Implication des cellules Nestin+ dans le remodelage vasculaire en conditions pathologiques

La protéine de filament intermédiaire Nestin, marqueur de cellules souches neurales, est exprimée dans les cellules vasculaires. Il a été démontré que les cellules de la crosse aortique dérivent de la crête neurale pendant le développement. Des cellules endothéliales exprimant Nestin sont retrouvées dans les capillaires durant l’embryogénèse ainsi que durant la vascularisation de tumeurs cancéreuses. Cette protéine est impliquée dans les mécanismes de prolifération cellulaire. Récemment des cellules Nestin+ ont été identifiées au niveau des cellules du muscle lisse de l’aorte. La régulation de Nestin dans ces cellules, pendant le développement et en conditions pathologiques, est inconnue. Cette thèse porte sur l’analyse de la protéine Nestin dans le remodelage vasculaire en situation diabétique et d’hypertension au niveau des artères carotide et aortique. Nos travaux examinent l’hypothèse que l’expression vasculaire de Nestine joue un rôle dans l’homéostasie durant le vieillissement physiologique et participe au remodelage suite à des stimuli pathologiques. La protéine Nestin est fortement exprimée dans les aortes de rats néonataux et cette expression diminue rapidement avec le développement. Au niveau de l’aorte l’expression de la protéine Nestin est retrouvée dans une sous-population de cellules du muscle lisse et au niveau des cellules endothéliales. L’expression de la protéine Nestin est corrélée avec sa proximité au cœur, une plus grande expression est observée dans l’arche aortique et une faible expression est détectée dans la partie thoracique. Nous avons déterminé qu’en présence de diabète de type I, il y a une perte de l’expression de la protéine Nestin dans la média de l’aorte et de la carotide. Cette perte d’expression représente un évènement précoce dans la pathologie diabétique et précède la dysfonction endothéliale. La diminution de l’expression de la protéine Nestin est également concomitante avec la perte de la capacité proliférative des cellules du muscle lisse. Dans les rats souffrant de diabète de type 1, une réduction significative de la densité des cellules du muscle lisse exprimant la protéine phosphorylée phosphohistone 3, une protéine impliquée dans un cycle cellulaire actif, est observée. De plus, cette réduction est corrélée avec la perte de l’expression de la protéine Nestin. Nous avons également démontré in vitro qu’un traitement hyperglycémique réduit l’expression de Nestin ainsi que la prolifération des cellules du muscle lisse. Enfin, l’utilisation d’un shARN dirigé contre Nestin nous a permis de déterminer l’implication de cette protéine dans la prolifération des cellules du muscle lisse en condition basale caractérisée par la diminution de l’incorporation de [3H] thymidine. Dans le modèle d’hypertension induite par une constriction aortique abdominale surrénale, l’augmentation de la pression sanguine est associée avec l’augmentation de l’expression de la protéine Nestin dans l’artère carotidienne. Une corrélation positive a été observée entre l’expression de la protéine Nestin dans la carotide et la pression artérielle moyenne à laquelle la paroi de la carotide est soumise. De plus, les facteurs de croissance impliqués dans le remodelage vasculaire secondaire à l’hypertension augmentent l’expression de Nestin dans les cellules du muscle lisse isolées des carotides. Puis, la réduction de l’expression de la protéine Nestin via un shARN atténue l’incorporation de [3H] thymidine, associée à la prolifération cellulaire, stimulée par ces facteurs de croissance alors que l’incorporation de [3H] leucine, associée à la synthèse protéique, demeure inchangée. Ces résultats suggèrent que l’augmentation de l’expression de la protéine Nestin, secondaire à l’hypertension, pourrait représenter une réponse adaptative où il y a une augmentation de la croissance des cellules du muscle lisse afin de permettre à la paroi vasculaire de s’ajuster à l’augmentation de la pression sanguine.

