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Background: Endovascular thrombectomy (EVT) has shown efficacy in acute ischemic stroke (AIS) patients with infective endocarditis (IE). The possibility to undertake advanced histopathological clot analysis following EVT offers a new avenue to establish the etiological basis of the stroke – which is often labelled “cryptogenic.” In this paper, we present our findings from four consecutive patients with IE who underwent EVT following an AIS at our tertiary referral comprehensive stroke centre. Methods: Comprehensive histopathological analysis of clot retrieved after EVT, including morphology, was undertaken. Results: The consistent observation was the presence of dense paucicellular fibrinoid material mixed/interspersed with clusters of bacterial cocci. This clot morphology may be specific to septic embolus due to IE unlike incidental bacteraemia and could possibly explain the refractoriness of such clots to systemic thrombolysis. Conclusion: Detailed morphological and histopathological analysis of EVT-retrieved clots including Gram staining can assist in etiological classification of the clot. Understanding the composition of the clot may be of clinical value in early diagnostics and mapping treatment planning in IE.
This article examines Buddhist and Jaina attitudes towards the salvation of the Magadhan king Ajātaśatru (alias Kūṇika), a narrative character found in both Buddhist and Jaina traditions. A number of Buddhist texts prophesy that Ajātaśatru, despite his next birth in hell, will attain liberation in his final birth. Jaina sources also speak of Kūṇika's descent into hell, but give no prophecy of his ultimate liberation. While the Buddhists offered various solutions to Ajātaśatru's sinful condition, the Jainas proposed no remedy to mitigate the consequences of Kūṇika's sins. The Buddhist prophecies of Ajātaśatru's eventual liberation indicate that some Buddhists in ancient India were particularly concerned with the salvation of an archetypal villain such as Ajātaśatru. The Jaina silence on Kūṇika's destiny suggests that the Jainas in general had little interest in bringing this violent figure to liberation, and deemed him incapable of overcoming his “false view of reality” (mithyātva) due to his strong passions.
The dynamic response to shear of a fluid-filled square cavity with stable temperature stratification is investigated numerically. The shear is imposed by the constant translation of the top lid, and is quantified by the associated Reynolds number. The stratification, quantified by a Richardson number, is imposed by maintaining the temperature of the top lid at a higher constant temperature than that of the bottom, and the side walls are insulating. The Navier–Stokes equations under the Boussinesq approximation are solved, using a pseudospectral approximation, over a wide range of Reynolds and Richardson numbers. Particular attention is paid to the dynamical mechanisms associated with the onset of instability of steady state solutions, and to the complex and rich dynamics occurring beyond.
The flow response of a rapidly rotating fluid-filled cube to low-amplitude librational forcing is investigated numerically. Librational forcing is the harmonic modulation of the mean rotation rate. The rotating cube supports inertial waves which may be excited by libration frequencies less than twice the rotation frequency. The response is comprised of two main components: resonant excitation of the inviscid inertial eigenmodes of the cube, and internal shear layers whose orientation is governed by the inviscid dispersion relation. The internal shear layers are driven by the fluxes in the forced boundary layers on walls orthogonal to the rotation axis and originate at the edges where these walls meet the walls parallel to the rotation axis, and are hence called edge beams. The relative contributions to the response from these components is obscured if the mean rotation period is not small enough compared to the viscous dissipation time, i.e. if the Ekman number is too large. We conduct simulations of the Navier–Stokes equations with no-slip boundary conditions using parameter values corresponding to a recent set of laboratory experiments, and reproduce the experimental observations and measurements. Then, we reduce the Ekman number by one and a half orders of magnitude, allowing for a better identification and quantification of the contributions to the response from the eigenmodes and the edge beams.
Salt, promoting oxidative stress, contributes to insulin resistance, whereas K, inhibiting oxidative stress, improves insulin sensitivity. Oxidative stress activation of NLRP3 inflammasome is a central player in the induction of insulin resistance. Therefore, we hypothesised that NLRP3 inflammasome may mediate the effects of salt and K on insulin resistance. In all, fifty normotensive subjects were recruited from a rural community of Northern China. The protocol included a low-salt diet for 7 d, then a high-salt diet for 7 d and a high-salt diet with K supplementation for another 7 d. In addition, THP-1 cells were cultured in different levels of Na with and without K. The results showed that salt loading elevated fasting blood glucose, insulin and C-peptide levels, as well as insulin resistance, whereas K supplementation reversed them. Meanwhile, additional K reversed the active effects of high salt on NLRP3 inflammasome in both the subjects and THP-1 cells, and the change of insulin resistance index notably related with the alteration of plasma IL-1β, the index of NLRP3 inflammasome activation, during intervention in the subjects. Additional K ameliorated oxidative stress induced by high salt in both the subjects and cultured THP-1 cells, and the change of oxidative stress related with the alteration of plasma IL-1β during intervention in the subjects. In vitro, antioxidant N-acetyl-l-cysteine significantly prevented the active effects of high Na or oxidant Rosup on NLRP3 inflammasome, so did K. Our study indicates that oxidative stress modulation of NLRP3 inflammasome may be involved in the impacts of Na and K on insulin resistance.
