Switch to etravirine for HIV-positive patients receiving statin treatment: a prospective study.

BACKGROUND: Lifestyle changes and statins are the cornerstones in management of dyslipidaemia in patients with HIV infection. Replacement of an antiretroviral therapy (ART) component is a proposed therapeutic strategy to reduce cardiovascular risk. In dyslipidaemic patients with HIV infection, we assessed the efficacy of replacing boosted protease inhibitor (bPI) or efavirenz (EFV) by etravirine (ETR) as an alternative to statin therapy. MATERIALS AND METHODS: A prospective, open-label, multicentre, 12-week study of patients with HIV infection on ART including bPI or EFV, and statin treatment. Four weeks after statin interruption, bPI or EFV was switched to ETR (400 mg, 8 weeks) if serum low-density lipoprotein cholesterol (LDL-C) was ≥ 3 mM. The primary endpoint was the proportion of patients on ETR with no indication for statin treatment at study completion. Serum levels of HIV RNA, lipids and biomarkers of cardiovascular disease were also measured. (ClinicalTrials.gov: NCT01543035). RESULTS: The 31 included patients had a HIV-1 RNA < 50 copies/mL (median age, 52 years; median CD4, 709 cell/mL; median LDL-C, 2·89 mM), 68% were on EFV, and 32% were on bPI. At week 4, 27 patients switched to ETR. At study completion, 15 patients (56%) on ETR did not qualify for statin treatment. After the ETR switch, serum levels of the cardiovascular biomarkers sICAM and MCP1/CCL2 decreased by 11·2% and 18·9%, respectively, and those of CCL5/RANTES and tissue inhibitor of metalloproteinase-1 increased by 14·3% and 13·4%, respectively, indicating reduced cardiovascular risk. There were no notable treatment-related adverse events. CONCLUSIONS: Replacing bPI or EFV by ETR is a viable strategy to obviate primary prevention statin treatment.

OLFM4 : a neutrophil shield against autoimmunity?

