167 resultados para Upper airway collapse
Resumo:
Objectives. To conduct a prospective evaluation to determine the utility of the BTA stat test in the detection of upper tract transitional cell carcinoma (UTTCC). Monitoring for UTTCC currently relies on invasive procedures such as upper tract imaging, ureteral washing cytology (UWC) and/or ureteroscopy, or voided urine cytology (VUC). The BTA stat test is a sensitive qualitative immunoassay that detects human complement factor H-related protein in voided urine.
Methods. A total of 81 patients participated, 27 with histopathologically confirmed UTTCC, 26 with upper tract calculi, and 28 with microscopic hematuria but no evidence of urologic disease. Voided specimens collected before surgery or treatment were tested with the BTA stat test and VUC. UWC was performed in specimens collected by a ureteral catheter.
Results. The BTA stat test was significantly more sensitive and specific than VUC or UWC. The overall sensitivity for each was 82%, 11%, and 48%; the specificity was 89%, 54%, and 33%. The positive predictive value for the BTA stat test was 79% and the negative predictive value was 91%, both the highest of the three tests.
Conclusions. The BTA stat test was superior to VUC and UWC in the detection of UTTCC. These results may support the adoption of a less aggressive follow-up policy when monitoring for UTTCC when the BTA stat result is negative. If cystoscopy is negative and the BTA stat test is positive, upper tract investigations should be expedited and, if the bladder is in place, bladder biopsies performed. (C) 2001, Elsevier Science Inc.
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The test of modifications to quantum mechanics aimed at identifying the fundamental reasons behind the unobservability of quantum mechanical superpositions at the macroscale is a crucial goal of modern quantum mechanics. Within the context of collapse models, current proposals based on interferometric techniques for their falsification are far from the experimental state of the art. Here we discuss an alternative approach to the testing of quantum collapse models that, by bypassing the need for the preparation of quantum superposition states might help us addressing nonlinear stochastic mechanisms such as the one at the basis of the continuous spontaneous localization model.
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This paper describes the results of non-linear elasto-plastic implicit dynamic finite element analyses that are used to predict the collapse behaviour of cold-formed steel portal frames at elevated temperatures. The collapse behaviour of a simple rigid-jointed beam idealisation and a more accurate semi-rigid jointed shell element idealisation are compared for two different fire scenarios. For the case of the shell element idealisation, the semi-rigidity of the cold-formed steel joints is explicitly taken into account through modelling of the bolt-hole elongation stiffness. In addition, the shell element idealisation is able to capture buckling of the cold-formed steel sections in the vicinity of the joints. The shell element idealisation is validated at ambient temperature against the results of full-scale tests reported in the literature. The behaviour at elevated temperatures is then considered for both the semi-rigid jointed shell and rigid-jointed beam idealisations. The inclusion of accurate joint rigidity and geometric non-linearity (second order analysis) are shown to affect the collapse behaviour at elevated temperatures. For each fire scenario considered, the importance of base fixity in preventing an undesirable outwards collapse mechanism is demonstrated. The results demonstrate that joint rigidity and varying fire scenarios should be considered in order to allow for conservative design.
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This paper investigates the computation of lower/upper expectations that must cohere with a collection of probabilistic assessments and a collection of judgements of epistemic independence. New algorithms, based on multilinear programming, are presented, both for independence among events and among random variables. Separation properties of graphical models are also investigated.
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We present new Herschel photometric and spectroscopic observations of Supernova 1987A, carried out in 2012. Our dedicated photometric measurements provide new 70 mu m data and improved imaging quality at 100 and 160 mu m compared to previous observations in 2010. Our Herschel spectra show only weak CO line emission, and provide an upper limit for the 63 mu m [O-I] line flux, eliminating the possibility that line contaminations distort the previously estimated dustmass. The far-infrared spectral energy distribution (SED) is well fitted by thermal emission from cold dust. The newly measured 70 mu m flux constrains the dust temperature, limiting it to nearly a single temperature. The far-infrared emission can be fitted by 0.5 +/- 0.1M(circle dot) of amorphous carbon, about a factor of two larger than the current nucleosynthetic mass prediction for carbon. The observation of SiO molecules at early and late phases suggests that silicates may also have formed and we could fit the SED with a combination of 0.3M(circle dot) of amorphous carbon and 0.5M(circle dot) of silicates, totalling 0.8M(circle dot) of dust. Our analysis thus supports the presence of a large dust reservoir in the ejecta of SN 1987A. The inferred dust mass suggests that supernovae can be an important source of dust in the interstellar medium, from local to high-redshift galaxies.
