Quality control for retinal OCT in multiple sclerosis: validation of the OSCAR-IB criteria.

BACKGROUND Retinal optical coherence tomography (OCT) permits quantification of retinal layer atrophy relevant to assessment of neurodegeneration in multiple sclerosis (MS). Measurement artefacts may limit the use of OCT to MS research. OBJECTIVE An expert task force convened with the aim to provide guidance on the use of validated quality control (QC) criteria for the use of OCT in MS research and clinical trials. METHODS A prospective multi-centre (n = 13) study. Peripapillary ring scan QC rating of an OCT training set (n = 50) was followed by a test set (n = 50). Inter-rater agreement was calculated using kappa statistics. Results were discussed at a round table after the assessment had taken place. RESULTS The inter-rater QC agreement was substantial (kappa = 0.7). Disagreement was found highest for judging signal strength (kappa = 0.40). Future steps to resolve these issues were discussed. CONCLUSION Substantial agreement for QC assessment was achieved with aid of the OSCAR-IB criteria. The task force has developed a website for free online training and QC certification. The criteria may prove useful for future research and trials in MS using OCT as a secondary outcome measure in a multi-centre setting.

Multiple sources of Greenland dust throughout the Holocene

It is contested that the mineral dust found in Greenlandic ice cores during the Holocene stems from multiple source areas. Particles entrained above a more productive, primary source dominate the signal’s multi-seasonal average. Data in sub-annual resolution, however, reveal at least one further source. Whereas distinct inputs from the primary source are visible in elevated concentration levels, various inputs of the secondary source(s) are reflected by multiple maxima in the coarse particle percentage. As long as the dust sources’ respective seasonal cycles are preserved, primary and secondary source can be distinguished. Since the two source’s ejecta eventually detected differ in size, which can be attributed to a change in atmospheric residence times, it is suggested that the secondary source is located in closer proximity to the drilling site than the primary one.

Segmented filamentous bacterium uses secondary and tertiary lymphoid tissues to induce gut IgA and specific T helper 17 cell responses.

Segmented filamentous bacterium (SFB) is a symbiont that drives postnatal maturation of gut adaptive immune responses. In contrast to nonpathogenic E. coli, SFB stimulated vigorous development of Peyer's patches germinal centers but paradoxically induced only a low frequency of specific immunoglobulin A (IgA)-secreting cells with delayed accumulation of somatic mutations. Moreover, blocking Peyer's patch development abolished IgA responses to E. coli, but not to SFB. Indeed, SFB stimulated the postnatal development of isolated lymphoid follicles and tertiary lymphoid tissue, which substituted for Peyer's patches as inductive sites for intestinal IgA and SFB-specific T helper 17 (Th17) cell responses. Strikingly, in mice depleted of gut organized lymphoid tissue, SFB still induced a substantial but nonspecific intestinal Th17 cell response. These results demonstrate that SFB has the remarkable capacity to induce and stimulate multiple types of intestinal lymphoid tissues that cooperate to generate potent IgA and Th17 cell responses displaying only limited target specificity.

Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial.

BACKGROUND Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living (ADL) and quality of life. OBJECTIVE We aimed to evaluate the effectiveness of a standardized, home-based training program to improve manual dexterity and dexterity-related ADL in MS patients. METHODS This was a randomized, rater-blinded controlled trial. Thirty-nine MS patients acknowledging impaired manual dexterity and having a pathological Coin Rotation Task (CRT), Nine Hole Peg Test (9HPT) or both were randomized 1:1 into two standardized training programs, the dexterity training program and the theraband training program. Patients trained five days per week in both programs over a period of 4 weeks. Primary outcome measures performed at baseline and after 4 weeks were the CRT, 9HPT and a dexterous-related ADL questionnaire. Secondary outcome measures were the Chedoke Arm and Hand Activity Inventory (CAHAI-8) and the JAMAR test. RESULTS The dexterity training program resulted in significant improvements in almost all outcome measures at study end compared with baseline. The theraband training program resulted in mostly non-significant improvements. CONCLUSION The home-based dexterity training program significantly improved manual dexterity and dexterity-related ADL in moderately disabled MS patients. Trial Registration NCT01507636.

