating process (consensus of experts unaware of the results of procalcitonin and C-reactive protein). Baseline and daily data on severity of illness, organ dysfunction, and outcome were collected. Sixty-four patients were included in the study and were a posteriori divided into the following groups: bacterial SIRS (n = 25) and nonbacterial SIRS (n = 39). Procalcitonin levels were significantly higher in patients with bacterial infection compared with patients without bacterial infection (p = .01). The area under the receiver operating characteristic curve for procalcitonin was greater than that for C-reactive protein (0.71 vs. 0.65, respectively). A positive procalcitonin level (>or=2.5 ng/mL), when added to bedside clinical judgment, increased the likelihood of bacterial infection from 39% to 92%, while a negative C-reactive protein level (<40 mg/L) decreased the probability of bacterial infection from 39% to 2%. Procalcitonin is better than C-reactive protein for differentiating bacterial from nonbacterial SIRS in critically ill children, although the accuracy of both tests is moderate. Diagnostic accuracy could be enhanced by combining these tests with bedside clinical judgment.

Quantifying uncertainty in stable isotope mixing models

DOE PAGES

Davis, Paul; Syme, James; Heikoop, Jeffrey; ...

2015-05-19

Mixing models are powerful tools for identifying biogeochemical sources and determining mixing fractions in a sample. However, identification of actual source contributors is often not simple, and source compositions typically vary or even overlap, significantly increasing model uncertainty in calculated mixing fractions. This study compares three probabilistic methods, SIAR [ Parnell et al., 2010] a pure Monte Carlo technique (PMC), and Stable Isotope Reference Source (SIRS) mixing model, a new technique that estimates mixing in systems with more than three sources and/or uncertain source compositions. In this paper, we use nitrate stable isotope examples (δ 15N and δ 18O) butmore » all methods tested are applicable to other tracers. In Phase I of a three-phase blind test, we compared methods for a set of six-source nitrate problems. PMC was unable to find solutions for two of the target water samples. The Bayesian method, SIAR, experienced anchoring problems, and SIRS calculated mixing fractions that most closely approximated the known mixing fractions. For that reason, SIRS was the only approach used in the next phase of testing. In Phase II, the problem was broadened where any subset of the six sources could be a possible solution to the mixing problem. Results showed a high rate of Type I errors where solutions included sources that were not contributing to the sample. In Phase III some sources were eliminated based on assumed site knowledge and assumed nitrate concentrations, substantially reduced mixing fraction uncertainties and lowered the Type I error rate. These results demonstrate that valuable insights into stable isotope mixing problems result from probabilistic mixing model approaches like SIRS. The results also emphasize the importance of identifying a minimal set of potential sources and quantifying uncertainties in source isotopic composition as well as demonstrating the value of additional information in reducing the uncertainty in calculated mixing fractions.« less

An online spatio-temporal prediction model for dengue fever epidemic in Kaohsiung,Taiwan

NASA Astrophysics Data System (ADS)

Cheng, Ming-Hung; Yu, Hwa-Lung; Angulo, Jose; Christakos, George

2013-04-01

Dengue Fever (DF) is one of the most serious vector-borne infectious diseases in tropical and subtropical areas. DF epidemics occur in Taiwan annually especially during summer and fall seasons. Kaohsiung city has been one of the major DF hotspots in decades. The emergence and re-emergence of the DF epidemic is complex and can be influenced by various factors including space-time dynamics of human and vector populations and virus serotypes as well as the associated uncertainties. This study integrates a stochastic space-time "Susceptible-Infected-Recovered" model under Bayesian maximum entropy framework (BME-SIR) to perform real-time prediction of disease diffusion across space-time. The proposed model is applied for spatiotemporal prediction of the DF epidemic at Kaohsiung city during 2002 when the historical series of high DF cases was recorded. The online prediction by BME-SIR model updates the parameters of SIR model and infected cases across districts over time. Results show that the proposed model is rigorous to initial guess of unknown model parameters, i.e. transmission and recovery rates, which can depend upon the virus serotypes and various human interventions. This study shows that spatial diffusion can be well characterized by BME-SIR model, especially at the district surrounding the disease outbreak locations. The prediction performance at DF hotspots, i.e. Cianjhen and Sanmin, can be degraded due to the implementation of various disease control strategies during the epidemics. The proposed online disease prediction BME-SIR model can provide the governmental agency with a valuable reference to timely identify, control, and efficiently prevent DF spread across space-time.

Risk of mortality, cancer incidence, and stroke in a population potentially exposed to cadmium.

PubMed

Elliott, P; Arnold, R; Cockings, S; Eaton, N; Järup, L; Jones, J; Quinn, M; Rosato, M; Thornton, I; Toledano, M; Tristan, E; Wakefield, J

2000-02-01

To follow up mortality and cancer incidence in a cohort potentially exposed to cadmium and to perform a geographical (ecological) analysis to further assess the health effects of potential exposure to cadmium. The English village of Shipham has very high concentrations of cadmium in the soil. A previous cohort study of residents of Shipham in 1939 showed overall mortality below that expected, but a 40% excess of mortality from stroke. This study extends the follow up of the cohort for mortality to 1997, and includes an analysis of cancer incidence from 1971 to 1992, and a geographical study of mortality and cancer incidence. Standardised mortality and incidence ratios (SMRs and SIRs) were estimated with regional reference rates. Comparisons were made with the nearby village of Hutton. All cause cohort mortality was lower than expected in both villages, although there was excess cancer incidence in both Shipham (SIR 167, 95% confidence interval (95% CI) 106 to 250) and Hutton (SIR 167, 95% CI 105 to 253). There was an excess of mortality from hypertension, cerebrovascular disease, and nephritis and nephrosis, of borderline significance, in Shipham (SMR 128, 95% CI 99 to 162). In the geographical study, all cause mortality in Shipham was also lower than expected (SMR 84, 95% CI 71 to 100). There was an excess in genitourinary cancers in both Shipham (SIR 160, 95% CI 107 to 239) and Hutton (SIR 153, 95% CI 122 to 192). No clear evidence of health effects from possible exposure to cadmium in Shipham was found despite the extremely high concentrations of cadmium in the soil.

Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Franzin, Alberto; Snider, Silvia; Picozzi, Piero

2009-07-01

Purpose: To assess the utility of the Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and Score Index for Radiosurgery (SIR) stratification systems in predicting survival in patients with brain metastasis treated with Gamma Knife radiosurgery (GKRS). Methods and Materials: A total of 185 patients were included in the study. Patients were stratified according to RPA and SIR classes. The RPA and SIR classes, age, Karnofsky Performance Status (KPS), and systemic disease were correlated with survival. Results: Five patients were lost to follow-up. Median survival in patients in RPA Class 1 (30 patients) was 17 months; in Class 2 (140more » patients), 10 months; and in Class 3 (10 patients), 3 months. Median survival in patients in SIR Class 1 (30 patients) was 3 months; in Class 2 (135 patients), 8 months; and in Class 3 (15 patients), 20 months. In univariate testing, age younger than 65 years (p = 0.0004), KPS higher than 70 (p = 0.0001), RPA class (p = 0.0078), SIR class (p = 0.0002), and control of the primary tumor (p = 0.02) were significantly associated with improved outcome. In multivariate analysis, KPS (p < 0.0001), SIR class (p = 0.0008), and RPA class (p = 0.03) had statistical value. Conclusions: This study supports the use of GKRS as a single-treatment modality in this selected group of patients. Stratification systems are useful in the estimation of patient eligibility for GKRS. A second-line treatment was necessary in 30% of patients to achieve distal or local brain control. This strategy is useful to control brain metastasis in long-surviving patients.« less

Deriving Two-Dimensional Ocean Wave Spectra and Surface Height Maps from the Shuttle Imaging Radar (SIR-B)

NASA Technical Reports Server (NTRS)

Tilley, D. G.

1986-01-01

Directional ocean wave spectra were derived from Shuttle Imaging Radar (SIR-B) imagery in regions where nearly simultaneous aircraft-based measurements of the wave spectra were also available as part of the NASA Shuttle Mission 41G experiments. The SIR-B response to a coherently speckled scene is used to estimate the stationary system transfer function in the 15 even terms of an eighth-order two-dimensional polynomial. Surface elevation contours are assigned to SIR-B ocean scenes Fourier filtered using a empirical model of the modulation transfer function calibrated with independent measurements of wave height. The empirical measurements of the wave height distribution are illustrated for a variety of sea states.

Science Results from the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR): Progress Report

NASA Technical Reports Server (NTRS)

Evans, Diane L. (Editor); Plaut, Jeffrey (Editor)

1996-01-01

The Spaceborne Imaging Radar-C/X-band Synthetic Aperture Radar (SIR-C/X-SAR) is the most advanced imaging radar system to fly in Earth orbit. Carried in the cargo bay of the Space Shuttle Endeavour in April and October of 1994, SIR-C/X-SAR simultaneously recorded SAR data at three wavelengths (L-, C-, and X-bands; 23.5, 5.8, and 3.1 cm, respectively). The SIR-C/X-SAR Science Team consists of 53 investigator teams from more than a dozen countries. Science investigations were undertaken in the fields of ecology, hydrology, ecology, and oceanography. This report contains 44 investigator team reports and several additional reports from coinvestigators and other researchers.

SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors.

PubMed

Gregoric, Pavle; Pavle, Gregoric; Sijacki, Ana; Ana, Sijacki; Stankovic, Sanja; Sanja, Stankovic; Radenkovic, Dejan; Dejan, Radenkovic; Ivancevic, Nenad; Nenad, Ivancevic; Karamarkovic, Aleksandar; Aleksandar, Karamarkovic; Popovic, Nada; Nada, Popovic; Karadzic, Borivoje; Borivoje, Karadzic; Stijak, Lazar; Stefanovic, Branislav; Branislav, Stefanovic; Milosevic, Zoran; Zoran, Milosević; Bajec, Djordje; Djordje, Bajec

2010-01-01

Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP). We evaluated 234 patients with first onset of SAP appears in last twenty four hours. A total of 77 (33%) patients died. SIRS score and serum IL-6 concentration were measured in first hour after admission. In 105 patients with SIRS score 3 and higher, initial measured IL-6 levels were significantly higher than in the group of remaining 129 patients (72 +/- 67 pg/mL, vs 18 +/- 15 pg/mL). All nonsurvivals were in the first group, with SIRS score 3 and 4 and initial IL-6 concentration 113 +/- 27 pg/mL. The values of C-reactive Protein (CRP) measured after 48h, Acute Physiology and Chronic Health Evaluation (APACHE II) score on admission and Ranson score showed the similar correlation, but serum amylase level did not correlate significantly with Ranson score, IL-6 concentration and APACHE II score. The combination of SIRS score on admission and IL-6 serum concentration can be early, predictor of illness severity and outcome in SAP.

Design of Microstrip Bandpass Filters Using SIRs with Even-Mode Harmonics Suppression for Cellular Systems

NASA Astrophysics Data System (ADS)

Theerawisitpong, Somboon; Suzuki, Toshitatsu; Morita, Noboru; Utsumi, Yozo

The design of microstrip bandpass filters using stepped-impedance resonators (SIRs) is examined. The passband center frequency for the WCDMA-FDD (uplink band) Japanese cellular system is 1950MHz with a 60-MHz bandwidth. The SIR physical characteristic can be designed using a SIR characteristic chart based on second harmonic suppression. In our filter design, passband design charts were obtained through the design procedure. Tchebycheff and maximally flat bandpass filters of any bandwidth and any number of steps can be designed using these passband design charts. In addition, sharp skirt characteristics in the passband can be realized by having two transmission zeros at both adjacent frequency bands by using open-ended quarter-wavelength stubs at input and output ports. A new even-mode harmonics suppression technique is proposed to enable a wide rejection band having a high suppression level. The unloaded quality factor of the resonator used in the proposed filters is greater than 240.

Risk of thyroid cancer in first-degree relatives of patients with non-medullary thyroid cancer by histology type and age at diagnosis: a joint study from five Nordic countries.

PubMed

Fallah, Mahdi; Pukkala, Eero; Tryggvadottir, Laufey; Olsen, Jörgen H; Tretli, Steinar; Sundquist, Kristina; Hemminki, Kari

2013-06-01

We aimed to estimate lifetime cumulative risk of thyroid cancer (CRTC) in first-degree relatives of patients with non-medullary thyroid cancers (NMTC), including papillary (PTC)/follicular/oxyphilic/anaplastic thyroid carcinoma, by histology and age at diagnosis in patients and their relatives. A population-based cohort of 63 495 first-degree relatives of 11 206 NMTC patients diagnosed in 1955-2009 in Nordic countries was followed for cancer incidence. Standardised incidence ratios (SIRs) were calculated using histology-specific, age-specific, sex-specific, period-specific and country-specific incidence rates as reference. The 0-84-year CRTC in female relatives of a patient with PTC was 2%, representing a threefold increase over the general population risk (SIR=2.9, 95% CI 2.4 to 3.4; Men: CRTC=1%, SIR=2.5, 95% CI 1.9 to 3.3). When there were ≥2 PTC patients diagnosed at age <60 years in a family, CRTC for female relatives was 10% (male 24%). Twins had a 23-fold increased risk of concordant PTC. Family history of follicular/oxyphilic/anaplastic carcinoma increased CRTC in relatives to about 1-2%. Although no familial case of concordant oxyphilic/anaplastic carcinoma was found, familial risks of discordant histology types of NMTC were interchangeably high for most of the types, for example, higher risk of PTC when a first-degree relative had follicular (SIR=3.0, 95%CI 1.7 to 4.9) or anaplastic (SIR=3.6, 95% CI 1.2 to 8.4) carcinoma. The earlier a patient was diagnosed with PTC in a family, the higher was the SIR in his/her younger relatives. There was a tendency towards concordant age at diagnosis of thyroid cancer among relatives of PTC patients. This study provides clinically relevant risk estimates for family members of NMTC patients.

View of the RMS end effector touching the SIR-B antenna during STS 41-G

NASA Image and Video Library

1984-10-05

41G-03-008 (5-13 Oct. 1984) --- The end effector of the space shuttle Challenger's remote manipulator system (RMS) taps against the shuttle imaging radar's (SIR-B) antenna to secure it during NASA's 41-G mission. Photo credit: NASA

The Spaceborne Imaging Radar program: SIR-C - The next step toward EOS

NASA Technical Reports Server (NTRS)

Evans, Diane; Elachi, Charles; Cimino, Jobea

1987-01-01

The NASA Shuttle Imaging Radar SIR-C experiments will investigate earth surface and environment phenomena to deepen understanding of terra firma, biosphere, hydrosphere, cryosphere, and atmosphere components of the earth system, capitalizing on the observational capabilities of orbiting multiparameter radar sensors alone or in combination with other sensors. The SIR-C sensor encompasses an antenna array, an exciter, receivers, a data-handling network, and the ground SAR processor. It will be possible to steer the antenna beam electronically, so that the radar look angle can be varied.

Comparison of an Agent-based Model of Disease Propagation with the Generalised SIR Epidemic Model

DTIC Science & Technology

2009-08-01

has become a practical method for conducting Epidemiological Modelling. In the agent- based approach the whole township can be modelled as a system of...SIR system was initially developed based on a very simplified model of social interaction. For instance an assumption of uniform population mixing was...simulating the progress of a disease within a host and of transmission between hosts is based upon Transportation Analysis and Simulation System

Cancer Incidence among Minnesota Taconite Mining Industry Workers

PubMed Central

Allen, Elizabeth M; Alexander, Bruce H; MacLehose, Richard F; Nelson, Heather H; Ramachandran, Gurumurthy; Mandel, Jeffrey H

2015-01-01

Purpose To evaluate cancer incidence among Minnesota Taconite mining workers. Methods We evaluated cancer incidence between 1988 and 2010 in a cohort of 40,720 Minnesota taconite mining workers employed between 1937 and 1983. Standardized incidence ratios (SIRs) with 95% confidence intervals (CI) were estimated by comparing numbers of incident cancers with frequencies in the Minnesota Cancer Surveillance System. SIRs for lung cancer by histological subtypes were also estimated. We adjusted for out-of-state migration and conducted a probabilistic bias analysis for smoking related cancers. Results A total of 5,700 cancers were identified including 51 mesotheliomas and 973 lung cancers. The SIR for lung cancer and mesothelioma were 1.3 (95% CI: 1.2-1.4) and 2.4 (95% CI: 1.8-3.2) respectively. Stomach, laryngeal, and bladder cancers were also elevated. However, adjusting for potential confounding by smoking attenuated the estimates for lung (SIR=1.1, 95% CI: 1.0-1.3), laryngeal (SIR=1.2, 95% CI: 0.8-1.6), oral (SIR=0.9, 95% CI: 0.7-1.2), and bladder cancers (SIR=1.0, 95% CI: 0.8-1.1). Conclusions Taconite workers may have an increased risk for certain cancers. Lifestyle and work-related factors may play a role in elevated morbidity. The extent to which mining-related exposures contribute to disease burden is being investigated. PMID:26381550

Prognostic significance of brain natriuretic peptide obtained in the ED in patients with SIRS or sepsis.

PubMed

Chen, Yunxia; Li, Chunsheng

2009-07-01

The study was conducted to know the significance of brain natriuretic peptide (BNP) for prognosis of septic patients. The subjects were 1000 patients selected in emergency department of Beijing Chaoyang Hospital of the Capital Medical University (Beijing, China) and were classified into 3 groups as follows: systemic inflammatory response syndrome (SIRS), non-SIRS, and sepsis groups. Plasma serum brain natriuretic peptide (BNP) levels and the positive detection rates of BNP were examined. The BNP level of 100 pg/mL or more was regarded as positive, and then the positive detection rates of BNP of these groups were compared. The prognostic values of BNP and APACHE (Acute physiology and chronic health evaluation) II score for the 28-day mortality were investigated, and their cutoff values for death were determined. There were significant differences in the positive detection rates of BNP between any 2 groups and in 28-day mortality between the patients with SIRS and non-SIRS groups. The BNP level had positive correlation to APACHE II score in 3 groups. Brain natriuretic peptide level of more than 113 pg/mL was independent predictor of death in septic patients. The positive rates of BNP in SIRS and septic patients were significantly higher than that of non-SIRS patients, and this is an index for unfavorable prognosis in septic patients.

Anterior Borderzone Angle for Hemodynamic Collateral Metric in Patients with Symptomatic Middle Cerebral Artery Stenosis.

PubMed

Li, Yongkun; Xiong, Yunyun; Cai, Qiankun; Liu, Dezhi; Dai, Qiliang; Liu, Wenhua; Huang, Zhixin; Sun, Wen; Liebeskind, David S; Wang, Yinzhou; Liu, Xinfeng

2018-01-01

We aimed to introduce a parameter of anterior borderzone angle (ABZA) to quantitatively evaluate the ACA-MCA leptomeningeal collaterals for middle cerebral artery stenosis (MCAS). Two hundred seventy-five patients with 50-100% MCAS and 100 controls were included. The 95% reference range of ABZA was obtained from the controls. ABZAtrans was defined as "ABZA/the 95% upper limit." Relationships between ABZA and MCAS, -ABZAtrans and the TICI grade, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grade were analyzed. An ABZA grade model for the ACA leptomeningeal collaterals was tentatively developed. The 95% reference range of ABZA was 0.0º-23.0º. ABZA was significantly associated with MCAS by a function of the fourth power (R2 = 0.723, p < 0.001), and could predict hemodynamic MCAS (≥70%) with an AUC of 0.928 (95% CI 0.903-0.953). ABZAtrans was negatively correlated with the TICI grade (rho = -0.752, p < 0.001) and positively with the ASITN/SIR grade (rho = 0.921, p < 0.001). The ABZA grade was created by rounding -ABZAtrans to a nearest integer, and was closely associated with the ASITN/SIR grade (rho = 0.894, p < 0.001). ABZA can be used as a hemodynamic parameter to quantitatively evaluate ACA leptomeningeal collaterals. © 2017 S. Karger AG, Basel.

Temporal trends in the systemic inflammatory response syndrome, sepsis, and medical coding of sepsis.

PubMed

Thomas, Benjamin S; Jafarzadeh, S Reza; Warren, David K; McCormick, Sandra; Fraser, Victoria J; Marschall, Jonas

2015-11-24

Recent reports using administrative claims data suggest the incidence of community- and hospital-onset sepsis is increasing. Whether this reflects changing epidemiology, more effective diagnostic methods, or changes in physician documentation and medical coding practices is unclear. We performed a temporal-trend study from 2008 to 2012 using administrative claims data and patient-level clinical data of adult patients admitted to Barnes-Jewish Hospital in St. Louis, Missouri. Temporal-trend and annual percent change were estimated using regression models with autoregressive integrated moving average errors. We analyzed 62,261 inpatient admissions during the 5-year study period. 'Any SIRS' (i.e., SIRS on a single calendar day during the hospitalization) and 'multi-day SIRS' (i.e., SIRS on 3 or more calendar days), which both use patient-level data, and medical coding for sepsis (i.e., ICD-9-CM discharge diagnosis codes 995.91, 995.92, or 785.52) were present in 35.3 %, 17.3 %, and 3.3 % of admissions, respectively. The incidence of admissions coded for sepsis increased 9.7 % (95 % CI: 6.1, 13.4) per year, while the patient data-defined events of 'any SIRS' decreased by 1.8 % (95 % CI: -3.2, -0.5) and 'multi-day SIRS' did not change significantly over the study period. Clinically-defined sepsis (defined as SIRS plus bacteremia) and severe sepsis (defined as SIRS plus hypotension and bacteremia) decreased at statistically significant rates of 5.7 % (95 % CI: -9.0, -2.4) and 8.6 % (95 % CI: -4.4, -12.6) annually. All-cause mortality, SIRS mortality, and SIRS and clinically-defined sepsis case fatality did not change significantly during the study period. Sepsis mortality, based on ICD-9-CM codes, however, increased by 8.8 % (95 % CI: 1.9, 16.2) annually. The incidence of sepsis, defined by ICD-9-CM codes, and sepsis mortality increased steadily without a concomitant increase in SIRS or clinically-defined sepsis. Our results highlight the need to develop strategies to integrate clinical patient-level data with administrative data to draw more accurate conclusions about the epidemiology of sepsis.

Budding Yeast Silencing Complexes and Regulation of Sir2 Activity by Protein-Protein Interactions

PubMed Central

Tanny, Jason C.; Kirkpatrick, Donald S.; Gerber, Scott A.; Gygi, Steven P.; Moazed, Danesh

2004-01-01

Gene silencing in the budding yeast Saccharomyces cerevisiae requires the enzymatic activity of the Sir2 protein, a highly conserved NAD-dependent deacetylase. In order to study the activity of native Sir2, we purified and characterized two budding yeast Sir2 complexes: the Sir2/Sir4 complex, which mediates silencing at mating-type loci and at telomeres, and the RENT complex, which mediates silencing at the ribosomal DNA repeats. Analyses of the protein compositions of these complexes confirmed previously described interactions. We show that the assembly of Sir2 into native silencing complexes does not alter its selectivity for acetylated substrates, nor does it allow the deacetylation of nucleosomal histones. The inability of Sir2 complexes to deacetylate nucleosomes suggests that additional factors influence Sir2 activity in vivo. In contrast, Sir2 complexes show significant enhancement in their affinities for acetylated substrates and their sensitivities to the physiological inhibitor nicotinamide relative to recombinant Sir2. Reconstitution experiments showed that, for the Sir2/Sir4 complex, these differences stem from the physical interaction of Sir2 with Sir4. Finally, we provide evidence that the different nicotinamide sensitivities of Sir2/Sir4 and RENT in vitro could contribute to locus-specific differences in how Sir2 activity is regulated in vivo. PMID:15282295

Epigenetics in Saccharomyces cerevisiae

PubMed Central

Grunstein, Michael; Gasser, Susan M.

2013-01-01

Saccharomyces cerevisiae provides a well-studied model system for heritable silent chromatin, in which a nonhistone protein complex—the SIR complex—represses genes by spreading in a sequence-independent manner, much like heterochromatin in higher eukaryotes. The ability to study mutations in histones and to screen genome-wide for mutations that impair silencing has yielded an unparalleled depth of detail about this system. Recent advances in the biochemistry and structural biology of the SIR-chromatin complex bring us much closer to a molecular understanding of how Sir3 selectively recognizes the deacetylated histone H4 tail and demethylated histone H3 core. The existence of appropriate mutants has also shown how components of the silencing machinery affect physiological processes beyond transcriptional repression. PMID:23818500

Distribution of a limited Sir2 protein pool regulates the strength of yeast rDNA silencing and is modulated by Sir4p.

PubMed Central

Smith, J S; Brachmann, C B; Pillus, L; Boeke, J D

1998-01-01

Transcriptional silencing in Saccharomyces cerevisiae occurs at the silent mating-type loci HML and HMR, at telomeres, and at the ribosomal DNA (rDNA) locus RDN1. Silencing in the rDNA occurs by a novel mechanism that depends on a single Silent Information Regulator (SIR) gene, SIR2. SIR4, essential for other silenced loci, paradoxically inhibits rDNA silencing. In this study, we elucidate a regulatory mechanism for rDNA silencing based on the finding that rDNA silencing strength directly correlates with cellular Sir2 protein levels. The endogenous level of Sir2p was shown to be limiting for rDNA silencing. Furthermore, small changes in Sir2p levels altered rDNA silencing strength. In rDNA silencing phenotypes, sir2 mutations were shown to be epistatic to sir4 mutations, indicating that SIR4 inhibition of rDNA silencing is mediated through SIR2. Furthermore, rDNA silencing is insensitive to SIR3 overexpression, but is severely reduced by overexpression of full-length Sir4p or a fragment of Sir4p that interacts with Sir2p. This negative effect of SIR4 overexpression was overridden by co-overexpression of SIR2, suggesting that SIR4 directly inhibits the rDNA silencing function of SIR2. Finally, genetic manipulations of SIR4 previously shown to promote extended life span also resulted in enhanced rDNA silencing. We propose a simple model in which telomeres act as regulators of rDNA silencing by competing for limiting amounts of Sir2 protein. PMID:9649515

Study on the threshold of a stochastic SIR epidemic model and its extensions

NASA Astrophysics Data System (ADS)

Zhao, Dianli

2016-09-01

This paper provides a simple but effective method for estimating the threshold of a class of the stochastic epidemic models by use of the nonnegative semimartingale convergence theorem. Firstly, the threshold R0SIR is obtained for the stochastic SIR model with a saturated incidence rate, whose value is below 1 or above 1 will completely determine the disease to go extinct or prevail for any size of the white noise. Besides, when R0SIR > 1 , the system is proved to be convergent in time mean. Then, the threshold of the stochastic SIVS models with or without saturated incidence rate are also established by the same method. Comparing with the previously-known literatures, the related results are improved, and the method is simpler than before.

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee.

PubMed

Khalilzadeh, Omid; Baerlocher, Mark O; Shyn, Paul B; Connolly, Bairbre L; Devane, A Michael; Morris, Christopher S; Cohen, Alan M; Midia, Mehran; Thornton, Raymond H; Gross, Kathleen; Caplin, Drew M; Aeron, Gunjan; Misra, Sanjay; Patel, Nilesh H; Walker, T Gregory; Martinez-Salazar, Gloria; Silberzweig, James E; Nikolic, Boris

2017-10-01

To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR classifications. SIR members were invited via online survey links, and 68 members participated among 140 surveyed. Answers on new and existing classifications were evaluated and compared statistically. Overall comparison between the two surveys was performed by generalized linear modeling. The proposed AE classification received superior evaluations in terms of consistency of reporting (P < .05) and potential for incorporation into existing quality-assurance framework (P < .05). Respondents gave a higher overall rating to the educational and research value of the new compared with the existing classification (P < .05). This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Soluble tumor necrosis factor receptor p55 predicts cytokinemia and systemic inflammatory response after cardiopulmonary bypass.

PubMed

el-Barbary, Mahmoud; Khabar, Khalid S A

2002-08-01

To examine the behavior of soluble tumor necrosis factor (TNF) receptors in circulation before and after cardiopulmonary bypass and the relationship to the development of cytokinemia and acute complications comprising systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). The predictive value of soluble TNF receptor is assessed herein. Prospective study comparing prebypass and postbypass levels in patients with and without complications indicative of SIRS and MODS. Cardiac surgical intensive care unit in a tertiary care hospital. A total of 20 pediatric patients who underwent cardiopulmonary bypass during open heart surgery. Blood samples were collected from catheters before and 2 hrs and 24 hrs after the onset of bypass. We measured plasma levels of soluble TNF receptors by using enzyme-linked immunosorbent assay in 20 patients before and after cardiopulmonary bypass. Clinical data, including duration of bypass and tests or signs indicative of SIRS/MODS, were collected. Soluble TNF receptor I (p55 sR), significantly increased (2241 +/- 312 pg/mL) at 2 hrs after bypass (p <.0005) and remained elevated (2826 +/- 695 pg/mL) at 1 day after bypass (p <.005) when compared with prebypass levels (725 +/- 130 pg/mL). Patients with the acute complications of SIRS/MODS had a higher ratio of postbypass to prebypass p55 sR levels (5.0-fold, p <.001) when compared with patients with no SIRS/MODS (1.75-fold). Remarkably, before surgery, levels of TNF p55 sR predict both cytokinemia (r =.67 to.73, p <.05) and SIRS/MODS (p <.01). The prebypass levels of TNF p55 sR were consistently higher (range, 1000-1400 pg/mL) in patients who subsequently developed SIRS/MODS than the levels (range, 400-570 pg/mL) in patients who did not develop SIRS/MODS. Hypotension, respiratory dysfunctions, and coagulopathy were particularly more prevailing (p <.005) among the complications that were associated with high prebypass levels of TNF p55 sR. Soluble TNF receptor p55 can be employed as a predictive marker for cytokinemia and the development of SIRS/MODS that may arise from a major insult to the body such as cardiopulmonary bypass.

A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality: A Systematic Review and Meta-Analysis.

PubMed

Serafim, Rodrigo; Gomes, José Andrade; Salluh, Jorge; Póvoa, Pedro

2018-03-01

Several studies were published to validate the quick Sepsis-related Organ Failure Assessment (qSOFA), namely in comparison with the systemic inflammatory response syndrome (SIRS) criteria. We performed a systematic review and meta-analysis with the aim of comparing the qSOFA and SIRS in patients outside the ICU. We searched MEDLINE, CINAHL, and the Web of Science database from February 23, 2016 until June 30, 2017 to identify full-text English-language studies published after the Sepsis-3 publication comparing the qSOFA and SIRS and their sensitivity or specificity in diagnosing sepsis, as well as hospital and ICU length of stay and hospital mortality. Data extraction from the selected studies followed the recommendations of the Meta-analyses of Observational Studies in Epidemiology group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. From 4,022 citations, 10 studies met the inclusion criteria. Pooling all the studies, a total of 229,480 patients were evaluated. The meta-analysis of sensitivity for the diagnosis of sepsis comparing the qSOFA and SIRS was in favor of SIRS (risk ratio [RR], 1.32; 95% CI, 0.40-2.24; P < .0001; I 2  = 100%). One study described the specificity for the diagnosis of infection comparing SIRS (84.4%; 95% CI, 76.2-90.6) with the qSOFA (97.3%; 95% CI < 92.1-99.4); the qSOFA demonstrated better specificity. The meta-analysis of the area under the receiver operating characteristic curve of six studies comparing the qSOFA and SIRS favored the qSOFA (RR, 0.03; 95% CI, 0.01-0.05; P = .002; I 2  = 48%) as a predictor of inhospital mortality. The SIRS was significantly superior to the qSOFA for sepsis diagnosis, and the qSOFA was slightly better than the SIRS in predicting hospital mortality. The association of both criteria could provide a better model to initiate or escalate therapy in patients with sepsis. PROSPERO CRD42017067645. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Risk of bile duct cancer among printing workers exposed to 1,2-dichloropropane and/or dichloromethane.

PubMed

Sobue, Tomotaka; Utada, Mai; Makiuchi, Takeshi; Ohno, Yuko; Uehara, Shinichiro; Hayashi, Tomoshige; Sato, Kyoko Kogawa; Endo, Ginji

2015-01-01

We conducted a retrospective cohort study to examine the risk of bile duct cancer among current and former workers in the offset color proof printing department at a printing company in Osaka, Japan. Standardized incidence ratios (SIRs) between January 1, 1985, and December 31, 2012, were estimated for the cumulative years of exposure to two chemicals, dichloromethane (DCM) and 1,2-dichloropropane (1,2-DCP), using the national incidence level as a reference. In addition, we examined risk patterns by the calendar year in which observation started. Among 106 workers with a total of 1,452.4 person-years of exposure, 17 bile duct cancer cases were observed, resulting in an estimated overall SIR of 1,132.5 (95% confidence interval (CI): 659.7-1,813.2). The SIR was 1,319.9 (95% CI: 658.9-2,361.7) for those who were exposed to both DCM and 1,2-DCP, and it was 1,002.8 (95% CI: 368.0-2,182.8) for those exposed to 1,2-DCP only. SIRs tended to increase according to years of exposure to 1,2-DCP but not DCM when a 5-year lag time was assumed. The SIRs were higher for the cohorts in which observation started in 1993-2000, particularly in cohorts in which it started in 1996-1999, compared with those in which it started before or after 1993-2000. We observed an extraordinarily high risk of bile duct cancer among the offset color proof printing workers. Elevated risk may be related to cumulative exposure to 1,2-DCP, but there remains some possibility that a portion of the risk is due to other unidentified substances.

Incidence and mortality in epithelial ovarian cancer by family history of any cancer.

PubMed

Hemminki, Kari; Sundquist, Jan; Brandt, Andreas

2011-09-01

Practically all data on familial risk in ovarian and other cancers are based on incident cancer, whereas familiality in cancer mortality is largely unknown. If fatal forms of cancer are a highly familial subtype, then familial risk for mortality may exceed that of incidence, which is relevant for clinical decision making and counseling. Ovarian cancer patients in the nationwide Swedish Family Cancer Database were classified according to fatal and nonfatal (incident) family history. Familial risks for incident and fatal ovarian cancer were calculated for offspring based on their parental or sibling family history of any cancer using standardized incidence ratios (SIRs) for incidence and standardized mortality ratios (SMRs) for mortality. Offspring without family history were referents. The database included 24,757 mothers and 8138 daughters with ovarian cancer. When a mother had ovarian cancer, the SIR for incident ovarian cancer in daughters was 2.69, and when a sister had ovarian cancer it was 3.49. The SMRs for fatal cancer by fatal cancer in probands were 3.39 and 5.80, respectively. For fatal serous cancers among siblings, the SMR was 6.16, compared with 10.01 for the endometrioid type. Ovarian cancer was associated with maternal (SIR, 1.22; SMR, 1.56) and sororal breast cancer (SIR, 1.27). Another discordant association was between ovarian and paternal prostate cancer (SIR, 1.12; SMR, 1.66). Fatal familial risks were higher for concordant ovarian, ovarian-breast, and ovarian-prostate cancers than the corresponding incident risks. This may suggest that highly fatal subtypes exist for these cancers, calling for genetic dissection. Cancer 2011 © 2011 American Cancer Society.

Treatment of severe acute pancreatitis and its complications

PubMed Central

Zerem, Enver

2014-01-01

Severe acute pancreatitis (SAP), which is the most serious type of this disorder, is associated with high morbidity and mortality. SAP runs a biphasic course. During the first 1-2 wk, a pro-inflammatory response results in systemic inflammatory response syndrome (SIRS). If the SIRS is severe, it can lead to early multisystem organ failure (MOF). After the first 1-2 wk, a transition from a pro-inflammatory response to an anti-inflammatory response occurs; during this transition, the patient is at risk for intestinal flora translocation and the development of secondary infection of the necrotic tissue, which can result in sepsis and late MOF. Many recommendations have been made regarding SAP management and its complications. However, despite the reduction in overall mortality in the last decade, SAP is still associated with high mortality. In the majority of cases, sterile necrosis should be managed conservatively, whereas in infected necrotizing pancreatitis, the infected non-vital solid tissue should be removed to control the sepsis. Intervention should be delayed for as long as possible to allow better demarcation and liquefaction of the necrosis. Currently, the step-up approach (delay, drain, and debride) may be considered as the reference standard intervention for this disorder. PMID:25320523

Prospective evaluation of the acute patient physiologic and laboratory evaluation score and an extended clinicopathological profile in dogs with systemic inflammatory response syndrome.

PubMed

Giunti, Massimo; Troia, Roberta; Bergamini, Paolo Famigli; Dondi, Francesco

2015-01-01

To investigate the prognostic value of the acute patient physiologic and laboratory evaluation (APPLE) score and relevant clinicopathological markers in dogs with systemic inflammatory response syndrome (SIRS). Prospective observational cohort study. Veterinary teaching hospital. Thirty-three dogs with SIRS admitted to the intensive care unit (ICU) were compared to 35 healthy control dogs. Dogs with SIRS were divided into septic (n = 20) and nonseptic (n = 13) etiologies and as survivors (alive to discharge, n = 22) and nonsurvivors (n = 11: died, n = 6, or humanely euthanized, n = 5). For all dogs, physiological and laboratory parameters were prospectively collected for the calculation of the APPLE fast score. No difference between septic and nonseptic SIRS dogs was detected for any parameter evaluated. Survivors had significantly higher total protein, albumin concentrations, antithrombin activity (ATA), and base excess (BE), as well as significantly lower lactate, urea, creatinine concentrations, urinary protein to creatinine ratio and APPLE fast score compared to nonsurvivors. Higher values of creatinine, lactate, anion gap, alanine transaminase (ALT), and APPLE fast score were significantly associated with an increased risk of death in SIRS dogs, while higher values of total protein, albumin, ATA, and BE were associated with a significantly reduced risk of mortality. When a multivariate binary logistic regression analysis was performed, the APPLE fast score was the only significant parameter retained. The determination of the APPLE fast score in clinical setting, as well as the measurement of APP, ATA, lactate, BE, anion gap, ALT, urinary proteins, and electrolytes may be beneficial for a better assessment of dogs with SIRS. Identified parameters were significantly related with the presence of SIRS and their evaluation should be considered for the assessment of disease severity, and guidance of the decision-making process in critically ill dogs. © Veterinary Emergency and Critical Care Society 2014.

Accumulation and Application of Knowledge Through Sports Institute for Research/Change Agent Research (SIR/CAR) System.

ERIC Educational Resources Information Center

Moriarty, Dick

The Sports Institute for Research Through Change Agent Research (SIR/CAR) is an interdisciplinary, public professional, study/action group, which brings together theoreticians and practitioners to investigate topics of vital interest to sport or athletic organizations functioning at the community, provincial/state, national, or international…

Substance geology of the western desert in Egypt and Sudan revealed by Shuttle Imaging Radar (SIR-A)

NASA Technical Reports Server (NTRS)

Breed, C. S.; Schaber, G. G.; Mccauley, J. F.; Grolier, M. J.; Haynes, C. V.; Elachi, C.; Blom, R.; Issawi, B.; Mchugh, W. P.

1983-01-01

A correlation of known archaeologic sites with the mapped locations of the streamcourses is expected and may lead to new interpretations of early human history in the Sahara. The valley networks, faults, and other subjacent bedrock features mapped on the SIR-A images are promising areas for ground water and mineral exploration. Additionally, the analogies between the interplay of wind and running water in the geologic history of the Sahara and of Mars are strengthened by the SIR-A discoveries of relict drainage systems beneath the eolian veneer of Egypt and Sudan.

The NAD+-dependent deacetylase, Bifidobacterium longum Sir2 in response to oxidative stress by deacetylating SigH (σH) and FOXO3a in Bifidobacterium longum and HEK293T cell respectively.

PubMed

Guo, Qing; Li, Shiyu; Xie, Yajie; Zhang, Qian; Liu, Mengge; Xu, Zhenrui; Sun, Hanxiao; Yang, Yan

2017-07-01

Silent information regulator 2 (Sir2) enzymes which catalyze NAD+-dependent protein/histone deacetylation. The mammalian sirtuin family SIRT1, SIRT2, SIRT3 and SIRT6 can regulate oxidative stress. The probiotics (Bifidobacterium longum(B.longum) and Lactobacillus acidophilus(L. acidophilus)) have Sir2 gene family and have antioxidant activity in human body. it remains unknown whether probiotics Sir2 has a direct role in regulating oxidative stress. To this end, we knockout BL-sir2(sir2 B. longum) and LA-sir2(sir2 L.acidophilus) in low oxygen level. The antioxidant activities of two sir2 deficient strains was decreased, while when reintroduction of BL-sir2 and LA-sir2, the antioxidant activities were recoveried. In order to understand the regulation mechanism of probiotics Sir2 oxidation response. Then, we screened 65 acetylated protein, and found that SigH (σ H ) was a substrate of BL-Sir2. In addition, the acetylation level of σ H decreased with the increase of BL-Sir2 level in B. longum. Thus, BL-Sir2 deacetylated σ H in response to oxidative stress. Next, we transfected BL-Sir2 into H 2 O 2 -induced oxidative damage of 293T cells, BL-Sir2 increased the activity of manganese superoxide dismutase (MnSOD/SOD2) and catalase (CAT) and reduced reactive oxygen species(ROS). Then, we analyzed the differential gene by RNA sequencing and Gene ontology (GO) and found that BL-Sir2 regulated forkhead transcription factor (FOXO3a) mediated antioxidant genes in overexpressed BL-Sir2 HEK293T cells. Our study is the first to link probiotics Sir2 with oxidative stress and uncover the antioxidant mechanism of BL-Sir2 in B. longum itself and human body. Copyright © 2017 Elsevier Inc. All rights reserved.

Lymphocyte integrin expression differences between SIRS and sepsis patients.

PubMed

Heffernan, D S; Monaghan, S F; Ayala, Alfred

2017-11-01

Systemic Inflammatory Response Syndrome (SIRS) and sepsis remain leading causes of death. Despite many similarities, the two entities are very distinct clinically and immunologically. T-Lymphocytes play a key pivotal role in the pathogenesis and ultimately outcome following both SIRS and sepsis. Integrins are essential in the trafficking and migration of lymphocytes. They also serve vital roles in efficient wound healing and clearance of infections. Here, we investigate whether integrin expression, specifically β1 (CD29) and β2 (CD18), are disrupted in SIRS and sepsis, and assess differences in integrin expression between these two critically ill clinical categories. T-Lymphocytes were isolated from whole blood collected from ICU patients exhibiting SIRS or sepsis. Samples were analyzed for CD18 (β2) and CD29 (β1) on CD3 + T cells through flow cytometry. Septic patients were stratified into either exclusively abdominal or non-abdominal sources of sepsis. CD18 was almost ubiquitously expressed on CD3 + T cells irrespective of clinical condition. However, CD29 (β1 integrin) was lowest in SIRS patients (20.4% of CD3 + T cells) when compared with either septic patients (35.5%) or healthy volunteers (54.1%). Furthermore, there was evidence of compartmentalization in septic patients, where abdominal sources had a greater percentage of CD3 + CD29 + T cells (41.7%) when compared with those with non-abdominal sources (29.5%). Distinct differences in T-cell integrin expression exists between patients in SIRS versus sepsis, as well as relative to the source of sepsis. Further work is needed to understand cause and effect relative to the progression from SIRS into sepsis.

Differential pattern of cell-surface and soluble TREM-1 between sepsis and SIRS.

PubMed

Oku, Reiko; Oda, Shigeto; Nakada, Taka-aki; Sadahiro, Tomohito; Nakamura, Masataka; Hirayama, Yoh; Abe, Ryuzo; Tateishi, Yoshihisa; Ito, Michihiro; Iseki, Toru; Hirasawa, Hiroyuki

2013-01-01

Triggering receptor expressed on myeloid cells-1 (TREM-1) was reported to play a key roll in amplification of production of inflammatory cytokines. TREM-1 is suggested to be a specific biomarker for sepsis for this reason, but the clinical significance of TREM-1 has not been elucidated. We investigated TREM-1 expression on the cell-surface, and plasma levels of soluble TREM-1 (sTREM-1) in patients with non-infectious systemic inflammatory response syndrome (SIRS) and sepsis admitted to the ICU. Thirty-five patients with SIRS and 21 patients with sepsis admitted to ICU were subjected to the study. TREM-1 expressions on the surfaces of monocytes and neutrophils were measured by flow cytometry. Plasma sTREM-1 level and serum interleukin (IL)-6 level were measured. Septic patients had decreased TREM-1 expression, clearly on neutrophils or to a lesser extent on monocyte compared to SIRS patients on ICU admission (neutrophils p<0.001, monocyte p<0.05). TREM-1 expression on neutrophils had a significant inverse correlation with serum IL-6 level (r=-0.64, p<0.0001). Plasma sTREM-1 level in septic patients was significantly higher than that in SIRS patients (p<0.05). Plasma sTREM-1 level positively correlated with severity score and non-survivors had increased plasma sTREM-1 level compared to survivors in all SIRS/sepsis patients (p<0.05). Patients with sepsis had increased soluble TREM-1 and decreased TREM-1 expression on neutrophil compared to SIRS patients. sTREM-1 may be useful to evaluate disease severity and outcome of patients with SIRS or sepsis. Copyright © 2012 Elsevier Ltd. All rights reserved.

Identification of Predictive Early Biomarkers for Sterile-SIRS after Cardiovascular Surgery.

PubMed

Stoppelkamp, Sandra; Veseli, Kujtim; Stang, Katharina; Schlensak, Christian; Wendel, Hans Peter; Walker, Tobias

2015-01-01

Systemic inflammatory response syndrome (SIRS) is a common complication after cardiovascular surgery that in severe cases can lead to multiple organ dysfunction syndrome and even death. We therefore set out to identify reliable early biomarkers for SIRS in a prospective small patient study for timely intervention. 21 Patients scheduled for planned cardiovascular surgery were recruited in the study, monitored for signs of SIRS and blood samples were taken to investigate biomarkers at pre-assigned time points: day of admission, start of surgery, end of surgery, days 1, 2, 3, 5 and 8 post surgery. Stored plasma and cryopreserved blood samples were analyzed for cytokine expression (IL1β, IL2, IL6, IL8, IL10, TNFα, IFNγ), other pro-inflammatory markers (sCD163, sTREM-1, ESM-1) and response to endotoxin. Acute phase proteins CRP, PCT and pro-inflammatory cytokines IL6 and IL8 were significantly increased (p<0.001) at the end of surgery in all patients but could not distinguish between groups. Normalization of samples revealed significant increases in IL1β changes (p<0.05) and decreased responses to endotoxin (p<0.01) in the SIRS group at the end of surgery. Soluble TREM-1 plasma concentrations were significantly increased in patients with SIRS (p<0.01). This small scale patient study could show that common sepsis markers PCT, CRP, IL6 and TNFα had low predictive value for early diagnosis of SIRS after cardiovascular surgery. A combination of normalized IL1β plasma levels, responses to endotoxin and soluble TREM-1 plasma concentrations at the end of surgery are predictive markers of SIRS development in this small scale study and could act as an indicator for starting early therapeutic interventions.

Italian cancer figures, report 2013: Multiple tumours.

PubMed

2013-01-01

This collaborative study, based on data collected by the network of Italian association of cancer registries (AIRTUM), provides updated estimates on the incidence risk of multiple primary cancer (MP). The objective is to highlight and quantify the bidirectional associations between different oncological diseases. The quantification of the excess or decreased risk of further cancers in cancer patients, in comparison with the general population, may contribute to understand the aetiology of cancer and to address clinical follow-up. Data herein presented were provided by AIRTUM population-based cancer registries, which cover nowadays 48% of the Italian population. This monograph utilizes the AIRTUM database (December 2012), considering all malignant cancer cases diagnosed between 1976 and 2010. All cases are coded according to ICD-O-3. Non-melanoma skin cancer cases, cases based on death certificate only, cases based on autopsy only, and cases with follow-up time equal to zero were excluded. To define multiple primaries, IARC-IACR rules were adopted (http://www.iacr.com.fr/MPrules_july2004.pdf). Data were subjected to standard quality control procedures (described in the AIRTUM data management protocol) and specific quality control checks defined for the present study. A cohort of cancer patients was followed over time from first cancer diagnosis until the date of second cancer diagnosis, death, or the end of follow-up, to evaluate whether the number of observed second cancer cases was greater than expected. Person years at risk (PY) were computed by first cancer site, geographic area (North, Centre, South and Islands), attained age, and attained calendar-year group. All second cancers diagnosed in the cohort's patients were included in the observed numbers of cases. The expected number of cancer cases was computed multiplying the accumulated PY by the expected rates, calculated from the AIRTUM database stratified by cancer site, geographic area, age, and calendar-year group. The Standardized Incidence Ratio (SIR) was calculated as the ratio of observed to expected cancer cases. The Excess Absolute Risk (EAR) beyond the expected amount were calculated subtracting the expected number of subsequent cancers from the observed number of cancer cases; the difference was then divided by the PY and the number of cancer cases in excess (or deficit) was expressed per 1,000 PY. Confidence intervals were stated at 95%. The two months (60 days) after first cancer diagnosis were defined as "synchronicity period", and in the main analysis observed and expected cases during this period were excluded. It was estimated the excess risk in the period after first diagnosis (≥ 0 months), excluding the synchronicity period (≥ 2 months), and during the following periods: 2-11, 12-59, 60-119 and 120 months after diagnosis. First-cancer-site-and-gender-specific sheets are presented, reporting both SIRs and EARs. For 5,979,338 person-years a cohort of 1,635,060 cancer patients (880,361 males and 754,699 females) diagnosed between 1976 and 2010 was followed. The mean follow-up length was 14 years. Overall, 85,399 metachronous (latency ≥2 months) cancers were observed, while 77,813 were expected during the study period: SIR: 1.10 (95%CI 1.09-1.10), EAR: 1.32 x 1,000 person-years (95%CI 1.19 - 1.46). The SIR was 1.08 (95%CI 1.08-1.09) for men (54,518 observed and 50,260 expected) and 1.12 (95%CI 1.11-1.13) for women (30,881/27,553), and the EAR 1.61 (95%CI 1.37-1.84) and 1.08 x 1,000 person-years (95%CI 0.93-1.24), respectively.Moreover, during the first two months after first cancer diagnosis (synchronous period) 14,807 cancers were observed while 3,536 were expected (SIR: 4.16; 95%CI 4.09-4.22); the SIR was 4.08 (95%CI 4.00-4.16) for men and 4.32 (95%CI 4.20-4.45) for women.The mean age of patients at first cancer diagnosis was 67.0 years among males and 65.8 among females.The risk of MP was related to age being higher for younger patients and lower for older ones. In relation to the time of first cancer diagnosis, the SIR was very high at the beginning and then decreased, although remaining constantly over 1, and then rose over time. No strong differences were evident across the different incidence periods, which all showed an increased MP risk.Women had higher SIRs than expected for 18 cancer sites, men for 12. The statistically significantly SIRs lower than 1 were 2 and 8, respectively. Increased overall MP risk was observed for patients of both sexes with a first primary in the oral cavity (SIR men: 1.93; SIR women: 1.48), pharynx (SIR men: 2.13; SIR women: 1.99), larynx (SIR men: 1.57; SIR women: 1.79), oesophagus (SIR men: 1.45; SIR women: 1.41), lung (SIR men: 1.09; SIR women: 1.13), kidney (SIR men: 1.14; SIR women: 1.15), urinary bladder (SIR men: 1.29; SIR women: 1.22), thyroid (SIR: 1.22 in both sexes), Hodgkin lymphoma (SIR men: 1.59; SIR women: 1.94), and non-Hodgkin lymphoma (SIR men: 1.13; SIR women: 1.12), and for the heterogeneous group "other sites" (SIR men: 1.09; SIR women: 1.07). Moreover, men had a higher MP risk if the first cancer was in the testis (SIR: 1.24), while the same was true for women with gallbladder (SIR: 1.21), skin melanoma (SIR: 1.17), bone (SIR: 1.41), breast (SIR: 1.12), cervix uteri (SIR: 1.23) and corpus uteri (SIR: 1.23), and ovarian cancer (SIR: 1.18). On the contrary, a first liver or pancreas cancer were associated with a decreased MP risk in both sexes (liver SIR: 0.86 and 0.81 for men and women, respectively; pancreas SIR: 0.70 and 0.78 for men and women, respectively), as were those of colon (SIR: 0.93), rectum (SIR: 0.83), gallbladder (SIR: 0.80), prostate (SIR: 0.93), mesothelioma (SIR: 0.65), and central nervous system (SIR: 0.82) among men. Among the cancers for which the EAR is statistically significant, those with higher Excess Absolute Risk of MP were those of the oral cavity (EAR: 16.0 x 1,000 person-years in men and 5.4 in women), pharynx (17.6 and 9.1), larynx (11.4 and 8.8), and oesophagus (8.5 and 4.8). This descriptive study provides quantitative information on the risk of developing a second cancer in an Italian population-based cohort of approximately 1.65 million cancer patients, compared to the risk of the general population. During the follow-up time (on average 14 years) cancer patients had an MP risk that was 10% higher in comparison to the general population and an Excess Absolute Risk of 1.32 x 1,000 person-years. Study of MPs and their risk measures are dependent on methods used in the calculation. The definition of MP is not univocal and using different rules can greatly change the number of cancers in a patient with MPs. However, the AIRTUM cancer registries adopt the same recommendations for MP definition. This monograph was therefore made possible by the shared rules and standards used by AIRTUM registries. The cancer site-specific sheets, which represent the core of the monograph, can be useful to highlight and quantify the bidirectional associations among different diseases and therefore provide indications for clinical follow-up. Lifestyle changes in more healthful directions can have a positive effect in the cancer patient population and should always be recommended.

EC comparison on the determination of 226Ra, 228Ra, 234U and 238U in water among European monitoring laboratories.

PubMed

Wätjen, U; Benedik, L; Spasova, Y; Vasile, M; Altzitzoglou, T; Beyermann, M

2010-01-01

In anticipation of new European requirements for monitoring radioactivity concentration in drinking water, IRMM organized an interlaboratory comparison on the determination of low levels of activity concentrations (about 10-100 mBq L(-1)) of the naturally occurring radionuclides (226)Ra, (228)Ra, (234)U and (238)U in three commercially available mineral waters. Using two or three different methods with traceability to the International System of Reference (SIR), the reference values of the water samples were determined prior to the proficiency test within combined standard uncertainties of the order of 3%-10%. An overview of radiochemical separation and measurement methods used by the 45 participating laboratories are given. The results of the participants are evaluated versus the reference values. Several of the participants' results deviate by more than a factor of two from the reference values, in particular for the radium isotopes. Such erroneous analysis results may lead to a crucial omission of remedial actions on drinking water supplies or to economic loss by an unjustified action. Copyright 2009 Elsevier Ltd. All rights reserved.

Diagnostic and prognostic value of presepsin vs. established biomarkers in critically ill patients with sepsis or systemic inflammatory response syndrome.

PubMed

Brodska, Helena; Valenta, Jiri; Pelinkova, Kveta; Stach, Zdenek; Sachl, Robert; Balik, Martin; Zima, Tomas; Drabek, Tomas

2018-03-28

Inflammatory biomarkers may aid to distinguish between systemic inflammatory response syndrome (SIRS) vs. sepsis. We tested the hypotheses that (1) presepsin, a novel biomarker, can distinguish between SIRS and sepsis, and (2) higher presepsin levels will be associated with increased severity of illness and (3) with 28-day mortality, outperforming traditional biomarkers. Procalcitonin (PCT), C-reactive protein (CRP), presepsin, and lactate were analyzed in 60 consecutive patients (sepsis and SIRS, n=30 per group) on day 1 (D1) to D3 (onset sepsis, or after cardiac surgery). The systemic organ failure assessment (SOFA) score was determined daily. There was no difference in mortality in sepsis vs. SIRS (12/30 vs. 8/30). Patients with sepsis had higher SOFA score vs. patients with SIRS (11±4 vs. 8±5; p=0.023), higher presepsin (AUC=0.674; p<0.021), PCT (AUC=0.791; p<0.001), CRP (AUC=0.903; p<0.0001), but not lactate (AUC=0.506; p=0.941). Unlike other biomarkers, presepsin did not correlate with SOFA on D1. All biomarkers were associated with mortality on D1: presepsin (AUC=0.734; p=0.0006; best cutoff=1843 pg/mL), PCT (AUC=0.844; p<0.0001), CRP (AUC=0.701; p=0.0048), and lactate (AUC=0.778; p<0.0001). Multiple regression analyses showed independent associations of CRP with diagnosis of sepsis, and CRP and lactate with mortality. Increased neutrophils (p=0.002) and decreased lymphocytes (p=0.007) and monocytes (p=0.046) were also associated with mortality. Presepsin did not outperform traditional sepsis biomarkers in diagnosing sepsis from SIRS and in prognostication of mortality in critically ill patients. Presepsin may have a limited adjunct value for both diagnosis and an early risk stratification, performing independently of clinical illness severity.

Differential expression of plasma miR-146a in sepsis patients compared with non-sepsis-SIRS patients.

PubMed

Wang, Lina; Wang, Hua-Cheng; Chen, Cha; Zeng, Jianming; Wang, Qian; Zheng, Lei; Yu, Huan-DU

2013-04-01

Sepsis is a subtype of systemic inflammatory response syndrome (SIRS), which is characterized by infection. Circulating microRNAs (miRNAs), including miR-150, miR-146a and miR-223, are potential biomarkers of sepsis. In this study, we demonstrated that measuring the relative expression of miR-146a/U6 in plasma, using the 2 -ΔΔCt method, provides a method for differentiating between sepsis and non-sepsis-SIRS. We observed a significant increase in miR-146a expression in the initial cohort of 6 non-sepsis-SIRS patients compared to the 4 sepsis patients (P=0.01) and in the second cohort of 8 non-sepsis-SIRS patients compared to the 10 sepsis patients (P=0.027). Additionally, we identified that sodium citrate and ethylenediaminetetraacetic acid (EDTA) K 2 may be used as anticoagulant reagents. Generation of a standard curve is not necessary in these diagnostic tests, unless the standard of normalization is carefully selected. Thus we provide more detailed guidance for the clinical use of circulating miRNA biomarkers.

Fifty years of cancer in an American Indian population.

PubMed

Mahoney, Martin C; Va, Puthiery; Stevens, Adrian; Kahn, Amy R; Michalek, Arthur M

2009-01-15

A clear understanding of cancer patterns among American Indian tribal groups has been complicated by a variety of issues. A retrospective cohort study design was applied to a Seneca Nation of Indians (SNI) cohort for the period from 1955 through 2004. Incident cancers were identified through a computer match with the New York State Cancer Registry. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for the overall interval as well as for each of the 5 10-year intervals. The SNI cohort consisted of 3935 men and 4193 women with a total of 120,403 person-years. Significant deficits in cancer incidence were noted among men for all sites combined (SIR, 69), and for lung (SIR, 59), prostate (SIR, 54), urinary bladder (SIR, 8), and Hodgkin lymphoma (SIR, 0); no cancer sites were identified with significantly elevated incidence. Women demonstrated significantly reduced cancer incidence for all sites combined (SIR, 70) and for breast (SIR, 39), colorectal (SIR, 72), ovary (SIR, 37), uterus (SIR, 42), bladder (SIR, 20), pancreas (SIR, 10), and non-Hodgkin lymphoma (SIR, 39); elevated incidence was noted for cancers of the lung (SIR, 139) and liver (SIR, 405). To the authors' knowledge, the current study represents the most comprehensive investigation to date of cancer patterns among an American Indian tribal group and provides insights for the development of tribal cancer control programming. Copyright (c) 2009 American Cancer Society.

Addendum to the Closure Report for Corrective Action Unit 326: Areas 6 and 27 Release Sites, Nevada Test Site, Nevada, Revision 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant Evenson

This document constitutes an addendum to the Closure Report for Corrective Action Unit 326: Areas 6 and 27 Release Sites, Nevada Test Site, Nevada (Revision 1), December 2002 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • Themore » cover, title, and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 06-25-01, CP-1 Heating Oil Release. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum to the Closure Report for Corrective Action Unit 403: Second Gas Station, Tonopah Test Range, Nevada, Revision 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant Evenson

This document constitutes an addendum to the Closure Report for Corrective Action Unit 403: Second Gas Station, Tonopah Test Range, Nevada, September 1998 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • The cover, title, and signature pagesmore » of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 03-02-004-0360, Underground Storage Tanks. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum to the Closure Report for Corrective Action Unit 339: Area 12 Fleet Operations Steam Cleaning Discharge Area, Nevada Test Site, Revision 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant Evenson

This document constitutes an addendum to the Closure Report for CAU 339: Area 12 Fleet Operations Steam Cleaning Discharge Area Nevada Test Site, December 1997 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • The cover, title, andmore » signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 12-19-01, A12 Fleet Ops Steam Cleaning Efflu. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Addendum 2 to the Closure Report for Corrective Action Unit 358: Areas 18, 19, 20 Cellars/Mud Pits, Nevada Test Site, Nevada, Revison 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant Evenson

This document constitutes an addendum to the Closure Report for Corrective Action Unit 358: Areas 18, 19, 20 Cellars/Mud Pits, Nevada Test Site, Nevada, January 2004 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additional information • The cover, title,more » and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the UR for CAS 19-09-05, Mud Pit. This UR was established as part of a Federal Facility Agreement and Consent Order (FFACO) corrective action and is based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since this UR was established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, this UR was reevaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the UR) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove the UR because contamination is not present at the site above the risk-based FALs. Requirements for inspecting and maintaining this UR will be canceled, and the postings and signage at this site will be removed. Fencing and posting may be present at this site that are unrelated to the FFACO UR such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at this site.« less

Using the Microcomputer to Generate Materials for Bibliographic Instruction.

ERIC Educational Resources Information Center

Hendley, Gaby G.

Guide-worksheets were developed on a word processor in a high school library for bibliographic instruction of English and social studies students to cover the following reference sources: Facts on File; Social Issues Resource Series (S.I.R.S.); Editorial Research Reports; Great Contemporary Issues (New York Times), which also includes Facts on…

Physical Characteristics of Some Soils from the Middle East

DTIC Science & Technology

1993-05-01

prove useful to others as well. 14 References Berlin, G.L., Tarabzouni, M.A., Al-Naser, A.H., Sheikho, K.M. and Larson, R.W. 1986. SIR-B subsurface ... imaging of a sand-buried landscape: Al Labbah Plateau, Saudi Arabia: IEEE Transactions on Geoscience and Remote Sensing, vol. GE-24, pp 595-602. Blom

Binary Arithmetic From Hariot (CA, 1600 A.D.) to the Computer Age.

ERIC Educational Resources Information Center

Glaser, Anton

This history of binary arithmetic begins with details of Thomas Hariot's contribution and includes specific references to Hariot's manuscripts kept at the British Museum. A binary code developed by Sir Francis Bacon is discussed. Briefly mentioned are contributions to binary arithmetic made by Leibniz, Fontenelle, Gauss, Euler, Benzout, Barlow,…

What to Do Until the Money Runs Out: A Refinement Framework for Cognitive Engineering in the Real World

NASA Technical Reports Server (NTRS)

Shafto, Michael G.; Remington, Roger W.; Trimble, Jay W.

1994-01-01

A case study is presented to illustrate some of the problems of applying cognitive science to complex human-machine systems. Disregard for facts about human cognition often undermines the safety, reliability, and cost-effectiveness of complex systems. Yet single-point methods (for example, better user-interface design), whether rooted in computer science or in experimental psychology, fall far short of addressing systems-level problems in a timely way using realistic resources. A model-based methodology is proposed for organizing and prioritizing the cognitive engineering effort, focusing appropriate expertise on major problems first, then moving to more sophisticated refinements if time and resources permit. This case study is based on a collaborative effort between the Human Factors Division at NASA-Ames and the Spaceborne Imaging Radar SIR-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) Project at the Jet Propulsion Laboratory (JPL), California institute of Technology. The first SIR-C/X-SAR Shuttle mission flew successfully in April, 1994. A series of such missions is planned to provide radar data to study Earth's ecosystems, climatic and geological processes, hydrologic cycle, and ocean circulation. In addition to JPL and NASA personnel, the SIR-C/X-SAR operations team included Scientists and engineers from the German and Italian space agencies.

Molecular characterization of the silencing complex SIR in Candida glabrata hyperadherent clinical isolates.

PubMed

Leiva-Peláez, Osney; Gutiérrez-Escobedo, Guadalupe; López-Fuentes, Eunice; Cruz-Mora, José; De Las Peñas, Alejandro; Castaño, Irene

2018-05-29

An important virulence factor for the fungal pathogen Candida glabrata is the ability to adhere to the host cells, which is mediated by the expression of adhesins. Epa1 is responsible for ∼95% of the in vitro adherence to epithelial cells and is the founding member of the Epa family of adhesins. The majority of EPA genes are localized close to different telomeres, which causes transcriptional repression due to subtelomeric silencing. In C. glabrata there are three Sir proteins (Sir2, Sir3 and Sir4) that are essential for subtelomeric silencing. Among a collection of 79 clinical isolates, some display a hyperadherent phenotype to epithelial cells compared to our standard laboratory strain, BG14. These isolates also express several subtelomeric EPA genes simultaneously. We cloned the SIR2, SIR3 and SIR4 genes from the hyperadherent isolates and from the BG14 and the sequenced strain CBS138 in a replicative vector to complement null mutants in each of these genes in the BG14 background. All the SIR2 and SIR4 alleles tested from selected hyper-adherent isolates were functional and efficient to silence a URA3 reporter gene inserted in a subtelomeric region. The SIR3 alleles from these isolates were also functional, except the allele from isolate MC2 (sir3-MC2), which was not functional to silence the reporter and did not complement the hyperadherent phenotype of the BG14 sir3Δ. Consistently, sir3-MC2 allele is recessive to the SIR3 allele from BG14. Sir3 and Sir4 alleles from the hyperadherent isolates contain several polymorphisms and two of them are present in all the hyperadherent isolates analyzed. Instead, the Sir3 and Sir4 alleles from the BG14 and another non-adherent isolate do not display these polymorphisms and are identical to each other. The particular combination of polymorphisms in sir3-MC2 and in SIR4-MC2 could explain in part the hyperadherent phenotype displayed by this isolate. Copyright © 2018 Elsevier Inc. All rights reserved.

Cancer incidence in the workers cohort of textile manufacturing factory in Alytus, Lithuania.

PubMed

Kuzmickiene, Irena; Didziapetris, Remigijus; Stukonis, Mecys

2004-02-01

Altogether 14,650 workers employed at least for 1 year a the textile factory in Alytus, Lithuania, were included in the cohort and followed during the period from 1978 to 1997. The standardized incidence ratio (SIR) for men was 1.28. The incidence of esophagus cancer was significant higher (SIR 3.42). It increased only slightly for lung (SIR 1.35). In the women cohort, SIR was 1.05. However, there was a significant increase of the incidence of gallbladder cancer (SIR 3.19). Among textile-processing (spinning and weaving departments) women workers, we found elevated total cancer incidence (SIR 1.35), incidence of breast cancer (SIR 1.49), and cervical cancer (SIR 1.82). In this cohort increased SIR values were observed for more than 10 years since first exposure for all cancer (SIR 1.70) and cervical cancer (SIR 2.44).

An online spatiotemporal prediction model for dengue fever epidemic in Kaohsiung (Taiwan).

PubMed

Yu, Hwa-Lung; Angulo, José M; Cheng, Ming-Hung; Wu, Jiaping; Christakos, George

2014-05-01

The emergence and re-emergence of disease epidemics is a complex question that may be influenced by diverse factors, including the space-time dynamics of human populations, environmental conditions, and associated uncertainties. This study proposes a stochastic framework to integrate space-time dynamics in the form of a Susceptible-Infected-Recovered (SIR) model, together with uncertain disease observations, into a Bayesian maximum entropy (BME) framework. The resulting model (BME-SIR) can be used to predict space-time disease spread. Specifically, it was applied to obtain a space-time prediction of the dengue fever (DF) epidemic that took place in Kaohsiung City (Taiwan) during 2002. In implementing the model, the SIR parameters were continually updated and information on new cases of infection was incorporated. The results obtained show that the proposed model is rigorous to user-specified initial values of unknown model parameters, that is, transmission and recovery rates. In general, this model provides a good characterization of the spatial diffusion of the DF epidemic, especially in the city districts proximal to the location of the outbreak. Prediction performance may be affected by various factors, such as virus serotypes and human intervention, which can change the space-time dynamics of disease diffusion. The proposed BME-SIR disease prediction model can provide government agencies with a valuable reference for the timely identification, control, and prevention of DF spread in space and time. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Fast differentiation of SIRS and sepsis from blood plasma of ICU patients using Raman spectroscopy.

PubMed

Neugebauer, Ute; Trenkmann, Sabine; Bocklitz, Thomas; Schmerler, Diana; Kiehntopf, Michael; Popp, Jürgen

2014-04-01

Currently, there is no biomarker that can reliable distinguish between infectious and non-infectious systemic inflammatory response syndrome (SIRS). However, such a biomarker would be of utmost importance for early identification and stratification of patients at risk to initiate timely and appropriate antibiotic treatment. Within this proof of principle study, the high potential of Raman spectroscopy for the fast differentiation of non-infectious SIRS and sepsis is demonstrated. Blood plasma collected from 70 patients from the intensive care unit (31 patients with sepsis and 39 patients classified with SIRS without infection) was analyzed by means of Raman spectroscopy. A PCA-LDA based classification model was trained with Raman spectra from test samples and yielded for sepsis a sensitivity of 1.0 and specificity of 0.82. These results have been confirmed with an independent dataset (prediction accuracy 80%). Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Comparison and Optimization of 3.0 T Breast Images Quality of Diffusion-Weighted Imaging with Multiple B-Values.

PubMed

Han, Xiaowei; Li, Junfeng; Wang, Xiaoyi

2017-04-01

Breast 3.0 T magnetic resonance diffusion-weighted imaging (MR-DWI) of benign and malignant lesions were obtained to measure and calculate the signal-to-noise ratio (SNR), signal intensity ratio (SIR), and contrast-to-noise ratio (CNR) of lesions at different b-values. The variation patterns of SNR and SIR were analyzed with different b-values and the images of DWI were compared at four different b-values with higher image quality. The effect of SIR on the differential diagnostic efficiency of benign and malignant lesions was compared using receiver operating characteristic curves to provide a reference for selecting the optimal b-value. A total of 96 qualified patients with 112 lesions and 14 patients with their contralateral 14 normal breasts were included in this study. The single-shot echo planar imaging sequence was used to perform the DWI and a total of 13 b-values were used: 0, 50, 100, 200, 400, 600, 800, 1000, 1200, 1500, 1800, 2000, and 2500 s/mm 2 . On DWI, the suitable regions of interest were selected. The SNRs of normal breasts (SNR normal ), SNR lesions , SIR, and CNR of benign and malignant lesions were measured on DWI with different b-values and calculated. The variation patterns of SNR, SIR, and CNR values on DWI for normal breasts, benign lesions, and malignant lesions with different b-values were analyzed by using Pearson correlation analysis. The SNR and SIR of benign and malignant lesions with the same b-values were compared using t-tests. The diagnostic efficiencies of SIR with different b-values for benign and malignant lesions were evaluated using receiver operating characteristic curves. Breast DWI had higher CNR for b-values ranging from 600 to 1200 s/mm 2 . It had the best CNR at b = 1000 s/mm 2 for the benign lesions and at b = 1200 s/mm 2 for the malignant lesions. The signal intensity and SNR values of normal breasts decreased with increasing b-values, with a negative correlation (r = -0.945, P < 0.01). The mean SNR values of benign and malignant lesions were negatively correlated (r = -0.982 and -0.947, respectively, and P < 0.01), gradually decreasing with increasing b-values. The mean SIR value of benign lesions gradually decreased with increasing b-values, a negative correlation (r = -0.991, P < 0.01). The mean SIR values of malignant lesions gradually increased with increasing b-values between 0 and 1200 s/mm 2 , and gradually decreased with increasing b-values ≥ 1500 s/mm 2 . For b-values of 600, 800, 1000, and 1200 s/mm 2 , the sensitivity and specificity of SIR in identifying benign and malignant lesions gradually increased with increasing b-values, peaking at 1200 s/mm 2 . Breast DWI had higher image quality for b-values ranging from 600 to 1200 s/mm 2 , and was best for b-values ranging from 1000 to 1200 s/mm 2 . The SIR had the highest diagnostic efficiency in differentiating benign and malignant lesions for a b-value of 1200 s/mm 2 . Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Reusability of coded data in the primary care electronic medical record: A dynamic cohort study concerning cancer diagnoses.

