Corneal Allograft Rejection:Risk Factors, Diagnosis, Prevention, and Treatment

Recent advances in corneal graft technology, including donor tissue retrieval, storage and surgical techniques, have greatly improved the clinical outcome of corneal grafts. Despite these advances, immune mediated corneal graft rejection remains the single most important cause of corneal graft failure. Several host factors have been identified as conferring a "high risk" status to the host. These include: more than two quadrant vascularisation, with associated lymphatics, which augment the afferent and efferent arc of the immune response; herpes simplex keratitis; uveitis; silicone oil keratopathy; previous failed (rejected) grafts; "hot eyes"; young recipient age; and multiple surgical procedures at the time of grafting. Large grafts, by virtue of being closer to the host limbus, with its complement of vessels and antigen-presenting Langerhans cells, also are more susceptible to rejection. The diagnosis of graft rejection is entirely clinical and in its early stages the clinical signs could be subtle. Graft rejection is largely mediated by the major histocompatibility antigens, minor antigens and perhaps blood group ABO antigens and some cornea-specific antigens. Just as rejection is mediated by active immune mediated events, the lack of rejection (tolerance) is also sustained by active immune regulatory mechanisms. The anterior chamber associated immune deviation (ACAID) and probably, conjunctiva associated lymphoid tissue (CALT) induced mucosal tolerance, besides others, play an important role. Although graft rejection can lead to graft failure, most rejections can be readily controlled if appropriate management is commenced at the proper time. Topical steroids are the mainstay of graft rejection management. In the high-risk situations however, systemic steroids, and other immunosuppressive drugs such as cyclosporin and tacrolimus (FK506) are of proven benefit, both for treatment and prevention of rejection.

The Existence of the Past

My goal in this paper is to address what I call the ‘Incoherence’ objection to the growing universe theory of time. At the root of the objection is the thought that one cannot wed objective temporal becoming with the existence of a tenseless past—which is apparently what the growing universe theorist tries to do. To do so, however, is to attribute both dynamic and static aspects to time, and, given the mutual exclusivity of these two aspects—so the thought goes—incoherence results. My solution to the problem is to offer an alternative account of past existence that is compatible with a dynamic conception of time. I take as my starting point Adams’ suggestion that the past exists in virtue of the existence of thisnesses of past individuals. I first seek to defend this suggestion, before developing it further, in order to provide a satisfactory response to the Incoherence objection. The result is a new growing universe theory which avoids the Incoherence objection but which has some surprising features of its own. Chief among these is the rejection of present events. I argue, however, that such a rejection is a necessary consequence of endorsing the growing universe theory, and that it is not as counter-intuitive as it initially sounds.

Motion Management for Radical Radiotherapy in Non-small Cell Lung Cancer

Intrafraction tumour motion is an issue that is of increased interest in the era of image-guided radiotherapy. It is particularly relevant for non-small cell lung cancer, for which a number of recent developments are in use to aid with motion management in the delivery of radical radiotherapy. The ability to deliver hypofractionated ablative doses, such as in stereotactic radiotherapy, has been aided by improvements in the ability to analyse tumour motion and amend treatment delivery. In addition, accounting for tumour motion can enable dose escalation to occur by reducing the normal tissue being irradiated by virtue of a reduction in target volumes. Motion management for lung tumours incorporates five key components: imaging, breath-hold techniques, abdominal compression, respiratory tracking and respiratory gating. These will be described, together with the relevant benefits and associated complexities. Many studies have described improved dosimetric coverage and reduced normal tissue complication probability rates when using motion management techniques. Despite the widespread uptake of many of these techniques, there is a paucity of literature reporting improved outcome in overall survival and local control for patients whenever motion management techniques are used. This overview will review the extent of lung tumour motion, ways in which motion is detected and summarise the key methods used in motion management.

Characterization of optical properties of PtSi at 3.392 mu m from 300 K to 85 K and relation of morphological effects

PtSi/Si Schottky junctions, fabricated using a conventional technique of Pt deposition with a subsequent thermal anneal, are examined using X-ray diffraction, atomic force microscopy and a novel prism/gap/sample optical coupling system. With the aid of X-ray diffraction and atomic farce microscopy it is shown that a post-anneal etch in aqua regia is essential for the removal of an unreacted, rough surface layer of Pt, to leave a much smoother PtSi film. The prism/gap/sample or Otto coupling rig is mounted in a small UHV chamber and has facilities for remote variation of the gap (by virtue of a piezoactuator system) and variation of the temperature in the range of similar to 300 K - 85 K. The system is used to excite surface plasmon polaritons on the outer surface of the PtSi and thus produce sensitive optical characterisation as a function of temperature. This is performed in order to yield an understanding of the temperature dependence of phonon and interface scattering of carriers in the PtSi.