MS Measurements

RMS measuring device is a nonlinear device consisting of linear and nonlinear devices. The performance of rms measurement is influenced by a number of factors; i) signal characteristics, 2) the measurement technique used and 3) the device characteristics. RMS measurement is not simple, particularly when the signals are complex and unknown. The problem of rms measurement on high crest-factor signals is fully discussed and a solution to this problem is presented in this thesis. The problem of rms measurement is systematically analized and found to have mainly three types of errors: (1) amplitude or waveform error 2) Frequency error and (3) averaging error. Various rms measurement techniques are studied and compared. On the basis of this study the rms -measurement is reclassified three categories: (1) Wave-form-error-free measurement (2) High-frequncy-error measurement and (3) Low-frequency error-free measurement. In modern digital sampled-data systems the signals are complex and waveform-error-free rms measurement is highly appreciated. Among the three basic blocks of rms measuring device the squarer is the most important one. A squaring technique is selected, that permits shaping of the squarer error characteristic in such a way as to achieve waveform-errob free rms measurement. The squarer is designed, fabricated and tested. A hybrid rms measurement using an analog rms computing device and digital display combines the speed of analog techniques and the resolution and ease of measurement of digital techniques. An A/D converter is modified to perform the square-rooting operation. A 10-V rms voltmeter using the developed rms detector is fabricated and tested. The chapters two, three and four analyse the problems involved in rms measurement and present a comparative study of rms computing techniques and devices. The fifth chapter gives the details of the developed rms detector that permits wave-form-error free rms measurement. The sixth chapter, enumerates the the highlights of the thesis and suggests a list of future projects

Hidrolipoclasia con solución salina hipotónica versus isotónica en adiposidad localizada

Introducción: La hidrolipoclasia es una técnica de moldeamiento corporal consistente en la infiltración de una solución en el tejido adiposo con la consiguiente aplicación de ultrasonido para producir lisis en los adipocitos y reducción del tejido adiposo en el área de tratamiento. Sin embargo, existen múltiples variaciones a la técnica, entre ellas el tipo de solución utilizada. El objetivo de este estudio fue comparar los resultados con la técnica de hidrolipoclasia en cuanto a reducción de medidas con el uso de solución salina hipotónica versus isotónica. Metodología: Estudio descriptivo de corte transversal, se analizaron historias clínicas de pacientes a los que se les realizó hidrolipoclasia entre enero de 2013 y febrero 2014 en dos centros médicos estéticos de Bogotá. Se compararon dos técnicas (utilizando solución salina isotónica versus hipotónica) en cuanto a la disminución de medidas antropométricas tomadas antes y después del tratamiento. Los datos fueron analizados mediante la comparación de medias utilizando la prueba t de Student. Resultados: Se analizaron 37 historias clínicas, 19 pacientes sometidos a hidrolipoclasia con solución salina hipotónica y 18 con isotónica. Después de la realización de un procedimiento hubo una disminución estadísticamente significativa (p: 0,000) en todas las medidas antropométricas evaluadas, siendo mayor comparativamente en los pacientes tratados con solución hipotónica en cintura, perímetro abdominal y perímetro a nivel de crestas iliacas. Los efectos secundarios incluyeron equimosis y hematomas. No se presentaron complicaciones. Conclusión: La hidrolipoclasia es segura y eficaz en el manejo de adiposidad localizada, teniendo una mayor efectividad cuando se utiliza solución salina hipotónica.

Hallazgos radiológicos de la enfermedad pulmonar en pacientes Colombianos con esclerodermia

La esclerosis sistémica (ES) es una enfermedad autoinmune multisistémica que afecta principalmente la piel, los pulmones, el tracto gastrointestinal, el corazón y los riñones. La enfermedad pulmonar, presente en casi el 100% de los casos, es el factor con mayor influencia en la mortalidad. El propósito de este estudio es realizar un análisis detallado de la enfermedad pulmonar por tomografía computarizada de alta resolución(TCAR) en pacientes Colombianos con ES, para lo cual se realizó un estudio de prevalencia analítica en 44 pacientes con ES valorados en el Hospital Universitario Mayor Méderi en los últimos 7 años. Los resultados mostraron características demográficas y clínicas similares a las previamente descritas. La prevalencia de enfermedad pulmonar intersticial fue alta, y los hallazgos de fibrosis pulmonar como vidrio esmerilado y panal de abejas se asociaron con la presencia del autoanticuerpo antiSCL70. La medida del diámetro esofágico por TCAR fue mayor en los pacientes con disfagia, antiSCL 70 y linfopenia, los cuales son marcadores de mal pronóstico.

La familia, bien, gracias : está en la tele.

