High level of extracellular potassium and its correlates after severe head injury: relationship to high intracranial pressure

OBJECT: Disturbed ionic and neurotransmitter homeostasis are now recognized as probably the most important mechanisms contributing to the development of secondary brain swelling after traumatic brain injury (TBI). Evidence obtained in animal models indicates that posttraumatic neuronal excitation by excitatory amino acids leads to an increase in extracellular potassium, probably due to ion channel activation. The purpose of this study was therefore to measure dialysate potassium in severely head injured patients and to correlate these results with measurements of intracranial pressure (ICP), patient outcome, and levels of dialysate glutamate and lactate, and cerebral blood flow (CBF) to determine the role of ischemia in this posttraumatic ion dysfunction. METHODS: Eighty-five patients with severe TBI (Glasgow Coma Scale Score < 8) were treated according to an intensive ICP management-focused protocol. All patients underwent intracerebral microdialyis. Dialysate potassium levels were analyzed using flame photometry, and dialysate glutamate and dialysate lactate levels were measured using high-performance liquid chromatography and an enzyme-linked amperometric method in 72 and 84 patients, respectively. Cerebral blood flow studies (stable xenon computerized tomography scanning) were performed in 59 patients. In approximately 20% of the patients, dialysate potassium values were increased (dialysate potassium > 1.8 mM) for 3 hours or more. A mean amount of dialysate potassium greater than 2 mM throughout the entire monitoring period was associated with ICP above 30 mm Hg and fatal outcome, as were progressively rising levels of dialysate potassium. The presence of dialysate potassium correlated positively with dialysate glutamate (p < 0.0001) and lactate (p < 0.0001) levels. Dialysate potassium was significantly inversely correlated with reduced CBF (p = 0.019). CONCLUSIONS: Dialysate potassium was increased after TBI in 20% of measurements. High levels of dialysate potassium were associated with increased ICP and poor outcome. The simultaneous increase in dialysate potassium, together with dialysate glutamate and lactate, supports the concept that glutamate induces ionic flux and consequently increases ICP, which the authors speculate may be due to astrocytic swelling. Reduced CBF was also significantly correlated with increased levels of dialysate potassium. This may be due to either cell swelling or altered vasoreactivity in cerebral blood vessels caused by higher levels of potassium after trauma. Additional studies in which potassium-sensitive microelectrodes are used are needed to validate these ionic events more clearly.

Possible role of Cdx2 in the serrated pathway of colorectal cancer characterized by BRAF mutation, high-level CpG Island methylator phenotype and mismatch repair-deficiency

Colorectal cancer is a heterogeneous disease at the histomorphological, clinical and molecular level. Approximately 20% of cases may progress through the "serrated" pathway characterized by BRAF mutation and high-level CpG Island Methylator Phenotype (CIMP). A large subgroup are additionally microsatellite instable (MSI) and demonstrate significant loss of tumor suppressor Cdx2. The aim of this study is to determine the specificity of Cdx2 protein expression and CpG promoter hypermethylation for BRAF(V600E) and high-level CIMP in colorectal cancer. Cdx2, Mlh1, Msh2, Msh6, and Pms2 were analyzed by immunohistochemistry using a multi-punch tissue microarray (TMA; n = 220 patients). KRAS and BRAF(V600E) mutation analysis, CDX2 methylation and CIMP were investigated. Loss of Cdx2 was correlated with larger tumor size (P = 0.0154), right-sided location (P = 0.0014), higher tumor grade (P < 0.0001), more advanced pT (P = 0.0234) and lymphatic invasion (P = 0.0351). Specificity was 100% for mismatch repair (MMR)-deficiency (P < 0.0001), 92.2% (P < 0.0001) for BRAF(V600E) and 91.8% for CIMP-high. Combined analysis of BRAF(V600E) /CIMP identified Cdx2 loss as sensitive (80%) and specific (91.5%) for mutation/high status. These results were validated on eight well-established colorectal cancer cell lines. CDX2 methylation correlated with BRAF(V600E) (P = 0.0184) and with Cdx2 protein loss (P = 0.0028). These results seem to indicate that Cdx2 may play a role in the serrated pathway to colorectal cancer as underlined by strong relationships with BRAF(V600E) , CIMP-high and MMR-deficiency. Whether this protein can only be used as a "surrogate" marker, or is functionally involved in the progression of these tumors remains to be elucidated.