Neutrophil extracellular traps (NETs) formation is a cell death mechanism characterized by the extrusion of DNA fibers associated to antimicrobial peptides such as LL37. Beside their antimicrobial role, NETs are highly immunogenic by their ability to activate plasmacytoid dendritic cells (pDCs). In this context, LL37 binds to NET-DNA, leading to endosomal Toll¬like-receptor (TLR) 9 binding, resulting in Interferon alpha (IFNa) production by pDCs. Uncontrolled pDC activation by NETs is an important player in the pathogenesis of autoimmune disease such as Lupus Erythematosus (LE); however the regulation of NET- driven pDC activation is poorly characterized. Olfactomedin 4 (OLFM4) is a granule protein present in a subset of circulating neutrophils and was shown to bear anti-inflammatory properties in a mouse model, raising the possibility that it may regulate neutrophil-induced inflammation. Therefore, in this project, we aimed at deciphering the mechanism by which OLFM4 may regulate inflammation induced by NET-activated pDC and its relevance in the pathogenesis of Lupus Erythematosus (LE). First, we show that OLFM4 directly interacted with LL37 in neutrophils, impairing LL37/DNA complexes formation and pDC activation to produce IFNa. Then, by using an in vivo model of acute inflammation depending on NET- driven activation of pDCs, we observed that the absence of Olfm4 led to uncontrolled type I IFN production, confirming the regulatory role of neutrophil-derived OLFM4. Beyond controlling NET-induced inflammation, we also show that OLFM4 could inhibit pDC activation mediated by DNA-containing immune complexes (ICs), suggesting that OLFM4 holds anti¬inflammatory properties in the context of LE. Of note, we identified a previously unknown population of OLFM4hi9h neutrophils in healthy individuals that may belong to the immunosuppressive subset of granulocytic myeloid-derived suppressor cells (g-MDSCs). Strikingly, we observed a decreased frequency of OLFM4h'9h cells among inflammatory Low density granulocytes (LDGs) neutrophils in LE patients, suggesting that a disequilibrium between pro- and anti-inflammatory neutrophils may participate to the disease pathogenesis. Altogether, this study demonstrates that OLFM4 is involved in the resolution of inflammation. -- La NETose (formation de Neutrophil Extracellular Traps, NETs) est une réponse à un stimulus inflammatoire caractérisée par l'expulsion de l'ADN lié à des peptides antimicrobiens comme le LL37, induisant la mort de la cellule. Les NETs possèdent des propriétés antibactériennes et sont pro-inflammatoires via leur capacité à activer les cellules dendritiques plasmacytoïdes (pDCs). Dans ce contexte, les complexes ADN/LL37 libérés lient le récepteur Toll-like 9 des pDCs, induisant la production d'Interféron alpha (IFNa). La production incontrôlée d'IFNa par les pDCs est impliquée dans la pathogenèse du Lupus Erythemateux (LE), cependant la régulation de l'activation des pDCs reste mal connue. L'Oflactomédine 4 (OLFM4) est une protéine produite par une sous-population de neutrophiles, avec des propriétés anti-inflammatoires possibles. Le but de ce projet était d'identifier les mécanismes par lesquels l'OLFM4 pourrait réguler l'inflammation induite par les NETs et sa relevance dans la pathogenèse du LE. Tout d'abord, nous avons montré que l'OLFM4 interagissait avec le LL37, empêchant la production des complexes ADN/LL37 qui activent les pDCs. Nous avons vérifié notre hypothèse in vivo en utilisant un modèle murin d'inflammation locale dépendant des pDCs et des NETs. Dans ce contexte, le déficit en Olfm4 était associé à une production accrue d'IFNa, confirmant le rôle de l'OLFM4 dans le contrôle de l'inflammation. De plus, l'OLFM4 pouvait également inhiber l'activation des pDCs induite par des complexes immuns, suggérant que l'OLFM4 serait aussi anti-inflammatoire dans le contexte du LE. Ensuite, nous avons identifié une nouvelle population de neutrophiles OLFM4h'9h chez les sujets sains qui pourraient appartenir au sous-type anti¬inflammatoire des g-MDSCs (granulocytic myeloid-derived suppressor cells). Nous avons observé une diminution de ces cellules parmi les neutrophiles pro-inflammatoires LDGs (Low Density Granulocytes) dans le LE suggérant qu'un déséquilibre entre les sous-types de neutrophiles pourrait participer à l'inflammation excessive de cette maladie. Ces travaux mettent en évidence l'implication de l'OLFM4 dans la résolution de l'inflammation et suggèrent qu'une expression altérée de l'OLFM4 pourrait participer à la pathogenèse du LE. -- Les neutrophils constituent la majorité des globules blancs circulants et sont rapidement mobilisés depuis le sang dans un organe lésé en cas d'infection ou de blessure. Ils représentent la première ligne de défense du système immunitaire. Ils sont indispensables dans la défense contre les infections par leur capacité à tuer les bactéries, par exemple en produisant des peptides antimicrobiens (AMPs) qui fonctionnent comme des antibiotiques naturels. De plus, les neutrophiles recrutent les autres membres du système immunitaire qui sont nécessaires à l'éradication complète des microbes et à la réparation des tissus. Les nombreux outils permettant aux neutrophiles de contrôler les infections ne sont cependant pas sans danger pour les tissus. En effet, diverses molécules comme les AMPs peuvent induire des dommages tissulaires substantiels en participant au développement d'une inflammation chronique. Ceci est particulièrement le cas lorsque les neutrophiles meurent par un processus nommé NETose. Dans ce contexte, la cellule subit une dissolution de sa membrane suivie de l'expulsion de son ADN associé à des AMPs. Ces complexes formés d'ADN et d'AMPs induisent la production de cytokines pro-inflammatoires dont l'Interféron alpha (IFNa). Certaines maladies auto-immunes comme le lupus érythémateux sont associées à un excès de NETose produit par les neutrophiles et à un excès d'IFNa qui participe au développement de la maladie. Dans cette thèse, nous avons montré que l'Olfactomédine 4 (OLFM4), une protéine produite par les neutrophiles eux-mêmes, est un inhibiteur de cette inflammation. Nous avons démontré que TOLFM4 empêchait la formation des complexes ADN/AMPs, réduisant par là la production d'IFNa in vitro et in vivo. Finalement, nos recherches ont suggéré que l'OLFM4 pourrait être insuffisamment produite chez les patients souffrant de lupus, ce qui pourrait participer à l'inflammation chronique associée à la maladie.

Five year trends in dyslipidaemia prevalence and management in Switzerland: The CoLaus study.

BACKGROUND AND AIMS: Data from prospective cohorts describing dyslipidaemia prevalence and treatment trends are lacking. Using data from the prospective CoLaus study, we aimed to examine changes in serum lipid levels, dyslipidaemia prevalence and management in a population-based sample of Swiss adults. METHODS AND RESULTS: Cardiovascular risk was assessed using PROCAM. Dyslipidaemia and low-density lipoprotein cholesterol (LDL-C) target levels were defined according to the Swiss Group for Lipids and Atherosclerosis. Complete baseline and follow up (FU) data were available for n = 4863 subjects during mean FU time of 5.6 years. Overall, 32.1% of participants were dyslipidaemic at baseline vs 46.3% at FU (p < 0.001). During this time, lipid lowering medication (LLM) rates among dyslipidaemic subjects increased from 34.0% to 39.2% (p < 0.001). In secondary prevention, LLM rates were 42.7% at baseline and 53.2% at FU (p = 0.004). In multivariate analysis, LLM use among dyslipidaemic subjects, between baseline and FU, was positively associated with personal history of CVD, older age, hypertension, higher BMI and diabetes, while negatively associated with higher educational level. Among treated subjects, LDL-C target achievement was positively associated with diabetes and negatively associated with personal history of CVD and higher BMI. Among subjects treated at baseline, LLM discontinuation was negatively associated with older age, male sex, smoking, hypertension and parental history of CVD. CONCLUSIONS: In Switzerland, the increase over time in dyslipidaemia prevalence was not paralleled by a similar increase in LLM. In a real-life setting, dyslipidaemia management remains far from optimal, both in primary and secondary prevention.

