Autonomic cardiovascular dysregulation as a potential mechanism underlying depression and coronary artery bypass grafting surgery outcomes.

BACKGROUND: Coronary artery bypass grafting (CABG) is often used to treat patients with significant coronary heart disease (CHD). To date, multiple longitudinal and cross-sectional studies have examined the association between depression and CABG outcomes. Although this relationship is well established, the mechanism underlying this relationship remains unclear. The purpose of this study was twofold. First, we compared three markers of autonomic nervous system (ANS) function in four groups of patients: 1) Patients with coronary heart disease and depression (CHD/Dep), 2) Patients without CHD but with depression (NonCHD/Dep), 3) Patients with CHD but without depression (CHD/NonDep), and 4) Patients without CHD and depression (NonCHD/NonDep). Second, we investigated the impact of depression and autonomic nervous system activity on CABG outcomes. METHODS: Patients were screened to determine whether they met some of the study's inclusion or exclusion criteria. ANS function (i.e., heart rate, heart rate variability, and plasma norepinephrine levels) were measured. Chi-square and one-way analysis of variance were performed to evaluate group differences across demographic, medical variables, and indicators of ANS function. Logistic regression and multiple regression analyses were used to assess impact of depression and autonomic nervous system activity on CABG outcomes. RESULTS: The results of the study provide some support to suggest that depressed patients with CHD have greater ANS dysregulation compared to those with only CHD or depression. Furthermore, independent predictors of in-hospital length of stay and non-routine discharge included having a diagnosis of depression and CHD, elevated heart rate, and low heart rate variability. CONCLUSIONS: The current study presents evidence to support the hypothesis that ANS dysregulation might be one of the underlying mechanisms that links depression to cardiovascular CABG surgery outcomes. Thus, future studies should focus on developing and testing interventions that targets modifying ANS dysregulation, which may lead to improved patient outcomes.

Antisense Gene Silencing and Bacteriophages as Novel Disinfection Processes for Engineered Systems

The growth and proliferation of invasive bacteria in engineered systems is an ongoing problem. While there are a variety of physical and chemical processes to remove and inactivate bacterial pathogens, there are many situations in which these tools are no longer effective or appropriate for the treatment of a microbial target. For example, certain strains of bacteria are becoming resistant to commonly used disinfectants, such as chlorine and UV. Additionally, the overuse of antibiotics has contributed to the spread of antibiotic resistance, and there is concern that wastewater treatment processes are contributing to the spread of antibiotic resistant bacteria.

Due to the continually evolving nature of bacteria, it is difficult to develop methods for universal bacterial control in a wide range of engineered systems, as many of our treatment processes are static in nature. Still, invasive bacteria are present in many natural and engineered systems, where the application of broad acting disinfectants is impractical, because their use may inhibit the original desired bioprocesses. Therefore, to better control the growth of treatment resistant bacteria and to address limitations with the current disinfection processes, novel tools that are both specific and adaptable need to be developed and characterized.

In this dissertation, two possible biological disinfection processes were investigated for use in controlling invasive bacteria in engineered systems. First, antisense gene silencing, which is the specific use of oligonucleotides to silence gene expression, was investigated. This work was followed by the investigation of bacteriophages (phages), which are viruses that are specific to bacteria, in engineered systems.


For the antisense gene silencing work, a computational approach was used to quantify the number of off-targets and to determine the effects of off-targets in prokaryotic organisms. For the organisms of Escherichia coli K-12 MG1655 and Mycobacterium tuberculosis H37Rv the mean number of off-targets was found to be 15.0 + 13.2 and 38.2 + 61.4, respectively, which results in a reduction of greater than 90% of the effective oligonucleotide concentration. It was also demonstrated that there was a high variability in the number of off-targets over the length of a gene, but that on average, there was no general gene location that could be targeted to reduce off-targets. Therefore, this analysis needs to be performed for each gene in question. It was also demonstrated that the thermodynamic binding energy between the oligonucleotide and the mRNA accounted for 83% of the variation in the silencing efficiency, compared to the number of off-targets, which explained 43% of the variance of the silencing efficiency. This suggests that optimizing thermodynamic parameters must be prioritized over minimizing the number of off-targets. In conclusion for the antisense work, these results suggest that off-target hybrids can account for a greater than 90% reduction in the concentration of the silencing oligonucleotides, and that the effective concentration can be increased through the rational design of silencing targets by minimizing off-target hybrids.

