Combination antiretroviral therapy -associated lipodystrophy : insights into pathogenesis and treatment

Introduction: Combination antiretroviral therapy (cART) has decreased morbidity and mortality of individuals infected with human immunodeficiency virus type 1 (HIV-1). Its use, however, is associated with adverse effects which increase the patients risk of conditions such as diabetes and coronary heart disease. Perhaps the most stigmatizing side effect is lipodystrophy, i.e., the loss of subcutaneous adipose tissue (SAT) in the face, limbs and trunk while fat accumulates intra-abdominally and dorsocervically. The pathogenesis of cART-associated lipodystrophy is obscure. Nucleoside reverse transcriptase inhibitors (NRTI) have been implicated to cause lipoatrophy via mitochondrial toxicity. There is no known effective treatment for cART-associated lipodystrophy during unchanged antiretroviral regimen in humans, but in vitro data have shown uridine to abrogate NRTI-induced toxicity in adipocytes. Aims: To investigate whether i) cART or lipodystrophy associated with its use affect arterial stiffness; ii) lipoatrophic SAT is inflamed compared to non-lipoatrophic SAT; iii) abdominal SAT from patients with compared to those without cART-associated lipoatrophy differs with respect to mitochondrial DNA (mtDNA) content, adipose tissue inflammation and gene expression, and if NRTIs stavudine and zidovudine are associated with different degree of changes; iv) lipoatrophic abdominal SAT differs from preserved dorsocervical SAT with respect to mtDNA content, adipose tissue inflammation and gene expression in patients with cART-associated lipodystrophy and v) whether uridine can revert lipoatrophy and the associated metabolic disturbances in patients on stavudine or zidovudine based cART. Subjects and methods: 64 cART-treated patients with (n=45) and without lipodystrophy/-atrophy (n=19) were compared cross-sectionally. A marker of arterial stiffness, heart rate corrected augmentation index (AgIHR), was measured by pulse wave analysis. Body composition was measured by magnetic resonance imaging and dual-energy X-ray absorptiometry, and liver fat content by proton magnetic resonance spectroscopy. Gene expression and mtDNA content in SAT were assessed by real-time polymerase chain reaction and microarray. Adipose tissue composition and inflammation were assessed by histology and immunohistochemistry. Dorsocervical and abdominal SAT were studied. The efficacy and safety of uridine for the treatment of cART-associated lipoatrophy were evaluated in a randomized, double-blind, placebo-controlled 3-month trial in 20 lipoatrophic cART-treated patients. Results: Duration of antiretroviral treatment and cumulative exposure to NRTIs and protease inhibitors, but not the presence of cART-associated lipodystrophy, predicted AgIHR independent of age and blood pressure. Gene expression of inflammatory markers was increased in SAT of lipodystrophic as compared to non-lipodystrophic patients. Expression of genes involved in adipogenesis, triglyceride synthesis and glucose disposal was lower and of those involved in mitochondrial biogenesis, apoptosis and oxidative stress higher in SAT of patients with than without cART-associated lipoatrophy. Most changes were more pronounced in stavudine-treated than in zidovudine-treated individuals. Lipoatrophic SAT had lower mtDNA than SAT of non-lipoatrophic patients. Expression of inflammatory genes was lower in dorsocervical than in abdominal SAT. Neither depot had characteristics of brown adipose tissue. Despite being spared from lipoatrophy, dorsocervical SAT of lipodystrophic patients had lower mtDNA than the phenotypically similar corresponding depot of non-lipodystrophic patients. The greatest difference in gene expression between dorsocervical and abdominal SAT, irrespective of lipodystrophy status, was in expression of homeobox genes that regulate transcription and regionalization of organs during embryonal development. Uridine increased limb fat and its proportion of total fat, but had no effect on liver fat content and markers of insulin resistance. Conclusions: Long-term cART is associated with increased arterial stiffness and, thus, with higher cardiovascular risk. Lipoatrophic abdominal SAT is characterized by inflammation, apoptosis and mtDNA depletion. As mtDNA is depleted even in non-lipoatrophic dorsocervical SAT, lipoatrophy is unlikely to be caused directly by mtDNA depletion. Preserved dorsocervical SAT of patients with cART-associated lipodystrophy is less inflamed than their lipoatrophic abdominal SAT, and does not resemble brown adipose tissue. The greatest difference in gene expression between dorsocervical and abdominal SAT is in expression of transcriptional regulators, homeobox genes, which might explain the differential susceptibility of these adipose tissue depots to cART-induced toxicity. Uridine is able to increase peripheral SAT in lipoatrophic patients during unchanged cART.