PubMed

Sollie, Annet; Sijmons, Rolf H; Helsper, Charles; Numans, Mattijs E

2017-03-01

To assess quality and reusability of coded cancer diagnoses in routine primary care data. To identify factors that influence data quality and areas for improvement. A dynamic cohort study in a Dutch network database containing 250,000 anonymized electronic medical records (EMRs) from 52 general practices was performed. Coded data from 2000 to 2011 for the three most common cancer types (breast, colon and prostate cancer) was compared to the Netherlands Cancer Registry. Data quality is expressed in Standard Incidence Ratios (SIRs): the ratio between the number of coded cases observed in the primary care network database and the expected number of cases based on the Netherlands Cancer Registry. Ratios were multiplied by 100% for readability. The overall SIR was 91.5% (95%CI 88.5-94.5) and showed improvement over the years. SIRs differ between cancer types: from 71.5% for colon cancer in males to 103.9% for breast cancer. There are differences in data quality (SIRs 76.2% - 99.7%) depending on the EMR system used, with SIRs up to 232.9% for breast cancer. Frequently observed errors in routine healthcare data can be classified as: lack of integrity checks, inaccurate use and/or lack of codes, and lack of EMR system functionality. Re-users of coded routine primary care Electronic Medical Record data should be aware that 30% of cancer cases can be missed. Up to 130% of cancer cases found in the EMR data can be false-positive. The type of EMR system and the type of cancer influence the quality of coded diagnosis registry. While data quality can be improved (e.g. through improving system design and by training EMR system users), re-use should only be taken care of by appropriately trained experts. Copyright © 2016. Published by Elsevier B.V.

Yeast heterochromatin regulators Sir2 and Sir3 act directly at euchromatic DNA replication origins.

PubMed

Hoggard, Timothy A; Chang, FuJung; Perry, Kelsey Rae; Subramanian, Sandya; Kenworthy, Jessica; Chueng, Julie; Shor, Erika; Hyland, Edel M; Boeke, Jef D; Weinreich, Michael; Fox, Catherine A

2018-05-01

Most active DNA replication origins are found within euchromatin, while origins within heterochromatin are often inactive or inhibited. In yeast, origin activity within heterochromatin is negatively controlled by the histone H4K16 deacetylase, Sir2, and at some heterochromatic loci also by the nucleosome binding protein, Sir3. The prevailing view has been that direct functions of Sir2 and Sir3 are confined to heterochromatin. However, growth defects in yeast mutants compromised for loading the MCM helicase, such as cdc6-4, are suppressed by deletion of either SIR2 or SIR3. While these and other observations indicate that SIR2,3 can have a negative impact on at least some euchromatic origins, the genomic scale of this effect was unknown. It was also unknown whether this suppression resulted from direct functions of Sir2,3 within euchromatin, or was an indirect effect of their previously established roles within heterochromatin. Using MCM ChIP-Seq, we show that a SIR2 deletion rescued MCM complex loading at ~80% of euchromatic origins in cdc6-4 cells. Therefore, Sir2 exhibited a pervasive effect at the majority of euchromatic origins. Using MNase-H4K16ac ChIP-Seq, we show that origin-adjacent nucleosomes were depleted for H4K16 acetylation in a SIR2-dependent manner in wild type (i.e. CDC6) cells. In addition, we present evidence that both Sir2 and Sir3 bound to nucleosomes adjacent to euchromatic origins. The relative levels of each of these molecular hallmarks of yeast heterochromatin-SIR2-dependent H4K16 hypoacetylation, Sir2, and Sir3 -correlated with how strongly a SIR2 deletion suppressed the MCM loading defect in cdc6-4 cells. Finally, a screen for histone H3 and H4 mutants that could suppress the cdc6-4 growth defect identified amino acids that map to a surface of the nucleosome important for Sir3 binding. We conclude that heterochromatin proteins directly modify the local chromatin environment of euchromatic DNA replication origins.

Risk of cancer in children, adolescents, and young adults with autistic disorder.

PubMed

Chiang, Huey-Ling; Liu, Chia-Jen; Hu, Yu-Wen; Chen, San-Chi; Hu, Li-Yu; Shen, Cheng-Che; Yeh, Chiu-Mei; Chen, Tzeng-Ji; Gau, Susan Shur-Fen

2015-02-01

To investigate whether individuals with autism have an increased risk for cancer relative to the general population. We enrolled patients with autistic disorder from the Taiwan National Health Insurance database in years 1997-2011. A total of 8438 patients diagnosed with autism were retrieved from the Registry for Catastrophic Illness Patients database. The diagnosis of cancers was also based on the certificate of catastrophic illness, which requires histological confirmation. The risk of cancer among the autism cohort was determined with a standardized incidence ratio (SIR). During the observation period, cancer occurred in 20 individuals with autism, which was significantly higher than a total number of expected cancers with a SIR estimate of 1.94 (95% CI 1.18-2.99). The number of cancer in males was greater than the expected number with a SIR of 1.95 (1.11-3.16), but no excess risk was found for females with a SIR of 1.91 (0.52-4.88). Cancer developed more than expected in individuals age 15-19 years with the SIR of 3.58 (1.44-7.38), but did not differ in other age range groups. The number of cancers of genitourinary system was significantly in excess of the expected number (SIR 4.15; 95% CI 1.13-10.65), and increased risk was found in ovarian cancer with SIR of 9.21 (1.12-33.29). Our study demonstrated that patients with autistic disorder have an increased risk of cancer. Copyright © 2015 Elsevier Inc. All rights reserved.

Developmental and Spatial Expression of sir2 Genes in the Cellular Slime Mold Dictyostelium discoideum.

PubMed

Katayama, Takahiro; Yasukawa, Hiro

2008-01-01

The cellular slime mold Dictyostelium discoideum grows as unicellular free-living amoebae in the presence of nutrients. Upon starvation, the amoebae aggregate and form multicellular structures that each consist of a stalk and spores. D. discoideum encodes at least four proteins (Sir2A, Sir2B, Sir2C, and Sir2D) homologous to human SIRT. RT-PCR and WISH analyses showed that the genes for Sir2A, Sir2C, and Sir2D were expressed at high levels in growing cells but at decreased levels in developing cells, whereas the gene encoding Sir2B was expressed in the prestalk-cell region in the developmental phase.

Analysis of Sir2E in the cellular slime mold Dictyostelium discoideum: cellular localization, spatial expression and overexpression.

PubMed

Katayama, Takahiro; Yasukawa, Hiro

2008-10-01

It has been reported that Dictyostelium discoideum encodes four silent information regulator 2 (Sir2) proteins (Sir2A-D) showing sequence similarity to human homologues of Sir2 (SIRT1-3). Further screening in a database revealed that D. discoideum encodes an additional Sir2 homologue (Sir2E). The amino acid sequence of Sir2E is not similar to those of SIRTs but is similar to those of proteins encoded by Giardia lamblia, Cryptosporidium hominis and Cryptosporidium parvum. Fluorescence of Sir2E-green fluorescent protein fusion protein was detected in the D. discoideum nucleus, indicating that Sir2E is a nuclear localizing protein. Reverse transcription-polymerase chain reaction and whole-mount in situ hybridization analyses showed that D. discoideum expressed sir2E in amoebae in the growth phase and in prestalk cells in the developmental phase. D. discoideum overexpressing sir2E grew faster than the wild type. These results indicate that Sir2E plays important roles both in the growth phase and developmental phase of D. discoideum.

The diagnostic and prognostic significance of monitoring blood levels of immature neutrophils in patients with systemic inflammation.

PubMed

Mare, Tracey Anne; Treacher, David Floyd; Shankar-Hari, Manu; Beale, Richard; Lewis, Sion Marc; Chambers, David John; Brown, Kenneth Alun

2015-02-25

In this cohort study, we investigated whether monitoring blood levels of immature neutrophils (myelocytes, metamyelocytes and band cells) differentiated patients with sepsis from those with the non-infectious (N-I) systemic inflammatory response syndrome (SIRS). We also ascertained if the appearance of circulating immature neutrophils was related to adverse outcome. Blood samples were routinely taken from 136 critically ill patients within 48 hours of ICU entry and from 20 healthy control subjects. Clinical and laboratory staff were blinded to each other's results, and patients were retrospectively characterised into those with SIRS (n = 122) and those without SIRS (n = 14). The patients with SIRS were further subdivided into categories of definite sepsis (n = 51), possible sepsis (n = 32) and N-I SIRS (n = 39). Two established criteria were used for monitoring immature white blood cells (WBCs): one where band cells >10% WBCs and the other where >10% of all forms of immature neutrophils were included but with a normal WBC count. Immature neutrophils in blood smears were identified according to nuclear morphology and cytoplasmic staining. With the first criterion, band cells were present in most patients with SIRS (mean = 66%) when compared with no SIRS (mean = 29%; P <0.01) and with healthy subjects (0%). The prevalence of band cells was higher in definite sepsis (mean = 82%) than in patients with possible sepsis (mean = 63%; P <0.05) or with N-I SIRS (mean = 39%; P <0.001), and they had a sensitivity of 84% and a specificity of 71% for the detection of definite sepsis. With the second criterion (that is, patients with normal WBC counts), we noted that immature neutrophils did not differentiate any of the patient groups from one another. Patients who died within 1 week of blood sample provision had higher levels of myelocytes and metamyelocytes (median = 9%; P <0.05) than patients who died at 2 to 4 weeks (median =0.5%). Raised blood levels of band cells have diagnostic significance for sepsis, provided that measurements are not confined to patients with normal WBC counts, whereas an increased prevalence of myelocytes and metamyelocytes may have prognostic application.

Shuttle imaging radar-C science plan

NASA Technical Reports Server (NTRS)

1986-01-01

The Shuttle Imaging Radar-C (SIR-C) mission will yield new and advanced scientific studies of the Earth. SIR-C will be the first instrument to simultaneously acquire images at L-band and C-band with HH, VV, HV, or VH polarizations, as well as images of the phase difference between HH and VV polarizations. These data will be digitally encoded and recorded using onboard high-density digital tape recorders and will later be digitally processed into images using the JPL Advanced Digital SAR Processor. SIR-C geologic studies include cold-region geomorphology, fluvial geomorphology, rock weathering and erosional processes, tectonics and geologic boundaries, geobotany, and radar stereogrammetry. Hydrology investigations cover arid, humid, wetland, snow-covered, and high-latitude regions. Additionally, SIR-C will provide the data to identify and map vegetation types, interpret landscape patterns and processes, assess the biophysical properties of plant canopies, and determine the degree of radar penetration of plant canopies. In oceanography, SIR-C will provide the information necessary to: forecast ocean directional wave spectra; better understand internal wave-current interactions; study the relationship of ocean-bottom features to surface expressions and the correlation of wind signatures to radar backscatter; and detect current-system boundaries, oceanic fronts, and mesoscale eddies. And, as the first spaceborne SAR with multi-frequency, multipolarization imaging capabilities, whole new areas of glaciology will be opened for study when SIR-C is flown in a polar orbit.

Conserved Locus-Specific Silencing Functions of Schizosaccharomyces pombe sir2+

PubMed Central

Freeman-Cook, Lisa L.; Gómez, Eliana B.; Spedale, Erik J.; Marlett, John; Forsburg, Susan L.; Pillus, Lorraine; Laurenson, Patricia

2005-01-01

In Schizosaccharomyces pombe, three genes, sir2+, hst2+, and hst4+, encode members of the Sir2 family of conserved NAD+-dependent protein deacetylases. The S. pombe sir2+ gene encodes a nuclear protein that is not essential for viability or for resistance to treatment with UV or a microtubule-destabilizing agent. However, sir2+ is essential for full transcriptional silencing of centromeres, telomeres, and the cryptic mating-type loci. Chromatin immunoprecipitation results suggest that the Sir2 protein acts directly at these chromosomal regions. Enrichment of Sir2p at silenced regions does not require the HP1 homolog Swi6p; instead, Swi6-GFP localization to telomeres depends in part on Sir2p. The phenotype of sir2 swi6 double mutants supports a model whereby Sir2p functions prior to Swi6p at telomeres and the silent mating-type loci. However, Sir2p does not appear to be essential for the localization of Swi6p to centromeric foci. Cross-complementation experiments showed that the Saccharomyces cerevisiae SIR2 gene can function in place of S. pombe sir2+, suggesting overlapping deacetylation substrates in both species. These results also suggest that, despite differences in most of the other molecules required, the two distantly related yeast species share a mechanism for targeting Sir2p homologs to silent chromatin. PMID:15545655

Occupational risk factors for systemic lupus erythematosus: a nationwide study based on hospitalizations in Sweden.

PubMed

Li, Xinjun; Sundquist, Jan; Sundquist, Kristina; Zöller, Bengt

2012-04-01

To investigate possible associations between occupation and hospitalization for systemic lupus erythematosus (SLE) in a nationwide study. A nationwide database was constructed in Sweden by linking the Swedish Census to the Hospital Discharge Register to obtain data on all first hospitalizations with a primary or secondary diagnosis of SLE in adults during the study period (1970 to 2008). Standardized incidence ratios (SIR) and 95% CI were calculated for different occupations. Two cohorts were defined based on occupational titles recorded in Swedish census data in 1970 and 1980. A total of 8921 male and 42290 female hospitalizations for SLE were retrieved in individuals aged over 15 years. High education (> 12 yrs) was associated with a lower risk of hospitalization for SLE among both women (SIR = 0.73) and men (SIR = 0.72). Among men with the same occupation in 2 consecutive censuses, increased risks (SIR) > 2.0 were present among artistic workers (2.52); shop managers and assistants (3.63); miners and quarry workers (6.04); shoe and leather workers (6.93); plumbers (2.21); other construction workers (2.08); glass, ceramic and tile workers (4.43); chimney sweeps (4.54); and military personnel (3.01). Among women with the same occupation in 2 consecutive censuses, no occupation was associated with SIR > 2.0. Occupation may carry significantly increased risk of hospital admission for SLE. Especially among men, several occupations were associated with increased risks for SLE.

Cancer incidence among women flax textile manufacturing workers in Lithuania.

PubMed

Kuzmickiene, Irena; Stukonis, Mecys

2010-07-01

To determine site-specific cancer incidence among women spinning-weaving and dyeing-finishing workers in the largest flax textile factory in Lithuania. The cancer incidence of a cohort of 3447 women workers from a flax textile factory was investigated for the period 1978-2002. All subjects were employed at the plant in the period 1957-2000 for a minimum of 12 months. Standardised incidence ratios (SIRs) were estimated by use of the corresponding national rates. SIRs were calculated for the spinning-weaving and dyeing-finishing work categories, and for two durations of employment categories (<10 years, > or =10 years). The cancer SIRs among spinning-weaving and dyeing-finishing workers were 0.84 (95% CI 0.69 to 1.00) and 0.90 (95% CI 0.52 to 1.44). An incidence deficit for non-melanoma skin cancer was found for the spinning-weaving unit (SIR 0.45, 95% CI 0.18 to 0.92). The risk of oral cavity and pharynx cancer was significantly increased in spinning-weaving unit workers with <10 years of employment (SIR 5.71, 95% CI 1.56 to 14.60). A significant excess of thyroid cancer and nervous system cancer was found among dyeing-finishing workers. The overall cancer and non-melanoma skin cancer incidence rate among flax spinning-weaving workers was lower compared with the Lithuanian population. The present findings lend some support to an excess of thyroid and nervous system cancers among dyeing-finishing workers and of oral cavity and pharynx cancer in spinning-weaving workers.

Immunosuppression after Sepsis: Systemic Inflammation and Sepsis Induce a Loss of Naïve T-Cells but No Enduring Cell-Autonomous Defects in T-Cell Function

PubMed Central

Markwart, Robby; Condotta, Stephanie A.; Requardt, Robert P.; Borken, Farina; Schubert, Katja; Weigel, Cynthia; Bauer, Michael; Griffith, Thomas S.; Förster, Martin; Brunkhorst, Frank M.; Badovinac, Vladimir P.; Rubio, Ignacio

2014-01-01

Sepsis describes the life-threatening systemic inflammatory response (SIRS) of an organism to an infection and is the leading cause of mortality on intensive care units (ICU) worldwide. An acute episode of sepsis is characterized by the extensive release of cytokines and other mediators resulting in a dysregulated immune response leading to organ damage and/or death. This initial pro-inflammatory burst often transits into a state of immune suppression characterised by loss of immune cells and T-cell dysfunction at later disease stages in sepsis survivors. However, despite these appreciations, the precise nature of the evoked defect in T-cell immunity in post-acute phases of SIRS remains unknown. Here we present an in-depth functional analysis of T-cell function in post-acute SIRS/sepsis. We document that T-cell function is not compromised on a per cell basis in experimental rodent models of infection-free SIRS (LPS or CpG) or septic peritonitis. Transgenic antigen-specific T-cells feature an unaltered cytokine response if challenged in vivo and ex vivo with cognate antigens. Isolated CD4+/CD8+ T-cells from post-acute septic animals do not exhibit defects in T-cell receptor-mediated activation at the the level of receptor-proximal signalling, activation marker upregulation or expansion. However, SIRS/sepsis induced transient lymphopenia and gave rise to an environment of immune attenuation at post acute disease stages. Thus, systemic inflammation has an acute impact on T-cell numbers and adaptive immunity, but does not cause major cell-autonomous enduring functional defects in T-cells. PMID:25541945

SIR-B ocean-wave enhancement with fast Fourier transform techniques

NASA Technical Reports Server (NTRS)

Tilley, David G.

1987-01-01

Shuttle Imaging Radar (SIR-B) imagery is Fourier filtered to remove the estimated system-transfer function, reduce speckle noise, and produce ocean scenes with a gray scale that is proportional to wave height. The SIR-B system response to speckled scenes of uniform surfaces yields an estimate of the stationary wavenumber response of the imaging radar, modeled by the 15 even terms of an eighth-order two-dimensional polynomial. Speckle can also be used to estimate the dynamic wavenumber response of the system due to surface motion during the aperture synthesis period, modeled with a single adaptive parameter describing an exponential correlation along track. A Fourier filter can then be devised to correct for the wavenumber response of the remote sensor and scene correlation, with subsequent subtraction of an estimate of the speckle noise component. A linearized velocity bunching model, combined with a surface tilt and hydrodynamic model, is incorporated in the Fourier filter to derive estimates of wave height from the radar intensities corresponding to individual picture elements.

Assessment of adrenocortical reserve capacity and inflammatory parameters in critically ill dogs.

PubMed

Csöndes, Judit; Fábián, Ibolya; Szabó, Bernadett; Máthé, Ákos; Vajdovich, Péter

2017-12-01

Inflammatory markers and adrenocorticotropic hormone (ACTH) stimulation test results may help us recognise critically ill dogs with poor disease outcome. Systemic inflammatory response syndrome (SIRS) criteria, the fast version of the Acute Patient Physiologic and Laboratory Evaluation Score (APPLE fast ), complete blood count, albumin and C-reactive protein (CRP) levels, baseline and stimulated cortisol levels and Δcortisol value were recorded in 50 client-owned dogs admitted to the Small Animal Hospital of the University of Veterinary Medicine Budapest with various inflammatory or neoplastic conditions. Increasing APPLE fast score was associated with a decreasing chance of survival (P = 0.0420). The Δcortisol value was significantly higher in SIRS dogs than in non-SIRS dogs (mean ± SD Δcortisol SIRS : 342.5 ± 273.96; mean ± SD Δcortisol non-SIRS : 175.3 ± 150.35; P = 0.0443). Elevated baseline or stimulated cortisol levels were associated with a higher chance of non-survival (P = 0.0135 and P = 0.0311, respectively). These data indicate that pathologically higher baseline and stimulated cortisol levels represent an exaggerated stress response in critically ill dogs, which is negatively associated with survival.

Sumoylation of Sir2 differentially regulates transcriptional silencing in yeast.

PubMed

Hannan, Abdul; Abraham, Neethu Maria; Goyal, Siddharth; Jamir, Imlitoshi; Priyakumar, U Deva; Mishra, Krishnaveni

2015-12-02

Silent information regulator 2 (Sir2), the founding member of the conserved sirtuin family of NAD(+)-dependent histone deacetylase, regulates several physiological processes including genome stability, gene silencing, metabolism and life span in yeast. Within the nucleus, Sir2 is associated with telomere clusters in the nuclear periphery and rDNA in the nucleolus and regulates gene silencing at these genomic sites. How distribution of Sir2 between telomere and rDNA is regulated is not known. Here we show that Sir2 is sumoylated and this modification modulates the intra-nuclear distribution of Sir2. We identify Siz2 as the key SUMO ligase and show that multiple lysines in Sir2 are subject to this sumoylation activity. Mutating K215 alone counteracts the inhibitory effect of Siz2 on telomeric silencing. SUMO modification of Sir2 impairs interaction with Sir4 but not Net1 and, furthermore, SUMO modified Sir2 shows predominant nucleolar localization. Our findings demonstrate that sumoylation of Sir2 modulates distribution between telomeres and rDNA and this is likely to have implications for Sir2 function in other loci as well. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Serum alpha1 -proteinase inhibitor concentrations in dogs with systemic inflammatory response syndrome or sepsis.

PubMed

Heilmann, Romy M; Grützner, Niels; Thames, Brittany E; Steiner, Jörg M; Barr, James W

2017-11-01

To determine whether the concentration of serum canine alpha 1 -proteinase inhibitor (cα 1 -PI) has diagnostic or prognostic utility in dogs with sepsis or noninfectious systemic inflammatory response syndrome (SIRS). Prospective, observational study from May to December 2010. University teaching hospital ICU. Sixty-nine client-owned dogs: 19 dogs with SIRS or sepsis and 50 healthy control dogs. None. Serum and plasma samples were collected from dogs with SIRS or sepsis on the day of hospital admission and once on the following 2 days, and on a single day in healthy controls. Patients were assessed using the 10-parameter Acute Patient Physiologic and Laboratory Evaluation (APPLE full ) and 5-parameter (APPLE fast ) score. Serum cα 1 -PI concentrations were measured, compared among groups of dogs, and evaluated for a correlation with the concentration of serum C-reactive protein, plasma interleukin-6, tumor necrosis factor-α, the APPLE scores, and survival to discharge. Serum cα 1 -PI concentrations were significantly lower in dogs with SIRS/sepsis (P < 0.001) than in healthy controls. While day 1 serum cα 1 -PI concentrations did not differ between dogs with SIRS and those with sepsis (P = 0.592), septic dogs had significantly lower serum cα 1 -PI concentrations on days 2 (P = 0.017) and 3 (P = 0.036) than dogs with SIRS. Serum cα 1 -PI concentrations did not differ between survivors and nonsurvivors (P = 1.000), but were inversely correlated with the APPLE full score (ρ = -0.48; P = 0.040) and plasma interleukin-6 concentrations (ρ = -0.50; P = 0.037). These results suggest a role of cα 1 -PI as a negative acute phase protein in dogs. The concentration of serum cα 1 -PI at the time of hospital admission does not have utility to identify dogs with sepsis from those with noninfectious SIRS, but may be a useful surrogate marker for early stratification of illness severity. © Veterinary Emergency and Critical Care Society 2017.

Blood lactate levels in 31 female dogs with pyometra

PubMed Central

Hagman, Ragnvi; Reezigt, Bert Jan; Bergström Ledin, Hanna; Karlstam, Erika

2009-01-01

Background Canine pyometra is a life-threatening disease common in countries where spaying of dogs is not routinely performed. The disease is associated with endotoxemia, sepsis, systemic inflammatory response syndrome (SIRS) and a 3–4% mortality rate. Blood lactate analysis is clinically valuable in predicting prognosis and survival, evaluating tissue perfusion and treatment response in human and veterinary critical care settings. The aims of the present study were to investigate 1) the blood lactate levels of female dogs with pyometra by a hand-held analyser and 2) if these levels are related with the clinical status or other biochemical or hematological disorders. Methods In total 31 female dogs with pyometra admitted for surgical ovariohysterectomy and 16 healthy female control dogs were included in the present study. A complete physical examination including SIRS-status determination was performed. Blood samples for lactate concentrations, hematological and biochemical parameters, acid-base and blood gas analysis and other laboratory parameters were collected and subsequently analysed. The diagnosis pyometra was verified with histopathological examination of the uterus and ovaries. Increased hospitalisation length and presence of SIRS were used as indicators of outcome. Results In the pyometra group the median blood lactate level was 1,6 mmol l-1 (range <0.8–2.7 mmol l-1). In the control group the median lactate level was 1,2 mmol l-1 (range <0.8–2.1 mmol l-1). Of the 31 bitches 19 (61%) fulfilled 2 or more criteria for SIRS at inclusion, 10 bitches (32%) fulfilled 3 of the SIRS criteria whereas none accomplished more than 3 criteria. Lactate levels did not differ significantly between the pyometra and control group, or between the SIRS positive and SIRS negative dogs with pyometra. Increased lactate concentration (>2.5 mmol l-1) was demonstrated in one female dog with pyometra (3%), and was not associated with longer hospitalisation or presence of SIRS. Lactate measurement was not indicative of peritonitis. None of the bitches died during or within two months of the hospital stay. The measurements of temperature, heart rate, respiratory rate, percentage bandforms of neutrophilic granulocytes, α2-globulins, creatinin, pvCO2, TCO2 and base excess showed significant differences between the SIRS positive and the SIRS negative pyometra cases. Conclusion Increased blood lactate concentrations were demonstrated in 3% (1/31), and SIRS was present in 61% (19/31) of the female dogs with pyometra. Preoperative lactate levels were not related with presence of SIRS or prolonged hospitalisation. Lactate measurement was not indicative of peritonitis. The value of a single and repeated lactate analysis in more severely affected cases remains to be determined. PMID:19134167

The Ubiquitin Ligase CHIP Prevents SirT6 Degradation through Noncanonical Ubiquitination

PubMed Central

Ronnebaum, Sarah M.; Wu, Yaxu; McDonough, Holly

2013-01-01

The ubiquitin ligase CHIP (carboxyl terminus of Hsp70-interacting protein) regulates protein quality control, and CHIP deletion accelerates aging and reduces the life span in mice. Here, we reveal a mechanism for CHIP's influence on longevity by demonstrating that CHIP stabilizes the sirtuin family member SirT6, a lysine deacetylase/ADP ribosylase involved in DNA repair, metabolism, and longevity. In CHIP-deficient cells, SirT6 protein half-life is substantially reduced due to increased proteasome-mediated degradation, but CHIP overexpression in these cells increases SirT6 protein expression without affecting SirT6 transcription. CHIP noncanonically ubiquitinates SirT6 at K170, which stabilizes SirT6 and prevents SirT6 canonical ubiquitination by other ubiquitin ligases. In CHIP-depleted cells, SirT6 K170 mutation increases SirT6 half-life and prevents proteasome-mediated degradation. The global decrease in SirT6 expression in the absence of CHIP is associated with decreased SirT6 promoter occupancy, which increases histone acetylation and promotes downstream gene transcription in CHIP-depleted cells. Cells lacking CHIP are hypersensitive to DNA-damaging agents, but DNA repair and cell viability are rescued by enforced expression of SirT6. The discovery of this CHIP-SirT6 interaction represents a novel protein-stabilizing mechanism and defines an intersection between protein quality control and epigenetic regulation to influence pathways that regulate the biology of aging. PMID:24043303

Systemic inflammatory response syndrome (SIRS)

PubMed Central

Balk, Robert A

2014-01-01

The concept of a systemic inflammatory response syndrome (SIRS) to describe the complex pathophysiologic response to an insult such as infection, trauma, burns, pancreatitis, or a variety of other injuries came from a 1991 consensus conference charged with the task of developing an easy-to-apply set of clinical parameters to aid in the early identification of potential candidates to enter into clinical trials to evaluate new treatments for sepsis. There was recognition that a diverse group of injuries produced a common inflammatory response in the host and provided attractive targets for new anti-inflammatory molecules designed to prevent further propagation and/or provide specific treatment. Effective application of these new anti-inflammatory strategies necessitated identification of early clinical markers that could be assessed in real-time and were likely to define a population of patients that would have a beneficial response to the targeted intervention. It was felt that early clinical manifestations might be more readily available to clinicians than more sophisticated and specific assays for inflammatory substances that were systemically released by the network of injurious inflammatory events. Therefore, the early definition of a systemic inflammatory response syndrome (SIRS) was built upon a foundation of basic clinical and laboratory abnormalities that were readily available in almost all clinical settings. With further refinement, it was hoped, that this definition would have a high degree of sensitivity, coupled with a reasonable degree of specificity. This manuscript reviews the derivation, application, utilization, potential benefits, and speculation regarding the future of the SIRS definition. PMID:24280933

Risk of cancer after primary total hip replacement: The influence of bearings, cementation and the material of the stem

PubMed Central

Levašič, Vesna; Milošev, Ingrid; Zadnik, Vesna

2018-01-01

Background and purpose Despite the increasing number of total hip replacements (THRs), their systemic influence is still not known. We have studied the influence of specific features of THRs—the bearing surface, the use of bone cement and the material of the stem—on the cancer incidence. Patients and methods In a retrospective cohort study we identified 8,343 patients with THRs performed at Valdoltra Hospital from September 1, 1997 to December 31, 2009. Patient data were linked to national cancer and population registries. The standardized incidence ratios (SIR) and Poisson regression relative risks (RR) were calculated for all and specific cancers. Results General cancer risk in our cohort was comparable to the population risk. Comparing with population, the risk of prostate cancer was statistically significantly higher in patients with metal-on-metal bearings (SIR =1.35); with metal-on-polyethylene bearings (SIR =1.30), with non-cemented THRs (SIR =1.40), and with titanium alloy THRs (SIR =1.41). In these last 3 groups there was a lower risk of hematopoietic tumors (SIR =0.69; 0.66 and 0.66 respectively). Risk of kidney cancer was significantly higher in the non-metal-on-metal, non-cemented, and titanium alloy groups (SIR =1.30; 1.46 and 1.41 respectively). Risk of colorectal and lung cancer was significantly lower in the investigated cohort (SIR =0.82 and 0.83, respectively). Risk for all cancers combined as well as for prostate and skin cancer, shown by Poisson analysis, was higher in the metal-on-metal group compared with non-metal-on-metal group (RR =1.56; 2.02 and 1.92, respectively). Interpretation Some associations were found between the THRs’ features, especially a positive association between metal-on-metal bearings, and specific cancers. PMID:29388497

Risk of gastrointestinal cancers in patients with cystic fibrosis: a systematic review and meta-analysis.

PubMed

Yamada, Akihiro; Komaki, Yuga; Komaki, Fukiko; Micic, Dejan; Zullow, Samantha; Sakuraba, Atsushi

2018-04-26

The management and life expectancy of patients with cystic fibrosis have improved substantially in the past three decades, which has resulted in an increased number of these patients being diagnosed with malignancies. Our aim was to assess the risk of gastrointestinal cancers in patients with cystic fibrosis. In this systematic review and meta-analysis, we searched PubMed, MEDLINE, Google Scholar, Scopus, Embase, and Cochrane databases with no language restrictions for studies published from inception of the databases to Aug 1, 2017, assessing the risk of gastrointestinal cancers in patients with cystic fibrosis. We also searched abstracts from scientific meetings and the bibliographies of identified articles for additional references. Studies were included if they reported the standardised incidence ratio (SIR) or incidence ratio per person-years. No exclusion criteria with regard to patient characteristics (age, sex, comorbidities, cystic fibrosis mutation type), study setting (location and time period), or method of reporting cancer diagnoses were applied. The primary outcome was risk of gastrointestinal cancer and site-specific gastrointestinal cancers in patients with cystic fibrosis compared with the general population. Pooled summary estimates were calculated using a random-effects model, and subgroup analyses were done to establish whether risk of gastrointestinal cancer varied according to patient lung transplant status. The study is registered with PROSPERO, number CRD42017075396. Our search identified 95 681 records, of which six cohort studies including 99 925 patients (544 695 person-years) were eligible for the meta-analysis. The overall risk of gastrointestinal cancer was significantly higher in patients with cystic fibrosis than in the general population (pooled SIR 8·13, 95% CI 6·48-10·21; p<0·0001; log SIR 2·10, 95% CI 1·87-2·32; p<0·0001, I 2 =93·93%). Subgroup analyses showed that the risk of gastrointestinal cancer among patients with cystic fibrosis who had a lung transplant was increased compared with that of patients who did not receive a transplant (pooled SIR 21·13, 95% CI 14·82-30·14; p<0·0001; log SIR 3·05, 95% CI 2·70-3·41; p<0·0001, I 2 =28·52% vs pooled SIR 4·18, 3·10-5·62; p<0·0001; log SIR 1·43, 1·13-1·73; p<0·0001, I 2 =22·66%). The risk for the following site-specific cancers was also significantly increased in patients with cystic fibrosis compared with the general population: small bowel cancer (pooled SIR 18·94, 95% CI 9·37-38·27; p<0·0001; log SIR 2·94, 95% CI 2·24-3·64; p<0·0001, I 2 =38·61%), colon cancer (10·91, 8·42-14·11; p<0·0001; log SIR 2·39, 2·13-2·65; p<0·0001, I 2 =88·09%), biliary tract cancer (17·87, 8·55-37·36; p<0·0001; log SIR 2·88, 2·15-3·62; p<0·0001, I 2 =10·16%), and pancreatic cancer (6·18, 1·31-29·27; p=0·022; log SIR 1·82, 0·27-3·38; p<0·0001, I 2 =62·57%). Our study suggests that patients with cystic fibrosis had a significantly increased risk of gastrointestinal cancer compared with the general population, including small bowel, colon, biliary tract, and pancreatic cancers. These findings highlight the need to develop individualised screening strategies for site-specific gastrointestinal cancers in patients with cystic fibrosis. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

NOX2 protects against progressive lung injury and multiple organ dysfunction syndrome.

PubMed

Whitmore, Laura C; Goss, Kelli L; Newell, Elizabeth A; Hilkin, Brieanna M; Hook, Jessica S; Moreland, Jessica G

2014-07-01

Systemic inflammatory response syndrome (SIRS) is a common clinical condition in patients in intensive care units that can lead to complications, including multiple organ dysfunction syndrome (MODS). MODS carries a high mortality rate, and it is unclear why some patients resolve SIRS, whereas others develop MODS. Although oxidant stress has been implicated in the development of MODS, several recent studies have demonstrated a requirement for NADPH oxidase 2 (NOX2)-derived oxidants in limiting inflammation. We recently demonstrated that NOX2 protects against lung injury and mortality in a murine model of SIRS. In the present study, we investigated the role of NOX2-derived oxidants in the progression from SIRS to MODS. Using a murine model of sterile systemic inflammation, we observed significantly greater illness and subacute mortality in gp91(phox-/y) (NOX2-deficient) mice compared with wild-type mice. Cellular analysis revealed continued neutrophil recruitment to the peritoneum and lungs of the NOX2-deficient mice and altered activation states of both neutrophils and macrophages. Histological examination showed multiple organ pathology indicative of MODS in the NOX2-deficient mice, and several inflammatory cytokines were elevated in lungs of the NOX2-deficient mice. Overall, these data suggest that NOX2 function protects against the development of MODS and is required for normal resolution of systemic inflammation. Copyright © 2014 the American Physiological Society.

Increased uptake of social security benefits among long-term survivors of cancer in childhood, adolescence and young adulthood: a Norwegian population-based cohort study.

PubMed

Ghaderi, S; Engeland, A; Moster, D; Ruud, E; Syse, A; Wesenberg, F; Bjørge, T

2013-04-16

As the number of cancer survivors increases, their health and welfare have come into focus. Thus, long-term medical consequences of cancer at a young age (<25 years), obtained from social security benefit records, were studied. Standardised incidence ratios (SIRs) of long-term medical consequences for 5-year cancer survivors, born during 1965-1985, were explored by linking population-based registries in Norway. Among the 5-year cancer survivors (4031 individuals), 29.7% received social security benefits. The survivors had an overall 4.4 times (95% confidence interval (95% CI): 4.1-4.6) higher risk of social security benefit uptake than the cancer-free population. Survivors of malignancies of bone and connective tissues (SIR: 10.8; 95% CI: 9.1-12.9), CNS tumours (SIR: 7.7; 95% CI: 6.9-8.6) and malignancies of the haematopoietic system (SIR: 6.1; 95% CI: 5.3-7.0) had the highest risks of social security benefits uptake. The most notified causes of social security benefit uptake were diseases of the nervous system, and injury and poisoning. The uptake of social security benefits among 5-year cancer survivors increased substantially and it may represent a solid outcome measure for the burden of the most severe late effects, especially in countries with comparable social welfare systems.

Advances in spaceborne synthetic aperture radar sensor technology

NASA Technical Reports Server (NTRS)

Caro, E. R.; Ruzek, M.

1986-01-01

The evolution of space SARs for NASA projects since Seasat (1978) is surveyed, with an emphasis on hardware development. The fundamental principles of SAR are reviewed; the SIR-A and SIR-B instruments flown as Shuttle payloads are characterized; their antennas, transmitters, receivers, and data subsystems are described; the advantages offered by the SIR-C dual-frequency (L and C band) dual-polarization distributed SAR (being developed for a future Shuttle flight and as the basis of an SAR for the Earth Observing System) are explained; and a number of technical challenges are identified (including RF elements, structural fidelity, pointing accuracy, data handling, and dc power). Drawings, diagrams, sample images, photographs, and tables are provided.

Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis.

PubMed

Haydar, Samir; Spanier, Matthew; Weems, Patricia; Wood, Samantha; Strout, Tania

2017-11-01

The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis. Electronic health records of 200 patients who were treated for suspected sepsis in our ED and ultimately discharged from our hospital with a diagnosis of sepsis were randomly selected for review from a population of adult ED patients (N=1880). Data extracted included the presence of SIRS criteria and the qSOFA score as well as time required to meet said criteria. In this cohort, 94.5% met SIRS criteria while in the ED whereas only 58.3% met qSOFA. The mean time from arrival to SIRS documentation was 47.1min (95% CI: 36.5-57.8) compared to 84.0min (95% CI: 62.2-105.8) for qSOFA. The median ED "door" to positive SIRS criteria was 12min and 29min for qSOFA. Although qSOFA may be valuable in predicting sepsis-related mortality, it performed poorly as a screening tool for identifying sepsis in the ED. As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Cancer incidence and all-cause mortality in a cohort of 21,582 Norwegian military peacekeepers deployed to Lebanon during 1978-1998.

PubMed

Strand, Leif Aage; Martinsen, Jan Ivar; Borud, Einar Kristian

2015-08-01

We investigated cancer incidence and all-cause mortality among 21,582 Norwegian male military peacekeepers deployed to Lebanon during 1978-1998. We also looked at cancer risk according to duration of service in Lebanon, in the occupational groups of cooks and mechanics, and the risk of alcohol- and smoking-related cancers among those who served during high- or low-conflict periods. The cohort was followed for cancer incidence and all-cause mortality from 1978 through 2012. Standardised incidence ratios (SIR) for cancer and mortality ratios (SMR) were calculated from national rates for the total cohort. SIRs were calculated according to duration of service; among cooks and mechanics; and according to high- and low-conflict exposure. Poisson regression, expressed as rate ratio (RR), was used to see the effect of duration of service, and of conflict exposure. A decreased risk was found for cancer incidence overall (1050 cases, SIR=0.90, 95% confidence interval [CI] 0.84-0.95) and for cancers of the prostate (SIR=0.78) and skin (other than melanoma) (SIR=0.58). The incidence of rectal cancer was 73% higher in those who served for 1 year or more than in those with shorter-term service (RR=1.73, 95% CI 1.00-3.02). The cancer risk in cooks and mechanics was within expected values. The risk of lung cancer was higher in the high-conflict exposure group than in the low-conflict exposure group (RR=1.79; 95% CI 1.00-3.18). In the total cohort, all-cause mortality was lower than expected (SMR=0.83; 95% CI 0.78-0.88). We found a "healthy soldier effect" for overall cancer incidence and all-cause mortality. Service during high-conflict periods was associated with a higher risk of lung cancer than service during low-conflict periods, but this risk was in line with that of the reference population. Copyright © 2015. Published by Elsevier Ltd.

SirT1 mediates hyperbaric oxygen preconditioning-induced ischemic tolerance in rat brain

PubMed Central

Yan, Wenjun; Fang, Zongping; Yang, Qianzi; Dong, Hailong; Lu, Yan; Lei, Chong; Xiong, Lize

2013-01-01

Our previous studies have shown that hyperbaric oxygen preconditioning (HBO-PC) induces tolerance to cerebral ischemia/reperfusion (I/R). This study aimed to investigate whether SirT1, a class III histone deacetylase, is involved in neuroprotection elicited by HBO-PC in animal and cell culture models of ischemia. Rats were subjected to middle cerebral artery occlusion for 120 minutes after HBO-PC (once a day for 5 days). Primary cultured cortical neurons were exposed to 2 hours of HBO-PC after 2 hours of oxygen–glucose deprivation (OGD). We showed that HBO-PC increased SirT1 protein and mRNA expression, promoted neurobehavioral score, reduced infarct volume, and improved morphology at 24 hours and 7 days after cerebral I/R. Neuroprotection of HBO-PC was attenuated by SirT1 inhibitor EX527 and SirT1 knockdown by short interfering RNA (siRNA), whereas it was mimicked by SirT1 activator resveratrol. Furthermore, HBO-PC enhanced SirT1 expression and cell viability and reduced lactate dehydrogenase release 24 hours after OGD/re-oxygenation. The neuroprotective effect of HBO-PC was emulated through upregulating SirT1 and, reversely, attenuated through downregulating SirT1. The modulation of SirT1 was made by adenovirus infection carrying SirT1 or SirT1 siRNA. Besides, SirT1 increased B-cell lymphoma 2 (Bcl-2) expression and decrease cleaved caspase 3. These results indicate that SirT1 mediates HBO-PC-induced tolerance to cerebral I/R through inhibition of apoptosis. PMID:23299244

The mitochondrial SIR2 related protein 2 (SIR2RP2) impacts Leishmania donovani growth and infectivity

PubMed Central

Mittal, Nimisha; Muthuswami, Rohini

2017-01-01

Background Leishmania donovani, a protozoan parasite is the major causative agent of visceral leishmaniasis. Increased toxicity and resistance to the existing repertoire of drugs has been reported. Hence, an urgent need exists for identifying newer drugs and drug targets. Previous reports have shown sirtuins (Silent Information Regulator) from kinetoplastids as promising drug targets. Leishmania species code for three SIR2 (Silent Information Regulator) related proteins. Here, we for the first time report the functional characterization of SIR2 related protein 2 (SIR2RP2) of L. donovani. Methodology Recombinant L. donovani SIR2RP2 was expressed in E. coli and purified. The enzymatic functions of SIR2RP2 were determined. The subcellular localization of LdSIR2RP2 was done by constructing C-terminal GFP-tagged full-length LdSIR2RP2. Deletion mutants of LdSIR2RP2 were generated in Leishmania by double targeted gene replacement methodology. These null mutants were tested for their proliferation, virulence, cell cycle defects, mitochondrial functioning and sensitivity to known SIR2 inhibitors. Conclusion Our data suggests that LdSIR2RP2 possesses NAD+-dependent ADP-ribosyltransferase activity. However, NAD+-dependent deacetylase and desuccinylase activities were not detected. The protein localises to the mitochondrion of the promastigotes. Gene deletion studies showed that ΔLdSIR2RP2 null mutants had restrictive growth phenotype associated with accumulation of cells in the G2/M phase and compromised mitochondrial functioning. The null mutants had attenuated infectivity. Deletion of LdSIR2RP2 resulted in increased sensitivity of the parasites to the known SIR2 inhibitors. The sirtuin inhibitors inhibited the ADP-ribosyltransferase activity of recombinant LdSIR2RP2. In conclusion, sirtuins could be used as potential new drug targets for visceral leishmaniasis. PMID:28493888

Addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 452: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, Revision 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant Evenson

This document constitutes an addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 452: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, April 1998 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additionalmore » information • The cover, title, and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the URs for CASs: • 25-25-09, Spill H940825C (from UST 25-3101-1) • 25-25-14, Spill H940314E (from UST 25-3102-3) • 25-25-15, Spill H941020E (from UST 25-3152-1) These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

Addendum 2 to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 454: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, Revision 0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grant Evenson

This document constitutes an addendum to the Streamlined Approach for Environmental Restoration Closure Report for Corrective Action Unit 454: Historical Underground Storage Tank Release Sites, Nevada Test Site, Nevada, April 1998 as described in the document Supplemental Investigation Report for FFACO Use Restrictions, Nevada Test Site, Nevada (SIR) dated November 2008. The SIR document was approved by NDEP on December 5, 2008. The approval of the SIR document constituted approval of each of the recommended UR removals. In conformance with the SIR document, this addendum consists of: • This page that refers the reader to the SIR document for additionalmore » information • The cover, title, and signature pages of the SIR document • The NDEP approval letter • The corresponding section of the SIR document This addendum provides the documentation justifying the cancellation of the URs for CASs: • 12-25-08, Spill H950524F (from UST 12-B-1) • 12-25-10, Spill H950919A (from UST 12-COMM-1) These URs were established as part of Federal Facility Agreement and Consent Order (FFACO) corrective actions and were based on the presence of contaminants at concentrations greater than the action levels established at the time of the initial investigation (FFACO, 1996). Since these URs were established, practices and procedures relating to the implementation of risk-based corrective actions (RBCA) have changed. Therefore, these URs were re-evaluated against the current RBCA criteria as defined in the Industrial Sites Project Establishment of Final Action Levels (NNSA/NSO, 2006). This re-evaluation consisted of comparing the original data (used to define the need for the URs) to risk-based final action levels (FALs) developed using the current Industrial Sites RBCA process. The re-evaluation resulted in a recommendation to remove these URs because contamination is not present at these sites above the risk-based FALs. Requirements for inspecting and maintaining these URs will be canceled, and the postings and signage at each site will be removed. Fencing and posting may be present at these sites that are unrelated to the FFACO URs such as for radiological control purposes as required by the NV/YMP Radiological Control Manual (NNSA/NSO, 2004). This modification will not affect or modify any non-FFACO requirements for fencing, posting, or monitoring at these sites.« less

The HIV hide and seek game: an immunogenomic analysis of the HIV epitope repertoire.

PubMed

Vider-Shalit, Tal; Almani, Michal; Sarid, Ronit; Louzoun, Yoram

2009-07-17

Viruses employ various means to evade immune detection. One common evasion strategy is the removal of CD8 cytotoxic T-lymphocyte (CTL) epitopes. Here, we use bioinformatic tools to compute the HIV CTL epitope repertoire presented by over 8000 HIV sequences in multiple Human Leukocyte Antigen alleles. We define the 'Size of Immune Repertoire' (SIR) score, which represents the ratio between the number of the predicted epitopes within a protein and their expected number within a scrambled version of the same protein. We show that HIV proteins present less epitopes than expected and that the number of epitopes gradually decreases from SIV to recent HIV sequences. The decrease of the SIR score of HIV is accompanied by a high frequency of replacement mutations within epitopes. The SIR score of the different HIV proteins is not uniform. The regulatory proteins, Tat and Rev, expressed early during cellular infection have a low SIR score, whereas virion-associated genes that are expressed later, such as Env, Pol and Gag, have a higher SIR score. Actually, the SIR score of Gag keeps increasing over time. We hypothesize that our results reflect an HIV immune evasion strategy. This involves the targeting of the CTL immune response to viral structural and enzyme proteins, allowing the virus a time interval to propagate before its host cells are destroyed by CTLs. An efficient anti-HIV CTL response against HIV should thus also target the regulatory genes that HIV seeks to hide from the immune system.

A retrospective analysis of cross-reacting cetuximab IgE antibody and its association with severe infusion reactions.

PubMed

Maier, Sabine; Chung, Christine H; Morse, Michael; Platts-Mills, Thomas; Townes, Leigh; Mukhopadhyay, Pralay; Bhagavatheeswaran, Prabhu; Racenberg, Jan; Trifan, Ovidiu C

2015-01-01

Severe infusion reactions (SIRs) at rates of 5% or less are known side effects of biological agents, including mAbs such as cetuximab. There are currently no prospectively validated risk factors to aid physicians in identifying patients who may be at risk of experiencing an SIR following administration of any of these drugs. A retrospective analysis of 545 banked serum or plasma samples from cancer patients participating in clinical trials of cetuximab was designed to evaluate whether the presence of pretreatment IgE antibodies against cetuximab, as determined by a commercially available assay system, is associated with SIRs during the initial cetuximab infusion. Patients with a positive test indicating the presence of pretreatment antibodies had a higher risk of experiencing an SIR; however, at the prespecified cutoff utilized in this analysis, the test has a relatively low-positive predictive value (0.577 [0.369-0.766]) and a negative predictive value of 0.961 (0.912-0.987) in an unselected patient population. Data collected in this large retrospective validation study support prior observations of an association between the presence of pretreatment IgE antibodies cross-reactive with cetuximab and SIRs. Further analysis of the test's ability to predict patients at risk of an SIR would be required before this assay could be used reliably in this patient population. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Geological mapping potential of computer-enhanced images from the Shuttle Imaging Radar - Lisbon Valley Anticline, Utah

NASA Technical Reports Server (NTRS)

Curlis, J. D.; Frost, V. S.; Dellwig, L. F.

1986-01-01

Computer-enhancement techniques applied to the SIR-A data from the Lisbon Valley area in the northern portion of the Paradox basin increased the value of the imagery in the development of geologically useful maps. The enhancement techniques include filtering to remove image speckle from the SIR-A data and combining these data with Landsat multispectral scanner data. A method well-suited for the combination of the data sets utilized a three-dimensional domain defined by intensity-hue-saturation (IHS) coordinates. Such a system allows the Landsat data to modulate image intensity, while the SIR-A data control image hue and saturation. Whereas the addition of Landsat data to the SIR-A image by means of a pixel-by-pixel ratio accentuated textural variations within the image, the addition of color to the combined images enabled isolation of areas in which gray-tone contrast was minimal. This isolation resulted in a more precise definition of stratigraphic units.

Plasma biomarkers of SIRS and MODS associated with canine babesiosis.

PubMed

Kuleš, J; de Torre-Minguela, C; Barić Rafaj, R; Gotić, J; Nižić, P; Ceron, J J; Mrljak, V

2016-04-01

Canine babesiosis is a tick-borne disease caused by the haemoprotozoan parasites of the genus Babesia. Early detection of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is of major importance in clinical practice for providing information about severity and outcomes of the disease and therapy. Plasma samples were taken at admission from five dogs with uncomplicated babesiosis caused by B. canis canis, five dogs with babesiosis and SIRS, five dogs with babesiosis and MODS, and five healthy dogs. After two-dimensional electrophoresis and capillary reversed - phase liquid chromatography coupled online with tandem mass spectrometry, 68 differentially expressed spots with level of significance P<0.05 were detected between groups. SIRS in babesiosis was characterised by increases in paraoxonase 1 and apoA-I, whereas MODS with decrease of complement inhibitors leading to prolonged complement activation and decrease of vitamin D binding protein due to haemolysis and activation of the coagulation cascade. Copyright © 2016 Elsevier Ltd. All rights reserved.

New Zealand SIR-B science investigations

NASA Technical Reports Server (NTRS)

Collins, M. A.; Oliver, P. J.; Cochrane, G. R.; Cole, J.; Coombs, D. S.; Barnes, E. J.; Ching, N. P.; Bennets, R. L.; Stephens, P. H.; Laing, A. K.

1984-01-01

It is proposed that shuttle imaging radar (SIR) data be used to study unusual geological features of New Zealand. Particular attention is planned for geological faults. SIR-B imagery is to be compared with LANDSAT multispectral imagery. Three other investigations which are to use SIR data are discussed. An ocean eddy is to be studied from a correlation of SIR-B and advanced very high resolution radiometer imagery. Timber volume is to be assessed by determining the age and size of pine forests from SIR-B data. Soil moisture is to be investigated by comparing SIR-B data with simultaneous gravimetric data. Land cover in a region already subjected to intensive investigation using LANDSAT and aircraft scanner data is to be discriminated by SIR-B data.

The threshold of a stochastic delayed SIR epidemic model with vaccination

NASA Astrophysics Data System (ADS)

Liu, Qun; Jiang, Daqing

2016-11-01

In this paper, we study the threshold dynamics of a stochastic delayed SIR epidemic model with vaccination. We obtain sufficient conditions for extinction and persistence in the mean of the epidemic. The threshold between persistence in the mean and extinction of the stochastic system is also obtained. Compared with the corresponding deterministic model, the threshold affected by the white noise is smaller than the basic reproduction number Rbar0 of the deterministic system. Results show that time delay has important effects on the persistence and extinction of the epidemic.

NICE guidance on sepsis is of limited value in postoperative colorectal patients: the scores that cry 'wolf!'

PubMed

Herrod, Pjj; Cox, M; Keevil, H; Smith, Kje; Lund, J N

2018-04-01

Background and aims Late recognition of sepsis and consequent death remains a problem. To address this, the National Institute for Health and Care Excellence has published updated guidance recommending the use of the Quick Sequential Organ Failure Assessment (Q-SOFA) score when assessing patients at risk of sepsis following the publication of the Third International Consensus Definitions for Sepsis and Septic Shock. The trauma from major surgery produces a systemic inflammatory response syndrome (SIRS) postoperatively as part of its natural history, which may falsely trigger scoring systems. We aimed to assess the accuracy of Q-SOFA and SIRS criteria as recommended scores for early detection of sepsis and septic complications in the first 48hrs after colorectal cancer surgery. Methods We reviewed all elective major colorectal operations in a single centre during a 12-month period from prospectively maintained electronic records. Results One hundred and thirty nine patients were included in this study. In all, 29 patients developed postoperative infective complications in hospital. Nineteen patients triggered on SIRS without developing infective complications, while 42 patients triggered on Q-SOFA with no infective complications. The area under the ROC curve was 0.52 for Q-SOFA and 0.67 for SIRS. Discussion Q-SOFA appears to perform little better than a coin toss at identifying postoperative sepsis after colorectal cancer resection and is inferior to the SIRS criteria. More work is required to assess whether a combination of scoring criteria, biochemical markers and automated tools could increase accurate detection of postoperative infection and trigger early intervention.

Use of a case-mix approach to study the trends in the incidence of second primary cancers.

PubMed

Gass, Boris; Marrer, Emilie; Bara, Simona; Ligier, Karine; Molinié, Florence; Colonna, Marc; Daubisse-Marliac, Laetitia; Trétarre, Brigitte; Lapôtre-Ledoux, Bénédicte; Woronoff, Anne-Sophie; Guizard, Anne-Valérie; Bouvier, Véronique; Troussard, Xavier; Gaiddon, Christian; Klein, Delphine; Velten, Michel; Jégu, Jérémie

2018-05-01

To analyze trends in second primary cancer (SPC) incidence by using a case-mix approach to standardize on first cancer site distribution. Cases registered by 13 French cancer registries between 1989 and 2010 and followed-up until June 2013 were included. The person-year approach was used to compute standardized incidence ratios (SIRs) of metachronous SPC. Usual SIRs and cancer site-specific weighted SIRs called "case-mix SIRs" (cmSIRs) were estimated by sex and calendar period of first cancer diagnosis. Calendar trends in SIRs and cmSIRs were compared. More than 2.9 million person-years at risk were included. Among males, SIRs dropped from 1.49 to 1.23 between 1989-1994 and 2005-2010, while cmSIRs decreased from 1.40 to 1.27. This difference seems mainly related to a stronger representation of prostate cancers (at lower risk of SPC) and a weaker contribution of bladder and head and neck cancers (at higher risk of SPC) in recent periods of diagnosis. Among females, both SIRs and cmSIRs have remained stable at around 1.22 and 1.21, respectively. The cmSIR is an indicator that is not influenced by changes in first cancer site distribution. Its use should be encouraged to assess second cancer incidence control. Copyright © 2018 Elsevier Inc. All rights reserved.

Traveling waves in a delayed SIR model with nonlocal dispersal and nonlinear incidence

NASA Astrophysics Data System (ADS)

Zhang, Shou-Peng; Yang, Yun-Rui; Zhou, Yong-Hui

2018-01-01

This paper is concerned with traveling waves of a delayed SIR model with nonlocal dispersal and a general nonlinear incidence. The existence and nonexistence of traveling waves of the system are established respectively by Schauder's fixed point theorem and two-sided Laplace transform. It is also shown that the spread speed c is influenced by the dispersal rate of the infected individuals and the delay τ.

A SIR/CAR Systems Analysis of the Longitudinal Changes in Little League Baseball Comparing Windsor with the Rest of Ontario and Canada.

ERIC Educational Resources Information Center

Zarebski, John; Moriarty, Dick

The trends and changes occurring in Windsor District 5 Little League Baseball between 1971 and 1978 were closely monitored in order for researchers to discern the results of Sports Institute for Research/Change Agent Research (SIR/CAR) intervention in these programs. Comparisons of the 1972, 1976, and 1978 studies reveal that the values focus of…

Laboratory Diagnosis of Sepsis? No SIRS, Not Just Yet

PubMed Central

2015-01-01

In order to maximize the benefit of prompt antimicrobial therapy and avoid the risk associated with inappropriate use of antimicrobial agents, patients with suspected sepsis must be rapidly differentiated from patients with systemic inflammatory response syndrome (SIRS). In combination with standard microbiological testing, a number of biomarkers have been recently evaluated for this purpose, and the performance characteristics of the most promising of these are reviewed. PMID:25631808

Serum amyloid A in the diagnosis of feline sepsis.

PubMed

Troìa, Roberta; Gruarin, Marta; Foglia, Armando; Agnoli, Chiara; Dondi, Francesco; Giunti, Massimo

2017-11-01

Systemic inflammatory response syndrome (SIRS) and sepsis can be challenging to diagnose in cats. Retrospectively, we investigated the diagnostic and prognostic potential of serum amyloid A (SAA), a major feline acute-phase protein (APP), in a population of critically ill cats with SIRS related to trauma or sepsis. A total of 56 SIRS cats (trauma n = 27; sepsis n = 29) were included and compared with healthy controls ( n = 18). SAA concentration was significantly increased in SIRS cats compared to controls, confirming its potential for the detection of systemic inflammation in this species. Significantly higher values of SAA were detected in cats belonging to the sepsis group; however, according to the results of the receiver operating characteristic curve analysis, the value of using SAA (>81 mg/L) to discriminate septic cats was only moderate (AUC = 0.76). Additionally, cats with sepsis had significantly higher serum bilirubin concentrations and toxic neutrophil changes compared to the trauma group. Overall, 38 of 56 cats were survivors; 18 of 56 were non-survivors, with 83% of the non-survivors (15 of 18) belonging to the sepsis group. Serum bilirubin concentration, but not SAA, was able to predict outcome. Prospective studies are needed to assess the potential of SAA in the diagnosis of feline sepsis and outcome prediction.

A comparative analysis of acute-phase proteins as inflammatory biomarkers in preclinical toxicology studies: implications for preclinical to clinical translation.

PubMed

Watterson, Claire; Lanevschi, Anne; Horner, Judith; Louden, Calvert

2009-01-01

Recently, in early clinical development, a few biologics and small molecules intended as antitumor or anti-inflammatory agents have caused a severe adverse pro-inflammatory systemic reaction also known as systemic inflammatory response syndrome (SIRS). This toxicity could result from expected pharmacological effects of a therapeutic antibody and/or from interaction with antigens expressed on cells/tissues other than the intended target. Clinical monitoring of SIRS is challenging because of the narrow diagnostic window to institute a successful intervening therapeutic strategy prior to acute circulatory collapse. Furthermore, for these classes of therapeutic agents, studies in animals have low predictive ability to identify potential human hazards. In vitro screens with human cells, though promising, need further development. Therefore, identification of improved preclinical diagnostic markers of SIRS will enable clinicians to select applicable markers for clinical testing and avoid potentially catastrophic events. There is limited preclinical toxicology data describing the interspecies performance of acute-phase proteins because the response time, type, and duration of major acute-phase proteins vary significantly between species. This review will attempt to address this intellectual gap, as well as the use and applicability of acute-phase proteins as preclinical to clinical translational biomarkers of SIRS.

Mutations Leading to Expression of the Cryptic HMR a Locus in the Yeast SACCHAROMYCES CEREVISIAE

PubMed Central

Kassir, Yona; Simchen, Giora

1985-01-01

Mutations leading to expression of the silent HMR a information in Saccharomyces cerevisiae result in sporulation proficiency in mata1/MATα diploids. An example of such a mutation is sir5-2, a recessive mutation in the gene SIR5. As expected, haploids carrying the sir5-2 mutation are nonmaters due to the simultaneous expression of HMRa and HMLα, resulting in the nonmating phenotype of an a/α diploid. However, sir5-2/sir5-2 mata1/MATα diploids mate as α yet are capable of sporulation. The sir5-2 mutation is unlinked to sir1-1, yet the two mutations do not complement each other: mata1/MATα sir5-2/SIR5 SIR1/sir1-1 diploids are capable of sporulation. In this case, recessive mutations in two unlinked genes form a mutant phenotype, in spite of the presence of the normal wild-type alleles.—The PAS1-1 mutation, Provider of a Sporulation function, is a dominant mutation tightly linked to HMRa. PAS1-1 does not affect the mating ability of a strain, yet it allows diploids lacking a functional MATa locus to sporulate. It is proposed that PAS1-1 leads to partial expression of the otherwise cryptic a1 information at HMRa. PMID:3884439

Cancer in the Sami population of North Norway, 1970-1997.

PubMed

Haldorsen, T; Tynes, T

2005-02-01

The Sami population in North Norway constitutes an ethnic minority with a lifestyle that diverges from that of the rest of the population. A cohort of 19 801 people of Sami origin was followed for cancer incidence over the period 1970-1997 by the Norwegian Cancer Registry. Among the Sami 1340 cases of cancer were observed versus 1658.2 expected, based on a regional reference population. For both sexes a significantly decreased incidence of colon cancer was observed. The standardized incidence ratio (SIR) for men was 0.50 (95% confidence interval (CI) 0.34-0.71) and for women 0.62 (95% CI 0.43-0.85). Low SIRs were observed for lung cancer: 0.63 (95% CI 0.51-0.77) and 0.60 (95% CI 0.37-0.91), for men and women, respectively. Men of Sami ancestry had a decreased risk of prostate cancer: SIR 0.57 (95% CI 0.45-0.71). Among women 127 cases of breast cancer were observed versus 149.6 expected. A relatively high physical activity and a diet rich in fish may in part explain the low cancer incidence. Some Sami were exposed to radioactivity as a result of their diet based on reindeer products. Adverse effects on their cancer incidence were not observed.

Increased uptake of social security benefits among long-term survivors of cancer in childhood, adolescence and young adulthood: a Norwegian population-based cohort study

PubMed Central

Ghaderi, S; Engeland, A; Moster, D; Ruud, E; Syse, A; Wesenberg, F; Bjørge, T

2013-01-01

Background: As the number of cancer survivors increases, their health and welfare have come into focus. Thus, long-term medical consequences of cancer at a young age (<25 years), obtained from social security benefit records, were studied. Methods: Standardised incidence ratios (SIRs) of long-term medical consequences for 5-year cancer survivors, born during 1965–1985, were explored by linking population-based registries in Norway. Results: Among the 5-year cancer survivors (4031 individuals), 29.7% received social security benefits. The survivors had an overall 4.4 times (95% confidence interval (95% CI): 4.1–4.6) higher risk of social security benefit uptake than the cancer-free population. Survivors of malignancies of bone and connective tissues (SIR: 10.8; 95% CI: 9.1–12.9), CNS tumours (SIR: 7.7; 95% CI: 6.9–8.6) and malignancies of the haematopoietic system (SIR: 6.1; 95% CI: 5.3–7.0) had the highest risks of social security benefits uptake. The most notified causes of social security benefit uptake were diseases of the nervous system, and injury and poisoning. Conclusion: The uptake of social security benefits among 5-year cancer survivors increased substantially and it may represent a solid outcome measure for the burden of the most severe late effects, especially in countries with comparable social welfare systems. PMID:23481179

Effect of resource constraints on intersimilar coupled networks.

PubMed

Shai, S; Dobson, S

2012-12-01

Most real-world networks do not live in isolation but are often coupled together within a larger system. Recent studies have shown that intersimilarity between coupled networks increases the connectivity of the overall system. However, unlike connected nodes in a single network, coupled nodes often share resources, like time, energy, and memory, which can impede flow processes through contention when intersimilarly coupled. We study a model of a constrained susceptible-infected-recovered (SIR) process on a system consisting of two random networks sharing the same set of nodes, where nodes are limited to interact with (and therefore infect) a maximum number of neighbors at each epidemic time step. We obtain that, in agreement with previous studies, when no limit exists (regular SIR model), positively correlated (intersimilar) coupling results in a lower epidemic threshold than negatively correlated (interdissimilar) coupling. However, in the case of the constrained SIR model, the obtained epidemic threshold is lower with negatively correlated coupling. The latter finding differentiates our work from previous studies and provides another step towards revealing the qualitative differences between single and coupled networks.

Effect of resource constraints on intersimilar coupled networks

NASA Astrophysics Data System (ADS)

Shai, S.; Dobson, S.

2012-12-01

Most real-world networks do not live in isolation but are often coupled together within a larger system. Recent studies have shown that intersimilarity between coupled networks increases the connectivity of the overall system. However, unlike connected nodes in a single network, coupled nodes often share resources, like time, energy, and memory, which can impede flow processes through contention when intersimilarly coupled. We study a model of a constrained susceptible-infected-recovered (SIR) process on a system consisting of two random networks sharing the same set of nodes, where nodes are limited to interact with (and therefore infect) a maximum number of neighbors at each epidemic time step. We obtain that, in agreement with previous studies, when no limit exists (regular SIR model), positively correlated (intersimilar) coupling results in a lower epidemic threshold than negatively correlated (interdissimilar) coupling. However, in the case of the constrained SIR model, the obtained epidemic threshold is lower with negatively correlated coupling. The latter finding differentiates our work from previous studies and provides another step towards revealing the qualitative differences between single and coupled networks.

Paleodrainages of the Eastern Sahara - The radar rivers revisited (SIR-A/B implications for a mid-tertiary Trans-African drainage system)

NASA Technical Reports Server (NTRS)

Mccauley, J. F.; Breed, C. S.; Schaber, G. G.; Mchugh, W. P.; Haynes, C. C.

1986-01-01

The images obtained by the Shuttle Imaging Radar (SIR)-A and -B systems over the southwestern Egypt and northwestern Sudan were coregistered with the Landsat images and the existing maps to aid in extrapolations of the buried paleodrainages ('radar rivers'), first discovered by SIR-A. Field observations explain the radar responses of three types of radar rivers, RR-1 (broad, aggraded valleys filled with alluvium), RR-2 (braided channels inset in the RR-1 valleys), and RR-3 (narrow, long, bedrock-incised channels). A generalized model of the radar rivers, based on field studies and regional geologic relations, shows inferred changes in river regimen since the large valleys were established during the later Paleogene-early Neogene. It is suggested that a former Trans-African master stream system may have flowed from headwaters in the Red Sea Hills southwestward across North Africa, discharging into the Atlantic at the Paleo-Niger delta, prior to the Neogene domal uplifts and building of volcanic edifices across the paths of these ancient watercourses.

Heterogeneous models for an early discrimination between sepsis and non-infective SIRS in medical ward patients: a pilot study.

PubMed

Mearelli, Filippo; Fiotti, Nicola; Altamura, Nicola; Zanetti, Michela; Fernandes, Giovanni; Burekovic, Ismet; Occhipinti, Alessandro; Orso, Daniele; Giansante, Carlo; Casarsa, Chiara; Biolo, Gianni

2014-10-01

The objective of the study was to determine the accuracy of phospholipase A2 group II (PLA2-II), interferon-gamma-inducible protein 10 (IP-10), angiopoietin-2 (Ang-2), and procalcitonin (PCT) plasma levels in early ruling in/out of sepsis among systemic inflammatory response syndrome (SIRS) patients. Biomarker levels were determined in 80 SIRS patients during the first 4 h of admission to the medical ward. The final diagnosis of sepsis or non-infective SIRS was issued according to good clinical practice. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for sepsis diagnosis were assessed. The optimal biomarker combinations with clinical variables were investigated by logistic regression and decision tree (CART). PLA2-II, IP-10 and PCT, but not Ang-2, were significantly higher in septic (n = 60) than in non-infective SIRS (n = 20) patients (P ≤ 0.001, 0.027, and 0.002, respectively). PLA2-II PPV and NPV were 88 and 86%, respectively. The corresponding figures were 100 and 31% for IP-10, and 93 and 35% for PCT. Binary logistic regression model had 100% PPV and NPV, while manual and software-generated CART reached an overall accuracy of 95 and 98%, respectively, both with 100% NPV. PLA2-II and IP-10 associated with clinical variables in regression or decision tree heterogeneous models may be valuable biomarkers for sepsis diagnosis in SIRS patients admitted to medical ward (MW). Further studies are needed to introduce them into clinical practice.

Legal Aspects of Offensive Information Operations in Space

DTIC Science & Technology

2005-01-01

decisional interaction with information systems.3 This same thought was expressed during the Second World War by Captain Sir Basil Liddel Hart: “[t]he...JOINT DOCTRINE FOR INFORMATION OPERATIONS, Oct. 9, 1998, at I-3 [hereinafter JOINT PUBLICATION 3-13]. 4. Captain Sir Basil Liddel Hart, Thoughts on...International Affairs) in the Office of the General Counsel, Department of Defense, presentation at Annual Review of the ABA Standing Committee on Law and

Plasma concentrations of inflammatory cytokines rise rapidly during ECMO-related SIRS due to the release of preformed stores in the intestine.