Regarding the work with phages, the disinfection rates of bacteria in the presence of phages was determined. The disinfection rates of E. coli K12 MG1655 in the presence of coliphage Ec2 ranged up to 2 h-1, and were dependent on both the initial phage and bacterial concentrations. Increasing initial phage concentrations resulted in increasing disinfection rates, and generally, increasing initial bacterial concentrations resulted in increasing disinfection rates. However, disinfection rates were found to plateau at higher bacterial and phage concentrations. A multiple linear regression model was used to predict the disinfection rates as a function of the initial phage and bacterial concentrations, and this model was able to explain 93% of the variance in the disinfection rates. The disinfection rates were also modeled with a particle aggregation model. The results from these model simulations suggested that at lower phage and bacterial concentrations there are not enough collisions to support active disinfection rates, which therefore, limits the conditions and systems where phage based bacterial disinfection is possible. Additionally, the particle aggregation model over predicted the disinfection rates at higher phage and bacterial concentrations of 108 PFU/mL and 108 CFU/mL, suggesting other interactions were occurring at these higher concentrations. Overall, this work highlights the need for the development of alternative models to more accurately describe the dynamics of this system at a variety of phage and bacterial concentrations. Finally, the minimum required hydraulic residence time was calculated for a continuous stirred-tank reactor and a plug flow reactor (PFR) as a function of both the initial phage and bacterial concentrations, which suggested that phage treatment in a PFR is theoretically possible.

In addition to determining disinfection rates, the long-term bacterial growth inhibition potential was determined for a variety of phages with both Gram-negative and Gram-positive bacteria. It was determined, that on average, phages can be used to inhibit bacterial growth for up to 24 h, and that this effect was concentration dependent for various phages at specific time points. Additionally, it was found that a phage cocktail was no more effective at inhibiting bacterial growth over the long-term than the best performing phage in isolation.

Finally, for an industrial application, the use of phages to inhibit invasive Lactobacilli in ethanol fermentations was investigated. It was demonstrated that phage 8014-B2 can achieve a greater than 3-log inactivation of Lactobacillus plantarum during a 48 h fermentation. Additionally, it was shown that phages can be used to protect final product yields and maintain yeast viability. Through modeling the fermentation system with differential equations it was determined that there was a 10 h window in the beginning of the fermentation run, where the addition of phages can be used to protect final product yields, and after 20 h no additional benefit of the phage addition was observed.

In conclusion, this dissertation improved the current methods for designing antisense gene silencing targets for prokaryotic organisms, and characterized phages from an engineering perspective. First, the current design strategy for antisense targets in prokaryotic organisms was improved through the development of an algorithm that minimized the number of off-targets. For the phage work, a framework was developed to predict the disinfection rates in terms of the initial phage and bacterial concentrations. In addition, the long-term bacterial growth inhibition potential of multiple phages was determined for several bacteria. In regard to the phage application, phages were shown to protect both final product yields and yeast concentrations during fermentation. Taken together, this work suggests that the rational design of phage treatment is possible and further work is needed to expand on this foundation.

Emergence: a paradigm for robust and scalable distributed applications

Natural distributed systems are adaptive, scalable and fault-tolerant. Emergence science describes how higher-level self-regulatory behaviour arises in natural systems from many participants following simple rulesets. Emergence advocates simple communication models, autonomy and independence, enhancing robustness and self-stabilization. High-quality distributed applications such as autonomic systems must satisfy the appropriate nonfunctional requirements which include scalability, efficiency, robustness, low-latency and stability. However the traditional design of distributed applications, especially in terms of the communication strategies employed, can introduce compromises between these characteristics. This paper discusses ways in which emergence science can be applied to distributed computing, avoiding some of the compromises associated with traditionally-designed applications. To demonstrate the effectiveness of this paradigm, an emergent election algorithm is described and its performance evaluated. The design incorporates nondeterministic behaviour. The resulting algorithm has very low communication complexity, and is simultaneously very stable, scalable and robust.

