Potential sources of operating room air contamination: a preliminary study.

BACKGROUND: The Neptune® surgical suction system (NSSS) and the Bair Hugger® (BH) forced-air warmer both discharge filtered exhaust or heated air into the operating room (OR), often in close proximity to a surgical site. AIM: To assess the effectiveness of this filtration, we examined the quantity and identity of microbial colonies emitted from their output ports compared with those obtained from circulating air entering the OR. METHODS: Air samples were collected from each device using industry-standard sampling devices in which a measured volume of air is impacted on to a blood agar plate at a controlled flow rate. Twelve ORs were studied. Sample plates were incubated for one week per study protocol, then interpreted for colony counts and sent for species identification. FINDINGS: The average colony count from the NSSS exhaust was not significantly different from that obtained from room air samples, however the average count from the BH output was significantly higher (P=0.0086) than room air. Genetic identification profiles revealed the presence of environmental or commensal organisms that differed depending on the source. High variability in colony counts from both devices suggests that certain NSSS and BH devices could be significant sources of OR air contamination. CONCLUSIONS: Our study showed that the BH patient warming device could be a source of airborne microbial contamination in the OR and that individual BH and NSSS units exhibit a higher output of microbial cfu than would be expected compared with incoming room air. We make simple suggestions on ways to mitigate these risks.

Bayesian Machine Learning Approach to the Quantification of Uncertainties on Ab Initio Potential Energy Surfaces.

This work introduces a novel methodology for the quantification of uncertainties associated with potential energy surfaces (PESs) computed from first-principles quantum mechanical calculations. The methodology relies on Bayesian inference and machine learning techniques to construct a stochastic PES and to express the inadequacies associated with the ab initio data points and their fit. By combining high fidelity calculations and reduced-order modeling, the resulting stochastic surface is efficiently forward propagated via quasi-classical trajectory and master equation calculations. In this way, the PES contribution to the uncertainty on predefined quantities of interest (QoIs) is explicitly determined. This study is done at both microscopic (e.g., rovibrational-specific rate coefficients) and macroscopic (e.g., thermal and chemical relaxation properties) levels. A correlation analysis is finally applied to identify the PES regions that require further refinement, based on their effects on the QoI reliability. The methodology is applied to the study of singlet (11A') and quintet (25A') PESs describing the interaction between O2 molecules and O atoms in their ground electronic state. The investigation of the singlet surface reveals a negligible uncertainty on the kinetic properties and relaxation times, which are found to be in excellent agreement with the ones previously published in the literature. On the other hand, the methodology demonstrated significant uncertainty on the quintet surface, due to inaccuracies in the description of the exchange barrier and the repulsive wall. When forward propagated, this uncertainty is responsible for the variability of 1 order of magnitude in the vibrational relaxation time and of factor four in the exchange reaction rate coefficient, both at 2500 K.

BRAF V600E mutation in Juvenile Xanthogranuloma family neoplasms of the central nervous system (CNS-JXG): a revised diagnostic algorithm to include pediatric Erdheim-Chester disease.

The family of juvenile xanthogranuloma family neoplasms (JXG) with ERK-pathway mutations are now classified within the "L" (Langerhans) group, which includes Langerhans cell histiocytosis (LCH) and Erdheim Chester disease (ECD). Although the BRAF V600E mutation constitutes the majority of molecular alterations in ECD and LCH, only three reported JXG neoplasms, all in male pediatric patients with localized central nervous system (CNS) involvement, are known to harbor the BRAF mutation. This retrospective case series seeks to redefine the clinicopathologic spectrum of pediatric CNS-JXG family neoplasms in the post-BRAF era, with a revised diagnostic algorithm to include pediatric ECD. Twenty-two CNS-JXG family lesions were retrieved from consult files with 64% (n = 14) having informative BRAF V600E mutational testing (molecular and/or VE1 immunohistochemistry). Of these, 71% (n = 10) were pediatric cases (≤18 years) and half (n = 5) harbored the BRAF V600E mutation. As compared to the BRAF wild-type cohort (WT), the BRAF V600E cohort had a similar mean age at diagnosis [BRAF V600E: 7 years (3-12 y), vs. WT: 7.6 years (1-18 y)] but demonstrated a stronger male/female ratio (BRAF V600E: 4 vs WT: 0.67), and had both more multifocal CNS disease ( BRAFV600E: 80% vs WT: 20%) and systemic disease (BRAF V600E: 40% vs WT: none). Radiographic features of CNS-JXG varied but typically included enhancing CNS mass lesion(s) with associated white matter changes in a subset of BRAF V600E neoplasms. After clinical-radiographic correlation, pediatric ECD was diagnosed in the BRAF V600E cohort. Treatment options varied, including surgical resection, chemotherapy, and targeted therapy with BRAF-inhibitor dabrafenib in one mutated case. BRAF V600E CNS-JXG neoplasms appear associated with male gender and aggressive disease presentation including pediatric ECD. We propose a revised diagnostic algorithm for CNS-JXG that includes an initial morphologic diagnosis with a final integrated diagnosis after clinical-radiographic and molecular correlation, in order to identify cases of pediatric ECD. Future studies with long-term follow-up are required to determine if pediatric BRAF V600E positive CNS-JXG neoplasms are a distinct entity in the L-group histiocytosis category or represent an expanded pediatric spectrum of ECD.

