Decreased generation of procoagulant platelets detected by flow cytometric analysis in patients with bleeding diathesis

Background: A clinically relevant bleeding diathesis is a frequent diagnostic challenge, which sometimes remains unexplained despite extensive investigations. The aim of our work was to evaluate the diagnostic utility of functional platelet testing by flow cytometry in this context. Methods: In case of negative results after standard laboratory work-up, flow cytometric analysis (FCA) of platelet function was done. We performed analysis of surface glycoproteins (GP) Ibα, IIb, IIIa; P-selectin expression and PAC-1 binding after graded doses of ADP, collagen and thrombin; content/secretion of dense granules; ability to generate procoagulant platelets. Results: Out of 437 patients investigated with standard tests between January 2007 and December 2011, we identified 67 (15.3%) with high bleeding scores and non-diagnostic standard laboratory work-up including platelet aggregation studies. Among these patients FCA revealed some potentially causative platelet defects: decreased dense-granule content/secretion (n=13); decreased alpha-granule secretion induced by ADP (n=10), convulxin (n=4) or thrombin (n=3); decreased fibrinogen-receptor activation induced by ADP (n=11), convulxin (n=11) or thrombin (n=8); decreased generation of COAT-platelets, i.e. highly procoagulant platelets induced by simultaneous activation with collagen and thrombin (n=16). Conclusion: Our work confirms that storage pool defects are frequent in patients with a bleeding diathesis and normal coagulation and platelet aggregations studies. Additionally, flow cytometric analysis is able to identify discrete platelet activation defects. In particular, we show for the first time that a relevant proportion of these patients has an isolated impaired ability to generate COAT-platelets - a conceptually new defect in platelet procoagulant activity, that is missed by conventional laboratory work-up. © 2014 Clinical Cytometry Society.

cDNA Library Generation for the Analysis of Small RNAs by High-Throughput Sequencing

The RNome of a cell is highly diverse and consists besides messenger RNAs (mRNAs), transfer RNAs (tRNAs), and ribosomal RNAs (rRNAs) also of other small and long transcript entities without apparent coding potential. This class of molecules, commonly referred to as non-protein-coding RNAs (ncRNAs), is involved in regulating numerous biological processes and thought to contribute to cellular complexity. Therefore, much effort is put into their identification and further functional characterization. Here we provide a cost-effective and reliable method for cDNA library construction of small RNAs in the size range of 20-500 residues. The effectiveness of the described method is demonstrated by the analysis of ribosome-associated small RNAs in the eukaryotic model organism Trypanosoma brucei.

Comparative Effectiveness and Safety of New-Generation Versus Early-Generation Drug-Eluting Stents According to Complexity of Coronary Artery Disease: A Patient-Level Pooled Analysis of 6,081 Patients.

OBJECTIVES The purpose of this study was to compare the 2-year safety and effectiveness of new- versus early-generation drug-eluting stents (DES) according to the severity of coronary artery disease (CAD) as assessed by the SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score. BACKGROUND New-generation DES are considered the standard-of-care in patients with CAD undergoing percutaneous coronary intervention. However, there are few data investigating the effects of new- over early-generation DES according to the anatomic complexity of CAD. METHODS Patient-level data from 4 contemporary, all-comers trials were pooled. The primary device-oriented clinical endpoint was the composite of cardiac death, myocardial infarction, or ischemia-driven target-lesion revascularization (TLR). The principal effectiveness and safety endpoints were TLR and definite stent thrombosis (ST), respectively. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated at 2 years for overall comparisons, as well as stratified for patients with lower (SYNTAX score ≤11) and higher complexity (SYNTAX score >11). RESULTS A total of 6,081 patients were included in the study. New-generation DES (n = 4,554) compared with early-generation DES (n = 1,527) reduced the primary endpoint (HR: 0.75 [95% CI: 0.63 to 0.89]; p = 0.001) without interaction (p = 0.219) between patients with lower (HR: 0.86 [95% CI: 0.64 to 1.16]; p = 0.322) versus higher CAD complexity (HR: 0.68 [95% CI: 0.54 to 0.85]; p = 0.001). In patients with SYNTAX score >11, new-generation DES significantly reduced TLR (HR: 0.36 [95% CI: 0.26 to 0.51]; p < 0.001) and definite ST (HR: 0.28 [95% CI: 0.15 to 0.55]; p < 0.001) to a greater extent than in the low-complexity group (TLR pint = 0.059; ST pint = 0.013). New-generation DES decreased the risk of cardiac mortality in patients with SYNTAX score >11 (HR: 0.45 [95% CI: 0.27 to 0.76]; p = 0.003) but not in patients with SYNTAX score ≤11 (pint = 0.042). CONCLUSIONS New-generation DES improve clinical outcomes compared with early-generation DES, with a greater safety and effectiveness in patients with SYNTAX score >11.

