Alterations in vascular matrix metalloproteinase due to ageing and chronic hypertension: effects of endothelin receptor blockade.

OBJECTIVE: To determine the effects of age and dual endothelin (ET)A/ETB receptor antagonism (bosentan) on aortic matrix metalloproteinase (MMP) abundance and tissue inhibitor of metalloproteinase (TIMP) expression in normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). METHODS: Male SHR and control WKY rats were randomly assigned to receive placebo or bosentan (100 mg/kg per day) for 3 months. Animals were killed under terminal anaesthesia at either 20 weeks (adult) or 17-20 months (senescent). Aortic gelatinase activity was determined by zymography, whereas MT-1 MMP and TIMP-1 expression were assessed by immunoblotting. RESULTS: In WKY rats, aortic MMP-2 but not proMMP-2 activity was 3.6-fold higher (P <0.02) in the senescent compared with the adult group. TIMP-1 (twofold) and MT-1 MMP (3.8-fold) expression increased (P <0.05) with age in the WKY groups. Short-term hypertension (adult SHR versus adult WKY) increased MMP-2 to 74.7 +/- 14.1 from 18.9 +/- 3.5 arbitrary units (AU) (P = 0.0012), but did not alter proMMP-2 activity. This increased further on progression to chronic hypertension (117.4 +/- 12.2 versus 74.7 +/- 14.1 AU; P <0.02). Bosentan decreased MMP-2 (78.9 +/- 3.8 versus 117.4 +/- 12.2 AU; P = 0.014) and proMMP-2 activity (P <0.006) in the senescent SHR group. CONCLUSION: Ageing and the development/progression of hypertension are associated with increased MMP-2 activity in the aorta, which is consistent with ongoing remodelling of the vasculature. However, the underlying mechanisms regulating MMP-2 abundance in ageing and hypertension appear to be divergent, as MT-1 MMP expression is differentially altered. Dual ETA/ETB receptor antagonism did not alter the age-dependent increase in aortic MMP activity in normotensive rats. However, bosentan decreased pro and active MMP-2 activity in senescent SHR rats, indicating that ET modulates late events in vascular remodelling in hypertension.

Chemical composition of B-type supergiants in the OB 8, OB 10, OB 48, OB 78 associations of M 31

Absolute and differential chemical abundances are presented for the largest group of massive stars in M31 studied to date. These results were derived from intermediate resolution spectra of seven B-type supergiants, lying within four OB associations covering a galactocentric distance of 5-12 kpc. The results are mainly based on an LTE analysis, and we additionally present a full non-LTE, unified model atmosphere analysis of one star (OB 78-277) to demonstrate the reliability of the differential LTE technique. A comparison of the stellar oxygen abundance with that of previous nebular results shows that there is an off set of between similar to0.15-0.4 dex between the two methods which is critically dependent on the empirical calibration adopted for the R 23 parameter with [O/H]. However within the typical errors of the stellar and nebular analyses (and given the strength of dependence of the nebular results on the calibration used) the oxygen abundances determined in each method are fairly consistent. We determine the radial oxygen abundance gradient from these stars, and do not detect any systematic gradient across this galactocentric range. We find that the inner regions of M31 are not, as previously thought, very "metal rich". Our abundances of C, N, O, Mg, Si, Al, S and Fe in the M31 supergiants are very similar to those of massive stars in the solar neighbourhood.

Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis.

Objective To investigate the effects of weaning protocols on the total duration of mechanical ventilation, mortality, adverse events, quality of life, weaning duration, and length of stay in the intensive care unit and hospital.

Design Systematic review.

Data sources Cochrane Central Register of Controlled Trials, Medline, Embase, CINAHL, LILACS, ISI Web of Science, ISI Conference Proceedings, Cambridge Scientific Abstracts, and reference lists of articles. We did not apply language restrictions.

Review methods We included randomised and quasi-randomised controlled trials of weaning from mechanical ventilation with and without protocols in critically ill adults.