Se hace un repaso a las series de televisión, emitidas aproximadamente desde los años 70, que tienen como protagonista a la familia. Las diferentes series aparecen agrupadas en función de la temática y el género. Así, en un primer bloque están aquellas cuya temática gira en torno al sexo, el dinero y el poder, del tipo 'Dallas', 'Dinastía' y 'Falcon Crest'. Otro apartado reseña algunas series incluidas en el género denominado de comedias de familia, a cuyo grupo pertenecen 'La familia Adams', 'Los Monster', 'La casa de la pradera' y 'Los Simpson', entre otros. Un tercer bloque muestra series que incluyen matrimonios con hijos y familias monoparentales. Finalmente, se hace una pequeña mención a los personajes conflictos de las series.

Obesidade adolescente, composição corporal e aptidão física

RESUMO: A principal razão que me levou a escolher este estágio e esta intervenção, foi o facto de gostar muito de trabalhar com jovens. Esse gosto, aliado à paixão que tenho pelo exercício e saúde, trouxe-me para um projecto que visa alterar e promover estilos de vida saudáveis em jovens obesos com idades entre os 12 e os 16 anos de idade. O estágio teve a duração de 10 meses, de Outubro de 2010 a Julho de 2011. Começamos com a definição dos protocolos a implementar e das tarefas a realizar. A primeira dessas tarefas, centrava-se no recrutamento da amostra que pretendíamos para desenvolver o estudo. Paralelamente ao projecto TOP, colaborámos também nas consultas de obesidade pediátrica no Hospital de Santa Maria, o que nos permitiu recrutar jovens que iam às consultas e incluí-los no projecto TOP. Após termos efectuado o recrutamento, começámos com as aulas práticas e teóricas. Essas aulas ocorriam na Universidade Lusófona, todos os sábados, das 10 às 12 horas. Eram sempre da nossa responsabilidade as aulas práticas, e as teóricas quando se falava de exercício. Nas aulas práticas realizavam-se circuitos, jogos tradicionais, jogos colectivos, e jogos que promovessem a competição saudável e a inter-ajuda, visto que ali todos os participantes tinham um objectivo comum. Durante o ano foram realizadas duas colónias de férias, onde organizámos outro tipo de actividades, nomeadamente mini-golf e caminhadas na zona do Jamor. Tanto as colónias de férias, como as avaliações eram da nossa inteira responsabilidade, desde a preparação, à execução e realização das mesmas. De referir que, tendo em conta os resutados obtidos, os participantes que melhoraram na sua capacidade cardiovascular apresentaram igualmente melhoras ao nível da composição corporal, nomeadamente com a diminuição do perímetro da anca e do perímetro acima das cristas ilíacas. Importa ainda referir que ocorreram melhorias significativas (p <0,05) ao nível da composição corporal, no que se refere ao perímetro da meia distância entre a grelha costal e as cristas ilíacas, no teste da flexibilidade dos membros inferiores e na força média. Os objectivos do estágio centravam-se em adquirir competências no que diz respeito a conhecer as características da população alvo tanto das consultas como do programa TOP, saber aplicar as recomendações internacionais de actividade física para adolescentes obesos, ser capaz de adaptar a prescrição de exercício às diferentes necessidades dos adolescentes, planear e colocar em prática os planos de aula da componente física do TOP, conduzir de forma autónoma uma consulta de avaliação e aconselhamento físico, interagir em contexto clínico com especialidades de outras áreas de intervenção, planear e implementar a calendarização das sessões teórico-práticas do Projecto TOP, saber colaborar com uma equipa multidisciplinar num ambiente clínico e colaborar na intervenção e elaboração de um projecto científico. Os resultados obtidos demonstram que uma replicação futura deste projecto, tendo em conta sempre limitações que possam ocorrer, por exemplo, ao nível dos protocolos e testes, pode melhorar a qualidade de vida do adolescente, com vista a um futuro adulto mais saudável.ABSTRACT: The main reason that made me decide on this internship is the fact that I enjoy working with young people. This, combined with the passion I have for exercising and health, led me to a project aiming at changing lifestyles by promoting a healthy lifestyle among obese young people aged between 12 and 16 years old. The internship lasted for 10 months, from October 2010 to July 2011. We started with the definition of protocols to implement and carry out the POT project (Pediatric Obesity Treatment). The first task focused on the recruitment of the sample we needed to conduct the study for this project. Along with the POT project, we‟ve also collaborated in clinical pediatric obesity surgery in Santa Maria Hospital, which allowed us to recruit young people who came to surgery and include them in the sample. After having carried out the recruitment, we started with the practical and theoretical lessons. These lessons took place at the Universidade Lusófona de Humanidades e Tecnologias (ULHT) every month on Saturdays from 10 to 12. It was always our responsibility to prepare and present both the physical lessons and the theoretical ones concerning advice on everyday exercising. During practical lessons, circuits, traditional games and team games were held in order to promote a healthy competition and mutual help, since all the participants had a common goal. During the year there were two holiday camps, where we did many more activities, including mini-golf and walking in the area of Jamor. In those camps, all activities and evaluation sessions were our responsibility. By analysing the results we came to the conclusion that the participants who improved their cardiovascular capacity also improved their body composition, particularly with the reduction of the hip circumference and the circumference above the iliac crests. It should also be noted that significant improvements (p <0.05) in terms of body composition occurred namely concerning the circumference of the half distance between the rib cage and the iliac crests, the test of lower limbs flexibility and average strength. The objectives of the internship were to develop the ability to understand the characteristics of the adolescents in the POT project, know how to apply international recommendations for physical activity for obese adolescents, being able to individualize the exercise prescription for the different needs of adolescents, plan and implement physical and theorical lessons, conduct an independent surgery with a physical evaluation and counseling, interact in the context of other clinical speciality areas, plan and implement the scheduling of theoretical-practical sessions, learn how to collaborate with a multidisciplinary team in a clinical setting, intervene and collaborate in the development of a scientific project. The results show that a future replication of this project, always taking into account constraints that may occur, for example, the ones concerning the protocols, the testing, can improve the quality of life of adolescents aiming to a healthier adult life.