Potential blindness in children of patients with hereditary bone disease.

Mono- and bi-allelic mutations in the low-density lipoprotein receptor related protein 5 (LRP5) may cause osteopetrosis, autosomal dominant and recessive exudative vitreoretinopathy, juvenile osteoporosis, or persistent hyperplastic primary vitreous (PHPV). We report on a child affected with PHPV and carrying compound mutations. The father carried the splice mutation and suffered from severe bone fragility since childhood. The mother carried the missense mutation without any clinical manifestations. The genetic diagnosis of their child allowed for appropriate treatment in the father and for the detection of osteopenia in the mother. Mono- and bi-allelic mutations in LRP5 may cause osteopetrosis, autosomal dominant and recessive exudative vitreoretinopathy, juvenile osteoporosis, or PHPV. PHPV is a component of persistent fetal vasculature of the eye, characterized by highly variable expressivity and resulting in a wide spectrum of anterior and/or posterior congenital developmental defects, which may lead to blindness. We evaluated a family diagnosed with PHPV in their only child. The child presented photophobia during the first 3 weeks of life, followed by leukocoria at 2 months of age. Molecular resequencing of NDP, FZD4, and LRP5 was performed in the child and segregation of the observed mutations in the parents. At presentation, fundus examination of the child showed a retrolental mass in the right eye. Ultrasonography revealed retinal detachment in both eyes. Thorough familial analysis revealed that the father suffered from many fractures since childhood without specific fragility bone diagnosis, treatment, or management. The mother was asymptomatic. Molecular analysis in the proband identified two mutations: a c.[2091+2T>C] splice mutation and c.[1682C>T] missense mutation. We report the case of a child affected with PHPV and carrying compound heterozygous LRP5 mutations. This genetic diagnosis allowed the clinical diagnosis of the bone problem to be made in the father, resulting in better management of the family. It also enabled preventive treatment to be prescribed for the mother and accurate genetic counseling to be provided.

Exercise performed immediately after fructose ingestion enhances fructose oxidation and suppresses fructose storage.

BACKGROUND: Exercise prevents the adverse effects of a high-fructose diet through mechanisms that remain unknown. OBJECTIVE: We assessed the hypothesis that exercise prevents fructose-induced increases in very-low-density lipoprotein (VLDL) triglycerides by decreasing the fructose conversion into glucose and VLDL-triglyceride and fructose carbon storage into hepatic glycogen and lipids. DESIGN: Eight healthy men were studied on 3 occasions after 4 d consuming a weight-maintenance, high-fructose diet. On the fifth day, the men ingested an oral (13)C-labeled fructose load (0.75 g/kg), and their total fructose oxidation ((13)CO2 production), fructose storage (fructose ingestion minus (13)C-fructose oxidation), fructose conversion into blood (13)C glucose (gluconeogenesis from fructose), blood VLDL-(13)C palmitate (a marker of hepatic de novo lipogenesis), and lactate concentrations were monitored over 7 postprandial h. On one occasion, participants remained lying down throughout the experiment [fructose treatment alone with no exercise condition (NoEx)], and on the other 2 occasions, they performed a 60-min exercise either 75 min before fructose ingestion [exercise, then fructose condition (ExFru)] or 90 min after fructose ingestion [fructose, then exercise condition (FruEx)]. RESULTS: Fructose oxidation was significantly (P < 0.001) higher in the FruEx (80% ± 3% of ingested fructose) than in the ExFru (46% ± 1%) and NoEx (49% ± 1%). Consequently, fructose storage was lower in the FruEx than in the other 2 conditions (P < 0.001). Fructose conversion into blood (13)C glucose, VLDL-(13)C palmitate, and postprandial plasma lactate concentrations was not significantly different between conditions. CONCLUSIONS: Compared with sedentary conditions, exercise performed immediately after fructose ingestion increases fructose oxidation and decreases fructose storage. In contrast, exercise performed before fructose ingestion does not significantly alter fructose oxidation and storage. In both conditions, exercise did not abolish fructose conversion into glucose or its incorporation into VLDL triglycerides. This trial was registered at clinicaltrials.gov as NCT01866215.

Enhancement of human adipose-derived stem cell expansion and stability for clinical use

Co-culture techniques associating both dermal fibroblasts and epidermal keratinocytes have shown to have better clinical outcome than keratinocyte culture alone for the treatment of severe burns. Since fat grafting has been shown to improve scar remodelling, new techniques such as cell-therapy-assisted surgical reconstruction with isolated and expanded autologous adipose-derived stem cells (ASCs) would be of benefit to increase graft acceptation. Therefore, integrating ASCs into standardized procedures for cultured skin grafting could be of benefit for the patient if cell quality and quantity could be maintained. The purpose of this study was to evaluate ASC processing from adult tissue with simple isolation (without enzymatic steps), expansion (low density of 325-3,000 cells/cm2) and storage conditions to assure methods to enhance the cellular resistance when transferred back to the patient. Co-culture with cell-banked skin progenitor cells (FE002-SK2) showed an increase of 40-50% ASCs yield at high passages alongside with a better preservation of morphology, proper adipogenic and osteogenic differentiation and efficient biocompatibility with 3D collagen scaffolds. ASCs can be considered as a valuable additional cell source to be delivered in biological bandages to the patient in a need of tissue reconstruction such as burn patients.