BROAD-BAND EXCITATION AND EMISSION OF SURFACE-PLASMONS

The well known advantages of using surface plasmons, in particular the high sensitivity to surface adsorbates, are nearly always compromised in practice by the use of monochromatic excitation and the consequent lack of proper spectroscopic information. This limitation arises from the angle/wavelength selective nature of the surface plasmon resonance. The work described here uses an elegant broadband excitation/decay scheme in a substrate(silica)-grating profiled photoresist-Ag film geometry. Laser radiation of wavelength 488 nm, incident through the silica substrate, excites by near-field coupling a broad band of surface plasmons at the photoresist-Ag interface within the spectral range of the photoresist fluorescence. With a judicious choice of grating period this mode can cross-couple to the mode supported at the Ag-air interface. This latter mode can, in turn, couple out to light by virtue of the same grating profile. The spectral distribution of the light emitted due to this three-step process has been studied as a function of the angle of emission and depth of the grating profiled surface for each polarization. It is found that the optimum emission efficiency occurs with a groove depth in the region of 65 nm. This is considerably greater than the optimum depth of 40 nm required for surface plasmon-photon coupling at a Ag-air interface or, in other words, for the last step of the process in isolation.

Highly Electrocatalytic Activity of RuO2 Nanocrystals for Triiodide Reduction in Dye-Sensitized Solar Cells

Dye-sensitized solar cells (DSCs) are promising alternatives to conventional silicon devices because of their simple fabrication procedure, low cost, and high efficiency. Platinum is generally used as a superior counter electrode (CE) material, but the disadvantages such as high cost and low abundance greatly restrict the large-scale application of DSCs. An efficient and sustainable way to overcome the limited supply of Pt is the development of high-efficiency Pt-free CE materials, which should possess both high electrical conductivity and superior electrocatalytic activity simultaneously. Herein, for the first time, a two-step strategy to synthesize ruthenium dioxide (RuO2) nanocrystals is reported, and it is shown that RuO2 catalysts exhibit promising electrocatalytic activity towards triiodide reduction, which results in comparable energy conversion efficiency to that of conventional Pt CEs. More importantly, by virtue of first-principles calculations, the catalytic mechanism of electrocatalysis for triiodide reduction on various CEs is investigated systematically and it is found that the electrochemical triiodide reduction reaction on RuO2 catalyst surfaces can be enhanced significantly, owing to the ideal combination of good electrocatalytic activity and high electrical conductivity.

Origin of extraordinarily high catalytic activity of Co3O4 and its morphological chemistry for CO oxidation at low temperature

Understanding and then designing efficient catalysts for CO oxidation at low temperature is one of the hottest topics in heterogeneous catalysis. Among the existing catalysts. Co3O4 is one of the most interesting systems: Morphology-controlled Co3O4 exhibits exceedingly high activity. In this study, by virtue of extensive density functional theory (OFT) calculations, the favored reaction mechanism in the system is identified. Through careful analyses on the energetics of elementary reactions on Co3O4(1 1 0)-A, Co3O4(1 1 0)-B, Co3O4(1 1 1) and Co3O4(1 0 0), which are the commonly exposed surfaces of Co3O4, we find the following regarding the relation between the activity and structure: (i) Co3+ is the active site rather than Co2+: and (ii) the three-coordinated surface oxygen bonded with three Co3+ may be slightly more reactive than the other two kinds of lattice oxygen, that is, the two-coordinated 0 bonded with one Co2+ and one Co3+ and the three-coordinated 0 bonded with one Co2+ and two Co3+. Following the results from Co3O4, we also extend the investigation to MnO2(1 1 0), Fe3O4(1 1 0), CuO(1 1 0) and CuO(1 1 1), which are the common metal oxide surfaces, aiming to understand the oxides in general. Three properties, such as the CO adsorption strength, the barrier of CO reacting with lattice 0 and the redox capacity, are identified to be the determining factors that can significantly affect the activity of oxides. Among these oxides, Co3O4 is found to be the most active one, stratifying all the three requirements. A new scheme to decompose barriers is introduced to understand the activity difference between lattice O-3c and O-2c on (1 1 0)-B surface. By utilizing the scheme, we demonstrate that the origin of activity variance lies in the geometric structures. (C) 2012 Elsevier Inc. All rights reserved.