Safety and Efficacy of New-Generation Drug-Eluting Stents in Women at High Risk for Atherothrombosis: From the Women in Innovation and Drug-Eluting Stents Collaborative Patient-Level Pooled Analysis

BACKGROUND The safety and efficacy of new-generation drug-eluting stents (DES) in women with multiple atherothrombotic risk (ATR) factors is unclear. METHODS AND RESULTS We pooled patient-level data for women enrolled in 26 randomized trials. Study population was categorized based on the presence or absence of high ATR, which was defined as having history of diabetes mellitus, prior percutaneous or surgical coronary revascularization, or prior myocardial infarction. The primary end point was major adverse cardiovascular events defined as a composite of all-cause mortality, myocardial infarction, or target lesion revascularization at 3 years of follow-up. Out of 10 449 women included in the pooled database, 5333 (51%) were at high ATR. Compared with women not at high ATR, those at high ATR had significantly higher risk of major adverse cardiovascular events (15.8% versus 10.6%; adjusted hazard ratio: 1.53; 95% confidence interval: 1.34-1.75; P=0.006) and all-cause mortality. In high-ATR risk women, the use of new-generation DES was associated with significantly lower risk of 3-year major adverse cardiovascular events (adjusted hazard ratio: 0.69; 95% confidence interval: 0.52-0.92) compared with early-generation DES. The benefit of new-generation DES on major adverse cardiovascular events was uniform between high-ATR and non-high-ATR women, without evidence of interaction (Pinteraction=0.14). At landmark analysis, in high-ATR women, stent thrombosis rates were comparable between DES generations in the first year, whereas between 1 and 3 years, stent thrombosis risk was lower with new-generation devices. CONCLUSIONS Use of new-generation DES even in women at high ATR is associated with a benefit consistent over 3 years of follow-up and a substantial improvement in very-late thrombotic safety.

Functional data analysis approaches for genotype-phenotype association studies from next-generation sequencing

Next-generation DNA sequencing platforms can effectively detect the entire spectrum of genomic variation and is emerging to be a major tool for systematic exploration of the universe of variants and interactions in the entire genome. However, the data produced by next-generation sequencing technologies will suffer from three basic problems: sequence errors, assembly errors, and missing data. Current statistical methods for genetic analysis are well suited for detecting the association of common variants, but are less suitable to rare variants. This raises great challenge for sequence-based genetic studies of complex diseases.^ This research dissertation utilized genome continuum model as a general principle, and stochastic calculus and functional data analysis as tools for developing novel and powerful statistical methods for next generation of association studies of both qualitative and quantitative traits in the context of sequencing data, which finally lead to shifting the paradigm of association analysis from the current locus-by-locus analysis to collectively analyzing genome regions.^ In this project, the functional principal component (FPC) methods coupled with high-dimensional data reduction techniques will be used to develop novel and powerful methods for testing the associations of the entire spectrum of genetic variation within a segment of genome or a gene regardless of whether the variants are common or rare.^ The classical quantitative genetics suffer from high type I error rates and low power for rare variants. To overcome these limitations for resequencing data, this project used functional linear models with scalar response to develop statistics for identifying quantitative trait loci (QTLs) for both common and rare variants. To illustrate their applications, the functional linear models were applied to five quantitative traits in Framingham heart studies. ^ This project proposed a novel concept of gene-gene co-association in which a gene or a genomic region is taken as a unit of association analysis and used stochastic calculus to develop a unified framework for testing the association of multiple genes or genomic regions for both common and rare alleles. The proposed methods were applied to gene-gene co-association analysis of psoriasis in two independent GWAS datasets which led to discovery of networks significantly associated with psoriasis.^