Modeling the transport phenomena within arterial wall: porous media approach

The transport of macromolecules, such as low-density lipoprotein (LDL), and their accumulation in the layers of the arterial wall play a critical role in the creation and development of atherosclerosis. Atherosclerosis is a disease of large arteries e.g., the aorta, coronary, carotid, and other proximal arteries that involves a distinctive accumulation of LDL and other lipid-bearing materials in the arterial wall. Over time, plaque hardens and narrows the arteries. The flow of oxygen-rich blood to organs and other parts of the body is reduced. This can lead to serious problems, including heart attack, stroke, or even death. It has been proven that the accumulation of macromolecules in the arterial wall depends not only on the ease with which materials enter the wall, but also on the hindrance to the passage of materials out of the wall posed by underlying layers. Therefore, attention was drawn to the fact that the wall structure of large arteries is different than other vessels which are disease-resistant. Atherosclerosis tends to be localized in regions of curvature and branching in arteries where fluid shear stress (shear rate) and other fluid mechanical characteristics deviate from their normal spatial and temporal distribution patterns in straight vessels. On the other hand, the smooth muscle cells (SMCs) residing in the media layer of the arterial wall respond to mechanical stimuli, such as shear stress. Shear stress may affect SMC proliferation and migration from the media layer to intima. This occurs in atherosclerosis and intimal hyperplasia. The study of blood flow and other body fluids and of heat transport through the arterial wall is one of the advanced applications of porous media in recent years. The arterial wall may be modeled in both macroscopic (as a continuous porous medium) and microscopic scales (as a heterogeneous porous medium). In the present study, the governing equations of mass, heat and momentum transport have been solved for different species and interstitial fluid within the arterial wall by means of computational fluid dynamics (CFD). Simulation models are based on the finite element (FE) and finite volume (FV) methods. The wall structure has been modeled by assuming the wall layers as porous media with different properties. In order to study the heat transport through human tissues, the simulations have been carried out for a non-homogeneous model of porous media. The tissue is composed of blood vessels, cells, and an interstitium. The interstitium consists of interstitial fluid and extracellular fibers. Numerical simulations are performed in a two-dimensional (2D) model to realize the effect of the shape and configuration of the discrete phase on the convective and conductive features of heat transfer, e.g. the interstitium of biological tissues. On the other hand, the governing equations of momentum and mass transport have been solved in the heterogeneous porous media model of the media layer, which has a major role in the transport and accumulation of solutes across the arterial wall. The transport of Adenosine 5´-triphosphate (ATP) is simulated across the media layer as a benchmark to observe how SMCs affect on the species mass transport. In addition, the transport of interstitial fluid has been simulated while the deformation of the media layer (due to high blood pressure) and its constituents such as SMCs are also involved in the model. In this context, the effect of pressure variation on shear stress is investigated over SMCs induced by the interstitial flow both in 2D and three-dimensional (3D) geometries for the media layer. The influence of hypertension (high pressure) on the transport of lowdensity lipoprotein (LDL) through deformable arterial wall layers is also studied. This is due to the pressure-driven convective flow across the arterial wall. The intima and media layers are assumed as homogeneous porous media. The results of the present study reveal that ATP concentration over the surface of SMCs and within the bulk of the media layer is significantly dependent on the distribution of cells. Moreover, the shear stress magnitude and distribution over the SMC surface are affected by transmural pressure and the deformation of the media layer of the aorta wall. This work reflects the fact that the second or even subsequent layers of SMCs may bear shear stresses of the same order of magnitude as the first layer does if cells are arranged in an arbitrary manner. This study has brought new insights into the simulation of the arterial wall, as the previous simplifications have been ignored. The configurations of SMCs used here with elliptic cross sections of SMCs closely resemble the physiological conditions of cells. Moreover, the deformation of SMCs with high transmural pressure which follows the media layer compaction has been studied for the first time. On the other hand, results demonstrate that LDL concentration through the intima and media layers changes significantly as wall layers compress with transmural pressure. It was also noticed that the fraction of leaky junctions across the endothelial cells and the area fraction of fenestral pores over the internal elastic lamina affect the LDL distribution dramatically through the thoracic aorta wall. The simulation techniques introduced in this work can also trigger new ideas for simulating porous media involved in any biomedical, biomechanical, chemical, and environmental engineering applications.

