Innate and adaptive immunity at mucosal surfaces of the female reproductive tract : stratification and integration of immune protection against the transmission of sexually transmitted infections

This review examines the multiple levels of pre-existing immunity in the upper and lower female reproductive tract. In addition, we highlight the need for further research of innate and adaptive immune protection of mucosal surfaces in the female reproductive tract. Innate mechanisms include the mucus lining, a tight epithelial barrier and the secretion of antimicrobial peptides and cytokines by epithelial and innate immune cells. Stimulation of the innate immune system also serves to bridge the adaptive arm resulting in the generation of pathogen-specific humoral and cell-mediated immunity. Less understood are the multiple components that act in a coordinated way to provide a network of ongoing protection. Innate and adaptive immunity in the human female reproductive tract are influenced by the stage of menstrual cycle and are directly regulated by the sex steroid hormones, progesterone and estradiol. Furthermore, the effect of hormones on immunity is mediated both directly on immune and epithelial cells and indirectly by stimulating growth factor secretion from stromal cells. The goal of this review is to focus on the diverse aspects of the innate and adaptive immune systems that contribute to a unique network of protection throughout the female reproductive tract.

A comparative analysis of risk stratification tools for emergency department patients with chest pain

Background: Appropriate disposition of emergency department (ED) patients with chest pain is dependent on clinical evaluation of risk. A number of chest pain risk stratification tools have been proposed. The aim of this study was to compare the predictive performance for major adverse cardiac events (MACE) using risk assessment tools from the National Heart Foundation of Australia (HFA), the Goldman risk score and the Thrombolysis in Myocardial Infarction risk score (TIMI RS). Methods: This prospective observational study evaluated ED patients aged ≥30 years with non-traumatic chest pain for which no definitive non-ischemic cause was found. Data collected included demographic and clinical information, investigation findings and occurrence of MACE by 30 days. The outcome of interest was the comparative predictive performance of the risk tools for MACE at 30 days, as analyzed by receiver operator curves (ROC). Results: Two hundred eighty-one patients were studied; the rate of MACE was 14.1%. Area under the curve (AUC) of the HFA, TIMI RS and Goldman tools for the endpoint of MACE was 0.54, 0.71 and 0.67, respectively, with the difference between the tools in predictive ability for MACE being highly significant [chi2 (3) = 67.21, N = 276, p < 0.0001]. Conclusion: The TIMI RS and Goldman tools performed better than the HFA in this undifferentiated ED chest pain population, but selection of cutoffs balancing sensitivity and specificity was problematic. There is an urgent need for validated risk stratification tools specific for the ED chest pain population.

On optimum stratification with proportional allocation for a class of pareto distributions

Cum ./LSTA_A_8828879_O_XML_IMAGES/LSTA_A_8828879_O_ILM0001.gif rule [Singh (1975)] has been suggested in the literature for finding approximately optimum strata boundaries for proportional allocation, when the stratification is done on the study variable. This paper shows that for the class of density functions arising from the Wang and Aggarwal (1984) representation of the Lorenz Curve (or DBV curves in case of inventory theory), the cum ./LSTA_A_8828879_O_XML_IMAGES/LSTA_A_8828879_O_ILM0002.gif rule in place of giving approximately optimum strata boundaries, yields exactly optimum boundaries. It is also shown that the conjecture of Mahalanobis (1952) “. . .an optimum or nearly optimum solutions will be obtained when the expected contribution of each stratum to the total aggregate value of Y is made equal for all strata” yields exactly optimum strata boundaries for the case considered in the paper.

Correlation of macrophage location and plaque stress distribution using USPIO-enhanced MRI in a patient with symptomatic severe carotid stenosis: A new insight into risk stratification

High resolution, USPIO-enhanced MR imaging can be used to identify inflamed atherosclerotic plaque. We report a case of a 79-year-old man with a symptomatic carotid stenosis of 82%. The plaque was retrieved for histology and finite element analysis (FEA) based on the preoperative MR imaging was used to predict maximal Von Mises stress on the plaque. Macrophage location correlated with maximal predicted stresses on the plaque. This supports the hypothesis that macrophages thin the fibrous cap at points of highest stress, leading to an increased risk of plaque rupture and subsequent stroke.

Effect of viscosity stratification on secondary and nonmodal instabilities

The effect of viscosity stratification on the different mechanism of transition to turbulence is not well understood. In this paper, a viscosity variation normal to the flow in a channel is investigated. The primary and secondary instability are computed, and the transient growth is analysed. It is found that viscosity stratification can have different effects in each case.