DEVELOPMENT OF NOVEL METHODS TO MINIMIZE THE IMPACT OF SEQUENCING ERRORS IN THE NEXT-GENERATION SEQUENCING DATA ANALYSIS

Next-generation sequencing (NGS) technology has become a prominent tool in biological and biomedical research. However, NGS data analysis, such as de novo assembly, mapping and variants detection is far from maturity, and the high sequencing error-rate is one of the major problems. . To minimize the impact of sequencing errors, we developed a highly robust and efficient method, MTM, to correct the errors in NGS reads. We demonstrated the effectiveness of MTM on both single-cell data with highly non-uniform coverage and normal data with uniformly high coverage, reflecting that MTM’s performance does not rely on the coverage of the sequencing reads. MTM was also compared with Hammer and Quake, the best methods for correcting non-uniform and uniform data respectively. For non-uniform data, MTM outperformed both Hammer and Quake. For uniform data, MTM showed better performance than Quake and comparable results to Hammer. By making better error correction with MTM, the quality of downstream analysis, such as mapping and SNP detection, was improved. SNP calling is a major application of NGS technologies. However, the existence of sequencing errors complicates this process, especially for the low coverage (

An Analysis of Next Generation Access Networks Deployment in rural areas

Next generation access networks (NGAN) will support a renewed electronic communication market where main opportunities lie in the provision of ubiquitous broadband connectivity, applications and content. From their deployment it is expected a wealth of innovations. Within this framework, the project reviews the variety of NGAN deployment options available for rural environments, derives a simple method for approximate cost calculations, and then discusses and compares the results obtained. Data for Spain are used for practical calculations, but the model is applicable with minor modifications to most of the rural areas of European countries. The final part of the paper is devoted to review the techno-economic implications of a network deployment in a rural environment as well as the adequacy and possible developments of the regulatory framework involved

Signal analysis and feature generation for pattern identification of partial discharges in high-voltage equipment

This paper proposes a method for the identification of different partial discharges (PDs) sources through the analysis of a collection of PD signals acquired with a PD measurement system. This method, robust and sensitive enough to cope with noisy data and external interferences, combines the characterization of each signal from the collection, with a clustering procedure, the CLARA algorithm. Several features are proposed for the characterization of the signals, being the wavelet variances, the frequency estimated with the Prony method, and the energy, the most relevant for the performance of the clustering procedure. The result of the unsupervised classification is a set of clusters each containing those signals which are more similar to each other than to those in other clusters. The analysis of the classification results permits both the identification of different PD sources and the discrimination between original PD signals, reflections, noise and external interferences. The methods and graphical tools detailed in this paper have been coded and published as a contributed package of the R environment under a GNU/GPL license.

Physical characterization of laser interaction and shock generation in laser shock processing: coupled theoretical-experimental analysis

Laser Shock Processing is developing as a key technology for the improvement of surface mechanical and corrosion resistance properties of metals due to its ability to introduce intense compressive residual stresses fields into high elastic limit materials by means of an intense laser driven shock wave generated by laser with intensities exceeding the 109 W/cm2 threshold, pulse energies in the range of 1 Joule and interaction times in the range of several ns. However, because of the relatively difficult-to-describe physics of shock wave formation in plasma following laser-matter interaction in solid state, only limited knowledge is available in the way of full comprehension and predictive assessment of the characteristic physical processes and material transformations with a specific consideration of real material properties. In the present paper, an account of the physical issues dominating the development of LSP processes from a moderately high intensity laser-matter interaction point of view is presented along with the theoretical and computational methods developed by the authors for their predictive assessment and new experimental contrast results obtained at laboratory scale.