PubMed

McILwain, R Britt; Timpa, Joseph G; Kurundkar, Ashish R; Holt, David W; Kelly, David R; Hartman, Yolanda E; Neel, Mary Lauren; Karnatak, Rajendra K; Schelonka, Robert L; Anantharamaiah, G M; Killingsworth, Cheryl R; Maheshwari, Akhil

2010-01-01

Extracorporeal membrane oxygenation (ECMO) is a life-saving support system used in neonates and young children with severe cardiorespiratory failure. Although ECMO has reduced mortality in these critically ill patients, almost all patients treated with ECMO develop a systemic inflammatory response syndrome (SIRS) characterized by a 'cytokine storm', leukocyte activation, and multisystem organ dysfunction. We used a neonatal porcine model of ECMO to investigate whether rising plasma concentrations of inflammatory cytokines during ECMO reflect de novo synthesis of these mediators in inflamed tissues, and therefore, can be used to assess the severity of ECMO-related SIRS. Previously healthy piglets (3-week-old) were subjected to venoarterial ECMO for up to 8 h. SIRS was assessed by histopathological analysis, measurement of neutrophil activation (flow cytometry), plasma cytokine concentrations (enzyme immunoassays), and tissue expression of inflammatory genes (PCR/western blots). Mast cell degranulation was investigated by measurement of plasma tryptase activity. Porcine neonatal ECMO was associated with systemic inflammatory changes similar to those seen in human neonates. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-8 (IL-8) concentrations rose rapidly during the first 2 h of ECMO, faster than the tissue expression of these cytokines. ECMO was associated with increased plasma mast cell tryptase activity, indicating that increased plasma concentrations of inflammatory cytokines during ECMO may result from mast cell degranulation and associated release of preformed cytokines stored in mast cells. TNF-alpha and IL-8 concentrations rose faster in plasma than in the peripheral tissues during ECMO, indicating that rising plasma levels of these cytokines immediately after the initiation of ECMO may not reflect increasing tissue synthesis of these cytokines. Mobilization of preformed cellular stores of inflammatory cytokines such as in mucosal mast cells may have an important pathophysiological role in ECMO-related SIRS.

Post-event spontaneous intrusive recollections and strength of memory for emotional events in men and women.

PubMed

Ferree, Nikole K; Cahill, Larry

2009-03-01

Spontaneous intrusive recollections (SIRs) follow traumatic events in clinical and non-clinical populations. To determine whether any relationship exists between SIRs and enhanced memory for emotional events, participants viewed emotional or neutral films, had their memory for the films tested two days later, and estimated the number of SIRs they experienced for each film. SIR frequency related positively to memory strength, an effect more pronounced in the emotional condition. These findings represent the first demonstration of a relationship between SIRs occurring after an emotional experience and subsequent memory strength for that experience. The results are consistent with the possibility that emotional arousal leads both to elevated SIR frequency and better memory, and that the covert rehearsal associated with SIRs enhances memory for emotional relative to neutral stimuli. Additional evidence of menstrual cycle influences on SIR incidence in female participants appears to merit consideration in future work.

Post-event spontaneous intrusive recollections and strength of memory for emotional events in men and women

PubMed Central

Ferree, Nikole K.; Cahill, Larry

2009-01-01

Spontaneous intrusive recollections (SIRs) follow traumatic events in clinical and non-clinical populations. To determine whether any relationship exists between SIRs and enhanced memory for emotional events, participants viewed emotional or neutral films, had their memory for the films tested two days later, and estimated the number of SIRs they experienced for each film. SIR frequency related positively to memory strength, an effect more pronounced in the emotional condition. These findings represent the first demonstration of a relationship between SIRs occurring after an emotional experience and subsequent memory strength for that experience. The results are consistent with the possibility that emotional arousal leads both to elevated SIR frequency and better memory, and that the covert rehearsal associated with SIRs enhances memory for emotional relative to neutral stimuli. Additional evidence of menstrual cycle influences on SIR incidence in female participants appears to merit consideration in future work. PMID:19131257

The optimal dynamic immunization under a controlled heterogeneous node-based SIRS model

NASA Astrophysics Data System (ADS)

Yang, Lu-Xing; Draief, Moez; Yang, Xiaofan

2016-05-01

Dynamic immunizations, under which the state of the propagation network of electronic viruses can be changed by adjusting the control measures, are regarded as an alternative to static immunizations. This paper addresses the optimal dynamical immunization under the widely accepted SIRS assumption. First, based on a controlled heterogeneous node-based SIRS model, an optimal control problem capturing the optimal dynamical immunization is formulated. Second, the existence of an optimal dynamical immunization scheme is shown, and the corresponding optimality system is derived. Next, some numerical examples are given to show that an optimal immunization strategy can be worked out by numerically solving the optimality system, from which it is found that the network topology has a complex impact on the optimal immunization strategy. Finally, the difference between a payoff and the minimum payoff is estimated in terms of the deviation of the corresponding immunization strategy from the optimal immunization strategy. The proposed optimal immunization scheme is justified, because it can achieve a low level of infections at a low cost.

Increased extracellular heat shock protein 90α in severe sepsis and SIRS associated with multiple organ failure and related to acute inflammatory-metabolic stress response in children.

PubMed

Fitrolaki, Michaela-Diana; Dimitriou, Helen; Venihaki, Maria; Katrinaki, Marianna; Ilia, Stavroula; Briassoulis, George

2016-08-01

Mammalian heat-shock-protein (HSP) 90α rapidly responses to environmental insults. We examined the hypothesis that not only serum HSP72 but also HSP90α is increased in the systemic inflammatory response syndrome (SIRS), severe-sepsis (SS), and/or sepsis (S) compared to healthy children (H); we assessed HSP90α relation to (a) multiple organ system failure (MOSF) and (b) inflammatory-metabolic response and severity of illness.A total of 65 children with S, SS, or SIRS and 25 H were included. ELISA was used to evaluate extracellular HSP90α and HSP72, chemiluminescence interleukins (ILs), flow-cytometry neutrophil-CD64 (nCD64)-expression.HSP90α, along with HSP72, were dramatically increased among MOSF patients. Patients in septic groups and SIRS had elevated HSP90α compared to H (P < 0.01). HSP90α was independently related to predicted death rate and severity of illness; positively to HSP72, nCD64, ILs, length of stay, days on ventilator, and fever; negatively to HDL and LDL (P < 0.05). The HSP72 was increased in SS/S and related negatively to HDL and LDL (P < 0.05).Serum HSP90α is markedly elevated in children with severe sepsis and is associated with MOSF. Better than the HSP72, also increased in SS, SIRS, and MOSF, HSP90α is related to the inflammatory stress, fever, outcome endpoints, and predicted mortality and inversely related to the low-LDL/low-HDL stress metabolic pattern.

Evidence for serum miR-15a and miR-16 levels as biomarkers that distinguish sepsis from systemic inflammatory response syndrome in human subjects.

PubMed

Wang, Huijuan; Zhang, Pengjun; Chen, Weijun; Feng, Dan; Jia, Yanhong; Xie, Li-xin

2012-02-11

Serum microRNAs may be useful biomarkers for diagnosing human diseases. We investigated serum levels of miR-15a and miR-16 in patients with sepsis and systemic inflammatory response syndrome (SIRS) without infection. We enrolled 166 sepsis patients, 32 SIRS patients, and 24 normal controls. Serum miR-15a and miR-16 expression levels were determined by quantitative reverse transcriptase polymerase chain reaction assays (qRT-PCR). Serum miR-15a (p<0.001) and miR-16 (p<0.05) were both significantly higher in sepsis patients compared with normal controls, and miR-15a (p<0.001) and miR-16 (p<0.01) levels in SIRS patients were also significantly higher than those in normal controls. Serum miR-15a and miR-16 levels were not correlated with white blood cell counts. Receiver operating characteristic curves showed that miR-15a had the highest area under the curve of 0.858 [95% confidence interval (CI) 0.800-0.916] for the diagnosis of sepsis compared with C reactive protein and procalcitonin with areas under the curve of 0.572 (95% CI 0.479-0.665; p=0.198) and 0.605 (95% CI 0.443-0.767; p=0.168), respectively. When its cut-off point was set at 0.21, serum miR-15a had a sensitivity of 68.3% and a specificity of 94.4%. Serum miR-15a and miR-16 can both distinguish sepsis/SIRS from normal controls. miR-15a may be a biomarker that distinguishes between sepsis and SIRS.

Serum Concentrations of Interleukin-6, Procalcitonin, and C-Reactive Protein: Discrimination of Septical Complications and Systemic Inflammatory Response Syndrome after Pediatric Surgery.

PubMed

Neunhoeffer, Felix; Plinke, Swantje; Renk, Hanna; Hofbeck, Michael; Fuchs, Jörg; Kumpf, Matthias; Zundel, Sabine; Seitz, Guido

2016-04-01

Early differentiation between sepsis and systemic inflammatory response syndrome (SIRS) is useful for therapeutic management in neonates and infants after surgery. To compare the early (first 2 days) diagnostic value of interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) after surgery in the differentiation of subsequent SIRS and septic complications. IL-6, PCT, and CRP were measured 0, 24, and 48 hours after surgery in neonates and infants with clinical suspicion of postoperative sepsis. Sensitivity, specificity, and predictive values for SIRS/septic complications were calculated. A total of 31 out of 205 neonates and infants showed clinical signs for postoperative sepsis and underwent sepsis work-up. Nine patients developed septic complications, sixteen patients met criteria for SIRS, and six patients showed an uneventful postoperative course during the first five postoperative days. IL-6, PCT, and CRP levels increased in all subgroups after surgery and were significantly higher in the sepsis group (p < 0.05). IL-6 peaked immediately, CRP at 24 to 48 hours, and PCT at 24 hours after surgery. Sensitivity and specificity (area under the curve) for IL-6 (cutoff 673 ng/dL) were 94.4 and 75% (86.2%), for CRP (cutoff 1.48 mg/dL) 76.2 and 75.0% (88.1%), and for PCT (cutoff 16.1 mg/L) 66.7 and 57.1% (65.6%). IL-6 appears to be an early marker for severe bacterial infections with high sensitivity. IL-6 and CRP were the most reliable markers for the discrimination between SIRS and sepsis within the postoperative period. Georg Thieme Verlag KG Stuttgart · New York.

Increased extracellular heat shock protein 90α in severe sepsis and SIRS associated with multiple organ failure and related to acute inflammatory-metabolic stress response in children

PubMed Central

Fitrolaki, Michaela-Diana; Dimitriou, Helen; Venihaki, Maria; Katrinaki, Marianna; Ilia, Stavroula; Briassoulis, George

2016-01-01

Abstract Mammalian heat-shock-protein (HSP) 90α rapidly responses to environmental insults. We examined the hypothesis that not only serum HSP72 but also HSP90α is increased in the systemic inflammatory response syndrome (SIRS), severe-sepsis (SS), and/or sepsis (S) compared to healthy children (H); we assessed HSP90α relation to (a) multiple organ system failure (MOSF) and (b) inflammatory-metabolic response and severity of illness. A total of 65 children with S, SS, or SIRS and 25 H were included. ELISA was used to evaluate extracellular HSP90α and HSP72, chemiluminescence interleukins (ILs), flow-cytometry neutrophil-CD64 (nCD64)-expression. HSP90α, along with HSP72, were dramatically increased among MOSF patients. Patients in septic groups and SIRS had elevated HSP90α compared to H (P < 0.01). HSP90α was independently related to predicted death rate and severity of illness; positively to HSP72, nCD64, ILs, length of stay, days on ventilator, and fever; negatively to HDL and LDL (P < 0.05). The HSP72 was increased in SS/S and related negatively to HDL and LDL (P < 0.05). Serum HSP90α is markedly elevated in children with severe sepsis and is associated with MOSF. Better than the HSP72, also increased in SS, SIRS, and MOSF, HSP90α is related to the inflammatory stress, fever, outcome endpoints, and predicted mortality and inversely related to the low-LDL/low-HDL stress metabolic pattern. PMID:27583886

Remote sensing of rice fields and sea pollution by SIR-B

NASA Technical Reports Server (NTRS)

Fugono, N.; Furuhama, Y.; Takasugi, T.; Okamoto, K.; Fujita, M.; Yoshikado, S.; Masuko, H.; Shinozuka, T.; Inomata, H.; Shiro, I.

1984-01-01

Sensor calibration, rice fields, and sea pollution are to be investigated with respect to shuttle imaging radar-B (SIR-B). It is planned that the resolution characteristics of the SIR-B be evaluated, the sidelobe characteristics of the SIR-B be investigated, and the relationship between backscatter cross section and image intensity be established. The microwave-scattering characteristics of rice fields are to be studied using SIR-B data. The possibility of classifying crops from SIR-B data is to be explored. The characteristics of the radar image of oil-like surface films under several sea surface conditions are to be determined. The absolute measurement capability of the sea surface scattering cross section is to be estimated using the SIR.

Sir2a regulates rDNA transcription and multiplication rate in the human malaria parasite Plasmodium falciparum

PubMed Central

Mancio-Silva, Liliana; Lopez-Rubio, Jose Juan; Claes, Aurélie; Scherf, Artur

2013-01-01

The Plasmodium falciparum histone deacetylase Sir2a localizes at telomeric regions where it contributes to epigenetic silencing of clonally variant virulence genes. Apart from telomeres, PfSir2a also accumulates in the nucleolus, which harbours the developmentally regulated ribosomal RNA genes. Here we investigate the nucleolar function of PfSir2a and demonstrate that PfSir2a fine-tunes ribosomal RNA gene transcription. Using a parasite line in which PfSir2a has been disrupted, we observe that histones near the transcription start sites of all ribosomal RNA genes are hyperacetylated and that transcription of ribosomal RNA genes is upregulated. Complementation of the PfSir2a-disrupted parasites restores the ribosomal RNA levels, whereas PfSir2a overexpression in wild-type parasites decreases ribosomal RNA synthesis. Furthermore, we observe that PfSir2a modulation of ribosomal RNA synthesis is linked to an altered number of daughter merozoites and the parasite multiplication rate. These findings provide new insights into an epigenetic mechanism that controls malaria parasite proliferation and virulence. PMID:23443558

Deteriorated Stress Response in Stationary-Phase Yeast: Sir2 and Yap1 Are Essential for Hsf1 Activation by Heat Shock and Oxidative Stress, Respectively

PubMed Central

Cohen, Aviv; Bar-Nun, Shoshana

2014-01-01

Stationary-phase cultures have been used as an important model of aging, a complex process involving multiple pathways and signaling networks. However, the molecular processes underlying stress response of non-dividing cells are poorly understood, although deteriorated stress response is one of the hallmarks of aging. The budding yeast Saccharomyces cerevisiae is a valuable model organism to study the genetics of aging, because yeast ages within days and are amenable to genetic manipulations. As a unicellular organism, yeast has evolved robust systems to respond to environmental challenges. This response is orchestrated largely by the conserved transcription factor Hsf1, which in S. cerevisiae regulates expression of multiple genes in response to diverse stresses. Here we demonstrate that Hsf1 response to heat shock and oxidative stress deteriorates during yeast transition from exponential growth to stationary-phase, whereas Hsf1 activation by glucose starvation is maintained. Overexpressing Hsf1 does not significantly improve heat shock response, indicating that Hsf1 dwindling is not the major cause for Hsf1 attenuated response in stationary-phase yeast. Rather, factors that participate in Hsf1 activation appear to be compromised. We uncover two factors, Yap1 and Sir2, which discretely function in Hsf1 activation by oxidative stress and heat shock. In Δyap1 mutant, Hsf1 does not respond to oxidative stress, while in Δsir2 mutant, Hsf1 does not respond to heat shock. Moreover, excess Sir2 mimics the heat shock response. This role of the NAD+-dependent Sir2 is supported by our finding that supplementing NAD+ precursors improves Hsf1 heat shock response in stationary-phase yeast, especially when combined with expression of excess Sir2. Finally, the combination of excess Hsf1, excess Sir2 and NAD+ precursors rejuvenates the heat shock response. PMID:25356557

Deteriorated stress response in stationary-phase yeast: Sir2 and Yap1 are essential for Hsf1 activation by heat shock and oxidative stress, respectively.

PubMed

Nussbaum, Inbal; Weindling, Esther; Jubran, Ritta; Cohen, Aviv; Bar-Nun, Shoshana

2014-01-01

Stationary-phase cultures have been used as an important model of aging, a complex process involving multiple pathways and signaling networks. However, the molecular processes underlying stress response of non-dividing cells are poorly understood, although deteriorated stress response is one of the hallmarks of aging. The budding yeast Saccharomyces cerevisiae is a valuable model organism to study the genetics of aging, because yeast ages within days and are amenable to genetic manipulations. As a unicellular organism, yeast has evolved robust systems to respond to environmental challenges. This response is orchestrated largely by the conserved transcription factor Hsf1, which in S. cerevisiae regulates expression of multiple genes in response to diverse stresses. Here we demonstrate that Hsf1 response to heat shock and oxidative stress deteriorates during yeast transition from exponential growth to stationary-phase, whereas Hsf1 activation by glucose starvation is maintained. Overexpressing Hsf1 does not significantly improve heat shock response, indicating that Hsf1 dwindling is not the major cause for Hsf1 attenuated response in stationary-phase yeast. Rather, factors that participate in Hsf1 activation appear to be compromised. We uncover two factors, Yap1 and Sir2, which discretely function in Hsf1 activation by oxidative stress and heat shock. In Δyap1 mutant, Hsf1 does not respond to oxidative stress, while in Δsir2 mutant, Hsf1 does not respond to heat shock. Moreover, excess Sir2 mimics the heat shock response. This role of the NAD+-dependent Sir2 is supported by our finding that supplementing NAD+ precursors improves Hsf1 heat shock response in stationary-phase yeast, especially when combined with expression of excess Sir2. Finally, the combination of excess Hsf1, excess Sir2 and NAD+ precursors rejuvenates the heat shock response.

C-Reactive Protein and Hemogram Parameters for the Non-Sepsis Systemic Inflammatory Response Syndrome and Sepsis: What Do They Mean?

PubMed

Gucyetmez, Bulent; Atalan, Hakan K

2016-01-01

Sepsis is one of the most common reasons of increased mortality and morbidity in the intensive care unit. The changes in CRP levels and hemogram parameters and their combinations may help to distinguish sepsis from non-sepsis SIRS. The aim of this study is to investigate the CRP and hemogram parameters as an indicator of sepsis. A total of 2777 patients admitted to the ICU of two centers between 2006-2013 were evaluated retrospectively. The patients were diagnosed as SIRS (-), non-sepsis SIRS and sepsis. The patients who were under 18 years old, re-admitted, diagnosed with hematological disease, on corticosteroid and immunosuppressive therapy, SIRS (-), culture negative, undocumented laboratory values and outcomes were excluded. 1257 patients were divided into 2 groups as non-sepsis SIRS and sepsis. The patients' demographic data, CRP levels, hemogram parameters, length of ICU stay and mortality were recorded. 1257 patients were categorized as non-sepsis SIRS (816, 64.9%) and sepsis (441, 35.1%). In the multivariate analysis, the likelihood of sepsis was increased 3.2 (2.2-4.6), 1.7 (1.2-2.4), 1.6 (1.2-2.1), 2.3 (1.4-3.8), 1.5 (1.1-2.1) times by the APACHE II≥13, SOFA score≥4, CRP≥4.0, LymC<0.45 and PLTC<150 respectively (p<0.001 p = 0.007 p = 0.004 p<0.001 p = 0.027). The likelihood of sepsis was increased 18.1 (8.4-38.7) times by the combination of CRP≥4.0, lymC<0.45 and PLTC<150 (P<0.001). While WBCC, NeuC, Neu%, NLCR and EoC are far from being the indicators to distinguish sepsis from non-sepsis SIRS, the combinations of CRP, LymC and PLTC can be used to determine the likelihood of sepsis.

Cancer risk in population examined with diagnostic doses of /sup 131/I

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holm, L.E.; Wiklund, K.E.; Lundell, G.E.

1989-02-15

Previously, we conducted a study of 35,074 patients receiving diagnostic doses of 131I for suspected thyroid disorders between 1951 and 1969. We reported that, between 1958 and 1984, the incidence of thyroid cancers in these patients was insignificantly greater than the incidence expected in the general population. This increase was attributed to the underlying condition that prompted the examination and not to the administration of 131I. The purpose of the present study was to analyze the total cancer risk in the same cohort of patients examined with diagnostic doses of 131I. To further evaluate the underlying risk of disease inmore » these patients, we compared the incidence of all cancers with that expected in the general population. The average radiation dose was approximately 500 mGy to the thyroid and less than 10 mGy to other organs. In the 35,074 patients, 3,746 cancers occurred following the first 5 years after examination, and the resulting standardized incidence rate (SIR) was 1.01 (95% confidence interval = 0.98-1.04). SIRs were significantly increased for endocrine tumors other than thyroid cancer (1.93) and for lymphomas (1.24), leukemias (1.34), and nervous system tumors (1.19). The risk of leukemia was similar for chronic lymphocytic leukemia (CLL) (SIR = 1.30) and non-CLL (SIR = 1.34). SIR was significantly decreased for cancers of the female genital organs (0.86). The risk for cancer of all sites and types combined was highest 5-9 years after examination (SIR = 1.07) and did not differ from unity thereafter. With greater than or equal to 10 years of follow-up, risk was not statistically associated with the dose of 131I. Overall, the data exclude cancer risk increments greater than 5% (SIR = 1.05) with 95% confidence.« less

Siberia Integrated Regional Study megaproject: approaches, first results and challenges

NASA Astrophysics Data System (ADS)

Gordov, E. P.; Vaganov, E. A.

2010-12-01

Siberia Integrated Regional Study (SIRS, http://sirs.scert.ru/en/) is a NEESPI megaproject coordinating national and international activity in the region in line with Earth System Science Program approach whose overall objectives are to understand impact of Global change on on-going regional climate and ecosystems dynamics; to study future potential changes in both, and to estimate possible influence of those processes on the whole Earth System dynamics. Needs for SIRS are caused by accelerated warming occurring in Siberia, complexity of on-going and potential land-surface processes sharpened by inherent hydrology pattern and permafrost presence, and lack of reliable high-resolution meteorological and climatic modeling data. The SIRS approaches include coordination of different scale national and international projects, capacity building targeted to early career researchers thematic education and training, and development of distributed information-computational infrastructure required in support of multidisciplinary teams of specialists performing cooperative work with tools for sharing of data, models and knowledge. Coordination within SIRS projects is devoted to major regional and global risks rising with regional environment changes and currently is concentrated on three interrelated problems, whose solution has strong regional environmental and socio-economical impacts and is very important for understanding potential change of the whole Earth System dynamics: Permafrost border shift, which seriously threatens the oil and gas transporting infrastructure and leads to additional carbon release; Desert - steppe- forest-tundra ecosystems changes, which might vary region input into global carbon cycle as well as provoke serious socio-economical consequences for local population; and Temperature/precipitation/hydrology regime changes, which might increase risks of forest and peat fires, thus causing significant carbon release from the region under study. Some findings of those projects will be presented in the report. The information-computational infrastructure is aimed to manage multidisciplinary environmental data and to generate high resolution data sets on demand. One of its key elements, optimizing the usage of information-computational resources, services and applications is the climatic web portal under development. The prototype (http://climate.risks.scert.ru/) is now providing an access to an interactive web- GIS system for climate change assessment on the base of available meteorological data archives in the selected region. SIRS education and training program is run via annual organization in the region either international multidisciplinary conference with elements of young scientists school ENVIROMIS or young scientists school and collocated international conference CITES (http://www.scert.ru/en/conferences/). All the listed above activities have an international dimension whose enlargement might significantly assist in profound understanding of regional and global consequences in on-going Siberia processes.

Behavior of a stochastic SIR epidemic model with saturated incidence and vaccination rules

NASA Astrophysics Data System (ADS)

Zhang, Yue; Li, Yang; Zhang, Qingling; Li, Aihua

2018-07-01

In this paper, the threshold behavior of a susceptible-infected-recovered (SIR) epidemic model with stochastic perturbation is investigated. Firstly, it is obtained that the system has a unique global positive solution with any positive initial value. Random effect may lead to disease extinction under a simple condition. Subsequently, sufficient condition for persistence has been established in the mean of the disease. Finally, some numerical simulations are carried out to confirm the analytical results.

The threshold of a stochastic delayed SIR epidemic model with temporary immunity

NASA Astrophysics Data System (ADS)

Liu, Qun; Chen, Qingmei; Jiang, Daqing

2016-05-01

This paper is concerned with the asymptotic properties of a stochastic delayed SIR epidemic model with temporary immunity. Sufficient conditions for extinction and persistence in the mean of the epidemic are established. The threshold between persistence in the mean and extinction of the epidemic is obtained. Compared with the corresponding deterministic model, the threshold affected by the white noise is smaller than the basic reproduction number R0 of the deterministic system.

Bifurcation analysis in SIR epidemic model with treatment

NASA Astrophysics Data System (ADS)

Balamuralitharan, S.; Radha, M.

2018-04-01

We investigated the bifurcation analysis of nonlinear system of SIR epidemic model with treatment. It is accepted that the treatment is corresponding to the quantity of infective which is below the limit and steady when the quantity of infective achieves the limit. We analyze about the Transcritical bifurcation which occurs at the disease free equilibrium point and Hopf bifurcation which occurs at endemic equilibrium point. Using MATLAB we show the picture of bifurcation at the disease free equilibrium point.

Laboratory Diagnosis of Sepsis? No SIRS, Not Just Yet.

PubMed

Dunne, W Michael

2015-08-01

In order to maximize the benefit of prompt antimicrobial therapy and avoid the risk associated with inappropriate use of antimicrobial agents, patients with suspected sepsis must be rapidly differentiated from patients with systemic inflammatory response syndrome (SIRS). In combination with standard microbiological testing, a number of biomarkers have been recently evaluated for this purpose, and the performance characteristics of the most promising of these are reviewed. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Cancer risk in childhood-onset systemic lupus.

PubMed

Bernatsky, Sasha; Clarke, Ann E; Labrecque, Jeremy; von Scheven, Emily; Schanberg, Laura E; Silverman, Earl D; Brunner, Hermine I; Haines, Kathleen A; Cron, Randy Q; O'Neil, Kathleen M; Oen, Kiem; Rosenberg, Alan M; Duffy, Ciarán M; Joseph, Lawrence; Lee, Jennifer L; Kale, Mruganka; Turnbull, Elizabeth M; Ramsey-Goldman, Rosalind

2013-01-01

The aim of this study was to assess cancer incidence in childhood-onset systemic lupus erythematosus (SLE). We ascertained cancers within SLE registries at 10 pediatric centers. Subjects were linked to cancer registries for the observational interval, spanning 1974 to 2009. The ratio of observed to expected cancers represents the standardized incidence ratio (SIR) or relative cancer risk in childhood-onset SLE, versus the general population. There were 1020 patients aged <18 at cohort entry. Most (82%) were female and Caucasian; mean age at cohort entry was 12.6 years (standard deviation (SD) = 3.6). Subjects were observed for a total of 7,986 (average 7.8) patient-years. Within this interval, only three invasive cancers were expected. However, 14 invasive cancers occurred with an SIR of 4.7, 95% confidence interval (CI) 2.6 to 7.8. Three hematologic cancers were found (two non-Hodgkin’s lymphoma, one leukemia), for an SIR of 5.2 (95% CI 1.1 to 15.2). The SIRs stratified by age group and sex, were similar across these strata. There was a trend for highest cancer occurrence 10 to 19 years after SLE diagnosis. These results suggest an increased cancer risk in pediatric onset SLE versus the general population. In absolute terms, this represents relatively few events. Of note, risk may be highest only after patients have transferred to adult care.

May thrombopoietin be a useful marker of sepsis severity assessment in patients with SIRS entering the emergency department?

PubMed

Segre, Elisabetta; Pigozzi, Luca; Lison, Davide; Pivetta, Emanuele; Bosco, Ornella; Vizio, Barbara; Suppo, Umberto; Turvani, Fabrizio; Morello, Fulvio; Battista, Stefania; Moiraghi, Corrado; Montrucchio, Giuseppe; Lupia, Enrico

2014-10-01

Thrombopoietin (TPO), a growth factor primarily involved in regulating thrombopoiesis, has been recently implicated in the pathogenesis of sepsis. TPO levels are, indeed, greatly increased in patients with sepsis compared to control subjects, and correlate with sepsis severity. The aim of this study was to evaluate TPO as predictive biomarker of sepsis and of sepsis severity in patients entering the emergency department (ED) with systemic inflammatory response syndrome (SIRS). This was a prospective observational study. Ours is a sub-study of the 'Need-speed trial', a multi-center observational study involving six Italian centers affiliated to the GREAT Italian Network. TPO was measured by ELISA. We enrolled 13 patients with SIRS (6 with acute pancreatitis, 3 with acute heart failure, 1 with pulmonary embolism, and 3 with allergic reactions), and 40 patients with sepsis, eight of whom had severe sepsis and three septic shock. TPO was significantly higher in patients with sepsis than with SIRS. In addition, TPO was higher in patients with severe sepsis than with sepsis, and in patients with septic shock than with severe sepsis, although these differences did not reach the statistical significance. Our preliminary results suggest that TPO may have the potential to be considered a promising early biomarker for both the diagnosis of sepsis and the assessment of sepsis severity in patients with SIRS entering the ED.

Structural Basis for Nicotinamide Inhibition and Base Exchange in Sir2 Enzymes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sanders, B.; Zhao, K; Slama, J

2007-01-01

The Sir2 family of proteins consists of broadly conserved NAD+-dependent deacetylases that are implicated in diverse biological processes, including DNA regulation, metabolism, and longevity. Sir2 proteins are regulated in part by the cellular concentrations of a noncompetitive inhibitor, nicotinamide, that reacts with a Sir2 reaction intermediate via a base-exchange reaction to reform NAD+ at the expense of deacetylation. To gain a mechanistic understanding of nicotinamide inhibition in Sir2 enzymes, we captured the structure of nicotinamide bound to a Sir2 homolog, yeast Hst2, in complex with its acetyl-lysine 16 histone H4 substrate and a reaction intermediate analog, ADP-HPD. Together with relatedmore » biochemical studies and structures, we identify a nicotinamide inhibition and base-exchange site that is distinct from the so-called 'C pocket' binding site for the nicotinamide group of NAD+. These results provide insights into the Sir2 mechanism of nicotinamide inhibition and have important implications for the development of Sir2-specific effectors.« less

TH-C-18A-01: Is Automatic Tube Current Modulation Still Necessary with Statistical Iterative Reconstruction?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, K; Zhao, W; Gomez-Cardona, D

Purpose: Automatic tube current modulation (TCM) has been widely used in modern multi-detector CT to reduce noise spatial nonuniformity and streaks to improve dose efficiency. With the advent of statistical iterative reconstruction (SIR), it is expected that the importance of TCM may diminish, since SIR incorporates statistical weighting factors to reduce the negative influence of photon-starved rays. The purpose of this work is to address the following questions: Does SIR offer the same benefits as TCM? If yes, are there still any clinical benefits to using TCM? Methods: An anthropomorphic CIRS chest phantom was scanned using a state-of-the-art clinical CTmore » system equipped with an SIR engine (Veo™, GE Healthcare). The phantom was first scanned with TCM using a routine protocol and a low-dose (LD) protocol. It was then scanned without TCM using the same protocols. For each acquisition, both FBP and Veo reconstructions were performed. All scans were repeated 50 times to generate an image ensemble from which noise spatial nonuniformity (NSN) and streak artifact levels were quantified. Monte-Carlo experiments were performed to estimate skin dose. Results: For FBP, noise streaks were reduced by 4% using TCM for both routine and LD scans. NSN values were actually slightly higher with TCM (0.25) than without TCM (0.24) for both routine and LD scans. In contrast, for Veo, noise streaks became negligible (<1%) with or without TCM for both routine and LD scans, and the NSN was reduced to 0.10 (low dose) or 0.08 (routine). The overall skin dose was 2% lower at the shoulders and more uniformly distributed across the skin without TCM. Conclusion: SIR without TCM offers superior reduction in noise nonuniformity and streaks relative to FBP with TCM. For some clinical applications in which skin dose may be a concern, SIR without TCM may be a better option. K. Li, W. Zhao, D. Gomez-Cardona: Nothing to disclose; G.-H. Chen: Research funded, General Electric Company Research funded, Siemens AG Research funded, Varian Medical Systems, Research funded, Hologic, Inc.« less

Gd-based Contrast Enhancement of the Perivascular Spaces in the Basal Ganglia.

PubMed

Naganawa, Shinji; Nakane, Toshiki; Kawai, Hisashi; Taoka, Toshiaki

2017-01-10

In textbooks, the perivascular space (PVS) is described as non-enhancing after the intravenous administration of gadolinium-based contrast agent (IV-GBCA). We noticed that the PVS sometimes has high signal intensity (SI) on heavily T 2 -weighted 3D-FLAIR (hT 2 -FL) images obtained 4 h after IV-GBCA. The purpose of this study was to retrospectively evaluate the contrast enhancement of the PVS. In 8 healthy subjects and 19 patients with suspected endolymphatic hydrops, magnetic resonance cisternography (MRC) and hT 2 -FL images were obtained before and 4 h after a single dose of IV-GBCA. No subjects had renal insufficiency. On axial MRC at the level of the anterior commissure (AC)-posterior commissure (PC) line, 1 cm circular regions of interest (ROIs) were drawn centering on the PVS in the bilateral basal ganglia and thalami. Three-millimeter diameter ROIs were set in the cerebrospinal fluid (CSF) of the bilateral ambient cistern. The ROIs on MRC were copied onto the hT 2 -FL images and the SI was measured. The SI ratio (SIR) was defined as SIR PVS = SI of PVS/SI of the thalami, and SIR CSF = SI of CSF/SI of the thalami. The average of the bilateral values was used for the calculation. The SIR CSF , SIR PVS , and SI of the thalami were compared between before and 4 h after IV-GBCA. The SIR was increased significantly from 1.02 ± 0.37 to 2.65 ± 0.82 in the CSF (P < 0.01) and from 1.20 ± 0.35 to 2.13 ± 1.23 in the PVS at 4 h after IV-GBCA (P < 0.01). The SI of the thalami showed no significant difference. The enhancement of the PVS at 4 h after IV-GBCA was confirmed even in subjects without renal insufficiency. It is possible that the GBCA in the blood vessels might have permeated into the cerebrospinal fluid (CSF) space and the PVS. This might be a first step in the imaging evaluation of the glymphatic system (waste clearance system) of the brain.

Using Statistical and Machine Learning Methods to Evaluate the Prognostic Accuracy of SIRS and qSOFA

PubMed Central

Liu, Tieming; Shepherd, Scott; Paiva, William

2018-01-01

Objectives The objective of this study was to compare the performance of two popularly used early sepsis diagnostic criteria, systemic inflammatory response syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA), using statistical and machine learning approaches. Methods This retrospective study examined patient visits in Emergency Department (ED) with sepsis related diagnosis. The outcome was 28-day in-hospital mortality. Using odds ratio (OR) and modeling methods (decision tree [DT], multivariate logistic regression [LR], and naïve Bayes [NB]), the relationships between diagnostic criteria and mortality were examined. Results Of 132,704 eligible patient visits, 14% died within 28 days of ED admission. The association of qSOFA ≥2 with mortality (OR = 3.06; 95% confidence interval [CI], 2.96–3.17) greater than the association of SIRS ≥2 with mortality (OR = 1.22; 95% CI, 1.18–1.26). The area under the ROC curve for qSOFA (AUROC = 0.70) was significantly greater than for SIRS (AUROC = 0.63). For qSOFA, the sensitivity and specificity were DT = 0.39, LR = 0.64, NB = 0.62 and DT = 0.89, LR = 0.63, NB = 0.66, respectively. For SIRS, the sensitivity and specificity were DT = 0.46, LR = 0.62, NB = 0.62 and DT = 0.70, LR = 0.59, NB = 0.58, respectively. Conclusions The evidences suggest that qSOFA is a better diagnostic criteria than SIRS. The low sensitivity of qSOFA can be improved by carefully selecting the threshold to translate the predicted probabilities into labels. These findings can guide healthcare providers in selecting risk-stratification measures for patients presenting to an ED with sepsis. PMID:29770247

The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community‐acquired pneumonia

PubMed Central

Barlow, Gavin; Nathwani, Dilip; Davey, Peter

2007-01-01

Background The performance of CURB65 in predicting mortality in community‐acquired pneumonia (CAP) has been tested in two large observational studies. However, it has not been tested against generic sepsis and early warning scores, which are increasingly being advocated for identification of high‐risk patients in acute medical wards. Method A retrospective analysis was performed of data prospectively collected for a CAP quality improvement study. The ability to stratify mortality and performance characteristics (sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating curve) were calculated for stratifications of CURB65, CRB65, the systemic inflammatory response syndrome (SIRS) criteria and the standardised early warning score (SEWS). Results 419 patients were included in the main analysis with a median age of 74 years (men = 47%). CURB65 and CRB65 stratified mortality in a more clinically useful way and had more favourable operating characteristics than SIRS or SEWS; for example, mortality in low‐risk patients was 2% when defined by CURB65, but 9% when defined by SEWS and 11–17% when defined by variations of the SIRS criteria. The sensitivity, specificity, positive predictive value and negative predictive value of CURB65 was 71%, 69%, 35% and 91%, respectively, compared with 62%, 73%, 35% and 89% for the best performing version of SIRS and 52%, 67%, 27% and 86% for SEWS. CURB65 had the greatest area under the receiver operating curve (0.78 v 0.73 for CRB65, 0.68 for SIRS and 0.64 for SEWS). Conclusions CURB65 should not be supplanted by SIRS or SEWS for initial prognostic assessment in CAP. Further research to identify better generic prognostic tools is required. PMID:16928720

Prognostic and diagnostic value of eosinopenia, C-reactive protein, procalcitonin, and circulating cell-free DNA in critically ill patients admitted with suspicion of sepsis.

PubMed

Garnacho-Montero, Jose; Huici-Moreno, María J; Gutiérrez-Pizarraya, Antonio; López, Isabel; Márquez-Vácaro, Juan Antonio; Macher, Hada; Guerrero, Juan Manuel; Puppo-Moreno, Antonio

2014-06-05

The aims of this study were to assess the reliability of circulating cell-free DNA (cf-DNA) concentrations, compared with C-reactive protein (CRP), procalcitonin (PCT) and eosinophil count, in the diagnosis of infections in patients with systemic inflammatory response syndrome (SIRS) and their prognostic values in a cohort of critically ill patients. We conducted a prospective cohort study in a medical-surgical intensive care unit of a university hospital. Eosinophil count and concentrations of cf-DNA, CRP, and PCT were measured in patients who fulfilled SIRS criteria at admission to the intensive care unit (ICU) and a second determination 24 hours later. DNA levels were determined by a PCR method using primers for the human beta-haemoglobin gene. One hundred and sixty consecutive patients were included: 43 SIRS without sepsis and 117 with sepsis. Levels of CRP and PCT, but not cf-DNA or eosinophil count, were significantly higher in patients with sepsis than in SIRS-no sepsis group on days 1 and 2. PCT on day 1 achieves the best area under the curve (AUC) for sepsis diagnosis (0.87; 95% confidence interval = 0.81-0.94). Levels of cf-DNA do not predict outcome and the accuracy of these biomarkers for mortality prediction was lower than that shown by APACHE II score. PCT decreases significantly from day 1 to day 2 in survivors in the entire cohort and in patients with sepsis without significant changes in the other biomarkers. Our data do not support the clinical utility of cf-DNA measurement in critical care patients with SIRS. PCT is of value especially for infection identification in patients with SIRS at admission to the ICU.

Procalcitonin: a marker of bacteraemia in SIRS.

PubMed

Bell, K; Wattie, M; Byth, K; Silvestrini, R; Clark, P; Stachowski, E; Benson, E M

2003-12-01

A number of European studies have documented the ability of procalcitonin (PCT), a novel inflammatory marker, to discriminate patients with sepsis from those with other causes of systemic inflammatory response syndrome (SIRS). The aim of this study was to assess procalcitonin's performance in an Australian intensive care unit (ICU) setting to examine whether it could discriminate between these two conditions. One hundred and twenty-three consecutive adult ICU patients fulfilling criteria for SIRS were enlisted in the study. Over a period of five days, daily serum PCT and C-reactive protein (CRP) levels were measured. At least two sets of cultures were taken of blood, sputum/broncho-alveolar lavage (BAL) and urine. Other cultures were taken as clinically indicated. Questionnaires to ascertain clinical suspicion of sepsis were prospectively answered by the ICU senior registrars. PCT values were ten times higher in patients with positive blood cultures; CRP values were also significantly higher in the bacteraemic patients. Both PCT and CRP had a good ability to discriminate bacteraemia from non-infectious SIRS, with the area under receiver operating characteristics (ROC) curves for PCT being 0.8 and for CRP being 0.82. However neither PCT or CRP was able to discriminate patients with localized sepsis from those without. Utilizing both tests resulted in a more sensitive screen than either one alone, while PCT was a more accurate diagnostic test for bacteraemia than CRP. The PCT value also differed between those who died in hospital and those who survived. Measurement of PCT alone or in combination with CRP can aid discrimination of septicaemia/bacteriemia with associated SIRS from non-infectious SIRS in an Australian ICU setting.

Status and Future Developments of SIRGAS

NASA Astrophysics Data System (ADS)

Fortes, L.; Lauría, E.; Brunini, C.; Amaya, W.; Sanchez, L.; Drewes, H.

2007-05-01

This paper presents the status and future developments of the SIRGAS (Geocentric Reference System for the Americas) project. Since its creation, in 1993, SIRGAS has coordinated two continental GPS campaigns in 1995 an 2000, responsible for the establishment of a very accurate 3D reference frame in the region. First focusing on South America, the project has expanded its scope to Latin America since 2001. Currently the maintenance of the SIRGAS reference frame is carried out through more than 80 continuous operating GNSS (Global Navigation Satellite System) stations available in the region, whose data is officially processed by the International GNSS Service (IGS) Regional Network Associate Analysis Centre for SIRGAS (IGS RNACC-SIR), functioning at the DGFI (Deutsches Geodatisches Forschungsinstitut), in Munich, to generate weekly coordinates and velocity information of each continuous GNSS station. Since October 2006, five additional experimental processing centers - located at the Brazilian Institute of Geography and Statistics (IBGE), National Institute of Statistics, Geography and Informatics of Mexico (INEGI), Military Geographic Institute of Argentina (IGM), University of La Plata (UNLP), Argentina, and Geographic Institute Agustín Codazzi, Colombia (IGAC) - have also been processing data from those stations in order to assume the official processing responsibility in near future. Many Latin American countries have already adopted SIRGAS as their new official reference system. Besides, efforts have been carried out in order to have the national geodetic networks of Central American countries connected to the SIRGAS reference frame, which will be accomplished by a GNSS campaign scheduled for the first semester of 2007. In terms of vertical datum, SIRGAS continues to coordinate with each member country all the necessary efforts towards making the geodetic leveling data available together with gravity information in order to support the computation of geopotential numbers, to be unified in a continental adjustment.

Sulfite Reductase Protects Plants against Sulfite Toxicity1[W][OA

PubMed Central

Yarmolinsky, Dmitry; Brychkova, Galina; Fluhr, Robert; Sagi, Moshe

2013-01-01

Plant sulfite reductase (SiR; Enzyme Commission 1.8.7.1) catalyzes the reduction of sulfite to sulfide in the reductive sulfate assimilation pathway. Comparison of SiR expression in tomato (Solanum lycopersicum ‘Rheinlands Ruhm’) and Arabidopsis (Arabidopsis thaliana) plants revealed that SiR is expressed in a different tissue-dependent manner that likely reflects dissimilarity in sulfur metabolism between the plant species. Using Arabidopsis and tomato SiR mutants with modified SiR expression, we show here that resistance to ectopically applied sulfur dioxide/sulfite is a function of SiR expression levels and that plants with reduced SiR expression exhibit higher sensitivity than the wild type, as manifested in pronounced leaf necrosis and chlorophyll bleaching. The sulfite-sensitive mutants accumulate applied sulfite and show a decline in glutathione levels. In contrast, mutants that overexpress SiR are more tolerant to sulfite toxicity, exhibiting little or no damage. Resistance to high sulfite application is manifested by fast sulfite disappearance and an increase in glutathione levels. The notion that SiR plays a role in the protection of plants against sulfite is supported by the rapid up-regulation of SiR transcript and activity within 30 min of sulfite injection into Arabidopsis and tomato leaves. Peroxisomal sulfite oxidase transcripts and activity levels are likewise promoted by sulfite application as compared with water injection controls. These results indicate that, in addition to participating in the sulfate assimilation reductive pathway, SiR also plays a role in protecting leaves against the toxicity of sulfite accumulation. PMID:23221833

Nutritional Control of Chronological Aging and Heterochromatin in Saccharomyces cerevisiae.

PubMed

McCleary, David F; Rine, Jasper

2017-03-01

Calorie restriction extends life span in organisms as diverse as yeast and mammals through incompletely understood mechanisms.The role of NAD + -dependent deacetylases known as Sirtuins in this process, particularly in the yeast Saccharomyces cerevisiae , is controversial. We measured chronological life span of wild-type and sir2 Δ strains over a higher glucose range than typically used for studying yeast calorie restriction. sir2 Δ extended life span in high glucose complete minimal medium and had little effect in low glucose medium, revealing a partial role for Sir2 in the calorie-restriction response under these conditions. Experiments performed on cells grown in rich medium with a newly developed genetic strategy revealed that sir2 Δ shortened life span in low glucose while having little effect in high glucose, again revealing a partial role for Sir2 In complete minimal media, Sir2 shortened life span as glucose levels increased; whereas in rich media, Sir2 extended life span as glucose levels decreased. Using a genetic strategy to measure the strength of gene silencing at HML , we determined increasing glucose stabilized Sir2-based silencing during growth on complete minimal media. Conversely, increasing glucose destabilized Sir-based silencing during growth on rich media, specifically during late cell divisions. In rich medium, silencing was far less stable in high glucose than in low glucose during stationary phase. Therefore, Sir2 was involved in a response to nutrient cues including glucose that regulates chronological aging, possibly through Sir2-dependent modification of chromatin or deacetylation of a nonhistone protein. Copyright © 2017 by the Genetics Society of America.

Modeling the Distribution of Fingerprint Characteristics. Revision 1.

DTIC Science & Technology

1980-09-19

the details of the print. The ridge-line details are termed Galton characteristics since Sir Francis Galton was among the first to study them...U.S.A. CONTENTS Abstract 1. Introduction 2. Background Information on Fingerprints 2.1. Types 2.2. Ridge counts 2.3. The Galton details 3. Data...The Multinomial Markov Model 7. The Poisson Markov Model 8. The Infinitely Divisible Model Acknowledgements References Appendices A The Galton

Analysis of a novel stochastic SIRS epidemic model with two different saturated incidence rates

NASA Astrophysics Data System (ADS)

Chang, Zhengbo; Meng, Xinzhu; Lu, Xiao

2017-04-01

This paper presents a stochastic SIRS epidemic model with two different nonlinear incidence rates and double epidemic asymmetrical hypothesis, and we devote to develop a mathematical method to obtain the threshold of the stochastic epidemic model. We firstly investigate the boundness and extinction of the stochastic system. Furthermore, we use Ito's formula, the comparison theorem and some new inequalities techniques of stochastic differential systems to discuss persistence in mean of two diseases on three cases. The results indicate that stochastic fluctuations can suppress the disease outbreak. Finally, numerical simulations about different noise disturbance coefficients are carried out to illustrate the obtained theoretical results.

The susceptible-infected-recovered (SIR) model for viral marketing

NASA Astrophysics Data System (ADS)

Ismail, Siti Suhaila; Akil, Ku Azlina Ku; Chulan, Majdah; Sharif, Noorzila

2017-11-01

Viral marketing is a marketing strategy utilizes social media to spread information about a product or services provided. It is the most powerful way to share information in a short amount of time. The objective of this study is to investigate the dynamic of viral marketing within a time duration in the point of view of mathematics. This study used the epidemiological model known as Susceptible-Infected-Recovered (SIR). The model consists of a system of three differential equations with three state variables namely susceptible (S), infected (I) and recovered (R). It considers a case of SIR model with demography. Numerical experiments have been performed. The results show that viral marketing reaches its peak within two days. The online messages shared will become higher if the initial number of the infected individual has been increased.

33 CFR 147.817 - Sir Douglas Morpeth Tension Leg Platform safety zone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Sir Douglas Morpeth Tension Leg... HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES SAFETY ZONES § 147.817 Sir Douglas Morpeth Tension Leg Platform safety zone. (a) Description. The Sir Douglas Morpeth Tension Leg Platform (Morpeth...

Enhanced radiosensitivity and radiation-induced apoptosis in glioma CD133-positive cells by knockdown of SirT1 expression

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, C.-J.; Hsu, C.-C.; Department of Surgery, Chi-Mei Medical Center, Taipei, Taiwan

2009-03-06

CD133-expressing glioma cells play a critical role in tumor recovery after treatment and are resistant to radiotherapy. Herein, we demonstrated that glioblastoma-derived CD133-positive cells (GBM-CD133{sup +}) are capable of self-renewal and express high levels of embryonic stem cell genes and SirT1 compared to GBM-CD133{sup -} cells. To evaluate the role of SirT1 in GBM-CD133{sup +}, we used a lentiviral vector expressing shRNA to knock-down SirT1 expression (sh-SirT1) in GBM-CD133{sup +}. Silencing of SirT1 significantly enhanced the sensitivity of GBM-CD133{sup +} to radiation and increased the level of radiation-mediated apoptosis. Importantly, knock-down of SirT1 increased the effectiveness of radiotherapy in themore » inhibition of tumor growth in nude mice transplanted with GBM-CD133{sup +}. Kaplan-Meier survival analysis indicated that the mean survival rate of GBM-CD133{sup +} mice treated with radiotherapy was significantly improved by Sh-SirT1 as well. In sum, these results suggest that SirT1 is a potential target for increasing the sensitivity of GBM and glioblastoma-associated cancer stem cells to radiotherapy.« less

Changes in cancer incidence patterns among a northeastern American Indian population: 1955-1969 versus 1990-2004.

PubMed

Mahoney, Martin C; Va, Puthiery; Stevens, Adrian; Kahn, Amy R; Michalek, Arthur M

2009-01-01

This manuscript examines shifts in patterns of cancer incidence among the Seneca Nation of Indians (SNI) for the interval 1955-1969 compared to 1990-2004. A retrospective cohort design was used to examine cancer incidence among the SNI during 2 time intervals: 1955-1969 and 1990-2004. Person-years at risk were multiplied by cancer incidence rates for New York State, exclusive of New York City, over 5-year intervals. A computer-aided match with the New York State Cancer Registry was used to identify incident cancers. Overall and site-specific standardized incidence ratios (SIRs = observed/expected x 100), and 95% confidence intervals (CIs), were calculated for both time periods. During the earlier interval, deficits in overall cancer incidence were noted among males (SIR = 56, CI 36-82) and females (SIR = 71, CI 50-98), and for female breast cancers (SIR = 21, CI 4-62). During the more recent intervals, deficits in overall cancer incidence persisted among both genders (males SIR = 63, CI 52-77; females SIR = 67, CI 55-80). Deficits were also noted among males for cancers of the lung (SIR = 60, CI 33-98), prostate (SIR = 51, CI = 33-76) and bladder (SIR = 17, CI = 2-61) and among females for breast (SIR = 33, CI = 20-53) and uterus (SIR = 36, CI = 10-92). No cancer sites demonstrated increased incidence. Persons ages 60-69 years, 70-79 years, and ages 80+ years tended to exhibit deficits in overall incidence. Despite marked changes over time, deficits in overall cancer incidence have persisted between the time intervals studied. Tribal-specific cancer data are important for the development and implementation of comprehensive cancer control plans which align with local needs.

Cancer incidence among alcoholic liver disease patients in Finland: A retrospective registry study during years 1996-2013.

PubMed

Sahlman, Perttu; Nissinen, Markku; Pukkala, Eero; Färkkilä, Martti

2016-06-01

Both alcohol abuse and liver cirrhosis are known risk factors for various cancers. This article was aimed to assess the long-term risk of malignancies among patients with severe alcoholic liver disease (ALD), i.e., alcoholic liver cirrhosis and alcoholic hepatitis. A cohort of 8,796 male and 3,077 female ALD patients from 1996 to 2012 was identified from the Finnish National Hospital Discharge Register. This nationwide cohort was combined with the data from the Finnish Cancer Registry for incidence of malignancies during the years 1996-2013. The cancer cases diagnosed were compared with the number of cancers in the general population. The number of malignancies in our cohort was 1,052 vs. 368 expected. There was statistically significant excess of cancers of the liver, (standardized incidence ratio [SIR] 59.20; 95% CI 53.11-65.61), pancreas (SIR 3.71; 95% CI 2.72-4.94), pharynx (SIR 9.25; 95% CI 6.05-13.56), mouth (SIR 8.31; 95% CI 4.84-13,29), oesophagus (SIR 7.92; 95% CI 5.49-11.07), tongue (SIR 7,21; 95% CI 3.60-12.89), larynx (SIR 5.20; 95% CI 2.77-8.89), lung (SIR 2.77; 95% CI 2.27-3.32), stomach (SIR 2.76; 95% CI 1.79-4.07), kidney (SIR 2.69; 95% CI 1.84-3.79) and colon (SIR 2.33; 95% CI 1.70-3.11). There was no decreased risk of any cancer among ALD patients. Severe ALD is associated with markedly increased risk of malignancies. The risk is especially high for hepatocellular carcinoma, but also significantly increased for cancers of the upper aerodigestive tract, pancreas and kidneys, and warrants cancer surveillance in selected cases. © 2016 UICC.

Immunoparalysis: Clinical and immunological associations in SIRS and severe sepsis patients.

PubMed

Papadopoulos, Panagiotis; Pistiki, Aikaterini; Theodorakopoulou, Maria; Christodoulopoulou, Theodora; Damoraki, Georgia; Goukos, Dimitris; Briassouli, Efrossini; Dimopoulou, Ioanna; Armaganidis, Apostolos; Nanas, Serafim; Briassoulis, George; Tsiodras, Sotirios

2017-04-01

This study was designed to identify changes in the monocytic membrane marker HLA-DR and heat shock proteins (HSPs) in relation to T-regulatory cells (T-regs) and other immunological marker changes in patients with systemic inflammatory response syndrome (SIRS) or sepsis/septic shock. Healthy volunteers, intensive care unit (ICU) patients with SIRS due to head injury and ICU patients with severe sepsis/septic shock were enrolled in the current study. Determination of CD14+/HLA-DR+ cells, intracellular heat-shock proteins and other immunological parameters were performed by flow cytometry and RT-PCR techniques as appropriate. Univariate and multivariate analysis examined associations of CD14/HLA-DR, HSPs, T-regs and suppressor of cytokine signalling (SOCS) proteins with SIRS, sepsis and outcome. Fifty patients (37 with severe sepsis and 13 with SIRS) were enrolled, together with 20 healthy volunteers used as a control group. Compared to healthy individuals, patients with SIRS and severe sepsis showed progressive decline of their CD14/HLA-DR expression (0% to 7.7% to 50% within each study subpopulation, p<0.001). Mean fluorescent intensity (MFI) levels of HSP70 and HSP90 on monocytes and polymorphonuclear cells were significantly higher in SIRS patients compared to controls and fell significantly in severe sepsis/septic shock patients (p<0.05 for all comparisons). There was no statistically significant difference between subgroups for levels of T-regulatory cells or relative copies of Suppressor of Cytokine Signalling 3 (SOCS3) proteins. In univariate models percent of CD14/HLA-DR was associated with mortality (OR: 1.8 95%CI 1.02-3.2, p=0.05), while in multivariate models after adjusting for CD14/HLA-DR only younger age and lower Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were associated with increased chances of survival (beta -0.05, OR 0.9, 95% CI 0.9-0.99, p=0.038 for age and beta -0.11, OR 0.89, 95% CI 0.8-0.99, p=0.037 for APACHE II score). Significant associations with SIRS and sepsis were found for CD14/HLA-DR expression and monocyte and polymorphonuclear cell levels of HSP70 and 90. The role of these biomarkers in assessing the prognosis of sepsis needs to be further explored and validated in prospective studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Epidemic outbreaks and its control using a fractional order model with seasonality and stochastic infection

NASA Astrophysics Data System (ADS)

He, Shaobo; Banerjee, Santo

2018-07-01

A fractional-order SIR epidemic model is proposed under the influence of both parametric seasonality and the external noise. The integer order SIR epidemic model originally is stable. By introducing seasonality and noise force to the model, behaviors of the system is changed. It is shown that the system has rich dynamical behaviors with different system parameters, fractional derivative order and the degree of seasonality and noise. Complexity of the stochastic model is investigated by using multi-scale fuzzy entropy. Finally, hard limiter controlled system is designed and simulation results show the ratio of infected individuals can converge to a small enough target ρ, which means the epidemic outbreak can be under control by the implementation of some effective medical and health measures.

Conversion of a Replication Origin to a Silencer through a Pathway Shared by a Forkhead Transcription Factor and an S Phase Cyclin

PubMed Central

Casey, Laurieann; Patterson, Erin E.; Müller, Ulrika

2008-01-01

Silencing of the mating-type locus HMR in Saccharomyces cerevisiae requires DNA elements called silencers. To establish HMR silencing, the origin recognition complex binds the HMR-E silencer and recruits the silent information regulator (Sir)1 protein. Sir1 in turn helps establish silencing by stabilizing binding of the other Sir proteins, Sir2–4. However, silencing is semistable even in sir1Δ cells, indicating that SIR1-independent establishment mechanisms exist. Furthermore, the requirement for SIR1 in silencing a sensitized version of HMR can be bypassed by high-copy expression of FKH1 (FKH1hc), a conserved forkhead transcription factor, or by deletion of the S phase cyclin CLB5 (clb5Δ). FKH1hc caused only a modest increase in Fkh1 levels but effectively reestablished Sir2–4 chromatin at HMR as determined by Sir3-directed chromatin immunoprecipitation. In addition, FKH1hc prolonged the cell cycle in a manner distinct from deletion of its close paralogue FKH2, and it created a cell cycle phenotype more reminiscent to that caused by a clb5Δ. Unexpectedly, and in contrast to SIR1, both FKH1hc and clb5Δ established silencing at HMR using the replication origins, ARS1 or ARSH4, as complete substitutes for HMR-E (HMRΔE::ARS). HMRΔE::ARS1 was a robust origin in CLB5 cells. However, initiation by HMRΔE::ARS1 was reduced by clb5Δ or FKH1hc, whereas ARS1 at its native locus was unaffected. The CLB5-sensitivity of HMRΔE::ARS1 did not result from formation of Sir2–4 chromatin because sir2Δ did not rescue origin firing in clb5Δ cells. These and other data supported a model in which FKH1 and CLB5 modulated Sir2–4 chromatin and late-origin firing through opposing regulation of a common pathway. PMID:18045995

Volterra-type Lyapunov functions for fractional-order epidemic systems

NASA Astrophysics Data System (ADS)

Vargas-De-León, Cruz

2015-07-01

In this paper we prove an elementary lemma which estimates fractional derivatives of Volterra-type Lyapunov functions in the sense Caputo when α ∈ (0, 1) . Moreover, by using this result, we study the uniform asymptotic stability of some Caputo-type epidemic systems with a pair of fractional-order differential equations. These epidemic systems are the Susceptible-Infected-Susceptible (SIS), Susceptible-Infected-Recovered (SIR) and Susceptible-Infected-Recovered-Susceptible (SIRS) models and Ross-Macdonald model for vector-borne diseases. We show that the unique endemic equilibrium is uniformly asymptotically stable if the basic reproductive number is greater than one. We illustrate our theoretical results with numerical simulations using the Adams-Bashforth-Moulton scheme implemented in the fde12 Matlab function.

DNAemia detection by multiplex PCR and biomarkers for infection in systemic inflammatory response syndrome patients.

PubMed

Fitting, Catherine; Parlato, Marianna; Adib-Conquy, Minou; Memain, Nathalie; Philippart, François; Misset, Benoît; Monchi, Mehran; Cavaillon, Jean-Marc; Adrie, Christophe

2012-01-01

Fast and reliable assays to precisely define the nature of the infectious agents causing sepsis are eagerly anticipated. New molecular biology techniques are now available to define the presence of bacterial or fungal DNA within the bloodstream of sepsis patients. We have used a new technique (VYOO®) that allows the enrichment of microbial DNA before a multiplex polymerase chain reaction (PCR) for pathogen detection provided by SIRS-Lab (Jena, Germany). We analyzed 72 sepsis patients and 14 non-infectious systemic inflammatory response syndrome (SIRS) patients. Among the sepsis patients, 20 had a positive blood culture and 35 had a positive microbiology in other biological samples. Of these, 51.4% were positive using the VYOO® test. Among the sepsis patients with a negative microbiology and the non-infectious SIRS, 29.4% and 14.2% were positive with the VYOO® test, respectively. The concordance in bacterial identification between microbiology and the VYOO® test was 46.2%. This study demonstrates that these new technologies offer great hopes, but improvements are still needed.

Lipopolysaccharide-binding protein in critically ill neonates and children with suspected infection: comparison with procalcitonin, interleukin-6, and C-reactive protein.

PubMed

Pavcnik-Arnol, Maja; Hojker, Sergej; Derganc, Metka

2004-07-01

To evaluate markers of infection in critically ill neonates and children, comparing lipopolysaccharide-binding protein (LBP) with procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP). Prospective, observational study in the level III multidisciplinary neonatal and pediatric intensive care unit. Sixty patients with systemic inflammatory response syndrome (SIRS) and suspected infection classified into two groups: SIRS/sepsis ( n=33) and SIRS/no sepsis ( n=27). We included 29 neonates aged less than 48 h (neonates <48 h), 12 neonates older than 48 h (neonates >48 h), and 19 children. Median disease severity was high in neonates aged under 48 h and moderate in neonates aged over 48 h and children. Serum LBP, PCT, IL-6, and CRP were measured on two consecutive days. Area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity, and predictive values were evaluated. Serum LBP was higher in patients with SIRS/sepsis than in patients with SIRS/no sepsis. AUC for LBP on the first day of suspected infection was 0.89 in the younger neonates, 0.93 in the older neonates, and 0.91 in children. In critically ill neonates aged under 48 h LBP on the first day of suspected infection is a better marker of sepsis than IL-6 and PCT, and is similar to CRP. In critically ill neonates aged over 48 h and children LBP is a better marker than IL-6 and CRP, and is similar to PCT.

Steroid therapy attenuates acute phase reactant response among children on ventricular assist device support.

PubMed

Byrnes, Jonathan W; Bhutta, Adnan T; Rettiganti, Mallikarjuna Rao; Gomez, Alberto; Garcia, Xiomara; Dyamenahalli, Umesh; Johnson, Charles; Jaquiss, Robert D B; Imamura, Michiaki; Prodhan, Parthak

2015-04-01

Hyperfibrinogenemia, which can create a procoagulant milieu, is frequently observed in patients supported with the Berlin EXCOR (Berlin Heart GmbH, Berlin, Germany) ventricular assist device (VAD). We began initiating corticosteroids in patients with systemic inflammatory response syndrome (SIRS) episodes to mitigate hyperfibrinogenemia. We set forth to describe the impact of corticosteroids on the hyperfibrinogenemic state in our institutional experience. Retrospective data was collected on 44 consecutive patients implanted with the Berlin EXCOR VAD from April 15, 2005 through May 6, 2013. Pertinent information was abstracted from the electronic medical record. The reduction of C-reactive protein (CRP) and fibrinogen levels among days from corticosteroid treatment were described. Infections and insulin use were reported based on whether patients received steroids and if steroids were given for SIRS. Over the initial 44 Berlin EXCOR VAD implantations, 14 patients were treated with 21 courses of corticosteroids for SIRS episodes as identified by clinical features and rise in CRP. Treatment with corticosteroids reduced fibrinogen levels by day 2 to a statistically significant degree (p = 0.008). No difference in hyperglycemia or infections occurred among patients receiving corticosteroids for SIRS. Treatment with corticosteroids can potentially mitigate the SIRS response among children supported on the Berlin EXCOR VAD. In patients who received corticosteroids to mitigate inflammation, there was no increase in infections or hyperglycemia requiring insulin administration compared with patients who did not receive steroids. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Correlation of nitric oxide and other free radicals with the severity of acute pancreatitis and complicated systemic inflammatory response syndrome.

PubMed

Que, Ri-sheng; Cao, Li-ping; Ding, Guo-ping; Hu, Jun-an; Mao, Ke-jie; Wang, Gui-feng

2010-05-01

To investigate the correlation of nitric oxide (NO) and other free radicals with the severity of acute pancreatitis (AP) and complicated systemic inflammatory response syndrome (SIRS). Fifty AP patients (24 simple AP patients and 26 patients with AP complicated by SIRS) were involved in the study. Fifty healthy volunteers were included as controls. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were evaluated, and plasma NO, plasma lipid peroxides, plasma vitamin E, plasma beta-carotene, whole-blood glutathione (GSH), and the activity of plasma GSH peroxidase were measured. Compared with the control group, the APACHE II scores heightened in the AP group, and the SIRS group had the highest APACHE II scores (P < 0.005, P < 0.001, respectively). Plasma NO and plasma lipid peroxides increased with the heightening APACHE II scores, demonstrating a significant linear positive correlation (r = 0.618, r = 0.577, respectively; P < 0.001). Plasma vitamin E, plasma beta-carotene, whole-blood GSH, and the activity of plasma GSH peroxidase decreased with the heightening APACHE II scores, demonstrating a significant linear negative correlation (r = -0.600, r = -0.609, r = -0.559, r = -0.592, respectively; P < 0.001). Nitric oxide and other free radicals take part in the aggravation of oxidative stress and oxidative injury and may play important roles in the pathogenesis of AP and SIRS. It may be valuable to measure free radicals to predict the severity of AP.

Serum derivative of reactive oxygen metabolites (d-ROMs) in pediatric hemato-oncological patients with neutropenic fever.

PubMed

Nishikawa, Takuro; Okamoto, Yasuhiro; Kodama, Yuichi; Tanabe, Takayuki; Shinkoda, Yuichi; Kawano, Yoshifumi

2010-07-15

Early markers for predicting the severity of neutropenic fever (NF) in patients with hemato-oncological patients have not yet been established. Reactive oxygen species are known to play an important role in the antimicrobial function of neutrophils. The aim of this study was to determine the serum levels of derivatives of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) levels in these patients, and to investigate the associations between these levels and the severity of NF. Twenty-seven pediatric hemato-oncological patients were enroled in this prospective study. Their median age was 10 years (range 1-19). Laboratory samples for C-reactive protein (CRP), d-ROMs, and BAP were collected at the onset of NF. The Free Radical Analytical System 4(R) was used to measure levels of d-ROMs and BAP. A total 36 NF episodes were evaluated. Levels of d-ROMs in NF patients with systemic inflammatory response syndrome (SIRS, n = 7) were significantly lower than those in subjects without SIRS (n = 29; 197.6 vs. 314.1 U.CARR, P = 0.017). There were no statistically significant differences in CRP, BAP, WBC count, or neutrophil count at the onset. The peak levels of CRP were significantly higher in patients with SIRS than in those without SIRS (23.9 vs. 6.1 mg/dl, P = 0.0003). Patients with low level of d-ROMs at the onset of NF should be observed stringently since they possibly have severe NF.

Should Age at Diagnosis Be Included as an Additional Variable in the Risk of Recurrence Classification System in Patients with Differentiated Thyroid Cancer.

PubMed

Pitoia, Fabián; Jerkovich, Fernando; Smulever, Anabella; Brenta, Gabriela; Bueno, Fernanda; Cross, Graciela

2017-07-01

To evaluate the influence of age at diagnosis on the frequency of structural incomplete response (SIR) according to the modified risk of recurrence (RR) staging system from the American Thyroid Association guidelines. We performed a retrospective analysis of 268 patients with differentiated thyroid cancer (DTC) followed up for at least 3 years after initial treatment (total thyroidectomy and remnant ablation). The median follow-up in the whole cohort was 74.3 months (range: 36.1-317.9) and the median age at diagnosis was 45.9 years (range: 18-87). The association between age at diagnosis and the initial and final response to treatment was assessed with analysis of variance (ANOVA). Patients were also divided into several groups considering age younger and older than 40, 50, and 60 years. Age at diagnosis was not associated with either an initial or final statistically significant different SIR to treatment ( p = 0.14 and p = 0.58, respectively). Additionally, we did not find any statistically significant differences when the percentages of SIR considering the classification of RR were compared between different groups of patients by using several age cutoffs. When patients are correctly risk stratified, it seems that age at diagnosis is not involved in the frequency of having a SIR at the initial evaluation or at the final follow-up, so it should not be included as an additional variable to be considered in the RR classifications.

Mulberry-American: The Artificial Harbor at Omaha

DTIC Science & Technology

2011-06-10

Robert F . Baumann, Ph.D. The opinions and conclusions expressed herein are those of the student author and do not necessarily represent the views...offer an interesting dynamic to the overall picture. For a detailed explanation of the Overlord planning process refer to Cross Channel Attack by Gordon ...British and Admiral Sir Bertram Ramsay , ANCXF. Any credit for success of Mulberry would be given to the British and any failure of Mulberry would

Desert Studies - A Global View

DTIC Science & Technology

1985-08-23

Exploration, Dec. 6-10, 1982, Ft. Worth, TX, p. 39-40. 1983: 2 abs. published, 2 papers submitted for publication Breed, C. S., 1983, Subsurface imaging with...2-10 (in Chinese). Elachi, C., Roth, L. E., and Schaber, G. G., 1984, Spaceborne radar subsurface imaging in hyperarid regions, 1984: IEEE...are 55) km o. 18t BIBLIOGRAPHY (CITED REFERENCES) Breed, C. S., 1983, Subsurface imaging with SIR-A in the Egyptian Desert (abs.): Summaries, 17th

Evolutionary Analysis of Heterochromatin Protein Compatibility by Interspecies Complementation in Saccharomyces

PubMed Central

Zill, Oliver A.; Scannell, Devin R.; Kuei, Jeffrey; Sadhu, Meru; Rine, Jasper

2012-01-01

The genetic bases for species-specific traits are widely sought, but reliable experimental methods with which to identify functionally divergent genes are lacking. In the Saccharomyces genus, interspecies complementation tests can be used to evaluate functional conservation and divergence of biological pathways or networks. Silent information regulator (SIR) proteins in S. bayanus provide an ideal test case for this approach because they show remarkable divergence in sequence and paralog number from those found in the closely related S. cerevisiae. We identified genes required for silencing in S. bayanus using a genetic screen for silencing-defective mutants. Complementation tests in interspecies hybrids identified an evolutionarily conserved Sir-protein-based silencing machinery, as defined by two interspecies complementation groups (SIR2 and SIR3). However, recessive mutations in S. bayanus SIR4 isolated from this screen could not be complemented by S. cerevisiae SIR4, revealing species-specific functional divergence in the Sir4 protein despite conservation of the overall function of the Sir2/3/4 complex. A cladistic complementation series localized the occurrence of functional changes in SIR4 to the S. cerevisiae and S. paradoxus branches of the Saccharomyces phylogeny. Most of this functional divergence mapped to sequence changes in the Sir4 PAD. Finally, a hemizygosity modifier screen in the interspecies hybrids identified additional genes involved in S. bayanus silencing. Thus, interspecies complementation tests can be used to identify (1) mutations in genetically underexplored organisms, (2) loci that have functionally diverged between species, and (3) evolutionary events of functional consequence within a genus. PMID:22923378

Sirtuins and Disease: The Road Ahead

PubMed Central

Carafa, Vincenzo; Nebbioso, Angela; Altucci, Lucia

2012-01-01

Sirtuins represent a promising new class of conserved histone deacetylases, originally identified in yeast. The activity of the sirtuin (SirT) family – made up of seven members (SirT1-7) – is NAD+ dependent. Sirtuins target a wide range of cellular proteins in nucleus, cytoplasm, and mitochondria for post-translational modification by acetylation (SirT1, 2, 3, and 5) or ADP-ribosylation (SirT4 and 6). Sirtuins regulate responses to stress and ensure that damaged DNA is not propagated, thus contrasting the accumulation of mutations. To date, sirtuins have emerged as potential therapeutic targets for treatment of human pathologies such as metabolic, cardiovascular and neurodegenerative diseases, and cancer. SirT1 is the founding member of this class of enzymes and is currently the best known of the group. SirT1 acts in various cellular processes, deacetylating both chromatin and non-histone proteins, and its role in cancer and aging has been extensively studied. SirT1 may play a critical role in tumor initiation and progression as well as drug resistance by blocking senescence and apoptosis, and by promoting cell growth and angiogenesis. Recently, growing interest in sirtuin modulation has led to the discovery and characterization of small molecules able to modify sirtuin activity. The present review highlights SirT mechanism(s) of action and deregulation in cancer, focusing on the therapeutic potential of SirT modulators both in cancer prevention and treatment. PMID:22319497

Interleukin-27 is a novel candidate diagnostic biomarker for bacterial infection in critically ill children.