Haja-asutusalueiden sähkönjakelujärjestelmien kehittäminen – erityisesti 1000 V jakelujännitteen käyttömahdollisuudet

Yhteiskunnan riippuvuus sähköstä on lisääntynyt voimakkaasti viime vuosikymmenien aikana. Sähkönjakelussa esiintyneet lyhyet ja pitkät keskeytykset ovat osoittaneet yhteiskunnan haavoittuvuuden ja yhteiskunta kestää entistä vähemmän sähkönjakelussa tapahtuvia häiriöitä. Keskeytyksistä aiheutuneiden haittojen arvostus on kasvanut ja tämä on luonut taloudelliset perusteet sähkön laatua parantaville investoinneille. Haja-asutusalueiden keskijänniteverkon johdot on rakennettu avojohtoina ja siten ne ovat alttiita sääolosuhteista johtuville myrsky- ja lumikuormavaurioille. Ilmastomuutoksen ennustetaan lisäävän tuulisuutta ja siten ongelmat sähkönjakelussa mahdollisesti lisääntyvät. Taajamissa käytetään enemmän kaapeleita ja johtolähdöt ovat lyhyitä, joten myrskyistä aiheutuvia keskeytyksiä on vähemmän kuin haja-asutusalueella. Olemassa olevat jakeluverkot ovat käytössä vielä vuosikymmeniä, joten uuden tekniikan kehittämisen rinnalla on kehitettävä myös olemassa olevaa jakeluverkkoa ja sen ylläpitoa. Ylläpidon tavoitteena on käyttövarmuuden parantamisen lisäksi huolehtia siitä, että jakeluverkkoihin sitoutunut omaisuus säilyttää arvonsa mahdollisimman hyvin pitoajan loppuun saakka. Jakeluverkkoihin investoitiin paljon 1950–70-luvuilla. Tältä ajalta on yhä käytössä puupylväitä, joiden ikääntymisen takia korvausinvestointien tarve kasvaa. Hyvänä puolena tässä on että käyttövarmuuden parantamiseksi olemassa olevaa jakeluverkkoa ei tarvitse uusia ennenaikaisesti. Tutkimuksessa päähuomio on haja-asutusalueiden 20 kV keskijänniteverkon kehittämisessä, sillä yli 90 % asiakkaiden kokemista keskeytyksistä johtuu keskijänniteverkon vioista. Erityisesti johtorakenteisiin ja johtojen sijoittamiseen on kiinnitettävä huomiota. Käyttövarmuuden lisäksi jakeluverkkojen kehittämistä ohjaavia tekijöitä ovat taloudellisuus, ympäristön huomioiminen, viranomaisvalvonta sekä asiakkaiden ja omistajien odotukset. Haja-asutusalueilla taloudelliset haasteet ovat suuret vakituisen väestön vähenemisen ja mahdollisesti sähköntarpeen pienenemisen takia. Taloudellisuus korostuu ja riskit kasvavat, kun tuottojen määrä supistuu tarvittaviin jakeluverkon investointeihin ja ylläpitokustannuksiin verrattuna. Ristiriitaa aiheuttaa se, että asiakkaat odottavat sähkönjakelulta parempaa luotettavuutta, mutta paremmasta sähkönlaadusta ei olla valmiita maksamaan juurikaan nykyistä enempää. Jakeluverkkojen kehittämistä voi hidastaa myös viranomaisvalvonta, jos tuottoja ei voida lisätä investointien lisätarpeiden suhteessa. Tutkimuksessa on analysoitu yleisellä tasolla kaapeloinnin lisäämistä, korkeiden pylväiden käyttämistä, leveitä johtokatuja, edullisten ja yksinkertaisten sähköasemien rakentamista haja-asutusalueille ja automaatioasemien lisäämistä keskijänniteverkon solmupisteisiin. Erityisesti tutkimuksessa on analysoitu uutena tekniikkana 1000 V jännitteen käyttömahdollisuutta jakeluverkkojen kehittämisessä. Sähköjohtojen siirtäminen teiden varsiin parantaa käyttövarmuutta, vaikka johdot rakennetaan samalla tekniikalla kuin olemassa olevat johdot. Hajaasutusalueille rakennettavilla sähköasemilla pitkät syöttöjohdot voidaan jakaa pienemmiksi syöttöalueiksi, jolloin keskeytyksistä aiheutuvat haitat koskettavat kerrallaan pienempää asiakasmäärää. Samaan tulokseen päästään oikein sijoitetuilla ja toteutetuilla automaatioasemilla. Tutkimuksen mukaan lupaavaksi tekniikaksi jakeluverkkojen kehittämisessä on osoittautumassa 1000 V jänniteportaan ottaminen 400 V pienjännitteen lisäksi. 1000 V verkoilla voidaan korvata häiriöherkkiä 20 kV keskijänniteverkon lyhyitä, alle viiden kilometrin pituisia haarajohtoja ja haarajohtojen jatkeita, missä siirrettävät tehot ovat pieniä. Uudessa jakelujärjestelmässä sähkö tuodaan 1000 V jännitteellä lähelle asiakasta, jossa jännite muunnetaan normaaliksi asiakkaille soveltuvaksi 400/230 V jännitteeksi. Edullisuus perustuu siihen, että rakentamisessa käytetään samoja pienjännitejohtoja kuin asiakkaille menevässä 400 V pienjänniteverkossa. 1000 V jakelutekniikassa sekä investointikustannukset että ylläpitokustannukset ovat pienemmät kuin perinteisessä 20 kV ilmajohtotekniikassa. 1000 V johdot säästävät maisemaa, sillä ne eivät tarvitse leveää johtokatua kuten 20 kV keskijännitejohdot. 1000 V verkkojen käyttö soveltuukin erityisesti vapaa-ajanasuntojen sähköistykseen herkissä ranta- ja järvimaisemissa. 1000 V verkot mahdollistavat kaapeliauraamisen lisäämisen ja näin voidaan vähentää ympäristöä haittaavien kyllästettyjen pylväiden käyttöä. 1000 V jakeluverkkojen osalta tutkimustyön tuloksia on sovellettu suomalaisessa Suur-Savon Sähkö Oy:ssä. Käytännön kokemuksia 1000 V jakelujärjestelmästä on useista kymmenistä kohteista. Tutkimustulokset osoittavat, ettei keskijänniteverkon maakaapelointi hajaasutusalueilla ole taloudellisesti kannattavaa nykyisillä keskeytyksistä aiheutuvilla haitta-arvoilla, mutta jos keskeytyskustannusten arvostus kasvaa, tulee kaapelointi kannattavaksi monissa paikoissa. Myös myrskyisyyden ja myrskyistä aiheutuvien jakelukeskeytysten lisääntyminen tekisi kaapeloinnista kannattavan. Tulevaisuudessa jakeluverkkojen rakentaminen on entistä monimuotoisempi tehtävä, jossa taloudellisuuden ja käyttövarmuuden lisäksi on huomioitava asiakkaat, omistajat, viranomaiset ja ympäristö. Tutkimusta jakelutekniikan kehittämiseksi tarvitaan edelleen. Tulevaisuuden osalta haja-asutusalueiden jakeluverkkojen kehittämiseen liittyy paljon epävarmuuksia. Hajautetun kiinteistökohtaisen sähköntuotannon lisääntyminen voi tehdä jakeluverkoista nykyistä tarpeettomampia, mutta esimerkiksi liikenteen sähköistyminen voi kasvattaa jakeluverkkojen merkitystä. Tästä syystä jakeluverkkojen rakentamisessa tarvitaan joustavuutta, jotta tarvittaessa voidaan helposti sopeutua erilaisiin kehityssuuntiin.