Instability and dewetting of ultrathin solid viscoelastic films on homogeneous and heterogeneous substrates

Instability and dewetting engendered by the van der Waals force in soft thin (<100 nm) linear viscoelastic solid (e. g., elastomeric gel) films on uniform and patterned surfaces are explored. Linear stability analysis shows that, although the elasticity of the film controls the onset of instability and the corresponding critical wavelength, the dominant length-scale remains invariant with the elastic modulus of the film. The unstable modes are found to be long-wave, for which a nonlinear long-wave analysis and simulations are performed to uncover the dynamics and morphology of dewetting. The stored elastic energy slows down the temporal growth of instability significantly. The simulations also show that a thermodynamically stable film with zero-frequency elasticity can be made unstable in the presence of physico-chemical defects on the substrate and can follow an entirely different pathway with far fewer holes as compared to the viscous films. Further, the elastic restoring force can retard the growth of a depression adjacent to the hole-rim and thus suppress the formation of satellite holes bordering the primary holes. These findings are in contrast to the dewetting of viscoelastic liquid films where nonzero frequency elasticity accelerates the film rupture and promotes the secondary instabilities. Thus, the zero-frequency elasticity can play a major role in imposing a better-defined long-range order to the dewetted structures by arresting the secondary instabilities. (C) 2011 American Institute of Physics. doi: 10.1063/1.3554748]

Structural characterization of gel-grown neodymium copper oxalate single crystals

Sparingly soluble neodymium copper oxalate (NCO) single crystals were grown by gel method, by the diffusion of a mixture of neodymium nitrate and cupric nitrate into the set gel containing oxalic acid. Tabular crystal, revealing well-defined dissolution figures has been recorded. X-ray diffraction studies of the powdered sample reveal that NCO is crystalline. Infrared absorption spectrum confirmed the formation of oxalato complex with water of crystallization, while energy dispersive X-ray analysis established the presence of neodymium dominant over copper in the sample. X-ray photoelectron spectroscopic studies established the presence of Nd and Cu in oxide states besides (C2O4)(2-) oxalate group. The intensities of Nd (3d(5/2)) and Cu (2p(3/2)) peaks measured in terms of maximum photoelectron count rates also revealed the presence of Nd in predominance. The inductively coupled plasma analysis supports the EDAX and XPS data by the estimation of neodymium percentage by weight to that of copper present in the NCO sample. On the basis of these findings, an empirical structure for NCO has been proposed. The implications are discussed.

A note on the effect of wall compliance on lowest?order mode propagation in fluid?filled/submerged impedance tubes

Wave propagation in fluid?filled/submerged tubes is of interest in large HVAC ducts, and also in understanding and interpreting the experimental results obtained from fluid?filled impedance tubes. Based on the closed form analytical solution of the coupled wave equations, an eigenequation, which is the determinant of an 8×8 matrix, is derived and solved to obtain the axial wave number of the lowest?order longitudinal modes for cylindrical ducts of various diameter and wall thickness. The dispersion behavior of the wave motion is analyzed. It is observed that the larger the diameter of the duct and/or the smaller its wall thickness, the more flexible the impedance tube leading to more coupling between the waves in the elastic media. Also, it is shown that the wave motion in water?filled ducts submerged in water exhibits anomalous dispersion behavior. The axial attenuation characteristics of plane waves along water?filled tubes submerged in water or air are also investigated. Finally, investigations on the sound intensity level difference characteristics of the wall of the air?filled tubes are reported.