Modeling the formation and aging of secondary organic aerosols during CalNex 2010

Four different literature parameterizations for the formation and evolution of urban secondary organic aerosol (SOA) frequently used in 3-D models are evaluated using a 0-D box model representing the Los Angeles metropolitan region during the California Research at the Nexus of Air Quality and Climate Change (CalNex) 2010 campaign. We constrain the model predictions with measurements from several platforms and compare predictions with particle- and gas-phase observations from the CalNex Pasadena ground site. That site provides a unique opportunity to study aerosol formation close to anthropogenic emission sources with limited recirculation. The model SOA that formed only from the oxidation of VOCs (V-SOA) is insufficient to explain the observed SOA concentrations, even when using SOA parameterizations with multi-generation oxidation that produce much higher yields than have been observed in chamber experiments, or when increasing yields to their upper limit estimates accounting for recently reported losses of vapors to chamber walls. The Community Multiscale Air Quality (WRF-CMAQ) model (version 5.0.1) provides excellent predictions of secondary inorganic particle species but underestimates the observed SOA mass by a factor of 25 when an older VOC-only parameterization is used, which is consistent with many previous model–measurement comparisons for pre-2007 anthropogenic SOA modules in urban areas. Including SOA from primary semi-volatile and intermediate-volatility organic compounds (P-S/IVOCs) following the parameterizations of Robinson et al. (2007), Grieshop et al. (2009), or Pye and Seinfeld (2010) improves model–measurement agreement for mass concentration. The results from the three parameterizations show large differences (e.g., a factor of 3 in SOA mass) and are not well constrained, underscoring the current uncertainties in this area. Our results strongly suggest that other precursors besides VOCs, such as P-S/IVOCs, are needed to explain the observed SOA concentrations in Pasadena. All the recent parameterizations overpredict urban SOA formation at long photochemical ages (3 days) compared to observations from multiple sites, which can lead to problems in regional and especially global modeling. However, reducing IVOC emissions by one-half in the model to better match recent IVOC measurements improves SOA predictions at these long photochemical ages. Among the explicitly modeled VOCs, the precursor compounds that contribute the greatest SOA mass are methylbenzenes. Measured polycyclic aromatic hydrocarbons (naphthalenes) contribute 0.7% of the modeled SOA mass. The amounts of SOA mass from diesel vehicles, gasoline vehicles, and cooking emissions are estimated to be 16–27, 35–61, and 19–35 %, respectively, depending on the parameterization used, which is consistent with the observed fossil fraction of urban SOA, 71(+-3) %. The relative contribution of each source is uncertain by almost a factor of 2 depending on the parameterization used. In-basin biogenic VOCs are predicted to contribute only a few percent to SOA. A regional SOA background of approximately 2.1 μgm-3 is also present due to the long-distance transport of highly aged OA, likely with a substantial contribution from regional biogenic SOA. The percentage of SOA from diesel vehicle emissions is the same, within the estimated uncertainty, as reported in previous work that analyzed the weekly cycles in OA concentrations (Bahreini et al., 2012; Hayes et al., 2013). However, the modeling work presented here suggests a strong anthropogenic source of modern carbon in SOA, due to cooking emissions, which was not accounted for in those previous studies and which is higher on weekends. Lastly, this work adapts a simple two-parameter model to predict SOA concentration and O/C from urban emissions. This model successfully predicts SOA concentration, and the optimal parameter combination is very similar to that found for Mexico City. This approach provides a computationally inexpensive method for predicting urban SOA in global and climate models. We estimate pollution SOA to account for 26 Tg yr-1 of SOA globally, or 17% of global SOA, one third of which is likely to be non-fossil.

Incident hypertension among pre-hypertensive adolescents: Evaluation of pre-hypertension as an independent risk factor among secondary school students in the Houston area