PubMed

Wong, Hector R; Cvijanovich, Natalie Z; Hall, Mark; Allen, Geoffrey L; Thomas, Neal J; Freishtat, Robert J; Anas, Nick; Meyer, Keith; Checchia, Paul A; Lin, Richard; Bigham, Michael T; Sen, Anita; Nowak, Jeffrey; Quasney, Michael; Henricksen, Jared W; Chopra, Arun; Banschbach, Sharon; Beckman, Eileen; Harmon, Kelli; Lahni, Patrick; Shanley, Thomas P

2012-10-29

Differentiating between sterile inflammation and bacterial infection in critically ill patients with fever and other signs of the systemic inflammatory response syndrome (SIRS) remains a clinical challenge. The objective of our study was to mine an existing genome-wide expression database for the discovery of candidate diagnostic biomarkers to predict the presence of bacterial infection in critically ill children. Genome-wide expression data were compared between patients with SIRS having negative bacterial cultures (n = 21) and patients with sepsis having positive bacterial cultures (n = 60). Differentially expressed genes were subjected to a leave-one-out cross-validation (LOOCV) procedure to predict SIRS or sepsis classes. Serum concentrations of interleukin-27 (IL-27) and procalcitonin (PCT) were compared between 101 patients with SIRS and 130 patients with sepsis. All data represent the first 24 hours of meeting criteria for either SIRS or sepsis. Two hundred twenty one gene probes were differentially regulated between patients with SIRS and patients with sepsis. The LOOCV procedure correctly predicted 86% of the SIRS and sepsis classes, and Epstein-Barr virus-induced gene 3 (EBI3) had the highest predictive strength. Computer-assisted image analyses of gene-expression mosaics were able to predict infection with a specificity of 90% and a positive predictive value of 94%. Because EBI3 is a subunit of the heterodimeric cytokine, IL-27, we tested the ability of serum IL-27 protein concentrations to predict infection. At a cut-point value of ≥5 ng/ml, serum IL-27 protein concentrations predicted infection with a specificity and a positive predictive value of >90%, and the overall performance of IL-27 was generally better than that of PCT. A decision tree combining IL-27 and PCT improved overall predictive capacity compared with that of either biomarker alone. Genome-wide expression analysis has provided the foundation for the identification of IL-27 as a novel candidate diagnostic biomarker for predicting bacterial infection in critically ill children. Additional studies will be required to test further the diagnostic performance of IL-27. The microarray data reported in this article have been deposited in the Gene Expression Omnibus under accession number GSE4607.

Reflection on the "New Dynamics" of Distance Education: An Interview with Sir John Daniel

ERIC Educational Resources Information Center

Latchem, Colin

2012-01-01

This article presents an interview with Sir John Daniel outgoing President and CEO of the Commonwealth of Learning. Sir John Daniel's term as President and Chief Executive Officer of the Commonwealth of Learning (COL) ended on May 31, 2012. Readers of "Distance Education" will know of Sir John's work at the Tele-universite (Directeur des…

Dimensional reduction for a SIR type model

NASA Astrophysics Data System (ADS)

Cahyono, Edi; Soeharyadi, Yudi; Mukhsar

2018-03-01

Epidemic phenomena are often modeled in the form of dynamical systems. Such model has also been used to model spread of rumor, spread of extreme ideology, and dissemination of knowledge. Among the simplest is SIR (susceptible, infected and recovered) model, a model that consists of three compartments, and hence three variables. The variables are functions of time which represent the number of subpopulations, namely suspect, infected and recovery. The sum of the three is assumed to be constant. Hence, the model is actually two dimensional which sits in three-dimensional ambient space. This paper deals with the reduction of a SIR type model into two variables in two-dimensional ambient space to understand the geometry and dynamics better. The dynamics is studied, and the phase portrait is presented. The two dimensional model preserves the equilibrium and the stability. The model has been applied for knowledge dissemination, which has been the interest of knowledge management.

Elevated platelet count as predictor of recurrence in rectal cancer patients undergoing preoperative chemoradiotherapy followed by surgery.

PubMed

Toiyama, Yuji; Inoue, Yasuhiro; Kawamura, Mikio; Kawamoto, Aya; Okugawa, Yoshinaga; Hiro, Jyunichiro; Saigusa, Susumu; Tanaka, Koji; Mohri, Yasuhiko; Kusunoki, Masato

2015-02-01

The impact of systemic inflammatory response (SIR) on prognostic and predictive outcome in rectal cancer after neoadjuvant chemoradiotherapy (CRT) has not been fully investigated. This retrospective study enrolled 89 patients with locally advanced rectal cancer who underwent neoadjuvant CRT and for whom platelet (PLT) counts and SIR status [neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR)] were available. Both clinical values of PLT and SIR status in rectal cancer patients were investigated. Elevated PLT, NLR, PLR, and pathologic TNM stage III [ypN(+)] were associated with significantly poor overall survival (OS). Elevated PLT, NLR, and ypN(+) were shown to independently predict OS. Elevated PLT and ypN(+) significantly predicted poor disease-free survival (DFS). Elevated PLT was identified as the only independent predictor of DFS. PLT counts are a promising pre-CRT biomarker for predicting recurrence and poor prognosis in rectal cancer.

An implementation research agenda

PubMed Central

Eccles, Martin P; Armstrong, David; Baker, Richard; Cleary, Kevin; Davies, Huw; Davies, Stephen; Glasziou, Paul; Ilott, Irene; Kinmonth, Ann-Louise; Leng, Gillian; Logan, Stuart; Marteau, Theresa; Michie, Susan; Rogers, Hugh; Rycroft-Malone, Jo; Sibbald, Bonnie

2009-01-01

In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to address possible ways forward to improve clinical effectiveness in the UK National Health Service (NHS) and promote clinical engagement to deliver this. The report contained a short section on research needs that emerged from the process of writing the report, but in order to more fully identify the relevant research agenda Professor Sir John Tooke asked Professor Martin Eccles to convene an expert group – the Clinical Effectiveness Research Agenda Group (CERAG) – to define the research agenda. The CERAG's terms of reference were 'to further elaborate the research agenda in relation to pursuing clinically effective practice within the (UK) National Health Service'. This editorial presents the summary of the CERAG report and recommendations. PMID:19351400

Tectonic geomorphology of the Andes with SIR-A and SIR-B

NASA Technical Reports Server (NTRS)

Bloom, Arthur L.; Fielding, Eric J.

1986-01-01

Data takes from SIR-A and SIR-B (Shuttle Imaging Radar) crossed all of the principal geomorphic provinces of the central Andes between 17 and 34 S latitude. In conjunction with Thematic Mapping images and photographs from hand-held cameras as well as from the Large Format Camera that was flown with SIR-B, the radar images give an excellent sampling of Andean geomorphology. In particular, the radar images show new details of volcanic rocks and landforms of late Cenozoic age in the Puna, and the exhumed surfaces of tilted blocks of Precambrian crystalline basement in the Sierras Pampeanas.

Performance of Quick Sequential (Sepsis Related) and Sequential (Sepsis Related) Organ Failure Assessment to Predict Mortality in Patients with Acute Pyelonephritis Associated with Upper Urinary Tract Calculi.

PubMed

Fukushima, Hiroshi; Kobayashi, Masaki; Kawano, Keizo; Morimoto, Shinji

2018-06-01

The Third International Consensus Definitions for Sepsis and Septic Shock Task Force proposed a new definition of sepsis based on the SOFA (Sequential [Sepsis-related] Organ Failure Assessment) score and introduced a novel scoring system, quickSOFA, to screen patients at high risk for sepsis. However, the clinical usefulness of these systems is unclear. Therefore, we investigated predictive performance for mortality in patients with acute pyelonephritis associated with upper urinary tract calculi. This retrospective study included 141 consecutive patients who were clinically diagnosed with acute pyelonephritis associated with upper urinary tract calculi outside the intensive care unit. We evaluated the performance of the quickSOFA, SOFA and SIRS (systemic inflammatory response syndrome) scores to predict in-hospital mortality and intensive care unit admission using the AUC of the ROC curve, net reclassification, integrated discrimination improvements and decision curve analysis. A total of 11 patients (8%) died in the hospital and 26 (18%) were admitted to the intensive care unit. The AUC of quickSOFA to predict in-hospital mortality and intensive care unit admission was significantly greater than that of SIRS (each p <0.001) and comparable to that of SOFA (p = 0.47 and 0.57, respectively). When incorporated into the baseline model consisting of patient age, gender and the Charlson Comorbidity Index, quickSOFA and SOFA provided a greater change in AUC, and in net classification and integrated discrimination improvements than SIRS for each outcome. Decision curve analyses revealed that the quickSOFA and SOFA incorporated models showed a superior net benefit compared to the SIRS incorporated model for most examined probabilities of the 2 outcomes. The in-hospital mortality rate of patients with a quickSOFA score of 2 or greater and a SOFA score of 7 or greater, which were the optimal cutoffs determined by the Youden index, was 18% and 28%, respectively. SOFA and quickSOFA are more clinically useful scoring systems than SIRS to predict mortality in patients with acute pyelonephritis associated with upper urinary tract calculi. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Frontiers for geological remote sensing from space; Geosat Workshop, 4th, Flagstaff, AZ, June 12-17, 1983, Report

NASA Technical Reports Server (NTRS)

Henderson, F. B. (Editor); Rock, B. N. (Editor)

1983-01-01

Consideration is given to: the applications of near-infrared spectroscopy to geological reconnaissance and exploration from space; imaging systems for identifying the spectral properties of geological materials in the visible and near-infrared; and Thematic Mapper (TM) data analysis. Consideration is also given to descriptions of individual geological remote sensing systems, including: GEO-SPAS; SPOT; the Thermal Infrared Multispectral Scanner (TIMS); and the Shuttle Imaging Radars A and B (SIR-A and SIR-B). Additional topics include: the importance of geobotany in geological remote sensing; achromatic holographic stereograms from Landsat MSS data; and the availability and applications of NOAA's non-Landsat satellite data archive.

New and Improved? A Comparison of the Original and Revised Versions of the Structured Interview of Reported Symptoms

ERIC Educational Resources Information Center

Green, Debbie; Rosenfeld, Barry; Belfi, Brian

2013-01-01

The current study evaluated the accuracy of the Structured Interview of Reported Symptoms, Second Edition (SIRS-2) in a criterion-group study using a sample of forensic psychiatric patients and a community simulation sample, comparing it to the original SIRS and to results published in the SIRS-2 manual. The SIRS-2 yielded an impressive…

Recombinant NAD-dependent SIR-2 protein of Leishmania donovani: immunobiochemical characterization as a potential vaccine against visceral leishmaniasis.

PubMed

Baharia, Rajendra K; Tandon, Rati; Sharma, Tanuj; Suthar, Manish K; Das, Sanchita; Siddiqi, Mohammad Imran; Saxena, Jitendra Kumar; Sundar, Shaym; Sunder, Shyam; Dube, Anuradha

2015-03-01

The development of a vaccine conferring long-lasting immunity remains a challenge against visceral leishmaniasis (VL). Immunoproteomic characterization of Leishmania donovani proteins led to the identification of a novel protein NAD+-dependent Silent Information regulatory-2 (SIR2 family or sirtuin) protein (LdSir2RP) as one of the potent immunostimulatory proteins. Proteins of the SIR2 family are characterized by a conserved catalytic domain that exerts unique NAD-dependent deacetylase activity. In the present study, an immunobiochemical characterization of LdSir2RP and further evaluation of its immunogenicity and prophylactic potential was done to assess for its possible involvement as a vaccine candidate against leishmaniasis. LdSir2RP was successfully cloned, expressed and purified. The gene was present as a monomeric protein of ~45 kDa and further established by the crosslinking experiment. rLdSir2RP shown cytosolic localization in L. donovani and demonstrating NAD+-dependent deacetylase activity. Bioinformatic analysis also confirmed that LdSir2RP protein has NAD binding domain. The rLdSir2RP was further assessed for its cellular response by lymphoproliferative assay and cytokine ELISA in cured Leishmania patients and hamsters (Mesocricetus auratus) in comparison to soluble Leishmania antigen and it was observed to stimulate the production of IFN-γ, IL-12 and TNF-α significantly but not the IL-4 and IL-10. The naïve hamsters when vaccinated with rLdSir2RP alongwith BCG resisted the L. donovani challenge to the tune of ~75% and generated strong IL-12 and IFN-γ mediated Th1 type immune response thereof. The efficacy was further supported by remarkable increase in IgG2 antibody level which is indicative of Th1 type of protective response. Further, with a possible implication in vaccine design against VL, identification of potential T-cell epitopes of rLdSir2RP was done using computational approach. The immunobiochemical characterization strongly suggest the potential of rLdSir2RP as vaccine candidate against VL and supports the concept of its being effective T-cell stimulatory antigen.

Efficacy of two hydrogen peroxide vapour aerial decontamination systems for enhanced disinfection of meticillin-resistant Staphylococcus aureus, Klebsiella pneumoniae and Clostridium difficile in single isolation rooms.

PubMed

Ali, S; Muzslay, M; Bruce, M; Jeanes, A; Moore, G; Wilson, A P R

2016-05-01

Hydrogen peroxide vapour (HPV) disinfection systems are being used to reduce patients' exposure to hospital pathogens in the environment. HPV whole-room aerial disinfection systems may vary in terms of operating concentration and mode of delivery. To assess the efficacy of two HPV systems (HPS1 and HPS2) for whole-room aerial disinfection of single isolation rooms (SIRs). Ten SIRs were selected for manual terminal disinfection after patient discharge. Test coupons seeded with biological indicator (BI) organisms [∼10(6) colony-forming units (cfu) of meticillin-resistant Staphylococcus aureus (MRSA) or Klebsiella pneumoniae, or ∼10(5)cfu Clostridium difficile 027 spores] prepared in a soil challenge were placed at five locations per room. For each cycle, 22 high-frequency-touch surfaces in SIRs were sampled with contact plates (∼25cm(2)) before and after HPV decontamination, and BIs were assayed for the persistence of pathogens. Approximately 95% of 214 sites were contaminated with bacteria after manual terminal disinfection, with high numbers present on the SIR floor (238.0-352.5cfu), bed control panel (24.0-33.5cfu), and nurse call button (21.5-7.0cfu). Enhanced disinfection using HPV reduced surface contamination to low levels: HPS1 [0.25cfu, interquartile range (IQR) 0-1.13] and HPS2 (0.5cfu, IQR 0-2.0). Both systems demonstrated similar turnaround times (∼2-2.5h), and no differences were observed in the efficacy of the two systems against BIs (C. difficile ∼5.1log10 reduction; MRSA/K. pneumoniae ∼6.3log10 reduction). Despite different operating concentrations of hydrogen peroxide, MRSA persisted on 27% of coupons after HPV decontamination. Enhanced disinfection with HPV reduces surface contamination left by manual terminal cleaning, minimizing the risks of cross-contamination. The starting concentration and mode of delivery of hydrogen peroxide may not improve the efficacy of decontamination in practice, and therefore the choice of HPV system may be based upon other considerations such as cost, convenience and logistics. Copyright © 2016. Published by Elsevier Ltd.

Local IGF-1 isoform protects cardiomyocytes from hypertrophic and oxidative stresses via SirT1 activity.

PubMed

Vinciguerra, Manlio; Santini, Maria Paola; Claycomb, William C; Ladurner, Andreas G; Rosenthal, Nadia

2009-12-10

Oxidative and hypertrophic stresses contribute to the pathogenesis of heart failure. Insulin-like growth factor-1 (IGF-1) is a peptide hormone with a complex post-transcriptional regulation, generating distinct isoforms. Locally acting IGF-1 isoform (mIGF-1) helps the heart to recover from toxic injury and from infarct. In the murine heart, moderate overexpression of the NAD(+)-dependent deacetylase SirT1 was reported to mitigate oxidative stress. SirT1 is known to promote lifespan extension and to protect from metabolic challenges. Circulating IGF-1 and SirT1 play antagonizing biological roles and share molecular targets in the heart, in turn affecting cardiomyocyte physiology. However, how different IGF-1 isoforms may impact SirT1 and affect cardiomyocyte function is unknown. Here we show that locally acting mIGF-1 increases SirT1 expression/activity, whereas circulating IGF-1 isoform does not affect it, in cultured HL-1 and neonatal cardiomyocytes. mIGF-1-induced SirT1 activity exerts protection against angiotensin II (Ang II)-triggered hypertrophy and against paraquat (PQ) and Ang II-induced oxidative stress. Conversely, circulating IGF-1 triggered itself oxidative stress and cardiomyocyte hypertrophy. Interestingly, potent cardio-protective genes (adiponectin, UCP-1 and MT-2) were increased specifically in mIGF-1-overexpressing cardiomyocytes, in a SirT1-dependent fashion. Thus, mIGF-1 protects cardiomyocytes from oxidative and hypertrophic stresses via SirT1 activity, and may represent a promising cardiac therapeutic.

Local IGF-1 isoform protects cardiomyocytes from hypertrophic and oxidative stresses via SirT1 activity

PubMed Central

Vinciguerra, Manlio; Santini, Maria Paola; Claycomb, William C.; Ladurner, Andreas G.; Rosenthal, Nadia

2010-01-01

Oxidative and hypertrophic stresses contribute to the pathogenesis of heart failure. Insulin-like growth factor-1 (IGF-1) is a peptide hormone with a complex post-transcriptional regulation, generating distinct isoforms. Locally acting IGF-1 isoform (mIGF-1) helps the heart to recover from toxic injury and from infarct. In the murine heart, moderate overexpression of the NAD+-dependent deacetylase SirT1 was reported to mitigate oxidative stress. SirT1 is known to promote lifespan extension and to protect from metabolic challenges. Circulating IGF-1 and SirT1 play antagonizing biological roles and share molecular targets in the heart, in turn affecting cardiomyocyte physiology. However, how different IGF-1 isoforms may impact SirT1 and affect cardiomyocyte function is unknown. Here we show that locally acting mIGF-1 increases SirT1 expression/activity, whereas circulating IGF-1 isoform does not affect it, in cultured HL-1 and neonatal cardiomyocytes. mIGF-1-induced SirT1 activity exerts protection against angiotensin II (Ang II)-triggered hypertrophy and against paraquat (PQ) and Ang II-induced oxidative stress. Conversely, circulating IGF-1 triggered itself oxidative stress and cardiomyocyte hypertrophy. Interestingly, potent cardio-protective genes (adiponectin, UCP-1 and MT-2) were increased specifically in mIGF-1-overexpressing cardiomyocytes, in a SirT1-dependent fashion. Thus, mIGF-1 protects cardiomyocytes from oxidative and hypertrophic stresses via SirT1 activity, and may represent a promising cardiac therapeutic. PMID:20228935

Systemic Inflammatory Response Syndrome After Administration of Unmodified T Lymphocytes

PubMed Central

Papadopoulou, Anastasia; Krance, Robert A; Allen, Carl E; Lee, Daniel; Rooney, Cliona M; Brenner, Malcolm K; Leen, Ann M; Heslop, Helen E

2014-01-01

Systemic inflammatory response syndrome (SIRS) is a rare systemic inflammatory response associated with fever, tachycardia, profound hypotension, and respiratory distress, which has been reported in cancer patients receiving T cells genetically modified with chimeric antigen receptors to retarget their specificity to tumor-associated antigens. The syndrome usually occurs following significant in vivo expansion of the infused cells and has been associated with tumor destruction/lysis. Analysis of patient plasma has shown elevated cytokine levels, and resolution of symptoms has been reported after administration of steroids and/or antibodies (such as anti–tumor necrosis factor and anti-interleukin (IL)-6 receptor antibodies) that interfere with cytokine responses.To date, SIRS has not been reported in subjects receiving genetically unmodified T cells with native receptors directed against tumor antigens, in which greater physiological control of T-cell activation and expansion may occur. Here, however, we report a patient with bulky refractory Epstein-Barr virus (EBV)–associated lymphoma, who developed this syndrome 2 weeks after receiving T cells directed against EBV antigens through their native receptors. She was treated with steroids and etanercept, with rapid resolution of symptoms. SIRS may therefore occur even when T cells recognize antigens physiologically through their “wild-type” native receptors and should be acknowledged as a potential complication of this therapy. PMID:24651135

[Octanol preconditioning alleviates mouse cardiomyocyte swelling induced by simulated ischemia/reperfusion challenge in vitro].

PubMed

Luo, Yukun; Fang, Jun; Fan, Lin; Lin, Chaogui; Chen, Zhaoyang; Chen, Lianglong

2012-10-01

To investigate the role of connexin 43-formed hemichannels in cell volume regulation induced by simulated ischemia/reperfusion (SI/R). Mouse cardiomyocytes isolated on a Langendorff apparatus with enzyme solution were aliquoted into control, SI/R and SI/R +octanol groups. Calcein-AM was used to stain the cells and the cell volume was measured with confocal microscope by stack scanning. Trypan blue was used to measure the cell viability after the treatments. Calcein-AM staining and cofocal microscopy yielded stable and reproducible results for cell volume measurement. Mouse cardiomyocytes subjected to simulated SI/R showed obvious cell swelling as compared with the control cells [(126∓6)% vs 100%, P<0.05], and octanol preconditioning significantly attenuated the cell swelling [(113∓6)%, P<0.05]. SI/R caused a significant reduction of the cell viability compared to the control cells [(19∓2)% vs (45∓3)%, P<0.01], and octanol preconditioning obviously reduced the viability of the cells with SI/R challenge [(31∓2)%, P<0.01]. Connexin 43-formed hemichannels are involved in the regulation of cardiomyocyte volumes induced by SI/R challenge, and octanol can alleviate the cell swelling to enhance the viability of the cardiomyocytes following SI/R.

Multi-agent systems in epidemiology: a first step for computational biology in the study of vector-borne disease transmission.

PubMed

Roche, Benjamin; Guégan, Jean-François; Bousquet, François

2008-10-15

Computational biology is often associated with genetic or genomic studies only. However, thanks to the increase of computational resources, computational models are appreciated as useful tools in many other scientific fields. Such modeling systems are particularly relevant for the study of complex systems, like the epidemiology of emerging infectious diseases. So far, mathematical models remain the main tool for the epidemiological and ecological analysis of infectious diseases, with SIR models could be seen as an implicit standard in epidemiology. Unfortunately, these models are based on differential equations and, therefore, can become very rapidly unmanageable due to the too many parameters which need to be taken into consideration. For instance, in the case of zoonotic and vector-borne diseases in wildlife many different potential host species could be involved in the life-cycle of disease transmission, and SIR models might not be the most suitable tool to truly capture the overall disease circulation within that environment. This limitation underlines the necessity to develop a standard spatial model that can cope with the transmission of disease in realistic ecosystems. Computational biology may prove to be flexible enough to take into account the natural complexity observed in both natural and man-made ecosystems. In this paper, we propose a new computational model to study the transmission of infectious diseases in a spatially explicit context. We developed a multi-agent system model for vector-borne disease transmission in a realistic spatial environment. Here we describe in detail the general behavior of this model that we hope will become a standard reference for the study of vector-borne disease transmission in wildlife. To conclude, we show how this simple model could be easily adapted and modified to be used as a common framework for further research developments in this field.

Noise spatial nonuniformity and the impact of statistical image reconstruction in CT myocardial perfusion imaging.

PubMed

Lauzier, Pascal Theriault; Tang, Jie; Speidel, Michael A; Chen, Guang-Hong

2012-07-01

To achieve high temporal resolution in CT myocardial perfusion imaging (MPI), images are often reconstructed using filtered backprojection (FBP) algorithms from data acquired within a short-scan angular range. However, the variation in the central angle from one time frame to the next in gated short scans has been shown to create detrimental partial scan artifacts when performing quantitative MPI measurements. This study has two main purposes. (1) To demonstrate the existence of a distinct detrimental effect in short-scan FBP, i.e., the introduction of a nonuniform spatial image noise distribution; this nonuniformity can lead to unexpectedly high image noise and streaking artifacts, which may affect CT MPI quantification. (2) To demonstrate that statistical image reconstruction (SIR) algorithms can be a potential solution to address the nonuniform spatial noise distribution problem and can also lead to radiation dose reduction in the context of CT MPI. Projection datasets from a numerically simulated perfusion phantom and an in vivo animal myocardial perfusion CT scan were used in this study. In the numerical phantom, multiple realizations of Poisson noise were added to projection data at each time frame to investigate the spatial distribution of noise. Images from all datasets were reconstructed using both FBP and SIR reconstruction algorithms. To quantify the spatial distribution of noise, the mean and standard deviation were measured in several regions of interest (ROIs) and analyzed across time frames. In the in vivo study, two low-dose scans at tube currents of 25 and 50 mA were reconstructed using FBP and SIR. Quantitative perfusion metrics, namely, the normalized upslope (NUS), myocardial blood volume (MBV), and first moment transit time (FMT), were measured for two ROIs and compared to reference values obtained from a high-dose scan performed at 500 mA. Images reconstructed using FBP showed a highly nonuniform spatial distribution of noise. This spatial nonuniformity led to large fluctuations in the temporal direction. In the numerical phantom study, the level of noise was shown to vary by as much as 87% within a given image, and as much as 110% between different time frames for a ROI far from isocenter. The spatially nonuniform noise pattern was shown to correlate with the source trajectory and the object structure. In contrast, images reconstructed using SIR showed a highly uniform spatial distribution of noise, leading to smaller unexpected noise fluctuations in the temporal direction when a short scan angular range was used. In the numerical phantom study, the noise varied by less than 37% within a given image, and by less than 20% between different time frames. Also, the noise standard deviation in SIR images was on average half of that of FBP images. In the in vivo studies, the deviation observed between quantitative perfusion metrics measured from low-dose scans and high-dose scans was mitigated when SIR was used instead of FBP to reconstruct images. (1) Images reconstructed using FBP suffered from nonuniform spatial noise levels. This nonuniformity is another manifestation of the detrimental effects caused by short-scan reconstruction in CT MPI. (2) Images reconstructed using SIR had a much lower and more uniform noise level and thus can be used as a potential solution to address the FBP nonuniformity. (3) Given the improvement in the accuracy of the perfusion metrics when using SIR, it may be desirable to use a statistical reconstruction framework to perform low-dose dynamic CT MPI.

Noise spatial nonuniformity and the impact of statistical image reconstruction in CT myocardial perfusion imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lauzier, Pascal Theriault; Tang Jie; Speidel, Michael A.

Purpose: To achieve high temporal resolution in CT myocardial perfusion imaging (MPI), images are often reconstructed using filtered backprojection (FBP) algorithms from data acquired within a short-scan angular range. However, the variation in the central angle from one time frame to the next in gated short scans has been shown to create detrimental partial scan artifacts when performing quantitative MPI measurements. This study has two main purposes. (1) To demonstrate the existence of a distinct detrimental effect in short-scan FBP, i.e., the introduction of a nonuniform spatial image noise distribution; this nonuniformity can lead to unexpectedly high image noise andmore » streaking artifacts, which may affect CT MPI quantification. (2) To demonstrate that statistical image reconstruction (SIR) algorithms can be a potential solution to address the nonuniform spatial noise distribution problem and can also lead to radiation dose reduction in the context of CT MPI. Methods: Projection datasets from a numerically simulated perfusion phantom and an in vivo animal myocardial perfusion CT scan were used in this study. In the numerical phantom, multiple realizations of Poisson noise were added to projection data at each time frame to investigate the spatial distribution of noise. Images from all datasets were reconstructed using both FBP and SIR reconstruction algorithms. To quantify the spatial distribution of noise, the mean and standard deviation were measured in several regions of interest (ROIs) and analyzed across time frames. In the in vivo study, two low-dose scans at tube currents of 25 and 50 mA were reconstructed using FBP and SIR. Quantitative perfusion metrics, namely, the normalized upslope (NUS), myocardial blood volume (MBV), and first moment transit time (FMT), were measured for two ROIs and compared to reference values obtained from a high-dose scan performed at 500 mA. Results: Images reconstructed using FBP showed a highly nonuniform spatial distribution of noise. This spatial nonuniformity led to large fluctuations in the temporal direction. In the numerical phantom study, the level of noise was shown to vary by as much as 87% within a given image, and as much as 110% between different time frames for a ROI far from isocenter. The spatially nonuniform noise pattern was shown to correlate with the source trajectory and the object structure. In contrast, images reconstructed using SIR showed a highly uniform spatial distribution of noise, leading to smaller unexpected noise fluctuations in the temporal direction when a short scan angular range was used. In the numerical phantom study, the noise varied by less than 37% within a given image, and by less than 20% between different time frames. Also, the noise standard deviation in SIR images was on average half of that of FBP images. In the in vivo studies, the deviation observed between quantitative perfusion metrics measured from low-dose scans and high-dose scans was mitigated when SIR was used instead of FBP to reconstruct images. Conclusions: (1) Images reconstructed using FBP suffered from nonuniform spatial noise levels. This nonuniformity is another manifestation of the detrimental effects caused by short-scan reconstruction in CT MPI. (2) Images reconstructed using SIR had a much lower and more uniform noise level and thus can be used as a potential solution to address the FBP nonuniformity. (3) Given the improvement in the accuracy of the perfusion metrics when using SIR, it may be desirable to use a statistical reconstruction framework to perform low-dose dynamic CT MPI.« less

Noise spatial nonuniformity and the impact of statistical image reconstruction in CT myocardial perfusion imaging

PubMed Central

Lauzier, Pascal Thériault; Tang, Jie; Speidel, Michael A.; Chen, Guang-Hong

2012-01-01

Purpose: To achieve high temporal resolution in CT myocardial perfusion imaging (MPI), images are often reconstructed using filtered backprojection (FBP) algorithms from data acquired within a short-scan angular range. However, the variation in the central angle from one time frame to the next in gated short scans has been shown to create detrimental partial scan artifacts when performing quantitative MPI measurements. This study has two main purposes. (1) To demonstrate the existence of a distinct detrimental effect in short-scan FBP, i.e., the introduction of a nonuniform spatial image noise distribution; this nonuniformity can lead to unexpectedly high image noise and streaking artifacts, which may affect CT MPI quantification. (2) To demonstrate that statistical image reconstruction (SIR) algorithms can be a potential solution to address the nonuniform spatial noise distribution problem and can also lead to radiation dose reduction in the context of CT MPI. Methods: Projection datasets from a numerically simulated perfusion phantom and an in vivo animal myocardial perfusion CT scan were used in this study. In the numerical phantom, multiple realizations of Poisson noise were added to projection data at each time frame to investigate the spatial distribution of noise. Images from all datasets were reconstructed using both FBP and SIR reconstruction algorithms. To quantify the spatial distribution of noise, the mean and standard deviation were measured in several regions of interest (ROIs) and analyzed across time frames. In the in vivo study, two low-dose scans at tube currents of 25 and 50 mA were reconstructed using FBP and SIR. Quantitative perfusion metrics, namely, the normalized upslope (NUS), myocardial blood volume (MBV), and first moment transit time (FMT), were measured for two ROIs and compared to reference values obtained from a high-dose scan performed at 500 mA. Results: Images reconstructed using FBP showed a highly nonuniform spatial distribution of noise. This spatial nonuniformity led to large fluctuations in the temporal direction. In the numerical phantom study, the level of noise was shown to vary by as much as 87% within a given image, and as much as 110% between different time frames for a ROI far from isocenter. The spatially nonuniform noise pattern was shown to correlate with the source trajectory and the object structure. In contrast, images reconstructed using SIR showed a highly uniform spatial distribution of noise, leading to smaller unexpected noise fluctuations in the temporal direction when a short scan angular range was used. In the numerical phantom study, the noise varied by less than 37% within a given image, and by less than 20% between different time frames. Also, the noise standard deviation in SIR images was on average half of that of FBP images. In the in vivo studies, the deviation observed between quantitative perfusion metrics measured from low-dose scans and high-dose scans was mitigated when SIR was used instead of FBP to reconstruct images. Conclusions: (1) Images reconstructed using FBP suffered from nonuniform spatial noise levels. This nonuniformity is another manifestation of the detrimental effects caused by short-scan reconstruction in CT MPI. (2) Images reconstructed using SIR had a much lower and more uniform noise level and thus can be used as a potential solution to address the FBP nonuniformity. (3) Given the improvement in the accuracy of the perfusion metrics when using SIR, it may be desirable to use a statistical reconstruction framework to perform low-dose dynamic CT MPI. PMID:22830741

The risk of cancer in patients with congenital heart disease: a nationwide population-based cohort study in Taiwan.

PubMed

Lee, Yu-Sheng; Chen, Yung-Tai; Jeng, Mei-Jy; Tsao, Pei-Chen; Yen, Hsiu-Ju; Lee, Pi-Chang; Li, Szu-Yuan; Liu, Chia-Jen; Chen, Tzeng-Ji; Chou, Pesus; Soong, Wen-Jue

2015-01-01

The relationship between congenital heart disease (CHD) and malignancies has not been determined. This study aimed to explore the association of CHD with malignancies and examine the risk factors for the development of cancer after a diagnosis of CHD. This nationwide, population-based cohort study on cancer risk evaluated 31,961 patients with newly diagnosed CHD using the Taiwan National Health Insurance Research Database (NHIRD) between 1998 and 2006. The standardized incidence ratios (SIRs) for all and specific cancer types were analyzed, while the Cox proportional hazard model was used to evaluate risk factors of cancer occurrence. Among patients with newly diagnosed CHD regardless of ages, 187 (0.6%) subsequently developed cancers after a diagnosis of CHD. Patients with CHD had increased risk of cancer (SIR, 1.45; 95% CI, 1.25-1.67), as well as significantly elevated risks of hematologic (SIR, 4.04; 95% CI, 2.76-5.70), central nervous system (CNS) (SIR, 3.51; 95% CI, 1.92-5.89), and head and neck (SIR, 1.81; 95% CI, 1.03-2.94) malignancies. Age (HR, 1.06; 95% CI, 1.05-1.06) and co-morbid chronic liver disease (HR, 1.91; 95% CI, 1.27-2.87) were independent risk factors for cancer occurrence among CHD patients. Patients with CHD have significantly increased cancer risk, particularly hematologic, CNS, and head and neck malignancies. Physicians who care for patients with CHD should be aware of their predisposition to malignancy after the diagnosis of CHD. Further studies are warranted to clarify the association between CHD and malignancies.

Influence of two different IR radiators on the antioxidative potential of the human skin

NASA Astrophysics Data System (ADS)

Darvin, M. E.; Patzelt, A.; Meinke, M.; Sterry, W.; Lademann, J.

2009-03-01

Resonance Raman spectroscopy was used for the fast in vivo detection of the concentration of carotenoid antioxidant substances such as beta-carotene and lycopene in human skin and for the measurement of their degradation dynamics, subsequent to infrared (IR) irradiation emitted by two different IR radiators applied at the same power density. One of the radiators was equipped with a water filter in front of the radiation source (WIRA) and the other was a usual broadband system without a water filter (standard IR radiator - SIR). It was found that the SIR exerted a higher influence on the degradation of carotenoids in the skin than the WIRA. Furthermore, all twelve volunteers who participated in the study felt that the irradiation with the SIR was disagreeably warmer on the skin surface compared to the WIRA, in spite of the same power density values for both radiators on the skin surface. The average degradation magnitude of the carotenoids in the skin of all volunteers after an IR irradiation was determined at 23% for WIRA and 33% for the SIR. A correlation (R2 ~ 0.6) was found between the individual level of carotenoids in the skin of the volunteers and the magnitude of degradation of the carotenoids for both IR radiators. Taking the previous investigations into consideration, which clearly showed production of free radicals in the skin subsequent to IR irradiation, it can be concluded that during the application of WIRA irradiation on the skin, fewer radicals are produced in comparison to the SIR.

Epstein-Barr virus-associated infectious mononucleosis and risk of systemic lupus erythematosus.

PubMed

Ulff-Møller, Constance J; Nielsen, Nete M; Rostgaard, Klaus; Hjalgrim, Henrik; Frisch, Morten

2010-09-01

Elevated levels of serological markers of EBV infection in patients with SLE and observations that infectious mononucleosis (IM) may precede some cases of SLE suggest a possible role of EBV in the aetiology of SLE. We evaluated the relationship between EBV-associated IM and subsequent risk of SLE in a population-based cohort study. We followed cohorts of Danes tested serologically for IM using the Paul-Bunnell (PB) heterophile antibody test between 1939 and 1989, and patients hospitalized with IM between 1977 and 2007 for subsequent first hospitalizations with SLE in the period 1977-2008. Standardized incidence ratios (SIRs) with 95% CI served as measures of relative risk. Risk of SLE was not increased either in individuals with a positive PB test (SIR = 1.1; 95% CI 0.8, 1.6; n = 27) or in individuals hospitalized with IM (SIR = 1.3; 95% CI 0.7, 2.2; n = 12). However, SLE risk in PB-negative individuals was significantly increased (SIR = 2.6; 95% CI 2.1, 3.2; n = 82), a risk that was particularly high 1-4 years after the PB test (SIR = 6.6; 95% CI 3.3, 13.2) and remained significantly elevated for >25 years. EBV-associated IM does not seem to be a risk factor for SLE. The temporal pattern of increased SLE risk in individuals with a negative PB test suggests that some patients who go on to develop SLE may present with unspecific symptoms, for which they may be tested for IM, long in advance of their SLE diagnosis.

Shuttle Imaging Radar B (SIR-B) Weddell Sea ice observations - A comparison of SIR-B and scanning multichannel microwave radiometer ice concentrations

NASA Technical Reports Server (NTRS)

Martin, Seelye; Holt, Benjamin; Cavalieri, Donald J.; Squire, Vernon

1987-01-01

Ice concentrations over the Weddell Sea were studied using SIR-B data obtained during the October 1984 mission, with special attention given to the effect of ocean waves on the radar return at the ice edge. Sea ice concentrations were derived from the SIR-B data using two image processing methods: the classification scheme at JPL and the manual classification method at Scott Polar Research Institute (SPRI), England. The SIR ice concentrations were compared with coincident concentrations from the Nimbus-7 SMMR. For concentrations greater than 40 percent, which was the smallest concentration observed jointly by SIR-B and the SMMR, the mean difference between the two data sets for 12 points was 2 percent. A comparison between the JPL and the SPRI SIR-B algorithms showed that the algorithms agree to within 1 percent in the interior ice pack, but the JPL algorithm gives slightly greater concentrations at the ice edge (due to the fact that the algorithm is affected by the wind waves in these areas).

The transcriptional repressor Sum1p counteracts Sir2p in regulation of the actin cytoskeleton, mitochondrial quality control and replicative lifespan in Saccharomyces cerevisiae.

PubMed

Higuchi-Sanabria, Ryo; Vevea, Jason D; Charalel, Joseph K; Sapar, Maria L; Pon, Liza A

2016-01-18

Increasing the stability or dynamics of the actin cytoskeleton can extend lifespan in C. elegans and S. cerevisiae . Actin cables of budding yeast, bundles of actin filaments that mediate cargo transport, affect lifespan control through effects on mitochondrial quality control. Sir2p, the founding member of the Sirtuin family of lifespan regulators, also affects actin cable dynamics, assembly, and function in mitochondrial quality control. Here, we obtained evidence for novel interactions between Sir2p and Sum1p, a transcriptional repressor that was originally identified through mutations that genetically suppress sir2 ∆ phenotypes unrelated to lifespan. We find that deletion of SUM1 in wild-type cells results in increased mitochondrial function and actin cable abundance. Furthermore, deletion of SUM1 suppresses defects in actin cables and mitochondria of sir2 ∆ yeast, and extends the replicative lifespan and cellular health span of sir2 ∆ cells. Thus, Sum1p suppresses Sir2p function in control of specific aging determinants and lifespan in budding yeast.

Heterochromatin assembly by interrupted Sir3 bridges across neighboring nucleosomes

PubMed Central

Behrouzi, Reza; Lu, Chenning; Currie, Mark A; Jih, Gloria; Iglesias, Nahid; Moazed, Danesh

2016-01-01

Heterochromatin is a conserved feature of eukaryotic chromosomes with central roles in regulation of gene expression and maintenance of genome stability. Heterochromatin formation involves spreading of chromatin-modifying factors away from initiation points over large DNA domains by poorly understood mechanisms. In Saccharomyces cerevisiae, heterochromatin formation requires the SIR complex, which contains subunits with histone-modifying, histone-binding, and self-association activities. Here, we analyze binding of the Sir proteins to reconstituted mono-, di-, tri-, and tetra-nucleosomal chromatin templates and show that key Sir-Sir interactions bridge only sites on different nucleosomes but not sites on the same nucleosome, and are therefore 'interrupted' with respect to sites on the same nucleosome. We observe maximal binding affinity and cooperativity to unmodified di-nucleosomes and propose that nucleosome pairs bearing unmodified histone H4-lysine16 and H3-lysine79 form the fundamental units of Sir chromatin binding and that cooperative binding requiring two appropriately modified nucleosomes mediates selective Sir recruitment and spreading. DOI: http://dx.doi.org/10.7554/eLife.17556.001 PMID:27835568

Revisiting node-based SIR models in complex networks with degree correlations

NASA Astrophysics Data System (ADS)

Wang, Yi; Cao, Jinde; Alofi, Abdulaziz; AL-Mazrooei, Abdullah; Elaiw, Ahmed

2015-11-01

In this paper, we consider two growing networks which will lead to the degree-degree correlations between two nearest neighbors in the network. When the network grows to some certain size, we introduce an SIR-like disease such as pandemic influenza H1N1/09 to the population. Due to its rapid spread, the population size changes slowly, and thus the disease spreads on correlated networks with approximately fixed size. To predict the disease evolution on correlated networks, we first review two node-based SIR models incorporating degree correlations and an edge-based SIR model without considering degree correlation, and then compare the predictions of these models with stochastic SIR simulations, respectively. We find that the edge-based model, even without considering degree correlations, agrees much better than the node-based models incorporating degree correlations with stochastic SIR simulations in many respects. Moreover, simulation results show that for networks with positive correlation, the edge-based model provides a better upper bound of the cumulative incidence than the node-based SIR models, whereas for networks with negative correlation, it provides a lower bound of the cumulative incidence.

Excess primary intestinal lymphoproliferative disorders in patients with inflammatory bowel disease.

PubMed

Sokol, Harry; Beaugerie, Laurent; Maynadié, Marc; Laharie, David; Dupas, Jean-Louis; Flourié, Bernard; Lerebours, Eric; Peyrin-Biroulet, Laurent; Allez, Matthieu; Simon, Tabassome; Carrat, Fabrice; Brousse, Nicole

2012-11-01

It remains to be shown whether inflammatory bowel disease (IBD) is associated with an increased risk of primary intestinal lymphoproliferative disorders (PILD). We assessed this risk in the CESAME French nationwide prospective observational cohort. In all, 680 gastroenterologists enrolled 19,486 patients with IBD (Crohn's disease in 60.3%) from May 2004 to June 2005. Follow-up ended on 31 December 2007. Available biopsy samples and surgical specimens from patients with PILD (n = 14) were centralized for review. The reference incidence of PILD in the general population was obtained from the Côte d'Or registry and was used as a comparator to assess the standardized incidence ratio (SIR). The influence of thiopurine exposure was explored in a nested case-control study. In the CESAME population the crude incidence of PILD was 0.12/1000 patient-years, with a corresponding SIR of 17.51 (95% confidence interval [CI], 6.43-38.11; P < 0.0001). The risk was highest in patients exposed to thiopurines (SIR 49.52, 95% CI 13.49-126.8; P < 0.0001), while it did not reach statistical significance in patients naïve to thiopurines (SIR 4.83, 95% CI, 0.12-26.91; P = 0.37). The odds ratio associated with ongoing thiopurine exposure (vs. naïve) was 2.97 (95% CI, 0.30-infinity; P = 0.38). All 14 cases of PILD were non-Hodgkin's B-cell LD, 78.6% occurred in males, 85.7% arose in IBD lesions, and 45.5% were Epstein-Barr virus-positive. Eleven cases occurred in patients with Crohn's disease. Mean (SD) age at PILD diagnosis was 55.1 (5.6) years and the median time since IBD onset was 8.0 years (interquartile range, 3.0-15.8). Patients with IBD have an increased risk of developing PILD. Copyright © 2012 Crohn's & Colitis Foundation of America, Inc.

On Hydromagnetic Waves in Atmospheres with Application to the Sun

NASA Astrophysics Data System (ADS)

Campos, L. M. B. C.

Sir James Lighthill has an exceptionally wide range of research interests; one of them is magnetohydrodynamics (MHD). In a major paper (Lighthill, 1959), he considers MHD waves in general, and in particular Alfvén waves with the Hall effect. He analyzes the radiation field using a method of asymptotic estimation of Fourier integrals, which was further developed in subsequent papers (Lighthill, 1964). This method is applied to internal or acoustic-gravity waves in his book on waves in fluids (Lighthill, 1978), which includes an appendix on MHD waves. As an applied mathematician, Sir James was always aware of the applications of his theories; in the case of MHD waves he considered their role in the heating of the solar atmosphere (Lighthill, 1967). In this presentation in honor of Sir James Lighthill, I choose to address the subject of hydromagnetic waves, with application to the solar atmosphere and wind, for two reasons: first it is less likely to be covered by other authors than, say, his better known work on aerodynamics, aeroacoustics, or biofluiddynamics; and I feel a volume in honor of Sir James should reflect his significant contributions to MHD. The second motivation is that about two decades ago, Sir James suggested that I consider magneto-atmospheric waves and their role in the solar atmosphere, and this may be an appropriate occasion to report on what was made of this suggestion. Sir James has a rare ability not only to initiate new areas of research but also to pinpoint subjects ripe for significant development, and this is also substantiated in the field of atmospheric waves. In the present communication paper I consider all three MHD modes (Alfvén, slow, and fast), including viscous and resistive dissipation, cases with external magnetic fields of varying strength and direction (spherical and spiral waves), and the Hall effect and some instances of nonlinear effects; application to the solar atmosphere and wind shows that MHD waves play a major role in energy and mass balance in the solar system. The case of weakly dissipative nonlinear magnetosonic waves relates to another celebrated paper on viscous effects on large amplitude sound waves (Lighthill, 1956). Although I have research interests influenced by, or in common with, Sir James, in other areas, such as aeroacoustics (e.g., Campos, 1986), aeronautics (Campos et al., 1995), and applied mathematics (Campos, 1984a, 1994a), I chose to concentrate on magneto-atmospheric waves and the Sun, as an expression of gratitude for Sir James's inspiring suggestion.

Flat Epithelial Atypia and Risk of Breast Cancer: A Mayo Cohort Study

PubMed Central

Said, Samar M.; Visscher, Daniel W.; Nassar, Aziza; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene H.; Ghosh, Karthik; Radisky, Derek C.; Hartmann, Lynn C.; Degnim, Amy C.

2014-01-01

Background Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to breast cancer development. It is often referred to as an “atypical” or high-risk lesion. However, the long term risk of breast cancer in women with FEA is undefined. Methods Biopsies with FEA were identified in excisional breast biopsies in the Mayo Clinic Benign Breast Disease (BBD) Cohort, which includes 11,591 women who had benign biopsies at Mayo-Rochester 1967–2001. Breast cancer risk of FEA, non-proliferative, proliferative and atypical hyperplasia (AH) subsets was assessed using standardized incidence ratios (SIRs), relative to the Iowa Surveillance, Epidemiology, and End Results registry. Results FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in AH + FEA was 4.74 (95% CI: 3.17–6.81) versus 4.23 (3.44–5.13) for AH without FEA (p=0.59). The SIR for PDWA + FEA was 2.04 (95% CI: 1.23–3.19) versus 1.90 (1.72–2.09) for PDWA without FEA (p=0.76). Conclusions FEA is an uncommon finding in women with BBD. FEA does not convey independent risk of breast cancer beyond that of the associated PDWA or AH. PMID:25639678

The SIR-B science investigations plan: Introduction

NASA Technical Reports Server (NTRS)

1984-01-01

The Shuttle Imaging Radar-B (SIR-B) and its capabilities are described. The SIR-B instrument is an upgraded version of SIR-A that has the additional capability of tilting the antenna mechanically to acquire data at incidence angles that vary from 15 to 60 deg. Like SEASAT and SIR-A, SIR-B will be an L-band (23-cm) HH polarized radar. The variable-incidence-angle capability will allow several experiments. A specific area may be imaged with a variety of incidence angles on successive days. These images can then be registered and used to produce curves of backscatter as a function of incidence angle for various terrain types. These curves can be used ultimately to characterize the terrain. Stereoimaging may also be done in the multiple-incidence-angle mode. In addition, large areas may be imaged and mosaicked together with only slight variations in incidence angle with each swath.

Evaluation of SIR-B imagery for geologic and geomorphic mapping, hydrology, and oceanography in Australia

NASA Technical Reports Server (NTRS)

Honey, F. R.; Simpson, C. J.; Huntington, J.; Horwitz, R.; Byrne, G.; Nilsson, C.

1984-01-01

The objectives of a study to evaluate the potential of Shuttle Imaging Radar-B (SIR-B) imagery for various applications are outlined. Specific goals include: the development of techniques for registration multiple acquisition, varied illumination, and incidence-angle SIR-B imagery, and a model for estimation of the relative contributions to the backscattered radiation of topography, surface roughness, and dielectric and conductivity components; (2) the evaluation of SIR-B imagery for delineation of agricultural lands affected by secondary salinity in the southwest and southeast agricultural regions of Australia; (3) the development of techniques for application of SIR-B imagery for geologic, geomorphologic and soils mapping and mineral exploration; and (4) the evaluation of the use of SIR-B imagery in determining ocean currents, current shear patterns, internal waves and bottom features for specific locations off the Australian coast.

Evaluation of SIR-A (Shuttle Imaging Radar) images from the Tres Marias region (Minas Gerais State, Brazil) using derived spatial features and registration with MSS-LANDSAT images

NASA Technical Reports Server (NTRS)

Parada, N. D. J. (Principal Investigator); Kux, H. J. H.; Dutra, L. V.

1984-01-01

Two image processing experiments are described using a MSS-LANDSAT scene from the Tres Marias region and a shuttle Imaging Radar SIR-A image digitized by a vidicon scanner. In the first experiment the study area is analyzed using the original and preprocessed SIR-A image data. The following thematic classes are obtained: (1) water, (2) dense savanna vegetation, (3) sparse savanna vegetation, (4) reforestation areas and (5) bare soil areas. In the second experiment, the SIR-A image was registered together with MSS-LANDSAT bands five, six, and seven. The same five classes mentioned above are obtained. These results are compared with those obtained using solely MSS-LANDSAT data. The spatial information as well as coregistered SIR-A and MSS-LANDSAT data can increase the separability between classes, as compared to the use of raw SIR-A data solely.

Annual incidence and standardized incidence ratio of cerebrovascular accidents in patients with systemic lupus erythematosus.

PubMed

Mok, C C; Ho, L Y; To, C H

2009-01-01

To study the annual incidence and standardized incidence ratio (SIR) of cerebrovascular accident (CVA) in patients with systemic lupus erythematosus (SLE). The annual incidence of CVA from 1999 to 2007 in a longitudinal cohort of SLE patients was calculated each year and compared with that of the regional population within the same study period. Age-specific SIRs and outcome of CVA in SLE patients were also studied. In 2007, there were 490 SLE patients in our cohort. The mean annual incidence of CVA between 1999 and 2007 was 6.45/1000 patients and no obvious trend over time was observed. Of the 20 CVAs in patients with SLE, 18 (90%) were ischaemic stroke whereas two (10%) were haemorrhagic stroke. The mean SIR of all types of CVA in SLE patients was 2.02 [95% confidence interval (CI) 1.30-3.81; p = 0.002]. The SIR of ischaemic stroke decreased with age and the stroke incidence was no longer significantly higher than that of the population in patients aged >or= 60 years. Haemorrhagic stroke occurred mainly in younger SLE patients. The duration of hospitalization and the mortality rate for CVA was non-significantly higher in SLE than in non-SLE patients. The incidence of CVA in SLE remained constant over the 8 years between 1999 and 2007. Younger SLE patients are at substantially increased risk of CVA compared to age-matched population. The duration of hospitalization and the mortality rate for CVA are similar in SLE and non-SLE patients.

Should Age at Diagnosis Be Included as an Additional Variable in the Risk of Recurrence Classification System in Patients with Differentiated Thyroid Cancer

PubMed Central

Pitoia, Fabián; Jerkovich, Fernando; Smulever, Anabella; Brenta, Gabriela; Bueno, Fernanda; Cross, Graciela

2017-01-01

Objective To evaluate the influence of age at diagnosis on the frequency of structural incomplete response (SIR) according to the modified risk of recurrence (RR) staging system from the American Thyroid Association guidelines. Patients and Methods We performed a retrospective analysis of 268 patients with differentiated thyroid cancer (DTC) followed up for at least 3 years after initial treatment (total thyroidectomy and remnant ablation). The median follow-up in the whole cohort was 74.3 months (range: 36.1-317.9) and the median age at diagnosis was 45.9 years (range: 18-87). The association between age at diagnosis and the initial and final response to treatment was assessed with analysis of variance (ANOVA). Patients were also divided into several groups considering age younger and older than 40, 50, and 60 years. Results Age at diagnosis was not associated with either an initial or final statistically significant different SIR to treatment (p = 0.14 and p = 0.58, respectively). Additionally, we did not find any statistically significant differences when the percentages of SIR considering the classification of RR were compared between different groups of patients by using several age cutoffs. Conclusions When patients are correctly risk stratified, it seems that age at diagnosis is not involved in the frequency of having a SIR at the initial evaluation or at the final follow-up, so it should not be included as an additional variable to be considered in the RR classifications. PMID:28785543

Malignancy in Pediatric-onset Systemic Lupus Erythematosus.

PubMed

Bernatsky, Sasha; Clarke, Ann E; Zahedi Niaki, Omid; Labrecque, Jeremy; Schanberg, Laura E; Silverman, Earl D; Hayward, Kristen; Imundo, Lisa; Brunner, Hermine I; Haines, Kathleen A; Cron, Randy Q; Oen, Kiem; Wagner-Weiner, Linda; Rosenberg, Alan M; O'Neil, Kathleen M; Duffy, Ciarán M; von Scheven, Emily; Joseph, Lawrence; Lee, Jennifer L; Ramsey-Goldman, Rosalind

2017-10-01

To determine cancer incidence in a large pediatric-onset systemic lupus erythematosus (SLE) population. Data were examined from 12 pediatric SLE registries in North America. Patients were linked to their regional cancer registries to detect cancers observed after cohort entry, defined as date first seen in the clinic. The expected number of malignancies was obtained by multiplying the person-years in the cohort (defined from cohort entry to end of followup) by the geographically matched age-, sex-, and calendar year-specific cancer rates. The standardized incidence ratio (SIR; ratio of cancers observed to expected) was generated, with 95% CI. A total of 1168 patients were identified from the registries. The mean age at cohort entry was 13 years (SD 3.3), and 83.7% of the subjects were female. The mean duration of followup was 7.6 years, resulting in a total observation period of 8839 years spanning the calendar period 1974-2009. During followup, fourteen invasive cancers occurred (1.6 cancers per 1000 person-yrs, SIR 4.13, 95% CI 2.26-6.93). Three of these were hematologic (all lymphomas), resulting in an SIR for hematologic cancers of 4.68 (95% CI 0.96-13.67). SIR were increased for both male and female patients, and across age groups. Although cancer remains a relatively rare outcome in pediatric-onset SLE, our data do suggest an increase in cancer for patients followed an average of 7.6 years. About one-fifth of the cancers were hematologic. Longer followup, and study of drug effects and disease activity, is warranted.

Mitochondrial N-formyl peptides induce cardiovascular collapse and sepsis-like syndrome

PubMed Central

McCarthy, Cameron G.; Szasz, Theodora; Goulopoulou, Styliani; Webb, R. Clinton

2015-01-01

Fifty percent of trauma patients who present sepsis-like syndrome do not have bacterial infections. This condition is known as systemic inflammatory response syndrome (SIRS). A unifying factor of SIRS and sepsis is cardiovascular collapse. Trauma and severe blood loss cause the release of endogenous molecules known as damage-associated molecular patterns. Mitochondrial N-formyl peptides (F-MIT) are damage-associated molecular patterns that share similarities with bacterial N-formylated peptides and are potent immune system activators. The goal of this study was to investigate whether F-MIT trigger SIRS, including hypotension and vascular collapse via formyl peptide receptor (FPR) activation. We evaluated cardiovascular parameters in Wistar rats treated with FPR or histamine receptor antagonists and inhibitors of the nitric oxide pathway before and after F-MIT infusion. F-MIT, but not nonformylated peptides or mitochondrial DNA, induced severe hypotension via FPR activation and nitric oxide and histamine release. Moreover, F-MIT infusion induced hyperthermia, blood clotting, and increased vascular permeability. To evaluate the role of leukocytes in F-MIT-induced hypotension, neutrophil, basophil, or mast cells were depleted. Depletion of basophils, but not neutrophils or mast cells, abolished F-MIT-induced hypotension. Rats that underwent hemorrhagic shock increased plasma levels of mitochondrial formylated proteins associated with lung damage and antagonism of FPR ameliorated hemorrhagic shock-induced lung injury. Finally, F-MIT induced vasodilatation in isolated resistance arteries via FPR activation; however, F-MIT impaired endothelium-dependent relaxation in the presence of blood. These data suggest that F-MIT may be the link among trauma, SIRS, and cardiovascular collapse. PMID:25637548

Sex differences in obesity related cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC-49).

PubMed

Schrijnders, Dennis; Hendriks, Steven H; Kleefstra, Nanne; Vissers, Pauline A J; Johnson, Jeffrey A; de Bock, Geertruida H; Bilo, Henk J G; Landman, Gijs W D

2018-01-01

Diabetes and obesity seem to be partly overlapping risk factors for the development of obesity-related cancer (mainly breast, prostate and colorectal cancer) in patients with type 2 diabetes (T2DM). In the general population, women have a lower risk for obesity-related cancer compared to men. Previous studies involving cardiovascular disease have shown that T2DM eliminates a female advantage of lower CVD risk in the general population compared to men. It is unclear whether the same could be true for obesity-related cancer. This study aimed to this investigate obesity-related cancer incidence in women and men known with T2DM as compared to the Dutch general population. This study included 69,583 patients with T2DM selected from a prospective primary care cohort, which was linked to the Dutch National Cancer Registry to obtain cancer specific data. Obesity-related cancers included liver, kidney, colorectal, gallbladder, pancreas, ovarian, endometrial, advanced prostate cancer, post-menopausal breast cancer and oesophageal adenocarcinoma. Primary outcome was sex-stratified, age and year of cancer diagnosis adjusted standardized incidence ratios (SIRs) for three time periods: 5 years before, the year after diagnosis and the next 4 years after T2DM diagnosis. The Dutch general population was used as reference group. Women with T2DM were at an increased risk for obesity-related cancer compared to women in the general population already 5 years before diabetes diagnosis (SIR 1.77; 95%CI: 1.63-1.91). In both men and women, there was a peak in obesity-related cancer incidence following diabetes diagnosis (SIR: 1.38; 95%CI 1.11-1.64 and SIR: 2.21; 95%CI 1.94-2.30, respectively). From the second to the fifth year after diabetes diagnosis the obesity-related cancer incidence was higher in women compared to women in the general population (SIR: 2.12; 95%CI 1.94-2.30). Women with T2DM seem to have a substantially higher obesity-related cancer risk. As opposed to men, in women this risk was already increased years before diabetes diagnosis. These results could imply that a relative advantage of women in the general population with regard to cancer risk is lost in women with T2DM.

Sex differences in obesity related cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC-49)

PubMed Central

Hendriks, Steven H.; Kleefstra, Nanne; Vissers, Pauline A. J.; de Bock, Geertruida H.; Bilo, Henk J. G.; Landman, Gijs W. D.

2018-01-01

Background Diabetes and obesity seem to be partly overlapping risk factors for the development of obesity-related cancer (mainly breast, prostate and colorectal cancer) in patients with type 2 diabetes (T2DM). In the general population, women have a lower risk for obesity-related cancer compared to men. Previous studies involving cardiovascular disease have shown that T2DM eliminates a female advantage of lower CVD risk in the general population compared to men. It is unclear whether the same could be true for obesity-related cancer. This study aimed to this investigate obesity-related cancer incidence in women and men known with T2DM as compared to the Dutch general population. Methods This study included 69,583 patients with T2DM selected from a prospective primary care cohort, which was linked to the Dutch National Cancer Registry to obtain cancer specific data. Obesity-related cancers included liver, kidney, colorectal, gallbladder, pancreas, ovarian, endometrial, advanced prostate cancer, post-menopausal breast cancer and oesophageal adenocarcinoma. Primary outcome was sex-stratified, age and year of cancer diagnosis adjusted standardized incidence ratios (SIRs) for three time periods: 5 years before, the year after diagnosis and the next 4 years after T2DM diagnosis. The Dutch general population was used as reference group. Results Women with T2DM were at an increased risk for obesity-related cancer compared to women in the general population already 5 years before diabetes diagnosis (SIR 1.77; 95%CI: 1.63–1.91). In both men and women, there was a peak in obesity-related cancer incidence following diabetes diagnosis (SIR: 1.38; 95%CI 1.11–1.64 and SIR: 2.21; 95%CI 1.94–2.30, respectively). From the second to the fifth year after diabetes diagnosis the obesity-related cancer incidence was higher in women compared to women in the general population (SIR: 2.12; 95%CI 1.94–2.30). Conclusions Women with T2DM seem to have a substantially higher obesity-related cancer risk. As opposed to men, in women this risk was already increased years before diabetes diagnosis. These results could imply that a relative advantage of women in the general population with regard to cancer risk is lost in women with T2DM. PMID:29370205

Simulation of emotional contagion using modified SIR model: A cellular automaton approach

NASA Astrophysics Data System (ADS)

Fu, Libi; Song, Weiguo; Lv, Wei; Lo, Siuming

2014-07-01

Emotion plays an important role in the decision-making of individuals in some emergency situations. The contagion of emotion may induce either normal or abnormal consolidated crowd behavior. This paper aims to simulate the dynamics of emotional contagion among crowds by modifying the epidemiological SIR model to a cellular automaton approach. This new cellular automaton model, entitled the “CA-SIRS model”, captures the dynamic process ‘susceptible-infected-recovered-susceptible', which is based on SIRS contagion in epidemiological theory. Moreover, in this new model, the process is integrated with individual movement. The simulation results of this model show that multiple waves and dynamical stability around a mean value will appear during emotion spreading. It was found that the proportion of initial infected individuals had little influence on the final stable proportion of infected population in a given system, and that infection frequency increased with an increase in the average crowd density. Our results further suggest that individual movement accelerates the spread speed of emotion and increases the stable proportion of infected population. Furthermore, decreasing the duration of an infection and the probability of reinfection can markedly reduce the number of infected individuals. It is hoped that this study will be helpful in crowd management and evacuation organization.

Differences in the effectiveness of serum biomarkers for the diagnosis of bacterial infections in adult and elderly patients admitted to the emergency department.

PubMed

Yilmaz, Hava; Duran, Latif; Yanik, Keramettin; Altuntaş, Mehmet; Sünbül, Mustafa

2015-01-01

This study aimed to evaluate the superiority of procalcitonin (PCT), C-reactive protein (CRP) levels, white blood cell (WBC) counts, and erythrocyte sedimentation rate (ESR) in discriminating among infection, systemic inflammatory response syndrome (SIRS), and sepsis, and their differences according to age groups. The patients were divided into an adult group and a geriatric group (over 65 years) and classified according to the presence of infection, SIRS, and sepsis. The patients' laboratory values (PCT, CRP, WBC, ESR), demographic characteristics, and vital signs were taken into consideration. When the laboratory parameters were evaluated, there were no significant differences in the PCT, WBC, and ESR values between the age groups (P > 0.05). CRP was significantly higher in the adult patient group compared to the geriatric group (P < 0.001). When the two groups were compared in terms of infection, there were no significant differences in the PCT levels and the WBC count (P > 0.05) in SIRS and sepsis. In addition, the CRP levels and the ESR were significantly higher in the adult sepsis patients when compared with the geriatric patients (P < 0.001). PCT levels do not distinguish among infection, SIRS, and sepsis in adult and geriatric age groups.

The risk of thromboembolic events in kidney transplant patients.

PubMed

Verhave, Jacobien C; Tagalakis, Vicky; Suissa, Samy; Madore, François; Hébert, Marie-Josée; Cardinal, Héloïse

2014-06-01

Little is known about the risk of venous thrombosis following kidney transplant. To determine this we estimated the risk of thromboembolic events (TEs) in a cohort of consecutive patients who underwent kidney transplantation at a single tertiary care center over an 11-year period and calculated standardized incidence ratios (SIRs) for a first TE in kidney transplant recipients compared with the general population. We then performed a nested case-control study and compared patients with and without TEs to identify risk factors for thrombosis. Among 913 kidney transplant recipients (KTRs), 68 patients developed these events. The SIR for TEs in KTRs compared with the general population was 7.9 over the duration of follow-up. The risk was particularly higher in the first post-transplant year (SIR 26.1) but remained elevated afterward (SIR 5.2). Hospitalization, use of sirolimus, low hemoglobin level, and use of renin-angiotensin system inhibitors were independently associated with these events. When cases of TEs that occurred during hospitalization were excluded, the risk of these events remained elevated. The risk of TEs in KTRs was eightfold higher than in the general population but not fully explained by the increased risk associated with hospitalization. Our results underscore the important risk of thrombosis in patients who received a kidney transplant, making vigilance mandatory especially during hospitalization.

Occupation and Bladder Cancer Phenotype: Identification of Workplace Patterns That Increase the Risk of Advanced Disease Beyond Overall Incidence.

PubMed

Noon, Aidan P; Martinsen, Jan Ivar; Catto, James W F; Pukkala, Eero

2016-07-20

We examined a national data set to determine if workers employed in specific occupations develop distinct bladder cancer (BCa) phenotypes. To compare the incidence and disease-specific mortality (DSM) of localized and advanced BCa in workers with different job titles. BCa incidence, stage at diagnosis, and DSM in 1.7 million Finnish men (13 717 with BCa) and 1.7 million women (4282 with BCa) with annotated occupational descriptions. Follow-up was 37 and 43 million person-years, respectively. The gender-specific incidence and BCa DSM within each occupational category was compared with the expected number of cases based on the entire Finnish population to generate standardized incidence ratios (SIRs) and standard mortality ratios (SMRs). Occupations were found that had significant differences in the incidence of localized (SIR loc ) and advanced (SIR adv , SMR adv ) BCa and DSM. Male chemical process workers (SIR loc /SIR adv : 5.19; 95% confidence interval [CI], 1.73-25.7), male military personnel (SIR loc /SIR adv : 6.4; 95% CI, 1.09-259.0), and male public safety workers (SIR loc /SIR adv : 1.77; 95% CI, 1.04-3.23) had significantly more localized than advanced tumors. In contrast, miscellaneous construction workers had more advanced than localized cancers for both genders (male SIR loc /SIR adv : 0.67; 95% CI, 0.53-0.86; female SIR loc /SIR adv : 0.12; 95% CI, 0.09-0.54). Male chemical process workers had fewer deaths from BCa than expected from advanced tumors (SMR adv : 0.32; 95% CI, 0.07-0.94), and miscellaneous constructions workers had more deaths from advanced tumors than expected (male SMR adv : 1.44; 95% CI, 1.10-1.85; female SMR adv : 3.35; 95% CI, 1.23-7.30). Limitations of this study are failure to control accurately for the effects of smoking and a lack of specific treatment information. Occupations exist that may differ in their risks for localized and advanced BCa and for DSM. Occupations have been identified that may have different patterns of bladder cancer than expected. These findings may be explained by confounding factors such as exposure to tobacco smoke; however, it could be that workers with these job titles are exposed to specific bladder carcinogens. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Hoarding symptoms among psychiatric outpatients: confirmatory factor analysis and psychometric properties of the Saving Inventory - Revised (SI-R).

PubMed

Lee, Siau Pheng; Ong, Clarissa; Sagayadevan, Vathsala; Ong, Rebecca; Abdin, Edimansyah; Lim, Susan; Vaingankar, Janhavi; Picco, Louisa; Verma, Swapna; Chong, Siow Ann; Subramaniam, Mythily

2016-10-26

The growing interest in problematic hoarding as an independent clinical condition has led to the development of the Saving Inventory-Revised (SI-R) to assess hoarding phenomenology. The SI-R is one of the most widely used instruments to measure hoarding symptoms; however, it lacks validation in non-Western samples. The current study examined the construct, convergent, and discriminant validity of the SI-R among 500 outpatients at a psychiatric hospital in Singapore. The three-factor structure solution of the SI-R was fitted in a confirmatory factor analysis. The final model achieved mediocre fit (χ2 = 1026.02, df = 186; RMSEA = 0.095, SRMR = 0.06; CFI = 0.86; NNFI = 0.85). Two reverse-coded items (items 2 and 4) were removed due to insufficient factor loadings, resulting in the modified 21-item SI-R (SIR-21). Our findings indicate the need to further examine the construct validity of the SI-R, particularly in non-Western samples. Nonetheless, correlations with other hoarding-related constructs, such as anxiety (Beck Anxiety Inventory) and depression (Beck Depression Inventory-II), supported the convergent and discriminant validity of the SIR-21 in our sample. Findings in our current majority Chinese sample were consistent with previous observations from other Chinese samples. Implications were discussed from a cross-cultural perspective, such as cultural emphasis on saving for future use and overlap between the concepts of discarding and acquiring in Chinese samples. Future studies should also examine differences among other ethnic groups (e.g., Malay, Indian).