Physical characterization of laser interaction and shock generation in laser processing: coupled theoretical-experimental analysis

Outline: • Introduction • Fundamental Physics of the Laser-Plasma Interaction in Laser Shock Processing • Theoretical/Computational Model Description • Some Results. Analysis of Interaction Parameters • Experimental Validation. Diagnosis Setup • Discussion and Outlook

Technical evaluation of a third generation optical pose tracker for motion analysis and image-guided surgery

Laparoscopic instrument tracking systems are an essential component in image-guided interventions and offer new possibilities to improve and automate objective assessment methods of surgical skills. In this study we present our system design to apply a third generation optical pose tracker (Micron- Tracker®) to laparoscopic practice. A technical evaluation of this design is performed in order to analyze its accuracy in computing the laparoscopic instrument tip position. Results show a stable fluctuation error over the entire analyzed workspace. The relative position errors are 1.776±1.675 mm, 1.817±1.762 mm, 1.854±1.740 mm, 2.455±2.164 mm, 2.545±2.496 mm, 2.764±2.342 mm, 2.512±2.493 mm for distances of 50, 100, 150, 200, 250, 300, and 350 mm, respectively. The accumulated distance error increases with the measured distance. The instrument inclination covered by the system is high, from 90 to 7.5 degrees. The system reports a low positional accuracy for the instrument tip.

Analysis of a Spanish energy scenario with Generation IV nuclear reactors

The advantages of fast-spectrum reactors consist not only of an efficient use of fuel through the breeding of fissile material and the use of natural or depleted uranium, but also of the potential reduction of the amount of actinides such as americium and neptunium contained in the irradiated fuel. The first aspect means a guaranteed future nuclear fuel supply. The second fact is key for high-level radioactive waste management, because these elements are the main responsible for the radioactivity of the irradiated fuel in the long term. The present study aims to analyze the hypothetical deployment of a Gen-IV Sodium Fast Reactor (SFR) fleet in Spain. A nuclear fleet of fast reactors would enable a fuel cycle strategy different than the open cycle, currently adopted by most of the countries with nuclear power. A transition from the current Gen-II to Gen-IV fleet is envisaged through an intermediate deployment of Gen-III reactors. Fuel reprocessing from the Gen-II and Gen-III Light Water Reactors (LWR) has been considered. In the so-called advanced fuel cycle, the reprocessed fuel used to produce energy will breed new fissile fuel and transmute minor actinides at the same time. A reference case scenario has been postulated and further sensitivity studies have been performed to analyze the impact of the different parameters on the required reactor fleet. The potential capability of Spain to supply the required fleet for the reference scenario using national resources has been verified. Finally, some consequences on irradiated final fuel inventory are assessed. Calculations are performed with the Monte Carlo transport-coupled depletion code SERPENT together with post-processing tools.

Core physics and safety analysis of Generation-IV Sodium Fast Reactors using existing and newly developed computational tools