Construction of a coarse-grain quasi-classical trajectory method. I. Theory and application to N2-N2 system.

This work aims to construct a reduced order model for energy transfer and dissociation in non-equilibrium nitrogen mixtures. The objective is twofold: to present the Coarse-Grain Quasi-Classical Trajectory (CG-QCT) method, a novel framework for constructing a reduced order model for diatom-diatom systems; and to analyze the physics of non-equilibrium relaxation of the nitrogen molecules undergoing dissociation in an ideal chemical reactor. The CG-QCT method couples the construction of the reduced order model under the coarse-grain model framework with the quasi-classical trajectory calculations to directly construct the reduced model without the need for computing the individual rovibrational specific kinetic data. In the coarse-grain model, the energy states are lumped together into groups containing states with similar properties, and the distribution of states within each of these groups is prescribed by a Boltzmann distribution at the local translational temperature. The required grouped kinetic properties are obtained directly by the QCT calculations. Two grouping strategies are considered: energy-based grouping, in which states of similar internal energy are lumped together, and vibrational grouping, in which states with the same vibrational quantum number are grouped together. A zero-dimensional chemical reactor simulation, in which the molecules are instantaneously heated, forcing the system into strong non-equilibrium, is used to study the differences between the two grouping strategies. The comparison of the numerical results against available experimental data demonstrates that the energy-based grouping is more suitable to capture dissociation, while the energy transfer process is better described with a vibrational grouping scheme. The dissociation process is found to be strongly dependent on the behavior of the high energy states, which contribute up to 50% of the dissociating molecules. Furthermore, up to 40% of the energy required to dissociate the molecules comes from the rotational mode, underscoring the importance of accounting for this mode when constructing non-equilibrium kinetic models. In contrast, the relaxation process is governed primarily by low energy states, which exhibit significantly slower transitions in the vibrational binning model due to the prevalence of mode separation in these states.

Enhanced B Cell Alloantigen Presentation and Its Epigenetic Dysregulation in Liver Transplant Rejection.

T cell suppression prevents acute cellular rejection but causes life-threatening infections and malignancies. Previously, liver transplant (LTx) rejection in children was associated with the single-nucleotide polymorphism (SNP) rs9296068 upstream of the HLA-DOA gene. HLA-DOA inhibits B cell presentation of antigen, a potentially novel antirejection drug target. Using archived samples from 122 white pediatric LTx patients (including 77 described previously), we confirmed the association between rs9296068 and LTx rejection (p = 0.001, odds ratio [OR] 2.55). Next-generation sequencing revealed that the putative transcription factor (CCCTC binding factor [CTCF]) binding SNP locus rs2395304, in linkage disequilibrium with rs9296068 (D' 0.578, r(2) = 0.4), is also associated with LTx rejection (p = 0.008, OR 2.34). Furthermore, LTx rejection is associated with enhanced B cell presentation of donor antigen relative to HLA-nonidentical antigen in a novel cell-based assay and with a downregulated HLA-DOA gene in a subset of these children. In lymphoblastoid B (Raji) cells, rs2395304 coimmunoprecipitates with CTCF, and CTCF knockdown with morpholino antisense oligonucleotides enhances alloantigen presentation and downregulates the HLA-DOA gene, reproducing observations made with HLA-DOA knockdown and clinical rejection. Alloantigen presentation is suppressed by inhibitors of methylation and histone deacetylation, reproducing observations made during resolution of rejection. Enhanced donor antigen presentation by B cells and its epigenetic dysregulation via the HLA-DOA gene represent novel opportunities for surveillance and treatment of transplant rejection.