Hyperinsulinemia is Associated with Increased Soluble Insulin Receptors Release from Hepatocytes

PubMed Central

Hiriart, Marcia; Sanchez-Soto, Carmen; Diaz-Garcia, Carlos Manlio; Castanares, Diana T.; Avitia, Morena; Velasco, Myrian; Mas-Oliva, Jaime; Macias-Silva, Marina; González-Villalpando, Clicerio; Delgado-Coello, Blanca; Sosa-Garrocho, Marcela; Vidaltamayo, Román; Fuentes-Silva, Deyanira

2014-01-01

It has been generally assumed that insulin circulates freely in blood. However it can also interact with plasma proteins. Insulin receptors are located in the membrane of target cells and consist of an alpha and beta subunits with a tyrosine kinase cytoplasmic domain. The ectodomain, called soluble insulin receptor (SIR) has been found elevated in patients with diabetes mellitus. We explored if insulin binds to SIRs in circulation under physiological conditions and hypothesize that this SIR may be released by hepatocytes in response to high insulin concentrations. The presence of SIR in rat and human plasmas and the culture medium of hepatocytes was explored using Western blot analysis. A purification protocol was performed to isolated SIR using affinity, gel filtration, and ion exchange chromatographies. A modified reverse hemolytic plaque assay was used to measure SIR release from cultured hepatocytes. Incubation with 1 nmol l−1 insulin induces the release of the insulin receptor ectodomains from normal rat hepatocytes. This effect can be partially prevented by blocking protease activity. Furthermore, plasma levels of SIR were higher in a model of metabolic syndrome, where rats are hyperinsulinemic. We also found increased SIR levels in hyperinsulinemic humans. SIR may be an important regulator of the amount of free insulin in circulation. In hyperinsulinemia, the amount of this soluble receptor increases and this could lead to higher amounts of insulin bound to this receptor, rather than free insulin, which is the biologically active form of the hormone. This observation could enlighten the mechanisms of insulin resistance. PMID:24995000

Hyperinsulinemia is Associated with Increased Soluble Insulin Receptors Release from Hepatocytes.

PubMed

Hiriart, Marcia; Sanchez-Soto, Carmen; Diaz-Garcia, Carlos Manlio; Castanares, Diana T; Avitia, Morena; Velasco, Myrian; Mas-Oliva, Jaime; Macias-Silva, Marina; González-Villalpando, Clicerio; Delgado-Coello, Blanca; Sosa-Garrocho, Marcela; Vidaltamayo, Román; Fuentes-Silva, Deyanira

2014-01-01

It has been generally assumed that insulin circulates freely in blood. However it can also interact with plasma proteins. Insulin receptors are located in the membrane of target cells and consist of an alpha and beta subunits with a tyrosine kinase cytoplasmic domain. The ectodomain, called soluble insulin receptor (SIR) has been found elevated in patients with diabetes mellitus. We explored if insulin binds to SIRs in circulation under physiological conditions and hypothesize that this SIR may be released by hepatocytes in response to high insulin concentrations. The presence of SIR in rat and human plasmas and the culture medium of hepatocytes was explored using Western blot analysis. A purification protocol was performed to isolated SIR using affinity, gel filtration, and ion exchange chromatographies. A modified reverse hemolytic plaque assay was used to measure SIR release from cultured hepatocytes. Incubation with 1 nmol l(-1) insulin induces the release of the insulin receptor ectodomains from normal rat hepatocytes. This effect can be partially prevented by blocking protease activity. Furthermore, plasma levels of SIR were higher in a model of metabolic syndrome, where rats are hyperinsulinemic. We also found increased SIR levels in hyperinsulinemic humans. SIR may be an important regulator of the amount of free insulin in circulation. In hyperinsulinemia, the amount of this soluble receptor increases and this could lead to higher amounts of insulin bound to this receptor, rather than free insulin, which is the biologically active form of the hormone. This observation could enlighten the mechanisms of insulin resistance.

Serum miR-146a and miR-223 as potential new biomarkers for sepsis.

PubMed

Wang, Jia-feng; Yu, Man-li; Yu, Guang; Bian, Jin-jun; Deng, Xiao-ming; Wan, Xiao-jian; Zhu, Ke-ming

2010-03-26

Current biomarkers cannot completely distinguish sepsis from systemic inflammatory response syndrome (SIRS) caused by other non-infectious diseases. Circulating microRNAs (miRNAs) are promising biomarkers for several diseases, but their correlation with sepsis is not totally clarified. Seven miRNAs related to inflammation or infection were included in the present study. Serum miRNA expression was investigated in 50 patients diagnosed with sepsis, 30 patients with SIRS and 20 healthy controls to evaluate the diagnostic and prognostic value. Expression levels of serum miRNAs were determined by quantitative PCR using the Qiagen miScript system. Serum CRP and IL-6 levels were determined by enzyme linked immunosorbent assay. Serum miR-146a and miR-223 were significantly reduced in septic patients compared with SIRS patients and healthy controls. The areas under the receiver operating characteristic curve of miR-146a, miR-223 and IL-6 were 0.858, 0.804 and 0.785, respectively. Serum miR-146a and miR-223 might serve as new biomarkers for sepsis with high specificity and sensitivity. (ClinicalTrials.gov number, NCT00862290.). Copyright (c) 2010 Elsevier Inc. All rights reserved.

Analysis of a multisensor image data set of south San Rafael Swell, Utah

NASA Technical Reports Server (NTRS)

Evans, D. L.

1982-01-01

A Shuttle Imaging Radar (SIR-A) image of the southern portion of the San Rafael Swell in Utah has been digitized and registered to coregistered Landsat, Seasat, and HCMM thermal inertia images. The addition of the SIR-A image to the registered data set improves rock type discrimination in both qualitative and quantitative analyses. Sedimentary units can be separated in a combined SIR-A/Seasat image that cannot be seen in either image alone. Discriminant Analyses show that the classification accuracy is improved with addition of the SIR-A image to Landsat images. Classification accuracy is further improved when texture information from the Seasat and SIR-A images is included.

Sirolimus and metformin synergistically inhibit hepatocellular carcinoma cell proliferation and improve long-term survival in patients with HCC related to hepatitis B virus induced cirrhosis after liver transplantation

PubMed Central

Shen, Chuan; Peng, Chenghong; Shen, Baiyong; Zhu, Zhecheng; Xu, Ning; Li, Tao; Xie, Junjie

2016-01-01

Immunosuppressive agents used postoperatively after liver transplantation (LT) for hepatocellular carcinoma (HCC) favor recurrence and metastasis. Therefore, new effective immunosuppressants are needed. This retrospective study assessed combined sirolimus and metformin on survival of HCC patients after LT. In 2001-2013, 133 HCC patients with LT were divided into four groups: sirolimus and metformin combination (Sir+Met), sirolimus monotherapy (Sir), other immunosuppressants in diabetes mellitus (DM) patients without metformin (No Sir with DM), and other immunosuppressants in patients without DM (No Sir without DM). Kaplan-Meier and Log-rank tests were used to assess survival. Cell proliferation and tumor xenograft assays were performed to disclose the mechanisms underlying the sirolimus and metformin effects. The Sir+Met group showed significantly prolonged survival compared to the other groups. The most significant cytotoxicity was seen in the Sir+Met group, with significantly decreased levels of phosphorylated PI3K, AKT, AMPK, mTOR, 4EBP1 and S6K, compared with the other groups. In agreement, Sir+Met had the highest suppressive effect on tumor growth among all groups (P<0.01). In summary, Sir+Met treatment significantly prolonged survival, likely by suppressing cell proliferation. Therefore, this combination could represent a potential routine-regimen for patients post LT. PMID:27577068

Mutations in Ran system affected telomere silencing in Saccharomyces cerevisiae

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hayashi, Naoyuki; Department of Molecular Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Ishikawa 920-0934; Kobayashi, Masahiko

The Ran GTPase system regulates the direction and timing of several cellular events, such as nuclear-cytosolic transport, centrosome formation, and nuclear envelope assembly in telophase. To gain insight into the Ran system's involvement in chromatin formation, we investigated gene silencing at the telomere in several mutants of the budding yeast Saccharomyces cerevisiae, which had defects in genes involved in the Ran system. A mutation of the RanGAP gene, rna1-1, caused reduced silencing at the telomere, and partial disruption of the nuclear Ran binding factor, yrb2-{delta}2, increased this silencing. The reduced telomere silencing in rna1-1 cells was suppressed by a highmore » dosage of the SIR3 gene or the SIT4 gene. Furthermore, hyperphosphorylated Sir3 protein accumulated in the rna1-1 mutant. These results suggest that RanGAP is required for the heterochromatin structure at the telomere in budding yeast.« less

The risk of cancer in patients with connective tissue diseases but without dermatomyositis or polymyositis: A multicenter cohort study conducted over 15 years in China.

PubMed

Xu, Wei; Guo, Huan; Liu, Zhi; Chen, Chen; Lei, Cong-Cong

2016-09-01

To investigate the relative risk of cancer in Chinese patients with connective tissue diseases (CTD) associated with and without dermatomyositis or polymyositis. A retrospective, multicenter cohort study investigated 32,380 CTD patients (2334 diagnosed with dermatomyositis or polymyositis) without a history of malignancies treated from January 1, 1997, to December 31, 2011. Standardized incidence ratios (SIR) of cancers determined the incidence of malignancies during follow-up. The data was compared with the cancer morbidity of the general population from the Chinese Cancer Registry Annual Report of National Central Cancer Registry. A total of 113 patients (348.98 per 100,000) developed cancer during follow-up, 75 (249.62 per 100,000) were patients with CTD without dermatomyositis or polymyositis. The risk of cancer among patients with CTD was increased (SIR=1.45, 95% confidence interval [CI] 1.22-1.71), and this risk increased with age (<40 years: SIR=1.00 [95%CI 0.45-2.21]; 41-60 years: SIR=1.53 [95%CI 1.17-2.00]; and >60 years SIR=2.34 (95%CI 0.93-2.77]) and the time of follow-up (<1year: SIR=1.22 [95%CI 0.88-1.70]; 1-5 years: SIR=1.14 [95%CI 0.79-1.65]; and 6-10 years SIR=1.70 [95%CI 1.34-2.85]), but was similar between genders (male SIR=1.60 [95%CI 1.10-2.31] and female SIR=1.25 [95%CI 1.01-1.55]). The cancer risk among CTD patients without dermatomyositis or polymyositis was not affected (SIR=0.93, 95%CI 0.75-1.16), regardless of gender, age, or follow-up. The cancer risk for patients with CTD without dermatomyositis or polymyositis was not increased or decreased, but it was increased when patients with dermatomyositis or polymyositis were included. Copyright © 2016 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

Interface of the transport systems research vehicle monochrome display system to the digital autonomous terminal access communication data bus

NASA Technical Reports Server (NTRS)

Easley, W. C.; Tanguy, J. S.

1986-01-01

An upgrade of the transport systems research vehicle (TSRV) experimental flight system retained the original monochrome display system. The original host computer was replaced with a Norden 11/70, a new digital autonomous terminal access communication (DATAC) data bus was installed for data transfer between display system and host, while a new data interface method was required. The new display data interface uses four split phase bipolar (SPBP) serial busses. The DATAC bus uses a shared interface ram (SIR) for intermediate storage of its data transfer. A display interface unit (DIU) was designed and configured to read from and write to the SIR to properly convert the data from parallel to SPBP serial and vice versa. It is found that separation of data for use by each SPBP bus and synchronization of data tranfer throughout the entire experimental flight system are major problems which require solution in DIU design. The techniques used to accomplish these new data interface requirements are described.

Evaluation of SIR-A space radar for geologic interpretation: United States, Panama, Colombia, and New Guinea

NASA Technical Reports Server (NTRS)

Macdonald, H.; Waite, W. P.; Kaupp, V. H.; Bridges, L. C.; Storm, M.

1983-01-01

Comparisons between LANDSAT MSS imagery, and aircraft and space radar imagery from different geologic environments in the United States, Panama, Colombia, and New Guinea demonstrate the interdependence of radar system geometry and terrain configuration for optimum retrieval of geologic information. Illustrations suggest that in the case of space radars (SIR-A in particular), the ability to acquire multiple look-angle/look-direction radar images of a given area is more valuable for landform mapping than further improvements in spatial resolution. Radar look-angle is concluded to be one of the most important system parameters of a space radar designed to be used for geologic reconnaissance mapping. The optimum set of system parameters must be determined for imaging different classes of landform features and tailoring the look-angle to local topography.

Approach to derivation of SIR-C science requirements for calibration. [Shuttle Imaging Radar

NASA Technical Reports Server (NTRS)

Dubois, Pascale C.; Evans, Diane; Van Zyl, Jakob

1992-01-01

Many of the experiments proposed for the forthcoming SIR-C mission require calibrated data, for example those which emphasize (1) deriving quantitative geophysical information (e.g., surface roughness and dielectric constant), (2) monitoring daily and seasonal changes in the Earth's surface (e.g., soil moisture), (3) extending local case studies to regional and worldwide scales, and (4) using SIR-C data with other spaceborne sensors (e.g., ERS-1, JERS-1, and Radarsat). There are three different aspects to the SIR-C calibration problem: radiometric and geometric calibration, which have been previously reported, and polarimetric calibration. The study described in this paper is an attempt at determining the science requirements for polarimetric calibration for SIR-C. A model describing the effect of miscalibration is presented first, followed by an example describing how to assess the calibration requirements specific to an experiment. The effects of miscalibration on some commonly used polarimetric parameters are also discussed. It is shown that polarimetric calibration requirements are strongly application dependent. In consequence, the SIR-C investigators are advised to assess the calibration requirements of their own experiment. A set of numbers summarizing SIR-C polarimetric calibration goals concludes this paper.

JSC Shuttle Mission Simulator (SMS) visual system payload bay video image

NASA Technical Reports Server (NTRS)

1981-01-01

This video image is of the STS-2 Columbia, Orbiter Vehicle (OV) 102, payload bay (PLB) showing the Office of Space Terrestrial Applications 1 (OSTA-1) pallet (Shuttle Imaging Radar A (SIR-A) antenna (left) and SIR-A recorder, Shuttle Multispectral Infrared Radiometer (SMIRR), Feature Identification Location Experiment (FILE), Measurement of Air Pollution for Satellites (MAPS) (right)). The image is used in JSC's Fixed Based (FB) Shuttle Mission Simulator (SMS). It is projected inside the FB-SMS crew compartment during mission simulation training. The FB-SMS is located in the Mission Simulation and Training Facility Bldg 5.

A class of stochastic delayed SIR epidemic models with generalized nonlinear incidence rate and temporary immunity

NASA Astrophysics Data System (ADS)

Fan, Kuangang; Zhang, Yan; Gao, Shujing; Wei, Xiang

2017-09-01

A class of SIR epidemic model with generalized nonlinear incidence rate is presented in this paper. Temporary immunity and stochastic perturbation are also considered. The existence and uniqueness of the global positive solution is achieved. Sufficient conditions guaranteeing the extinction and persistence of the epidemic disease are established. Moreover, the threshold behavior is discussed, and the threshold value R0 is obtained. We show that if R0 < 1, the disease eventually becomes extinct with probability one, whereas if R0 > 1, then the system remains permanent in the mean.

Sir Walter Langdon-Brown (1870-1946).

PubMed

Keynes, Milo

2008-02-01

Sir Walter Langdon-Brown, born of robust Puritan stock, was a distinguished physician, teacher, medical historian and humanist at St Bartholomew's Hospital, London, before becoming Regius Professor of Physics at Cambridge. His contributions to clinical medicine were wide in relating symptoms and signs of disease to physiology, putting therapeutics on a scientific basis, showing the close linkage of the sympathetic nervous system to the ductless glands, and being regarded as a founder of clinical endocrinology. He was the first English physician to relate the work of Freud, Jung and Adler to clinical medicine and a pioneer in psychosomatic medicine and the study of neurotic behaviour.

Solar Radiometric Data Quality Assessment of SIRS, SKYRAD and GNDRAD Measurements (Poster)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Habte, A.; Stoffel, T.; Reda, I.

2014-03-01

Solar radiation is the driving force for the earth's weather and climate. Understanding the elements of this dynamic energy balance requires accurate measurements of broadband solar irradiance. Since the mid-1990's the ARM Program has deployed pyrheliometers and pyranometers for the measurement of direct normal irradiance (DNI), global horizontal irradiance (GHI), diffuse horizontal irradiance (DHI), and upwelling shortwave (US) radiation at permanent and mobile field research sites. This poster summarizes the basis for assessing the broadband solar radiation data available from the SIRS, SKYRAD, and GNDRAD measurement systems and provides examples of data inspections.

Plasma Bacterial and Mitochondrial DNA Distinguish Bacterial Sepsis from Sterile SIRS and Quantify Inflammatory Tissue Injury in Nonhuman Primates

PubMed Central

Sursal, Tolga; Stearns-Kurosawa, Deborah J; Itagaki, Kiyoshi; Oh, Sun-Young; Sun, Shiqin; Kurosawa, Shinichiro; Hauser, Carl J

2012-01-01

Systemic inflammatory response syndrome (SIRS) is a fundamental host response common to bacterial infection and sterile tissue injury. SIRS can cause organ dysfunction and death but its mechanisms are incompletely understood. Moreover, SIRS can progress to organ failure or death despite being sterile or after control of the inciting infection. Biomarkers discriminating between sepsis, sterile SIRS and post-infective SIRS would therefore help direct care. Circulating mitochondrial DNA (mtDNA) is a damage-associated molecular pattern (DAMP) reflecting cellular injury. Circulating bacterial 16S-DNA (bDNA) is a pathogen-associated pattern (PAMP) reflecting ongoing infection. We developed qPCR assays to quantify these markers and predicted their plasma levels might help distinguish sterile injury from infection. To study these events in primates we assayed banked serum from papio baboons that had undergone a brief challenge of intravenous Bacillus anthracis deltaSterne (modified to remove toxins) followed by antibiotics (anthrax) that causes organ failure and death. To investigate the progression of sepsis to “severe” sepsis and death we studied animals where anthrax was pretreated with drotrecogin alfa (aPC), which attenuates sepsis in baboons. We also contrasted lethal anthrax bacteremia against non-lethal E.coli bacteremia and against sterile tissue injury from Shiga-like toxin-1 (Stx1). bDNA and mtDNA levels in timed samples were correlated with blood culture results and assays of organ function. Sterile injury by Stx1 increased mtDNA but bDNA was undetectable: consistent with the absence of infection. The bacterial challenges caused parallel early bDNA and mtDNA increases, but bDNA detected pathogens even after bacteria were undetectable by culture. Sub-lethal E.coli challenge only caused transient rises in mtDNA consistent with a self-limited injury. In lethal anthrax challenge (n=4) bDNA increased transiently but mtDNA levels remained elevated until death, consistent with persistent septic tissue damage after bacterial clearance. Critically, aPC pre-treatment (n=4) allowed mtDNA levels to decay after bacterial clearance with sparing of organ function and survival. In summary, host tissue injury correlates with mtDNA whether infective or sterile. mtDNA and bDNA PCRs can quantify tissue injury incurred by septic or sterile mechanisms and suggest the source of SIRS of unknown origin. PMID:23247122

qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis.

PubMed

Goulden, Robert; Hoyle, Marie-Claire; Monis, Jessie; Railton, Darran; Riley, Victoria; Martin, Paul; Martina, Reynaldo; Nsutebu, Emmanuel

2018-06-01

The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely used National Early Warning Score (NEWS). This was a retrospective cohort study carried out in a UK tertiary centre. The study population comprised emergency admissions in whom sepsis was suspected and treated. The accuracy for predicting inhospital mortality and ICU admission was calculated and compared for qSOFA, SIRS and NEWS. Among 1818 patients, 53 were admitted to ICU (3%) and 265 died in hospital (15%). For predicting inhospital mortality, the area under the receiver operating characteristics curve for NEWS (0.65, 95% CI 0.61 to 0.68) was similar to qSOFA (0.62, 95% CI 0.59 to 0.66) (test for difference, P=0.18) and superior to SIRS (P<0.001), which was not predictive. The sensitivity of NEWS≥5 (74%, 95% CI 68% to 79%) was similar to SIRS≥2 (80%, 95% CI 74% to 84%) and higher than qSOFA≥2 (37%, 95% CI 31% to 43%). The specificity of NEWS≥5 (43%, 95% CI 41% to 46%) was higher than SIRS≥2 (21%, 95% CI 19% to 23%) and lower than qSOFA≥2 (79%, 95% CI 77% to 81%). The negative predictive value was 88% (86%-90%) for qSOFA, 86% (82%-89%) for SIRS and 91% (88%-93%) for NEWS. Results were similar for the secondary outcome of ICU admission. NEWS has equivalent or superior value for most test characteristics relative to SIRS and qSOFA, calling into question the rationale of adopting qSOFA in institutions where NEWS is already in use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Interleukin-27 is a novel candidate diagnostic biomarker for bacterial infection in critically ill children

PubMed Central

2012-01-01

Introduction Differentiating between sterile inflammation and bacterial infection in critically ill patients with fever and other signs of the systemic inflammatory response syndrome (SIRS) remains a clinical challenge. The objective of our study was to mine an existing genome-wide expression database for the discovery of candidate diagnostic biomarkers to predict the presence of bacterial infection in critically ill children. Methods Genome-wide expression data were compared between patients with SIRS having negative bacterial cultures (n = 21) and patients with sepsis having positive bacterial cultures (n = 60). Differentially expressed genes were subjected to a leave-one-out cross-validation (LOOCV) procedure to predict SIRS or sepsis classes. Serum concentrations of interleukin-27 (IL-27) and procalcitonin (PCT) were compared between 101 patients with SIRS and 130 patients with sepsis. All data represent the first 24 hours of meeting criteria for either SIRS or sepsis. Results Two hundred twenty one gene probes were differentially regulated between patients with SIRS and patients with sepsis. The LOOCV procedure correctly predicted 86% of the SIRS and sepsis classes, and Epstein-Barr virus-induced gene 3 (EBI3) had the highest predictive strength. Computer-assisted image analyses of gene-expression mosaics were able to predict infection with a specificity of 90% and a positive predictive value of 94%. Because EBI3 is a subunit of the heterodimeric cytokine, IL-27, we tested the ability of serum IL-27 protein concentrations to predict infection. At a cut-point value of ≥5 ng/ml, serum IL-27 protein concentrations predicted infection with a specificity and a positive predictive value of >90%, and the overall performance of IL-27 was generally better than that of PCT. A decision tree combining IL-27 and PCT improved overall predictive capacity compared with that of either biomarker alone. Conclusions Genome-wide expression analysis has provided the foundation for the identification of IL-27 as a novel candidate diagnostic biomarker for predicting bacterial infection in critically ill children. Additional studies will be required to test further the diagnostic performance of IL-27. The microarray data reported in this article have been deposited in the Gene Expression Omnibus under accession number GSE4607. PMID:23107287

Benign Thyroid Diseases and Risk of Thyroid Cancer: A Nationwide Cohort Study.

PubMed

Kitahara, Cari M; K Rmendiné Farkas, Dóra; Jørgensen, Jens Otto L; Cronin-Fenton, Deirdre; Sørensen, Henrik Toft

2018-06-01

Thyroid nodules, adenomas, and goiter have consistently been associated with thyroid cancer risk. Few studies have assessed whether thyroid dysfunction and thyroid autoimmunity influence this risk. To examine thyroid cancer risk after diagnoses of a wide range of benign thyroid conditions. Hospital and cancer registry linkage cohort study for the years 1978 to 2013. Nationwide (Denmark). Patients diagnosed with hyperthyroidism (n = 85,169), hypothyroidism (n = 63,143), thyroiditis (n = 12,532), nontoxic nodular goiter (n = 65,782), simple goiter (n = 11,582), other/unspecified goiter (n = 21,953), or adenoma (n = 6,481) among 8,258,807 residents of Denmark during the study period. We computed standardized incidence ratios (SIRs) for differentiated thyroid cancer, excluding the first 12 months of follow-up after benign thyroid disease diagnosis. SIRs were significantly elevated for all benign thyroid diseases apart from hypothyroidism. SIRs were higher for men than women and in the earlier follow-up periods. Elevated SIRs were observed for localized and regional/distant thyroid cancer. After excluding the first 10 years of follow-up, hyperthyroidism [n = 27 thyroid cancer cases; SIR = 2.00; 95% confidence interval (CI): 1.32 to 2.92], nontoxic nodular goiter (n = 83; SIR = 4.91; 95% CI: 3.91 to 6.09), simple goiter (n = 8; SIR = 4.33; 95% CI: 1.87 to 8.53), other/unspecified goiter (n = 20; SIR = 3.94; 95% CI: 2.40 to 6.08), and adenoma (n = 9; SIR = 6.02; 95% CI: 2.76 to 11.5) remained positively associated with thyroid cancer risk. We found an unexpected increased risk of differentiated thyroid cancer, including regional/distant disease, following diagnosis of hyperthyroidism and thyroiditis that could not be solely attributed to increased medical surveillance. Hypothyroidism was less clearly associated with thyroid cancer risk.

Increased risk of histologically defined cancer subtypes in human immunodeficiency virus-infected individuals: clues for possible immunosuppression-related or infectious etiology.

PubMed

Shiels, Meredith S; Engels, Eric A

2012-10-01

Malignancies that occur in excess among human immunodeficiency virus (HIV)-infected individuals may be caused by immunosuppression or infections. Because histologically defined cancer subtypes have not been systematically evaluated, their risk was assessed among people with acquired immunodeficiency syndrome (AIDS). Analyses included 569,268 people with AIDS from the HIV/AIDS Cancer Match Study, a linkage of 15 US population-based HIV/AIDS and cancer registries during 1980 to 2007. Standardized incidence ratios (SIRs) were estimated to compare cancer risk in people with AIDS to the general population overall, and stratified by age, calendar period (a proxy of changing HIV therapies), and time since onset of AIDS (a proxy of immunosuppression). Sixteen individual cancer histologies or histology groupings manifested significantly elevated SIRs. Risks were most elevated for adult T cell leukemia/lymphoma (SIR = 11.3), neoplasms of histiocytes and accessory lymphoid cells (SIR = 10.7), giant cell carcinoma (SIR = 7.51), and leukemia not otherwise specified (SIR = 6.69). SIRs ranged from 1.4 to 4.6 for spindle cell carcinoma, bronchioloalveolar adenocarcinoma, adnexal and skin appendage neoplasms, sarcoma not otherwise specified, spindle cell sarcoma, leiomyosarcoma, mesothelioma, germ cell tumors, plasma cell tumors, immunoproliferative diseases, acute lymphocytic leukemia, and myeloid leukemias. For several of these cancer subtypes, significant declines in SIRs were observed across calendar periods (consistent with decreasing risk with improved HIV therapies) or increase in SIRs with time since onset of AIDS (ie, prolonged immunosuppression). The elevated risk of certain cancer subtypes in people with AIDS may point to an etiologic role of immunosuppression or infection. Future studies are needed to further investigate these associations and evaluate candidate infectious agents. Copyright © 2012 American Cancer Society.

Dynamical prediction of flu seasonality driven by ambient temperature: influenza vs. common cold

NASA Astrophysics Data System (ADS)

Postnikov, Eugene B.

2016-01-01

This work presents a comparative analysis of Influenzanet data for influenza itself and common cold in the Netherlands during the last 5 years, from the point of view of modelling by linearised SIRS equations parametrically driven by the ambient temperature. It is argued that this approach allows for the forecast of common cold, but not of influenza in a strict sense. The difference in their kinetic models is discussed with reference to the clinical background.

Plasma bacterial and mitochondrial DNA distinguish bacterial sepsis from sterile systemic inflammatory response syndrome and quantify inflammatory tissue injury in nonhuman primates.

PubMed

Sursal, Tolga; Stearns-Kurosawa, Deborah J; Itagaki, Kiyoshi; Oh, Sun-Young; Sun, Shiqin; Kurosawa, Shinichiro; Hauser, Carl J

2013-01-01

Systemic inflammatory response syndrome (SIRS) is a fundamental host response common to bacterial infection and sterile tissue injury. Systemic inflammatory response syndrome can cause organ dysfunction and death, but its mechanisms are incompletely understood. Moreover, SIRS can progress to organ failure or death despite being sterile or after control of the inciting infection. Biomarkers discriminating between sepsis, sterile SIRS, and postinfective SIRS would therefore help direct care. Circulating mitochondrial DNA (mtDNA) is a damage-associated molecular pattern reflecting cellular injury. Circulating bacterial 16S DNA (bDNA) is a pathogen-associated pattern (PAMP) reflecting ongoing infection. We developed quantitative polymerase chain reaction assays to quantify these markers, and predicting their plasma levels might help distinguish sterile injury from infection. To study these events in primates, we assayed banked serum from Papio baboons that had undergone a brief challenge of intravenous Bacillus anthracis delta Sterne (modified to remove toxins) followed by antibiotics (anthrax) that causes organ failure and death. To investigate the progression of sepsis to "severe" sepsis and death, we studied animals where anthrax was pretreated with drotrecogin alfa (activated protein C), which attenuates sepsis in baboons. We also contrasted lethal anthrax bacteremia against nonlethal E. coli bacteremia and against sterile tissue injury from Shiga-like toxin 1. Bacterial DNA and mtDNA levels in timed samples were correlated with blood culture results and assays of organ function. Sterile injury by Shiga-like toxin 1 increased mtDNA, but bDNA was undetectable: consistent with the absence of infection. The bacterial challenges caused parallel early bDNA and mtDNA increases, but bDNA detected pathogens even after bacteria were undetectable by culture. Sublethal E. coli challenge only caused transient rises in mtDNA consistent with a self-limited injury. In lethal anthrax challenge (n = 4), bDNA increased transiently, but mtDNA levels remained elevated until death, consistent with persistent septic tissue damage after bacterial clearance. Critically, activated protein C pretreatment (n = 4) allowed mtDNA levels to decay after bacterial clearance with sparing of organ function and survival. In summary, host tissue injury correlates with mtDNA whether infective or sterile. Mitochondrial DNA and bDNA polymerase chain reactions can quantify tissue injury incurred by septic or sterile mechanisms and suggest the source of SIRS of unknown origin.

EDITORIAL: Siberia Integrated Regional Study: multidisciplinary investigations of the dynamic relationship between the Siberian environment and global climate change

NASA Astrophysics Data System (ADS)

Gordov, E. P.; Vaganov, E. A.

2010-03-01

This is an editorial overview of the Siberia Integrated Regional Study (SIRS), which is a large-scale investigation of ongoing and future environmental change in Siberia and its relationship to global processes, approaches, existing challenges and future direction. Introduction The SIRS is a mega-project within the Northern Eurasia Earth Science Partnership Initiative (NEESPI), which coordinates interdisciplinary, national and international activities in Northern Eurasia that follow the Earth System Science Program (ESSP) approach. Under the direction of the International Geosphere-Biosphere Program (IGBP), SIRS is one of the Integrated Regional Studies (IRS) that aims to investigate environmental change in Siberia under the current environment of global change, and the potential impact on Earth system dynamics [1]. The regions of interest are those that may function as 'choke or switch points' for the global Earth system, where changes in regional biophysical, biogeochemical and anthropogenic components may have significant consequences for the Earth system at the global scale. Siberia is a large and significant region that may compel change [2]. Regional consequences of global warming (e.g. anomalous increases in cold season temperatures) have already been documented for Siberia [3]. This result is also supported by climate modeling results for the 20th-22nd centuries [4]. Future climatic change threatens Siberia with the shift of permafrost boundaries northward, dramatic changes in land cover (redistribution among boreal forest, wetlands, tundra, and steppe zones often precipitated by fire regime change) and the entire hydrological regime of the territory [5-8]. These processes feed back to and influence climate dynamics through the exchange of energy, water, greenhouse gases and aerosols [9]. Even though there have been a handful of national and international projects focused on the Siberian environment, scientists have minimal knowledge about the processes that control change in this understudied region, particularly those concerning the primary components that influence regional climate (i.e. cloud cover, precipitation) and responses and feedbacks to and from terrestrial and aquatic systems. This provides a strong impetus for the SIRS project. SIRS was initiated at a boreal forest conference in Krasnoyarsk in 2002 under the auspices of the IGBP and ESSP regional strategy by Will Steffen (IGBP) and the Siberian Branch of the Russian Academy of Sciences (SB RAS). Russian and foreign scientific activities continued under the Siberian Center for Environmental Research and Training (SCERT) in 2003. In 2005, the Siberian Branch of the Russian National Committee (SB RNC) for IGBP endorsed these activities and recommended investigations focus on four major themes: quantification of the terrestrial biota full greenhouse gas budget, with a focus on the exchange between biota and atmosphere; monitoring and modeling of regional climate change impacts; development of SIRS informational-computational infrastructure; and development of a regional strategy of adaptation to and mitigation of the negative consequences of global change. SIRS development [10, 11] supports Siberian Earth science investigations funded by the RAS Foundation for Basic Research, the European Commission (EC), the International Science and Technology Center (ISTC) and the National Aeronautics and Space Administration (NASA). SB RNC is responsible for SIRS advances, and SCERT hosts the Committee office and houses major SIRS informational-computational infrastructure development. NEESPI (www.neespi.org/) serves as an IGBP and World Climate Research Programme (WCRP) external project, and as a NEESPI mega-project, SIRS has organized distribution centers in Krasnoyarsk and Tomsk to support NEESPI activity, and has coordinated training and educational activity aimed at young scientists. SIRS approaches and outcomes Organizational activity The 'Siberian Geosphere-Biosphere Program: integrated regional study of contemporary natural and climatic changes' is one of several funded interdisciplinary projects, and it serves to unite regional studies from 14 RAS and SB RAS institutes and 5 universities. In the course of this and similar national1 and international projects, ENVIROMIS and ENVIROMIS-2 (Environmental Observations, Modelling and Information Systems) was formed, which is the SIRS professional community comprising regional, national and international specialists dealing with Siberian environmental dynamics studies. Results of those and parallel projects were analyzed in by coordinated activities: 'Enviro-RISKS-Man-induced Environmental Risks: monitoring, management and remediation of man-made changes in Siberia' [12]. Currently, a new set of SB RAS integrated2 and international projects within the Asia-Pacific Network for Global Change Study (APN) and ISTC are under way. While a number of projects have been initiated and clustered under the SIRS umbrella and their results and data are distributed through the SIRS web portal (http://sirs.scert.ru/), the organizational SIRS infrastructure is inadequate. SIRS has neither SB RAS stable funding nor a dedicated Project Office. Both obstacles are a major concern for the SIRS governing body. Information-computational infrastructure development The SIRS informational-computational infrastructure, which is currently under extensive development, is designed to stimulate national and international cooperative Earth science investigations, easily exchange data and knowledge, coordinate activities, and optimize the usage of resources, services and applications [13]. The infrastructure is organized as a set of thematic, bilingual (Russian and English), internet-accessible informational-computational systems, the first of which is the scientific web portal ATMOS (http://atmos.iao.ru/). ATMOS is an integrated set of distributed topical websites, combining standard multimedia information with research databases, models and analytical tools for on-line use and visualization, designed primarily for atmospheric physics and chemistry (http://risks.scert.ru/)3 [12, 14]. These powerful tools have already promoted understanding of the interactions between Siberian ecosystems, the atmosphere and human dynamics, under the impact of global climate change. For example, the climate site of the Enviro-RISKS portal (http://climate.risks.scert.ru/) processes unique data sets, from monitoring and modeling regional meteorology, atmospheric pollution transformation/transport and climate, all of which are significant for dynamic regional assessments. This is a user-friendly, interactive web system that can be used for regional climate change assessment and visualization based upon standard meteorological data. All major reanalysis and climatic characteristics are provided (surface air temperature, pressure, humidity, precipitation, soil moisture, and geopotential height), and the users can (but do not need to) access the data files directly but freely receive the results of their analyses through the Grid Analysis and Display System (GrADS; www.iges.org/grads/) or Interactive Data Language (IDL; www.ittvis.com/idl/). Specific spatial and temporal domains can be selected, as well as a wide range of statistical analyses, data manipulations, and visualization tools (including animation) that may be required for global, continental, and regional climate change assessments. The SIRS infrastructure has become an indispensable tool, providing researchers with an open platform (portal plus tools) that may be used, adapted, enriched or altered on the basis of the specific scientific applications in regions of Siberia, the Russian Federation, and the northern exatropics. SIRS capacity building/young scientists' education/training The SIRS educational capacity building programme includes ENVIROMIS biannual Multidisciplinary Conference, CITES (Computational and Information Technologies for Environmental Sciences) biannual Young Scientists' School (YSS) and international conferences [15]. These include lecture courses for young scientists, training sessions, invited lectures and thematic workshops (www.scert.ru/en/conferences/). The first event was organized in 2000, and thereafter each year 50-70 young scientists from Russia and the Commonwealth of Independent States participate in CITES and ENVIROMIS conferences. These events are organized to support multidisciplinary education, contain no parallel sessions, are composed of about 50% students, and all presentations are posted to assist future professional activity. In the first years, these activities were supported internationally (INTAS, the EC International Cooperation Program within FP5 and FP6); however, recent activities have been supported by the Russian Foundation for Basic Research, the RF Ministry of Education and Science and the SB RAS. Some results gained in the course of SIRS projects being carried out, and current challenges While some findings on regional climate dynamics were reported in the EGU 2009 NEESPI session and in manuscripts listed on the NEESPI website (www.neespi.org/science/NEESPI_publications.pdf), a majority of them have been published in Russian journals and are still unknown in the international climatic community. However, additional reports can be found in the Enviro-RISKS final scientific report [16], mainly in the third volume devoted to climate change, terrestrial ecosystems and hydrology (www.dmi.dk/dmi/sr08-05-3.pdf). We have already established that temperatures have increased, particularly in the winter in Eastern Siberia (0.5°/decade), and the number of frost days (~1 day yr-1) and growing season length has also increased (~1 day yr-1) [17, 18]. Even more troubling is the potential for these transient phenomena to manifest themselves as nonlinear reactions to ongoing climatic change [19]. There are three main scientific research challenges to the SIRS community, which are also very important from a regional socio-economic point of view and for the global carbon cycle. Permafrost fate, especially its border shift, seriously threatens infrastructure and might form a significant carbon and methane source to the atmosphere. Climate-related drying would alter biogenic emissions in peatlands that have been deposited over millennia and would increase the potential for peat fires which cannot be extinguished. Temperature/precipitation/hydrology regime change, which might increase risks of forest and peat fires, thus changing significantly the carbon, terrestrial and hydrologic cycle of the region. Desert-steppe-forest-tundra ecosystem borders northward shifts, which will also change regional input into the global carbon and radiation balance and give rise to serious socio-economical consequences for local populations (i.e. alter potential agricultural lands). New in situ instrumentation, data sets, models and research are required to address these challenges. The SB RAS has adopted a long-term integrated project 'Development of the basic network for monitoring of natural and climatic processes in Siberia' to establish a network of dedicated sites and stations equipped with modern instrumentation to monitor environmental changes in the region. One example is the Zotino tall tower observatory (ZOTTO) launched a few years ago (www.sfu-kras.ru/science/achievement/zotto/public) [20]. It is anticipated that together with ZOTTO, the future SB RAS network will serve as an important source of reliable environmental data for analyses. Another important SIRS objective is the development of a high-resolution regional climate model that properly takes into account specifics of this region (e.g., presence of permafrost, interaction of the biosphere and terrestrial hydrology, etc). Development of an integrated model was recently discussed at the NEESPI Workshop (www.scert.ru/en/conferences/cites2009/) by leading SIRS specialists and their German and US partners. Conclusions Devoted to regional-global linkages, understanding, monitoring and assessment of global change impacts on a regional level, SIRS targets provide substantiated recommendations for regional decision makers to understand and work towards mitigating the negative effects of climate change for Siberia and its population. This approach will allow the Siberian Branch of the Russian National Committee for IGBP to perform its mission, ensuring the growth of scientific knowledge of the dynamic Siberian environment and its subsystems, and to develop a solid basis for mitigation and adaptation strategies for the negative consequences of global change. 1 For example, 'Complex monitoring of the Great Vasyugan Bog: modern state and development processes investigations' and 'Ecological problems of Siberian cities'. 2 For example, 'Models of biosphere change based on the boreal ecosystems' carbon balance using field and satellite data observations' and 'Information technologies, mathematical models and methods for monitoring and control of ecosystems intended for stationary, mobile and remote observations'. 3 'Environmental observations, modeling and information systems' (http://enviromis.scert.ru/) and 'Man-induced environmental risks: monitoring, management and mitigation of man-made changes in Siberia (Enviro-RISKS)'. References [1] Brasseur G 2003 IGBP Newsletter No 50 (June 2002) IGBP II - Special Edition Issue 3rd IGBP Congress Overview Global Change Newsletter No 55 pp 2-4 [2] 2005 Bulletin of the Russian National Committee for the International Geosphere Biosphere Programme 4 [3] Ippolitov I I, Kabanov M V, Komarov A I and Kuskov A I 2004 Patterns of modern natural-climatic changes in Siberia: observed changes of annual temperature and pressure Geogr. Nat. Resources 3 90-6 [4] Volodin E M and Dianskii N A 2003 Response of a coupled atmosphere-ocean general circulation model to increased carbon dioxide Izvestiya, Atmospheric and Oceanic Physics 239 170-86 [5] Groisman P Y et al 2009 The Northern Eurasia Earth Science Partnership: an example of science applied to societal needs Bull. Am. Meteorol. Soc. 90 671-88 [6] Shiklomanov and Lammers R L 2009 Record Russian river discharge in 2007 and the limits of analysis Environ. Res. Lett. 4 045015 [7] Tchebakova N M, Parfenova E and Soja A J 2009 The effects of climate, permafrost and fire on vegetation change in Siberia in a changing climate Environ. Res. Lett. 4 045013 [8] Soja A et al 2007 Climate-induced boreal forest change: predictions versus current observations Global Planet. Change 56 274-96 [9] Groisman P Y and Bartalev S V 2007 Northern Eurasia Earth Science Partnership Initiative (NEESPI): science plan overview Global Planet. Change 56 215-34 [10] Gordov E P and Begni G 2005 Siberia integrated regional study development Comput. Technol. 10 149-55 [11] Gordov E P, Begni G, Heiman M, Kabanov M V, Lykossov V N, Shvidenko A Z and Vaganov E A 2006 Siberia integrated regional study as a basis for international scientific cooperation Comput. Technol. 11 16-28 [12] Baklanov A and Gordov E P 2006 Man-induced environmental risks: monitoring, management and remediation of man-made changes in Siberia Comput. Technol. 11 162-71 [13] Gordov E P 2004 Computational and information technologies for environmental sciences Comput. Technol. 9 3-10 Gordov E P 2004 Modern tendencies in regional environmental studies Geogr. Nat. Resources. (special issue) 11-18 Akhlyostin A Yu and Fazliev A Z 2003 Software for presentation of scientific information in the framework of a WEB portal Proc. SPIE 5396 111-8 Gordov E P, De Rudder A, Lykosov V N, Fazliev A Z and Fedra K 2004 Web-portal ATMOS as basis for integrated investigations of Siberia environment Comput. Technol. 9 3-13 Gordov E P, Lykosov V N and Fazliev A Z 2006 Web portal on environmental sciences 'ATMOS' Adv. Geosci. 8 33-8 Okladnikov I G and Titov A G 2006 Web-system for processing and visualization of meteorological data Environmental Observations, Modeling and Information Systems ed E P Gordov (Tomsk: Tomsk CSTI) 42 pp Gordov E P, Okladnikov I G and Titov A G 2007 Development of elements of a web-based information-computational system for studies of regional environment processes Comput. Technol. 12 20-8 Okladnikov I G, Titov A G, Melnikova V N and Shulgina T M 2008 Web-system for processing and visualization of meteorological and climatic data Comput. Technol. 13 64-9 Titov A G, Gordov E P, Okladnikov I G and Shulgina N M 2009 Web-system for processing and visualization of meteorological data for Siberian environment research International J. Digital Earth 2 105-19 Gordov E P and Lykossov V N 2007 Development of information-computational infrastructure for integrated study of Siberia environment Comput. Technol. 12 19-30 [14] Shokin Y I and Fedotov A M 2003 Integration of informational and telecommunicational resources of Siberian Branch of RAS Comput. Technol. 8 161-71 [15] Gordov E P, Kabanov M V and Lykossov V N 2006 Information-computational technologies for environmental science: young scientists training Comput. Technol. 11 3-15 Gordov E P and Lykossov V N 2008 ICT for environmental sciences: synthesis of science and education Comput. Technol. 13 3-11 [16] Baklanov A A and Gordov E P (eds) 2008 Enviro-RISKS: man-induced environmental risks: monitoring, management and remediation of man-made changes in Siberia. Final Scientific Report of EC 6FP CA Enviro-RISKS Project DMI Scientific Report 08-05 Copenhagen (ISBN: 978-87-7478-571-2) Four volumes available at www.dmi.dk/dmi/sr08-05-1.pdf, www.dmi.dk/dmi/sr08-052.pdf, www.dmi.dk/dmi/sr08-05-3.pdf and www.dmi.dk/dmi/sr08-05-4.pdf [17] Kobysheva N V (ed) 2001 Klimat Rossii (St Petersburg: Gidrometizdat) p 665 [18] Ippolitov I I, Kabanov M V and Loginov S V 2007 Spatiotemporal scales of warming observed in Siberia Reports of the Russian Academy of Sciences/Earth Science Section 413 248-51 [19] Shulgina T M, Genina E Yu, Gordov E P and Nikitchuk K 2009 Comparative analysis of atmosphere temperature variability for Northern Eurasia based on the reanalysis and in-situ observed data Geophys. Res. Abs. 11 EGU2009-880 [20] Kozlova E A, Manning A C, Kisilyakhov Y, Seifert T and Heimann M 2008 Seasonal, synoptic, and diurnal-scale variability of biogeochemical trace gases and O2 from a 300-m tall tower in central Siberia Global Biogeochem. Cycles 22 GB4020

Sepsis

MedlinePlus

Septicemia; Sepsis syndrome; Systemic inflammatory response syndrome; SIRS; Septic shock ... The symptoms of sepsis are not caused by the germs themselves. Instead, chemicals the body releases cause the response. A bacterial infection anywhere ...

Measuring ocean waves from space; Proceedings of the Symposium, Johns Hopkins University, Laurel, MD, Apr. 15-17, 1986

NASA Technical Reports Server (NTRS)

Beal, Robert C. (Editor)

1987-01-01

Papers are presented on ocean-wave prediction; the quasi-universal form of the spectra of wind-generated gravity waves at different stages of their development; the limitations of the spectral measurements and observations of the group structure of surface waves; the effect of swell on the growth of wind wave; operational wave forecasting; ocean-wave models, and seakeeping using directional wave spectra. Consideration is given to microwave measurements of the ocean-wave directional spectra; SIR research; estimating wave energy spectra from SAR imagery, with the radar ocean-wave spectrometer, and SIR-B; the wave-measurement capabilities of the surface contour radar and the airborne oceanographic lidar; and SIR-B ocean-wave enhancement with fast-Fourier transform techniques. Topics discussed include wave-current interaction; the design and applicability of Spectrasat; the need for a global wave monitoring system; the age and source of ocean swell observed in Hurricane Josephine; and the use of satellite technology for insulin treatment.

Monitoring of the tidal dynamics of the Dutch Waddensea by SIR-B

NASA Technical Reports Server (NTRS)

Koopmans, B. N.; Vanderzee, D.; Verstappen, A. T.; Woldai, T.; Hoschititzky, H.

1984-01-01

The potential of LANDSAT data, covering the entire tidal flats at a certain, known, tidal situation, was assessed. It was discovered that the data cannot be used for systematic survey because of the long interval between subsequent passes, weather conditions often interfere with recording, and of the lack of correlation between passes and the tidal situation. The objective is to overcome the problems by using: (1) the synoptic view obtained by SIR-B, which has the potential of surveying large areas of the flats simultaneously; (2) the all-weather capability of the microwave system; (3) the recording during consecutive days, which results in a straightforeward correlation with the tidal cycle and the picturing of different tidal stages; and (4) the multiangle incidence of SIR-B to analyze the bottom configuration of submerged parts of the flats. The use of a weather independent monitoring device, such as radar, an improvement in the monitoring technique of tidal coastal areas.

A Dual Polarization, Active, Microstrip Antenna for an Orbital Imaging Radar System Operating at L-Band

NASA Technical Reports Server (NTRS)

Kelly, Kenneth C.; Huang, John

1999-01-01

A highly successful Earth orbiting synthetic antenna aperture radar (SAR) system, known as the SIR-C mission, was carried into orbit in 1994 on a U.S. Shuttle (Space Transportation System) mission. The radar system was mounted in the cargo bay with no need to fold, or in any other way reduce the size of the antennas for launch. Weight and size were not limited for the L-Band, C-Band, and X-Band radar systems of the SIR-C radar imaging mission; the set of antennas weighed 10,500 kg, the L-Band antenna having the major share of the weight. This paper treats designing an L-Band antenna functionally similar to that used for SIR-C, but at a fraction of the cost and at a weight in the order of 250 kg. Further, the antenna must be folded to fit into the small payload shroud of low cost booster rocket systems. Over 31 square meters of antenna area is required. This low weight, foldable, electronic scanning antenna is for the proposed LightSAR radar system which is to be placed in Earth orbit on a small, dedicated space craft at the lowest possible cost for an efficient L-Band radar imaging system. This LightSAR spacecraft radar is to be continuously available for at least five operational years, and have the ability to map or repeat-map any area on earth within a few days of any request. A microstrip patch array, with microstrip transmission lines heavily employed in the aperture and in the corporate feed network, was chosen as the low cost approach for this active dual-polarization, 80 MHz (6.4%) bandwidth antenna design.

A Dual Polarization, Active, Microstrip Antenna for an Orbital Imaging Radar System Operating at L-Band

NASA Technical Reports Server (NTRS)

Kelly, Kenneth C.; Huang, John

2000-01-01

A highly successful Earth orbiting synthetic antenna aperture radar (SAR) system, known as the SIR-C mission, was carried into orbit in 1994 on a U.S. Shuttle (Space Transportation System) mission. The radar system was mounted in the cargo bay with no need to fold, or in any other way reduce the size of the antennas for launch. Weight and size were not limited for the L-Band, C-Band, and X-Band radar systems of the SIR-C radar imaging mission; the set of antennas weighed 10,500 kg, the L-Band antenna having the major share of the weight. This paper treats designing an L-Band antenna functionally similar to that used for SIR-C, but at a fraction of the cost and at a weight in the order of 250 kg. Further, the antenna must be folded to fit into the small payload shroud of low cost booster rocket systems. Over 31 square meters of antenna area is required. This low weight, foldable, electronic scanning antenna is for the proposed LightSAR radar system which is to be placed in Earth orbit on a small, dedicated space craft at the lowest possible cost for an efficient L- Band radar imaging system. This LightSAR spacecraft radar is to be continuously available for at least five operational years, and have the ability to map or repeat-map any area on earth within a few days of any request. A microstrip patch array, with microstrip transmission lines heavily employed in the aperture and in the corporate feed network, was chosen as the low cost approach for this active dual-polarization, 80 MHz (6.4%) bandwidth antenna design.

New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study.

PubMed

Ranzani, Otavio T; Prina, Elena; Menéndez, Rosario; Ceccato, Adrian; Cilloniz, Catia; Méndez, Raul; Gabarrus, Albert; Barbeta, Enric; Bassi, Gianluigi Li; Ferrer, Miquel; Torres, Antoni

2017-11-15

The Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia. This was a cohort study including adult patients with community-acquired pneumonia from two Spanish university hospitals. SIRS, qSOFA, the Confusion, Respiratory Rate and Blood Pressure (CRB) score, modified SOFA (mSOFA), the Confusion, Urea, Respiratory Rate, Blood Pressure and Age (CURB-65) score, and Pneumonia Severity Index (PSI) were calculated with data from the emergency department. We used decision-curve analysis to evaluate the clinical usefulness of each score and the primary outcome was in-hospital mortality. Of 6,874 patients, 442 (6.4%) died in-hospital. SIRS presented the worst discrimination, followed by qSOFA, CRB, mSOFA, CURB-65, and PSI. Overall, overestimation of in-hospital mortality and miscalibration was more evident for qSOFA and mSOFA. SIRS had lower net benefit than qSOFA and CRB, significantly increasing the risk of over-treatment and being comparable with the "treat-all" strategy. PSI had higher net benefit than mSOFA and CURB-65 for mortality, whereas mSOFA seemed more applicable when considering mortality/intensive care unit admission. Sepsis-3 flowchart resulted in better identification of patients at high risk of mortality. qSOFA and CRB outperformed SIRS and presented better clinical usefulness as prompt tools for patients with community-acquired pneumonia in the emergency department. Among the tools for a comprehensive patient assessment, PSI had the best decision-aid tool profile.

The relationship of packed cell transfusion to red blood cell deformability in systemic inflammatory response syndrome patients.

PubMed

Friedlander, M H; Simon, R; Machiedo, G W

1998-02-01

RBC deformability (RBCD) is decreased in critically ill patients. This is thought to impede the passage of the RBC through the microcirculation. The cell transit analyzer (CTA) provides an evaluation of RBCD. RBCD was examined in 16 patients admitted to the surgical intensive care unit. CTA analysis was conducted within 24 h of admission to the surgical intensive care unit or as soon as possible thereafter, and then repeated every 72 h. Counts per second (C/s) was the parameter used as an index of RBCD. Patients were classified as Septic/SIRS or nonseptic at the time of each blood collection by standard clinical criteria. There were 34 total specimens, 22 septic/SIRS and 12 nonseptic. The C/s for the SIRS samples (41.7 +/- 3.4 was significantly (p < .05) lower than that of the non-SIRS samples (54.3 +/- 5.3). Seventeen of the Septic/SIRS samples were obtained following blood transfusion. Pearson's test calculated for the C/s and the total number of packed RBC transfusions showed a positive correlation (r = .594) that was statistically significant (p < .02). CTA was also performed on 10 U of banked packed RBC in vitro. Deformability was maintained at a constant level until the very end of the storage period, at which time there was a statistically significant decrease in C/s (p < .0001). These data suggest that packed RBC transfusion is associated with a significant improvement in the abnormally low RBCD seen in critically ill patients. This may be due to replacement of previously rigidified cells by cells with a more normal RBCD.

Association between intravenous chloride load during resuscitation and in-hospital mortality among patients with SIRS.

PubMed

Shaw, Andrew D; Raghunathan, Karthik; Peyerl, Fred W; Munson, Sibyl H; Paluszkiewicz, Scott M; Schermer, Carol R

2014-12-01

Recent data suggest that both elevated serum chloride levels and volume overload may be harmful during fluid resuscitation. The purpose of this study was to examine the relationship between the intravenous chloride load and in-hospital mortality among patients with systemic inflammatory response syndrome (SIRS), with and without adjustment for the crystalloid volume administered. We conducted a retrospective analysis of 109,836 patients ≥ 18 years old that met criteria for SIRS and received fluid resuscitation with crystalloids. We examined the association between changes in serum chloride concentration, the administered chloride load and fluid volume, and the 'volume-adjusted chloride load' and in-hospital mortality. In general, increases in the serum chloride concentration were associated with increased mortality. Mortality was lowest (3.7%) among patients with minimal increases in serum chloride concentration (0-10 mmol/L) and when the total administered chloride load was low (3.5% among patients receiving 100-200 mmol; P < 0.05 versus patients receiving ≥ 500 mmol). After controlling for crystalloid fluid volume, mortality was lowest (2.6%) when the volume-adjusted chloride load was 105-115 mmol/L. With adjustment for severity of illness, the odds of mortality increased (1.094, 95% CI 1.062, 1.127) with increasing volume-adjusted chloride load (≥ 105 mmol/L). Among patients with SIRS, a fluid resuscitation strategy employing lower chloride loads was associated with lower in-hospital mortality. This association was independent of the total fluid volume administered and remained significant after adjustment for severity of illness, supporting the hypothesis that crystalloids with lower chloride content may be preferable for managing patients with SIRS.

Diagnostic and prognostic value of sCD14-ST--presepsin for patients admitted to hospital intensive care unit (ICU).

PubMed

Godnic, Matej; Stubljar, David; Stubjar, David; Skvarc, Miha; Jukic, Tomislav

2015-07-01

Sepsis is a serious problem in intensive care units all over the world. Biomarkers could be useful to identify patients at risk. We focused especially on the performance of presepsin (sCD14-ST), compared to C-reactive protein (CRP), procalcitonin (PCT) and CD64, to determine its diagnostic and prognostic indications. The study was conducted on 47 hospitalized patients after procedures, who were divided into three groups; systemic inflammatory response (SIRS), sepsis and septic shock. Expression of CD64 on neutrophils presented as CD64 index, sCD14-ST, CRP and PCT were measured in whole blood or plasma samples. All patients had standard samples like urine, respiratory tract samples etc. taken for culturing. Blood cultures were drawn to confirm bloodstream infection. Forty (85 %) patients had SIRS with bacterial infection and seven (15 %) patients had SIRS with no infection. All infections were confirmed with blood cultures. Biomarkers were evaluated in all patients. In patients with confirmed infection the values were high. The patients with bacterial infection showed statistical significance with CD64 index (p = 0.003), CRP (p = 0.049) and sCD14-ST (p = 0.026), but not with PCT (p = 1.000). The severity of diagnosed SIRS was significant only with PCT (p < 0.001). CD64 index, CRP and sCD14-ST served as good parameters to determine possible infection in patients that needed intensive care after major procedures. Values of PCT were the only ones to predict SIRS severity and could distinguish between sepsis and severe sepsis or septic shock.

Increased risk of inflammatory bowel disease in women with endometriosis: a nationwide Danish cohort study.

PubMed

Jess, Tine; Frisch, Morten; Jørgensen, Kristian Tore; Pedersen, Bo Vestergaard; Nielsen, Nete Munk

2012-09-01

An association between endometriosis and certain autoimmune diseases has been suggested. However, the impact of endometriosis on risk of inflammatory bowel disease (IBD) remains unknown. To assess the risk of Crohn's disease (CD) and ulcerative colitis (UC) in an unselected nationwide Danish cohort of women with endometriosis. By use of national registers, 37 661 women hospitalised with endometriosis during 1977-2007 were identified. The relative risk of developing IBD after an endometriosis diagnosis was calculated as observed versus expected numbers and presented as standardised incidence ratios (SIRs) with 95% CIs. Women with endometriosis had a increased risk of IBD overall (SIR=1.5; 95% CI 1.4 to 1.7) and of UC (SIR=1.5; 95% CI 1.3 to 1.7) and CD (SIR=1.6; 95% CI 1.3 to 2.0) separately, even 20 years after a diagnosis of endometriosis (UC: SIR=1.5; 95% CI 1.1 to 2.1; CD: SIR=1.8; 95% CI 1.1 to 3.2). Restricting analyses to women with surgically verified endometriosis suggested even stronger associations (UC: SIR=1.8; 95% CI 1.4 to 2.3; CD: SIR=1.7; 95% CI 1.2 to 2.5). The risk of IBD in women with endometriosis was increased even in the long term, hence suggesting a genuine association between the diseases, which may either reflect common immunological features or an impact of endometriosis treatment with oral contraceptives on risk of IBD.

Risk of cancer in patients with scleroderma: a population based cohort study

PubMed Central

Hill, C; Nguyen, A; Roder, D; Roberts-Thomson, P

2003-01-01

Background: Previous studies have suggested an increased risk of cancer among patients with scleroderma. Objective: To study a population based cohort of patients with scleroderma in South Australia. Methods: Subjects with scleroderma were identified from the South Australian Scleroderma Registry established in 1993. All subjects on the scleroderma registry were linked to the South Australian Cancer Registry to identify all cases of cancer until 31 December 2000. Standardised incidence ratios (SIRs) for cancer for subjects with scleroderma were determined using the age- and sex-specific rates for South Australia. Results: In 441 patients with scleroderma, 90 cases of cancer were identified, 47 of which developed after inclusion on the scleroderma registry. The SIRs for all cancers among these patients were significantly increased (SIR=1.99; 95% confidence interval (95% CI) 1.46 to 2.65) compared with the cancer incidence rates for South Australia. The SIRs for lung cancer (SIR=5.9; 95% CI 3.05 to 10.31) were also significantly increased. The SIRs for all cancers among the subgroups with diffuse scleroderma (SIR=2.73; 95% CI 1.31 to 5.02) and limited scleroderma (SIR=1.85; 95% CI 1.23 to 2.68) were significantly increased. Conclusions: This population based cohort study provides evidence that scleroderma is associated with cancer, and in particular, lung cancer. In addition, both diffuse and limited forms of scleroderma are associated with a similarly increased risk of cancer. PMID:12860727

Tolerance of Sir1p/Origin Recognition Complex-Dependent Silencing for Enhanced Origin Firing at HMRa

PubMed Central

McConnell, Kristopher H.; Müller, Philipp; Fox, Catherine A.

2006-01-01

The HMR-E silencer is a DNA element that directs the formation of silent chromatin at the HMRa locus in Saccharomyces cerevisiae. Sir1p is one of four Sir proteins required for silent chromatin formation at HMRa. Sir1p functions by binding the origin recognition complex (ORC), which binds to HMR-E, and recruiting the other Sir proteins (Sir2p to -4p). ORCs also bind to hundreds of nonsilencer positions distributed throughout the genome, marking them as replication origins, the sites for replication initiation. HMR-E also acts as a replication origin, but compared to many origins in the genome, it fires extremely inefficiently and late during S phase. One postulate to explain this observation is that ORC's role in origin firing is incompatible with its role in binding Sir1p and/or the formation of silent chromatin. Here we examined a mutant HMR-E silencer and fusions between robust replication origins and HMR-E for HMRa silencing, origin firing, and replication timing. Origin firing within HMRa and from the HMR-E silencer itself could be significantly enhanced, and the timing of HMRa replication during an otherwise normal S phase advanced, without a substantial reduction in SIR1-dependent silencing. However, although the robust origin/silencer fusions silenced HMRa quite well, they were measurably less effective than a comparable silencer containing HMR-E's native ORC binding site. PMID:16479013

Soluble triggering receptor expressed on myeloid cells 1 and the diagnosis of sepsis.

PubMed

Barati, Mitra; Bashar, Farshid Rahimi; Shahrami, Reza; Zadeh, Mohammad Hossein Jarrah; Taher, Mahshid Talebi; Nojomi, Marzieh

2010-06-01

Early diagnosis and assessment of the systemic inflammatory response to infection are difficult with usual markers (fever, leukocytosis, C-reactive protein [CRP]). Triggering receptor expressed on myeloid cells-1 (TREM-1) expression on phagocytes is up-regulated by microbial products. We studied the ability of soluble TREM-1 (sTREM-1) to identify patients with sepsis. Plasma samples were obtained on intensive care unit admission from patients with systemic inflammatory response syndrome for sTREM-1 measurement. Soluble TREM-1, CRP concentrations and erythrocyte sedimentation rate (ESR) were higher in the sepsis group (n = 52) than in the non-infectious systemic inflammatory response syndrome group (n = 43; P = .00, .02, and .001, respectively). Soluble TREM-1, CRP concentrations, white blood cell count and ESR were higher in the sepsis group than in the non SIRS group (n = 37; P = .04, .00, .01, and .00, respectively). In a receiver-operating characteristic curve analysis, ESR, CRP and sTREM-1 had an area under the curve larger than 0.65 (P = .00), in distinguishing between septic and non-infectious SIRS patients. CRP, ESR, sTREM-1 had a sensitivity of 60%, 70% and 70% and a specificity of 60%, 69% and, 60% respectively in diagnosing infection in SIRS. C-reactive protein and ESR performed better than sTREM-1 and white blood cell count in diagnosing infection. Copyright (c) 2010. Published by Elsevier Inc.

Upper gastrointestinal bleeding in patients with hepatic cirrhosis: clinical course and mortality prediction.

PubMed

Afessa, B; Kubilis, P S

2000-02-01

We conducted this study to describe the complications and validate the accuracy of previously reported prognostic indices in predicting the mortality of cirrhotic patients hospitalized for upper GI bleeding. This prospective, observational study included 111 consecutive hospitalizations of 85 cirrhotic patients admitted for GI bleeding. Data obtained included intensive care unit (ICU) admission status, Child-Pugh score, the development of systemic inflammatory response syndrome (SIRS), organ failure, and inhospital mortality. The performances of Garden's, Gatta's, and Acute Physiology and Chronic Health Evaluation (APACHE) II prognostic systems in predicting mortality were assessed. Patients' mean age was 48.7 yr, and the median APACHE II and Child-Pugh scores were 17 and 9, respectively. Their ICU admission rate was 71%. Organ failure developed in 57%, and SIRS in 46% of the patients. Nine patients had acute respiratory distress syndrome, and three patients had hepatorenal syndrome. The inhospital mortality was 21%. The APACHE II, Garden's, and Gatta' s predicted mortality rates were 39%, 24%, and 20%, respectively, and their areas under the receiver operating characteristic curve (AUC) were 0.78, 0.70, and 0.71, respectively. The AUC for Child-Pugh score was 0.76. SIRS and organ failure develop in many patients with hepatic cirrhosis hospitalized for upper GI bleeding, and are associated with increased mortality. Although the APACHE II prognostic system overestimated the mortality of these patients, the receiver operating characteristic curves did not show significant differences between the various prognostic systems.

Trends of Second Primary Malignancy in Patients with Thyroid Cancer: A Population-Based Cohort Study in Israel.

PubMed

Izkhakov, Elena; Barchana, Micha; Liphshitz, Irena; Silverman, Barbara G; Stern, Naftali; Keinan-Boker, Lital

2017-06-01

Thyroid cancer (TC) is the most common endocrine malignancy. TC patients have a good prognosis and a low disease-related mortality rate. Since such patients are often young, they may be at a higher risk for a second primary malignancy (SPM). This study sought to determine the incidence, risk, and types of SPM between 1980 and 2011, and to assess SPM trends over time among Israeli TC patients. Data were derived from the Israel National Cancer Registry. Primary TC patients diagnosed during 1980-2009 were followed up for SPM incidence until December 31, 2011. Standardized incidence ratios (SIRs) of observed to expected SPM (based on the general population rates) were calculated using Poisson regression. Analyses were stratified by time period of initial TC diagnosis (1980-1995 and 1996-2009). A total of 11,538 TC patients were identified. After exclusion of 107 duplicate cases, records of 1032 patients with SPM were analyzed (an SPM incidence of 8.9%). SIRs for all-site SPMs were 1.23 [confidence interval 1.08-1.35] for males and 1.19 [confidence interval 1.10-1.27] for females. SIRs for tumors of the urinary system and prostate were significantly elevated in males, as were SIRs for tumors of the brain, urinary system, breast, and lung in females. Variables associated with increased risk of developing SPMs included a younger age at TC diagnosis, a shorter latency period, being born in Asia/Africa for both sexes, and being born in Israel for females. Compared with the general population, a subanalysis by TC diagnosis during 1980-1995 and 1996-2009 disclosed a higher SPM incidence for the latter time period in males and for both time periods, with a slightly higher SIR for the latter time period in females. The overall risk of SPM in Israeli TC patients was significantly greater for both sexes compared with the general population, thus identifying TC patients as a high-risk group and calling for caretakers to apply specific follow-up guidelines.

Systemic inflammatory response syndrome is more associated with bacteremia in elderly patients with suspected sepsis in emergency departments.

PubMed

Chou, Hsien-Ling; Han, Shih-Tsung; Yeh, Chun-Fu; Tzeng, I-Shaing; Hsieh, Tsung-Han; Wu, Chin-Chieh; Kuan, Jen-Tse; Chen, Kuan-Fu

2016-12-01

Early diagnosis of bacteremia for patients with suspected sepsis is 1 way to improve prognosis of sepsis. Systemic inflammatory response syndrome (SIRS) has long been utilized as a screening tool to detect bacteremia by front-line healthcare providers. The value of SIRS to predict bacteremia in elderly patients (≥65 years) with suspected sepsis has not yet been examined in emergency departments (EDs).We aimed to evaluate the performance of SIRS components in predicting bacteremia among elderly patients in EDs.We retrospectively evaluated patients with suspected sepsis and 2 sets of blood culture collected within 4 hours after admitting to ED in a tertiary teaching hospital between 2010 and 2012. Patients were categorized into 3-year age groups: young (18-64 years), young-old (65-74 years), and old patients (≥75 years). Vital signs and Glasgow Coma Scale with verbal response obtained at the triage, comorbidities, sites of infection, blood cultures, and laboratory results were retrieved via the electronic medical records.A total of 20,192 patients were included in our study. Among them, 9862 (48.9%) were the elderly patients (young-old and old patients), 2656 (13.2%) developed bacteremia. Among patients with bacteremia, we found the elderly patients had higher SIRS performance (adjusted odds ratio [aOR]: 2.40, 95% confidence interval [CI]: 1.90-3.03 in the young-old and aOR: 2.66, 95% CI: 2.19-3.23 in the old). Fever at the triage was most predictive of bacteremia, especially in the elderly patients (aOR: 2.19, 95% CI: 1.81-2.65 in the young-old and aOR: 2.27, 95% CI: 1.95-2.63 in the old), and tachypnea was not predictive of bacteremia among the elderly patients (all P > 0.2).The performance of SIRS to predict bacteremia was more suitable for elderly patients in EDs observed in this study. The elderly patients presented with more fever and less tachypnea when they had bacteremia.

The α-MSH analogue AP214 attenuates rise in pulmonary pressure and fall in ejection fraction in lipopolysaccharide-induced systemic inflammatory response syndrome in pigs.

PubMed

Kristensen, Jens; Jonassen, Thomas E N; Rehling, Michael; Tønnesen, Else; Sloth, Erik; Nielsen, Søren; Frøkiaer, Jørgen

2011-01-01

The effect of an α-melanocyte stimulating hormone (α-MSH) analogue (AP214) on experimentally endotoxin-induced systemic inflammatory response syndrome (SIRS) was studied, because α-MSH in rodent models has shown promise in attenuating inflammatory response markers and associated organ damage in SIRS. SIRS is associated with considerable morbidity and mortality. Consequently, new treatment modalities are still warranted to address the different aspects of the pathophysiological process. SIRS was induced by lipopolysaccharide (LPS) (Escherichia coli endotoxin) infusion in anaesthetized Danish Landrace pigs (20-25 kg). The pigs received an α-MSH analogue (AP214) or saline as a bolus at the initiation of the LPS infusion. The hemodynamic response was registered as well as echocardiographic indices of left ventricular function. The cardiovascular response was recorded together with echocardiographic indices of left ventricular function in control and in intervention animals. AP214 reduced the early peak in pulmonary pressure and pulmonary vascular resistance by approximately 33%. Furthermore, AP214 prevented the decline in left ventricular fractional shortening as observed in the control group. Mean change and standard deviation in fractional shortening (ΔFS) in control group: - 7·3 (4·7), AP214 (low dose): 0·9 (8·2) and AP214 (high dose) 4·1 (6·0), P < 0·05 for both intervention groups versus control. In the porcine model, the peak increase in pulmonary pressure was attenuated, and the LPS-induced decline in left ventricular function was prevented. © 2010 The Authors. Clinical Physiology and Functional Imaging © 2010 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Systemic inflammatory response syndrome-based severe sepsis screening algorithms in emergency department patients with suspected sepsis.

PubMed

Shetty, Amith L; Brown, Tristam; Booth, Tarra; Van, Kim Linh; Dor-Shiffer, Daphna E; Vaghasiya, Milan R; Eccleston, Cassanne E; Iredell, Jonathan

2016-06-01

Systemic inflammatory response syndrome (SIRS)-based severe sepsis screening algorithms have been utilised in stratification and initiation of early broad spectrum antibiotics for patients presenting to EDs with suspected sepsis. We aimed to investigate the performance of some of these algorithms on a cohort of suspected sepsis patients. We conducted a retrospective analysis on an ED-based prospective sepsis registry at a tertiary Sydney hospital, Australia. Definitions for sepsis were based on the 2012 Surviving Sepsis Campaign guidelines. Numerical values for SIRS criteria and ED investigation results were recorded at the trigger of sepsis pathway on the registry. Performance of specific SIRS-based screening algorithms at sites from USA, Canada, UK, Australia and Ireland health institutions were investigated. Severe sepsis screening algorithms' performance was measured on 747 patients presenting with suspected sepsis (401 with severe sepsis, prevalence 53.7%). Sensitivity and specificity of algorithms to flag severe sepsis ranged from 20.2% (95% CI 16.4-24.5%) to 82.3% (95% CI 78.2-85.9%) and 57.8% (95% CI 52.4-63.1%) to 94.8% (95% CI 91.9-96.9%), respectively. Variations in SIRS values between uncomplicated and severe sepsis cohorts were only minor, except a higher mean lactate (>1.6 mmol/L, P < 0.01). We found the Ireland and JFK Medical Center sepsis algorithms performed modestly in stratifying suspected sepsis patients into high-risk groups. Algorithms with lactate levels thresholds of >2 mmol/L rather than >4 mmol/L performed better. ED sepsis registry-based characterisation of patients may help further refine sepsis definitions of the future. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Predicting the severity of systemic inflammatory response syndrome (SIRS)-associated coagulopathy with hemostatic molecular markers and vascular endothelial injury markers.