Immune modulation in advanced radiotherapies: Targeting out-of-field effects

By virtue of being a localized treatment modality, radiotherapy is unable to deliver a tumoricidal radiation dose to tissues outside of the irradiated field. Nevertheless, ionizing radiation may result in radiation damage mediated by a bystander like effect away from the irradiated field, but this response is likely to be modest when radiotherapy is the sole treatment modality. Over the last decade there has been a re-emergence of immune modulating therapies as anti-cancer treatment modalities. Clinical trials on vaccines have on the whole been largely disappointing, but greater response rates have been observed from the immune checkpoint modulators. A clinical benefit of using such agents has been shown in disease sites such as melanoma and non-small cell lung cancer. There is growing pre-clinical data and a number of case reports which suggest the presence of abscopal effects when radiotherapy is co-administered with immune checkpoint inhibitors, suggesting that this combination may lead to an enhanced tumour response outside of the primary treatment field. In this review, the mechanisms of such an enhanced out-of-field tumour response, the potential clinical utilities, the optimal radiotherapy delivery and considerations for clinical follow-up following treatment are discussed.

Developments in Directional Modulation Technology

Directional modulation (DM), as a promising physical-layer security technique, is able to secure wireless communications by virtue of the property of its direction-dependent signal modulation format transmission. Here modulated signal waveform signatures can only be detected by legitimate receiver(s) positioned along a-prior assigned directions. This paper reviews the development in DM technology over recent years, and provides some recommendations for future studies.

The androgen receptor fuels prostate cancer by regulating central metabolism and biosynthesis

The androgen receptor (AR) is a key regulator of prostate growth and the principal drug target for the treatment of prostate cancer. Previous studies have mapped AR targets and identified some candidates which may contribute to cancer progression, but did not characterize AR biology in an integrated manner. In this study, we took an interdisciplinary approach, integrating detailed genomic studies with metabolomic profiling and identify an anabolic transcriptional network involving AR as the core regulator. Restricting flux through anabolic pathways is an attractive approach to deprive tumours of the building blocks needed to sustain tumour growth. Therefore, we searched for targets of the AR that may contribute to these anabolic processes and could be amenable to therapeutic intervention by virtue of differential expression in prostate tumours. This highlighted calcium/calmodulin-dependent protein kinase kinase 2, which we show is overexpressed in prostate cancer and regulates cancer cell growth via its unexpected role as a hormone-dependent modulator of anabolic metabolism. In conclusion, it is possible to progress from transcriptional studies to a promising therapeutic target by taking an unbiased interdisciplinary approach.

Designing Bare Essentials: Aldi, Lidle and the architectures of cheapness

They’re cheap. They’re in every settlement of significance in Britain, Ireland and elsewhere. We all use them but perhaps do not always admit to it. Especially, if we are architects.
Over the past decades Aldi/Lidl low cost supermarkets have escaped from middle Europe to take over large tracts of the English speaking world remaking them according to a formula of mass-produced sheds, buff-coloured cobble-lock car parks, logos in primary colours, bare-shelves and eclectic special offers. Response within architectural discourse to this phenomenon has been largely one of indifference and such places remain, perhaps reiterating Pevsner’s controversial insights into the bicycle shed, on the peripheries of what we might term architecture. This paper seeks to explore the spatial complexities of the discount supermarket and in doing so open up a discussion on the architecture of cheapness. As a road-map, it takes former managing director Dieter Brandes’ treatise on the Aldi formula, Bare Essentials: the Aldi Way to Retailing, and investigates the strategies through which economic exigencies manifest themselves in a series of spatial tactics which involve building. Central to this is the idea of architecture as system rather than form and, in Aldi/Lidl’s case, the result of a spatial network of flows. To understand the architecture of the supermarket, then, it is necessary to measure the times and spaces of supply across the scales of intersection between global and local.
Evaluating the energy, economy and precision of such systems challenges the liminal position of the commercial, the placeless and especially the cheap within architectural discourse. As is well known, architectures of mass-production and prefabrication and their origins exercised modernist thinkers such as Sigfried Giedion and Walter Gropius in the early twentieth century and has undergone a resurgence in recent times. Meanwhile, the mapping of the hitherto overlooked forms and iconography of commerce in Learning from Las Vegas (1971) was extended by Rem Koolhaas et al into an investigation of the technologies, systems and precedents of retail in the Harvard Design School Guide to Shopping, thirty years later in 2001. While obviously always a criteria for building, to find writings on architecture which explicitly celebrate cheapness as a design virtue or, indeed, even iterate the word cheap is more difficult. Walter Gropius’ essay ‘How can we build cheaper, better, more attractive houses?’ (1927), however, situates the cheap within the discussions – articulated, amongst others, by Karl Teige and Bruno Taut – surrounding the minimal dwelling and the moral benefits of absence of the 1920s and 30s.
In our contemporary age of heightened consumption, it is perhaps fitting that an architecture of bare essentials is defined in retail rather than in housing, a commercial existenzminimum where the Miesian paradox of ‘less is more’ is resold as a paradigm of ‘more for less’ in the ubiquitous yet overlooked architectures of the discount supermarket.