Glacial Lake Wright, a High-Level Antarctic Lake During the LGM and Early Holocene

We report evidence of a large proglacial lake (Glacial Lake Wright) that existed in Wright Valley in the McMurdo Dry Valleys region of Antarctica at the last glacial maximum (LGM) and in the early Holocene. At its highstands, Glacial Lake Wright would have stretched 50 km and covered c. 210 km(2). Chronology for lake-level changes comes from 30 AMS radiocarbon dates of lacustrine algae preserved in deltas, shorelines, and glaciolacustrine deposits that extend up to 480 m above present-day lakes. Emerging evidence suggests that Glacial Lake Wright was only one of a series of large lakes to occupy the McMurdo Dry Valleys and the valleys fronting the Royal Society Range at the LGM. Although the cause of such high lake levels is not well understood, it is believed to relate to cool, dry conditions which produced fewer clouds, less snowfall, and greater amounts of absorbed radiation, leading to increased meltwater production.

Chromosomally and extrachromosomally mediated high-level gentamicin resistance in Streptococcus agalactiae

Streptococcus agalactiae (group B Streptococcus, GBS) is a leading cause of sepsis in neonates. The rate of invasive GBS disease in non-pregnant adults also continues to climb. Aminoglycosides alone have little or no effect on GBS, but synergistic killing with penicillin has been shown in vitro. High-level gentamicin resistance (HLGR) in GBS isolates, however, leads to loss of a synergistic effect. We therefore performed a multicentre study to determine the frequency of HLGR GBS isolates and to elucidate the molecular mechanisms leading to gentamicin resistance. From eight centres in four countries, 1128 invasive and colonizing GBS isolates were pooled and investigated for the presence of HLGR. We identified two strains that displayed HLGR (BSU1203 and BSU452), both of which carried the aacA-aphD gene, typically conferring HLGR. Though, only one strain (BSU1203) also carried the previously described chromosomal gentamicin resistance transposon, designated Tn3706. In the other strain (BSU452), plasmid purification and subsequent DNA sequencing resulted in the detection of plasmid pIP501 carrying a remnant of a Tn3 family transposon. Its ability to confer HLGR was proven by transfer into an Enterococcus faecalis isolate. Conversely, loss of HLGR was documented after curing both GBS BSU452 and the transformed E. faecalis strain from the plasmid. This is the first report showing a plasmid mediated HLGR in GBS. Thus, in our clinical GBS isolates HLGR is mediated both chromosomally and extrachromosomally.

Impact of nuclear data uncertainties in the Phase-1B Benchmark

Accurate control over the spent nuclear fuel content is essential for its safe and optimized transportation, storage and management. Consequently, the reactivity of spent fuel and its isotopic content must be accurately determined. Nowadays, to predict isotopic evolution throughout irradiation and decay periods is not a problem thanks to the development of powerful codes and methodologies. In order to have a realistic confidence level in the prediction of spent fuel isotopic content, it is desirable to determine how uncertainties in the basic nuclear data affect isotopic prediction calculations by quantifying their associated uncertainties

Introducing Nuclear Energy to High-School Students: The Spanish Young Generation in Nuclear (Jóvenes Nucleares) Lectures