Knapsack sets for cryptography

The basic goal of this study is to extend old and propose new ways to generate knapsack sets suitable for use in public key cryptography. The knapsack problem and its cryptographic use are reviewed in the introductory chapter. Terminology is based on common cryptographic vocabulary. For example, solving the knapsack problem (which is here a subset sum problem) is termed decipherment. Chapter 1 also reviews the most famous knapsack cryptosystem, the Merkle Hellman system. It is based on a superincreasing knapsack and uses modular multiplication as a trapdoor transformation. The insecurity caused by these two properties exemplifies the two general categories of attacks against knapsack systems. These categories provide the motivation for Chapters 2 and 4. Chapter 2 discusses the density of a knapsack and the dangers of having a low density. Chapter 3 interrupts for a while the more abstract treatment by showing examples of small injective knapsacks and extrapolating conjectures on some characteristics of knapsacks of larger size, especially their density and number. The most common trapdoor technique, modular multiplication, is likely to cause insecurity, but as argued in Chapter 4, it is difficult to find any other simple trapdoor techniques. This discussion also provides a basis for the introduction of various categories of non injectivity in Chapter 5. Besides general ideas of non injectivity of knapsack systems, Chapter 5 introduces and evaluates several ways to construct such systems, most notably the "exceptional blocks" in superincreasing knapsacks and the usage of "too small" a modulus in the modular multiplication as a trapdoor technique. The author believes that non injectivity is the most promising direction for development of knapsack cryptosystema. Chapter 6 modifies two well known knapsack schemes, the Merkle Hellman multiplicative trapdoor knapsack and the Graham Shamir knapsack. The main interest is in aspects other than non injectivity, although that is also exploited. In the end of the chapter, constructions proposed by Desmedt et. al. are presented to serve as a comparison for the developments of the subsequent three chapters. Chapter 7 provides a general framework for the iterative construction of injective knapsacks from smaller knapsacks, together with a simple example, the "three elements" system. In Chapters 8 and 9 the general framework is put into practice in two different ways. Modularly injective small knapsacks are used in Chapter 9 to construct a large knapsack, which is called the congruential knapsack. The addends of a subset sum can be found by decrementing the sum iteratively by using each of the small knapsacks and their moduli in turn. The construction is also generalized to the non injective case, which can lead to especially good results in the density, without complicating the deciphering process too much. Chapter 9 presents three related ways to realize the general framework of Chapter 7. The main idea is to join iteratively small knapsacks, each element of which would satisfy the superincreasing condition. As a whole, none of these systems need become superincreasing, though the development of density is not better than that. The new knapsack systems are injective but they can be deciphered with the same searching method as the non injective knapsacks with the "exceptional blocks" in Chapter 5. The final Chapter 10 first reviews the Chor Rivest knapsack system, which has withstood all cryptanalytic attacks. A couple of modifications to the use of this system are presented in order to further increase the security or make the construction easier. The latter goal is attempted by reducing the size of the Chor Rivest knapsack embedded in the modified system. '