MEMS based microactuator for microjet applications

The objective of this work is to confirm the possibility of utilization of PolyVinyliDeneFlouride (PVDF) films in MEMS based microactuator for microjet applications. A membrane type microactuator is designed, developed, packaged and tested. The microactuator consists of PVDF film attached to thin Silicon diaphragm. As the voltage difference is applied across it, due to the piezoelectric behaviour, it deforms primarily in d31 mode, which in turn deflects the diaphragm. Using finite element methods, coupled field analysis is carried out to optimize the dimensions of the actuator with respect to the output force and input voltage. A cavity with a square diaphragm of 1mm×1mm×5μm is realized using standard microfabrication technique. 50μm thick PVDF film, cut with special dicing saw, is glued inside the metalized cavity using low stress, conductive, room temperature cured epoxy. The 3mm×3mm×0.675mm actuator die is packaged using Chip-On-Board technique in conjunction with low temperature soldering for taking the connections. The micro-actuator is tested in both actuation and sensing mode. The developed actuator is proposed to use with micro nozzle to study the utilization in drug delivery system.

Influence of rock depth on seismic site classification for shallow bedrock regions

Seismic site classifications are used to represent site effects for estimating hazard parameters (response spectral ordinates) at the soil surface. Seismic site classifications have generally been carried out using average shear wave velocity and/or standard penetration test n-values of top 30-m soil layers, according to the recommendations of the National Earthquake Hazards Reduction Program (NEHRP) or the International Building Code (IBC). The site classification system in the NEHRP and the IBC is based on the studies carried out in the United States where soil layers extend up to several hundred meters before reaching any distinct soil-bedrock interface and may not be directly applicable to other regions, especially in regions having shallow geological deposits. This paper investigates the influence of rock depth on site classes based on the recommendations of the NEHRP and the IBC. For this study, soil sites having a wide range of average shear wave velocities (or standard penetration test n-values) have been collected from different parts of Australia, China, and India. Shear wave velocities of rock layers underneath soil layers have also been collected at depths from a few meters to 180 m. It is shown that a site classification system based on the top 30-m soil layers often represents stiffer site classes for soil sites having shallow rock depths (rock depths less than 25 m from the soil surface). A new site classification system based on average soil thickness up to engineering bedrock has been proposed herein, which is considered more representative for soil sites in shallow bedrock regions. It has been observed that response spectral ordinates, amplification factors, and site periods estimated using one-dimensional shear wave analysis considering the depth of engineering bedrock are different from those obtained considering top 30-m soil layers.

Recent advances in muffler acoustics

Exhaust noise in engines has always been a major source of automotive noise. Challenges for muffler design have been constraints on size, back pressure, and, of course, the cost. Designing for sufficient insertion loss at the engine firing frequency and the first few harmonics has been the biggest challenge. Most advances in the design of efficient mufflers have resulted from linear plane wave theory, making use of the transfer matrix method. This review paper deals with evaluating approximate source characteristics required for prediction of the unmuffled intake and exhaust noise, making use of the electroacoustical analogies. In the last few years, significant advances have been made in the analysis of variable area perforated ducts, transverse plane wave analysis of short elliptical as well as circular chambers, double-tuned expansion chambers and concentric tube resonators, catalytic converters, diesel particulate filters, air cleaners, etc. The development of long strand fibrous materials that can be used in hot exhaust systems without binders has led to the use of combination mufflers in exhaust systems. Breakthroughs have been achieved in the prediction and control of breakout noise from the elliptical and circular muffler shell as well as the end plates of typical mufflers. Diesel particulate filters and inlet air cleaners have also been modeled acoustically. Some of these recent advances are the subject of this review paper.

Slow Slip Acceleration beneath Andaman Islands Triggered by the 11 April 2012 Indian Ocean Earthquakes

The M-w 8.6 and 8.2 strike-slip earthquakes that struck the northeast Indian Ocean on 11 April 2012 resulted in coseismic deformation both at near and distant sites. The slip distribution, deduced using seismic-wave analysis for the orthogonal faults that ruptured during these earthquakes, is sufficient to predict the coseismic displacements at the Global Positioning System (GPS) sites, such as NTUS, PALK, and CUSV, but fall short at four continuous sites in the Andaman Islands region. Slip modeling, for times prior to the events, suggests that the lower portion of the thrust fault beneath the Andaman Islands has been slipping at least at the rate of 40 cm/yr, in response to the 2004 Sumatra-Andaman coseismic stress change. Modeling of GPS displacements suggests that the en echelon and orthogonal fault ruptures of the 2012 intraplate oceanic earthquakes could have possibly accelerated the ongoing slow slip, along the lower portion of the thrust fault beneath the islands with a month-long slip of 4-10 cm. The misfit to the coseismic GPS displacements along the Andaman Islands could be improved with a better source model, assuming that no local process contributed to this anomaly.