PubMed

Iba, Toshiaki; Gando, Satoshi; Murata, Atsuo; Kushimoto, Shigeki; Saitoh, Daizoh; Eguchi, Yutaka; Ohtomo, Yasuhiro; Okamoto, Kohji; Koseki, Kazuhide; Mayumi, Toshihiko; Ikeda, Toshiaki; Ishhikura, Hiroyasu; Ueyama, Masashi; Ogura, Yuji; Endo, Shigeatsu; Shimazaki, Shuji

2007-11-01

The changes in biomarkers of coagulation or fibrinolysis, anticoagulation, inflammation, and endothelial damage occur in patients with systemic inflammatory response syndrome (SIRS). The purpose of this study is to assess the prognostic value of these markers in patients with SIRS-associated hypercoagulopathy. Sixty-six SIRS patients with a platelet count less than 15.0 x 10(4)/mm3 in three university hospital intensive care units were enrolled in this prospective, comparative study. Blood samples were obtained on day 0 and day 2. Twelve hemostatic, inflammatory, and vascular endothelial indices were measured and the data were compared between the severe group (patients with a total maximum Sequential Organ Failure Assessment score of 10 or more and nonsurvivors; n = 25) and the less-severe group (Sequential Organ Failure Assessment score <10; n = 41). Significant changes between the groups were observed in platelet count, fibrin or fibrinogen degradation products, interleukin-6, soluble thrombomodulin, antithrombin (AT) activity, and protein C activity, both on day 0 and on day 2. In contrast, the d-dimer, soluble fibrin, plasmin-[alpha]2-antiplasmin complex, and E-selectin levels were higher in the severe group only on day 2. No significant difference was seen regarding the thrombin-AT complex and total plasminogen activator inhibitor on both days. A comparison of the areas under the receiver operating characteristic curve revealed the AT activity to be the best predictor of a progression of organ dysfunction. The changes in some hemostatic molecular markers and vascular endothelial markers were conspicuous in patients with organ dysfunction. The AT activity is considered to be the most useful predictor of organ dysfunction.

Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children.

PubMed

Rey, Corsino; Los Arcos, Marta; Concha, Andrés; Medina, Alberto; Prieto, Soledad; Martinez, Pablo; Prieto, Belen

2007-03-01

To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. Prospective, observational study. Paediatric intensive care unit (PICU). Ninety-four children. Leucocyte count, PCT and CRP were measured when considered necessary during the PICU stay. Patients were classified, when PCT and CRP were measured, into one of six categories (negative, SIRS, localized infection, sepsis, severe sepsis, and septic shock) according to the definitions of the American College of Chest Physicians /Society of Critical Care Medicine. A total of 359 patient day episodes were obtained. Leucocyte count did not differ across the six diagnostic classes considered. Median plasma PCT concentrations were 0.17, 0.43, 0.79, 1.80, 15.40 and 19.13 ng/ml in negative, systemic inflammatory response syndrome (SIRS), localized infection, sepsis, severe sepsis, and septic shock groups, respectively, whereas median plasma CRP concentrations were 1.35, 3.80, 6.45, 5.70, 7.60 and 16.2 mg/dl, respectively. The area under the ROC curve for the diagnosis of septic patients was 0.532 for leucocyte count (95% CI, 0.462-0.602), 0.750 for CRP (95% CI, 0.699-0.802) and 0.912 for PCT (95% CI, 0.882-0.943). We obtained four groups using CRP values and five groups using PCT values that classified a significant percentage of patients according to the severity of the different SIRS groups. PCT is a better diagnostic marker of sepsis in critically ill children than CRP. The CRP, and especially PCT, may become a helpful clinical tool to stratify patients with SIRS according to disease severity.

Predictive comparisons of procalcitonin (PCT) level, arterial ketone body ratio (AKBR), APACHE III score and multiple organ dysfunction score (MODS) in systemic inflammatory response syndrome (SIRS).

PubMed

Lee, Young-Joo; Park, Chan-Hee; Yun, Jang-Woon; Lee, Young-Suk

2004-02-29

Procalcitonin (PCT) is a newly introduced marker of systemic inflammation and bacterial infection. A marked increase in circulating PCT level in critically ill patients has been related with the severity of illness and poor survival. The goal of this study was to compare the prognostic power of PCT and three other parameters, the arterial ketone body ratio (AKBR), the acute physiology, age, chronic health evaluation (APACHE) III score and the multiple organ dysfunction score (MODS), in the differentiation between survivors and nonsurvivors of systemic inflammatory response syndrome (SIRS). The study was performed in 95 patients over 16 years of age who met the criteria of SIRS. PCT and AKBR were assayed in arterial blood samples. The APACHE III score and MODS were recorded after the first 24 hours of surgical ICU (SICU) admission and then daily for two weeks or until either discharge or death. The patients were divided into two groups, survivors (n=71) and nonsurvivors (n=24), in accordance with the ICU outcome. They were also divided into three groups according to the trend of PCT level: declining, increasing or no change. Significant differences between survivors and nonsurvivors were found in APACHE III score and MODS throughout the study period, but in PCT value only up to the 7th day and in AKBR only up to the 3rd day. PCT values of the three groups were not significantly different on the first day between survivors and nonsurvivors. Receiver operating characteristic (ROC) curves for prediction of mortality by PCT, AKBR, APACHE III score and MODS were 0.690, 0.320, 0.915 and 0.913, respectively, on the admission day. In conclusion, PCT could have some use as a mortality predictor in SIRS patients but was less reliable than APACHE III score or MODS.

Scientific objectives and selection of targets for the SMART-1 Infrared Spectrometer (SIR)

USGS Publications Warehouse

Basilevsky, A.T.; Keller, H.U.; Nathues, A.; Mall, U.; Hiesinger, H.; Rosiek, M.

2004-01-01

The European SMART-1 mission to the Moon, primarily a testbed for innovative technologies, was launched in September 2003 and will reach the Moon in 2005. On board are several scientific instruments, including the point-spectrometer SMART-1 Infrared Spectrometer (SIR). Taking into account the capabilities of the SMART-1 mission and the SIR instrument in particular, as well as the open questions in lunar science, a selection of targets for SIR observations has been compiled. SIR can address at least five topics: (1) Surface/regolith processes; (2) Lunar volcanism; (3) Lunar crust structure; (4) Search for spectral signatures of ices at the lunar poles; and (5) Ground truth and study of geometric effects on the spectral shape. For each topic we will discuss specific observation modes, necessary to achieve our scientific goals. The majority of SIR targets will be observed in the nadir-tracking mode. More than 100 targets, which require off-nadir pointing and off-nadir tracking, are planned. It is expected that results of SIR observations will significantly increase our understanding of the Moon. Since the exact arrival date and the orbital parameters of the SMART-1 spacecraft are not known yet, a more detailed planning of the scientific observations will follow in the near future. ?? 2004 Elsevier Ltd. All rights reserved.

Knock-out of a mitochondrial sirtuin protects neurons from degeneration in Caenorhabditis elegans.

PubMed

Sangaletti, Rachele; D'Amico, Massimo; Grant, Jeff; Della-Morte, David; Bianchi, Laura

2017-08-01

Sirtuins are NAD⁺-dependent deacetylases, lipoamidases, and ADP-ribosyltransferases that link cellular metabolism to multiple intracellular pathways that influence processes as diverse as cell survival, longevity, and cancer growth. Sirtuins influence the extent of neuronal death in stroke. However, different sirtuins appear to have opposite roles in neuronal protection. In Caenorhabditis elegans, we found that knock-out of mitochondrial sirtuin sir-2.3, homologous to mammalian SIRT4, is protective in both chemical ischemia and hyperactive channel induced necrosis. Furthermore, the protective effect of sir-2.3 knock-out is enhanced by block of glycolysis and eliminated by a null mutation in daf-16/FOXO transcription factor, supporting the involvement of the insulin/IGF pathway. However, data in Caenorhabditis elegans cell culture suggest that the effects of sir-2.3 knock-out act downstream of the DAF-2/IGF-1 receptor. Analysis of ROS in sir-2.3 knock-out reveals that ROS become elevated in this mutant under ischemic conditions in dietary deprivation (DD), but to a lesser extent than in wild type, suggesting more robust activation of a ROS scavenging system in this mutant in the absence of food. This work suggests a deleterious role of SIRT4 during ischemic processes in mammals that must be further investigated and reveals a novel pathway that can be targeted for the design of therapies aimed at protecting neurons from death in ischemic conditions.

Predictive value of preoperative inflammatory response biomarkers for metabolic syndrome and post-PCNL systemic inflammatory response syndrome in patients with nephrolithiasis.

PubMed

Tang, Kun; Liu, Haoran; Jiang, Kehua; Ye, Tao; Yan, Libin; Liu, Peijun; Xia, Ding; Chen, Zhiqiang; Xu, Hua; Ye, Zhangqun

2017-10-17

Neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) were promising biomarkers used to predict diagnosis and prognosis in various inflammatory responses diseases and cancers. However, there have been no reports regarding these biomarkers in kidney stone patients. This study aimed to evaluate the predictive value of inflammatory biomarkers for metabolic syndrome (MetS) and post-PCNL SIRS in nephrolithiasis patients. We retrospectively enrolled 513 patients with nephrolithiasis and 204 healthy controls. NLR, dNLR, LMR and PLR in nephrolithiasis patients were significantly higher than control group. Patients with renal stone have higher NLR, dNLR, LMR and PLR than those without. ROC curve analysis indicated NLR, dNLR, LMR and PLR for predicting patients with nephrolithiasis and MetS, displayed AUC of 0.730, 0.717, 0.627 and 0.606. Additionally, ROC curves, using post-PCNL SIRS as the end-point for NLR, dNLR, LMR and PLR with AUC of 0.831, 0.813, 0.723 and 0.685. Multivariate analysis revealed that NLR, dNLR represented independent factors for predicting post-PCNL SIRS. While LMR independently associated with MetS. These resluts demonstrate preoperative NLR, dNLR and LMR appears to be effective predictors of post-PCNL SIRS and LMR of MetS in nephrolithiasis patients.

Temporal relationship between cancer and myositis identifies two distinctive subgroups of cancers: impact on cancer risk and survival in patients with myositis.

PubMed

Kang, Eun Ha; Lee, Sang Jin; Ascherman, Dana P; Lee, Yun Jong; Lee, Eun Young; Lee, Eun Bong; Song, Yeong Wook

2016-09-01

The aim was to compare standardized incidence ratios (SIRs) of cancers temporally related and unrelated to active myositis in patients with myositis. Fifty-two cancer cases were identified in 281 myositis patients. SIRs of cancers having temporal overlap with the active phase of myositis [cancers concurrent with active myositis (CAM), n = 30] and cancers not having such temporal overlap [cancers non-concurrent with active myositis (CNM), n = 22] were compared in 281 patients. Patients with CAM were older at diagnosis of myositis, had a greater tendency to be male, more frequent dysphagia and less frequent interstitial lung disease than patients with CNM. CAM SIR (95% CI) was 1.78 (1.19, 2.56) and CNM SIR 1.23 (0.75, 1.90). The peak SIR was observed in the seventh decade of life for CAM and in the third decade for CNM. When stratified by myositis-cancer intervals, CAM SIR was 9.94 (6.43, 14.67) within 1 year of myositis diagnosis, whereas no temporal relationship was found for CNM. Elevated SIRs were observed for oesophageal cancer [57.77 (11.91, 168.82)], non-Hodgkin's lymphoma [41.43 (13.45, 96.69)], adenocarcinoma of unknown primary origin [67.6 (18.42, 173.07]), lung cancer [7.27 (1.98, 18.61)] and ovarian cancer [19.15 (2.32, 69.17)] within 3 years of CAM diagnosis. The cancer stage at the time of diagnosis was more advanced in CAM than CNM (P < 0.001), with a correspondingly increased hazard ratio of mortality [4.3 (1.5, 12.7)] in patients with CAM vs CNM. A significantly elevated SIR was found for CAM, whereas there was a comparable SIR for CNM relative to the general population. Multiple types of cancers showed elevated SIRs among CAM, but none among CNM. Given that cancer stages in CAM were far advanced at diagnosis, mortality risk was greater in patients with CAM. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Risks of Primary Extracolonic Cancers Following Colorectal Cancer in Lynch Syndrome

PubMed Central

2012-01-01

Background Lynch syndrome is a highly penetrant cancer predisposition syndrome caused by germline mutations in DNA mismatch repair (MMR) genes. We estimated the risks of primary cancers other than colorectal cancer following a diagnosis of colorectal cancer in mutation carriers. Methods We obtained data from the Colon Cancer Family Registry for 764 carriers of an MMR gene mutation (316 MLH1, 357 MSH2, 49 MSH6, and 42 PMS2), who had a previous diagnosis of colorectal cancer. The Kaplan–Meier method was used to estimate their cumulative risk of cancers 10 and 20 years after colorectal cancer. We estimated the age-, sex-, country- and calendar period–specific standardized incidence ratios (SIRs) of cancers following colorectal cancer, compared with the general population. Results Following colorectal cancer, carriers of MMR gene mutations had the following 10-year risk of cancers in other organs: kidney, renal pelvis, ureter, and bladder (2%, 95% confidence interval [CI] = 1% to 3%); small intestine, stomach, and hepatobiliary tract (1%, 95% CI = 0.2% to 2%); prostate (3%, 95% CI = 1% to 5%); endometrium (12%, 95% CI = 8% to 17%); breast (2%, 95% CI = 1% to 4%); and ovary (1%, 95% CI = 0% to 2%). They were at elevated risk compared with the general population: cancers of the kidney, renal pelvis, and ureter (SIR = 12.54, 95% CI = 7.97 to 17.94), urinary bladder (SIR = 7.22, 95% CI = 4.08 to 10.99), small intestine (SIR = 72.68, 95% CI = 39.95 to 111.29), stomach (SIR = 5.65, 95% CI = 2.32 to 9.69), and hepatobiliary tract (SIR = 5.94, 95% CI = 1.81 to 10.94) for both sexes; cancer of the prostate (SIR = 2.05, 95% CI = 1.23 to 3.01), endometrium (SIR = 40.23, 95% CI = 27.91 to 56.06), breast (SIR = 1.76, 95% CI = 1.07 to 2.59), and ovary (SIR = 4.19, 95% CI = 1.28 to 7.97). Conclusion Carriers of MMR gene mutations who have already had a colorectal cancer are at increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers. PMID:22933731

Cardiovascular Morbidity After Radiotherapy or Chemoradiation in Patients With Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maduro, John H.; Department of Medical Oncology, University of Groningen and University Medical Center Groningen, Groningen; Dekker, Helena A. den

2010-12-01

Purpose: To evaluate the risk of cardiovascular events (CVE) in patients with cervical cancer treated with radiotherapy or chemoradiation. Methods and Materials: The incidence of CVE in patients treated between 1989 and 2002 by radiotherapy or chemoradiation was compared with a Dutch reference population. Standardized incidence ratios (SIRs) were calculated for myocardial infarction (MI), angina pectoris (AP), congestive heart failure (CHF), cerebrovascular accident (CVA) separately and for any cardiac event combined (MI, AP, and CHF). Results: In 277 patients with a median follow-up of 4.5 years (range, 0.1-17 years) and a median survival of 9.2 years, 27 cardiac events occurred.more » The 5-, 10-, and 15-year actuarial incidence of any cardiac event were 9, 14, and 16%, respectively. For the whole population, the SIR for MI was elevated (2.05, 95% CI: 1.12-3.43). The radiotherapy group (n = 132) was older and had more cardiovascular risk factors than the chemoradiation group (n = 145). The SIR for MI in the radiotherapy group was 2.88 (95% CI: 1.44-5.15) and in the chemoradiation group 1.00 (95% CI: 0.21-7.47). In multivariate analyses, there was no relation between treatment modality and the risk for MI. Conclusions: In this cohort of cervical cancer patients, an increased risk for developing a MI was observed. This increased risk of MI, in combination with the high prevalence of cardiovascular risk factors in cervical cancer patients, urges the need to explore strategies to reduce their risk for cardiovascular morbidity.« less

Biomarkers of Endothelial Activation Are Associated with Poor Outcome in Critical Illness.

PubMed

Mikacenic, Carmen; Hahn, William O; Price, Brenda L; Harju-Baker, Susanna; Katz, Ronit; Kain, Kevin C; Himmelfarb, Jonathan; Liles, W Conrad; Wurfel, Mark M

2015-01-01

Endothelial activation plays a role in organ dysfunction in the systemic inflammatory response syndrome (SIRS). Angiopoietin-1 (Ang-1) promotes vascular quiescence while angiopoietin-2 (Ang-2) mediates microvascular leak. Circulating levels of Ang-1 and Ang-2 in patients with SIRS could provide insight on risks for organ dysfunction and death distinct from inflammatory proteins. In this study, we determined if biomarkers of endothelial activation and inflammation exhibit independent associations with poor outcomes in SIRS. We studied 943 critically ill patients with SIRS admitted to an Intensive Care Unit (ICU) of an academic medical center. We measured plasma levels of endothelial markers (Ang-1, Ang-2, soluble vascular cell adhesion molecule-1 (sVCAM-1)) and inflammatory markers (interleukin-6 (IL-6), interleukin-8 (IL-8), granulocyte-colony stimulating factor (G-CSF), soluble tumor necrosis factor receptor-1 (sTNFR-1)) within 24 hours of enrollment. We tested for associations between each marker and 28 day mortality, shock, and day 3 sequential organ failure assessment (SOFA) score. For 28 day mortality, we performed sensitivity analysis for those subjects with sepsis and those with sterile inflammation. We used multivariate models to adjust for clinical covariates and determine if associations identified with endothelial activation markers were independent of those observed with inflammatory markers. Higher levels of all biomarkers were associated with increased 28 day mortality except levels of Ang-1 which were associated with lower mortality. After adjustment for comorbidities and sTNFR-1 concentration, a doubling of Ang-1 concentration was associated with lower 28 day mortality (Odds ratio (OR) = 0.81; p<0.01), shock (OR = 0.82; p<0.001), and SOFA score (β = -0.50; p<0.001), while Ang-2 concentration was associated with increased mortality (OR = 1.55; p<0.001), shock (OR = 1.51; p<0.001), and SOFA score (β = +0.63; p<0.001). sVCAM-1 was not independently associated with SIRS outcomes. In critically ill patients with SIRS, early measurements of Ang-1 and Ang-2 are associated with death and organ dysfunction independently of simultaneously-measured markers of inflammation.

Cancers in concrete workers: results of a cohort study of 33 668 workers

PubMed Central

Knutsson, A.; Damber, L.; Jarvholm, B.

2000-01-01

OBJECTIVES—To study cancer morbidity patterns in concrete workers.
METHODS—A cohort of 33 503 concrete workers was enrolled in the study from 1971-86. The average duration of follow up was 19.4 years (582 225 person-years). The workers' cancer morbidity was compared with the morbidity of the general population.
RESULTS—A total of 3572 incident cancers were observed. Significantly increased standardised incidence ratios (SIRs) were found for all malignant neoplasms (SIR 107; 95% confidence interval (95%CI) 103 to 110), cancer of the lip (SIR 179; 95%CI 134 to 234), cancer of the stomach (SIR 139; 95%CI 122 to 158), cancer of the lung (SIR 125; 95%CI 114 to 137), and cancer of the prostate (SIR 108; 95%CI 101 to 116). Reduced risk was found for cancer of the large intestine (SIR 80; 95%CI 69 to 93) and cancer of the testis (SIR 50; 95%CI 26 to 87). Smoking was more prevalent among the concrete workers than in the general population (50% v 35%).
CONCLUSION—The study has shown a slightly increased overall risk of cancer among concrete workers. The increased risk of lung cancer could entirely be due to differences in smoking habits between concrete workers and the general population. There is a possibility that the smoking also has contributed to the increased risks of stomach cancer and lip cancer, but occupational factors may have contributed to these cancer sites.


Keywords: occupational diseases; constructions workers; smoking PMID:10810113

Risk of cancer in patients with irritable bowel syndrome: a nationwide population-based study.

PubMed

Hu, Li-Yu; Ku, Fan-Chen; Lu, Ti; Shen, Cheng-Che; Hu, Yu-Wen; Yeh, Chiu-Mei; Tzeng, Cheng-Hwai; Chen, Tzeng-Ji; Chen, Pan-Ming; Liu, Chia-Jen

2015-12-01

The aim of our study was to evaluate the overall cancer risk among patients with the irritable bowel syndrome (IBS) by using a nationwide population-based data set. We obtained data on newly diagnosed IBS patients (age ≥ 20 years) without antecedent cancer from the Taiwan National Health Insurance Research Database for the period between 2000 and 2010. Standardized incidence ratios (SIRs) were calculated for various types of cancer in the IBS patients. A total of 1,043 people among the 29,838 IBS patients had developed cancer, and the follow-up was 139,185 person-years (median, 4.56 years), leading to a significantly increased SIR (1.18; 95% confidence interval [CI]) = 1.11-1.26) among all cancer types. However, after excluding cancer that developed within the first year after IBS diagnosis, the increased SIR of overall cancer was nonsignificant. In particular, the IBS patients exhibited an increased risk of cancers of the colon and rectum (SIR = 1.51; 95% CI = 1.31-1.73), liver and biliary tract (SIR = 1.40; 95% CI = 1.21-1.62), pancreas (SIR = 1.56; 95% CI = 1.02-2.28), and kidney (SIR = 1.56; 95% CI = 1.10-2.15). An increased SIR in IBS patients was observed only within the first year of IBS diagnosis. The findings of this study might have resulted from detection bias, localized symptoms, or paraneoplastic syndromes associated with IBS-like symptoms. Additional prospective studies are necessary to confirm these findings. Copyright © 2015 Elsevier Inc. All rights reserved.

International comparison of activity measurements of a solution of 75Se

NASA Astrophysics Data System (ADS)

Ratel, Guy

2002-04-01

Activity measurements of a solution of 75Se, supplied by the BIPM, have been carried out by 21 laboratories within the framework of an international comparison. Seven different methods were used. Details on source preparation, experimental facilities and counting data are reported. The measured activity-concentration values show a total spread of 6.62% before correction and 6.02% after correction for delayed events, with standard deviations of the unweighted means of 0.45% and 0.36%, respectively. The correction for delayed events was measured directly by four laboratories. Unfortunately no consensus on the activity value could be deduced from their results. The results of the comparison have been entered in the tables of the International Reference System (SIR) for γ-ray emitting radionuclides. The half-life of the metastable state was also determined by two laboratories and found to be in good agreement with the values found in the literature.

KEY COMPARISON: BIPM comparison BIPM.RI(II)-K1.Cu-64 of the activity measurements of the radionuclide 64Cu

NASA Astrophysics Data System (ADS)

Michotte, C.; Courte, S.; Ratel, G.; Kossert, K.; Nähle, O. J.

2009-01-01

In 2009, the Physikalisch-Technische Bundesanstalt (PTB), Germany, submitted a sample of known activity of 64Cu to the International Reference System (SIR) for activity comparison at the Bureau International des Poids et Mesures (BIPM). The value of the activity submitted was about 9.3 MBq. The result of this new comparison has been approved for publication by Section II of the Consultative Committee for Ionizing Radiation (CCRI(II)), comparison identifier BIPM.RI(II)-K1.Cu-64. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCRI Section II, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

Incidence of lung cancer among subway drivers in Stockholm.

PubMed

Gustavsson, Per; Bigert, Carolina; Pollán, Marina

2008-07-01

Very high levels of airborne particles have been detected in the subway system in Stockholm. Subway particles are more toxic to DNA in cultured human lung cells than particles from ambient air. This cohort comprised all men in Stockholm County who were gainfully employed in 1970. They were followed for cancer incidence until 1989. Lung cancer cases were identified from the national cancer register. Subway drivers were identified from the census in 1970. The reference cohort comprised all transport and communication workers in Stockholm. There were nine cases of lung cancer among the subway drivers, giving a SIR of 0.82 (95% confidence interval 0.38-1.56). The lung cancer incidence was not increased among the subway drivers. The study gives some evidence against the hypothesis that subway particles would be more potent in inducing lung cancer than particles in ambient air. (c) 2008 Wiley-Liss, Inc.

Space shuttle radar images of Indonesia

NASA Technical Reports Server (NTRS)

Sabins, Floyd F.; Ford, John P.

1986-01-01

Sabins (1983) interpreted Shuttle Imaging Radar (SIR)-A images of Indonesia; Sabins and Ford (1985) interpreted SIR-B images. These investigations had the following major results: (1) major lithologic assemblages are recognizable by their terrain characteristics in the SIR images, and (2) both local and regional geologic structures are mappable. These results are summarized.

77 FR 21150 - Requested Administrative Waiver of the Coastwise Trade Laws: Vessel SIR MARTIN II; Invitation for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-09

... DEPARTMENT OF TRANSPORTATION Maritime Administration [Docket No. MARAD 2012 0047] Requested Administrative Waiver of the Coastwise Trade Laws: Vessel SIR MARTIN II; Invitation for Public Comments AGENCY... the vessel SIR MARTIN II is: Intended Commercial Use of Vessel: ``Day charter up to 6 passengers for...

Symmetric/Asymmetrical SIRs Dual-Band BPF Design for WLAN Applications

NASA Astrophysics Data System (ADS)

Ho, Min-Hua; Ho, Hao-Hung; Chen, Mingchih

This paper presents the dual-band bandpass filters (BPFs) design composed of λ/2 and symmetrically/asymmetrically paired λ/4 stepped impedance resonators (SIRs) for the WLAN applications. The filters cover both the operating frequencies of 2.45 and 5.2GHz. The dual-coupling mechanism is used in the filter design to provide alternative routes for signals of selected frequencies. A prototype filter is composed of λ/2 and symmetrical λ/4 SIRs. The enhanced wide-stopband filter is then developed from the filter with the symmetrical λ/4 SIRs replaced by the asymmetrical ones. The asymmetrical λ/4 SIRs have their higher resonances frequencies isolated from the adjacent I/O SIRs and extend the enhanced filter an upper stopband limit beyond ten time the fundamental frequency. Also, the filter might possess a cross-coupling structure which introduces transmission zeros by the passband edges to improve the signal selectivity. The tapped-line feed is adopted in this circuit to create additional attenuation poles for improving the stopband rejection levels. Experiments are conducted to verify the circuit performance.

Nilpotent singularities and dynamics in an SIR type of compartmental model with hospital resources

NASA Astrophysics Data System (ADS)

Shan, Chunhua; Yi, Yingfei; Zhu, Huaiping

2016-03-01

An SIR type of compartmental model with a standard incidence rate and a nonlinear recovery rate was formulated to study the impact of available resources of public health system especially the number of hospital beds. Cusp, focus and elliptic type of nilpotent singularities of codimension 3 are discovered and analyzed in this three dimensional model. Complex dynamics of disease transmission including multi-steady states and multi-periodicity are revealed by bifurcation analysis. Large-amplitude oscillations found in our model provide a more reasonable explanation for disease recurrence. With clinical data, our studies have practical implications for the prevention and control of infectious diseases.

Albireo: 260 Years of Astrometric Observations

NASA Astrophysics Data System (ADS)

Hass, Jacob; Phung, Kevin; Carro, Joseph; Hock, Emily; Loveland, Donald; Nibbe, Tristan; Sharp, Zoe; Smit, Jenny; Genet, Russell

2016-03-01

The historical record of Albireo's observations reflects the progress of double star research. Some 294 astrometric observations have been published starting with Bradley's 1755 observation and ending with our 2015 observation. Several observation techniques were used over this 260 year span. Noteworthy are the historic contributions of astronomers such as James Bradley, Christian Mayer, William Herschel, Giuseppe Piazzi, Friedrich Georg Wilhelm von Struve, Sir John Herschel, Sir James South, Edward Skinner King, and Andrei Tokovinin. Overall trend lines of the past observations of Albireo are compared to our current observation, and are generally concurrent. Dividing Albireo's past observations of separation into time segments shows evidence of a known third star in Albireo's system.

Interlobate comparison of glacial-depositional style as evidenced by small-relief glacial landscape features in Illinois, Indiana, and Ohio, utilizing SIR-B

NASA Technical Reports Server (NTRS)

Johnson, W. H.; Bleuer, N. K.; Fraser, G. S.; Totten, S. M.

1984-01-01

The objectives and expected results of an investigation of the use of the Shuttle Imaging Radar-B (SIR-B) as a basic tool in the recognition and mapping of glacial landforms are discussed. The main goals are: (1) to evaluate the ability of SIR-B to delineate varying sizes, shapes, and relief of surface forms; (2) to compare and contrast SIR-B imagery with selected Seasat SAR imagery; (3) to utilize SIR-B imagery synergistically with available SEASAT SAR, LANDSAT RBV, and other imagery sources to identify and map suites of glacial landforms; and (4) eventually to interpret the suites in terms of ice dynamics and conditions of deglaciation, to relate them to the stratigraphic record, and to evaluate interactions of the major lobes and sublobes.

Deferred Pre-Emptive Switch from Calcineurin Inhibitor to Sirolimus Leads to Improvement in GFR and Expansion of T Regulatory Cell Population: A Randomized, Controlled Trial

PubMed Central

Bansal, Dinesh; Yadav, Ashok K.; Kumar, Vinod; Minz, Mukut; Sakhuja, Vinay; Jha, Vivekanand

2013-01-01

Background Measures to prevent chronic calcineurin inhibitor (CNI) toxicity have included limiting exposure by switching to sirolimus (SIR). SIR may favorably influence T regulator cell (Treg) population. This randomized controlled trial compares the effect of switching from CNI to SIR on glomerular filtration rate (GFR) and Treg frequency. Methods In this prospective open label randomized trial, primary living donor kidney transplant recipients on CNI-based immunosuppression were randomized to continue CNI or switched to sirolimus 2 months after surgery; 29 were randomized to receive CNI and 31 to SIR. All patients received mycophenolate mofetil and steroids. The main outcome parameter was estimated GFR (eGFR) at 180 days. Treg population was estimated by flowcytometry. Results Baseline characteristics in the two groups were similar. Forty-eight patients completed the trial. At six months, patients in the SIR group had significantly higher eGFR as compared to those in the CNI group (88.94±11.78 vs 80.59±16.51 mL/min, p = 0.038). Patients on SIR had a 12 mL/min gain of eGFR of at the end of six months. Patients in the SIR group showed significant increase in Treg population at 30 days, which persisted till day 180. There was no difference in the adverse events in terms of number of acute rejection episodes, death, infections, proteinuria, lipid profile, blood pressure control and hematological parameters between the two groups. Four patients taking SIR developed enthesitis. No patient left the study or switched treatment because of adverse event. Conclusions A deferred pre-emptive switch over from CNI to SIR safely improves renal function and Treg population at 6 months in living donor kidney transplant recipients. Registered in Clinical Trials Registry of India (CTRI/2011/091/000034) PMID:24146762

Nicotinamide riboside attenuates alcohol induced liver injuries via activation of SirT1/PGC-1α/mitochondrial biosynthesis pathway.

PubMed

Wang, Sufan; Wan, Ting; Ye, Mingtong; Qiu, Yun; Pei, Lei; Jiang, Rui; Pang, Nengzhi; Huang, Yuanling; Liang, Baoxia; Ling, Wenhua; Lin, Xiaojun; Zhang, Zhenfeng; Yang, Lili

2018-07-01

Nicotinamide riboside (NR) is a nicotinamide adenine dinucleotide (NAD + ) precursor which is present in foods such as milk and beer. It was reported that NR can prevent obesity, increase longevity, and promote liver regeneration. However, whether NR can prevent ethanol-induced liver injuries is not known. This study aimed to explore the effect of NR on ethanol induced liver injuries and the underlying mechanisms. We fed C57BL/6 J mice with Lieber-DeCarli ethanol liquid diet with or without 400 mg/kg·bw NR for 16 days. Liver injuries and SirT1-PGC-1α-mitochondrial function were analyzed. In in vitro experiments, HepG2 cells (CYP2E1 over-expressing cells) were incubated with ethanol ± 0.5 mmol/L NR. Lipid accumulation and mitochondrial function were compared. SirT1 knockdown in HepG2 cells were further applied to confirm the role of SirT1 in the protection of NR on lipid accumulation. We found that ethanol significantly decreased the expression and activity of hepatic SirT1 and induced abnormal expression of enzymes of lipid metabolism in mice. Both in vivo and in vitro experiments showed that NR activated SirT1 through increasing NAD + levels, decreased oxidative stress, increased deacetylation of PGC-1α and mitochondrial function. In SirT1 knockdown HepG2 cells, NR lost its ability in enhancing mitochondrial function, and its protection against lipid accumulation induced by ethanol. NR can protect against ethanol induced liver injuries via replenishing NAD + , reducing oxidative stress, and activating SirT1-PGC-1α-mitochondrial biosynthesis. Our data indicate that SirT1 plays an important role in the protection of NR against lipid accumulation and mitochondrial dysfunctions induced by ethanol. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Taking advantage of public reporting: An infection composite score to assist evaluating hospital performance for infection prevention efforts.

PubMed

Fakih, Mohamad G; Skierczynski, Boguslow; Bufalino, Angelo; Groves, Clariecia; Roberts, Phillip; Heavens, Michelle; Hendrich, Ann; Haydar, Ziad

2016-12-01

The standardized infection ratio (SIR) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance. We piloted an infection composite score (ICS) in 82 hospitals of a single health system. The ICS is a combined score for central line-associated bloodstream infections, catheter-associated urinary tract infections, colon and abdominal hysterectomy surgical site infections, and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and Clostridium difficile infections. Individual facility ICSs were calculated by normalizing each of the 6 SIR events to the system SIR for baseline and performance periods (ICS ib and ICS ip , respectively). A hospital ICS ib reflected its baseline performance compared with system baseline, whereas a ICS ip provided information of its outcome changes compared with system baseline. Both the ICS ib (baseline 2013) and ICS ip (performance 2014) were calculated for 63 hospitals (reporting at least 4 of the 6 event types). The ICS ip improved in 36 of 63 (57.1%) hospitals in 2014 when compared with the ICS ib in 2013. The ICS ib 2013 median was 0.96 (range, 0.13-2.94) versus the 2014 ICS ip median of 0.92 (range, 0-6.55). Variation was more evident in hospitals with ≤100 beds. The system performance score (ICS sp ) in 2014 was 0.95, a 5% improvement compared with 2013. The proposed ICS may help large health systems and state hospital associations better evaluate key infectious outcomes, comparing them with historic and concurrent performance of peers. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Time trends and occupational variation in the incidence of testicular cancer in the Nordic countries.

PubMed

Ylönen, Outi; Jyrkkiö, Sirkku; Pukkala, Eero; Syvänen, Kari; Boström, Peter J

2018-02-20

To describe the trends and occupational variation in the incidence of testicular cancer in the Nordic countries utilising national cancer registries, NORDCAN (NORDCAN project/database presents the incidence, mortality, prevalence and survival from >50 cancers in the Nordic countries) and NOCCA (Nordic Occupational Cancer) databases. We obtained the incidence data of testicular cancer for 5-year periods from 1960-1964 to 2000-2014 and for 5-year age-groups from the NORDCAN database. Morphological data on incident cases of seminoma and non-seminoma were obtained from national cancer registries. Age-standardised incidence rates (ASR) were calculated per 100 000 person-years (World Standard). Regression analysis was used to evaluate the annual change in the incidence of testicular cancer in each of the Nordic countries. The risk of testicular cancer in different professions was described based on NOCCA information and expressed as standardised incidence ratios (SIRs). During 2010-2014 the ASR for testicular cancer varied from 11.3 in Norway to 5.8 in Finland. Until 1998, the incidence was highest in Denmark. There has not been an increase in Denmark and Iceland since the 1990s, whilst the incidence is still strongly increasing in Norway, Sweden, and Finland. There were no remarkable changes in the ratio of seminoma and non-seminoma incidences during the past 50 years. There was no increase in the incidences in children and those of pension age. The highest significant excess risks of testicular seminoma were found in physicians (SIR 1.48, 95% confidence interval [CI] 1.07-1.99), artistic workers (SIR 1.47, 95% CI 1.06-1.99) and religious workers etc. (SIR 1.33, 95% CI 1.14-1.56). The lowest SIRs of testicular seminoma were seen amongst cooks and stewards (SIR 0.56, 95% CI 0.29-0.98), and forestry workers (SIR 0.64, 95% CI 0.47-0.86). The occupational category of administrators was the only one with a significantly elevated SIR for testicular non-seminoma (SIR 1.21, 95% CI 1.04-1.42). The only SIRs significantly <1.0 were seen amongst engine operators (SIR 0.60, 95% CI 0.41-0.84) and public safety workers (SIR 0.67, 95% CI 0.43-0.99). There have always been differences in the incidence of testicular cancer between the Nordic countries. There is also some divergence in the incidences in different age groups and in the trends of the incidence. The effect of occupation-related factors on incidence of testicular cancer is only moderate. Our study describes the differences, but provides no explanation for this variation. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Spinning: an arising cause of rhabdomyolysis in young females.

PubMed

Kim, Y H; Ham, Y R; Na, K R; Lee, K W; Choi, D E

2016-09-01

'Spinning' is an indoor cycling regimen. The number of case reports of spinning-induced rhabdomyolysis (SIR) has increased since 2004 in South Korea. The aim of this study is to evaluate the clinical characteristics of SIR and compare it with other causes of rhabdomyolysis. Patients who were diagnosed with rhabdomyolysis from 1 September 2011 to 30 April 2015 were included. We analysed the incidence of rhabdomyolysis, biochemical parameters and forced hospitalisation, which was defined as the days from admission to creatinine phosphokinase < 2000 IU/L. Among 70 included patients, 13 (18.6%) patients were diagnosed with SIR. The mean age of the patients with SIR was 25.69 ± 5.0 years, and most were females under 35 years old (12, 92.3%). Interestingly, the mean duration of spinning exercise before admission was only 59.23 min. Moreover, the patients with SIR showed more severe progress than the all-patients-except-SIR (AESIR) group. The serum creatinine phosphokinase, aspartate transaminase and alanine transaminase levels of the patients with SIR were statistically significantly higher than the patients with AESIR. Additionally, the duration of forced hospitalisation was longer than that of the AESIR (P < 0.01). Spinning could be an important cause of rhabdomyolysis in young, unfit females, which is typically severe. A graded exercise programme is advised at the first session. © 2016 Royal Australasian College of Physicians.

Bell's Palsy (For Kids)

MedlinePlus

... palsy was named after a Scottish doctor, Sir Charles Bell, who studied the two facial nerves that ... who focuses on how the nervous system works — will do a test called electromyography (say: eh-lek- ...

Sense International Romania: 15 Years Working on Behalf of Children with Deafblindness

ERIC Educational Resources Information Center

Buica, Cristian B.

2018-01-01

Sense International Romania (SIR) was established in 2001 as a local branch of Sense International UK. Until 1999, little has been done for children with dual sensory loss or multiple sensory impairments. Ms. Cristiana Salomie, the director of SIR, and Dr. Cristian B. Buica describe how things have been changing since then, highlighting SIR's…

Cancer Incidence in Patients With Schizophrenia or Bipolar Disorder: A Nationwide Population-Based Study in Taiwan, 1997–2009

PubMed Central

Lin, Gen-Min; Chen, Yu-Jung; Kuo, De-Jhen; Jaiteh, Lamin E. S.; Wu, Yi-Chung; Lo, Tzu-Shun; Li, Yi-Hwei

2013-01-01

Background: Both genetic and environmental factors have been reasoned for cancer development in schizophrenia patients. However, the influence of age of onset and duration of schizophrenia on cancer incidence has rarely been emphasized. Besides, bipolar disorder tends to resemble schizophrenia from the perspective of multiple rare mutations. Comparing pattern and risk of cancers between schizophrenia and bipolar patients is illuminating. Methods: This study used the Taiwan National Health Insurance Database. A total of 71 317 schizophrenia and 20 567 bipolar disorder patients from 1997 to 2009 were enrolled. Both cohorts were followed up for cancer during the same period by record linkage with the cancer certification in Taiwan. Age and gender standardized incidence ratios (SIRs) of overall and site-specific cancers were calculated. Results: The SIR for all cancers was 1.17 for the schizophrenia cohort. Increased cancer risk (SIR: 1.31, 95% CI: 1.17–1.48) was observed in females but not males. For the bipolar disorder cohort, the SIR for all cancers was 1.29, but the excess risk was found in males (SIR: 1.42, 95% CI: 1.14–1.77) and not females. Cancer risk decreases as the duration and age of onset of schizophrenia increases. If schizophrenia is diagnosed before 50, the SIRs for colorectal, breast, cervical, and uterine cancers increase but if diagnosed after 50, the SIRs for all cancers decrease except for breast cancer. In bipolar disorder, the SIRs for all site-specific cancers were insignificant. Conclusions: Among schizophrenia patients, overall cancer risk varies inversely with age at diagnosis and disease duration. Besides, gender-specific cancer risks differ between schizophrenia and bipolar disorder. PMID:22045828

A Buoyancy-Based Screen of Drosophila Larvae for Fat-Storage Mutants Reveals a Role for Sir2 in Coupling Fat Storage to Nutrient Availability

PubMed Central

Reis, Tânia; Van Gilst, Marc R.; Hariharan, Iswar K.

2010-01-01

Obesity has a strong genetic component, but few of the genes that predispose to obesity are known. Genetic screens in invertebrates have the potential to identify genes and pathways that regulate the levels of stored fat, many of which are likely to be conserved in humans. To facilitate such screens, we have developed a simple buoyancy-based screening method for identifying mutant Drosophila larvae with increased levels of stored fat. Using this approach, we have identified 66 genes that when mutated increase organismal fat levels. Among these was a sirtuin family member, Sir2. Sirtuins regulate the storage and metabolism of carbohydrates and lipids by deacetylating key regulatory proteins. However, since mammalian sirtuins function in many tissues in different ways, it has been difficult to define their role in energy homeostasis accurately under normal feeding conditions. We show that knockdown of Sir2 in the larval fat body results in increased fat levels. Moreover, using genetic mosaics, we demonstrate that Sir2 restricts fat accumulation in individual cells of the fat body in a cell-autonomous manner. Consistent with this function, changes in the expression of metabolic enzymes in Sir2 mutants point to a shift away from catabolism. Surprisingly, although Sir2 is typically upregulated under conditions of starvation, Sir2 mutant larvae survive better than wild type under conditions of amino-acid starvation as long as sugars are provided. Our findings point to a Sir2-mediated pathway that activates a catabolic response to amino-acid starvation irrespective of the sugar content of the diet. PMID:21085633

Risk of second primary cancers after testicular cancer in East and West Germany: A focus on contralateral testicular cancers

PubMed Central

Rusner, Carsten; Streller, Brigitte; Stegmaier, Christa; Trocchi, Pietro; Kuss, Oliver; McGlynn, Katherine A; Trabert, Britton; Stang, Andreas

2014-01-01

Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type (seminoma and non-seminoma) among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany (1961–1989 and 1996–2008) and Saarland (a federal state in West Germany; 1970–2008), respectively. We estimated the risk of a second primary cancer using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 (SIR: 1.9; 95% CI: 1.7–2.1), and 159 cancers (any location) were observed between 1996 and 2008 (SIR: 1.7; 95% CI: 1.4–2.0). The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups. PMID:24407180

Increased incidence of bowel cancer after non-surgical treatment of appendicitis.

PubMed

Enblad, Malin; Birgisson, Helgi; Ekbom, Anders; Sandin, Fredrik; Graf, Wilhelm

2017-11-01

There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013. The cohort was matched with the Swedish Cancer Registry and the standardised incidence ratios (SIR) with 95% confidence interval (95% CI) for appendiceal, colorectal and small bowel cancers were calculated. Of 13 595 patients with non-surgical treatment of appendicitis, 352 (2.6%) were diagnosed with appendiceal, colorectal or small bowel cancer (SIR 4.1, 95% CI 3.7-4.6). The largest incidence increase was found for appendiceal (SIR 35, 95% CI 26-46) and right-sided colon cancer (SIR 7.5, 95% CI 6.6-8.6). SIR was still elevated when excluding patients with less than 12 months since appendicitis and the incidence of right-sided colon cancer was elevated five years after appendicitis (SIR 3.5, 95% CI 2.1-5.4). An increased incidence of bowel cancer was found after appendicitis with abscess (SIR 4.6, 95% CI 4.0-5.2), and without abscess (SIR 3.5, 95% CI 2.9-4.1). Patients with non-surgical treatment of appendicitis have an increased short and long-term incidence of bowel cancer. This should be considered in the discussion about optimal management of patients with appendicitis. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Cancer Risk After Pediatric Solid Organ Transplantation.

PubMed

Yanik, Elizabeth L; Smith, Jodi M; Shiels, Meredith S; Clarke, Christina A; Lynch, Charles F; Kahn, Amy R; Koch, Lori; Pawlish, Karen S; Engels, Eric A

2017-05-01

The effects of pediatric solid organ transplantation on cancer risk may differ from those observed in adult recipients. We described cancers in pediatric recipients and compared incidence to the general population. The US transplant registry was linked to 16 cancer registries to identify cancer diagnoses among recipients <18 years old at transplant. Standardized incidence ratios (SIRs) were estimated by dividing observed cancer counts among recipients by expected counts based on the general population rates. Cox regression was used to estimate the associations between recipient characteristics and non-Hodgkin's lymphoma (NHL) risk. Among 17 958 pediatric recipients, 392 cancers were diagnosed, of which 279 (71%) were NHL. Compared with the general population, incidence was significantly increased for NHL (SIR = 212, 95% confidence interval [CI] = 188-238), Hodgkin's lymphoma (SIR = 19, 95% CI = 13-26), leukemia (SIR = 4, 95% CI = 2-7), myeloma (SIR = 229, 95% CI = 47-671), and cancers of the liver, soft tissue, ovary, vulva, testis, bladder, kidney, and thyroid. NHL risk was highest during the first year after transplantation among recipients <5 years old at transplant (SIR = 313), among recipients seronegative for Epstein-Barr virus (EBV) at transplant (SIR = 446), and among intestine transplant recipients (SIR = 1280). In multivariable analyses, seronegative EBV status, the first year after transplantation, intestine transplantation, and induction immunosuppression were independently associated with higher NHL incidence. Pediatric recipients have a markedly increased risk for many cancers. NHL constitutes the majority of diagnosed cancers, with the highest risk occurring in the first year after transplantation. NHL risk was high in recipients susceptible to primary EBV infection after transplant and in intestine transplant recipients, perhaps due to EBV transmission in the donor organ. Copyright © 2017 by the American Academy of Pediatrics.

The Jeremiah Metzger Lecture. Humanities in medicine: treatment of a deficiency disorder.

PubMed Central

Hook, E. W.

1997-01-01

Al Jonson pointed out that Sir William Osler provided one of the best rationales for Humanities in Medicine (21, 65). In 1919, in one of Sir William's last lectures given just a few months prior to his death, a lecture to the British Classical Society, he discussed how the sciences and the humanities can inform each other. He compared the humanities to thyroid hormone-thyroxine had just been discovered in 1914-"a hormone...," Sir William said, "...which lubricates the wheels of life...Deprive man of the lubricants ... and ... he sinks into dementia..." And so to the Classical Society, Sir William said, "You secrete materials which do for society at large what the thyroid gland does for the individual. The humanities are the hormones..." And Al Jonsen suggested that we in Medicine reaffirm Sir William's metaphor that the humanities are the hormones which will do for medicine what they do for society at large. PMID:9108678

Analysis of data acquired by Shuttle Imaging Radar SIR-A and Landsat Thematic Mapper over Baldwin County, Alabama

NASA Technical Reports Server (NTRS)

Wu, S.-T.

1985-01-01

Seasonally compatible data collected by SIR-A and by Landsat 4 TM over the lower coastal plain in Alabama were coregistered, forming a SIR-A/TM multichannel data set with 30 m x 30 m pixel size. Spectral signature plots and histogram analysis of the data were used to observe data characteristics. Radar returns from pine forest classes correlated highly with the tree ages, suggesting the potential utility of microwave remote sensing for forest biomass estimation. As compared with the TM-only data set, the use of SIR-A/TM data set improved classification accuracy of the seven land cover types studied. In addition, the SIR-A/TM classified data support previous finding by Engheta and Elachi (1982) that microwave data appear to be correlated with differing bottomland hardwood forest vegetation as associated with varying water regimens (i.e., wet versus dry).

dSir2 mediates the increased spontaneous physical activity in flies on calorie restriction.

PubMed

Parashar, Vijay; Rogina, Blanka

2009-06-22

Calorie restriction (CR) is the most effective way to increase life span and delay the onset of age-related symptoms in animals. We have previously reported that CR affects a variety of physiological phenotypes in flies and results in dramatic behavioral, physical and demographic changes. Here we show effects of low and high calorie levels on the spontaneous physical activity of flies. Wild type flies maintained on a low calorie diet exhibit higher spontaneous activity compared to flies on higher calorie diets. This increase is dependent on the presence of Sir2 since a low calorie diet does not increase the activity of dSir2 null flies. Similarly, increasing dSir2 activity by feeding flies resveratrol, a CR mimetic, increases spontaneous physical activity of flies on high caloric food. In Drosophila, spontaneous physical activity therefore closely mimics life span in its dependence on Sir2.

Space Radar Image of Wadi Kufra, Libya

NASA Image and Video Library

1998-04-14

The ability of a sophisticated radar instrument to image large regions of the world from space, using different frequencies that can penetrate dry sand cover, produced the discovery in this image: a previously unknown branch of an ancient river, buried under thousands of years of windblown sand in a region of the Sahara Desert in North Africa. This area is near the Kufra Oasis in southeast Libya, centered at 23.3 degrees north latitude, 22.9 degrees east longitude. The image was acquired by the Spaceborne Imaging Radar-C/X-band Synthetic Aperture (SIR-C/X-SAR) imaging radar when it flew aboard the space shuttle Endeavour on its 60th orbit on October 4, 1994. This SIR-C image reveals a system of old, now inactive stream valleys, called "paleodrainage systems, http://photojournal.jpl.nasa.gov/catalog/PIA01310

[Monoclonal antibodies against inflammatory mediators for the treatment of patients with sepsis].

PubMed

Matsubara, Tomoyo

2002-03-01

Sepsis is a common cause of morbidity and mortality, particularly in immunocompromised and critically ill patients. Recently, a new designation, systemic inflammatory response syndrome(SIRS), has been studied. When an abnormal generalized inflammatory reaction is due to an infection, the terms sepsis and SIRS are synonymous. The systemic response to infection is mediated via the macrophage-derived cytokines that target end organ receptors in response to injury or infection. One strategy used to perturb the septic cascade is to block a particular inflammatory molecule. Results have been published on clinical trials in sepsis patients treated with several monoclonal antibodies, such as antiendotoxin antibodies, anti-tumor necrosis factor antibodies, and anti CD14 antibodies. In this chapter, the results of clinical trials in patients and in vivo data from animal models of sepsis are summarized.

Spectrum of Cancer Risk among U.S. Solid Organ Transplant Recipients: The Transplant Cancer Match Study

PubMed Central

Engels, Eric A.; Pfeiffer, Ruth M.; Fraumeni, Joseph F.; Kasiske, Bertram L.; Israni, Ajay K.; Snyder, Jon J.; Wolfe, Robert A.; Goodrich, Nathan P.; Bayakly, A. Rana; Clarke, Christina A.; Copeland, Glenn; Finch, Jack L.; Fleissner, Mary Lou; Goodman, Marc T.; Kahn, Amy; Koch, Lori; Lynch, Charles F.; Madeleine, Margaret M.; Pawlish, Karen; Rao, Chandrika; Williams, Melanie A.; Castenson, David; Curry, Michael; Parsons, Ruth; Fant, Gregory; Lin, Monica

2012-01-01

Context Solid organ transplant recipients have elevated cancer risk due to immunosuppression and oncogenic viral infections. Since most prior research has concerned kidney recipients, large studies that include recipients of differing organs can inform cancer etiology. Objective Describe the overall pattern of cancer among solid organ transplant recipients. Design Cohort study using linked data from the U.S. Scientific Registry of Transplant Recipients (1987–2008) and 13 state/regional cancer registries. Participants and Setting Solid organ transplant recipients in the U.S. Main Outcome Measure Standardized incidence ratios (SIRs) and excess absolute risks (EARs) assessing relative and absolute cancer risk in transplant recipients compared to the general population. Results Registry linkages yielded data on 175,732 solid organ transplants (58.4% kidney, 21.6% liver, 10.0% heart, 4.0% lung). Overall cancer risk was elevated (N=10,656 cases, incidence 1374.7 per 100,000 person-years; SIR 2.10, 95%CI 2.06–2.14; EAR 719.3, 95%CI 693.3–745.6, per 100,000 person-years). Risk was increased (p<0.001) for 32 different malignancies, some related to known infections (e.g., anal cancer, Kaposi sarcoma) and others unrelated (e.g., melanoma, thyroid and lip cancers). The most common malignancies with elevated risk were non-Hodgkin lymphoma (N=1504, incidence 194.0; SIR 7.54, 95%CI 7.17–7.93; EAR 168.3, 95%CI 158.6–178.4) and cancers of the lung (N=1344, incidence 173.4; SIR 1.97, 95%CI 1.86–2.08; EAR 85.3, 95%CI 76.2–94.8), liver (N=930, incidence 120.0; SIR 11.56, 95%CI 10.83–12.33; EAR 109.6, 95%CI 102.0–117.6), and kidney (N=752, incidence 97.0; SIR 4.65, 95%CI 4.32–4.99; EAR 76.1, 95%CI 69.3–83.3). Lung cancer risk was most elevated in lung recipients (SIR 6.13, 95%CI 5.18–7.21) but also increased among other recipients (SIR 1.46, 95%CI 1.34–1.59 for kidney; 1.95, 1.74–2.19 for liver; 2.67, 2.40–2.95 for heart). Liver cancer was elevated only among liver recipients (SIR 43.83, 95%CI 40.90–46.91), who manifested exceptional risk in the first 6 months (SIR 508.97, 95%CI 474.16–545.66) and continuing two-fold excess for 10–15 years (SIR 2.22, 95%CI 1.57–3.04). Among kidney recipients, kidney cancer was elevated (SIR 6.66, 95%CI 6.12–7.23) and bimodal in onset. Kidney cancer was also increased in liver and heart recipients (SIR 1.80, 95%CI 1.40–2.29, and 2.90, 2.32–3.59, respectively). Conclusions Recipients of a kidney, liver, heart, or lung transplant have an increased risk for diverse infection-related and unrelated cancers, compared with the general population. PMID:22045767

Estimating Dynamical Systems: Derivative Estimation Hints from Sir Ronald A. Fisher

ERIC Educational Resources Information Center

Deboeck, Pascal R.

2010-01-01

The fitting of dynamical systems to psychological data offers the promise of addressing new and innovative questions about how people change over time. One method of fitting dynamical systems is to estimate the derivatives of a time series and then examine the relationships between derivatives using a differential equation model. One common…

Shuttle Imaging Radar-A (SIR-A) experiment

NASA Technical Reports Server (NTRS)

Elachi, C. (Editor); Cimino, J. B. (Editor)

1982-01-01

The SIR-A experiment was conducted in order to acquire radar data over a variety of regions to further understanding of the radar signatures of various geologic features. The capability of the Shuttle as a scientific platform for observation of the Earth's resources was assessed. The SIR-A sensor operated nominally and the full data acquisition capacity of the optical recorder was used.

SIR-B measurements and modeling of vegetation

NASA Technical Reports Server (NTRS)

Ulaby, Fawwaz T.; Dobson, M. Craig

1986-01-01

A summary is presented of the results derived from analysis of six SIR-B data takes over an agricultural test site in west central Illinois. The first part describes the procedure used to calibrate the SIR-B imagery, the second part pertains to the observed radar response to soil moisture content, and the last part examines the information derivable from multiangle observations.

Dynamic re-weighted total variation technique and statistic Iterative reconstruction method for x-ray CT metal artifact reduction

NASA Astrophysics Data System (ADS)

Peng, Chengtao; Qiu, Bensheng; Zhang, Cheng; Ma, Changyu; Yuan, Gang; Li, Ming

2017-07-01

Over the years, the X-ray computed tomography (CT) has been successfully used in clinical diagnosis. However, when the body of the patient to be examined contains metal objects, the image reconstructed would be polluted by severe metal artifacts, which affect the doctor's diagnosis of disease. In this work, we proposed a dynamic re-weighted total variation (DRWTV) technique combined with the statistic iterative reconstruction (SIR) method to reduce the artifacts. The DRWTV method is based on the total variation (TV) and re-weighted total variation (RWTV) techniques, but it provides a sparser representation than TV and protects the tissue details better than RWTV. Besides, the DRWTV can suppress the artifacts and noise, and the SIR convergence speed is also accelerated. The performance of the algorithm is tested on both simulated phantom dataset and clinical dataset, which are the teeth phantom with two metal implants and the skull with three metal implants, respectively. The proposed algorithm (SIR-DRWTV) is compared with two traditional iterative algorithms, which are SIR and SIR constrained by RWTV regulation (SIR-RWTV). The results show that the proposed algorithm has the best performance in reducing metal artifacts and protecting tissue details.

Molecular Links between Caloric Restriction and Sir2/SIRT1 Activation

PubMed Central

2014-01-01

Ageing is the most significant risk factor for a range of prevalent diseases, including cancer, cardiovascular disease, and diabetes. Accordingly, interventions are needed for delaying or preventing disorders associated with the ageing process, i.e., promotion of healthy ageing. Calorie restriction is the only nongenetic and the most robust approach to slow the process of ageing in evolutionarily divergent species, ranging from yeasts, worms, and flies to mammals. Although it has been known for more than 80 years that calorie restriction increases lifespan, a mechanistic understanding of this phenomenon remains elusive. Yeast silent information regulator 2 (Sir2), the founding member of the sirtuin family of protein deacetylases, and its mammalian homologue Sir2-like protein 1 (SIRT1), have been suggested to promote survival and longevity of organisms. SIRT1 exerts protective effects against a number of age-associated disorders. Caloric restriction increases both Sir2 and SIRT1 activity. This review focuses on the mechanistic insights between caloric restriction and Sir2/SIRT1 activation. A number of molecular links, including nicotinamide adenine dinucleotide, nicotinamide, biotin, and related metabolites, are suggested to be the most important conduits mediating caloric restriction-induced Sir2/SIRT1 activation and lifespan extension. PMID:25349818

The Nuts and Bolts of Transcriptionally Silent Chromatin in Saccharomyces cerevisiae

PubMed Central

Gartenberg, Marc R.; Smith, Jeffrey S.

2016-01-01

Transcriptional silencing in Saccharomyces cerevisiae occurs at several genomic sites including the silent mating-type loci, telomeres, and the ribosomal DNA (rDNA) tandem array. Epigenetic silencing at each of these domains is characterized by the absence of nearly all histone modifications, including most prominently the lack of histone H4 lysine 16 acetylation. In all cases, silencing requires Sir2, a highly-conserved NAD+-dependent histone deacetylase. At locations other than the rDNA, silencing also requires additional Sir proteins, Sir1, Sir3, and Sir4 that together form a repressive heterochromatin-like structure termed silent chromatin. The mechanisms of silent chromatin establishment, maintenance, and inheritance have been investigated extensively over the last 25 years, and these studies have revealed numerous paradigms for transcriptional repression, chromatin organization, and epigenetic gene regulation. Studies of Sir2-dependent silencing at the rDNA have also contributed to understanding the mechanisms for maintaining the stability of repetitive DNA and regulating replicative cell aging. The goal of this comprehensive review is to distill a wide array of biochemical, molecular genetic, cell biological, and genomics studies down to the “nuts and bolts” of silent chromatin and the processes that yield transcriptional silencing. PMID:27516616

[Malignant tumor incidence in employees of the Alytus textile factory (1978-1997)].

PubMed

Kuzmickiene, Irena; Stukonis, Mecys; Didziapetris, Remigijus

2002-01-01

The purpose of this study was to evaluate cancer incidence in the large cotton-manufacturing factory in Lithuania. Altogether 10,198 workers employed at least 1 year in 1969-1997 were included in the cohort and followed during the period 1978/01/01-1997/12/31. National cancer rates were used to calculate the expected number of cancer cases. The overall cancer risk for men was slightly higher than that in the general population (standardized incidence rate (SIR) 1.15, 95% confidence interval (95% CI) 0.98-1.34). A significant increase in the incidence of esophagus (11 observed cases, SIR 3.76, 95% CI 1.88-6.67) and slightly increased of lung (42 observed cases, SIR 1.26, 95% CI 0.91-1.70) cancer became evident. None of the cancer risk showed statistically significant excess cancer incidence in the textile-processing (spinning and weaving) departments (SIR 0.98). In the women cohort the level of the general incidence was very close to expected, standardized incidence rates (SIR) being 0.99 (95% CI 0.88-1.13). However, there was a significant increase in the number of cases of gall bladder (6 observed, SIR 3.19, 95% CI 1.17-6.95). The analysis of the results among textile-processing (spinning and weaving departments) workers indicated the elevated risk of breast cancer (44 observed cases, SIR 1.49, 95% CI 1.08-2.0) and cervical cancer (24 observed cases, SIR 1.68, 95% CI 1.08-2.50). The number of lung cancer cases in this group was a higher, but statistically not significant (5 observed cases, SIR 1.53, 95% CI 0.5-3.58). Increased SIR values were observed for > or = 10 years since the first exposure for all cancers, cervix uteri, ovary and kidney. The overall cancer risk for men cohort was slightly higher than that in the general population. There was a significant increase in the number of cancer of the esophagus. The overall excess risk in women cohort was only for gall bladder, but for spinners and weavers the elevated risk was for cervix uteri and breast cancer. After 10 years of employment the excess risk was already for all cancers, cervix uteri, ovary and kidney malignant tumors.

Low concentration of uncouplers of oxidative phosphorylation decreases the TNF-induced endothelial permeability and lethality in mice.

PubMed

Zakharova, Vlada V; Pletjushkina, Olga Yu; Galkin, Ivan I; Zinovkin, Roman A; Chernyak, Boris V; Krysko, Dmitri V; Bachert, Claus; Krysko, Olga; Skulachev, Vladimir P; Popova, Ekaterina N

2017-04-01

Mitochondrial dysfunctions occur in many diseases linked to the systemic inflammatory response syndrome (SIRS). Mild uncoupling of oxidative phosphorylation is known to rescue model animals from pathologies related to mitochondrial dysfunctions and overproduction of reactive oxygen species (ROS). To study the potential of SIRS therapy by uncoupling, we tested protonophore dinitrophenol (DNP) and a free fatty acid (FFA) anion carrier, lipophilic cation dodecyltriphenylphosphonium (C 12 TPP) in mice and in vitro models of SIRS. DNP and C 12 TPP prevented the body temperature drop and lethality in mice injected with high doses of a SIRS inducer, tumor necrosis factor (TNF). The mitochondria-targeted antioxidant plastoquinonyl decyltriphenylphosphonium (SkQ1) which also catalyzes FFA-dependent uncoupling revealed similar protective effects and downregulated expression of the NFκB-regulated genes (VCAM1, ICAM1, MCP1, and IL-6) involved in the inflammatory response of endothelium in aortas of the TNF-treated mice. In vitro mild uncoupling rescued from TNF-induced endothelial permeability, disassembly of cell contacts and VE-cadherin cleavage by the matrix metalloprotease 9 (ММР9). The uncouplers prevented TNF-induced expression of MMP9 via inhibition of NFκB signaling. Water-soluble antioxidant Trolox also prevented TNF-induced activation and permeability of endothelium in vitro via inhibition of NFκB signaling, suggesting that the protective action of the uncouplers is linked to their antioxidant potential. Copyright © 2017 Elsevier B.V. All rights reserved.

Knock-out of a mitochondrial sirtuin protects neurons from degeneration in Caenorhabditis elegans

PubMed Central

Sangaletti, Rachele; Grant, Jeff; Della-Morte, David

2017-01-01

Sirtuins are NAD⁺-dependent deacetylases, lipoamidases, and ADP-ribosyltransferases that link cellular metabolism to multiple intracellular pathways that influence processes as diverse as cell survival, longevity, and cancer growth. Sirtuins influence the extent of neuronal death in stroke. However, different sirtuins appear to have opposite roles in neuronal protection. In Caenorhabditis elegans, we found that knock-out of mitochondrial sirtuin sir-2.3, homologous to mammalian SIRT4, is protective in both chemical ischemia and hyperactive channel induced necrosis. Furthermore, the protective effect of sir-2.3 knock-out is enhanced by block of glycolysis and eliminated by a null mutation in daf-16/FOXO transcription factor, supporting the involvement of the insulin/IGF pathway. However, data in Caenorhabditis elegans cell culture suggest that the effects of sir-2.3 knock-out act downstream of the DAF-2/IGF-1 receptor. Analysis of ROS in sir-2.3 knock-out reveals that ROS become elevated in this mutant under ischemic conditions in dietary deprivation (DD), but to a lesser extent than in wild type, suggesting more robust activation of a ROS scavenging system in this mutant in the absence of food. This work suggests a deleterious role of SIRT4 during ischemic processes in mammals that must be further investigated and reveals a novel pathway that can be targeted for the design of therapies aimed at protecting neurons from death in ischemic conditions. PMID:28820880

Exogenous nitric oxide can control SIRS and downregulate NFkappaB.

PubMed

Lozano, Francisco S; Barros, Marcello B; García-Criado, Francisco J; Gomez-Alonso, Alberto

2005-03-01

Nitric oxide (NO) participates in inflammation and affects almost all steps of its development. Several experimental studies have unveiled the beneficial effects of NO through modulation of the Systemic Inflammatory Response Syndrome (SIRS). In this sense, in the present work we attempted to evaluate the beneficial effects of exogenous NO and its levels of action (biochemical and cellular) in a model of SIRS induced by two sequential insults. Dacron graft implantation (first insult) and subsequent administration of Zymosan A (second insult) in Wistar rats. The animals were divided into four groups: 1) No manipulation (Basal); 2) Laparotomy (L) + mineral oil (Sham); 3) L + Graft-Zymosan (GZ) (Control); and 4) L + GZ + NO (Assay). Determinations: Survival, TNF-alpha, SOA, ICAM-1, and NFkappaB. The model established (Control) induced a mortality rate of 20%. Also, it significantly increased the levels of TNF-alpha (P <0.001) and SOA (P <0.01), ICAM-1 expression, and NFkappaB levels (P <0.05). Treatment with NO reduced mortality to 0%, significantly decreasing TNF-alpha (P <0.001) and SOA (P <0.01) levels, ICAM-1 expression, and NFkappaB levels (P <0.05). The exogenous administration of NO before the two sequential insults controlled SIRS at biochemical level (TNF-alpha, SOA) and at cellular level (transcription) in a lasting manner. The cascade-like interrelationship of both levels and the study design do not allow us the pinpoint the key to its modulation.

Effect of Temperature to Adsorption Capacity and Coefficient Distribution on Rare Earth Elements Adsorption (Y, Gd, Dy) Using SIR

NASA Astrophysics Data System (ADS)

Aziz, N.; Mindaryani, A.; Supranto; Taftazani, A.; Biyantoro, D.

2018-04-01

The use of REE like element of Yttrium (Y) as a superconducting material requires a purity of more than 90%, so it needs to increase the purity of Y from the settling process. The purpose of this research is to study the separation process of REE that is Y, Gd, Dy elements from REE hydroxide (REE(OH)3) using SIR method are consisting of Amberlite XAD-16 resin impregnated with Di-(2-ethylhexyl) phosphate ( D2EHPA) and Tributyl Phosphate (TBP) and determine the isotherm model on REE adsorption and determine the kinetic model of pseudo adsorption reaction. This research was started by activating XAD-16 resin and is mixed with TBP-D2EHPA solvents so it will form SIR, then it is conducted on variation of SIR composition, temperature variation of adsorption process, determination of equilibrium equation and kinetic sorption occurring in SIR adsorption based on experimental data of liquid concentration as function of time. Based on the calculation result, the most effective SIR composition for REE separation is 0.75 g, the equilibrium equation for Y, Gd and Dy follows the Henry equilibrium model and the pseudo kinetic model of the reaction order Y, Gd, and Dy is followed by the pseudo reaction of order 2 The result of separation of LTJ with SIR is said to be effective from another method because purity is obtained that is 96.73% and qualify as a super conductor material.

The tumor suppressor SirT2 regulates cell cycle progression and genome stability by modulating the mitotic deposition of H4K20 methylation

PubMed Central

Serrano, Lourdes; Martínez-Redondo, Paloma; Marazuela-Duque, Anna; Vazquez, Berta N.; Dooley, Scott J.; Voigt, Philipp; Beck, David B.; Kane-Goldsmith, Noriko; Tong, Qiang; Rabanal, Rosa M.; Fondevila, Dolors; Muñoz, Purificación; Krüger, Marcus; Tischfield, Jay A.; Vaquero, Alejandro

2013-01-01

The establishment of the epigenetic mark H4K20me1 (monomethylation of H4K20) by PR-Set7 during G2/M directly impacts S-phase progression and genome stability. However, the mechanisms involved in the regulation of this event are not well understood. Here we show that SirT2 regulates H4K20me1 deposition through the deacetylation of H4K16Ac (acetylation of H4K16) and determines the levels of H4K20me2/3 throughout the cell cycle. SirT2 binds and deacetylates PR-Set7 at K90, modulating its chromatin localization. Consistently, SirT2 depletion significantly reduces PR-Set7 chromatin levels, alters the size and number of PR-Set7 foci, and decreases the overall mitotic deposition of H4K20me1. Upon stress, the interaction between SirT2 and PR-Set7 increases along with the H4K20me1 levels, suggesting a novel mitotic checkpoint mechanism. SirT2 loss in mice induces significant defects associated with defective H4K20me1–3 levels. Accordingly, SirT2-deficient animals exhibit genomic instability and chromosomal aberrations and are prone to tumorigenesis. Our studies suggest that the dynamic cross-talk between the environment and the genome during mitosis determines the fate of the subsequent cell cycle. PMID:23468428

Potential risk factors for haematological cancers in semiconductor workers.