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The paper reports on the sixth season of fieldwork of the Cyrenaican Prehistory Project (CPP) undertaken in September 2012. As in the spring 2012 season, work focussed on the Haua Fteah cave and on studies of materials excavated in previous seasons, with no fieldwork undertaken elsewhere in the Gebel Akhdar. An important discovery, in a sounding excavated below the base of McBurney's 1955 Deep Sounding (Trench S), is of a rockfall or roof collapse conceivably dating to the cold climatic regime of Marine Isotope Stage (MIS) 6 (globally dated to c. 190-130 ka) but more likely the result of a seismic event within MIS 5 (globally dated to c. 130-80 ka). The sediments and associated molluscan fauna in Trench S and in Trench D, a trench being cut down the side of the Deep Sounding, indicate that this part of the cave was at least seasonally waterlogged during the accumulation, probably during MIS 5, of the -6.5 rn of sediment cut through by the Deep Sounding. Evidence for human fréquentation of the cave in this period is more or less visible depending on how close the trench area was to standing water as it fluctuated through time. Trench M, the trench being cut down the side of McBurney's Middle Trench, has now reached the depth of the latest Middle Stone Age or Middle Palaeolithic (Levalloiso-Mousterian) industries. The preliminary indications from its excavation are that the transition from the Levalloiso-Mousterian to the blade-based Upper Palaeolithic or Late Stone Age Dabban industry was complex and perhaps protracted, at a time when the climate was oscillating between warmstage stable environmental conditions and colder and more arid environments. The estimated age of the sediments, c. 50-40 ka, places these oscillations within the earlier part of MIS 3 (globally dated to 60-24 ka), when global climates experienced rapid fluctuations as part of an overall trend to increasing aridity and cold.
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The masses and the evolutionary states of the progenitors of core-collapse supernovae are not well constrained by direct observations. Stellar evolution theory generally predicts that massive stars with initial masses less than about 30M_sol should undergo core-collapse when they are cool M-type supergiants. However the only two detections of a SN progenitor before explosion are SN1987A and SN1993J, and neither of these was an M-type supergiant. Attempting to identify the progenitors of supernovae is a difficult task, as precisely predicting the time of explosion of a massive star is impossible for obvious reasons. There are several different types of supernovae which have different spectral and photometric evolution, and how exactly these are related to the evolutionary states of the progenitor stars is not currently known. I will describe a novel project which may allow the direct identification of core-collapse supernovae progenitors on pre-explosion images of resolved, nearby galaxies. This project is now possible with the excellent image archives maintained by several facilities and will be enhanced by the new initiatives to create Virtual Observatories, the earliest of which ASTROVIRTEL is already producing results.
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Nontypable Haemophilus influenzae (NTHi) is a major cause of opportunistic respiratory tract disease, and initiates infection by colonizing the nasopharynx. Bacterial surface proteins play determining roles in the NTHi-airways interplay, but their specific and relative contribution to colonization and infection of the respiratory tract has not been addressed comprehensively. In this study, we focused on the ompP5 and hap genes, present in all H. influenzae genome sequenced isolates, and encoding the P5 and Hap surface proteins, respectively. We employed isogenic single and double mutants of the ompP5 and hap genes generated in the pathogenic strain NTHi375 to evaluate P5 and Hap contribution to biofilm growth under continuous flow, to NTHi adhesion, and invasion/phagocytosis on nasal, pharyngeal, bronchial, alveolar cultured epithelial cells and alveolar macrophages, and to NTHi murine pulmonary infection. We show that P5 is not required for bacterial biofilm growth, but it is involved in NTHi interplay with respiratory cells and in mouse lung infection. Mechanistically, P5NTHi375 is not a ligand for CEACAM1 or α5 integrin receptors. Hap involvement in NTHi375-host interaction was shown to be limited, despite promoting bacterial cell adhesion when expressed in H. influenzae RdKW20. We also show that Hap does not contribute to bacterial biofilm growth, and that its absence partially restores the deficiency in lung infection observed for the ΔompP5 mutant. Altogether, this work frames the relative importance of the P5 and Hap surface proteins in NTHi virulence.