Amphioxus molecular biology: insights into vertebrate evolution and developmental mechanisms

The cephalochordate amphioxus is the best available proxy for the last common invertebrate ancestor of the vertebrates. During the last decade, the developmental genetics of amphioxus have been extensively examined for insights into the evolutionary origin and early evolution of the vertebrates. Comparisons between expression domains of homologous genes in amphioxus and vertebrates have strengthened proposed homologies between specific body parts. Molecular genetic studies have also highlighted parallels in the developmental mechanisms of amphioxus and vertebrates. In both groups, a similar nested pattern of Hox gene expression is involved in rostrocaudal patterning of the neural tube, and homologous genes also appear to be involved in dorsoventral neural patterning. Studies of amphioxus molecular biology have also hinted that the protochordate ancestor of the vertebrates included cell populations that modified their developmental genetic pathways during early vertebrate evolution to yield definitive neural crest and neurogenic placodes. We also discuss how the application of expressed sequence tag and gene-mapping approaches to amphioxus have combined with developmental studies to advance our understanding of chordate genome evolution. We conclude by considering the potential offered by the sequencing of the amphioxus genome, which was completed in late 2004.

Ecology of sponge assemblages (Porifera) in the Wakatobi region, south-east Sulawesi, Indonesia: richness and abundance

The influence of sedimentation, depth and substratum angle on sponge assemblages in the Wakatobi region, south-eastern Sulawesi, Indonesia was considered. Sponge assemblages were sampled from two reef localities. The first reef (Sampela) was highly impacted by high sedimentation rates with fine sediment particles that settle slowly, while the second (Hoga) experienced only fast settling coarse sediment with lower overall sedimentation rates. Sponge assemblages were sampled (area occupied and numbers) on the reef fiat (0 m) and at 5 (reef crest), 10 and 15 m (15 m at Hoga only). Some significant (P < 0.001) differences were observed in the area occupied and the number of sponge patches between surface angles and sites. Significantly lower (t > 4.61, df = 9, P < 0.001) sponge numbers, percentage cover and richness were associated with the reef flat at both sites compared with all other depths at each site, with the exception of abundance of sponges on the reef flat at Sampela, which was much greater than at any other depth sampled. Species richness increased with depth at both sites but differences between surface angles were only recorded at Sampela, with higher species richness being found on vertical, inclined and horizontal surfaces respectively A total of 100 sponge species (total area sampled 52.5 m(2)) was reported from the two sites, with 58 species found at Sampela and 71 species at Hoga (41% of species shared). Multi-dimensional scaling (MDS) indicated differences in assemblage structure between sites and most depth intervals, but not substratum angles. A number of biological (e.g. competition and predation) and physical (e.g. sedimentation and aerial exposure) factors were considered to control sponge abundance and richness. Unexpectedly a significant (F-1,F-169 = 148.98, P < 0.001) positive linear relationship was found between sponge density and area occupied. In areas of high sponge coverage, the number of patches was also high, possibly due to fragmentation of large sponges produced as a result of predation and physical disturbance. The MDS results were also the same whether sponge numbers or percentage cover estimates were used, suggesting that although these different approaches yield different sorts of information, the same assemblage structure can be identified.