PubMed

Lee, K; Kim, S-G; Kim, D

2015-10-01

There has recently been increased interest in cancer incidence in electronics workers. To determine the cancer incidence ratio in electronics workers and the potential factors affecting the risk for development of cancer. Epidemiological study performed in electronics workers who were employed between 1999 and 2008 in South Korea. Cancer incidence ratio was analysed with respect to departments, divisions, job titles, gender, age, hepatitis B and C virus infection and work duration. We compared the incidence of haematological cancer in this cohort with that expected in the general population. The study population was 56283. Overall, the standardized incidence ratio (SIR) for haematological cancer was 0.85. In particular, the SIR for leukaemia was 0.86 and for non-Hodgkin lymphoma (NHL) was 0.93, which were not statistically significant. The SIR for NHL was significantly increased [SIR 5.23, 95% confidence interval (CI) 1.31-20.95] in female office workers. We also found that the SIR for NHL was significantly increased in female workers who tested positive for hepatitis virus infection (SIR 7.69, 95% CI 1.08-54.60). The raised SIR for NHL among female workers was due to potential risk factors such as hepatitis virus infection although additional research and an ongoing, long-term, prospective epidemiological cohort study is needed. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Three-Dimensional Static Articulation Accuracy of Virtual Models-Part II: Effect of Model Scanner-CAD Systems and Articulation Method.

PubMed

Yee, Sophia Hui Xin; Esguerra, Roxanna Jean; Chew, Amelia Anya Qin'An; Wong, Keng Mun; Tan, Keson Beng Choon

2018-02-01

Accurate maxillomandibular relationship transfer is important for CAD/CAM prostheses. This study compared the 3D-accuracy of virtual model static articulation in three laboratory scanner-CAD systems (Ceramill Map400 [AG], inEos X5 [SIR], Scanner S600 Arti [ZKN]) using two virtual articulation methods: mounted models (MO), interocclusal record (IR). The master model simulated a single crown opposing a 3-unit fixed partial denture. Reference values were obtained by measuring interarch and interocclusal reference features with a coordinate measuring machine (CMM). MO group stone casts were articulator-mounted with acrylic resin bite registrations while IR group casts were hand-articulated with poly(vinyl siloxane) bite registrations. Five test model sets were scanned and articulated virtually with each system (6 test groups, 15 data sets). STL files of the virtual models were measured with CMM software. dR R , dR C , and dR L , represented interarch global distortions at right, central, and left sides, respectively, while dR M , dX M , dY M , and dZ M represented interocclusal global and linear distortions between preparations. Mean interarch 3D distortion ranged from -348.7 to 192.2 μm for dR R , -86.3 to 44.1 μm for dR C , and -168.1 to 4.4 μm for dR L . Mean interocclusal distortion ranged from -257.2 to -85.2 μm for dR M , -285.7 to 183.9 μm for dX M , -100.5 to 114.8 μm for dY M , and -269.1 to -50.6 μm for dZ M . ANOVA showed that articulation method had significant effect on dR R and dX M , while system had a significant effect on dR R , dR C , dR L , dR M , and dZ M . There were significant differences between 6 test groups for dR R, dR L dX M , and dZ M . dR R and dX M were significantly greater in AG-IR, and this was significantly different from SIR-IR, ZKN-IR, and all MO groups. Interarch and interocclusal distances increased in MO groups, while they decreased in IR groups. AG-IR had the greatest interarch distortion as well as interocclusal superior-inferior distortion. The other groups performed similarly to each other, and the overall interarch distortion did not exceed 0.7%. In these systems and articulation methods, interocclusal distortions may result in hyper- or infra-occluded prostheses. © 2017 by the American College of Prosthodontists.

Supplemental Information for New York State Standardized Interconnection Requirements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ingram, Michael; Narang, David J.; Mather, Barry A.

This document is intended to aid in the understanding and application of the New York State Standardized Interconnection Requirements (SIR) and Application Process for New Distributed Generators 5 MW or Less Connected in Parallel with Utility Distribution Systems, and it aims to provide supplemental information and discussion on selected topics relevant to the SIR. This guide focuses on technical issues that have to date resulted in the majority of utility findings within the context of interconnecting photovoltaic (PV) inverters. This guide provides background on the overall issue and related mitigation measures for selected topics, including substation backfeeding, anti-islanding and considerationsmore » for monitoring and controlling distributed energy resources (DER).« less

Multigroup SIR epidemic model with stochastic perturbation

NASA Astrophysics Data System (ADS)

Ji, Chunyan; Jiang, Daqing; Shi, Ningzhong

2011-05-01

In this paper, we discuss a multigroup SIR model with stochastic perturbation. We deduce the globally asymptotic stability of the disease-free equilibrium when R0≤1, which means the disease will die out. On the other hand, when R0>1, we derive the disease will prevail, which is measured through the difference between the solution and the endemic equilibrium of the deterministic model in time average. Furthermore, we prove the system is persistent in the mean which also reflects the disease will prevail. The key to our analysis is choosing appropriate Lyapunov functions. Finally, we illustrate the dynamic behavior of the model with n=2 and their approximations via a range of numerical experiments.

Computational Studies on Sirtuins from Trypanosoma cruzi: Structures, Conformations and Interactions with Phytochemicals

PubMed Central

Sacconnay, Lionel; Angleviel, Melissa; Randazzo, Giuseppe Marco; Marçal Ferreira Queiroz, Marcos; Ferreira Queiroz, Emerson; Wolfender, Jean-Luc; Carrupt, Pierre-Alain; Nurisso, Alessandra

2014-01-01

Background The silent-information regulator 2 proteins, otherwise called sirtuins, are currently considered as emerging anti-parasitic targets. Nicotinamide, a pan-sirtuin inhibitor, is known to cause kinetoplast alterations and the arrested growth of T. cruzi, the protozoan responsible for Chagas disease. These observations suggested that sirtuins from this parasite (TcSir2rp1 and TcSir2rp3) could play an important role in the regulation of the parasitic cell cycle. Thus, their inhibition could be exploited for the development of novel anti-trypanosomal compounds. Methods Homology modeling was used to determine the three-dimensional features of the sirtuin TcSir2rp1 from T. cruzi. The apo-form of human SIRT2 and the same structure solved in complex with its co-substrate NAD+ allowed the modeling of TcSir2rp1 in the open and closed conformational states. Molecular docking studies were then carried out. A library composed of fifty natural and diverse compounds that are known to be active against this parasite, was established based on the literature and virtually screened against TcSir2rp1 and TcSir2rp3, which was previously modeled by our group. Results In this study, two conformational states of TcSir2rp1 were described for the first time. The molecular docking results of compounds capable of binding sirtuins proved to be meaningful when the closed conformation of the protein was taken into account for calculations. This specific conformation was then used for the virtual screening of antritrypanosomal phytochemicals against TcSir2rp1 and TcSir2rp3. The calculations identified a limited number of scaffolds extracted from Vismia orientalis, Cussonia zimmermannii, Amomum aculeatum and Anacardium occidentale that potentially interact with both proteins. Conclusions The study provided reliable models for future structure-based drug design projects concerning sirtuins from T. cruzi. Molecular docking studies highlighted not only the advantages of performing in silico interaction studies on their closed conformations but they also suggested the potential mechanism of action of four phytochemicals known for their anti-trypanosomal activity in vitro. PMID:24551254

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

PubMed

Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers.

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control

PubMed Central

Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

Background The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. Patients and Methods 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Results Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33–3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Conclusions Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers. PMID:27398803

Clinical diagnosis of sepsis and the combined use of biomarkers and culture- and non-culture-based assays.

PubMed

Bloos, Frank

2015-01-01

Sepsis is among the most common causes of death in hospitalized patients, and early recognition followed by immediate initiation of therapy is an important concept to improve survival in these patients. According to the definition of sepsis, diagnosis of sepsis requires the recognition of the systemic inflammatory response syndrome (SIRS) caused by infection as well as recognition of possible infection-related organ dysfunctions for diagnosis of severe sepsis or septic shock. Both SIRS and organ dysfunctions may occur frequently in hospitalized patients for various reasons. However, the fast recognition of acute infection as a cause of SIRS and newly developed organ dysfunction may be a demanding task since culture-based results of microbiological samples will be available only days after onset of symptoms. Biomarkers and PCR-based pathogen detection may help the physician in differentiating SIRS from sepsis. Procalcitonin (PCT) is the best investigated biomarker for this purpose. Furthermore, the current data support the usage of PCT for guidance of antimicrobial therapy. C-reactive protein (CRP) may be used to monitor the course of infection but has only limited discriminative capabilities. Interleukin-6 is widely used for its fast response to the infectious stimulus, but conclusive data for the application of this biomarker are missing. None of the available biomarkers can by itself reliably differentiate SIRS from sepsis but can aid and shorten the decision process. PCR-based pathogen detection can theoretically shorten the recognition of the underlying pathogen to about 8 h. However, this technique is expensive and requires additional staff in the laboratory; controlled prospective studies are missing. Although current studies suggest that PCR-based pathogen detection may be useful to shorten time to adequate antimicrobial therapy and diagnose invasive Candida infections, no general recommendations about the application of PCR for the diagnosis of sepsis can be given.

The relationship between right-sided tumour location, tumour microenvironment, systemic inflammation, adjuvant therapy and survival in patients undergoing surgery for colon and rectal cancer.

PubMed

Patel, Meera; McSorley, Stephen T; Park, James H; Roxburgh, Campbell S D; Edwards, Joann; Horgan, Paul G; McMillan, Donald C

2018-03-06

There has been an increasing interest in the role of tumour location in the treatment and prognosis of patients with colorectal cancer (CRC), specifically in the adjuvant setting. Together with genomic data, this has led to the proposal that right-sided and left-sided tumours should be considered as distinct biological and clinical entities. The aim of the present study was to examine the relationship between tumour location, tumour microenvironment, systemic inflammatory response (SIR), adjuvant chemotherapy and survival in patients undergoing potentially curative surgery for stage I-III colon and rectal cancer. Clinicopathological characteristics were extracted from a prospective database. MMR and BRAF status was determined using immunohistochemistry. The tumour microenvironment was assessed using routine H&E pathological sections. SIR was assessed using modified Glasgow Prognostic Score (mGPS), neutrophil:lymphocyte ratio (NLR), neutrophil:platelet score (NPS) and lymphocyte:monocyte ratio (LMR). Overall, 972 patients were included. The majority were over 65 years (68%), male (55%), TNM stage II/III (82%). In all, 40% of patients had right-sided tumours and 31% had rectal cancers. Right-sided tumour location was associated with older age (P=0.001), deficient MMR (P=0.005), higher T stage (P<0.001), poor tumour differentiation (P<0.001), venous invasion (P=0.021), and high CD3 + within cancer cell nests (P=0.048). Right-sided location was consistently associated with a high SIR, mGPS (P<0.001) and NPS (P<0.001). There was no relationship between tumour location, adjuvant chemotherapy (P=0.632) or cancer-specific survival (CSS; P=0.377). In those 275 patients who received adjuvant chemotherapy, right-sided location was not associated with the MMR status (P=0.509) but was associated with higher T stage (P=0.001), venous invasion (P=0.036), CD3 + at the invasive margin (P=0.033) and CD3 + within cancer nests (P=0.012). There was no relationship between tumour location, SIR or CSS in the adjuvant group. Right-sided tumour location was associated with an elevated tumour lymphocytic infiltrate and an elevated SIR. There was no association between tumour location and survival in the non-adjuvant or adjuvant setting in patients undergoing potentially curative surgery for stage I-III colon and rectal cancer.

Assessment of Required Accuracy of Digital Elevation Data for Hydrologic Modeling

NASA Technical Reports Server (NTRS)

Kenward, T.; Lettenmaier, D. P.

1997-01-01

The effect of vertical accuracy of Digital Elevation Models (DEMs) on hydrologic models is evaluated by comparing three DEMs and resulting hydrologic model predictions applied to a 7.2 sq km USDA - ARS watershed at Mahantango Creek, PA. The high resolution (5 m) DEM was resempled to a 30 m resolution using method that constrained the spatial structure of the elevations to be comparable with the USGS and SIR-C DEMs. This resulting 30 m DEM was used as the reference product for subsequent comparisons. Spatial fields of directly derived quantities, such as elevation differences, slope, and contributing area, were compared to the reference product, as were hydrologic model output fields derived using each of the three DEMs at the common 30 m spatial resolution.

Flat epithelial atypia and risk of breast cancer: A Mayo cohort study.

PubMed

Said, Samar M; Visscher, Daniel W; Nassar, Aziza; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene H; Ghosh, Karthik; Radisky, Derek C; Hartmann, Lynn C; Degnim, Amy C

2015-05-15

Based on its cytologic features, and its co-occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an "atypical" or high-risk lesion. However, to the authors' knowledge, the long-term risk of breast cancer in women with FEA is undefined. Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry. FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow-up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17-6.81) versus 4.23 (95% CI, 3.44-5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23-3.19) versus 1.90 (95% CI, 1.72-2.09) for patients with PDWA without FEA (P = .76). FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH. © 2015 American Cancer Society.

Does the Breast Cancer Age at Diagnosis Differ by Ethnicity? A Study on Immigrants to Sweden

PubMed Central

Hemminki, Kari; Sundquist, Jan; Brandt, Andreas

2011-01-01

Background. Age-specific incidence rates for breast cancer in low-risk and high-risk ethnic populations differ by age at which the incidence maximum is reached: around 50 years in low-risk populations and over 60 years in high-risk populations. The interpretation of these differences remains unsettled, one line primarily referring to biological differences, the second one to cohort effects of rapidly increasing rates in young populations, and the third one to incomplete registration of cancer in the elderly. Methods. The nationwide Family-Cancer Database was used to analyze standardized incidence ratios (SIRs) and age at diagnosis of breast cancer in female immigrants to Sweden by their region of origin compared with women native to Sweden matched on birth year and other relevant factors. Results. We showed first that the SIRs for breast cancer were lower in many immigrant groups compared with natives of Sweden; women from Turkey had the lowest SIR of 0.45, followed by those from Chile (0.54) and Southeast Asia (0.57). Women from nine regions showed an earlier mean age at diagnosis than their matched Swedish controls, the largest differences being 5.5 years for women from Turkey, 5.1 years for those from Asian Arab and “Other African” countries, 4.3 years for those from Iran, and 4.0 years for those from Iraq. Conclusions. The results show that in many immigrant groups, the diagnostic age is earlier (<50 years) than in natives of Sweden (>50 years), suggesting that true biological factors underlie the differences. These factors may explain much of the international variation in breast cancer incidence. Identifying these factors should advance understanding of breast cancer etiology and prevention. PMID:21266400

Does the breast cancer age at diagnosis differ by ethnicity? A study on immigrants to Sweden.

PubMed

Hemminki, Kari; Mousavi, Seyed Mohsen; Sundquist, Jan; Brandt, Andreas

2011-01-01

Age-specific incidence rates for breast cancer in low-risk and high-risk ethnic populations differ by age at which the incidence maximum is reached: around 50 years in low-risk populations and over 60 years in high-risk populations. The interpretation of these differences remains unsettled, one line primarily referring to biological differences, the second one to cohort effects of rapidly increasing rates in young populations, and the third one to incomplete registration of cancer in the elderly. The nationwide Family-Cancer Database was used to analyze standardized incidence ratios (SIRs) and age at diagnosis of breast cancer in female immigrants to Sweden by their region of origin compared with women native to Sweden matched on birth year and other relevant factors. We showed first that the SIRs for breast cancer were lower in many immigrant groups compared with natives of Sweden; women from Turkey had the lowest SIR of 0.45, followed by those from Chile (0.54) and Southeast Asia (0.57). Women from nine regions showed an earlier mean age at diagnosis than their matched Swedish controls, the largest differences being 5.5 years for women from Turkey, 5.1 years for those from Asian Arab and "Other African" countries, 4.3 years for those from Iran, and 4.0 years for those from Iraq. The results show that in many immigrant groups, the diagnostic age is earlier (<50 years) than in natives of Sweden (>50 years), suggesting that true biological factors underlie the differences. These factors may explain much of the international variation in breast cancer incidence. Identifying these factors should advance understanding of breast cancer etiology and prevention.

Sentinel node biopsy performance after neoadjuvant chemotherapy in locally advanced breast cancer: A systematic review and meta-analysis.

PubMed

Mocellin, Simone; Goldin, Elena; Marchet, Alberto; Nitti, Donato

2016-01-15

The use of sentinel node biopsy (SNB) after neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer is debated. Our aim was to quantitatively review the available evidence on the performance of SNB after NAC in patients with locally advanced breast cancer. We performed a systematic review (by searching the PubMed, Cochrane and Scopus databases) and random effects meta-analysis to investigate on the feasibility and accuracy of SNB in these patients. The two outcomes of interest were the sentinel node identification rate (SIR) and the false negative rate (FNR). Sensitivity analysis and meta-regression were used to investigate the potential sources of between-study heterogeneity. We retrieved 72 eligible studies enrolling 7,451 patients. Upon meta-analysis, summary SIR resulted 89.6% [95% confidence interval (CI): 87.8-91.2; heterogeneity I(2): 76.9%], which poorly compares with the 95% SIR observed in some recent series of early breast cancer. The summary FNR resulted 14.2% (CI: 12.5-16.0; heterogeneity I(2): 29.1%), which was significantly higher than the 8-10% reference value. Considering an average post-NAC lymph node positivity rate of 50%, the downstaging due to false negative SNB would occur in 7/100 patients (with an excess error rate of 2-3/100 as compared to the early-stage setting). No plausible source of between-study heterogeneity was found. Based on the largest series of studies ever meta-analyzed, our findings highlight the limits of SNB performance in this population, where the impact of SNB on patient survival is still to be defined. © 2015 UICC.

Systemic inflammatory response syndromes in the era of interventional cardiology.

PubMed

Gorla, Riccardo; Erbel, Raimund; Eagle, Kim A; Bossone, Eduardo

2018-04-12

Systemic inflammatory response syndrome (SIRS), initially reported after cardiovascular surgery, has been described after various interventional cardiology procedures, including endovascular/thoracic aortic repair (EVAR/TEVAR), implantation of heart rhythm devices, percutaneous coronary intervention (PCI), electrophysiology procedures (EP), and transcatheter aortic valve implantation (TAVI). In these settings, a comprehensive understanding of the triggers, pathogenesis as well as a common diagnostic/therapeutic algorithm is lacking and will be discussed in this review. SIRS occurs in about 40% and 50% of patients undergoing TEVAR/EVAR and TAVI respectively; it affects 0.1% of patients undergoing implantation of heart rhythm devices. Prevalence is unknown after PCI or EP. Clinical presentation includes fever, dyspnoea/tachypnoea, tachycardia, weakness, chest pain and pericardial/pleural effusion. Several triggers can be identified, related to implanted devices, biomaterial, and procedural aspects (prolonged hypotension, aneurysm thrombus manipulation, active fixation atrial leads, coronary microembolization, balloon dilatation/stent implantantation, contrast medium, coronary/myocardial microperforation). Nonetheless, these triggers share three main pathogenic pathways leading to SIRS clinical manifestations: leucocytes activation, endothelial injury/activation, and myocardial/pericardial injury. Therapy consists of non-steroidal agents, with corticosteroids as second-line treatment in non-responders. Although a benign evolution is reported after implantation of heart rhythm devices, PCI and EP, major adverse events may occur after EVAR/TEVAR and TAVI at short- and mid-term follow up. Copyright © 2018 Elsevier Inc. All rights reserved.

Neutrophil CD64 expression, procalcitonin and presepsin are useful to differentiate infections from flares in SLE patients with SIRS.

PubMed

Echeverri, A; Naranjo-Escobar, J; Posso-Osorio, I; Aguirre-Valencia, D; Zambrano, D; Castaño, G L; Martínez, J D; Cañas, C A; Tobón, G J

2018-06-01

Background/Objective Differentiating systemic lupus erythematosus (SLE) activity from infections in febrile patients is difficult because of similar initial clinical presentation. The aim of this study is to evaluate the usefulness of a number of biomarkers for differentiating infections from activity in SLE patients admitted with systemic inflammatory response (SIRS). Methods Patients with SLE and SIRS admitted to the emergency room were included in this study. Measurements of different markers including procalcitonin, neutrophil CD64 expression and presepsin, were performed. Infection was considered present when positive cultures and/or polymerase chain reaction were obtained. Sensitivity and specificity were calculated for all biomarkers. Results Twenty-seven patients were admitted, 23 women (82.5%), mean age 33.2 years. An infectious disease was confirmed in 12 cases. Markers for SLE activity including anti-DNA titers by IIF ( p = 0.041) and enzyme-linked immunosorbent assay ( p = 0.009) were used for differentiating SLE flares from infection. On the contrary, increased procalcitonin ( p = 0.047), neutrophil CD64 expression by flow cytometry ( p = 0.037) and presepsin ( p = 0.037) levels were observed in infected SLE patients. Conclusions High neutrophil CD64 expression, presepsin and procalcitonin levels are useful to differentiate infections from activity in SLE patients. In most cases, a positive bioscore that includes these three markers demonstrate the presence of an infectious disease.

Highlights from the 2014 Schizophrenia International Research Society Conference April 5-9, 2014.

PubMed

Curley, Allison A

2014-07-01

The 2014 Schizophrenia International Research Society (SIRS) Conference, held in Florence, Italy, attracted more than 1,700 attendees from over 55 countries to the stately Firenze Fiera Conference Center from April 5-9, 2014. Providing plenary sessions, special sessions, symposia, workshops, oral presentations and poster presentations, this 4th Biennial SIRS Conference was jointly sponsored by Vanderbilt University School of Medicine, Department of Psychiatry and SIRS. In conjunction with the Schizophrenia Research Forum, a Web project of the Brain and Behavior Research Foundation, and with our thanks to the SIRS organizers and staff, we bring you the following report on the meeting's discussions concerning drug therapy developments for schizophrenia.

Descriptive analysis and comparison of strategic incremental rehearsal to "Business as Usual" sight-word instruction for an adult nonreader with intellectual disability.

PubMed

Richman, David M; Grubb, Laura; Thompson, Samuel

2018-01-01

Strategic Incremental Rehearsal (SIR) is an effective method for teaching sight-word acquisition, but has neither been evaluated for use in adults with an intellectual disability, nor directly compared to the ongoing instruction in the natural environment. Experimental analysis of sight word acquisition via an alternating treatment design was conducted with a 23-year-old woman with Down syndrome. SIR was compared to the current reading instruction (CRI) in a classroom for young adults with intellectual disabilities. CRI procedures included non-contingent praise, receptive touch prompts ("touch the word bat"), echoic prompts ("say bat"), textual prompts ("read the word"), and pre-determined introduction of new words. SIR procedures included textual prompts on flash cards, contingent praise, corrective feedback, and mastery-based introduction of new words. The results indicated that SIR was associated with more rapid acquisition of sight words than CRI. Directions for future research could include systematic comparisons to other procedures, and evaluations of procedural permutations of SIR.

Salivary gland and nasopharyngeal cancers in individuals with acquired immunodeficiency syndrome in United States.

PubMed

Shebl, Fatma M; Bhatia, Kishor; Engels, Eric A

2010-05-15

Individuals with acquired immunodeficiency syndrome (AIDS) manifest an increased risk of cancer, particularly cancers caused by oncogenic viruses. Because some salivary gland and nasopharyngeal cancers are associated with Epstein Barr virus, the impact of AIDS on these cancers needs further evaluation. We used linked U.S. AIDS and cancer registry data (N = 519,934 people with AIDS) to derive standardized incidence ratios (SIRs) comparing risk of salivary gland and nasopharyngeal cancers to the general population. For salivary gland cancers (N = 43 cases), individuals with AIDS had strongly elevated risks for lymphoepithelial carcinoma (SIR 39, 95% CI 16-81) and squamous cell carcinoma (SIR 4.9, 95% CI 2.5-8.6). Among nasopharyngeal cancers (N = 39 cases), risks were elevated for both keratinizing and nonkeratinizing carcinomas (SIR 2.4, 95% CI 1.5-3.7 and SIR 2.4, 95% CI 1.2-4.4, respectively). The elevated risks of salivary gland and nasopharyngeal cancers among people with AIDS suggest that immunosuppression and oncogenic viral infections are etiologically important.

Influences of menstrual cycle position and sex hormone levels on spontaneous intrusive recollections following emotional stimuli.

PubMed

Ferree, Nikole K; Kamat, Rujvi; Cahill, Larry

2011-12-01

Spontaneous intrusive recollections (SIRs) are known to follow emotional events in clinical and non-clinical populations. Previous work in our lab has found that women report more SIRs than men after exposure to emotional films, and that this effect is driven entirely by women in the luteal phase of the menstrual cycle. To replicate and extend this finding, participants viewed emotional films, provided saliva samples for sex hormone concentration analysis, and estimated SIR frequency following film viewing. Women in the luteal phase reported significantly more SIRs than did women in the follicular phase, and SIR frequency significantly correlated with salivary progesterone levels. The results are consistent with an emerging pattern in the literature suggesting that menstrual cycle position of female participants can potently influence findings in numerous cognitive domains. The potential implications of these results for disorders characterized by intrusions, such as post-traumatic stress disorder, are also discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

Revisiting the white blood cell count: immature granulocytes count as a diagnostic marker to discriminate between SIRS and sepsis--a prospective, observational study.

PubMed

Nierhaus, Axel; Klatte, Stefanie; Linssen, Jo; Eismann, Nina M; Wichmann, Dominic; Hedke, Jörg; Braune, Stephan A; Kluge, Stefan

2013-02-12

Sepsis is a serious disease condition and a major cause of intensive care unit (ICU) admission. Its diagnosis in critically ill patients is complicated. To diagnose an infection rapidly, and to accurately differentiate systemic inflammatory response syndrome (SIRS) from sepsis, is challenging yet early diagnosis is vital for early induction of an appropriate therapy. The aim of this study was to evaluate whether the immature granulocyte (IG) count is a useful early diagnostic marker of sepsis compared to other markers. Therefore, a total of 70 consecutive surgical intensive care patients were assessed. IGs were measured from whole blood samples using an automated analyzer. C-reactive protein (CRP), lipopolysaccharide binding protein (LBP) and interleukin-6 (IL-6) concentrations were also determined. The observation period was a maximum of 21 days and ended with the patients' discharge from ICU or death. Receiver operating characteristic (ROC) analyses were conducted and area under the curve (AUC) was calculated to determine sensitivities and specificities for the parameters. We found that the IG count significantly discriminates between infected and non-infected patients (P < 0.0001) with a sensitivity of 89.2% and a specificity of 76.4%, particularly within the first 48 hours after SIRS onset. Regarding the discriminative power for infection, the IG count was more indicative than other clinical parameters such as CRP, LBP and IL-6, which had a sensitivity of less than 68%. Additionally, the highest diagnostic odds ratio (DOR) with 26.7 was calculated for the IG count within the first 48 hours. During the course of the disease ROC curve analyses showed a superior positive predictive value of the IG count compared to the other measured parameters during the first five days following the fulfillment of SIRS criteria. However, the number of IGs was not correlated with ICU mortality. The total number of IG in peripheral blood from ICU patients is a good marker to discriminate infected and non-infected patients very early during SIRS. However, the IG count is not suitable as a prognostic marker for mortality. Routine and serial measurement of IGs may provide new possibilities for rapid screening of SIRS patients on ICU with suspected infections.

Quantitative use of multiincidence-angle SAR for geologic mapping

NASA Technical Reports Server (NTRS)

Farr, T. G.; Albee, A. L.; Evans, D. L.; Solomon, J. E.; Daily, M. I.; Labotka, T. C.; Smith, M. O.

1984-01-01

It is proposed that techniques be developed and used for quantitative interpretation of shuttle imaging radar-B (SIR-B) data for lithologic identification and mapping. The use of backscatter versus incidence angle signatures derived from SIR-B images is to be investigated. The use of SIR-B with other sensors for geologic mapping is also to be considered. Anticipated results are discussed in terms of geologic mapping.

Application and calibration of the subsurface mapping capability of SIR-B in desert regions

NASA Technical Reports Server (NTRS)

Schaber, G. G.; Mccauley, J. F.; Breed, C. S.; Grolier, M. J.; Issawi, B.; Haynes, C. V.; Mchugh, W.; Walker, A. S.; Blom, R.

1984-01-01

The penetration capability of the shuttle imaging radar (SIR-B) sensor in desert regions is investigated. Refined models to explain this penetration capability in terms of radar physics and regional geologic conditions are devised. The sand-buried radar-rivers discovered in the Western Desert in Egypt and Sudan are defined. Results and procedures developed during previous SIR-A investigation of the same area are extrapolated.

Unique reversibility in extraction mechanism of U compared to solvent extraction for sorption of U(VI) and Pu(IV) by a novel solvent impregnated resin containing trialkyl phosphine oxide functionalized ionic liquid.

PubMed

Paramanik, M; Panja, S; Dhami, P S; Yadav, J S; Kaushik, C P; Ghosh, S K

2018-07-15

Novel Solvent Impregnated Resin (SIR) material was prepared by impregnating a trialkyl phosphine oxide functionalized ionic liquid (IL) into an inert polymeric material XAD-7. A series of SIR materials were prepared by varying the IL quantity. Sorption of both U(VI) and Pu(IV) were found to increase with increasing IL concentration in SIR up to an optimum IL concentration of 435 mg g -1 of SIR beyond which no effect of IL concentration was observed. A change of mechanism of sorption for U(VI) by SIR was observed in comparison to solvent extraction. The dependency of U(VI) sorption with nitric acid concentration showed a reverse trend compared to solvent extraction studies while for Pu(IV) the trend remained same as observed with solvent extraction. Sorption of both the radionuclides was found to follow pseudo second order mechanism and Langmuir adsorption isotherm. Distribution co-efficient measurements on IL impregnated SIR showed highly selective sorption of U(VI) and Pu(IV) over other trivalent f-elements and fission products from nitric acid medium. Copyright © 2018 Elsevier B.V. All rights reserved.

The molecular topography of silenced chromatin in Saccharomyces cerevisiae

PubMed Central

Thurtle, Deborah M.; Rine, Jasper

2014-01-01

Heterochromatin imparts regional, promoter-independent repression of genes and is epigenetically heritable. Understanding how silencing achieves this regional repression is a fundamental problem in genetics and development. Current models of yeast silencing posit that Sir proteins, recruited by transcription factors bound to the silencers, spread throughout the silenced region. To test this model directly at high resolution, we probed the silenced chromatin architecture by chromatin immunoprecipitation (ChIP) followed by next-generation sequencing (ChIP-seq) of Sir proteins, histones, and a key histone modification, H4K16-acetyl. These analyses revealed that Sir proteins are strikingly concentrated at and immediately adjacent to the silencers, with lower levels of enrichment over the promoters at HML and HMR, the critical targets for transcriptional repression. The telomeres also showed discrete peaks of Sir enrichment yet a continuous domain of hypoacetylated histone H4K16. Surprisingly, ChIP-seq of cross-linked chromatin revealed a distribution of nucleosomes at silenced loci that was similar to Sir proteins, whereas native nucleosome maps showed a regular distribution throughout silenced loci, indicating that cross-linking captured a specialized chromatin organization imposed by Sir proteins. This specialized chromatin architecture observed in yeast informs the importance of a steric contribution to regional repression in other organisms. PMID:24493645

The role of space borne imaging radars in environmental monitoring: Some shuttle imaging radar results in Asia

NASA Technical Reports Server (NTRS)

Imhoff, M.; Vermillion, C.

1986-01-01

The synoptic view afforded by orbiting Earth sensors can be extremely valuable for resource evaluation, environmental monitoring and development planning. For many regions of the world, however, cloud cover has prevented the acquisition of remotely sensed data during the most environmentally stressful periods of the year. This paper discusses how synthetic aperture imaging radar can be used to provide valuable data about the condition of the Earth's surface during periods of bad weather. Examples are given of applications using data from the Shuttle Imaging Radars (SIR) A and B for agriculture land use and crop condition assessment, monsoon flood boundary and flood damage assessment, water resource monitoring and terrain modeling, coastal forest mapping and vegetation penetration, and coastal development monitoring. Recent SIR-B results in Bangladesh are emphasized, radar system basics are reviewed and future SAR systems discussed.

The role of space borne imaging radars in environmental monitoring: Some shuttle imaging radar results in Asia

NASA Technical Reports Server (NTRS)

Imhoff, Marc L.; Vermillion, C. H.

1986-01-01

The synoptic view afforded by orbiting Earth sensors can be extremely valuable for resource evaluation, environmental monitoring and development planning. For many regions of the world, however, cloud cover has prevented the acquisition of remotely sensed data during the most environmentally stressful periods of the year. How synthetic aperture imaging radar can be used to provide valuable data about the condition of the Earth's surface during periods of bad weather is discussed. Examples are given of applications using data from the Shuttle Imaging Radars (SIR) A and B for agricultural land use and crop condition assessment, monsoon flood boundary and flood damage assessment, water resource monitoring and terrain modeling, coastal forest mapping and vegetation penetration, and coastal development monitoring. Recent SIR-B results in Bangladesh are emphasized, radar system basics are reviewed and future SAR systems are discussed.

Novel surgical performance evaluation approximates Standardized Incidence Ratio with high accuracy at simple means.

PubMed

Gabbay, Itay E; Gabbay, Uri

2013-01-01

Excess adverse events may be attributable to poor surgical performance but also to case-mix, which is controlled through the Standardized Incidence Ratio (SIR). SIR calculations can be complicated, resource consuming, and unfeasible in some settings. This article suggests a novel method for SIR approximation. In order to evaluate a potential SIR surrogate measure we predefined acceptance criteria. We developed a new measure - Approximate Risk Index (ARI). "Number Needed for Event" (NNE) is the theoretical number of patients needed "to produce" one adverse event. ARI is defined as the quotient of the group of patients needed for no observed events Ge by total patients treated Ga. Our evaluation compared 2500 surgical units and over 3 million heterogeneous risk surgical patients that were induced through a computerized simulation. Surgical unit's data were computed for SIR and ARI to evaluate compliance with the predefined criteria. Approximation was evaluated by correlation analysis and performance prediction capability by Receiver Operating Characteristics (ROC) analysis. ARI strongly correlates with SIR (r(2) = 0.87, p < 0.05). ARI prediction of excessive risk revealed excellent ROC (Area Under the Curve > 0.9) 87% sensitivity and 91% specificity. ARI provides good approximation of SIR and excellent prediction capability. ARI is simple and cost-effective as it requires thorough risk evaluation of only the adverse events patients. ARI can provide a crucial screening and performance evaluation quality control tool. The ARI method may suit other clinical and epidemiological settings where relatively small fraction of the entire population is affected. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Vitamin D protects endothelial cells from irradiation-induced senescence and apoptosis by modulating MAPK/SirT1 axis.

PubMed

Marampon, F; Gravina, G L; Festuccia, C; Popov, V M; Colapietro, E A; Sanità, P; Musio, D; De Felice, F; Lenzi, A; Jannini, E A; Di Cesare, E; Tombolini, V

2016-04-01

Radiotherapy toxicity is related to oxidative stress-mediated endothelial dysfunction. Here, we investigated on radioprotective properties of Vitamin D (Vit.D) on human endothelial cells (HUVEC). HUVEC, pre-treated with Vit.D, were exposed to ionizing radiation (IR): ROS production, cellular viability, apoptosis, senescence and western blot for protein detection were performed. The role of MAPKs pathway was investigated by using U0126 (10 μM) MEKs/ERKs-, SB203580 (2.5 μM) p38-inhibitor or by over/expressing MKK6 p38-upstream activator. Vit.D reduced IR-induced ROS production protecting proliferating and quiescent HUVEC from cellular apoptosis or senescence, respectively, by regulating MAPKs pathways. In proliferating HUVEC, Vit.D prevented IR-induced apoptosis by activating ERKs while in quiescent HUVEC counteracted IR-induced senescence by inhibiting the p38-IR-induced activation. MEKs&ERKs inhibition in proliferating or MKK6/mediated p38 activation in quiescent HUVEC, respectively, reverted anti-apoptotic or anti-senescent Vit.D properties. SirT1 protein expression levels were up-regulated by Vit.D. ERKs inhibition blocked Vit.D-induced SirT1 protein up-regulation in proliferating cells. In quiescent HUVEC cells, p38 inhibition counteracted the IR-induced SirT1 protein down-regulation, while MKK6 transfection abrogated the Vit.D positive effects on SirT1 protein levels after irradiation. SirT1 inhibition by sirtinol blocked the Vit.D radioprotective effects. Vit.D protects HUVEC from IR induced/oxidative stress by positively regulating the MAPKs/SirT1 axis.

Second neoplasms after invasive and borderline ovarian cancer.

PubMed

Levi, Fabio; Randimbison, Lalao; Blanc-Moya, Rafael; La Vecchia, Carlo

2009-06-01

Excess risk of subsequent cancers has been documented in women diagnosed with ovarian cancer. We updated to 2006 data on second cancers in women diagnosed with invasive and borderline ovarian cancer in the Swiss canton of Vaud. Between 1974 and 2006, 304 borderline and 1530 invasive first ovarian tumours were abstracted from the Vaud Cancer Registry database and followed up till the end of 2006. Calculation of expected numbers of tumours in the cohorts was based on site-specific, age-specific and calendar-year-specific incidence rates. We computed the standardized incidence ratios (SIRs) of second cancers, and the corresponding 95% confidence intervals (CI). There was no change in the incidence of malignant cancers, but that of borderline tumours increased over more recent years. Overall, 110 second neoplasms were observed versus 49.7 expected after invasive ovarian cancer (SIR 2.21; 95% CI: 1.82-2.67). Significant excess risks were observed for cancers of the breast, corpus uteri and leukaemias. When synchronous cancers were excluded, the overall SIR for all sites declined to 1.05. Thirty-one second neoplasms were observed after borderline tumours compared with 21.1 expected (SIR=1.47; 95% CI: 1.00-2.09). SIRs were above unity for ovary, colorectum and uterus. After exclusion of synchronous neoplasms, SIR for all neoplasms declined to 1.09, and remained significant only for second ovarian cancers (SIR=4.93). The present record linkage cohort study shows an excess risk for selected synchronous neoplasms in women diagnosed with both borderline and invasive ovarian cancer, likely because of shared genetic and perhaps environmental factors.

Sir James Reid and the Death of Queen Victoria: An Early Model for End-of-Life Care.

PubMed

Abrams, Robert C

2015-12-01

An appraisal of the last ten days of Queen Victoria's life, viewed primarily from the perspective of her personal physician, Sir James Reid, is presented. Sir James' clinical encounters with his patient and the Royal Family are examined to reveal his strategic and medical thinking and gauge his level of success in basic palliative aims. It was found that the lack of effective medical interventions, tensions within the Royal Family, the importance of his post to Sir James' professional career, and the political ramifications unavoidably connected with the illness of a head of state, all presented challenges to Reid's efforts to ease the physical and emotional pain of Queen Victoria's dying. Key features of Sir James' approach included reliance on physician-patient and physician-family relationships, emphasis on emotional support for the patient, and the careful selection of interventions for the family. In the first years of the 20th century, an era when the contemporary concepts of palliative care, hospice, and family dynamics did not exist, Sir James' management of the Queen's final illness suggested an early model for end-of-life care. By the end of Queen Victoria's life, Sir James was seen to have preserved his patient's comfort and dignity, at the same time advancing family and societal acceptance of the death of this matriarchal figure. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

How Reliable Is the Prediction of Solar Wind Background?

NASA Astrophysics Data System (ADS)

Jian, Lan K.; MacNeice, Peter; Taktakishvili, Aleksandre; Odstrcil, Dusan; Jackson, Bernard; Yu, Hsiu-Shan; Riley, Pete; Sokolov, Igor

2015-04-01

The prediction of solar wind background is a necessary part of space weather forecasting. Multiple coronal and heliospheric models have been installed at the Community Coordinated Modeling Center (CCMC) to produce the solar wind, including the Wang-Sheely-Arge (WSA)-Enlil model, MHD-Around-a-Sphere (MAS)-Enlil model, Space Weather Modeling Framework (SWMF), and heliospheric tomography using interplanetary scintillation (IPS) data. By comparing the modeling results with the OMNI data over 7 Carrington rotations in 2007, we have conducted a third-party validation of these models for the near-Earth solar wind. This work will help the models get ready for the transition from research to operation. Besides visual comparison, we have quantitatively assessed the models’ capabilities in reproducing the time series and statistics of solar wind parameters. Using improved algorithms, we have identified magnetic field sector boundaries (SBs) and slow-to-fast stream interaction regions (SIRs) as focused structures. The success rate of capturing them and the time offset vary largely with models. For this period, the 2014 version of MAS-Enlil model works best for SBs, and the heliospheric tomography works best for SIRs. General strengths and weaknesses for each model are identified to provide an unbiased reference to model developers and users.

Potential of fluid-attenuated inversion recovery (FLAIR) in identification of temporomandibular joint effusion compared with T2-weighted images.

PubMed

Imoto, Kenichi; Otonari-Yamamoto, Mika; Nishikawa, Keiichi; Sano, Tsukasa; Yamamoto, Aya

2011-08-01

The purpose of this study was to determine the potential of fluid-attenuated inversion recovery (FLAIR) sequence images in the identification of joint effusion (JE) compared with T2-weighted images. A total of 31 joints (28 patients) with JE were investigated by magnetic resonance imaging (MRI). Regions of interest were placed over JE, cerebrospinal fluid (CSF), and gray matter (GM) on T2-weighted and FLAIR images and their signal intensities compared. The signal intensity ratios (SIRs) of JE and CSF were calculated with GM as the reference point. The Pearson product-moment correlation coefficient was used for the statistical analysis. The SIR of JE showed a strong correlation between T2-weighted and FLAIR images. However, no correlation was observed for CSF. The average suppression ratio for JE was lower than that for CSF. MRI using FLAIR sequences revealed that JE was not just water content, but a fluid accumulation containing elements such as protein. Further studies are needed, and FLAIR sequences could be useful for the diagnosis of pain and symptoms of the temporomandibular joint (TMJ). Copyright © 2011 Mosby, Inc. All rights reserved.

Risk of second primary cancer among women with breast cancer: a population-based study in Granada (Spain).

PubMed

Molina-Montes, Esther; Pollán, Marina; Payer, Tilman; Molina, Elena; Dávila-Arias, Cristina; Sánchez, María-José

2013-08-01

The higher risk of developing new cancers in breast cancer survivors is a public health concern. Our aim was to examine risk of second primary cancers among women diagnosed with breast cancer. We studied two cohorts of female cancer patients identified in a population-based cancer registry in Granada (Spain): women first diagnosed with a primary breast cancer (n=5897) and those with a primary cancer in another site (n=22,814), followed during 1985-2007 for second cancers and breast cancer occurrence, respectively. We used Standardized Incidence Ratios (SIRs) to estimate second cancer risk by age (<50y, ≥50y), time since diagnosis (≤5y, >5y) and calendar periods (≤1995, >1996). SIR for breast cancer was calculated in the second cohort. The risk of developing second cancers (n=314) was 39% higher (95% CI=1.23-1.54) among breast cancer patients, and particularly high among women under 50 (SIR=1.96, 95% CI=1.48-2.44). Excess risk for endometrial cancer (SIR=3.04, 95% CI=2.14-3.94) was statistically significant and remained so in women over 50. Younger women were at higher risk of second ovarian cancer (SIR=4.90, 95% CI=1.27-8.53). Increased SIRs were observed during the first five years after breast cancer diagnosis, whereas SIRs decreased thereafter. Breast cancer incidence (n=171) was not higher among women previously diagnosed with other cancer types (SIR=0.86, 95% CI=0.74-1.00). Women diagnosed with breast cancer have a higher incidence of second primary cancers, particularly of endometrial cancer in women over 50 at diagnosis, and ovarian cancer in younger women. These findings may be explained by treatment-related effects or shared risk factors. Copyright © 2013 Elsevier Inc. All rights reserved.

How Hydroclimate Influences the Effectiveness of Particle Filter Data Assimilation of Streamflow in Initializing Short- to Medium-range Streamflow Forecasts

NASA Astrophysics Data System (ADS)

Clark, E.; Wood, A.; Nijssen, B.; Clark, M. P.

2017-12-01

Short- to medium-range (1- to 7-day) streamflow forecasts are important for flood control operations and in issuing potentially life-save flood warnings. In the U.S., the National Weather Service River Forecast Centers (RFCs) issue such forecasts in real time, depending heavily on a manual data assimilation (DA) approach. Forecasters adjust model inputs, states, parameters and outputs based on experience and consideration of a range of supporting real-time information. Achieving high-quality forecasts from new automated, centralized forecast systems will depend critically on the adequacy of automated DA approaches to make analogous corrections to the forecasting system. Such approaches would further enable systematic evaluation of real-time flood forecasting methods and strategies. Toward this goal, we have implemented a real-time Sequential Importance Resampling particle filter (SIR-PF) approach to assimilate observed streamflow into simulated initial hydrologic conditions (states) for initializing ensemble flood forecasts. Assimilating streamflow alone in SIR-PF improves simulated streamflow and soil moisture during the model spin up period prior to a forecast, with consequent benefits for forecasts. Nevertheless, it only consistently limits error in simulated snow water equivalent during the snowmelt season and in basins where precipitation falls primarily as snow. We examine how the simulated initial conditions with and without SIR-PF propagate into 1- to 7-day ensemble streamflow forecasts. Forecasts are evaluated in terms of reliability and skill over a 10-year period from 2005-2015. The focus of this analysis is on how interactions between hydroclimate and SIR-PF performance impact forecast skill. To this end, we examine forecasts for 5 hydroclimatically diverse basins in the western U.S. Some of these basins receive most of their precipitation as snow, others as rain. Some freeze throughout the mid-winter while others experience significant mid-winter melt events. We describe the methodology and present seasonal and inter-basin variations in DA-enhanced forecast skill.

Modeling the Intra- and Extracellular Cytokine Signaling Pathway under Heat Stroke in the Liver

PubMed Central

Rodriguez-Fernandez, Maria; Grosman, Benyamin; Yuraszeck, Theresa M.; Helwig, Bryan G.; Leon, Lisa R.; Doyle III, Francis J.

2013-01-01

Heat stroke (HS) is a life-threatening illness induced by prolonged exposure to a hot environment that causes central nervous system abnormalities and severe hyperthermia. Current data suggest that the pathophysiological responses to heat stroke may not only be due to the immediate effects of heat exposure per se but also the result of a systemic inflammatory response syndrome (SIRS). The observation that pro- (e.g., IL-1) and anti-inflammatory (e.g., IL-10) cytokines are elevated concomitantly during recovery suggests a complex network of interactions involved in the manifestation of heat-induced SIRS. In this study, we measured a set of circulating cytokine/soluble cytokine receptor proteins and liver cytokine and receptor mRNA accumulation in wild-type and tumor necrosis factor (TNF) receptor knockout mice to assess the effect of neutralization of TNF signaling on the SIRS following HS. Using a systems approach, we developed a computational model describing dynamic changes (intra- and extracellular events) in the cytokine signaling pathways in response to HS that was fitted to novel genomic (liver mRNA accumulation) and proteomic (circulating cytokines and receptors) data using global optimization. The model allows integration of relevant biological knowledge and formulation of new hypotheses regarding the molecular mechanisms behind the complex etiology of HS that may serve as future therapeutic targets. Moreover, using our unique modeling framework, we explored cytokine signaling pathways with three in silico experiments (e.g. by simulating different heat insult scenarios and responses in cytokine knockout strains in silico). PMID:24039931

Prognostic value of severity by various visceral proteins in critically ill patients with SIRS during 7 days of stay.

PubMed

Bouharras-El Idrissi, Hicham; Molina-López, Jorge; Herrera-Quintana, Lourdes; Domínguez-García, Álvaro; Lobo-Támer, Gabriela; Pérez-Moreno, Irene; Pérez-de la Cruz, Antonio; Planells-Del Pozo, Elena

2016-11-29

Critically ill patients typically develop a catabolic stress state as a result of a systemic inflammatory response (SIRS) that alters clinical-nutritional biomarkers, increasing energy demands and nutritional requirements. To evaluate the status of albumin, prealbumin and transferrin in critically ill patients and the association between these clinical-nutritional parameters with the severity during a seven day stay in intensive care unit (ICU). Multicenter, prospective, observational and analytical follow-up study. A total of 115 subjects in critical condition were included in this study. Clinical and nutritional parameters and severity were monitored at admission and at the seventh day of the ICU stay. A significant decrease in APACHE II and SOFA (p < 0.05) throughout the evolution of critically ill patients in ICU. In general, patients showed an alteration of most of the parameters analyzed. The status of albumin, prealbumin and transferrin were below reference levels both at admission and the 7th day in ICU. A high percentage of patients presented an unbalanced status of albumin (71.3%), prealbumin (84.3%) and transferrin (69.0%). At admission, 27% to 47% of patients with altered protein parameters had APACHE II above 18. The number of patients with altered protein parameters and APACHE II below 18 were significantly higher than severe ones throughout the ICU stay (p < 0.01). Regarding the multivariate analysis, low prealbumin status was the best predictor of severity critical (p < 0.05) both at admission and 7th day of the ICU stay. The results of the present study support the idea of including low prealbumin status as a severity predictor in APACHE II scale, due to the association found between severity and poor status of prealbumin.

Comparison of oxidative stress & leukocyte activation in patients with severe sepsis & burn injury

PubMed Central

Mühl, Diana; Woth, Gábor; Drenkovics, Livia; Varga, Adrienn; Ghosh, Subhamay; Csontos, Csaba; Bogár, Lajos; Wéber, György; Lantos, János

2011-01-01

Background & objectives: We evaluated pro- and anti-oxidant disturbances in sepsis and non-sepsis burn patients with systemic inflammatory response syndrome (SIRS). Adhesion molecules and inflammation markers on leukocytes were also analyzed. We hypothesized that oxidative stress and leukocyte activation markers can lead to the severity of sepsis. Methods: In 28 severe sepsis and 27 acute burn injury patients blood samples were collected at admission and 4 days consecutively. Oxidative stress markers: production of reactive oxygen species (ROS), myeloperoxidase, malondialdehyde and endogenous antioxidants: plasma protein sulphydryl groups, reduced glutathione, superoxide dismutase and catalase were measured. Flow cytometry was used to determine CD11a, CD14, CD18, CD49d and CD97 adhesion molecules on leukocytes. Procalcitonin, C-reactive protein, fibrinogen, platelet count and lactate were also analyzed. Results: Pro-oxidant parameters were significantly elevated in sepsis patients at admission, ROS intensity increased in burn patients until the 5th day. Endogenous antioxidant levels except catalase showed increased levels after burn trauma compared to sepsis. Elevated granulocyte activation and suppressed lymphocyte function were found at admission and early activation of granulocytes caused by increasing activation/migration markers in sepsis. Leukocyte adhesion molecule expression confirmed the suppressed lymphocyte and monocyte function in sepsis. Interpretation & conclusions: Severe sepsis is accompanied by oxidative stress and pathological leukocyte endothelial cell interactions. The laboratory parameters used for the evaluation of sepsis and several markers of pro- and antioxidant status were different between sepsis and non-sepsis burn patients. The tendency of changes in these parameters may refer to major oxidative stress in sepsis and developing SIRS in burns. PMID:21808137

Simulation of L-band and HH microwave backscattering from coniferous forest stands - A comparison with SIR-B data

NASA Technical Reports Server (NTRS)

Sun, Guo-Qing; Simonett, David S.

1988-01-01

SIR-B images of the Mt. Shasta region of northern California are used to evaluate a composite L-band HH backscattering model of coniferous forest stands. It is found that both SIR-B and simulated backscattering coefficients for eight stands studied have similar trends and relations to average tree height and average number of trees per pixel. Also, the dispersion and distribution of simulated backscattering coefficients from each stand broadly match SIR-B data from the same stand. Although the limited quality and quantity of experimental data makes it difficult to draw any strong conclusions, the comparisons indicate that a stand-based L-band HH composite model seems promising for explaining backscattering features.

Temperature variability analysis using wavelets and multiscale entropy in patients with systemic inflammatory response syndrome, sepsis, and septic shock.

PubMed

Papaioannou, Vasilios E; Chouvarda, Ioanna G; Maglaveras, Nikos K; Pneumatikos, Ioannis A

2012-12-12

Even though temperature is a continuous quantitative variable, its measurement has been considered a snapshot of a process, indicating whether a patient is febrile or afebrile. Recently, other diagnostic techniques have been proposed for the association between different properties of the temperature curve with severity of illness in the Intensive Care Unit (ICU), based on complexity analysis of continuously monitored body temperature. In this study, we tried to assess temperature complexity in patients with systemic inflammation during a suspected ICU-acquired infection, by using wavelets transformation and multiscale entropy of temperature signals, in a cohort of mixed critically ill patients. Twenty-two patients were enrolled in the study. In five, systemic inflammatory response syndrome (SIRS, group 1) developed, 10 had sepsis (group 2), and seven had septic shock (group 3). All temperature curves were studied during the first 24 hours of an inflammatory state. A wavelet transformation was applied, decomposing the signal in different frequency components (scales) that have been found to reflect neurogenic and metabolic inputs on temperature oscillations. Wavelet energy and entropy per different scales associated with complexity in specific frequency bands and multiscale entropy of the whole signal were calculated. Moreover, a clustering technique and a linear discriminant analysis (LDA) were applied for permitting pattern recognition in data sets and assessing diagnostic accuracy of different wavelet features among the three classes of patients. Statistically significant differences were found in wavelet entropy between patients with SIRS and groups 2 and 3, and in specific ultradian bands between SIRS and group 3, with decreased entropy in sepsis. Cluster analysis using wavelet features in specific bands revealed concrete clusters closely related with the groups in focus. LDA after wrapper-based feature selection was able to classify with an accuracy of more than 80% SIRS from the two sepsis groups, based on multiparametric patterns of entropy values in the very low frequencies and indicating reduced metabolic inputs on local thermoregulation, probably associated with extensive vasodilatation. We suggest that complexity analysis of temperature signals can assess inherent thermoregulatory dynamics during systemic inflammation and has increased discriminating value in patients with infectious versus noninfectious conditions, probably associated with severity of illness.

Temperature variability analysis using wavelets and multiscale entropy in patients with systemic inflammatory response syndrome, sepsis, and septic shock

PubMed Central

2012-01-01

Background Even though temperature is a continuous quantitative variable, its measurement has been considered a snapshot of a process, indicating whether a patient is febrile or afebrile. Recently, other diagnostic techniques have been proposed for the association between different properties of the temperature curve with severity of illness in the Intensive Care Unit (ICU), based on complexity analysis of continuously monitored body temperature. In this study, we tried to assess temperature complexity in patients with systemic inflammation during a suspected ICU-acquired infection, by using wavelets transformation and multiscale entropy of temperature signals, in a cohort of mixed critically ill patients. Methods Twenty-two patients were enrolled in the study. In five, systemic inflammatory response syndrome (SIRS, group 1) developed, 10 had sepsis (group 2), and seven had septic shock (group 3). All temperature curves were studied during the first 24 hours of an inflammatory state. A wavelet transformation was applied, decomposing the signal in different frequency components (scales) that have been found to reflect neurogenic and metabolic inputs on temperature oscillations. Wavelet energy and entropy per different scales associated with complexity in specific frequency bands and multiscale entropy of the whole signal were calculated. Moreover, a clustering technique and a linear discriminant analysis (LDA) were applied for permitting pattern recognition in data sets and assessing diagnostic accuracy of different wavelet features among the three classes of patients. Results Statistically significant differences were found in wavelet entropy between patients with SIRS and groups 2 and 3, and in specific ultradian bands between SIRS and group 3, with decreased entropy in sepsis. Cluster analysis using wavelet features in specific bands revealed concrete clusters closely related with the groups in focus. LDA after wrapper-based feature selection was able to classify with an accuracy of more than 80% SIRS from the two sepsis groups, based on multiparametric patterns of entropy values in the very low frequencies and indicating reduced metabolic inputs on local thermoregulation, probably associated with extensive vasodilatation. Conclusions We suggest that complexity analysis of temperature signals can assess inherent thermoregulatory dynamics during systemic inflammation and has increased discriminating value in patients with infectious versus noninfectious conditions, probably associated with severity of illness. PMID:22424316

Structured implicit review: a new method for monitoring nursing care quality.

PubMed

Pearson, M L; Lee, J L; Chang, B L; Elliott, M; Kahn, K L; Rubenstein, L V

2000-11-01

Nurses' independent decisions about assessment, treatment, and nursing interventions for hospitalized patients are important determinants of quality of care. Physician peer implicit review of medical records has been central to Medicare quality management and is considered the gold standard for reviewing physician care, but peer implicit review of nursing processes of care has not received similar attention. The objective of this study was to develop and evaluate nurse structured implicit review (SIR) methods. We developed SIR instruments for rating the quality of inpatient nursing care for congestive heart failure (CHF) and cerebrovascular accident (CVA). Nurse reviewers used the SIR form to rate a nationally representative sample of randomly selected medical records for each disease from 297 acute care hospitals in 5 states (collected by the RAND-HCFA Prospective Payment System study). The study subjects were elderly Medicare inpatients with CHF (n = 291) or CVA (n = 283). We developed and tested scales reflecting domains of nursing process, evaluated interrater and interitem reliability, and assessed the extent to which items and scales predicted overall ratings of the quality of nursing care. Interrater reliability for 14 of 16 scales (CHF) or 10 of 16 scales (CVA) was > or = 0.40. Interitem reliability was > 0.80 for all but 1 scale (both diseases). Functional Assessment, Physical Assessment, and Medication Tracking ratings were the strongest predictors of overall nursing quality ratings (P < 0.001 for each). Nurse peer review with SIR has adequate interrater and excellent scale reliabilities and can be a valuable tool for assessing nurse performance.

Duration of antimicrobial prophylaxis in patients undergoing hepatectomy: a prospective randomized controlled trial using flomoxef.

PubMed

Togo, Shinji; Tanaka, Kuniya; Matsuo, Kenichi; Nagano, Yasuhiko; Ueda, Michio; Morioka, Daisuke; Endo, Itaru; Shimada, Hiroshi

2007-05-01

Although the usefulness of antimicrobial prophylaxis for clean-contaminated surgery has been recognized, only a few randomized controlled studies on the duration of administration after hepatectomy have been performed. We investigated the duration of antimicrobial prophylaxis after hepatectomy. The subjects were 180 patients who underwent hepatectomy without reconstruction of the biliary or intestinal tract between April 2003 and March 2006 at our department. The patients were randomly allocated to groups to be treated with flomoxef sodium as antimicrobial prophylaxis for 2 days (89 patients) or 5 days (91 patients), including the operation day. The presence or absence of systemic inflammatory response syndrome (SIRS) and infections was investigated. No significant differences were noted in patient background between the two groups. Infections occurred in seven and six patients in the 2 day and 5 day treatment groups (7.9% and 6.6%), respectively, showing no significant difference between the two groups. No significant difference was noted when the cases were divided into surgical site infections and remote infections. The positive rate of SIRS was significantly higher in the 2 day treatment group than in the 5 day treatment group on days 2 and 3 after surgery. The risk factors in patients who developed infections were blood loss, operation time and the complication of biliary fistula. Two day administration of flomoxef sodium may be sufficient for antimicrobial prophylaxis after hepatectomy. However, when SIRS is positive on post-operative day 2, and induction of liver failure is of concern, it may be safer to continue antimicrobial drug administration until SIRS is eliminated.

Diagnostic value of decoy receptor 3 combined with procalcitonin and soluble urokinase-type plasminogen activator receptor for sepsis.

PubMed

Zhao, Jing-Jing; Lou, Xiao-Li; Chen, Hong-Wei; Zhu, Feng-Ting; Hou, Yan-Qiang

2018-01-01

The levels of decoy receptor 3 (DcR3), soluble urokinase type plasminogen activator receptor (suPAR) and procalcitonin (PCT) are significantly increased in sepsis. We investigated the diagnostic value of DcR3 combined with suPAR and PCT in sepsis. Patients with sepsis, non-infectious systemic inflammatory response comprehensive syndrome (SIRS) and healthy controls were recruited according to the diagnostic standard. We measured DcR3, suPAR, PCT, interleukin-6 (IL-6) and C-reactive protein (CRP), and the diagnostic value was evaluated by receiver operating characteristics (ROC) curves. In our analysis, serum DcR3, suPAR and PCT levels of the sepsis group were significantly higher than those of the SIRS and control groups. However, IL-6, CRP and WBC showed no significant difference between the SIRS group and the sepsis group. The serum DcR3 level was positively correlated with the serum suPAR level ( r  = 0.37, p  = 0.0022) and PCT level ( r  = 0.37, p  = 0.0021). Using DcR3, suPAR and PCT to distinguish SIRS from sepsis, the area under the curve (AUC) values were 0.892, 0.778 and 0.692. When DcR3, suPAR and PCT combined were used for diagnosis of sepsis, the AUC was 0.933, at a cut-off point of 0.342. This combination improved the sensitivity and specificity of diagnosis of sepsis, suggesting that use of the combination of three indexes enhanced the efficiency of sepsis diagnosis.

Patterns of Gram-stained fecal flora as a quick diagnostic marker in patients with severe SIRS.

PubMed

Shimizu, Kentaro; Ogura, Hiroshi; Tomono, Kazunori; Tasaki, Osamu; Asahara, Takashi; Nomoto, Koji; Morotomi, Masami; Matsushima, Asako; Nakahori, Yasutaka; Yamano, Shuhei; Osuka, Akinori; Kuwagata, Yasuyuki; Sugimoto, Hisashi

2011-06-01

The gut is an important target organ of injury during critically ill conditions. Although Gram staining is a common and quick method for identifying bacteria, its clinical application has not been fully evaluated in critically ill conditions. This study's aims were to identify patterns of Gram-stained fecal flora and compare them to cultured bacterial counts and to investigate the association between the patterns and septic complications in patients with severe systemic inflammatory response syndrome (SIRS). Fifty-two patients with SIRS were included whose Gram-stained fecal flora was classified into three patterns. In a diverse pattern, large numbers of multiple kinds of bacteria completely covered the field. In a single pattern, one specific kind of bacteria or fungi predominantly covered the field. In a depleted pattern, most bacteria were diminished in the field. In the analysis of fecal flora, the numbers of total obligate anaerobes in the depleted pattern was significantly lower than those in the diverse pattern and single pattern (p < 0.05). The concentrations of total organic acids, acetic acid, and propionic acid in the depleted pattern were significantly lower than those in diverse pattern and single pattern (p < 0.05). Mortality due to multiple organ dysfunction syndrome for the single pattern (52%) and the depleted pattern (64%) was significantly higher than that for the diverse pattern (6%) (p < 0.05). Gram-stained fecal flora can be classified into three patterns and are associated with both cultured bacterial counts and clinical information. Gram-stained fecal bacteria can be used as a quick bedside diagnostic marker for severe SIRS patients.

Needs for providing overseas organ transplant medical function and information with eHealth telecare systems-instrument development for health professionals in Taiwan.

PubMed

Shih, F-J; Fan, Y-W; Chiu, C-M; Shih, F-J; Wang, S-S

2014-05-01

The use of eHealth systems for facilitating overseas organ transplantation (OOT) between 2 medical parties has been discussed. Nevertheless, little information is available about organ transplant health professionals' (OTHPs') needs in using the eHealth telecare systems (eHTSs) for providing OOT medical service. This project attempted to answer this question. A purposive sample including OT surgeons (OTSs), registered nurses (RNs), and organ transplant coordinating nurses (OTCNs) was obtained from 5 hospitals in Taiwan. A Delphi research method was used in this research. The subjects were invited to respond to a sequence of surveys to learn their appraisal of the needs in using eHTSs for providing OOT medical service. Twenty-two subjects including surgeons (n = 10), RNs (n = 9), and OTCNs (n = 3) participated in this research. Their years working in the field ranged from 3 to 45 (mean 15.77) years. To learn OTHPs' appraisals of their needs in using eHTSs for providing OOT medical service, system function requirements (SFR) and system information requirements (SIR) for telecare were produced. SFR were identified to encompass the following 9 aspects: (a) safety in the supervisor mechanism for protection of privacy including account, password, and unediting mode of medical prescriptions; (b) unlimited to particular software or hardware; (c) options of related medical term language in English and traditional and simplified Chinese; (d) available any time and anywhere; (e) being able to save print and export medical records by E-mail systems under authorization; (f) friendly operation; (g) real-time and accurate information; (h) tape-recording functions (OTHPs may convey important medical information to others); and (i) online mutual communications between OTHPs and their clients. SIR included: (a) a comprehensive preoperative medical profile before departure for another country; (b) a comprehensive medical profile of OOT performed in another country; (c) a comprehensive postoperative treatment profile after return to original country; and (d) physiologic health indicators of long-term recovery in the community. In this project, OTHPs addressed their tangible needs for operating an eHTS to facilitate OOT. These findings would serve as a valuable reference for eHTS experts to continue to work with OTHPs to move to the next development stage. Copyright © 2014 Elsevier Inc. All rights reserved.

Geological remote sensing in Africa

NASA Technical Reports Server (NTRS)

Sabins, Floyd F., Jr.; Bailey, G. Bryan; Abrams, Michael J.

1987-01-01

Programs using remote sensing to obtain geologic information in Africa are reviewed. Studies include the use of Landsat MSS data to evaluate petroleum resources in sedimentary rock terrains in Kenya and Sudan and the use of Landsat TM 30-m resolution data to search for mineral deposits in an ophiolite complex in Oman. Digitally enhanced multispectral SPOT data at a scale of 1:62,000 were used to map folds, faults, diapirs, bedding attitudes, and stratigraphic units in the Atlas Mountains in northern Algeria. In another study, SIR-A data over a vegetated and faulted area of Sierra Leone were compared with data collected by the Landsat MSS and TM systems. It was found that the lineaments on the SIR-A data were more easily detected.

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society.

PubMed

Santosa, Katherine B; Fattah, Adel; Gavilán, Javier; Hadlock, Tessa A; Snyder-Warwick, Alison K

2017-07-01

There is no widely accepted assessment tool or common language used by clinicians caring for patients with facial palsy, making exchange of information challenging. Standardized photography may represent such a language and is imperative for precise exchange of information and comparison of outcomes in this special patient population. To review the literature to evaluate the use of facial photography in the management of patients with facial palsy and to examine the use of photography in documenting facial nerve function among members of the Sir Charles Bell Society-a group of medical professionals dedicated to care of patients with facial palsy. A literature search was performed to review photographic standards in patients with facial palsy. In addition, a cross-sectional survey of members of the Sir Charles Bell Society was conducted to examine use of medical photography in documenting facial nerve function. The literature search and analysis was performed in August and September 2015, and the survey was conducted in August and September 2013. The literature review searched EMBASE, CINAHL, and MEDLINE databases from inception of each database through September 2015. Additional studies were identified by scanning references from relevant studies. Only English-language articles were eligible for inclusion. Articles that discussed patients with facial palsy and outlined photographic guidelines for this patient population were included in the study. The survey was disseminated to the Sir Charles Bell Society members in electronic form. It consisted of 10 questions related to facial grading scales, patient-reported outcome measures, other psychological assessment tools, and photographic and videographic recordings. In total, 393 articles were identified in the literature search, 7 of which fit the inclusion criteria. Six of the 7 articles discussed or proposed views specific to patients with facial palsy. However, none of the articles specifically focused on photographic standards for the population with facial palsy. Eighty-three of 151 members (55%) of the Sir Charles Bell Society responded to the survey. All survey respondents used photographic documentation, but there was variability in which facial expressions were used. Eighty-two percent (68 of 83) used some form of videography. From these data, we propose a set of minimum photographic standards for patients with facial palsy, including the following 10 static views: at rest or repose, small closed-mouth smile, large smile showing teeth, elevation of eyebrows, closure of eyes gently, closure of eyes tightly, puckering of lips, showing bottom teeth, snarling or wrinkling of the nose, and nasal base view. There is no consensus on photographic standardization to report outcomes for patients with facial palsy. Minimum photographic standards for facial paralysis publications are proposed. Videography of the dynamic movements of these views should also be recorded. NA.

Venous Thromboembolism and Varicose Veins Share Familial Susceptibility: A Nationwide Family Study in Sweden

PubMed Central

Zöller, Bengt; Ji, Jianguang; Sundquist, Jan; Sundquist, Kristina

2014-01-01

Background Varicose veins (VVs) have been associated with venous thromboembolism (VTE), but whether these diseases share familial susceptibility has not been determined. This nationwide study aimed to determine whether VTE shares familial susceptibility with VVs. Methods and Results Swedish Multigeneration Register data for persons aged 0 to 76 years during the period 1964–2008 were linked to the Swedish Inpatient and Outpatient Registers. Familial risks (standardized incidence ratios [SIRs]) of VTE and VVs were examined in 2 ways (ie, bidirectionally): risk of VTE in subjects whose siblings had been diagnosed with VVs and risk of VVs in persons whose siblings had been diagnosed with VTE. The analyses were repeated for spouses to determine the importance of shared adult family environment. In total, 96 810 siblings had VVs and 87 564 had VTE. An increased risk of VTE was observed in persons whose siblings had VVs (SIR 1.30, 95% CI 1.26 to 1.33), whereas persons whose siblings had VTE had an increased risk of VVs (SIR 1.30, 95% CI 1.27 to 1.34). If 2 or more siblings were affected by VTE, the risk for VVs was 1.70 (95% CI 1.53 to 1.88). Conversely, if 2 or more siblings were affected by VVs, the risk for VTE was 1.52 (95% CI 1.38 to 1.67). In spouses of VTE patients, a minor increased risk of VVs was observed (SIR 1.05 for husbands, SIR 1.06 for wives). The risk of VTE in spouses of VV patients was similarly small (SIR 1.01 for husbands, SIR 1.05 for wives). Conclusions VVs and VTE share familial susceptibility. This novel finding suggests the existence of shared familial and possibly genetic factors. PMID:25158864

Cancer Incidence in World Trade Center Rescue and Recovery Workers, 2001–2008

PubMed Central

Wallenstein, Sylvan; Shapiro, Moshe; Teitelbaum, Susan L.; Stevenson, Lori; Kochman, Anne; Kaplan, Julia; Dellenbaugh, Cornelia; Kahn, Amy; Biro, F. Noah; Crane, Michael; Crowley, Laura; Gabrilove, Janice; Gonsalves, Lou; Harrison, Denise; Herbert, Robin; Luft, Benjamin; Markowitz, Steven B.; Moline, Jacqueline; Niu, Xiaoling; Sacks, Henry; Shukla, Gauri; Udasin, Iris; Lucchini, Roberto G.; Boffetta, Paolo; Landrigan, Philip J.

2013-01-01

Background: World Trade Center (WTC) rescue and recovery workers were exposed to a complex mix of pollutants and carcinogens. Objective: The purpose of this investigation was to evaluate cancer incidence in responders during the first 7 years after 11 September 2001. Methods: Cancers among 20,984 consented participants in the WTC Health Program were identified through linkage to state tumor registries in New York, New Jersey, Connecticut, and Pennsylvania. Standardized incidence ratios (SIRs) were calculated to compare cancers diagnosed in responders to predicted numbers for the general population. Multivariate regression models were used to estimate associations with degree of exposure. Results: A total of 575 cancers were diagnosed in 552 individuals. Increases above registry-based expectations were noted for all cancer sites combined (SIR = 1.15; 95% CI: 1.06, 1.25), thyroid cancer (SIR = 2.39; 95% CI: 1.70, 3.27), prostate cancer (SIR = 1.21; 95% CI: 1.01, 1.44), combined hematopoietic and lymphoid cancers (SIR = 1.36; 95% CI: 1.07, 1.71), and soft tissue cancers (SIR = 2.26; 95% CI: 1.13, 4.05). When restricted to 302 cancers diagnosed ≥ 6 months after enrollment, the SIR for all cancers decreased to 1.06 (95% CI: 0.94, 1.18), but thyroid and prostate cancer diagnoses remained greater than expected. All cancers combined were increased in very highly exposed responders and among those exposed to significant amounts of dust, compared with responders who reported lower levels of exposure. Conclusion: Estimates should be interpreted with caution given the short follow-up and long latency period for most cancers, the intensive medical surveillance of this cohort, and the small numbers of cancers at specific sites. However, our findings highlight the need for continued follow-up and surveillance of WTC responders. PMID:23613120

Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies.