Natural inspiration for self-adaptive systems

The emergent behaviour of autonomic systems, together with the scale of their deployment, impedes prediction of the full range of configuration and failure scenarios; thus it is not possible to devise management and recovery strategies to cover all possible outcomes. One solution to this problem is to embed self-managing and self-healing abilities into such applications. Traditional design approaches favour determinism, even when unnecessary. This can lead to conflicts between the non-functional requirements. Natural systems such as ant colonies have evolved cooperative, finely tuned emergent behaviours which allow the colonies to function at very large scale and to be very robust, although non-deterministic. Simple pheromone-exchange communication systems are highly efficient and are a major contribution to their success. This paper proposes that we look to natural systems for inspiration when designing architecture and communications strategies, and presents an election algorithm which encapsulates non-deterministic behaviour to achieve high scalability, robustness and stability.

Generic support for policy-based self-adaptive systems

This paper presents a policy definition language which forms part of a generic policy toolkit for autonomic computing systems in which the policies themselves can be modified dynamically and automatically. Targeted enhancements to the current state of practice include: policy self-adaptation where the policy itself is dynamically modified to match environmental conditions; improved support for non autonomics-expert developers; and facilitating easy deployment of adaptive policies into legacy code. The policy definition language permits powerful expression of self-managing behaviours and facilitates a diverse policy behaviour space. Features include support for multiple versions of a given policy type, multiple configuration templates, and meta policies to dynamically select between policy instances. An example deployment scenario illustrates advanced functionality in the context of a multi policy stock trading system which is sensitive to environmental volatility.

Stability of 5-aminolevulinic acid in novel non-aqueous gel and patch-type systems intended for topical application.

Aminolevulinic acid (ALA) stability within topical formulations intended for photodynamic therapy (PDT) is poor due to dimerisation to pyrazine-2,5-dipropionic acid (PY). Most strategies to improve stability use low pH vehicles, which can cause cutaneous irritancy. To overcome this problem, a novel approach is investigated that uses a non-aqueous vehicle to retard proton-induced charge separation across the 4-carbonyl group on ALA and lessen nucleophilic attack that leads to condensation dimerisation. Bioadhesive anhydrous vehicles based on methylvinylether-maleic anhydride copolymer patches and poly(ethyleneglycol) or glycerol thickened poly(acrylic acid) gels were formulated. ALA stability fell below pharmaceutically acceptable levels after 6 months, with bioadhesive patches stored at 5°C demonstrating the best stability by maintaining 86.2% of their original loading. Glycerol-based gels maintained 40.2% in similar conditions. However, ALA loss did not correspond to expected increases in PY, indicating the presence of another degradative process that prevented dimerisation. Nuclear magnetic resonance (NMR) analysis was inconclusive in respect of the mechanism observed in the patch system, but showed clearly that an esterification reaction involving ALA and both glycerol and poly(ethyleneglycol) was occurring. This was especially marked in the glycerol gels, where only 2.21% of the total expected PY was detected after 204 days at 5°C. Non-specific esterase hydrolysis demonstrated that ALA was recoverable from the gel systems, further supporting esterified binding within the gel matrices. It is conceivable that skin esterases could duplicate this finding upon topical application of the gel and convert these derivatives back to ALA in situ, provided skin penetration is not affected adversely.

Quadratic Forms on Complex Random Matrices and Multiple-Antenna Systems

This research published in the foremost international journal in information theory and shows interplay between complex random matrix and multiantenna information theory. Dr T. Ratnarajah is leader in this area of research and his work has been contributed in the development of graduate curricula (course reader) in Massachusetts Institute of Technology (MIT), USA, By Professor Alan Edelman. The course name is "The Mathematics and Applications of Random Matrices", see http://web.mit.edu/18.338/www/projects.html

Investigation on drop penetration and wetting characteristics of powder-liquid systems in relation to the mixing of acrylic bone cement

