Discovery and refinement of loci associated with lipid levels.

Levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol are heritable, modifiable risk factors for coronary artery disease. To identify new loci and refine known loci influencing these lipids, we examined 188,577 individuals using genome-wide and custom genotyping arrays. We identify and annotate 157 loci associated with lipid levels at P < 5 × 10(-8), including 62 loci not previously associated with lipid levels in humans. Using dense genotyping in individuals of European, East Asian, South Asian and African ancestry, we narrow association signals in 12 loci. We find that loci associated with blood lipid levels are often associated with cardiovascular and metabolic traits, including coronary artery disease, type 2 diabetes, blood pressure, waist-hip ratio and body mass index. Our results demonstrate the value of using genetic data from individuals of diverse ancestry and provide insights into the biological mechanisms regulating blood lipids to guide future genetic, biological and therapeutic research.

Adverse effects of intraperitoneal onlay mesh used for incisional hernia repair

Context: In the past 50 years, the use of prosthetic mesh in surgery has dramatically¦changed the management of primary, as well as incisional hernias. Currently, there¦are a large number of different mesh brands and no consensus on the best material,¦nor the best mesh implantation technique to use. The purpose of this study is to¦illustrate the adverse effects of intraperitoneal onlay mesh used for incisional¦hernia repair encountered in patients treated at CHUV for complications after¦incisional hernia repair.¦Materials & Methods: This work is an observational retrospective study. A PubMed¦search and a systematic review of literature were performed. Thereafter, the medical¦records of 22 patients who presented with pain, abdominal discomfort, ileus, fistula,¦abscess, seroma, mesh infection or recurrent incisional hernia after a laparoscopic or¦open repair with intra-abdominal mesh were reviewed.¦Results: Twenty-two persons were reoperated for complications after incisional¦hernia repair with a prosthetic mesh. Ten were male and twelve female, with a¦median age of 58,6 years (range 24-82). Mesh placement was performed by a¦laparoscopic approach in nine patients and by open approach in thirteen others.¦Eight different mesh brands were found (Ultrapro®, Mersilene®, Parietex Composite®,¦Proceed®, DynaMesh®, Gore® DualMesh®, Permacol®, Titanium Metals UK Ltd®).¦Mean time from implantation and reoperation for complication was 34.2 months¦(range 1-147). In our sample of 22 patients, 21 (96%) presented mesh adhesion and¦15 (68%) presented hernia recurrence. Others complications like mesh shrinkage,¦mesh migration, nerve entrapment, seroma, fistula and abscess were also evaluated.¦Conclusion: The majority of articles deal with complications induced by¦intraperitoneal prosthetic mesh, but the effectiveness of mesh has been studied¦mostly on experimental models. Actually and as shown in the present study,¦intraperitoneal mesh placement was associated with severe complications witch may¦potentially be life threatening. In our opinion, intraperitoneal mesh placement should¦only be reserved in exceptional situations, when the modified Rives-Stoppa could not¦be achieved and when tissues covering the mesh are insufficient.

Laparoscopic inguinal hernia repair with extraperitoneal double-mesh technique.

Totally extraperitoneal laparoscopic hernia repair is an efficient but technically demanding procedure. As mechanisms of hernia recurrence may be related to these technical difficulties, we have modified a previously described double-mesh technique in an effort to simplify the procedure. Extraperitoneal laparoscopic hernia repairs were performed in 82 male and 17 female patients having inguinal, femoral, and recurrent bilateral hernias. A standard propylene mesh measuring 15 x 15 cm was cut into two pieces of 4 x 15 cm and 11 x 15 cm. The smaller mesh was placed over both inguinal rings without splitting. The larger mesh was then inserted over the first mesh and stapled to low-risk zones, reinforcing the large-vessel area and the nerve transition zone. The mean procedure duration was 60 minutes for unilateral and 100 minutes for bilateral hernia repair. Patients were discharged from the hospital within 48 hours. The mean postoperative follow-up was 22 months, with no recurrences, neuralgia, or bleeding complications. Over a 2-year period, this technique was found to be satisfactory without recurrences or significant complications. In our hands, this technique was easier to perform: it allows for a less than perfect positioning of the meshes and avoids most of the stapling to crucial zones.

Posterior vaginal wall repair with synthetic absorbable mesh: A new technique for and old procedure

The objective of this study was to assess the applicability of posterior wall repair with a synthetic absorbable mesh. Between January and September 1996, five posterior repairs using absorbable synthetic meshes were performed. Five posterior wall repairs in patients matched for age, parity, and rectocele degree were performed according to usual procedures during the same period, and were used as controls. No febrile morbidity, cuff or posterior vaginal wall infections, thrombophlebitis, rectal injury, or hemorrhagic complications were observed in the 10 women who entered the study. In summary, posterior wall repair can be easily performed with an absorbable soft tissue patch, theoretically preserving sexual activity, and probably offers better functional results with longer experience, thus providing a safe and useful procedure in sexually active women.