Cardiovascular disease has been the leading cause of death in the United States for over fifty years. While multiple risk factors for cardiovascular disease have been identified, hypertension is one of the most commonly recognized and treatable. Recent studies indicate that the prevalence of hypertension among children and adolescents is between 3-5%, much higher than originally estimated and likely rising due to the epidemic of obesity in the U.S. In 2004, the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents published new guidelines for the diagnosis and treatment of hypertension in this population. Included in these recommendations was the creation of a new diagnosis, pre-hypertension, aimed at identifying children at-risk for hypertension to provide early lifestyle interventions in an effort to prevent its ultimate development. In order to determine the risk associated with pre-hypertension for the development of incident HTN, a secondary analysis of a repeated cross-sectional study measuring blood pressure in Houston area adolescents from 2000 to 2007 was performed. Of 1006 students participating in the blood pressure screening on more than one occasion not diagnosed with hypertension at initial encounter, eleven were later found to have hypertension providing an overall incident rate of 0.5% per year. Incidence rates were higher among overweight adolescents–1.9% per year [IRR 8.6 (1.97, 51.63)]; students “at-risk for hypertension” (pre-hypertensive or initial blood pressure in the hypertensive range but falling on subsequent measures)–1.4% per year [IRR 4.77 (1.21, 19.78)]; and those with blood pressure ≥90th percentile on three occasions–6.6% per year [IRR 21.87 (3.40, 112.40)]. Students with pre-hypertension as currently defined by the Task Force did have an increased rate of hypertension (1.1% per year) but it did not reach statistical significance [IRR 2.44 (0.42, 10.18)]. Further research is needed to determine the morbidity and mortality associated with pre-hypertension in this age group as well as the effectiveness of various interventions for preventing the development of hypertensive disease among these at-risk individuals. ^

Safety, pharmacokinetics, and antiretroviral activity of multiple doses of ibalizumab (formerly TNX-355), an anti-CD4 monoclonal antibody in HIV-1 infected adults

Context: Despite tremendous strides in HIV treatment over the past decade, resistance remains a major problem. A growing number of patients develop resistance and require new therapies to suppress viral replication. ^ Objective: To assess the safety of multiple administrations of the anti-CD4 receptor (anti-CD4) monoclonal antibody ibalizumab given as intravenous (IV) infusions, in three dosage regimens, in subjects infected with human immunodeficiency virus (HIV-1). ^ Design: Phase 1, multi-center, open-label, randomized clinical trial comparing the safety, pharmacokinetics and antiviral activity of three dosages of ibalizumab. ^ Setting: Six clinical trial sites in the United States. ^ Participants: A total of twenty-two HIV-positive patients on no anti-retroviral therapy or a stable failing regimen. ^ Intervention: Randomized to one of two treatment groups in Arms A and B followed by non-randomized enrollment in Arm C. Patients randomized to Arm A received 10 mg/kg of ibalizumab every 7 days, for a total of 10 doses; patients randomized to Arm B received a total of six doses of ibalizumab; a single loading dose of 10 mg/kg on Day 1 followed by five maintenance doses of 6 mg/kg every 14 days, starting at Week 1. Patients assigned to Arm C received 25 mg/kg of ibalizumab every 14 days for a total of 5 doses. All patients were followed for safety for an additional 7 to 8 weeks. ^ Main Outcome Measures: Clinical and laboratory assessments of safety and tolerability of multiple administrations of ibalizumab in HIV-infected patients. Secondary measures of efficacy include HIV-1 RNA (viral load) measurements. ^ Results: 21 patients were treatment-experienced and 1 was naïve to HIV therapy. Six patients were failing despite therapy and 15 were on no current HIV treatment. Mean baseline viral load (4.78 log 10; range 3.7-5.9) and CD4+ cell counts (332/μL; range 89-494) were similar across cohorts. Mean peak decreases in viral load from baseline of 0.99 log10(1.11 log10, and 0.96 log 10 occurred by Wk 2 in Cohorts A, B and C, respectively. Viral loads decreased by >1.0 log10 in 64%; 4 patients viral loads were suppressed to < 400 copies/mL. Viral loads returned towards baseline by Week 9 with reduced susceptibility to ibalizumab. CD4+ cell counts rose transiently and returned toward baseline. Maximum median elevations above BL in CD4+ cell counts for Cohorts A, B and C were +257, +198 and +103 cells/μL, respectively and occurred within 3 Wks in 16 of 22 subjects. The half-life of ibalizumab was 3-3.5 days and elimination was characteristic of capacity-limited kinetics. Administration of ibalizumab was well tolerated. Four serious adverse events were reported during the study. None of these events were related to study drug. Headache, nausea and cough were the most frequently reported treatment emergent adverse events and there were no laboratory abnormalities related to study drug. ^ Conclusions: Ibalizumab administered either weekly or bi-weekly was safe, well tolerated, and demonstrated antiviral activity. Further studies with ibalizumab in combination with standard antiretroviral treatments are warranted.^