This study investigated methyl methacrylate – polymethyl methacrylate powder bed interactions through droplet analyses, using model fluids and commercially available bone cement. The effects of storage temperature of liquid monomer and powder packing configuration on drop penetration time were investigated. Methyl methacrylate showed much more rapid imbibition than caprolactone due to decrease in both contact angle and fluid viscosity. Drop penetration of caprolactone through polymethyl methacrylate increased with decrease in bed macro-voids and increase in bulk density as predicted by the modified constant drawing area penetration model and confirmed by drop penetration images. Linear relationships were found between droplet mass and drawing area with imbibition time. Further experiments showed gravimetric analysis of the polymerised methyl methacrylate – polymethyl methacrylate matrix under various storage temperatures correlated with Reynolds number and Washburn analyses. These observations have direct implications for the design of mixing and delivery systems for acrylic bone cements used in orthopaedic surgery.

Rheological, mechanical and membrane penetration properties of novel dual drug systems for percutaneous delivery

In this study it has been demonstrated that mixtures of two solid drugs, ibuprofen and methyl nicotinate, with different but complementary pharmacological activities and which exist as a single liquid phase over a wide composition range at skin temperature, can be formulated as o/w emulsions without the use of an additional hydrophobic carrier. These novel dual drug systems provided significantly enhanced in vitro penetration rates through a model lipophilic barrier membrane compared to conventional individual formulations of each active. Thus, for ibuprofen, drug penetration flux enhancements of three- and 10-fold were observed when compared to an aqueous ibuprofen suspension and a commercial alcohol-based ibuprofen formulation, respectively. Methyl nicotinate penetration rates were shown to be similar for aqueous gels and emulsified systems. Mechanisms explaining these observations are proposed. Novel dual drug formulations of ibuprofen and methyl nicotinate, formulated within the liquid range at skin temperature, were investigated by oscillatory rheology and texture profile analysis. demonstrating the effects of drug and viscosity enhancer concentrations, and disperse phase type upon the rheological, mechanical and drug penetration properties of these systems. (C) 2000 Elsevier Science B.V. All rights reserved.

Dynamic mechanical analysis of polymeric systems of pharmaceutical and biomedical significance

Dynamic mechanical analysis (DMA) is an analytical technique in which an oscillating stress is applied to a sample and the resultant strain measured as functions of both oscillatory frequency and temperature. From this, a comprehensive knowledge of the relationships between the various viscoelastic parameters, e.g. storage and loss moduli, mechanical damping parameter (tan delta), dynamic viscosity, and temperature may be obtained. An introduction to the theory of DMA and pharmaceutical and biomedical examples of the use of this technique are presented in this concise review. In particular, examples are described in which DMA has been employed to quantify the storage and loss moduli of polymers, polymer damping properties, glass transition temperature(s), rate and extent of curing of polymer systems, polymer-polymer compatibility and identification of sol-gel transitions. Furthermore, future applications of the technique for the optimisation of the formulation of pharmaceutical and biomedical systems are discussed. (C) 1999 Elsevier Science B.V. All rights reserved.

Distillable entanglement and area laws in spin and harmonic-oscillator systems

We address the presence of nondistillable (bound) entanglement in natural many-body systems. In particular, we consider standard harmonic and spin-1/2 chains, at thermal equilibrium and characterized by few interaction parameters. The existence of bound entanglement is addressed by calculating explicitly the negativity of entanglement for different partitions. This allows us to individuate a range of temperatures for which no entanglement can be distilled by means of local operations, despite the system being globally entangled. We discuss how the appearance of bound entanglement can be linked to entanglement-area laws, typical of these systems. Various types of interactions are explored, showing that the presence of bound entanglement is an intrinsic feature of these systems. In the harmonic case, we analytically prove that thermal bound entanglement persists for systems composed by an arbitrary number of particles. Our results strongly suggest the existence of bound entangled states in the macroscopic limit also for spin-1/2 systems.