PubMed

Jess, Tine; Rungoe, Christine; Peyrin-Biroulet, Laurent

2012-06-01

Patients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer (CRC). Studies examining the magnitude of this association have yielded conflicting results. We performed a meta-analysis of population-based cohort studies to determine the risk of CRC in patients with UC. We used MEDLINE, EMBASE, Cochrane, and CINAHL to perform a systematic literature search. We included 8 studies in the meta-analysis on the basis of strict inclusion and exclusion criteria. We calculated pooled standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) for risk of CRC in patients with UC and performed meta-regression analyses of the effect of cohort size, calendar period, observation time, percentage with proctitis, and rates of colectomy on the risk of CRC. An average of 1.6% of patients with UC was diagnosed with CRC during 14 years of follow-up. SIRs ranged from 1.05 to 3.1, with a pooled SIR of 2.4 (95% CI, 2.1-2.7). Men with UC had a greater risk of CRC (SIR, 2.6; 95% CI, 2.2-3.0) than women (SIR, 1.9; 95% CI, 1.5-2.3). Young age was a risk factor for CRC (SIR, 8.6; 95% CI, 3.8-19.5; although this might have resulted from small numbers), as was extensive colitis (SIR, 4.8; 95% CI, 3.9-5.9). In meta-regression analyses, only cohort size was associated with risk of CRC. In population-based cohorts, UC increases the risk of CRC 2.4-fold. Male sex, young age at diagnosis with UC, and extensive colitis increase the risk. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

Parkinson's Disease Prevalence and Proximity to Agricultural Cultivated Fields

PubMed Central

Yitshak Sade, Maayan; Zlotnik, Yair; Kloog, Itai; Novack, Victor; Peretz, Chava; Ifergane, Gal

2015-01-01

The risk for developing Parkinson's disease (PD) is a combination of multiple environmental and genetic factors. The Negev (Southern Israel) contains approximately 252.5 km2 of agricultural cultivated fields (ACF). We aimed to estimate the prevalence and incidence of PD and to examine possible geographical clustering and associations with agricultural exposures. We screened all “Clalit” Health Services members in the Negev (70% of the population) between the years 2000 and 2012. Individual demographic, clinical, and medication prescription data were available. We used a refined medication tracer algorithm to identify PD patients. We used mixed Poisson models to calculate the smoothed standardized incidence rates (SIRs) for each locality. We identified ACF and calculate the size and distance of the fields from each locality. We identified 3,792 cases of PD. SIRs were higher than expected in Jewish rural localities (median SIR [95% CI]: 1.41 [1.28; 1.53] in 2001–2004, 1.62 [1.48; 1.76] in 2005–2008, and 1.57 [1.44; 1.80] in 2009–2012). Highest SIR was observed in localities located in proximity to large ACF (SIR 1.54, 95% CI 1.32; 1.79). In conclusion, in this population based study we found that PD SIRs were higher than expected in rural localities. Furthermore, it appears that proximity to ACF and the field size contribute to PD risk. PMID:26357584

Structure and interactions of the Bacillus subtilis sporulation inhibitor of DNA replication, SirA, with domain I of DnaA

PubMed Central

Jameson, Katie H; Rostami, Nadia; Fogg, Mark J; Turkenburg, Johan P; Grahl, Anne; Murray, Heath; Wilkinson, Anthony J

2014-01-01

Chromosome copy number in cells is controlled so that the frequency of initiation of DNA replication matches that of cell division. In bacteria, this is achieved through regulation of the interaction between the initiator protein DnaA and specific DNA elements arrayed at the origin of replication. DnaA assembles at the origin and promotes DNA unwinding and the assembly of a replication initiation complex. SirA is a DnaA-interacting protein that inhibits initiation of replication in diploid Bacillus subtilis cells committed to the developmental pathway leading to formation of a dormant spore. Here we present the crystal structure of SirA in complex with the N-terminal domain of DnaA revealing a heterodimeric complex. The interacting surfaces of both proteins are α-helical with predominantly apolar side-chains packing in a hydrophobic interface. Site-directed mutagenesis experiments confirm the importance of this interface for the interaction of the two proteins in vitro and in vivo. Localization of GFP–SirA indicates that the protein accumulates at the replisome in sporulating cells, likely through a direct interaction with DnaA. The SirA interacting surface of DnaA corresponds closely to the HobA-interacting surface of DnaA from Helicobacter pylori even though HobA is an activator of DnaA and SirA is an inhibitor. PMID:25041308

Scavengers of reactive γ-ketoaldehydes extend Caenorhabditis elegans lifespan and healthspan through protein-level interactions with SIR-2.1 and ETS-7

PubMed Central

Nguyen, Thuy T.; Caito, Samuel W.; Zackert, William E.; West, James D.; Zhu, Shijun

2016-01-01

Isoketals (IsoKs) are highly reactive γ-ketoaldehyde products of lipid peroxidation that covalently adduct lysine side chains in proteins, impairing their function. Using C. elegans as a model organism, we sought to test the hypothesis that IsoKs contribute to molecular aging through adduction and inactivation of specific protein targets, and that this process can be abrogated using salicylamine (SA), a selective IsoK scavenger. Treatment with SA extends adult nematode longevity by nearly 56% and prevents multiple deleterious age-related biochemical and functional changes. Testing of a variety of molecular targets for SA's action revealed the sirtuin SIR-2.1 as the leading candidate. When SA was administered to a SIR-2.1 knockout strain, the effects on lifespan and healthspan extension were abolished. The SIR-2.1-dependent effects of SA were not mediated by large changes in gene expression programs or by significant changes in mitochondrial function. However, expression array analysis did show SA-dependent regulation of the transcription factor ets-7 and associated genes. In ets-7 knockout worms, SA's longevity effects were abolished, similar to sir-2.1 knockouts. However, SA dose-dependently increases ets-7 mRNA levels in non-functional SIR-2.1 mutant, suggesting that both are necessary for SA's complete lifespan and healthspan extension. PMID:27514077

The Geography of Primary Hepatic Neoplasms Treatments in Canada: Changes in Latitudes and Changes in Attitudes

PubMed Central

Cwinn, Matthew; Rahman, Sheikh Hasibur

2017-01-01

Background Studies on treatment modalities for primary hepatic neoplasms (PHN) in Canada are lacking. Our primary aim was to analyze the age-standardized incidence of hepatic resection, ablation, transplantation, and embolization for PHN between 2002 and 2013. Secondary aim was to evaluate temporal trends for these treatment modalities. Study Design National Canadian Cancer Registries were accessed for relevant epidemiological data. Age-standardized incidence of treatment ratios (SIRs) was calculated and comparisons were performed for Atlantic Canada, Ontario, the Prairies, and British Columbia. Results British Columbia recorded the highest SIRs for ablation (1.9; 95% CI 1.8–2.0), hepatic resection (1.2; 95% CI 1.1–1.3), and transarterial locoregional therapies (2.8; 95% CI 2.4–3.2). For hepatic resection, the lowest SIR was found in Atlantic Canada (0.7; 95% CI 0.6–0.9), while the Prairies recorded the lowest estimate for transarterial therapies (0.2; 95% CI 0.1–0.4). Liver transplantation had the highest SIR in Ontario (1.5; 95% CI 1.3–1.6) and the lowest SIR in British Columbia. No significant temporal changes in SIRs were observed for any of the treatments except for transarterial therapies. Conclusions Treatment of PHN in Canada differs by geography. Variations might be due to differences in expertise or access to therapeutic modalities. PMID:28815170

Geoeffectiveness of Stream Interaction Regions during 2007-2008

NASA Astrophysics Data System (ADS)

Sanchez-Garcia, Elsa; Aguilar-Rodriguez, Ernesto; Ontiveros, Veronica

2016-07-01

The Stream Interaction Regions (SIRs) are generated in the interplanetary medium when a fast solar wind stream overtakes a slower one. If these large-scale phenomena interact with the Earth's magnetosphere they can give rise to geomagnetic storms (GSs). In this study we analyze the degree of geoeffectiveness of 20 events that were generated by SIRs. The events were observed during the 2007-2008 period that comprising the extended downward phase of solar cycle 23. The degree of geoeffectivity is measured using magnetic indices from different latitudes: PCN (Polar cap north), PCS (polar cap south), AA (antipodal amplitude), AE (Auroral Electrojet), Kp (estimated global index) and Dst (Disturbance storm time). We discuss some results on the correlation of these magnetic indices with the characteristics of shocks associated with the SIRs observed by STEREO-A/B, WIND and ACE spacecraft. All the 20 SIRs events generated GSs with Dst values in ranging from -86 nT up to -12 nT. Moreover, 6 out of the 20 events presented storm sudden commencement (SSC). We also discuss on the characteristics of the SIR-associated shocks and the intensity of the GSs.

Salivary Gland and Nasopharyngeal Cancers in Individuals with Acquired Immunodeficiency Syndrome in United States

PubMed Central

Shebl, Fatma M.; Bhatia, Kishor; Engels, Eric A.

2009-01-01

Individuals with acquired immunodeficiency syndrome (AIDS) manifest an increased risk of cancer, particularly cancers caused by oncogenic viruses. Because some salivary gland and nasopharyngeal cancers are associated with Epstein Barr virus, the impact of AIDS on these cancers needs further evaluation. We used linked U.S. AIDS and cancer registry data (N=519,934 people with AIDS) to derive standardized incidence ratios (SIRs) comparing risk of salivary gland and nasopharyngeal cancers to the general population. For salivary gland cancers (N=43 cases), individuals with AIDS had strongly elevated risks for lymphoepithelial carcinoma (SIR 39, 95% CI 16-81) and squamous cell carcinoma (SIR 4.9, 95% CI 2.5-8.6). Among nasopharyngeal cancers (N=39 cases), risks were elevated for both keratinizing and non-keratinizing carcinomas (SIR 2.4, 95% CI 1.5-3.7, and SIR 2.4, 95% CI 1.2-4.4, respectively). The elevated risks of salivary gland and nasopharyngeal cancers among people with AIDS suggest that immunosuppression and oncogenic viral infections are etiologically important. PMID:19810095

Lessons Learned from 10 Years of STEREO Solar Wind Observations

NASA Astrophysics Data System (ADS)

Jian, L. K.; Russell, C. T.; Luhmann, J. G.; Galvin, A. B.

2017-12-01

We have conducted long-term observations of large-scale solar wind structures since the launch of STEREO spacecraft, specifically interplanetary CMEs (ICMEs), slow-to-fast stream interaction regions (SIRs), and interplanetary shocks. In combination with our previous observations of the same solar wind structures in 1995-2009 using Wind/ACE data and the same identification criteria, we have first studied the solar cycle variations of these structures, especially for the same phases of solar cycles 23 and 24. Attributing the shocks to the interplanetary drivers, we have statistically compared the shocks driven by ICMEs and SIRs, and explained the shocks without a clear local driver. In addition, using the longitudinal and latitudinal separations between the twin spacecraft, we have investigated the recurrence and variability of ICMEs and SIRs, and gained the critical implications for the proposed L5 mission. At last, we have associated the heliospheric current sheet (HCS) crossings with the ICMEs and SIRs, and compared the properties of SIRs with and without HCS crossings, which correspond to the helmet streamers and pseudostreamers, respectively. The findings are important constraints on the theories of slow wind origin.

Occupational risks for nasal cancer in Sweden.

PubMed

Hemelt, Marjolein; Granström, Charlotta; Hemminki, Kari

2004-10-01

An elevated risk of nasal cancer (NC) has been associated with numerous occupations but with contradicting results. We sought to address recent and current risks of NC in a nationwide study. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios (SIRs) for 52 occupational groups. SIRs were adjusted for age and socioeconomic status. Among 739 male cases, significantly elevated SIRs for nasal adenocarcinoma were observed in woodworkers, teachers, and fishermen. In woodworkers, the risk increased with a longer occupational history in exposure to softwood in combination with hardwood. Electrical workers had a significant elevated risk for squamous cell carcinoma. Among 182 female cases, significantly elevated SIRs were observed in glass, ceramic, and tile workers. The study identified some known risk occupations and suggested some new ones.

Commentary on "Risks of primary extracolonic cancers following colorectal cancer in Lynch syndrome." Win AK, Lindor NM, Young JP, Macrae FA, Young GP, Williamson E, Parry S, Goldblatt J, Lipton L, Winship I, Leggett B, Tucker KM, Giles GG, Buchanan DD, Clendenning M, Rosty C, Arnold J, Levine AJ, Haile RW, Gallinger S, Le Marchand L, Newcomb PA, Hopper JL, Jenkins MA, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population Health, The University of Melbourne, Victoria, Australia: J Natl Cancer Inst 2012;104(18):1363-72 [Epub 2012 Aug 28].

PubMed

See, William A

2013-07-01

Lynch syndrome is a highly penetrant cancer predisposition syndrome caused by germline mutations in DNA mismatch repair (MMR) genes. We estimated the risks of primary cancers other than colorectal cancer following a diagnosis of colorectal cancer in mutation carriers. We obtained data from the Colon Cancer Family Registry for 764 carriers of an MMR gene mutation (316 MLH1, 357 MSH2, 49 MSH6, and 42 PMS2), who had a previous diagnosis of colorectal cancer. The Kaplan-Meier method was used to estimate their cumulative risk of cancers 10 and 20 years after colorectal cancer. We estimated the age-, sex-, country- and calendar period-specific standardized incidence ratios (SIRs) of cancers following colorectal cancer, compared with the general population. Following colorectal cancer, carriers of MMR gene mutations had the following 10-year risk of cancers in other organs: kidney, renal pelvis, ureter, and bladder (2%, 95% confidence interval [CI] = 1% to 3%); small intestine, stomach, and hepatobiliary tract (1%, 95% CI = 0.2% to 2%); prostate (3%, 95% CI = 1% to 5%); endometrium (12%, 95% CI = 8% to 17%); breast (2%, 95% CI = 1% to 4%); and ovary (1%, 95% CI = 0% to 2%). They were at elevated risk compared with the general population: cancers of the kidney, renal pelvis, and ureter (SIR = 12.54, 95% CI = 7.97 to 17.94), urinary bladder (SIR = 7.22, 95% CI = 4.08 to 10.99), small intestine (SIR = 72.68, 95% CI = 39.95 to 111.29), stomach (SIR = 5.65, 95% CI = 2.32 to 9.69), and hepatobiliary tract (SIR = 5.94, 95% CI = 1.81 to 10.94) for both sexes; cancer of the prostate (SIR = 2.05, 95% CI = 1.23 to 3.01), endometrium (SIR = 40.23, 95% CI = 27.91 to 56.06), breast (SIR = 1.76, 95% CI = 1.07 to 2.59), and ovary (SIR = 4.19, 95% CI = 1.28 to 7.97). Carriers of MMR gene mutations who have already had a colorectal cancer are at increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers. Copyright © 2013. Published by Elsevier Inc.

Accelerated hematopoietic syndrome after radiation doses bridging hematopoietic (H-ARS) and gastrointestinal (GI-ARS) acute radiation syndrome: early hematological changes and systemic inflammatory response syndrome in minipig.

PubMed

Moroni, Maria; Elliott, Thomas B; Deutz, Nicolaas E; Olsen, Cara H; Owens, Rossitsa; Christensen, Christine; Lombardini, Eric D; Whitnall, Mark H

2014-05-01

To characterize acute radiation syndrome (ARS) sequelae at doses intermediate between the bone marrow (H-ARS) and full gastrointestinal (GI-ARS) syndrome. Male minipigs, approximately 5 months old, 9-12 kg in weight, were irradiated with Cobalt-60 (total body, bilateral gamma irradiation, 0.6 Gy/min). Endpoints were 10-day survival, gastrointestinal histology, plasma citrulline, bacterial translocation, vomiting, diarrhea, vital signs, systemic inflammatory response syndrome (SIRS), febrile neutropenia (FN). We exposed animals to doses (2.2-5.0 Gy) above those causing H-ARS (1.6-2.0 Gy), and evaluated development of ARS. Compared to what was observed during H-ARS (historical data: Moroni et al. 2011a , 2011c ), doses above 2 Gy produced signs of increasingly severe pulmonary damage, faster deterioration of clinical conditions, and faster increases in levels of C-reactive protein (CRP). In the range of 4.6-5.0 Gy, animals died by day 9-10; signs of the classic GI syndrome, as measured by diarrhea, vomiting and bacterial translocation, did not occur. At doses above 2 Gy we observed transient reduction in circulating citrulline levels, and animals exhibited earlier depletion of blood elements and faster onset of SIRS and FN. An accelerated hematopoietic subsyndrome (AH-ARS) is observed at radiation doses between those producing H-ARS and GI-ARS. It is characterized by early onset of SIRS and FN, and greater lung damage, compared to H-ARS.

Levonorgestrel-releasing intrauterine system and the risk of breast cancer: A nationwide cohort study.

PubMed

Soini, Tuuli; Hurskainen, Ritva; Grénman, Seija; Mäenpää, Johanna; Paavonen, Jorma; Joensuu, Heikki; Pukkala, Eero

2016-01-01

Prolonged steroid hormone therapy increases the risk of breast cancer, especially the risk of lobular cancer, but the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) use is controversial. In this study we aimed to test the hypothesis that risk for lobular breast cancer is elevated among LNG-IUS users. We identified from the national Medical Reimbursement Registry of Finland the women aged 30-49 who had used LNG-IUS for the treatment or prevention of menorrhagia in 1994-2007, and from the Finnish Cancer Registry breast cancers diagnosed before the age of 55 and by the end of 2012. A total of 2015 women had breast cancer diagnosed in a cohort of 93 843 LNG-IUS users during follow-up consisting of 1 032 767 women-years. The LNG-IUS users had an increased risk for both ductal breast cancer [standardized incidence ratio (SIR) 1.20, 95% confidence interval (CI) 1.14-1.25] and for lobular breast cancer (SIR 1.33, 95% CI 1.20-1.46), as compared with the general female population. The highest risk was found in LNG-IUS users who purchased the device at least twice, whose SIR for lobular cancer was 1.73 (95% CI 1.37-2.15). The results imply that intrauterine administration of levonorgestrel is not only related to an excess risk of lobular breast cancer but also, in contrary to previous assumptions, to an excess risk of ductal breast cancer.

Increased risk of stomach and esophageal malignancies in people with AIDS.

PubMed

Persson, E Christina; Shiels, Meredith S; Dawsey, Sanford M; Bhatia, Kishor; Anderson, Lesley A; Engels, Eric A

2012-10-01

People infected with human immunodeficiency virus (HIV) have an increased risk of some malignancies, but little is known about the effects of infection on risk of cancers of the upper gastrointestinal tract. We evaluated the risks of different histologic and anatomic subtypes of carcinomas and non-Hodgkin lymphomas (NHLs) of the stomach and esophagus in people with acquired immunodeficiency syndrome (AIDS). We analyzed data from the HIV/AIDS Cancer Match Study, which links data collected from 1980 to 2007 for 16 US population-based HIV and AIDS and cancer registries. We compared risks of stomach and esophageal malignancies in people with AIDS (N = 596,955) with those of the general population using standardized incidence ratios (SIRs). We assessed calendar trends using Poisson regression. People with AIDS had increased risks of carcinomas of the esophagus (SIR, 1.69; 95% confidence interval [CI], 1.37-2.07; n = 95) and stomach (SIR, 1.44; 95% CI, 1.17-1.76; n = 96). Risk was increased for esophageal adenocarcinoma (SIR, 1.91; 95% CI, 1.31-2.70) and squamous cell carcinoma (SIR, 1.47; 95% CI, 1.10-1.92). People with AIDS had greater risks of carcinomas of the gastric cardia (SIR, 1.36; 95% CI, 0.83-2.11) and noncardia (SIR, 1.53; 95% CI, 1.12-2.05) than the general population. Although most stomach and esophageal NHLs that developed in people with AIDS were diffuse large B-cell lymphomas, these individuals also had an increased risk of stomach mucosa-associated lymphoid tissue lymphoma (SIR, 5.99; 95% CI, 3.19-10.2; n = 13). The incidence of carcinomas remained fairly constant over time, but rates of NHL decreased from 1980 to 2007 (P(trend) < .0001). People with AIDS are at increased risk for developing esophageal and stomach carcinomas and NHLs. Although the incidence of NHL decreased from 1980 to 2007 as treatments for HIV infection improved, HIV-infected individuals face continued risks of esophageal and stomach carcinomas. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

Increased Risk of Stomach and Esophageal Malignancies in People With AIDS

PubMed Central

Persson, E. Christina; Shiels, Meredith S.; Dawsey, Sanford M.; Bhatia, Kishor; Anderson, Lesley A.; Engels, Eric A.

2013-01-01

BACKGROUND & AIMS People infected with human immunodeficiency virus (HIV) have an increased risk of some malignancies, but little is known about the effects of infection on risk of cancers of the upper gastrointestinal tract. We evaluated the risks of different histologic and anatomic subtypes of carcinomas and non-Hodgkin lymphomas (NHLs) of the stomach and esophagus in people with acquired immunodeficiency syndrome (AIDS). METHODS We analyzed data from the HIV/AIDS Cancer Match Study, which links data collected from 1980 to 2007 for 16 US population-based HIV and AIDS and cancer registries. We compared risks of stomach and esophageal malignancies in people with AIDS (N = 596,955) with those of the general population using standardized incidence ratios (SIRs). We assessed calendar trends using Poisson regression. RESULTS People with AIDS had increased risks of carcinomas of the esophagus (SIR, 1.69; 95% confidence interval [CI], 1.37–2.07; n = 95) and stomach (SIR, 1.44; 95% CI, 1.17–1.76; n = 96). Risk was increased for esophageal adenocarcinoma (SIR, 1.91; 95% CI, 1.31–2.70) and squamous cell carcinoma (SIR, 1.47; 95% CI, 1.10 –1.92). People with AIDS had greater risks of carcinomas of the gastric cardia (SIR, 1.36; 95% CI, 0.83–2.11) and noncardia (SIR, 1.53; 95% CI, 1.12–2.05) than the general population. Although most stomach and esophageal NHLs that developed in people with AIDS were diffuse large B-cell lymphomas, these individuals also had an increased risk of stomach mucosa–associated lymphoid tissue lymphoma (SIR, 5.99; 95% CI, 3.19 –10.2; n = 13). The incidence of carcinomas remained fairly constant over time, but rates of NHL decreased from 1980 to 2007 (Ptrend < .0001). CONCLUSIONS People with AIDS are at increased risk for developing esophageal and stomach carcinomas and NHLs. Although the incidence of NHL decreased from 1980 to 2007 as treatments for HIV infection improved, HIV-infected individuals face continued risks of esophageal and stomach carcinomas. PMID:22796240

Risk of lymphoma in women with breast implants: analysis of clinical studies.

PubMed

Largent, Joan; Oefelein, Michael; Kaplan, Hilton M; Okerson, Ted; Boyle, Peter

2012-05-01

Large studies suggest that the overall rate of lymphoma in women with breast implants is no greater than in the general population; clinical reports suggest an association between breast implants and the rare non-Hodgkin lymphoma, anaplastic large cell lymphoma (ALCL). Observed cases of lymphoma reported in Allergan-sponsored breast implant clinical studies were compared with expected cases on the basis of the incidence of lymphoma among women in the National Cancer Institute's Surveillance Epidemiology and End Results program, using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). In clinical studies, there were 28 observed cases of lymphoma among 89 382 patients and 204 682 person-years of follow-up compared with 43 expected cases [SIR: 28/43=0.65 (95% CI: 0.43-0.94), P=0.02]. SIRs were calculated stratifying by baseline cancer history: women without prior cancer [SIR: 17/24=0.70 (95% CI: 0.41-1.13), P=0.17] and women with prior cancer [SIR: 11/14=0.79 (95% CI: 0.39-1.41), P=0.52]. SIRs were calculated by implant shell type: textured shell implants [SIR: 16/23=0.70 (95% CI: 0.40-1.13), P=0.16] and smooth shell implants [SIR: 12/19=0.63 (95% CI: 0.33-1.10), P=0.12]. Surveillance Epidemiology and End Results reported 12 cases of primary breast ALCL in women between 1996 and 2007 without a history of cancer, for an average annual incidence of 4.28 (95% CI: 3.51-5.05)/100 million women in the US - these women may or may not have breast implants. In clinical studies, three ALCL cases were reported in women with breast implants and a history of breast cancer, yielding a crude incidence rate of 1.46 (95% CI: 0.30-4.3)/100 000 person-years. Large clinical studies, based on over 200 000 person-years of follow-up, suggest no evidence of an increased risk of lymphoma among women who have received breast implants.

Development and validation of a diagnostic model for early differentiation of sepsis and non-infectious SIRS in critically ill children - a data-driven approach using machine-learning algorithms.

PubMed

Lamping, Florian; Jack, Thomas; Rübsamen, Nicole; Sasse, Michael; Beerbaum, Philipp; Mikolajczyk, Rafael T; Boehne, Martin; Karch, André

2018-03-15

Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU). Two hundred thirty-eight cases of non-infectious SIRS and 58 cases of sepsis (as defined by IPSCC criteria) were included. We applied a Random Forest approach to identify the best set of predictors out of 44 variables measured at the day of onset of the disease. The developed diagnostic model was validated in a temporal split-sample approach. A model including four clinical (length of PICU stay until onset of non-infectious SIRS/sepsis, central line, core temperature, number of non-infectious SIRS/sepsis episodes prior to diagnosis) and four laboratory parameters (interleukin-6, platelet count, procalcitonin, CRP) was identified in the training dataset. Validation in the test dataset revealed an AUC of 0.78 (95% CI: 0.70-0.87). Our model was superior to previously proposed biomarkers such as CRP, interleukin-6, procalcitonin or a combination of CRP and procalcitonin (maximum AUC = 0.63; 95% CI: 0.52-0.74). When aiming at a complete identification of sepsis cases (100%; 95% CI: 87-100%), 28% (95% CI: 20-38%) of non-infectious SIRS cases were assorted correctly. Our approach allows early recognition of sepsis with an accuracy superior to previously described biomarkers, and could potentially reduce antibiotic use by 30% in non-infectious SIRS cases. External validation studies are necessary to confirm the generalizability of our approach across populations and treatment practices. ClinicalTrials.gov number: NCT00209768; registration date: September 21, 2005.

Elevated risk of human papillomavirus-related second cancers in survivors of anal canal cancer.

PubMed

Nelson, Rebecca A; Lai, Lily L

2017-10-15

Over the last decade, the causal link between human papillomavirus (HPV) infection and squamous cell carcinoma of the anus (SCCA) has been well described. Because HPV infection in one site is often associated with other sites of infection, it then follows that patients with SCCA may have an increased risk of additional HPV-related cancers. Identifying and targeting at-risk sites through cancer screening and surveillance may help to guide best practices. The current study sought to ascertain sites and risk of HPV-related second primary malignancies (SPMs) in survivors of SCCA. Using population-based data from 1992 through 2012, the authors identified patients with SCCA and determined their risk of HPV-related SPMs, including anal, oral, and genital cancers. Standardized incidence ratios (SIRs), defined as observed to expected cases, were calculated to determine excess risk. Of 10,537 patients with SCCA, 416 developed HPV-related SPMs, which corresponded to an overall SIR of 21.5 (99% confidence interval [99% CI], 19.0-24.2). Men were found to have a higher SIR (35.8; 99% CI, 30.7-41.6) compared with women (12.8; 99% CI, 10.4-15.5). SIRs for a second SCCA were markedly higher in men (127.5; 99% CI, 108.1-149.2) compared with women (47.0; 99% CI, 34.7-62.1), whereas SIRs for oral cavity and pharyngeal cancers were elevated in men (3.1; 99% CI, 1.5-5.7) and women (4.4; 99% CI, 1.5-9.7). SIRs for sex-specific sites also were elevated, with male genital cancers having an SIR of 19.6 (99% CI, 8.7-37.6) and female genital cancers an SIR of 8.3 (99% CI, 6.1-11.0). Patients with index SCCA are at an increased risk of subsequent HPV-related SPMs. The elevated risk is most striking in patients with second primary SCCAs; however, the risk of second cancers also appears to be increased in other HPV-related sites. Cancer 2017;123:4013-21. © 2017 American Cancer Society. © 2017 American Cancer Society.

A Distal Forearm Fracture in Childhood Is Associated With an Increased Risk for Future Fragility Fractures in Adult Men, but Not Women

PubMed Central

Amin, Shreyasee; Melton, L Joseph; Achenbach, Sara J; Atkinson, Elizabeth J; Dekutoski, Mark B; Kirmani, Salman; Fischer, Philip R; Khosla, Sundeep

2014-01-01

Distal forearm fractures are among the most common fractures during childhood, but it remains unclear whether they predict an increased fracture risk later in life. We studied a population-based cohort of 1776 children ≤18 years of age, from Olmsted County, MN, USA, who had a distal forearm fracture in 1935–1992. Incident fractures occurring at age ≥35 years were identified through review of complete medical records using the linkage system of the Rochester Epidemiology Project. Observed nonpathologic fractures resulting from no more than moderate trauma (fragility fractures) were compared with expected numbers estimated from fracture site–specific incidence rates, based on age, sex, and calendar year, for Olmsted County (standardized incidence ratios [SIR]). In 1086 boys (mean ± SD age; 11 ± 4 years) and 690 girls (10 ± 4 years) followed for 27,292 person-years after the age of 35 years, subsequent fragility fractures were observed in 144 (13%) men and 74 (11%) women. There was an increased risk for future fragility fractures in boys who had a distal forearm fracture (SIR, 1.9; 95% CI, 1.6–2.3) but not girls (SIR, 1.0; 95% CI, 0.8–1.2). Fragility fractures at both major osteoporotic (hip, spine, wrist, and shoulder) sites (SIR, 2.6; 95% CI, 2.1–3.3) and remaining sites (SIR, 1.7; 95% CI, 1.3–2.0) were increased in men, irrespective of age at distal forearm fracture as boys. A distal forearm fracture in boys, but not girls, is associated with an increased risk for fragility fractures as older adults. It is necessary to determine whether the increased fractures observed in men is due to persistent deficits of bone strength, continued high fracture risk activity, or both. Until then, men should be asked about a childhood distal forearm fracture and, if so, warrant further screening and counseling on measures to optimize bone health and prevent fractures. PMID:23456800

The Temporal Kinetics of Circulating Angiopoietin Levels in Children with Sepsis

PubMed Central

Giuliano, John S.; Tran, Kevin; Li, Fang-yong; Northrup, Veronika; Tala, Joana A.; Bhandari, Vineet

2013-01-01

Objective Capillary integrity continues to challenge critical care physicians worldwide when treating children with sepsis. Vascular growth factors, specifically angiopoietin (angpt)-1 and angpt-2, play opposing roles in capillary stabilization in septic patients, respectively. We aim to determine whether pediatric patients with severe sepsis/shock have persistently high angpt-2/1 ratios when compared to non-septic pediatric intensive care unit (PICU) patients over a 7-day period. Design Prospective, observational study. Patients were classified within 24h of admission into: non-systemic inflammatory response syndrome (non-SIRS), SIRS/sepsis, or severe sepsis/shock. Plasma levels of angpt-1 and angpt-2 were measured via ELISA. The angpt-2/1 ratio was graphically plotted and determined whether patients fell into ‘constant’ or ‘variable’ patterns. Setting Tertiary care center PICU. Patients Critically ill pediatric patients with varying sepsis severity. Interventions None Measurements and Main Results Forty five patients were enrolled (n=9 non-SIRS, n=19 SIRS/sepsis, and n=17 severe sepsis/shock). Gender, age, weight, comorbidities and PICU length of stay were not significantly different between the groups. Admission pediatric risk stratification scores and net fluid ins/outs were significantly elevated in the severe sepsis/shock group when compared (all p<0.05). Admission angpt-2 levels and angpt-2/1 ratios were significantly different in the severe sepsis/shock group when all groups were compared (both p<0.05). Additionally, the latter were significantly elevated in the severe sepsis/shock group at multiple time points (all p≤0.05) with the peak occurring on day 2 of illness. In a separate analysis, 32% of SIRS/sepsis and 82% of severe sepsis/shock had ‘variable’ angpt-2/1 ratio patterns compared to none in the control group (p<0.001). Conclusions Pediatric patients with severe sepsis and septic shock possess significantly elevated angpt-2/1 ratios during their first 3 days of illness which peak at day 2 of illness. A subset of these patients demonstrated ‘variable’ angpt-2/1 ratio patterns. PMID:24141659

Shuttle radar images for geologic mapping in tropical rainforest

NASA Technical Reports Server (NTRS)

Ford, J. P.; Da Cunha, R.

1986-01-01

Images of forested low-relief terrain in the Amazon basin of Brazil, obtained with airborne imaging radar in the Radambrasil project, are compared with SIR-A and Landsat MSS band-7 images to evaluate their usefulness in constructing geologic maps. Sample images are shown, and it is found that Radam images are more useful in distinguishing drainage patterns and mapping the region distribution of stream channels due to their relatively low depression angles (less than 25 deg as opposed to 43-37 deg for SIR-A), but that SIR-A images give superior discrimination of alluvial forest, where trees stand in water, due to the higher reflectivity of branches and water at the SIR-A wavelength (23.5 cm as opposed to 3 cm for Radam). Alluvial forest is also identified by Landsat band 7.

Analysis of multiple incidence angle SIR-B data for determining forest stand characteristics

NASA Technical Reports Server (NTRS)

Hoffer, R. M.; Lozano-Garcia, D. F.; Gillespie, D. D.; Mueller, P. W.; Ruzek, M. J.

1986-01-01

For the first time in the U.S. space program, digital synthetic aperture radar (SR) data were obtained from different incidence angles during Space Shuttle Mission 41-G. Shuttle Imaging Radar-B (SIR-B) data were obtained at incidence angles of 58 deg., 45 deg., and 28 deg., on October 9, 10, and 11, 1984, respectively, for a predominantly forested study area in northern Florida. Cloud-free LANDSAT Thematic Mapper (T.M.) data were obtained over the same area on October 12. The SIR-B data were processed and then digitally registered to the LANDSAT T.M. data by scientists at the Jet Propulsion Laboratory. This is the only known digitally registered SIR-B and T.M. data set for which the data were obtained nearly simultaneously. The data analysis of this information is discussed.

The incidence of leukaemia in women with BRCA1 and BRCA2 mutations: an International Prospective Cohort Study.

PubMed

Iqbal, Javaid; Nussenzweig, Andre; Lubinski, Jan; Byrski, Tomasz; Eisen, Andrea; Bordeleau, Louise; Tung, Nadine M; Manoukian, Siranoush; Phelan, Catherine M; Sun, Ping; Narod, Steven A

2016-05-10

Germline mutations in BRCA1 and BRCA2 increase the susceptibility to develop breast and ovarian cancers as well as increase the risk of some other cancers. Primary objective was to estimate the risk of leukaemia in BRCA1 and BRCA2 mutation carriers. We followed 7243 women with a BRCA1 or a BRCA2 mutation for incident cases of leukaemia. We used the standardised incidence ratio (SIR) to estimate the relative risk of leukaemia, according to mutation and history of breast cancer. We identified five incident cases of leukaemia (two BRCA1, three BRCA2). All five women had a prior history of breast cancer and four had received chemotherapy. The mean time from breast cancer diagnosis to the development of leukaemia was 10.2 years (range 3-18 years). The SIR for BRCA1 carriers was 0.66 (95% CI: 0.11-2.19, P=0.61) and the SIR for BRCA2 carriers was 2.42 (95% CI: 0.61-6.58, P=0.17). The SIR was significantly higher than expected for women with a BRCA2 mutation and breast cancer (SIR=4.76, 95% CI:1.21-12.96, P=0.03), in particular for women who received chemotherapy (SIR=8.11, 2.06-22.07, P=0.007). We observed an increased risk of leukaemia in women with a BRCA2 mutation who receive chemotherapy for breast cancer.

A novel and facile strategy for highly flame retardant polymer foam composite materials: Transforming silicone resin coating into silica self-extinguishing layer.

PubMed

Wu, Qian; Zhang, Qian; Zhao, Li; Li, Shi-Neng; Wu, Lian-Bin; Jiang, Jian-Xiong; Tang, Long-Cheng

2017-08-15

In this study, a novel strategy was developed to fabricate highly flame retardant polymer foam composite materials coated by synthesized silicone resin (SiR) polymer via a facile dip-coating processing. Applying the SiR polymer coating, the mechanical property and thermal stability of SiR-coated polymer foam (PSiR) composites are greatly enhanced without significantly altering their structure and morphology. The minimum oxygen concentration to support the combustion of foam materials is greatly increased, i.e. from LOI 14.6% for pure foam to LOI 26-29% for the PSiR composites studied. Especially, adjusting pendant group to SiOSi group ratio (R/Si ratio) of SiRs produces highly flame retardant PSiR composites with low smoke toxicity. Cone calorimetry results demonstrate that 44-68% reduction in the peak heat release rate for the PSiR composites containing different R/Si ratios over pure foam is achieved by the presence of appropriate SiR coating. Digital and SEM images of post-burn chars indicate that the SiR polymer coating can be transformed into silica self-extinguishing porous layer as effective inorganic barrier effect, thus preserving the polymer foam structure from fire. Our results show that the SiR dip-coating technique is a promising strategy for producing flame retardant polymer foam composite materials with improved mechanical properties. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparison of endoscopic and percutaneous drainage of symptomatic necrotic collections in acute necrotizing pancreatitis.

PubMed

Woo, Shanan; Walklin, Ryan; Ackermann, Travis; Lo, Sheng Wei; Shilton, Hamish; Pilgrim, Charles; Evans, Peter; Burnes, James; Croagh, Daniel

2018-05-10

Primary endoscopic and percutaneous drainage for pancreatic necrotic collections is increasingly used. We aim to compare the relative effectiveness of both modalities in reducing the duration and severity of illness by measuring their effects on systemic inflammatory response syndrome (SIRS). We retrospectively reviewed all cases of endoscopic and percutaneous drainage for pancreatic necrotic collections performed in 2011-2016 at two hospitals. We assessed the post-procedure length of hospital stay, reduction in C-reactive protein levels, resolution of SIRS, the complication rates, and the number of procedures required for resolution. Thirty-two patients were identified and 57 cases (36 endoscopic, 21 percutaneous) were included. There was no significant difference in C-reactive protein reduction between endoscopic and percutaneous drainage (69.5% vs 68.8%, P = 0.224). Resolution of SIRS was defined as the post-procedure normalization of white cell count (endoscopic vs percutaneous: 70.4% vs 64.3%, P = 0.477), temperature (endoscopic vs percutaneous: 93.3% vs 60.0%, P = 0.064), heart rate (endoscopic vs percutaneous: 56.0% vs 11.1%, P = 0.0234), and respiratory rate (endoscopic vs percutaneous: 83.3% vs 0.0%, P = 0.00339). Post-procedure length of hospital stay was 27 days with endoscopic drainage and 46 days with percutaneous drainage (P = 0.0183). Endoscopic drainage was associated with a shorter post-procedure length of hospital stay and a greater rate of normalization of SIRS parameters than percutaneous drainage, although only the effects on heart rate and respiratory rate reached statistical significance. Further studies are needed to establish which primary drainage modality is superior for pancreatic necrotic collections. © 2018 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

Is β-blocker (atenolol) a preferred antihypertensive in acute intracerebral hemorrhage?

PubMed

Kalita, Jayantee; Misra, Usha Kant; Kumar, Bishwanath

2013-07-01

The mortality in intracerebral hemorrhage (ICH) is mainly due to raised intracranial pressure, and its complications mediated by sympathetic overactivity. There is paucity of studies evaluating the role of β-blockers in the outcome of ICH. This study reports the role of atenolol in reducing mortality, pneumonia, systemic inflammatory response syndrome (SIRS), and 3 months outcome in the patients with hypertensive ICH. 138 consecutive patients with hypertensive ICH were included and their stroke risk factors and clinical details were recorded. Consciousness was assessed by Glasgow Coma Scale and severity of stroke by Canadian Neurological Scale. Volume of hematoma was measures on CT scan and occurrence of SIRS and pneumonia were noted. 3 months outcome was categorized into good (Barthel index >12) and poor (BI < 12). The patients were categorized into those receiving atenolol and nonatenolol. The effects of atenolol on stroke outcome parameters were evaluated. Seventy-nine patients received atenolol and 59 did not and they mainly received amlodipine. There was no difference in the base line clinical characteristics between the two groups except smoking (P = 0.01) and baseline blood pressure (P = 0.007). Atenolol significantly reduced the mortality (11.4 vs 37.3 %, P < 0.0001), SIRS (16.4 vs 40.9 %, P = 0.007), and pneumonia (8.9 vs 30.5 %, P = 0.002) compared to those not receiving atenolol. At 3 months, patients with atenolol had insignificantly better outcome compared to nonatenolol group (49.1 vs 31.9 %, P = 0.11). Use of atenolol in hypertensive ICH results in reduction in mortality, SIRS, and pneumonia which may be due to its β-adrenergic blocking effect.

A high-protein diet during hospitalization is associated with an accelerated decrease in soluble urokinase plasminogen activator receptor levels in acutely ill elderly medical patients with SIRS.

PubMed

Tavenier, Juliette; Haupt, Thomas H; Andersen, Aino L; Buhl, Sussi F; Langkilde, Anne; Andersen, Jens R; Jensen, Jens-Erik B; Pedersen, Mette M; Petersen, Janne; Andersen, Ove

2017-05-01

Acute illness and hospitalization in elderly individuals are often accompanied by the systemic inflammatory response syndrome (SIRS) and malnutrition, both associated with wasting and mortality. Nutritional support and resistance training were shown to increase muscle anabolism and reduce inflammation in healthy elderly. We hypothesized that nutritional support and resistance training would accelerate the resolution of inflammation in hospitalized elderly patients with SIRS. Acutely admitted patients aged >65 years with SIRS were randomized to an intervention consisting of a high-protein diet (1.7 g/kg per day) during hospitalization, and daily protein supplement (18.8 g) and 3 weekly resistance training sessions for 12 weeks after discharge (Intervention, n=14), or to standard-care (Control, n=15). Plasma levels of the inflammatory biomarkers soluble urokinase plasminogen activator receptor (suPAR), interleukin-6, C-reactive protein (CRP), and albumin were measured at admission, discharge, and 4 and 13 weeks after discharge. The Intervention group had an earlier decrease in suPAR levels than the Control group: -15.4% vs. +14.5%, P=.007 during hospitalization, and -2.4% vs. -28.6%, P=.007 between discharge and 4 weeks. There were no significant effects of the intervention on the other biomarkers. All biomarkers improved significantly between admission and 13 weeks, although with different kinetics (suPAR: -22%, interleukin-6: -86%, CRP: -89%, albumin: +11%). Nutritional support during hospitalization was associated with an accelerated decrease in suPAR levels, whereas the combined nutrition and resistance training intervention after discharge did not appear to affect the inflammatory state. Our results indicate that improved nutritional care during hospitalization may accelerate recovery in acutely ill elderly medical patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Procalcitonin fails to predict bacteremia in SIRS patients: a cohort study.

PubMed

Hoenigl, M; Raggam, R B; Wagner, J; Prueller, F; Grisold, A J; Leitner, E; Seeber, K; Prattes, J; Valentin, T; Zollner-Schwetz, I; Schilcher, G; Krause, R

2014-10-01

Procalcitonin (PCT) has previously been proposed as useful marker to rule out bloodstream-infection (BSI). The objective of this study was to evaluate the sensitivity of different PCT cut-offs for prediction of BSI in patients with community (CA)- and hospital-acquired (HA)-BSI. A total of 898 patients fulfilling systemic-inflammatory-response-syndrome (SIRS) criteria were enrolled in this prospective cohort study at the Medical University of Graz, Austria. Of those 666 patients had positive blood cultures (282 CA-BSI, 384 HA-BSI, enrolled between January 2011 and December 2012) and 232 negative blood cultures (enrolled between January 2011 and July 2011 at the emergency department). Blood samples for determination of laboratory infection markers (e.g. PCT) were collected simultaneously with blood cultures. Procalcitonin was significantly (p < 0.001) higher in SIRS patients with bacteremia/fungemia than in those without. Receiver operating characteristic curve analysis revealed an area under the curve (AUC) value of 0.675 for PCT (95% CI 0.636-0.714) for differentiating patients with BSI from those without. AUC for IL-6 was 0.558 (95% CI 0.515-0.600). However, even at the lowest cut-off evaluated (i.e. 0.1 ng/ml) PCT failed to predict BSI in 7% (n = 46) of patients. In the group of patients with SIRS and negative blood culture 79% (n = 185) had PCT levels > 0.1. Procalcitonin was significantly higher in patients with BSI than in those without and superior to IL-6 and CRP. The clinical importance of this is questionable, because a suitable PCT threshold for excluding BSI was not established. An approach where blood cultures are guided by PCT only can therefore not be recommended. © 2014 John Wiley & Sons Ltd.

A Two-Biomarker Model Predicts Mortality in the Critically Ill with Sepsis.

PubMed

Mikacenic, Carmen; Price, Brenda L; Harju-Baker, Susanna; O'Mahony, D Shane; Robinson-Cohen, Cassianne; Radella, Frank; Hahn, William O; Katz, Ronit; Christiani, David C; Himmelfarb, Jonathan; Liles, W Conrad; Wurfel, Mark M

2017-10-15

Improving the prospective identification of patients with systemic inflammatory response syndrome (SIRS) and sepsis at low risk for organ dysfunction and death is a major clinical challenge. To develop and validate a multibiomarker-based prediction model for 28-day mortality in critically ill patients with SIRS and sepsis. A derivation cohort (n = 888) and internal test cohort (n = 278) were taken from a prospective study of critically ill intensive care unit (ICU) patients meeting two of four SIRS criteria at an academic medical center for whom plasma was obtained within 24 hours. The validation cohort (n = 759) was taken from a prospective cohort enrolled at another academic medical center ICU for whom plasma was obtained within 48 hours. We measured concentrations of angiopoietin-1, angiopoietin-2, IL-6, IL-8, soluble tumor necrosis factor receptor-1, soluble vascular cell adhesion molecule-1, granulocyte colony-stimulating factor, and soluble Fas. We identified a two-biomarker model in the derivation cohort that predicted mortality (area under the receiver operator characteristic curve [AUC], 0.79; 95% confidence interval [CI], 0.74-0.83). It performed well in the internal test cohort (AUC, 0.75; 95% CI, 0.65-0.85) and the external validation cohort (AUC, 0.77; 95% CI, 0.72-0.83). We determined a model score threshold demonstrating high negative predictive value (0.95) for death. In addition to a low risk of death, patients below this threshold had shorter ICU length of stay, lower incidence of acute kidney injury, acute respiratory distress syndrome, and need for vasopressors. We have developed a simple, robust biomarker-based model that identifies patients with SIRS/sepsis at low risk for death and organ dysfunction.

Use of a Combination Biomarker Algorithm To Identify Medical Intensive Care Unit Patients with Suspected Sepsis at Very Low Likelihood of Bacterial Infection.

PubMed

Han, Jennifer H; Nachamkin, Irving; Coffin, Susan E; Gerber, Jeffrey S; Fuchs, Barry; Garrigan, Charles; Han, Xiaoyan; Bilker, Warren B; Wise, Jacqueleen; Tolomeo, Pam; Lautenbach, Ebbing

2015-10-01

Sepsis remains a diagnostic challenge in the intensive care unit (ICU), and the use of biomarkers may help in differentiating bacterial sepsis from other causes of systemic inflammatory syndrome (SIRS). The goal of this study was to assess test characteristics of a number of biomarkers for identifying ICU patients with a very low likelihood of bacterial sepsis. A prospective cohort study was conducted in a medical ICU of a university hospital. Immunocompetent patients with presumed bacterial sepsis were consecutively enrolled from January 2012 to May 2013. Concentrations of nine biomarkers (α-2 macroglobulin, C-reactive protein [CRP], ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) were determined at baseline and at 24 h, 48 h, and 72 h after enrollment. Performance characteristics were calculated for various combinations of biomarkers for discrimination of bacterial sepsis from other causes of SIRS. Seventy patients were included during the study period; 31 (44%) had bacterial sepsis, and 39 (56%) had other causes of SIRS. PCT and CRP values were significantly higher at all measured time points in patients with bacterial sepsis. A number of combinations of PCT and CRP, using various cutoff values and measurement time points, demonstrated high negative predictive values (81.1% to 85.7%) and specificities (63.2% to 79.5%) for diagnosing bacterial sepsis. Combinations of PCT and CRP demonstrated a high ability to discriminate bacterial sepsis from other causes of SIRS in medical ICU patients. Future studies should focus on the use of these algorithms to improve antibiotic use in the ICU setting. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Clinical Significance of Tissue Factor and CD13 Double-Positive Microparticles in Sirs Patients with Trauma and Severe Sepsis.

PubMed

Matsumoto, Hisatake; Yamakawa, Kazuma; Ogura, Hiroshi; Koh, Taichin; Matsumoto, Naoya; Shimazu, Takeshi

2017-04-01

Activated immune cells such as monocytes are key factors in systemic inflammatory response syndrome (SIRS) following trauma and sepsis. Activated monocytes induce almost all tissue factor (TF) expression contributing to inflammation and coagulation. TF and CD13 double-positive microparticles (TF/CD13MPs) are predominantly released from these activated monocytes. This study aimed to evaluate TF/CD13MPs and assess their usefulness as a biomarker of pathogenesis in early SIRS following trauma and sepsis. This prospective study comprising 24 trauma patients, 25 severe sepsis patients, and 23 healthy controls was conducted from November 2012 to February 2015. Blood samples were collected from patients within 24 h after injury and diagnosis of severe sepsis and from healthy controls. Numbers of TF/CD13MPs were measured by flow cytometry immediately thereafter. Injury Severity Score (ISS) and Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were calculated at patient enrollment. APACHE II and SOFA scores and International Society of Thrombosis and Haemostasis (ISTH) overt disseminated intravascular coagulation (DIC) diagnostic criteria algorithm were calculated at the time of enrollment of severe sepsis patients. Numbers of TF/CD13MPs were significantly increased in both trauma and severe sepsis patients versus controls and correlated significantly with ISS and APACHE II score in trauma patients and with APACHE II and ISTH DIC scores in severe sepsis patients. Increased numbers of TF/CD13MPs correlated significantly with severities in the acute phase in trauma and severe sepsis patients, suggesting that TF/CD13MPs are important in the pathogenesis of early SIRS following trauma and sepsis.

Use of a Combination Biomarker Algorithm To Identify Medical Intensive Care Unit Patients with Suspected Sepsis at Very Low Likelihood of Bacterial Infection

PubMed Central

Nachamkin, Irving; Coffin, Susan E.; Gerber, Jeffrey S.; Fuchs, Barry; Garrigan, Charles; Han, Xiaoyan; Bilker, Warren B.; Wise, Jacqueleen; Tolomeo, Pam; Lautenbach, Ebbing

2015-01-01

Sepsis remains a diagnostic challenge in the intensive care unit (ICU), and the use of biomarkers may help in differentiating bacterial sepsis from other causes of systemic inflammatory syndrome (SIRS). The goal of this study was to assess test characteristics of a number of biomarkers for identifying ICU patients with a very low likelihood of bacterial sepsis. A prospective cohort study was conducted in a medical ICU of a university hospital. Immunocompetent patients with presumed bacterial sepsis were consecutively enrolled from January 2012 to May 2013. Concentrations of nine biomarkers (α-2 macroglobulin, C-reactive protein [CRP], ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) were determined at baseline and at 24 h, 48 h, and 72 h after enrollment. Performance characteristics were calculated for various combinations of biomarkers for discrimination of bacterial sepsis from other causes of SIRS. Seventy patients were included during the study period; 31 (44%) had bacterial sepsis, and 39 (56%) had other causes of SIRS. PCT and CRP values were significantly higher at all measured time points in patients with bacterial sepsis. A number of combinations of PCT and CRP, using various cutoff values and measurement time points, demonstrated high negative predictive values (81.1% to 85.7%) and specificities (63.2% to 79.5%) for diagnosing bacterial sepsis. Combinations of PCT and CRP demonstrated a high ability to discriminate bacterial sepsis from other causes of SIRS in medical ICU patients. Future studies should focus on the use of these algorithms to improve antibiotic use in the ICU setting. PMID:26239984

Three dimensional perspective view of portion of western Galapagos Islands

NASA Image and Video Library

1994-04-18

STS059-S-085 (18 April 1994) --- This is a three-dimensional perspective view of part of Isla Isabela in the western Galapagos Islands. It was taken by the L-Band radar in HH polarization from the Spaceborne Imaging Radar-C and X-Band Synthetic Aperture Radar (SIR-C/X-SAR) on the 40th orbit of the Space Shuttle Endeavour. This view was constructed by overlaying a SIR-C radar image on a U.S. Geological Survey digital elevation map. The image is centered at about .5 degrees south latitude and 91 degrees west longitude, and covers an area of 75 by 60 kilometers. The radar incidence angle at the center of the image is about 20 degrees. The western Galapagos Islands, which lie about 1200 kilometers west of Ecuador in the eastern Pacific, have six active volcanoes similar to the volcanoes found in Hawaii. Since the time of Charles Darwin's visit to the area in 1835, there have been over 60 recorded eruptions on these volcanoes. This SIR-C/X-SAR image of Alcedo and Sierra Negra volcanoes shows the rougher lava flows as bright features, while ash deposits and smooth pahoehoe lava flows appear dark. The Galapagos Islands are one of the SIR-C/X-SAR supersites and data of this area will be taken several times during the flight to allow scientists to conduct topographic change studies and to search for different lava flow types, ash deposits and fault lines. SIR-C/X-SAR is part of NASA's Mission to Planet Earth (MTPE). SIR-C/X-SAR radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43938

Mortality and cancer morbidity after exposure to military aircraft fuel.

PubMed

Seldén, A; Ahlborg, G

1991-08-01

In order to elucidate a possible excess risk of lymphatic malignancies due to aircraft fuel exposure in the Swedish Armed Forces (SAF), a historical prospective cohort study was conducted. During a 9-year follow-up period, 3 cases of malignant lymphoma were detected versus 3.21 expected tumors of the lymphatic system (standardized incidence ratio (SIR) 93; 95% confidence interval (CI) 19-273) among 2,176 men. The overall SIR was 91 (CI 66-120), whereas the corresponding mortality ratio was only 54 (CI 42-68; p less than 0.001). In conclusion, no evidence was found for an association between military aircraft fuel and the occurrence of malignant lymphomas or other malignancies among exposed men in the SAF. For a definite risk assessment, further follow-up is necessary.

Granular statistical mechanics - Building on the legacy of Sir Sam Edwards

NASA Astrophysics Data System (ADS)

Blumenfeld, Raphael

When Sir Sam Edwards laid down the foundations for the statistical mechanics of jammed granular materials he opened a new field in soft condensed matter and many followed. In this presentation we review briefly the Edwards formalism and some of its less discussed consequences. We point out that the formalism is useful for other classes of systems - cellular and porous materials. A certain shortcoming of the original formalism is then discussed and a modification to overcome it is proposed. Finally, a derivation of an equation of state with the new formalism is presented; the equation of state is analogous to the PVT relation for thermal gases, relating the volume, the boundary stress and measures of the structural and stress fluctuations. NUDT, Changsha, China, Imperial College London, UK, Cambridge University, UK.

The use of the chick embryo chorioallantoic membrane as experimental model to study virus growth and to test the clonal selection hypothesis. The contribution of Sir Mac Farlane Burnet.

PubMed

Ribatti, Domenico

2018-06-07

Sir Mac Farlane Burnet was the most honored of all Australian scientists. In 1960, Burnet shared the Nobel Prize for Medicine with Peter Medawar of Britain for the discovery of acquired immunological tolerance. He developed techniques for growing influenza viruses in the chorioallantoic membrane of the chick embryo. This became a standard laboratory practice. He continued to work with chick embryos long after the use of cell cultures had become general. His virology research resulted in significant discoveries concerning the nature and replication of viruses and their interaction with the immune system. Copyright © 2018 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

Predicting changes in reported notifiable disease rates for New Zealand using a SIR modelling approach

NASA Astrophysics Data System (ADS)

McBride, Graham; Slaney, David; Tait, Andrew

2013-04-01

The New Zealand health system has defined as 'notifiable' over 50 diseases. Of these campylobacteriosis is the most commonly reported comprising 41% of all notifications in 2011 (presently about 150 illness cases per 100,000 population per annum). Furthermore, the incidence of this mild illness, which is potentially waterborne, is under-reported by at least an order-of-magnitude. Increased downstream pathogen loads and/or disease incidence have been found to be associated with increased rainfall, particularly in agricultural landscapes. Therefore, given the predominance of agricultural land uses in New Zealand, transmission and exposure to its agent (thermotolerant Campylobacter bacteria) may be affected by changing rainfall and temperature patterns associated with climate change. Reporting rates for other potentially water-borne zoonoses are also noticeable (for example, the reported rate for cryptosporidiosis for 2011 was 14 per 100,000 population). The distribution of Cryptosporidium oocysts in the environment may be influenced by climate change because it has often been implicated in drinking-water contamination, and heavy rainfall events have been found to be associated with increased pathogen loads in rivers and disease incidence. Given this background, which may also be applicable to other countries with agriculturally-dominated landscapes, a New Zealand study was initiated to develop a decision-support system for the projected effects of climate change on a selected suite of environmentally-transmitted pathogens, including Campylobacter and Cryptosporodium oocysts. Herein we report on the manner in which a linear SIR (Susceptible-Ill-Recovered) model previously developed for campylobacteriosis can be extended to cryptosporidiosis, applied to changes in pathogen contact rate and hence reported illness, and coupled to climate change projections associated with different greenhouse gas emission scenarios. The resulting SIR model outputs provided projected changes in reported disease incidence as a function of temperature and rainfall. These models account for age-dependency (children versus adults), which is especially important because children can report substantially higher rates of zoonoses. The model is linear because the zoonotic pathogen 'reservoir' is overwhelmingly among animals, and so the usual interaction in which human-pathogen interactions affect the degree of environmental contamination does not apply in the short term (on the order of one year). Accordingly, the interaction can be approximated by a constant contact rate over a given year, even though the contact rates may vary between decades because of climate change and variability. This linearity property enables the derivation of analytical solutions to the model's governing equations, thereby providing for a more elegant examination of the model's properties and for making projections under climate change. The models have been calibrated to reported rates of these diseases. Simple exponential functions have been used to vary the pathogen contact rates for the reference years 2015, 2040 and 2090 under three climate change scenarios of low, medium and high emissions of greenhouse gases (B1, A1B, and A2). These formulations have been guided by the results of statistical models calibrated to historical disease reporting rates. The models have been used to calculate the ratio of reported illness rates to present rates projected for future years across New Zealand at the ~5 km scale. Detailed results will be presented for the reference year 2040.

ARC-20180410-AAV3109-SOFIA-Penrose-NASAWeb

NASA Image and Video Library

2018-04-10

Lecture by Sir Roger Penrose on the New Cosmological View of Dark Matter, which Strangely and Slowly Decays. Sir Penrose shares his latest research and provides insight into the thinking of a modern day theoretical physicist.

Delineation of major geologic structures in Turkey using SIR-B data

NASA Technical Reports Server (NTRS)

Toksoz, M. N.; Pettengill, G. H.; Ford, P.; Gulen, L.

1984-01-01

Shuttle Imaging Radar-B (SIR-B) images of well mapped segments of major faults, such as the North Anatolian Fault (NAF) and East Anatolian Fault (EAF) will be studied to identify the prominent signatures that characterize the fault zones for those specific regions. The information will be used to delineate the unmapped fault zones in areas with similar geological and geomorphological properties. The data obtained from SIR-B images will be compared and correlated with the LANDSAT thematic mapper and seismicity alignments based on well constrained earthquake epicenters.

Basal cell carcinoma of the eyelid in Finland during 1953-97.

PubMed

Paavilainen, Ville; Tuominen, Juhani; Pukkala, Eero; Saari, K Matti

2005-04-01

To study the incidence of basal cell carcinoma (BCC) of the eyelid in Finland. We studied 6241 cases of BCC of the eyelid reported to the nationwide Finnish Cancer Registry during 1953-97. We determined the age- and sex- specific incidence rates and overall rates adjusted for age to the world standard population, and social class- and occupation-specific standardized incidence ratios, with the total Finnish population as reference. The incidence rates of BCC of the eyelid varied between 0.7 and 3.0 per 100 000 person-years in men and between 0.5 and 2.8 per 100 000 person-years in women during the study period. The age-adjusted incidence rates of BCC of the eyelid increased during 1953-87 (p < 0.0001). The incidence of BCC of the eyelid rose significantly with age. There were no significant differences in standardized incidence ratios (SIRs) for BCC of the eyelid between different social class and occupation categories. Age-adjusted incidence rates showed that BCC of the eyelid was more than twice as frequent during 1978-97 than before 1968. Ageing may partly explain the increased incidence of BCC of the eyelid, whereas there were no differences in the SIRs for BCC of the eyelid between different social class and occupation categories in Finland.

Risk of cancer in patients receiving non-biologic disease-modifying therapy for rheumatoid arthritis compared with the UK general population

PubMed Central

Mercer, Louise K.; Davies, Rebecca; Galloway, James B.; Low, Audrey; Lunt, Mark; Dixon, William G.; Watson, Kath D.; Symmons, Deborah P. M.

2013-01-01

Objectives. To quantify the risk of cancer and compare it with that for the general population in a modern cohort of UK patients with RA and to identify risk factors for cancer among this cohort. Methods. The study population comprised biologic-naïve RA subjects receiving non-biologic disease-modifying therapy recruited to the British Society for Rheumatology Biologics Register from 2002 to 2009. Standardized incidence ratios (SIRs) for cancers were calculated using age- and gender-specific cancer rates in the English population. Poisson regression models adjusted for age and gender using England general population data were used to determine the association of other predictors with incident malignancy. Results. The cohort comprised 3771 individuals with RA contributing 13 315 person-years of follow-up. One hundred and eighty-two cancers were reported: 156 solid and 26 myelo- or lymphoproliferative cancers. The overall SIR was 1.28 (95% CI 1.10, 1.48). Risks of lung cancer (SIR 2.39, 95% CI 1.75, 3.19), Hodgkin lymphoma (SIR 12.82, 95% CI 4.16, 29.92) and non-Hodgkin lymphoma (SIR 3.12, 95% CI 1.79, 5.07) were higher compared with the general population and risks of prostate cancer (SIR 0.35, 95% CI 0.11, 0.82) and cancers of the female genital organs (SIR 0.35, 95% CI 0.10, 0.90) were reduced. Within the cohort, cancer risk was more than 2-fold higher in current or ex-smokers than in non-smokers. Conclusion. The overall incidence of cancer was increased in this national cohort of subjects with RA. The association of RA with certain cancers needs to be considered when studying the effects of biologic therapy, such as anti-TNF, on cancer risk. PMID:23238979

Three dimensional perspective view of Mammoth Mountain, California

NASA Image and Video Library

1994-04-17

STS059-S-084 (17 April 1994) --- This is a three-dimensional perspective of Mammoth Mountain, California. This view was constructed by overlaying a SIR-C radar image on a U.S. Geological Survey digital elevation map. Vertical exaggeration is 2x. The image is centered at 37.6 degrees north, 119.0 degrees west. It was acquired from the Spaceborne Imaging Radar-C and X-Band Synthetic Aperture Radar (SIR-C/X-SAR) onboard the Space Shuttle Endeavour on its 67th orbit, April 13, 1994. In this color representation, red is C-Band HV-polarization, green is C-Band VV-polarization and blue is the ratio of C-Band VV to C-Band HV. Blue areas are smooth and yellow areas are rock outcrops with varying amounts of snow and vegetation. Crowley Lake is in the foreground and Highway 395 crosses in the middle of the image. Mammoth Mountain is shown in the upper right. SIR-C/X-SAR is part of NASA's Mission to Planet Earth (MTPE). SIR-C/X-SAR radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43933

Solid Tumors After Chemotherapy or Surgery for Testicular Nonseminoma: A Population-Based Study

PubMed Central

Fung, Chunkit; Fossa, Sophie D.; Milano, Michael T.; Oldenburg, Jan; Travis, Lois B.

2013-01-01

Purpose Increased risks of solid tumors after older radiotherapy strategies for testicular cancer (TC) are well established. Few population-based studies, however, focus on solid cancer risk among survivors of TC managed with nonradiotherapy approaches. We quantified the site-specific risk of solid cancers among testicular nonseminoma patients treated in the modern era of cisplatin-based chemotherapy, without radiotherapy. Patients and Methods Standardized incidence ratios (SIRs) for solid tumors were calculated for 12,691 patients with testicular nonseminoma reported to the population-based Surveillance, Epidemiology, and End Results program (1980 to 2008) and treated initially with either chemotherapy (n = 6,013) or surgery (n = 6,678) without radiotherapy. Patients accrued 116,073 person-years of follow-up. Results Two hundred ten second solid cancers were observed. No increased risk followed surgery alone (SIR, 0.93; 95% CI, 0.76 to 1.14; n = 99 solid cancers), whereas significantly increased 40% excesses (SIR, 1.43; 95% CI, 1.18 to 1.73; n = 111 solid cancers) occurred after chemotherapy. Increased risks of solid cancers after chemotherapy were observed in most follow-up periods (median latency, 12.5 years), including more than 20 years after treatment (SIR, 1.54; 95% CI, 0.96 to 2.33); significantly increased three- to seven-fold risks occurred for cancers of the kidney (SIR, 3.37; 95% CI, 1.79 to 5.77), thyroid (SIR, 4.40; 95% CI, 2.19 to 7.88), and soft tissue (SIR, 7.49; 95% CI, 3.59 to 13.78). Conclusion To our knowledge, this is the first large population-based series reporting significantly increased risks of solid cancers among patients with testicular nonseminoma treated in the modern era of cisplatin-based chemotherapy. Subsequent analytic studies should focus on the evaluation of dose-response relationships, types of solid cancers, latency patterns, and interactions with other possible factors, including genetic susceptibility. PMID:24043737

The Shuttle Imaging Radar B (SIR-B) experiment report

NASA Technical Reports Server (NTRS)

Cimino, Jo Bea; Holt, Benjamin; Richardson, Annie

1988-01-01

The primary objective of the SIR-B experiment was to acquire multiple-incidence-angle radar imagery of a variety of Earth's surfaces to better understand the effects of imaging geometry on radar backscatter. A complementary objective was to map extensive regions of particular interest. Under these broad objectives, many specific scientific experiments were defined by the 43 SIR-B Science Team members, including studies in the area of geology, vegetation, radar penetration, oceanography, image analysis, and calibration technique development. Approximately 20 percent of the planned digital data were collected, meeting 40 percent of the scientific objectives. This report is an overview of the SIR-B experiment and includes the science investigations, hardware design, mission scenario, mission operations, events of the actual missions, astronaut participation, data products (including auxiliary data), calibrations, and a summary of the actual coverage. Also included are several image samples.

Shuttle imaging radar views the Earth from Challenger: The SIR-B experiment

NASA Technical Reports Server (NTRS)

Ford, J. P.; Cimino, J. B.; Holt, B.; Ruzek, M. R.

1986-01-01

In October 1984, SIR-B obtained digital image data of about 6.5 million km2 of the Earth's surface. The coverage is mostly of selected experimental test sites located between latitudes 60 deg north and 60 deg south. Programmed adjustments made to the look angle of the steerable radar antenna and to the flight attitude of the shuttle during the mission permitted collection of multiple-incidence-angle coverage or extended mapping coverage as required for the experiments. The SIR-B images included here are representative of the coverage obtained for scientific studies in geology, cartography, hydrology, vegetation cover, and oceanography. The relations between radar backscatter and incidence angle for discriminating various types of surfaces, and the use of multiple-incidence-angle SIR-B images for stereo measurement and viewing, are illustrated with examples. Interpretation of the images is facilitated by corresponding images or photographs obtained by different sensors or by sketch maps or diagrams.

The Scientific Papers of the Honourable Henry Cavendish, F. R. S. 2 Volume Set

NASA Astrophysics Data System (ADS)

Cavendish, Henry; Clerk Maxwell, James; Thorpe, Edward, , Sir; Larmor, Joseph, , Sir

2011-02-01

Volume 1: Preface Sir Joseph Larmor; Introduction; First published paper on electricity, 1771; Preliminary propositions; Appendix; Thoughts concerning electricity; Account of the experiments; Second published paper on electricity, 1776; Experiments in 1771; Experiments in 1772; Experiments in 1773; Measurers; Experiments with the artificial torpedo; Resistance to electricity; Results of comparisons of charges; Results on resistance; Notes by the editor, 1879 James Clerk Maxwell; Life of Cavendish Thomas Young; Index to Cavendish Manuscripts. Volume 2: Introduction; Reprint of papers communicated by Cavendish to the Royal Society and published in the Philosophical Transactions; Unpublished papers from the original manuscripts in the possession of the Duke of Devonshire, K. G., LL. D., F. R. S.; Cavendish's mathematical and dynamical manuscripts Sir Joseph Larmor; Cavendish as a geologist Sir Archibald Geikie; Cavendish's astronomical manuscripts Sir Frank W. Dyson; Cavendish's magnetic work Charles Chree; Index.

Using CONTENT 1.5 to analyze an SIR model for childhood infectious diseases

NASA Astrophysics Data System (ADS)

Su, Rui; He, Daihai

2008-11-01

In this work, we introduce a standard software CONTENT 1.5 for analysis of dynamical systems. A simple model for childhood infectious diseases is used as an example. The detailed steps to obtain the bifurcation structures of the system are given. These bifurcation structures can be used to explain the observed dynamical transition in measles incidences.

The Preservation of Schwa in the Converging Phonological System of Frenchville (PA) French

ERIC Educational Resources Information Center

Bullock, Barbara E.; Gerfen, Chip

2005-01-01

The phonological system of the French of Frenchville, Pennsylvania (USA) demonstrates a dramatic case of transfer in the latest (and last) generation of bilingual French-English speakers: the mid front round vowels, [ligature of o and e] and [slashed o], have often been replaced by the English rhoticized schwa as found in the word "sir."…

Geographical and epidemiological analysis of oncological incidence in paediatric and adolescent ages in a municipality of North-Western Italy: Vercelli, years 2002-2009.

PubMed

Salerno, C; Berchialla, P; Palin, L A; Barasolo, E; Fossale, P G; Marciani, P

2017-01-01

This study of the geographical incidence on the oncological mortality in young age (0-44 years) in the City of Vercelli, was aimed to address the concerns of the population and the request of municipal administrators. A detailed and sophisticated study for a City of medium-small size is due for the presence of various sources of pressure, such as a MSW incinerator just a few kilometres from the city and an intensive agricultural activity that characterizes the entire area. The study is based on the census analysis of the population, and of the hospital admission cards, and it considers epidemiological standardized estimators and spatial analysis through Bayesian models, as well. Both approaches highlight Major risks for the area south of the city for major tumours such as total cancer in women (SIR / SMR significant excess of about 50%), colorectal (mean increments SMR / SIR between 3 and 4 times), ovary (mean increments SMR / SIR between 3:04 and times), and nervous system (increases 3 times for both indicators). These results deserve further studies through inferential case-control and cohort analysis, given the marginal role of the possible occupational hazards in the aetiology of juvenile cancer disorders.