三峡库区寨坝变形体的渗流变形有限元耦合分析

三峡库区寨坝民德小学变形体是山前坡积物、崩积物以及滑坡堆积物等的混杂体，中部存在孤立的块碎石含水层，地下水位较高。公路开挖引起了远场集中通道排水疏干和开挖面附近卸载，导致了不均匀变形破坏产生。本文给出了这种开挖卸载与排水疏干共同作用下，边坡饱和-非饱和渗流与变形耦合的有限元分析方法。研究表明，集中通道排水造成了坡体大范围的孔隙水压力下降，从而导致不均匀变形和地面开裂；其中通道排水诱发的不均匀变形将随着排水通道的封堵和地下水位的回升而停止，而纯粹的开挖卸载主要影响开挖面附近的土体变形。这一典型实例所揭示的机理模式，可以解释工程施工区通常出现的因开挖和开挖引起的排水所诱发的远近变形破坏现象的实质。

Elimination of loading reverberation in the split hopkinson torsional bar

The loading reverberation is a multiple wave effect on the specimen in the split Hopkinson torsional bar (SHTB). Its existence intensively destroys the microstructure pattern in the tested material and therefore, interferes with the study correlating the deformed microstructure to the macroscopic stress-strain response. This paper discusses the problem of the loading reverberation and its effects on the post-mortem observations in the SHTB experiment. The cause of the loading reverberation is illustrated by a stress wave analysis. The modification of the standard SHTB is introduced, which involves attaching two unloading bars at the two ends of the original main bar system and adopting a new loading head and a couple of specially designed clutches. The clutches are placed between the main bar system and the unloading bars in order to lead the secondary loading wave out of the main bar system and to cut off the connection in a timely manner. The loading head of the standard torsional bar was redesigned by using a tube-type loading device associated with a ratchet system to ensure the exclusion of the reflected wave. Thus, the secondary loading waves were wholly trapped in the two unloading bars. The wave recording results and the contrasting experiments for examining the post-mortem microstructure during shear banding both before and after the modification highly support the effectiveness of the modified version. The modified SHTB realizes a single wave pulse loading process and will become a useful tool for investigating the relation between the deformed microstructure and the macroscopic stress-strain response. It will play an important role especially in the study of the evolution of the microstructure during the shear banding process. (C) 1995 American Institute of Physics.

Avaliação da função endotelial microvascular, da rigidez arterial e da resposta inflamatória sistêmica em pacientes submetidos a cirurgia cardíaca com circulação extracorpórea