Epithelial-to-mesenchymal transition mediates docetaxel resistance and high risk of relapse in prostate cancer

Molecular characterization of radical prostatectomy specimens after systemic therapy may identify a gene expression profile for resistance to therapy. This study assessed tumor cells from patients with prostate cancer participating in a phase II neoadjuvant docetaxel and androgen deprivation trial to identify mediators of resistance. Transcriptional level of 93 genes from a docetaxel-resistant prostate cancer cell lines microarray study was analyzed by TaqMan low-density arrays in tumors from patients with high-risk localized prostate cancer (36 surgically treated, 28 with neoadjuvant docetaxel þ androgen deprivation). Gene expression was compared between groups and correlated with clinical outcome. VIM, AR and RELA were validated by immunohistochemistry. CD44 and ZEB1 expression was tested by immunofluorescence in cells and tumor samples. Parental and docetaxel-resistant castration-resistant prostate cancer cell lines were tested for epithelial-to-mesenchymal transition (EMT) markers before and after docetaxel exposure. Reversion of EMT phenotype was investigated as a docetaxel resistance reversion strategy. Expression of 63 (67.7%) genes differed between groups (P < 0.05), including genes related to androgen receptor, NF-k B transcription factor, and EMT. Increased expression of EMT markers correlated with radiologic relapse. Docetaxel-resistant cells had increased EMT and stem-like cell markers expression. ZEB1 siRNA transfection reverted docetaxel resistance and reduced CD44 expression in DU-145R and PC-3R. Before docetaxel exposure, a selected CD44 þ subpopulation of PC-3 cells exhibited EMT phenotype and intrinsic docetaxel resistance; ZEB1/CD44 þ subpopulations were found in tumor cell lines and primary tumors; this correlated with aggressive clinical behavior. This study identifies genes potentially related to chemotherapy resistance and supports evi-dence of the EMT role in docetaxel resistance and adverse clinical behavior in early prostate cancer.

Analysis of the tensile modulus of polypropylene composites reinforced with stone groundwood fibers

One of the most relevant properties of composite materials to be considered is stiffness. Fiberglass has been used traditionally as a fibrous reinforcing element when stiff materials are required. However, natural fibers are been exploited as replacements for synthetic fibers to satisfy environmental concerns. Among the different natural fibers, wood fibers show the combination of relatively high aspect ratio, good specific stiffness and strength, low density, low cost, and less variability than other natural fibers of such those from annual crops. In this work, composites from polypropylene and stone groundwood fibers from softwood were prepared and mechanically characterized under tensile loads. The Young’s moduli of the ensuing composites were analyzed and their micromechanics aspects evaluated. The reinforcing effect of stone groundwood fibers was compared to that of conventional reinforcement such fiberglass. The Halpin-Tsai model with the modification proposed by Tsai-Pagano accounted fairly for the behavior of PP composites reinforced with stone groundwood fibers. It was also demonstrated that the aspect ratio of the reinforcement plays a role in the Young’s modulus of injection molded specimens

Avaliação da fotodegradação de poliolefinas através de exposição natural e artificial

Samples of polypropylene (PP) and low-density polyethylene (LDPE) were submitted to ultraviolet radiation, in the natural environment and also in the laboratory. Chemical modifications were quantified by the carbonyl index (CI), mechanical properties and melt flow index. The degradation in the laboratory was comparatively faster than in the environment for both types of polymers. The accelerating factor was determined for the various properties investigated. This parameter, however, showed a large variation with the degradation criteria and the type of polymer. The existence of a "universal accelerating factor", therefore, was not observed in the current study.

RAPID AND SENSITIVE DETERMINATION OF PALLADIUM USING HOMOGENEOUS LIQUID-LIQUID MICROEXTRACTION VIA FLOTATION ASSISTANCE FOLLOWED BY GRAPHITE FURNACE ATOMIC ABSORPTION SPECTROMETRY

A method for the determination of trace amounts of palladium was developed using homogeneous liquid-liquid microextraction via flotation assistance (HLLME-FA) followed by graphite furnace atomic absorption spectrometry (GFAAS). Ammonium pyrrolidine dithiocarbamate (APDC) was used as a complexing agent. This was applied to determine palladium in three types of water samples. In this study, a special extraction cell was designed to facilitate collection of the low-density solvent extraction. No centrifugation was required in this procedure. The water sample solution was added to the extraction cell which contained an appropriate mixture of extraction and homogeneous solvents. By using air flotation, the organic solvent was collected at the conical part of the designed cell. Parameters affecting extraction efficiency were investigated and optimized. Under the optimum conditions, the calibration graph was linear in the range of 1.0-200 µg L-1 with a limit of detection of 0.3 µg L-1. The performance of the method was evaluated for the extraction and determination of palladium in water samples and satisfactory results were obtained. In order to verify the accuracy of the approach, the standard addition method was applied for the determination of palladium in spiked synthetic samples and satisfactory results were obtained.