FEMALE SEXUAL MATURATION AND BLOOD PRESSURE (SECONDARY-SEX CHARACTERISTICS, GROWTH, DEVELOPMENT)

This study described the relationship of sexual maturation and blood pressure in a sample (n = 361) of white females, ages seven through 18, attending public schools in a defined area of Central Texas during October through December, 1984. Other correlates of blood pressure were also described for this sample.^ A survey was performed to obtain the data on height, weight, body mass, pulse rate, upper arm circumference and length, and blood pressure. Each subject self-assessed her secondary sex characteristics (breast and pubic hair) according to drawings of the Tanner stages of maturation. The subjects were interviewed to obtain data on personal health habits and menstrual status. Student age, ethnic group and place of residence were abstracted from school records. Parents or guardians of the subjects responded to a questionnaire pertaining to parental and subject health history and parents' occupation and educational attainment.^ In the simple linear regression analysis, sexual maturation and variables of body size were significantly (p < 0.001) and positively associated with systolic and fourth- and fifth-phase diastolic blood pressure. The demographic and socioeconomic variables were not sufficiently variant in this population to have differential effects on the relation between blood pressure and maturation. Stepwise multiple regression was used to assess the contribution of sexual maturation to the variance of blood pressure after accounting for the variables of body size. Sexual maturation (breast stage) along with weight, height and body mass remained in the multiple regression models for fourth- and fifth-phase diastolic blood pressure. Only height and body mass remained in the regression model for systolic blood pressure; sexual maturation did not contribute more to the explanation of the systolic blood pressure variance.^ The association of sexual maturation with blood pressure level was established in this sample of young white females. More research is needed first, to determine if this relationship prevails in other populations of young females, and second, to determine the relationship of sexual maturation sequence and change with the change of blood pressure during childhood and adolescence. ^

Motivational interviewing and feedback for college drinkers: Handling missing values with complete case analysis and multiple imputation

Objective: In this secondary data analysis, three statistical methodologies were implemented to handle cases with missing data in a motivational interviewing and feedback study. The aim was to evaluate the impact that these methodologies have on the data analysis. ^ Methods: We first evaluated whether the assumption of missing completely at random held for this study. We then proceeded to conduct a secondary data analysis using a mixed linear model to handle missing data with three methodologies (a) complete case analysis, (b) multiple imputation with explicit model containing outcome variables, time, and the interaction of time and treatment, and (c) multiple imputation with explicit model containing outcome variables, time, the interaction of time and treatment, and additional covariates (e.g., age, gender, smoke, years in school, marital status, housing, race/ethnicity, and if participants play on athletic team). Several comparisons were conducted including the following ones: 1) the motivation interviewing with feedback group (MIF) vs. the assessment only group (AO), the motivation interviewing group (MIO) vs. AO, and the intervention of the feedback only group (FBO) vs. AO, 2) MIF vs. FBO, and 3) MIF vs. MIO.^ Results: We first evaluated the patterns of missingness in this study, which indicated that about 13% of participants showed monotone missing patterns, and about 3.5% showed non-monotone missing patterns. Then we evaluated the assumption of missing completely at random by Little's missing completely at random (MCAR) test, in which the Chi-Square test statistic was 167.8 with 125 degrees of freedom, and its associated p-value was p=0.006, which indicated that the data could not be assumed to be missing completely at random. After that, we compared if the three different strategies reached the same results. For the comparison between MIF and AO as well as the comparison between MIF and FBO, only the multiple imputation with additional covariates by uncongenial and congenial models reached different results. For the comparison between MIF and MIO, all the methodologies for handling missing values obtained different results. ^ Discussions: The study indicated that, first, missingness was crucial in this study. Second, to understand the assumptions of the model was important since we could not identify if the data were missing at random or missing not at random. Therefore, future researches should focus on exploring more sensitivity analyses under missing not at random assumption.^

Multiple Input-Output Bidirectional Solid State Transformer Based on a Series Resonant Converter