A Cirurgia de Revascularização do Miocárdio, realizada com o auxílio da Circulação Extracorpórea, está associada a alterações importantes na microcirculação e na produção e circulação de citocinas e marcadores inflamatórios. No presente estudo, foram avaliados 23 pacientes com indicação de Revascularização do Miocárdio, no dia do procedimento e 7 e 28 dias após a cirurgia. A microcirculação cutânea, enquanto reflexo da microcirculação coronariana, foi estudada através da hiperemia térmica e/ ou reativa pós oclusiva e da iontoforese de substâncias vasoativas por mecanismos dependentes e independentes do endotélio. A rigidez arterial foi aferida através da análise da onda de pulso digital. Foi avaliado ainda o impacto da doença e do procedimento cirúrgico sobre a produção e circulação sérica de citocinas e marcadores inflamatórios, tais como: PCR-HS, nitrito/ nitrato, IL-6, Il-7, IL-8, IL-10, IFN-γ, TNF-α e G-CSF. Foi observada uma tendência à redução da vasodilatação da microcirculação cutânea após a administração de doses acumulativas de acetilcolina (endotélio dependente) através da iontoforese de 7 e 28 dias após o procedimento cirúrgico. A hiperemia térmica foi mais pronunciada na avaliação basal do que aos 7 e 28 dias. A hiperemia reativa pós oclusiva não demonstrou alterações 7 dias após o procedimento. Aos 28 dias, houve um aumento da condutância microvascular cutânea. Quando avaliada a vasodilatação endotélio-independente (nitroprussiato de sódio), observamos aumento do fluxo microvascular cutâneo diretamente proporcional à carga/ dose aplicada, sem diferenças nos valores obtidos no basal e 7 e 28 dias após o procedimento. A rigidez arterial não apresentou alterações. A análise dos fatores inflamatórios e das citocinas demonstrou aumento marcante da IL-6 e da IL-8 após 7 dias do procedimento cirúrgico, com retorno parcial aos níveis basais da IL-6 e total da IL-8 após 28 dias. O IFN-γ, TNF-α e G-CSF apenas apresentaram níveis detectáveis na avaliação basal e IL-7 e IL-10 não demonstraram alterações significativas nos tempos avaliados. A PCR-HS demonstrou níveis mais elevados após 7 dias e retorno parcial aos níveis basais após 28 dias. O nitrito/ nitrato, após 7 dias, apresentou leve queda em sua concentração plasmática. Concluímos que a pequena diferença entre o valores obtidos entre o basal e após 7 dias do procedimento cirúrgico com a iontoforese de acetilcolina resulta em minimização do impacto endotelial e um valor constante deste dado após 28 dias, sugere recomposição fisiológica completa. Este resultado foi semelhante com a análise da hiperemia térmica e reativa pós oclusiva. As interleucinas IL-6 e IL-8, bem como a PCR-HS apresentaram comportamento correlacionável, refletindo a cinética inflamatória. A rigidez arterial não demonstrou alterações.

I. A seismotectonic study of the Middle America Subduction Zone. II. Lithosphere and upper mantle structure of the Canadian Shield and Eastern North America

This thesis consists of two separate parts. Part I (Chapter 1) is concerned with seismotectonics of the Middle America subduction zone. In this chapter, stress distribution and Benioff zone geometry are investigated along almost 2000 km of this subduction zone, from the Rivera Fracture Zone in the north to Guatemala in the south. Particular emphasis is placed on the effects on stress distribution of two aseismic ridges, the Tehuantepec Ridge and the Orozco Fracture Zone, which subduct at seismic gaps. Stress distribution is determined by studying seismicity distribution, and by analysis of 190 focal mechanisms, both new and previously published, which are collected here. In addition, two recent large earthquakes that have occurred near the Tehuantepec Ridge and the Orozco Fracture Zone are discussed in more detail. A consistent stress release pattern is found along most of the Middle America subduction zone: thrust events at shallow depths, followed down-dip by an area of low seismic activity, followed by a zone of normal events at over 175 km from the trench and 60 km depth. The zone of low activity is interpreted as showing decoupling of the plates, and the zone of normal activity as showing the breakup of the descending plate. The portion of subducted lithosphere containing the Orozco Fracture Zone does not differ significantly, in Benioff zone geometry or in stress distribution, from adjoining segments. The Playa Azul earthquake of October 25, 1981, M_s=7.3, occurred in this area. Body and surface wave analysis of this event shows a simple source with a shallow thrust mechanism and gives M_o=1.3x10²⁷ dyne-cm. A stress drop of about 45 bars is calculated; this is slightly higher than that of other thrust events in this subduction zone. In the Tehuantepec Ridge area, only minor differences in stress distribution are seen relative to adjoining segments. For both ridges, the only major difference from adjoining areas is the infrequency or lack of occurrence of large interplate thrust events.