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Non-typeable Haemophilus influenzae (NTHi) is an opportunist pathogen well adapted to the human upper respiratory tract and responsible for many respiratory diseases. In the human airway, NTHi is exposed to pollutants, such as alkylating agents, that damage its DNA. In this study, we examined the significance of genes involved in the repair of DNA alkylation damage in NTHi virulence. Two knockout mutants, tagI and mfd, encoding N(3)methyladenine-DNA glycosylase I and the key protein involved in transcription-coupled repair, respectively, were constructed and their virulence in a BALB/c mice model was examined. This work shows that N-3-methyladenine-DNA glycosylase I is constitutively expressed in NTHi and that it is relevant for its virulence.
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We present optical and near-infrared photometry and spectroscopy of SN 2009ib, a Type II-P supernova in NGC 1559. This object has moderate brightness, similar to those of the intermediate-luminosity SNe 2008in and 2009N. Its plateau phase is unusually long, lasting for about 130 d after explosion. The spectra are similar to those of the subluminous SN 2002gd, with moderate expansion velocities. We estimate the Ni-56 mass produced as 0.046 +/- A 0.015 M-aS (TM). We determine the distance to SN 2009ib using both the expanding photosphere method (EPM) and the standard candle method. We also apply EPM to SN 1986L, a Type II-P SN that exploded in the same galaxy. Combining the results of different methods, we conclude the distance to NGC 1559 as D = 19.8 +/- A 3.0 Mpc. We examine archival, pre-explosion images of the field taken with the Hubble Space Telescope, and find a faint source at the position of the SN, which has a yellow colour [(V - I)(0) = 0.85 mag]. Assuming it is a single star, we estimate its initial mass as M-ZAMS = 20 M-aS (TM). We also examine the possibility, that instead of the yellow source the progenitor of SN 2009ib is a red supergiant star too faint to be detected. In this case, we estimate the upper limit for the initial zero-age main sequence (ZAMS) mass of the progenitor to be similar to 14-17 M-aS (TM). In addition, we infer the physical properties of the progenitor at the explosion via hydrodynamical modelling of the observables, and estimate the total energy as similar to 0.55 x 10(51) erg, the pre-explosion radius as similar to 400 R-aS (TM), and the ejected envelope mass as similar to 15 M-aS (TM), which implies that the mass of the progenitor before explosion was similar to 16.5-17 M-aS (TM).
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We investigate line formation processes in Type IIb supernovae (SNe) from 100 to 500 days post-explosion using spectral synthesis calculations. The modelling identifies the nuclear burning layers and physical mechanisms that produce the major emission lines, and the diagnostic potential of these. We compare the model calculations with data on the three best observed Type IIb SNe to-date - SN 1993J, SN 2008ax, and SN 2011dh. Oxygen nucleosynthesis depends sensitively on the main-sequence mass of the star and modelling of the [O I] lambda lambda 6300, 6364 lines constrains the progenitors of these three SNe to the M-ZAMS = 12-16 M-circle dot range (ejected oxygen masses 0.3-0.9 M-circle dot), with SN 2011dh towards the lower end and SN 1993J towards the upper end of the range. The high ejecta masses from M-ZAMS greater than or similar to 17 M-circle dot progenitors give rise to brighter nebular phase emission lines than observed. Nucleosynthesis analysis thus supports a scenario of low-to-moderate mass progenitors for Type IIb SNe, and by implication an origin in binary systems. We demonstrate how oxygen and magnesium recombination lines may be combined to diagnose the magnesium mass in the SN ejecta. For SN 2011dh, a magnesium mass of 0.02-0.14 M-circle dot is derived, which gives a Mg/O production ratio consistent with the solar value. Nitrogen left in the He envelope from CNO burning gives strong [N II] lambda lambda 6548, 6583 emission lines that dominate over Ha emission in our models. The hydrogen envelopes of Type IIb SNe are too small and dilute to produce any noticeable H alpha emission or absorption after similar to 150 days, and nebular phase emission seen around 6550 angstrom is in many cases likely caused by [N II] lambda lambda 6548, 6583. Finally, the influence of radiative transport on the emergent line profiles is investigated. Significant line blocking in the metal core remains for several hundred days, which affects the emergent spectrum. These radiative transfer effects lead to early-time blueshifts of the emission line peaks, which gradually disappear as the optical depths decrease with time. The modelled evolution of this effect matches the observed evolution in SN 2011dh.