Praying for Salvation: A Map of Relatedness

This article attempts to push Mauss’ work on the sociality of prayer (1909) to its fullest conclusion by arguing that prayer can be viewed anthropologically as providing a map for social and emotional relatedness. Based on fieldwork among deep-sea fisher families living in Gamrie, North-East Scotland (home to 700 people and six Protestant churches), the author takes as his primary ethnographic departure the ritual of the ‘mid-week prayer meeting’. Among the self-proclaimed ‘fundamentalists’ of Gamrie’s Brethren and Presbyterian churches, attending the prayer meeting means praying for salvation. Yet, contrary to the stereotype of Protestant soteriology as highly individualist, in the context of Gamrie, salvation is not principally focused upon the self, but is instead sought on behalf of the ‘unconverted’ other. Locally, this ‘other’ is made sense of with reference to three different categories of relatedness: the family, the village and the nation. The author’s argument is that each category of relatedness carries with it a different affective quality: anguish for one’s family, resentment toward one’s village, and resignation towards one’s nation. As such, prayers for salvation establish and maintain not only vertical – human-divine – relatedness, but also horizontal relatedness between persons, while also giving them their emotional tenor. In ‘fundamentalist’ Gamrie, these human relationships, and crucially their affective asymmetries, may be mapped, therefore, by treating prayers as social phenomena that seek to engage with a world dichotomised into vice and virtue, rebellion and submission, and, ultimately, damnation and salvation.

Establishing the ‘Truth’ of the Matter: Confessional Reflexivity as Introspection and Avowal

The conceptualisation of reflexivity commonly found in social anthropology deploys the term as if it were both a ‘virtuous’ mechanism of self‐reflection and an ethical technique of truth telling, with reflexivity frequently deployed as an moral practice of introspection and avowal. Further, because reflexivity is used as a methodology for constructing the authority of ethnographic accounts, reflexivity in anthropology has come to closely resemble Foucault’s descriptions of confession. By discussing Lynch’s (2000) critical analysis of reflexivity as an ‘academic virtue’, I consider his argument through the lens of my own concept of ‘confessional reflexivity’. While supporting Lynch’s diagnosis of the ‘problem of reflexivity’, I attempt to critique his ethnomethodological cure as essentialist, I conclude that a way forward might be found by blending Foucault’s (1976, 1993) theory of confession with Bourdieu’s (1992) theory of ‘epistemic reflexivity’.

Virtuosidade organizacional, empenhamento e comportamentos de cidadania organizacional