Energy transfer models in nitrogen plasmas: analysis of N2(X¹Σg⁺)-N(4S(u))-e⁻ interaction.

The relaxation of N2(X¹Σg⁺) molecules in a background gas composed of N((4)S(u)) atoms and free electrons is studied by using an ideal isochoric and isothermic chemical reactor. A rovibrational state-to-state model is developed to study energy transfer process induced by free electron and atomic collisions. The required cross sections and the corresponding rate coefficients are taken from two well-known kinetic databases: NASA Ames kinetic mechanism for the description of the N2(X¹Σg⁺)-N((4)S(u)) processes and the Phys4Entry database for the electron driven processes, N2(X¹Σg⁺)-e(-). The evolution of the population densities of each individual rovibrational level is explicitly determined via the numerical solution of the master equation for temperatures ranging from 10000 to 30,000 K. It was found that the distribution of the rovibrational energy levels of N2(X¹Σg⁺) is strongly influenced by the electron driven collisional processes, which promote the excitation of the low lying vibrational levels. The macroscopic vibrational energy relaxation is governed by the molecule-atom collisions, when free electrons, initially cold are relaxing to the final heat-bath temperature. Thus, the main role of the free electrons is to ensure the equilibration of vibrational and free electron excitation, thus validating the existence of the local equilibrium T(V)-T(e). However, if electrons and heavy particles are assumed to be in equilibrium at the heat bath temperature, electron driven processes dominate the vibrational relaxation. Finally, we have assessed the validity of the Landau-Teller model for the description of the inelastic energy transfer between molecules and free electrons. In the case of free-electron temperatures lower than 10,000 K, Landau-Teller relaxation model gives an accurate description of the vibrational relaxation, while at higher temperatures the error in the predictions can be significant and the model should not be used.

Nonequilibrium shock-heated nitrogen flows using a rovibrational state-to-state method.

A rovibrational collisional model is developed to study the internal energy excitation and dissociation processes behind a strong shock wave in a nitrogen flow. The reaction rate coefficients are obtained from the ab initio database of the NASA Ames Research Center. The master equation is coupled with a one-dimensional flow solver to study the nonequilibrium phenomena encountered in the gas during a hyperbolic reentry into Earth's atmosphere. The analysis of the populations of the rovibrational levels demonstrates how rotational and vibrational relaxation proceed at the same rate. This contrasts with the common misconception that translational and rotational relaxation occur concurrently. A significant part of the relaxation process occurs in non-quasi-steady-state conditions. Exchange processes are found to have a significant impact on the relaxation of the gas, while predissociation has a negligible effect. The results obtained by means of the full rovibrational collisional model are used to assess the validity of reduced order models (vibrational collisional and multitemperature) which are based on the same kinetic database. It is found that thermalization and dissociation are drastically overestimated by the reduced order models. The reasons of the failure differ in the two cases. In the vibrational collisional model the overestimation of the dissociation is a consequence of the assumption of equilibrium between the rotational energy and the translational energy. The multitemperature model fails to predict the correct thermochemical relaxation due to the failure of the quasi-steady-state assumption, used to derive the phenomenological rate coefficient for dissociation.

Ovarian cancer stem-like side-population cells are tumourigenic and chemoresistant.

BACKGROUND: Ovarian cancer is the most lethal gynaecological malignancy. Although ovarian cancer patients often respond initially to chemotherapy, they usually develop chemoresistance. We hypothesised that a small portion of ovarian cancer cells have stem-like cell properties that contribute to tumourigenesis and drug resistance. METHODS: Flow cytometry and Hoechst 33342 efflux isolated side-population (SP) cells from ascites derived from ovarian cancer patients and from mice inoculated with human ovarian cancer cell lines. The SP cells were examined for stem cell markers OCT4, NANOG, STELLAR, and ABCG2/BCRP1 by immunocytochemistry and RT-PCR. The SP cells and non-SP cells were studied for tumourigenesis and chemoresistance in vitro and in vivo. RESULTS: The SP cells expressed ABCG2/BCRP1, OCT4, STELLAR, and NANOG, detected by immunocytochemistry and RT-PCR. ABCG2/BCRP1 expression was higher in SP than in non-SP cells. Xenogeneic mice inoculated with SP cells yielded more tumours than did mice inoculated with non-SP cells. In parallel, SP cell culture resulted in extensive cell proliferation, which was markedly more than in non-SP cells. SP cells resisted chemotherapy compared with non-SP cells, both in vivo and in vitro. CONCLUSION: Ovarian cancer SP cells are tumourigenic and chemoresistant. ABCG2/BCRP1 has an important role in chemoresistance, which has implications for new therapeutic approaches.