Radiological imaging in digital systems: the effect of exposure parameters in diagnostic quality and patient dose

Esta tese pretende contribuir para o estudo e análise dos factores relacionados com as técnicas de aquisição de imagens radiológicas digitais, a qualidade diagnóstica e a gestão da dose de radiação em sistema de radiologia digital. A metodologia encontra-se organizada em duas componentes. A componente observacional, baseada num desenho do estudo de natureza retrospectiva e transversal. Os dados recolhidos a partir de sistemas CR e DR permitiram a avaliação dos parâmetros técnicos de exposição utilizados em radiologia digital, a avaliação da dose absorvida e o índice de exposição no detector. No contexto desta classificação metodológica (retrospectiva e transversal), também foi possível desenvolver estudos da qualidade diagnóstica em sistemas digitais: estudos de observadores a partir de imagens arquivadas no sistema PACS. A componente experimental da tese baseou-se na realização de experiências em fantomas para avaliar a relação entre dose e qualidade de imagem. As experiências efectuadas permitiram caracterizar as propriedades físicas dos sistemas de radiologia digital, através da manipulação das variáveis relacionadas com os parâmetros de exposição e a avaliação da influência destas na dose e na qualidade da imagem. Utilizando um fantoma contrastedetalhe, fantomas antropomórficos e um fantoma de osso animal, foi possível objectivar medidas de quantificação da qualidade diagnóstica e medidas de detectabilidade de objectos. Da investigação efectuada, foi possível salientar algumas conclusões. As medidas quantitativas referentes à performance dos detectores são a base do processo de optimização, permitindo a medição e a determinação dos parâmetros físicos dos sistemas de radiologia digital. Os parâmetros de exposição utilizados na prática clínica mostram que a prática não está em conformidade com o referencial Europeu. Verifica-se a necessidade de avaliar, melhorar e implementar um padrão de referência para o processo de optimização, através de novos referenciais de boa prática ajustados aos sistemas digitais. Os parâmetros de exposição influenciam a dose no paciente, mas a percepção da qualidade de imagem digital não parece afectada com a variação da exposição. Os estudos que se realizaram envolvendo tanto imagens de fantomas como imagens de pacientes mostram que a sobreexposição é um risco potencial em radiologia digital. A avaliação da qualidade diagnóstica das imagens mostrou que com a variação da exposição não se observou degradação substancial da qualidade das imagens quando a redução de dose é efectuada. Propõe-se o estudo e a implementação de novos níveis de referência de diagnóstico ajustados aos sistemas de radiologia digital. Como contributo da tese, é proposto um modelo (STDI) para a optimização de sistemas de radiologia digital.

Communication between nodes for autonomic and distributed management

Over the last decade, the most widespread approaches for traditional management were based on the Simple Network Management Protocol (SNMP) or Common Management Information Protocol (CMIP). However, they both have several problems in terms of scalability, due to their centralization characteristics. Although the distributed management approaches exhibit better performance in terms of scalability, they still underperform regarding communication costs, autonomy, extensibility, exibility, robustness, and cooperation between network nodes. The cooperation between network nodes normally requires excessive overheads for synchronization and dissemination of management information in the network. For emerging dynamic and large-scale networking environments, as envisioned in Next Generation Networks (NGNs), exponential growth in the number of network devices and mobile communications and application demands is expected. Thus, a high degree of management automation is an important requirement, along with new mechanisms that promote it optimally and e ciently, taking into account the need for high cooperation between the nodes. Current approaches for self and autonomic management allow the network administrator to manage large areas, performing fast reaction and e ciently facing unexpected problems. The management functionalities should be delegated to a self-organized plane operating within the network, that decrease the network complexity and the control information ow, as opposed to centralized or external servers. This Thesis aims to propose and develop a communication framework for distributed network management which integrates a set of mechanisms for initial communication, exchange of management information, network (re) organization and data dissemination, attempting to meet the autonomic and distributed management requirements posed by NGNs. The mechanisms are lightweight and portable, and they can operate in di erent hardware architectures and include all the requirements to maintain the basis for an e cient communication between nodes in order to ensure autonomic network management. Moreover, those mechanisms were explored in diverse network conditions and events, such as device and link errors, di erent tra c/network loads and requirements. The results obtained through simulation and real experimentation show that the proposed mechanisms provide a lower convergence time, smaller overhead impact in the network, faster dissemination of management information, increase stability and quality of the nodes associations, and enable the support for e cient data information delivery in comparison to the base mechanisms analyzed. Finally, all mechanisms for communication between nodes proposed in this Thesis, that support and distribute the management information and network control functionalities, were devised and developed to operate in completely decentralized scenarios.