Dependence of the large-scale vortex instability on latitude, stratification and domain size

In an earlier study, we reported on the excitation of large-scale vortices in Cartesian hydrodynamical convection models subject to rapid enough rotation. In that study, the conditions for the onset of the instability were investigated in terms of the Reynolds (Re) and Coriolis (Co) numbers in models located at the stellar North pole. In this study, we extend our investigation to varying domain sizes, increasing stratification, and place the box at different latitudes. The effect of the increasing box size is to increase the sizes of the generated structures, so that the principal vortex always fills roughly half of the computational domain. The instability becomes stronger in the sense that the temperature anomaly and change in the radial velocity are observed to be enhanced. The model with the smallest box size is found to be stable against the instability, suggesting that a sufficient scale separation between the convective eddies and the scale of the domain is required for the instability to work. The instability can be seen upto the colatitude of 30 degrees, above which value the flow becomes dominated by other types of mean flows. The instability can also be seen in a model with larger stratification. Unlike the weakly stratified cases, the temperature anomaly caused by the vortex structures is seen to depend on depth.

Linear stability, transient growth and the role of viscosity stratification in compressible Couette flow

Linear stability and the nonmodal transient energy growth in compressible plane Couette flow are investigated for two prototype mean flows: (a) the uniform shear flow with constant viscosity, and (b) the nonuniform shear flow with stratified viscosity. Both mean flows are linearly unstable for a range of supersonic Mach numbers (M). For a given M, the critical Reynolds number (Re) is significantly smaller for the uniform shear flow than its nonuniform shear counterpart; for a given Re, the dominant instability (over all streamwise wave numbers, α) of each mean flow belongs to different modes for a range of supersonic M. An analysis of perturbation energy reveals that the instability is primarily caused by an excess transfer of energy from mean flow to perturbations. It is shown that the energy transfer from mean flow occurs close to the moving top wall for “mode I” instability, whereas it occurs in the bulk of the flow domain for “mode II.” For the nonmodal transient growth analysis, it is shown that the maximum temporal amplification of perturbation energy, Gmax, and the corresponding time scale are significantly larger for the uniform shear case compared to those for its nonuniform counterpart. For α=0, the linear stability operator can be partitioned into L∼L̅ +Re2 Lp, and the Re-dependent operator Lp is shown to have a negligibly small contribution to perturbation energy which is responsible for the validity of the well-known quadratic-scaling law in uniform shear flow: G(t∕Re)∼Re2. In contrast, the dominance of Lp is responsible for the invalidity of this scaling law in nonuniform shear flow. An inviscid reduced model, based on Ellingsen-Palm-type solution, has been shown to capture all salient features of transient energy growth of full viscous problem. For both modal and nonmodal instability, it is shown that the viscosity stratification of the underlying mean flow would lead to a delayed transition in compressible Couette flow.

Does acoustic adaptation drive vertical stratification? A test in a tropical cricket assemblage

In species-rich assemblages, differential utilization of vertical space can be driven by resource availability. For animals that communicate acoustically over long distances under habitat-induced constraints, access to an effective transmission channel is a valuable resource. The acoustic adaptation hypothesis suggests that habitat acoustics imposes a selective pressure that drives the evolution of both signal structure and choice of calling sites by signalers. This predicts that species-specific signals transmit best in native habitats. In this study, we have tested the hypothesis that vertical stratification of calling heights of acoustically communicating species is driven by acoustic adaptation. This was tested in an assemblage of 12 coexisting species of crickets and katydids in a tropical wet evergreen forest. We carried out transmission experiments using natural calls at different heights from the forest floor to the canopy. We measured signal degradation using 3 different measures: total attenuation, signal-to-noise ratio (SNR), and envelope distortion. Different sets of species supported the hypothesis depending on which attribute of signal degradation was examined. The hypothesis was upheld by 5 species for attenuation and by 3 species each for SNR and envelope distortion. Only 1 species of 12 provided support for the hypothesis by all 3 measures of signal degradation. The results thus provided no overall support for acoustic adaptation as a driver of vertical stratification of coexisting cricket and katydid species.

Effect of port gas injection on in-cylinder stratification in a CNG fuelled SI engine

The concept of barrel stratification of air-fuel mixture is evaluated for a port gas injection (PGI) single cylinder spark ignition (SI) internal combustion (IC) engine using a transient three-dimensional computational fluid dynamic (CFD) model. The gaseous fuel used in the study is compressed natural gas (CNG). It is observed that compared to the premixed gas carburettor case, a substantial amount of in-cylinder stratification can be achieved with port gas injection system. A detailed parametric study is reported to understand the effect of the various injection parameters such as injection location, injection orientation, start of injection (SOT) and its duration, and injection rate. Furthermore, the best injection timing is evaluated for various load and speed cases. It is observed that the best stratification pattern can be achieved at 50% engine load. The injection location is observed to have a profound effect on the in-cylinder stratification pattern, and injection towards the side of the spark plug is observed to give a rich fuel-air mixture near the spark plug. It is also shown that there exists an optimal injection pressure.