Os recentes colapsos morais e financeiros de organizações outrora reputadas, que têm ocorrido por todo o mundo, conduziram a comunidade empresarial, a imprensa popular e de negócios, assim como os investigadores a redescobrirem o papel da virtuosidade no contexto organizacional. A presente investigação pretende contribuir para manter este momentum. Procuramos responder à sugestão de alguns autores para que o estudo exploratório de Cameron, Bright e Caza (2004), que relaciona virtuosidade organizacional com desempenho, tenha continuidade, e que a sua medida de virtuosidade seja empregue noutros contextos e em relação a outros resultados (Wright & Goodstein, 2007). Este estudo empírico investiga como (a) as percepções de virtuosidade organizacional dos indivíduos explicam os seus níveis de empenhamento organizacional, (b) o empenhamento organizacional influencia os comportamentos de cidadania organizacional, (c) as percepções de virtuosidade organizacional predizem directamente os comportamentos de cidadania organizacional, e (d) o empenhamento organizacional medeia a relação entre as percepções de virtuosidade organizacional e os comportamentos de cidadania organizacional. Foram inquiridos 212 indivíduos oriundos de 14 organizações do sector industrial. Os indivíduos descreveram as suas percepções de virtuosidade organizacional e o seu empenhamento para com a organização; os seus comportamentos de cidadania organizacional foram relatados pelo respectivo supervisor. Os principais resultados sugerem que (a) as percepções de virtuosidade organizacional explicam o empenhamento afectivo e o empenhamento normativo, (b) o empenhamento normativo fomenta os comportamentos altruístas, (c) as percepções de virtuosidade organizacional explicam o desportivismo, a virtude cívica, o altruísmo, e o comportamento de cidadania organizacional global, e (d) o empenhamento normativo medeia a relação entre as percepções de virtuosidade organizacional e o altruísmo. Pesem embora as limitações do estudo, a evidência empírica obtida sugere que a virtuosidade organizacional é digna de um estatuto mais elevado na literatura e que deve ser levada em consideração pela comunidade empresarial.

On the application of optimal control techniques in lossy fieldbuses

The performance of real-time networks is under continuous improvement as a result of several trends in the digital world. However, these tendencies not only cause improvements, but also exacerbates a series of unideal aspects of real-time networks such as communication latency, jitter of the latency and packet drop rate. This Thesis focuses on the communication errors that appear on such realtime networks, from the point-of-view of automatic control. Specifically, it investigates the effects of packet drops in automatic control over fieldbuses, as well as the architectures and optimal techniques for their compensation. Firstly, a new approach to address the problems that rise in virtue of such packet drops, is proposed. This novel approach is based on the simultaneous transmission of several values in a single message. Such messages can be from sensor to controller, in which case they are comprised of several past sensor readings, or from controller to actuator in which case they are comprised of estimates of several future control values. A series of tests reveal the advantages of this approach. The above-explained approach is then expanded as to accommodate the techniques of contemporary optimal control. However, unlike the aforementioned approach, that deliberately does not send certain messages in order to make a more efficient use of network resources; in the second case, the techniques are used to reduce the effects of packet losses. After these two approaches that are based on data aggregation, it is also studied the optimal control in packet dropping fieldbuses, using generalized actuator output functions. This study ends with the development of a new optimal controller, as well as the function, among the generalized functions that dictate the actuator’s behaviour in the absence of a new control message, that leads to the optimal performance. The Thesis also presents a different line of research, related with the output oscillations that take place as a consequence of the use of classic co-design techniques of networked control. The proposed algorithm has the goal of allowing the execution of such classical co-design algorithms without causing an output oscillation that increases the value of the cost function. Such increases may, under certain circumstances, negate the advantages of the application of the classical co-design techniques. A yet another line of research, investigated algorithms, more efficient than contemporary ones, to generate task execution sequences that guarantee that at least a given number of activated jobs will be executed out of every set composed by a predetermined number of contiguous activations. This algorithm may, in the future, be applied to the generation of message transmission patterns in the above-mentioned techniques for the efficient use of network resources. The proposed task generation algorithm is better than its predecessors in the sense that it is capable of scheduling systems that cannot be scheduled by its predecessor algorithms. The Thesis also presents a mechanism that allows to perform multi-path routing in wireless sensor networks, while ensuring that no value will be counted in duplicate. Thereby, this technique improves the performance of wireless sensor networks, rendering them more suitable for control applications. As mentioned before, this Thesis is centered around techniques for the improvement of performance of distributed control systems in which several elements are connected through a fieldbus that may be subject to packet drops. The first three approaches are directly related to this topic, with the first two approaching the problem from an architectural standpoint, whereas the third one does so from more theoretical grounds. The fourth approach ensures that the approaches to this and similar problems that can be found in the literature that try to achieve goals similar to objectives of this Thesis, can do so without causing other problems that may invalidate the solutions in question. Then, the thesis presents an approach to the problem dealt with in it, which is centered in the efficient generation of the transmission patterns that are used in the aforementioned approaches.