Las fuentes de alimentación de modo conmutado (SMPS en sus siglas en inglés) se utilizan ampliamente en una gran variedad de aplicaciones. La tarea más difícil para los diseñadores de SMPS consiste en lograr simultáneamente la operación del convertidor con alto rendimiento y alta densidad de energía. El tamaño y el peso de un convertidor de potencia está dominado por los componentes pasivos, ya que estos elementos son normalmente más grandes y más pesados que otros elementos en el circuito. Para una potencia de salida dada, la cantidad de energía almacenada en el convertidor que ha de ser entregada a la carga en cada ciclo de conmutación, es inversamente proporcional a la frecuencia de conmutación del convertidor. Por lo tanto, el aumento de la frecuencia de conmutación se considera un medio para lograr soluciones más compactas con los niveles de densidad de potencia más altos. La importancia de investigar en el rango de alta frecuencia de conmutación radica en todos los beneficios que se pueden lograr: además de la reducción en el tamaño de los componentes pasivos, el aumento de la frecuencia de conmutación puede mejorar significativamente prestaciones dinámicas de convertidores de potencia. Almacenamiento de energía pequeña y el período de conmutación corto conducen a una respuesta transitoria del convertidor más rápida en presencia de las variaciones de la tensión de entrada o de la carga. Las limitaciones más importantes del incremento de la frecuencia de conmutación se relacionan con mayores pérdidas del núcleo magnético convencional, así como las pérdidas de los devanados debido a los efectos pelicular y proximidad. También, un problema potencial es el aumento de los efectos de los elementos parásitos de los componentes magnéticos - inductancia de dispersión y la capacidad entre los devanados - que causan pérdidas adicionales debido a las corrientes no deseadas. Otro factor limitante supone el incremento de las pérdidas de conmutación y el aumento de la influencia de los elementos parásitos (pistas de circuitos impresos, interconexiones y empaquetado) en el comportamiento del circuito. El uso de topologías resonantes puede abordar estos problemas mediante el uso de las técnicas de conmutaciones suaves para reducir las pérdidas de conmutación incorporando los parásitos en los elementos del circuito. Sin embargo, las mejoras de rendimiento se reducen significativamente debido a las corrientes circulantes cuando el convertidor opera fuera de las condiciones de funcionamiento nominales. A medida que la tensión de entrada o la carga cambian las corrientes circulantes incrementan en comparación con aquellos en condiciones de funcionamiento nominales. Se pueden obtener muchos beneficios potenciales de la operación de convertidores resonantes a más alta frecuencia si se emplean en aplicaciones con condiciones de tensión de entrada favorables como las que se encuentran en las arquitecturas de potencia distribuidas. La regulación de la carga y en particular la regulación de la tensión de entrada reducen tanto la densidad de potencia del convertidor como el rendimiento. Debido a la relativamente constante tensión de bus que se encuentra en arquitecturas de potencia distribuidas los convertidores resonantes son adecuados para el uso en convertidores de tipo bus (transformadores cc/cc de estado sólido). En el mercado ya están disponibles productos comerciales de transformadores cc/cc de dos puertos que tienen muy alta densidad de potencia y alto rendimiento se basan en convertidor resonante serie que opera justo en la frecuencia de resonancia y en el orden de los megahercios. Sin embargo, las mejoras futuras en el rendimiento de las arquitecturas de potencia se esperan que vengan del uso de dos o más buses de distribución de baja tensión en vez de una sola. Teniendo eso en cuenta, el objetivo principal de esta tesis es aplicar el concepto del convertidor resonante serie que funciona en su punto óptimo en un nuevo transformador cc/cc bidireccional de puertos múltiples para atender las necesidades futuras de las arquitecturas de potencia. El nuevo transformador cc/cc bidireccional de puertos múltiples se basa en la topología de convertidor resonante serie y reduce a sólo uno el número de componentes magnéticos. Conmutaciones suaves de los interruptores hacen que sea posible la operación en las altas frecuencias de conmutación para alcanzar altas densidades de potencia. Los problemas posibles con respecto a inductancias parásitas se eliminan, ya que se absorben en los Resumen elementos del circuito. El convertidor se caracteriza con una muy buena regulación de la carga propia y cruzada debido a sus pequeñas impedancias de salida intrínsecas. El transformador cc/cc de puertos múltiples opera a una frecuencia de conmutación fija y sin regulación de la tensión de entrada. En esta tesis se analiza de forma teórica y en profundidad el funcionamiento y el diseño de la topología y del transformador, modelándolos en detalle para poder optimizar su diseño. Los resultados experimentales obtenidos se corresponden con gran exactitud a aquellos proporcionados por los modelos. El efecto de los elementos parásitos son críticos y afectan a diferentes aspectos del convertidor, regulación de la tensión de salida, pérdidas de conducción, regulación cruzada, etc. También se obtienen los criterios de diseño para seleccionar los valores de los condensadores de resonancia para lograr diferentes objetivos de diseño, tales como pérdidas de conducción mínimas, la eliminación de la regulación cruzada o conmutación en apagado con corriente cero en plena carga de todos los puentes secundarios. Las conmutaciones en encendido con tensión cero en todos los interruptores se consiguen ajustando el entrehierro para obtener una inductancia magnetizante finita en el transformador. Se propone, además, un cambio en los señales de disparo para conseguir que la operación con conmutaciones en apagado con corriente cero de todos los puentes secundarios sea independiente de la variación de la carga y de las tolerancias de los condensadores resonantes. La viabilidad de la topología propuesta