Temporal variation in the genetic structure of a drone congregation area: an insight into the population dynamics of wild African honeybees (Apis mellifera scutellata).

The mating system of the honeybee (Apis mellifera) has been regarded as one of the most panmictic in the animal kingdom, with thousands of males aggregating in drone congregation areas (DCAs) that virgin queens visit to mate with tens of partners. Although males from many colonies gather at such congregations, the temporal changes in the colonies contributing drones remain unknown. Yet, changes in the DCAs' genetic structure will ultimately determine population gene flow and effective population size. By repeatedly sampling drones from an African DCA over a period of 3 years, we studied the temporal changes in the genetic structure of a wild honeybee population. Using three sets of tightly linked microsatellite markers, we were able to reconstruct individual queen genotypes with a high accuracy, follow them through time and estimate their rate of replacement. The number of queens contributing drones to the DCA varied from 12 to 72 and was correlated with temperature and rainfall. We found that more than 80% of these queens were replaced by mostly unrelated ones in successive eight months sampling intervals, which resulted in a clear temporal genetic differentiation of the DCA. Our results suggest that the frequent long-range migration of colonies without nest-site fidelity is the main driver of this high queen turnover. DCAs of African honeybees should thus be regarded as extremely dynamic systems which together with migration boost the effective population size and maintain a high genetic diversity in the population.

Allospecific CD154+ T cells associate with rejection risk after pediatric liver transplantation.

Antigen-specific T cells, which express CD154 rapidly, but remain untested in alloimmunity, were measured with flow cytometry in 16-h MLR of 58 identically-immunosuppressed children with liver transplantation (LTx), to identify Rejectors (who had experienced biopsy-proven rejection within 60 days posttransplantation). Thirty-one children were sampled once, cross-sectionally. Twenty-seven children were sampled longitudinally, pre-LTx, and at 1-60 and 61-200 days after LTx. Results were correlated with proliferative alloresponses measured by CFSE-dye dilution (n = 23), and CTLA4, a negative T-cell costimulator, which antagonizes CD154-mediated effects (n = 31). In cross-sectional observations, logistic regression and leave-one-out cross-validation identified donor-specific, CD154 + T-cytotoxic (Tc)-memory cells as best associated with rejection outcomes. In the longitudinal cohort, (1) the association between CD154 + Tc-memory cells and rejection outcomes was replicated with sensitivity/specificity 92.3%/84.6% for observations at 1-60 days, and (2) elevated pre-LTx CD154 + Tc-memory cell responses were associated with significantly increased incidence (p = 0.02) and hazard (HR = 7.355) of rejection in survival/proportional hazard analysis. CD154 expression correlated with proliferative alloresponses (r = 0.835, p = 7.1e-07), and inversely with CTLA4 expression of allospecific CD154 + Tc-memory cells (r =-0.706, p = 3.0e-05). Allospecific CD154 + T-helper-memory cells, not CD154 + Tc-memory, were inhibited by increasing Tacrolimus concentrations (p = 0.026). Collectively, allospecific CD154 + T cells provide an estimate of rejection risk in children with LTx.

Thermally driven molecular linear motors: a molecular dynamics study.

We conduct molecular dynamics simulations of a molecular linear motor consisting of coaxial carbon nanotubes with a long outer carbon nanotube confining and guiding the motion of an inner short, capsulelike nanotube. The simulations indicate that the motion of the capsule can be controlled by thermophoretic forces induced by thermal gradients. The simulations find large terminal velocities of 100-400 nm/ns for imposed thermal gradients in the range of 1-3 K/nm. Moreover, the results indicate that the thermophoretic force is velocity dependent and its magnitude decreases for increasing velocity.

Effects of the transient receptor potential vanilloid 1 antagonist A-425619 on body temperature and thermoregulation in the rat.