Refinement of Rapid PCC Coarse Aggregate Testing Program, HR-1071, 1999

The characterization and categorization of coarse aggregates for use in portland cement concrete (PCC) pavements is a highly refined process at the Iowa Department of Transportation. Over the past 10 to 15 years, much effort has been directed at pursuing direct testing schemes to supplement or replace existing physical testing schemes. Direct testing refers to the process of directly measuring the chemical and mineralogical properties of an aggregate and then attempting to correlate those measured properties to historical performance information (i.e., field service record). This is in contrast to indirect measurement techniques, which generally attempt to extrapolate the performance of laboratory test specimens to expected field performance. The purpose of this research project was to investigate and refine the use of direct testing methods, such as X-ray analysis techniques and thermal analysis techniques, to categorize carbonate aggregates for use in portland cement concrete. The results of this study indicated that the general testing methods that are currently used to obtain data for estimating service life tend to be very reliable and have good to excellent repeatability. Several changes in the current techniques were recommended to enhance the long-term reliability of the carbonate database. These changes can be summarized as follows: (a) Limits that are more stringent need to be set on the maximum particle size in the samples subjected to testing. This should help to improve the reliability of all three of the test methods studied during this project. (b) X-ray diffraction testing needs to be refined to incorporate the use of an internal standard. This will help to minimize the influence of sample positioning errors and it will also allow for the calculation of the concentration of the various minerals present in the samples. (c) Thermal analysis data needs to be corrected for moisture content and clay content prior to calculating the carbonate content of the sample.

Accuracy and predictability in use of AO three-dimensionally preformed titanium mesh plates for posttraumatic orbital reconstruction: a pilot study.

The aim of this study was to prospectively evaluate the accuracy and predictability of new three-dimensionally preformed AO titanium mesh plates for posttraumatic orbital wall reconstruction.We analyzed the preoperative and postoperative clinical and radiologic data of 10 patients with isolated blow-out orbital fractures. Fracture locations were as follows: floor (N = 7; 70%), medial wall (N = 1; 1%), and floor/medial wall (N = 2; 2%). The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures. A three-dimensional preformed AO titanium mesh plate (0.4 mm in thickness) was selected according to the size of the defect previously measured on the preoperative computed tomographic (CT) scan examination and fixed at the inferior orbital rim with 1 or 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative CT scan. Coronal CT scan slices were used to measure bony orbital volume using OsiriX Medical Image software. Reconstructed versus uninjured orbital volume were statistically correlated.Nine patients (90%) had a successful treatment outcome without complications. One patient (10%) developed a mechanical limitation of upward gaze with a resulting handicapping diplopia requiring hardware removal. Postoperative orbital CT scan showed an anatomic three-dimensional placement of the orbital mesh plates in all of the patients. Volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 2.5 cm(3). There was no significant difference in volume between the reconstructed and uninjured orbits.This preliminary study has demonstrated that three-dimensionally preformed AO titanium mesh plates for posttraumatic orbital wall reconstruction results in (1) a high rate of success with an acceptable rate of major clinical complications (10%) and (2) an anatomic restoration of the bony orbital contour and volume that closely approximates that of the contralateral uninjured orbit.

Computer-aided volume measurement of posttraumatic orbits reconstructed with AO titanium mesh plates: accuracy and reliability

PURPOSE: To prospectively evaluate the accuracy and reliability of "freehand" posttraumatic orbital wall reconstruction with AO (Arbeitsgemeinschaft Osteosynthese) titanium mesh plates by using computer-aided volumetric measurement of the bony orbits. METHODS: Bony orbital volume was measured in 12 patients from coronal CT scan slices using OsiriX Medical Image software. After defining the volumetric limits of the orbit, the segmentation of the bony orbital region of interest of each single slice was performed. At the end of the segmentation process, all regions of interest were grouped and the volume was computed. The same procedure was performed on both orbits, and thereafter the volume of the contralateral uninjured orbit was used as a control for comparison. RESULTS: In all patients, the volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 1.85 cm3 (7%). CONCLUSIONS: This preliminary study has demonstrated that posttraumatic orbital wall reconstruction using "freehand" bending and placement of AO titanium mesh plates results in a high success rate in re-establishing preoperative bony volume, which closely approximates that of the contralateral uninjured orbit.

Comparison of three separate antiadhesive barriers for intraperitoneal onlay mesh hernia repair in an experimental model (Br J Surg 2011; 98: 442-449).

The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length.

The use of external mesh reinforcement to reduce intimal hyperplasia and preserve the structure of human saphenous veins.