se verifica a través una extensa tarea de simulación y el trabajo experimental. La optimización del diseño del transformador de alta frecuencia también se aborda en este trabajo, ya que es el componente más voluminoso en el convertidor. El impacto de de la duración del tiempo muerto y el tamaño del entrehierro en el rendimiento del convertidor se analizan en un ejemplo de diseño de transformador cc/cc de tres puertos y cientos de vatios de potencia. En la parte final de esta investigación se considera la implementación y el análisis de las prestaciones de un transformador cc/cc de cuatro puertos para una aplicación de muy baja tensión y de decenas de vatios de potencia, y sin requisitos de aislamiento. Abstract Recently, switch mode power supplies (SMPS) have been used in a great variety of applications. The most challenging issue for designers of SMPS is to achieve simultaneously high efficiency operation at high power density. The size and weight of a power converter is dominated by the passive components since these elements are normally larger and heavier than other elements in the circuit. If the output power is constant, the stored amount of energy in the converter which is to be delivered to the load in each switching cycle is inversely proportional to the converter’s switching frequency. Therefore, increasing the switching frequency is considered a mean to achieve more compact solutions at higher power density levels. The importance of investigation in high switching frequency range comes from all the benefits that can be achieved. Besides the reduction in size of passive components, increasing switching frequency can significantly improve dynamic performances of power converters. Small energy storage and short switching period lead to faster transient response of the converter against the input voltage and load variations. The most important limitations for pushing up the switching frequency are related to increased conventional magnetic core loss as well as the winding loss due to the skin and proximity effect. A potential problem is also increased magnetic parasitics – leakage inductance and capacitance between the windings – that cause additional loss due to unwanted currents. Higher switching loss and the increased influence of printed circuit boards, interconnections and packaging on circuit behavior is another limiting factor. Resonant power conversion can address these problems by using soft switching techniques to reduce switching loss incorporating the parasitics into the circuit elements. However the performance gains are significantly reduced due to the circulating currents when the converter operates out of the nominal operating conditions. As the input voltage or the load change the circulating currents become higher comparing to those ones at nominal operating conditions. Multiple Input-Output Many potential gains from operating resonant converters at higher switching frequency can be obtained if they are employed in applications with favorable input voltage conditions such as those found in distributed power architectures. Load and particularly input voltage regulation reduce a converter’s power density and efficiency. Due to a relatively constant bus voltage in distributed power architectures the resonant converters are suitable for bus voltage conversion (dc/dc or solid state transformation). Unregulated two port dc/dc transformer products achieving very high power density and efficiency figures are based on series resonant converter operating just at the resonant frequency and operating in the megahertz range are already available in the market. However, further efficiency improvements of power architectures are expected to come from using two or more separate low voltage distribution buses instead of a single one. The principal objective of this dissertation is to implement the concept of the series resonant converter operating at its optimum point into a novel bidirectional multiple port dc/dc transformer to address the future needs of power architectures. The new multiple port dc/dc transformer is based on a series resonant converter topology and reduces to only one the number of magnetic components. Soft switching commutations make possible high switching frequencies to be adopted and high power densities to be achieved. Possible problems regarding stray inductances are eliminated since they are absorbed into the circuit elements. The converter features very good inherent load and cross regulation due to the small output impedances. The proposed multiple port dc/dc transformer operates at fixed switching frequency without line regulation. Extensive theoretical analysis of the topology and modeling in details are provided in order to compare with the experimental results. The relationships that show how the output voltage regulation and conduction losses are affected by the circuit parasitics are derived. The methods to select the resonant capacitor values to achieve different design goals such as minimum conduction losses, elimination of cross regulation or ZCS operation at full load of all the secondary side bridges are discussed. ZVS turn-on of all the switches is achieved by relying on the finite magnetizing inductance of the Abstract transformer. A change of the driving pattern is proposed to achieve ZCS operation of all the secondary side bridges independent on load variations or resonant capacitor tolerances. The feasibility of the proposed topology is verified through extensive simulation and experimental work. The optimization of the high frequency transformer design is also addressed in this work since it is the most bulky component in the converter. The impact of dead time interval and the gap size on the overall converter efficiency is analyzed on the design example of the three port dc/dc transformer of several hundreds of watts of the output power for high voltage applications. The final part of this research considers the implementation and performance analysis of the four port dc/dc transformer in a low voltage application of tens of watts of the output power and without isolation requirements.