El futuro de la energía nuclear de fisión dependerá, entre otros factores, de la capacidad que las nuevas tecnologías demuestren para solventar los principales retos a largo plazo que se plantean. Los principales retos se pueden resumir en los siguientes aspectos: la capacidad de proporcionar una solución final, segura y fiable a los residuos radiactivos; así como dar solución a la limitación de recursos naturales necesarios para alimentar los reactores nucleares; y por último, una mejora robusta en la seguridad de las centrales que en definitiva evite cualquier daño potencial tanto en la población como en el medio ambiente como consecuencia de cualquier escenario imaginable o más allá de lo imaginable. Siguiendo estas motivaciones, la Generación IV de reactores nucleares surge con el compromiso de proporcionar electricidad de forma sostenible, segura, económica y evitando la proliferación de material fisible. Entre los sistemas conceptuales que se consideran para la Gen IV, los reactores rápidos destacan por su capacidad potencial de transmutar actínidos a la vez que permiten una utilización óptima de los recursos naturales. Entre los refrigerantes que se plantean, el sodio parece una de las soluciones más prometedoras. Como consecuencia, esta tesis surgió dentro del marco del proyecto europeo CP-ESFR con el principal objetivo de evaluar la física de núcleo y seguridad de los reactores rápidos refrigerados por sodio, al tiempo que se desarrollaron herramientas apropiadas para dichos análisis. Efectivamente, en una primera parte de la tesis, se abarca el estudio de la física del núcleo de un reactor rápido representativo, incluyendo el análisis detallado de la capacidad de transmutar actínidos minoritarios. Como resultado de dichos análisis, se publicó un artículo en la revista Annals of Nuclear Energy [96]. Por otra parte, a través de un análisis de un hipotético escenario nuclear español, se evalúo la disponibilidad de recursos naturales necesarios en el caso particular de España para alimentar una flota específica de reactores rápidos, siguiendo varios escenarios de demanda, y teniendo en cuenta la capacidad de reproducción de plutonio que tienen estos sistemas. Como resultado de este trabajo también surgió una publicación en otra revista científica de prestigio internacional como es Energy Conversion and Management [97]. Con objeto de realizar esos y otros análisis, se desarrollaron diversos modelos del núcleo del ESFR siguiendo varias configuraciones, y para diferentes códigos. Por otro lado, con objeto de poder realizar análisis de seguridad de reactores rápidos, son necesarias herramientas multidimensionales de alta fidelidad específicas para reactores rápidos. Dichas herramientas deben integrar fenómenos relacionados con la neutrónica y con la termo-hidráulica, entre otros, mediante una aproximación multi-física. Siguiendo este objetivo, se evalúo el código de difusión neutrónica ANDES para su aplicación a reactores rápidos. ANDES es un código de resolución nodal que se encuentra implementado dentro del sistema COBAYA3 y está basado en el método ACMFD. Por lo tanto, el método ACMFD fue sometido a una revisión en profundidad para evaluar su aptitud para la aplicación a reactores rápidos. Durante ese proceso, se identificaron determinadas limitaciones que se discutirán a lo largo de este trabajo, junto con los desarrollos que se han elaborado e implementado para la resolución de dichas dificultades. Por otra parte, se desarrolló satisfactoriamente el acomplamiento del código neutrónico ANDES con un código termo-hidráulico de subcanales llamado SUBCHANFLOW, desarrollado recientemente en el KIT. Como conclusión de esta parte, todos los desarrollos implementados son evaluados y verificados. En paralelo con esos desarrollos, se calcularon para el núcleo del ESFR las secciones eficaces en multigrupos homogeneizadas a nivel nodal, así como otros parámetros neutrónicos, mediante los códigos ERANOS, primero, y SERPENT, después. Dichos parámetros se utilizaron más adelante para realizar cálculos estacionarios con ANDES. Además, como consecuencia de la contribución de la UPM al paquete de seguridad del proyecto CP-ESFR, se calcularon mediante el código SERPENT los parámetros de cinética puntual que se necesitan introducir en los típicos códigos termo-hidráulicos de planta, para estudios de seguridad. En concreto, dichos parámetros sirvieron para el análisis del impacto que tienen los actínidos minoritarios en el comportamiento de transitorios. Concluyendo, la tesis presenta una aproximación sistemática y multidisciplinar aplicada al análisis de seguridad y comportamiento neutrónico de los reactores rápidos de sodio de la Gen-IV, usando herramientas de cálculo existentes y recién desarrolladas ad' hoc para tal aplicación. Se ha empleado una cantidad importante de tiempo en identificar limitaciones de los métodos nodales analíticos en su aplicación en multigrupos a reactores rápidos, y se proponen interesantes soluciones para abordarlas. ABSTRACT The future of nuclear reactors will depend, among other aspects, on the capability to solve the long-term challenges linked to this technology. These are the capability to provide a definite, safe and reliable solution to the nuclear wastes; the limitation of natural resources, needed to fuel the reactors; and last but not least, the improved safety, which would avoid any potential damage on the public and or environment as a consequence of any imaginable and beyond imaginable circumstance. Following these motivations, the IV Generation of nuclear reactors arises, with the aim to provide sustainable, safe, economic and proliferationresistant electricity. Among the systems considered for the Gen IV, fast reactors have a representative role thanks to their potential capacity to transmute actinides together with the optimal usage of natural resources, being the sodium fast reactors the most promising concept. As a consequence, this thesis was born in the framework of the CP-ESFR project with the generic aim of evaluating the core physics and safety of sodium fast reactors, as well as the development of the approppriated tools to perform such analyses. Indeed, in a first part of this thesis work, the main core physics of the representative sodium fast reactor are assessed, including a detailed analysis of the capability to transmute minor actinides. A part of the results obtained have been published in Annals of Nuclear Energy [96]. Moreover, by means of the analysis of a hypothetical Spanish nuclear scenario, the availability of natural resources required to deploy an specific fleet of fast reactor is assessed, taking into account the breeding properties of such systems. This work also led to a publication in Energy Conversion and Management [97]. In order to perform those and other analyses, several models of the ESFR core were created for different codes. On the other hand, in order to perform safety studies of sodium fast reactors, high fidelity multidimensional analysis tools for sodium fast reactors are required. Such tools should integrate neutronic and thermal-hydraulic phenomena in a multi-physics approach. Following this motivation, the neutron diffusion code ANDES is assessed for sodium fast reactor applications. ANDES is the nodal solver implemented inside the multigroup pin-by-pin diffusion COBAYA3 code, and is based on the analytical method ACMFD. Thus, the ACMFD was verified for SFR applications and while doing so, some limitations were encountered, which are discussed through this work. In order to solve those, some new developments are proposed and implemented in ANDES. Moreover, the code was satisfactorily coupled with the thermal-hydraulic code SUBCHANFLOW, recently developed at KIT. Finally, the different implementations are verified. In addition to those developments, the node homogenized multigroup cross sections and other neutron parameters were obtained for the ESFR core using ERANOS and SERPENT codes, and employed afterwards by ANDES to perform steady state calculations. Moreover, as a result of the UPM contribution to the safety package of the CP-ESFR project, the point kinetic parameters required by the typical plant thermal-hydraulic codes were computed for the ESFR core using SERPENT, which final aim was the assessment of the impact of minor actinides in transient behaviour. All in all, the thesis provides a systematic and multi-purpose approach applied to the assessment of safety and performance parameters of Generation-IV SFR, using existing and newly developed analytical tools. An important amount of time was employed in identifying the limitations that the analytical nodal diffusion methods present when applied to fast reactors following a multigroup approach, and interesting solutions are proposed in order to overcome them.