Creating carbon footprint calculating tool for plastic packaging products

The environmental challenges of plastic packaging industry have increased remarkably along with climate change debate. The interest to study carbon footprints of packaging has increased in packaging industry to find out the real climate change impacts of packaging. In this thesis the greenhouse gas discharges of plastic packaging during their life cycle is examined. The carbon footprint is calculated for food packaging manufactured from plastic laminate. The structure of the laminate is low density polyethylene (PE-LD) and oriented polypropylene (OPP), which have been joined together with laminating adhesive. The purpose is to find out the possibilities to create a carbon footprint calculating tool for plastic packaging and its usability in a plastic packaging manufacturing company. As a carbon footprint calculating method PAS 2050 standard has been used. In the calculations direct and indirect greenhouse gas discharges as well as avoided discharges are considered. Avoided discharges are born for example in packaging waste utilization as energy. The results of the calculations have been used to create a simple calculating tool to be used for similar laminate structures. Although the utilization of the calculating tool is limited to one manufacturing plant because the primary activity data is dependent of geographical location and for example the discharges of used energy in the plant. The results give an approximation of the climate change potential caused by the laminate. It is although noticed that calculations do not include all environmental impacts of plastic packaging´s life cycle.

Metabolic syndrome – early cardio-metabolic, vascular and hepatic changes

Background: Metabolic syndrome (MetS) is a combination of several cardio-metabolic risk factors including obesity, hyperglycemia, hypertension and dyslipidemia. MetS has been associated with increased levels of apolipoprotein B (apoB) and low-density lipoprotein oxidation (OxLDL) and with an increased risk of cardiovascular disease and non-alcoholic fatty liver disease. Aims: To establish the relation of apoB and OxLDL with the MetS development and to determine the status of MetS as a risk factor for adverse liver changes and for subclinical atherosclerosis. Subjects and Methods: The present thesis is part of the two large scale population-based, prospective, observational studies. Cardiovascular Risk in Young Finns study was launched in 1980 including 3,596 subjects aged 3-18 years. Thereafter follow-up studies have been conducted regularly. In the latest follow-ups that were performed in 2001 (N=2,283) and 2007 (N=2,204), non-invasive ultrasound studies were introduced to the study protocol to measure subclinical atherosclerosis i.e. carotid intima-media thickness (IMT), carotid artery distensibility (Cdist) and brachial flow-mediated dilatation (FMD). Alanine-aminotransferase (ALT) and gammaglutamyltransferase (GGT) were measured in 2007 to assess liver function. The Bogalusa Heart Study is a long-term epidemiologic study of cardiovascular risk factors launched in 1972 in a biracial community of Bogalusa, Louisiana, USA. Total of 374 youths (aged 9-18 years at baseline in 1984-88) who underwent non-invasive ultrasound studies of the carotid artery as adults, were included in the analyses of the present thesis. Results: The odds ratios (95% confidence intervals) for MetS incidence during a 6-year follow-up by quartiles of apoB were 2.0(1.0-3.8) for the second quartile, 3.1(1.7-5.7) for the third quartile and 4.2(2.3-7.6) for the fourth quartile. OxLDL was not independently associated with incident MetS. Youth (aged 9-18 years) with MetS or with high body mass index were at 2-3 times the risk of having MetS, high IMT, and type 2 diabetes 24-years later as adults. IMT increased 79±7μm (mean±SEM) in subjects with MetS and 42±2μm in subjects without the MetS (P<0.0001) during 6- years. Subjects who lost the MetS diagnosis during 6-year follow-up had reduced IMT progression compared to persistent MetS group (0.036±0.005vs.0.079±0.010 mm, P=0.001) and reduced Cdist change compared to incident MetS group (-0.12±0.05vs.-0.38±0.10 %/mmHg, P=0.03) over 6-year follow-up. MetS predicted elevated ALT (β±SEM=0.380±0.052, P<0.0001 in men and 0.160±0.052, P=0.002 in women) and GGT (β±SEM=0.240±0.058, P<0.0001 in men and 0.262±0.053, P<0.0001 in women) levels after 6-years. Conclusions: These findings suggest that apoB may give additional information on early metabolic disturbances predisposing MetS. MetS may be used to identify individuals at increased risk of developing atherosclerosis and non-alcoholic liver disease. However, recovery from the MetS may have positive effects on liver and vascular properties.