Data selection Three authors independently assessed trial quality and extracted data. A priori subgroup and sensitivity analyses were performed. We contacted study authors for additional information.

Results Eleven trials that included 1971 patients met the inclusion criteria. Compared with usual care, the geometric mean duration of mechanical ventilation in the weaning protocol group was reduced by 25% (95% confidence interval 9% to 39%, P=0.006; 10 trials); the duration of weaning was reduced by 78% (31% to 93%, P=0.009; six trials); and stay in the intensive care unit length by 10% (2% to 19%, P=0.02; eight trials). There was significant heterogeneity among studies for total duration of mechanical ventilation (I(2)=76%, P

Conclusion There is evidence of a reduction in the duration of mechanical ventilation, weaning, and stay in the intensive care unit when standardised weaning protocols are used, but there is significant heterogeneity among studies and an insufficient number of studies to investigate the source of this heterogeneity. Some studies suggest that organisational context could influence outcomes, but this could not be evaluated as it was outside the scope of this review.

Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients (Review)

BACKGROUND: Reducing weaning time is desirable in minimizing potential complications from mechanical ventilation. Standardized weaning protocols are purported to reduce time spent on mechanical ventilation. However, evidence supporting their use in clinical practice is inconsistent.

OBJECTIVES: To assess the effects of protocolized weaning from mechanical ventilation on the total duration of mechanical ventilation for critically ill adults; ascertain differences between protocolized and non-protocolized weaning in terms of mortality, adverse events, quality of life, weaning duration, intensive care unit (ICU) and hospital length of stay (LOS); and explore variation in outcomes by type of ICU, type of protocol and approach to delivering the protocol.

SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2010), MEDLINE (1950 to 2010), EMBASE (1988 to 2010), CINAHL (1937 to 2010), LILACS (1982 to 2010), ISI Web of Science and ISI Conference Proceedings (1970 to 2010), Cambridge Scientific Abstracts (inception to 2010) and reference lists of articles. We did not apply language restrictions.

SELECTION CRITERIA: We included randomized and quasi-randomized controlled trials of protocolized weaning versus non-protocolized weaning from mechanical ventilation in critically ill adults.

DATA COLLECTION AND ANALYSIS: Three authors independently assessed trial quality and extracted data. A priori subgroup and sensitivity analyses were performed. We contacted study authors for additional information.

MAIN RESULTS: Eleven trials that included 1971 patients met the inclusion criteria. The total duration of mechanical ventilation geometric mean in the protocolized weaning group was on average reduced by 25% compared with the usual care group (N = 10 trials, 95% CI 9% to 39%, P = 0.006); weaning duration was reduced by 78% (N = 6 trials, 95% CI 31% to 93%, P = 0.009); and ICU LOS by 10% (N = 8 trials, 95% CI 2% to 19%, P = 0.02). There was significant heterogeneity among studies for total duration of mechanical ventilation (I(2) = 76%, P <0.01) and weaning duration (I(2) = 97%, P <0.01), which could not be explained by subgroup analyses based on type of unit or type of approach.

AUTHORS' CONCLUSIONS: There is some evidence of a reduction in the duration of mechanical ventilation, weaning duration and ICU LOS with use of standardized protocols, but there is significant heterogeneity among studies and an insufficient number of studies to investigate the source of this heterogeneity. Although some study authors suggest that organizational context may influence outcomes, these factors were not considered in all included studies and therefore could not be evaluated.

Integrated Low-Loss Passive SiGe Power Splitter and Combiner Operating Across 78-86 GHz Band

This paper describes the design, implementation, and characterization of a new type of passive power splitting and combining structure for use in a differential four-way power-combining amplifier operating at E-band. In order to achieve lowest insertion loss, input and output coils inductances are resonated with shunt capacitances. Simple C-L-C and L-C networks are proposed in order to compensate inductive loading due to routing line that would otherwise introduce mismatch and increase loss. Across 78-86 GHz band, measured insertion loss is about 7 dB. Measured return losses are >10 dB from 73 GHz to 94 GHz at the input port and >9 dB from 60 GHz to 94 GHz at the output port. When integrated with driver and power amplifier cells, the simulated complete circuit exhibits 18.2 dB gain and 20.3 dBm saturated output power.