The saphenous vein is the conduit of choice in bypass graft procedures. Haemodynamic factors play a major role in the development of intimal hyperplasia (IH), and subsequent bypass failure. To evaluate the potential protective effect of external reinforcement on such a failure, we developed an ex vivo model for the perfusion of segments of human saphenous veins under arterial shear stress. In veins submitted to pulsatile high pressure (mean pressure at 100 mmHg) for 3 or 7 days, the use of an external macroporous polyester mesh 1) prevented the dilatation of the vessel, 2) decreased the development of IH, 3) reduced the apoptosis of smooth muscle cells, and the subsequent fibrosis of the media layer, 4) prevented the remodelling of extracellular matrix through the up-regulation of matrix metalloproteinases (MMP-2, MMP-9) and plasminogen activator type I. The data show that, in an experimental ex vivo setting, an external scaffold decreases IH and maintains the integrity of veins exposed to arterial pressure, via increase in shear stress and decrease wall tension, that likely contribute to trigger selective molecular and cellular changes.

Local alignment refinement using structural assessment.

Homology modeling is the most commonly used technique to build a three-dimensional model for a protein sequence. It heavily relies on the quality of the sequence alignment between the protein to model and related proteins with a known three dimensional structure. Alignment quality can be assessed according to the physico-chemical properties of the three dimensional models it produces.In this work, we introduce fifteen predictors designed to evaluate the properties of the models obtained for various alignments. They consist of an energy value obtained from different force fields (CHARMM, ProsaII or ANOLEA) computed on residue selected around misaligned regions. These predictors were evaluated on ten challenging test cases. For each target, all possible ungapped alignments are generated and their corresponding models are computed and evaluated.The best predictor, retrieving the structural alignment for 9 out of 10 test cases, is based on the ANOLEA atomistic mean force potential and takes into account residues around misaligned secondary structure elements. The performance of the other predictors is significantly lower. This work shows that substantial improvement in local alignments can be obtained by careful assessment of the local structure of the resulting models.

Implantación de un modelo de red abierta tipo mesh para propagar el acceso libre al servicio de biblioteca y contenidos abiertos

Implantación de un modelo de red abierta tipo mesh para propagar el acceso libre al servicio de biblioteca y contenidos abiertos.

G+: Enhanced Traffic Grooming in WDM Mesh Networks using Lighttours

In this article, a new technique for grooming low-speed traffic demands into high-speed optical routes is proposed. This enhancement allows a transparent wavelength-routing switch (WRS) to aggregate traffic en route over existing optical routes without incurring expensive optical-electrical-optical (OEO) conversions. This implies that: a) an optical route may be considered as having more than one ingress node (all inline) and, b) traffic demands can partially use optical routes to reach their destination. The proposed optical routes are named "lighttours" since the traffic originating from different sources can be forwarded together in a single optical route, i.e., as taking a "tour" over different sources towards the same destination. The possibility of creating lighttours is the consequence of a novel WRS architecture proposed in this article, named "enhanced grooming" (G+). The ability to groom more traffic in the middle of a lighttour is achieved with the support of a simple optical device named lambda-monitor (previously introduced in the RingO project). In this article, we present the new WRS architecture and its advantages. To compare the advantages of lighttours with respect to classical lightpaths, an integer linear programming (ILP) model is proposed for the well-known multilayer problem: traffic grooming, routing and wavelength assignment The ILP model may be used for several objectives. However, this article focuses on two objectives: maximizing the network throughput, and minimizing the number of optical-electro-optical conversions used. Experiments show that G+ can route all the traffic using only half of the total OEO conversions needed by classical grooming. An heuristic is also proposed, aiming at achieving near optimal results in polynomial time

Estudi i implementació pràctica d'una xarxa Wifi Mesh

En el projecte ens centrarem en el funcionament de les Xarxes mallades sense fils, es fa una breu explicació de les xarxes Ad-hoc, ja que aquestes formen un part important dintre d’una xarxa Mesh. S’explicaran diversos protocols d’enrutament com ara BATMAN, AODV, 802.11s i OLSR. Aquest últim és el que utilitzarem per a la configuració de la xarxa que realitzarem. S’explicarà el tipus de paquets que s’envien entre els nodes perquè el funcionament de la xarxa sigui òptim i tots els clients puguin tenir-hi accés i estiguin connectats entre ells. Al finalitzar l’estudi teòric d’aquest tipus de xarxa i veure les seves avantatges i desavantatges respecte altres tipus de xarxes sense fils, es muntaran dos petites xarxa. Per a muntar-les utilitzarem de Punts d’Accés els nodes Ubuquiti Nanoestation LocoM2. Una de les xarxes serà al poble Bellcaire d’Urgell, on és connectaran tres cases, on només una te accés a Internet i els nodes estaran connectats en línia, es a dir, del Node1 – Node2 – Node3. La segona serà a una casa de Barcelona on mitjançant els tres nodes obtindrem una connexió d’Internet a tota la casa, en aquest cas els tres nodes estaran connectats els tres formant un cercle, es a dir, Node1-Node2-Node3-Node1. Finalment, és mirarà una proposta de futur, on es parlaria amb l’Ajuntament del poble on s’ha fet la primera proba per realitzar una Xarxa mallada sense fils a tots els llocs públics del poble.