Transient receptor potential vanilloid 1 (TRPV1) receptor antagonists have gained much attention for their potential to treat inflammatory and neuropathic pain. However, systemic administration of TRPV1 antagonists induces a period of hyperthermia, a potential liability for small molecule development. Here we characterize the effects of the TRPV1 antagonist A-425619 on body temperature (T(b)) in the rat when administered: (1) alone at different times of the circadian cycle, (2) as repeated hourly or daily treatment, (3) as pre-treatment to prevent capsaicin-induced hypothermia, (4) to capsaicin-desensitized animals, and (5) prior to a heat challenge. Changes in T(b) were compared with compound exposure data, locomotor activity, and time course of efficacy in inflammatory pain models. Without affecting locomotor activity, oral administration of A-425619 induced a transient period of hyperthermia that was followed by a period of hypothermia, a profile unique among reported TRPV1 antagonists. Repeated hourly administration of A-425619 produced an increase in T(b) similar to a single administration. A-425619 had no effect on T(b) when administered to capsaicin-desensitized rats. The duration of A-425619-induced hyperthermia, but not hypothermia, was dependent on the time of the circadian cycle when administered. Pre-treatment with A-425619 attenuated capsaicin-induced hypothermia and did not potentiate T(b) or alter thermoregulatory behavioral responses during a heat challenge. These results indicate that A-425619-induced hyperthermia is transient, circadian-dependent, not related to exposure levels, locomotor activity, or time course of analgesic action, and does not affect the ability to thermoregulate during a heat challenge.

Casimir forces between arbitrary compact objects.

We develop an exact method for computing the Casimir energy between arbitrary compact objects, either dielectrics or perfect conductors. The energy is obtained as an interaction between multipoles, generated by quantum current fluctuations. The objects' shape and composition enter only through their scattering matrices. The result is exact when all multipoles are included, and converges rapidly. A low frequency expansion yields the energy as a series in the ratio of the objects' size to their separation. As an example, we obtain this series for two dielectric spheres and the full interaction at all separations for perfectly conducting spheres.

Parity doubling and SU(2)LxSU(2)R restoration in the hadron spectrum.

We construct the most general nonlinear representation of chiral SU(2)LxSU(2)R broken down spontaneously to the isospin SU(2), on a pair of hadrons of same spin and isospin and opposite parity. We show that any such representation is equivalent, through a hadron field transformation, to two irreducible representations on two hadrons of opposite parity with different masses and axial-vector couplings. This implies that chiral symmetry realized in the Nambu-Goldstone mode does not predict the existence of degenerate multiplets of hadrons of opposite parity nor any relations between their couplings or masses.

Casimir Interaction between a plate and a cylinder.

We find the exact Casimir force between a plate and a cylinder, a geometry intermediate between parallel plates, where the force is known exactly, and the plate sphere, where it is known at large separations. The force has an unexpectedly weak decay approximately L/[H3 ln(H/R)] at large plate-cylinder separations H (L and R are the cylinder length and radius), due to transverse magnetic modes. Path integral quantization with a partial wave expansion additionally gives a qualitative difference for the density of states of electric and magnetic modes, and corrections at finite temperatures.

Attractive Casimir forces in a closed geometry.

We study the Casimir force acting on a conducting piston with arbitrary cross section. We find the exact solution for a rectangular cross section and the first three terms in the asymptotic expansion for small height to width ratio when the cross section is arbitrary. Though weakened by the presence of the walls, the Casimir force turns out to be always attractive. Claims of repulsive Casimir forces for related configurations, like the cube, are invalidated by cutoff dependence.

In utero angiopoietin-2 gene delivery remodels placental blood vessel phenotype: a murine model for studying placental angiogenesis.

Angiopoietin (Ang)-2, the natural antagonist of the Ang1/Tie2 receptor is a complex regulator of blood vessel plasticity that plays a pivotal role in both vessel sprouting [in the presence of vascular endothelial growth factor (VEGF)-A] and vessel regression (in the absence of VEGF-A). Based on the spatial and temporal expression of Ang2 throughout human gestation, we recently suggested that the Ang2 may play a pivotal role in placental angiogenesis. Further, to examine this tenet we have developed a novel murine model system in which in utero Ang2 gene delivery via a non-replicating adenoviral expression vector has the potential to manipulate the blood vessel phenotype in vivo during pregnancy. Ang2 overexpression selectively and rapidly remodels the labyrinth perivascular extracellular matrix, subsequently promoting plasticity of the maternal and fetal vessels, which appear honeycombed due to a 2-fold increase in blood vessel luminal area. High levels of Ang2 impair endothelial cell adhesiveness, leading to vascular leakiness with perivascular oedema, which increases placental weight. These observations suggest that the Ang2 overexpression may play a key role in placental vascular remodelling. Furthermore, we suggest a novel new model to study the pathobiology of placental vascularization and the effect of placental blood vessels on fetal phenotype.