One of the main goals of Spanish Young Generation (JJNN) is to spread knowledge about nuclear energy, not only pointing out its advantages and its role in our society, but also trying to correct some of the ideas that are due to the biased information and to the lack of knowledge. With this goal in mind, lectures were given in several high schools, aimed at students ranging from 14 to 18 years old. This paper explains the experience accumulated during those talks and the conclusions that can be drawn, so as to better focus the communication about nuclear energy, especially the one aimed at a young public. In order to evaluate the degree of knowledge and information on a specific topic of a given group of individuals, statistical methods must be used. At the beginning of each lecture (and sometimes at the end, in order to evaluate the impact of the talk) the students were submitted to a short survey conducted by Spanish Young Generation. It consisted in eight questions, dealing with the relation between the main environmental issues (global warming, acid rain, radioactive waste…) and nuclear energy. The answers can be surprising, especially for professionals of the nuclear field who, since they are so familiar with this topic, often forget that this is just the case of a minority of people. A better knowledge of the degree of information of a given group enables to focus and personalize the communication. Another communication tool is the direct contact with students: it starts with their questions, which can then lead to a small debate. If the surveys inform about the topics they are unaware of, the direct exchange with them enables to find the most effective way to provide them the information. Of course, it depends a lot on the public attending the talk (age, background…) and on the debate following the talk: a good communication, adapted to the public, is necessary. Therefore, the outcome of the performed exercise is that Spanish teenagers have still a lack of knowledge about nuclear energy. We can learn that items that are evident for nuclear young professionals are unknown for high school teenagers

High-level characteristics of or-and independent and-parallelism in prolog

Although studies of a number of parallel implementations of logic programming languages are now available, their results are difficult to interpret due to the multiplicity of factors involved, the effect of each of which is difficult to sepárate. In this paper we present the results of a high-level simulation study of or- and independent and-parallelism with a wide selection of Prolog programs that aims to determine the intrinsic amount of parallelism, independently of implementation factors, thus facilitating this separation. We expect this study will be instrumental in better understanding and comparing results from actual implementations, as shown by some examples provided in the paper. In addition, the paper examines some of the issues and tradeoffs associated with the combination of and- and or-parallelism and proposes reasonable solutions based on the simulation data obtained.

Towards high-level execution primitives for and-parallelism: preliminary results

Most implementations of parallel logic programming rely on complex low-level machinery which is arguably difflcult to implement and modify. We explore an alternative approach aimed at taming that complexity by raising core parts of the implementation to the source language level for the particular case of and-parallelism. Therefore, we handle a signiflcant portion of the parallel implementation mechanism at the Prolog level with the help of a comparatively small number of concurrency-related primitives which take care of lower-level tasks such as locking, thread management, stack set management, etc. The approach does not eliminate altogether modiflcations to the abstract machine, but it does greatly simplify them and it also facilitates experimenting with different alternatives. We show how this approach allows implementing both restricted and unrestricted (i.e., non fork-join) parallelism. Preliminary experiments show that the amount of performance sacriflced is reasonable, although granularity control is required in some cases. Also, we observe that the availability of unrestricted parallelism contributes to better observed speedups.

A comparative study of Monte Carlo-coupled depletion codes applied to a Sodium Fast Reactor design loaded with minor actinides

inor actinides (MAs) transmutation is a main design objective of advanced nuclear systems such as generation IV Sodium Fast Reactors (SFRs). In advanced fuel cycles, MA contents in final high level waste packages are main contributors to short term heat production as well as to long-term radiotoxicity. Therefore, MA transmutation would have an impact on repository designs and would reduce the environment burden of nuclear energy. In order to predict such consequences Monte Carlo (MC) transport codes are used in reactor design tasks and they are important complements and references for routinely used deterministic computational tools. In this paper two promising Monte Carlo transport-coupled depletion codes, EVOLCODE and SERPENT, are used to examine the impact of MA burning strategies in a SFR core, 3600 MWth. The core concept proposal for MA loading in two configurations is the result of an optimization effort upon a preliminary reference design to reduce the reactivity insertion as a consequence of sodium voiding, one of the main concerns of this technology. The objective of this paper is double. Firstly, efficiencies of the two core configurations for MA transmutation are addressed and evaluated in terms of actinides mass changes and reactivity coefficients. Results are compared with those without MA loading. Secondly, a comparison of the two codes is provided. The discrepancies in the results are quantified and discussed.