Computer modelling and estimation of recruitment patterns of non-branching coral colonies at three sites in Wakatobi Marine Park, S.E. Sulawesi, Indonesia; implications for coral reef conservation

We have studied growth and estimated recruitment of massive coral colonies at three sites, Kaledupa, Hoga and Sampela, separated by about 1.5 km in the Wakatobi Marine National Park, S.E. Sulawesi, Indonesia. There was significantly higher species richness (P<0.05), coral cover (P<0.05) and rugosity (P<0.01) at Kaledupa than at Sampela. A model for coral reef growth has been developed based on a rational polynomial function, where dx/dt is an index of coral growth with time; W is the variable (for example, coral weight, coral length or coral area), up to the power of n in the numerator and m in the denominator; a1……an and b1…bm are constants. The values for n and m represent the degree of the polynomial, and can relate to the morphology of the coral. The model was used to simulate typical coral growth curves, and tested using published data obtained by weighing coral colonies underwater in reefs on the south-west coast of Curaçao [‘Neth. J. Sea Res. 10 (1976) 285’]. The model proved an accurate fit to the data, and parameters were obtained for a number of coral species. Surface area data was obtained on over 1200 massive corals at three different sites in the Wakatobi Marine National Park, S.E. Sulawesi, Indonesia. The year of an individual's recruitment was calculated from knowledge of the growth rate modified by application of the rational polynomial model. The estimated pattern of recruitment was variable, with little numbers of massive corals settling and growing before 1950 at the heavily used site, Sampela, relative to the reef site with little or no human use, Kaledupa, and the intermediate site, Hoga. There was a significantly greater sedimentation rate at Sampela than at either Kaledupa (P<0.0001) or Hoga (P<0.0005). The relative mean abundance of fish families present at the reef crests at the three sites, determined using digital video photography, did not correlate with sedimentation rates, underwater visibility or lack of large non-branching coral colonies. Radial growth rates of three genera of non-branching corals were significantly lower at Sampela than at Kaledupa or at Hoga, and there was a high correlation (r=0.89) between radial growth rates and underwater visibility. Porites spp. was the most abundant coral over all the sites and at all depths followed by Favites (P<0.04) and Favia spp. (P<0.03). Colony ages of Porites corals were significantly lower at the 5 m reef flat on the Sampela reef than at the same depth on both other reefs (P<0.005). At Sampela, only 2.8% of corals on the 5 m reef crest are of a size to have survived from before 1950. The Scleractinian coral community of Sampela is severely impacted by depositing sediments which can lead to the suffocation of corals, whilst also decreasing light penetration resulting in decreased growth and calcification rates. The net loss of material from Sampela, if not checked, could result in the loss of this protective barrier which would be to the detriment of the sublittoral sand flats and hence the Sampela village.

The occipital lateral plate mesoderm - a novel source for vertebrate neck musculature

In vertebrates, body musculature originates from somites, whereas head muscles originate from the cranial mesoderm. Neck muscles are located in the transition between these regions. We show that the chick occipital lateral plate mesoderm has myogenic capacity and gives rise to large muscles located in the neck and thorax. We present molecular and genetic evidence to show that these muscles not only have a unique origin, but additionally display a distinct temporal development, forming later than any other muscle group described to date. We further report that these muscles, found in the body of the animal, develop like head musculature rather than deploying the programme used by the trunk muscles. Using mouse genetics we reveal that these muscles are formed in trunk muscle mutants but are absent in head muscle mutants. In concordance with this conclusion, their connective tissue is neural crest in origin. Finally, we provide evidence that the mechanism by which these neck muscles develop is conserved in vertebrates.