RB-mediated suppression of spontaneous multiple neuroendocrine neoplasia and lung metastases in Rb+/− mice

Alterations in pathways mediated by retinoblastoma susceptibility gene (RB) product are among the most common in human cancer. Mice with a single copy of the Rb gene are shown to develop a syndrome of multiple neuroendocrine neoplasia. The earliest Rb-deficient atypical cells were identified in the intermediate and anterior lobes of the pituitary, the thyroid and parathyroid glands, and the adrenal medulla within the first 3 months of postnatal development. These cells form gross tumors with various degrees of malignancy by postnatal day 350. By age of 380 days, 84% of Rb+/− mice exhibited lung metastases from C-cell thyroid carcinomas. Expression of a human RB transgene in the Rb+/− mice suppressed carcinogenesis in all tissues studied. Of particular clinical relevance, the frequency of lung metastases also was reduced to 12% in Rb+/− mice by repeated i.v. administration of lipid-entrapped, polycation-condensed RB complementary DNA. Thus, in spite of long latency periods during which secondary alterations can accumulate, the initial loss of Rb function remains essential for tumor progression in multiple types of neuroendocrine cells. Restoration of RB function in humans may prove an effective general approach to the treatment of RB-deficient disseminated tumors.

Three 1-Aminocyclopropane-1-Carboxylate Synthase Genes Regulated by Primary and Secondary Pollination Signals in Orchid Flowers1

The temporal and spatial expression patterns of three 1-aminocyclopropane-1-carboxylate (ACC) synthase genes were investigated in pollinated orchid (Phalaenopsis spp.) flowers. Pollination signals initiate a cascade of development events in multiple floral organs, including the induction of ethylene biosynthesis, which coordinates several postpollination developmental responses. The initiation and propagation of ethylene biosynthesis is regulated by the coordinated expression of three distinct ACC synthase genes in orchid flowers. One ACC synthase gene (Phal-ACS1) is regulated by ethylene and participates in amplification and interorgan transmission of the pollination signal, as we have previously described in a related orchid genus. Two additional ACC synthase genes (Phal-ACS2 and Phal-ACS3) are expressed primarily in the stigma and ovary of pollinated orchid flowers. Phal-ACS2 mRNA accumulated in the stigma within 1 h after pollination, whereas Phal-ACS1 mRNA was not detected until 6 h after pollination. Similar to the expression of Phal-ACS2, the Phal-ACS3 gene was expressed within 2 h after pollination in the ovary. Exogenous application of auxin, but not ACC, mimicked pollination by stimulating a rapid increase in ACC synthase activity in the stigma and ovary and inducing Phal-ACS2 and Phal-ACS3 mRNA accumulation in the stigma and ovary, respectively. These results provide the basis for an expanded model of interorgan regulation of three ACC synthase genes that respond to both primary (Phal-ACS2 and Phal-ACS3) and secondary (Phal-ACS1) pollination signals.