Signal analysis and feature generation for pattern identification of partial discharges in high-voltage equipment

This paper proposes a method for the identification of different partial discharges (PDs) sources through the analysis of a collection of PD signals acquired with a PD measurement system. This method, robust and sensitive enough to cope with noisy data and external interferences, combines the characterization of each signal from the collection, with a clustering procedure, the CLARA algorithm. Several features are proposed for the characterization of the signals, being the wavelet variances, the frequency estimated with the Prony method, and the energy, the most relevant for the performance of the clustering procedure. The result of the unsupervised classification is a set of clusters each containing those signals which are more similar to each other than to those in other clusters. The analysis of the classification results permits both the identification of different PD sources and the discrimination between original PD signals, reflections, noise and external interferences. The methods and graphical tools detailed in this paper have been coded and published as a contributed package of the R environment under a GNU/GPL license.

Generation of longer cDNA fragments from serial analysis of gene expression tags for gene identification

We have developed a technique called the generation of longer cDNA fragments from serial analysis of gene expression (SAGE) tags for gene identification (GLGI), to convert SAGE tags of 10 bases into their corresponding 3′ cDNA fragments covering hundred bases. A primer containing the 10-base SAGE tag is used as the sense primer, and a single base anchored oligo(dT) primer is used as an antisense primer in PCR, together with Pfu DNA polymerase. By using this approach, a cDNA fragment extending from the SAGE tag toward the 3′ end of the corresponding sequence can be generated. Application of the GLGI technique can solve two critical issues in applying the SAGE technique: one is that a longer fragment corresponding to a SAGE tag, which has no match in databases, can be generated for further studies; the other is that the specific fragment corresponding to a SAGE tag can be identified from multiple sequences that match the same SAGE tag. The development of the GLGI method provides several potential applications. First, it provides a strategy for even wider application of the SAGE technique for quantitative analysis of global gene expression. Second, a combined application of SAGE/GLGI can be used to complete the catalogue of the expressed genes in human and in other eukaryotic species. Third, it can be used to identify the 3′ cDNA sequence from any exon within a gene. It can also be used to confirm the reality of exons predicted by bioinformatic tools in genomic sequences. Fourth, a combined application of SAGE/GLGI can be applied to define the 3′ boundary of expressed genes in the genomic sequences in human and in other eukaryotic genomes.