Floral ontogeny in Polygalaceae and its bearing on the homologies of keeled flowers in Fabales

Keeled flowers are characteristic of many species of Polygalaceae (tribe Polygaleae), in which there is often a distinctive crest located at the abaxial petal. This study of floral ontogeny across the entire family highlights potential suites of characters that relate to the evolution of keeled and crested flowers. One character suite encompasses interconnected transformations of the lateral perianth organs acting as an evolutionary module: bracteoles, lateral sepals (with delayed initiation and petaloid appearance), and lateral petals (suppressed or lost). The plastochron between initiation of the lateral sepals and that of the other sepals is relatively long in the tribe Polygaleae, in which the calyx is usually heteromorphic. By contrast, in the petal whorl, the difference between a zygomorphic and an actinomorphic corolla involves organ suppression rather than heterochrony. Four primary androecial patterns are identified in the family, and the gynoecium ranges between syncarpous‐bicarpellate and multicarpellate. Stigma diversity is based on two primary morphological types: one in which the papillate stigmatic surfaces lie close together, the other in which they are physically separated. The floral ontogeny of Polygalaceae is considered alongside comparative data available for other members of the order Fabales, and hypotheses to account for the similarities and differences between keeled flowers are discussed.

Initiation of deep convection at marginal instability in an ensemble of mesoscale models: a case-study from COPS

The present study investigates the initiation of precipitating deep convection in an ensemble of convection-resolving mesoscale models. Results of eight different model runs from five non-hydrostatic models are compared for a case of the Convective and Orographically-induced Precipitation Study (COPS). An isolated convective cell initiated east of the Black Forest crest in southwest Germany, although convective available potential energy was only moderate and convective inhibition was high. Measurements revealed that, due to the absence of synoptic forcing, convection was initiated by local processes related to the orography. In particular, the lifting by low-level convergence in the planetary boundary layer is assumed to be the dominant process on that day. The models used different configurations as well as different initial and boundary conditions. By comparing the different model performance with each other and with measurements, the processes which need to be well represented to initiate convection at the right place and time are discussed. Besides an accurate specification of the thermodynamic and kinematic fields, the results highlight the role of boundary-layer convergence features for quantitative precipitation forecasts in mountainous terrain.

The occipital lateral plate mesoderm is a novel source for vertebrate neck musculature

In vertebrates, body musculature originates from somites, whereas head muscles originate from the cranial mesoderm. Neck muscles are located in the transition between these regions. We show that the chick occipital lateral plate mesoderm has myogenic capacity and gives rise to large muscles located in the neck and thorax. We present molecular and genetic evidence to show that these muscles not only have a unique origin, but additionally display a distinct temporal development, forming later than any other muscle group described to date. We further report that these muscles, found in the body of the animal, develop like head musculature rather than deploying the programme used by the trunk muscles. Using mouse genetics we reveal that these muscles are formed in trunk muscle mutants but are absent in head muscle mutants. In concordance with this conclusion, their connective tissue is neural crest in origin. Finally, we provide evidence that the mechanism by which these neck muscles develop is conserved in vertebrates.

Morphometric analysis of aeolian bedforms in the Namib Sand Sea using ASTER data

The ASTER Global Digital Elevation Model (GDEM) has made elevation data at 30 m spatial resolution freely available, enabling reinvestigation of morphometric relationships derived from limited field data using much larger sample sizes. These data are used to analyse a range of morphometric relationships derived for dunes (between dune height, spacing, and equivalent sand thickness) in the Namib Sand Sea, which was chosen because there are a number of extant studies that could be used for comparison with the results. The relative accuracy of GDEM for capturing dune height and shape was tested against multiple individual ASTER DEM scenes and against field surveys, highlighting the smoothing of the dune crest and resultant underestimation of dune height, and the omission of the smallest dunes, because of the 30 m sampling of ASTER DEM products. It is demonstrated that morphometric relationships derived from GDEM data are broadly comparable with relationships derived by previous methods, across a range of different dune types. The data confirm patterns of dune height, spacing and equivalent sand thickness mapped previously in the Namib Sand Sea, but add new detail to these patterns.

Réflexions sur le ‘Nucléaire interdit'

A discussion of the taboo on nuclear use from the perspective of different governments, focusing on the circumstances of the post-Cold War environment where the danger of nuclear proliferation looms large.