Measuring the significance of inconsistency in the Viewpoints framework

Measuring inconsistency is crucial to effective inconsistency management in software development. A complete measurement of inconsistency should focus on not only the degree but also the significance of inconsistency. However, most of the approaches available only take the degree of inconsistency into account. The significance of inconsistency has not yet been given much needed consideration. This paper presents an approach for measuring the significance of inconsistency arising from different viewpoints in the Viewpoints framework. We call an individual set of requirements belonging to different viewpoints a combined requirements collection in this paper. We argue that the
significance of inconsistency arising in a combined requirements collection is closely associated with global priority levels of requirements involved in the inconsistency. Here we assume that the global priority level of an individual requirement captures the relative importance of every viewpoint including this requirement as well as the local priority level of the requirement within the viewpoint. Then we use the synthesis of global priority levels of all the requirements in a combined collection to measure the significance of the
collection. Following this, we present a scoring matrix function to measure the significance of inconsistency in an inconsistent combined requirements collection, which describes the contribution made by each subset of the requirements collection to the significance of the set of requirements involved in the inconsistency. An ordering relationship between inconsistencies of two combined requirements collections, termed more significant than, is also presented by comparing their significance scoring matrix functions. Finally, these techniques were implemented in a prototype tool called IncMeasurer, which we developed as a proof of concept.

Massive stars exploding in a He-rich circumstellar medium - V. Observations of the slow-evolving SN Ibn OGLE-2012-SN-006

We present optical observations of the peculiar Type Ibn supernova (SN Ibn) OGLE-2012-SN-006, discovered and monitored by the Optical Gravitational Lensing Experiment-IV survey, and spectroscopically followed by Public ESO Spectroscopic Survey of Transient Objects (PESSTO) at late phases. Stringent pre-discovery limits constrain the explosion epoch with fair precision to JD = 245 6203.8 +/- 4.0. The rise time to the I-band light-curve maximum is about two weeks. The object reaches the peak absolute magnitude M-I = -19.65 +/- 0.19 on JD = 245 6218.1 +/- 1.8. After maximum, the light curve declines for about 25 d with a rate of 4 mag (100 d)(-1). The symmetric I-band peak resembles that of canonical Type Ib/c supernovae (SNe), whereas SNe Ibn usually exhibit asymmetric and narrower early-time light curves. Since 25 d past maximum, the light curve flattens with a decline rate slower than that of the Co-56-Fe-56 decay, although at very late phases it steepens to approach that rate. However, other observables suggest that the match with the Co-56 decay rate is a mere coincidence, and the radioactive decay is not the main mechanism powering the light curve of OGLE-2012-SN-006. An early-time spectrum is dominated by a blue continuum, with only a marginal evidence for the presence of He I lines marking this SN type. This spectrum shows broad absorptions bluewards than 5000 angstrom, likely O II lines, which are similar to spectral features observed in superluminous SNe at early epochs. The object has been spectroscopically monitored by PESSTO from 90 to 180 d after peak, and these spectra show the typical features observed in a number of SN 2006jc-like events, including a blue spectral energy distribution and prominent and narrow (v(FWHM) approximate to 1900 km s(-1)) He I emission lines. This suggests that the ejecta are interacting with He-rich circumstellar material. The detection of broad (10(4) km s(-1)) O I and Ca II features likely produced in the SN ejecta (including the [OI] lambda lambda 6300,6364 doublet in the latest spectra) lends support to the interpretation of OGLE-2012-SN-006 as a core-collapse event.