Part II involves upper mantle P wave structure studies, for the Canadian shield and eastern North America. In Chapter 2, the P wave structure of the Canadian shield is determined through forward waveform modeling of the phases P_nl, P, and PP. Effects of lateral heterogeneity are kept to a minimum by using earthquakes just outside the shield as sources, with propagation paths largely within the shield. Previous mantle structure studies have used recordings of P waves in the upper mantle triplication range of 15-30°; however, the lack of large earthquakes in the shield region makes compilation of a complete P wave dataset difficult. By using the phase PP, which undergoes triplications at 30-60°, much more information becomes available. The WKBJ technique is used to calculate synthetic seismograms for PP, and these records are modeled almost as well as the P. A new velocity model, designated S25, is proposed for the Canadian shield. This model contains a thick, high-Q, high-velocity lid to 165 km and a deep low-velocity zone. These features combine to produce seismograms that are markedly different from those generated by other shield structure models. The upper mantle discontinuities in S25 are placed at 405 and 660 km, with a simple linear gradient in velocity between them. Details of the shape of the discontinuities are not well constrained. Below 405 km, this model is not very different from many proposed P wave models for both shield and tectonic regions.

Chapter 3 looks in more detail at recordings of P_nl in eastern North America. First, seismograms from four eastern North American earthquakes are analyzed, and seismic moments for the events are calculated. These earthquakes are important in that they are among the largest to have occurred in eastern North America in the last thirty years, yet in some cases were not large enough to produce many good long-period teleseismic records. A simple layer-over-a-halfspace model is used for the initial modeling, and is found to provide an excellent fit for many features of the observed waveforms. The effects on P_nl of varying lid structure are then investigated. A thick lid with a positive gradient in velocity, such as that proposed for the Canadian shield in Chapter 2, will have a pronounced effect on the waveforms, beginning at distances of 800 or 900 km. P_nl records from the same eastern North American events are recalculated for several lid structure models, to survey what kinds of variations might be seen. For several records it is possible to see likely effects of lid structure in the data. However, the dataset is too sparse to make any general observations about variations in lid structure. This type of modeling is expected to be important in the future, as the analysis is extended to more recent eastern North American events, and as broadband instruments make more high-quality regional recordings available.

体全息光栅透镜的设计和应用

设计了一种新型的体全息光栅透镜，在一块光学平板(体全息记录材料)内可以将输入光束产生横向传输并聚焦，或对输入光点产生横传的准直．它由一束平面波和一束球面波正交入射到光学平板上干涉形成的．研究了该体全息透镜的光栅间距变化情况，为设计和制备体全息光栅透镜及相关器件提供了理论依据．基于两光束耦合波理论，得到了该光栅透镜的耦合波方程，近似计算了该透镜的衍射效率及其达到高衍射效率时透镜的最佳尺寸．最后，讨论了该透镜在集成光学等领域中的应用．

强外加电场与大调制度下光折变动力学光栅形成研究

强外加电场与大调制度在光折变效应的研究中已经得到了广泛应用。采用PDECOL算法, 严格求解光折变带输运方程, 得到外加电场时不同调制度下光折变晶体中随时间变化的空间电荷场、载流子浓度, 并讨论了外加电场对它们的影响。通过将物质方程与耦合波方程联立数值求解, 可得到光折变光栅形成过程中两波耦合增益系数以及光束条纹相位的变化。模拟结果表明, 在强外加电场作用下, 两束记录光之间的光强与相位耦合都得到了增强, 而原有的解析式忽视了强外加电场与大调制度对空间电荷场相位耦合的影响, 此时不再适用。同时发现折射率光

超短脉冲激光光束被局域体全息光栅衍射的性质分析

利用二维耦合波理论,分析了超短脉冲激光光束被完全重叠型的局域体全息光栅衍射的时空变化性质,给出了衍射和透射脉冲激光光束沿光栅出射边界的强度时空分布。以LiNbO3晶体为例,数值研究了衍射光脉冲强度沿光栅出射边界的分布和脉冲波形的变化及光栅的总衍射效率受光栅二维尺寸、入射角度、光栅折射率调制度及入射脉冲的脉冲时域半峰全宽等条件的影响而变化的情况。与一维体全息光栅对超短脉冲激光光束衍射的性质,及此光栅对连续光衍射的性质作比较,给出了合理选择光栅参量及入射条件以在光栅出射边界上得到总衍射效率较大且分布较均匀的衍