In a previous paper, an inviscid vortex force map approach was developed for the normal force of a flat plate at arbitrarily high angle of attack and leading/trailing edge force-producing critical regions were identified. In this paper, this vortex force map approach is extended to viscous flows and general airfoils, for both lift and drag forces due to vortices. The vortex force factors for the vortex force map are obtained here by using Howe’s integral force formula. A decomposed form of the force formula, ensuring vortices far away from the body have negligible effect on the force, is also derived. Using Joukowsky and NACA0012 airfoils for illustration, it is found that the vortex force map for general airfoils is similar to that of a flat plate, meaning that force-producing critical regions similar to those of a flat plate also exist for more general airfoils and for viscous flow. The vortex force approach is validated against NACA0012 at several angles of attack and Reynolds numbers, by using computational fluid dynamics.
This study aimed to determine the effects of supplementing the diet of adult Nile tilapia Oreochromis niloticus with phosphatidylcholine (PC) on growth performance, body composition, fatty acid composition and gene expression. Genetically Improved Farmed Tilapia fish with an initial body weight of 83·1 (sd 2·9) g were divided into six groups. Each group was hand-fed a semi-purified diet containing 1·7 (control diet), 4·0, 6·5, 11·5, 21·3 or 41·0 g PC/kg diet for 68 d. Supplemental PC improved the feed efficiency rate, which was highest in the 11·5 g PC/kg diet. Weight gain and specific growth rate were unaffected. Dietary PC increased PC content in the liver and decreased crude fat content in the liver, viscera and body. SFA and MUFA increased and PUFA decreased in muscle with increasing dietary PC. Cytoplasmic phospholipase A2 and secreted phospholipase A2 mRNA expression were up-regulated in the brain and heart in PC-supplemented fish. PC reduced fatty acid synthase mRNA expression in the liver and visceral tissue but increased expression in muscle. Hormone-sensitive lipase and lipoprotein lipase expression increased in the liver with increasing dietary PC. Growth hormone mRNA expression was reduced in the brain and insulin-like growth factor-1 mRNA expression in liver reduced with PC above 6·5 g/kg. Our results demonstrate that dietary supplementation with PC improves feed efficiency and reduces liver fat in adult Nile tilapia, without increasing weight gain, representing a novel dietary approach to reduce feed requirements and improve the health of Nile tilapia.
Soft X-ray spectro-tomography provides three-dimensional (3D) chemical mapping based on natural X-ray absorption properties. Since radiation damage is intrinsic to X-ray absorption, it is important to find ways to maximize signal within a given dose. For tomography, using the smallest number of tilt series images that gives a faithful reconstruction is one such method. Compressed sensing (CS) methods have relatively recently been applied to tomographic reconstruction algorithms, providing faithful 3D reconstructions with a much smaller number of projection images than when conventional reconstruction methods are used. Here, CS is applied in the context of scanning transmission X-ray microscopy tomography. Reconstructions by weighted back-projection, the simultaneous iterative reconstruction technique, and CS are compared. The effects of varying tilt angle increment and angular range for the tomographic reconstructions are examined. Optimization of the regularization parameter in the CS reconstruction is explored and discussed. The comparisons show that CS can provide improved reconstruction fidelity relative to weighted back-projection and simultaneous iterative reconstruction techniques, with increasingly pronounced advantages as the angular sampling is reduced. In particular, missing wedge artifacts are significantly reduced and there is enhanced recovery of sharp edges. Examples of using CS for low-dose scanning transmission X-ray microscopy spectroscopic tomography are presented.
Palivizumab is the standard immunoprophylaxis against serious disease due to respiratory syncytial virus infection. Current evidence-based prophylaxis guidelines may not address certain children with CHD within specific high-risk groups or clinical/management settings.
An international steering committee of clinicians with expertise in paediatric heart disease identified key questions concerning palivizumab administration; in collaboration with an additional international expert faculty, evidence-based recommendations were formulated using a quasi-Delphi consensus methodology.
Palivizumab prophylaxis was recommended for children with the following conditions: <2 years with unoperated haemodynamically significant CHD, who are cyanotic, who have pulmonary hypertension, or symptomatic airway abnormalities; <1 year with cardiomyopathies requiring treatment; in the 1st year of life with surgically operated CHD with haemodynamically significant residual problems or aged 1–2 years up to 6 months postoperatively; and on heart transplant waiting lists or in their 1st year after heart transplant. Unanimous consensus was not reached for use of immunoprophylaxis in children with asymptomatic CHD and other co-morbid factors such as arrhythmias, Down syndrome, or immunodeficiency, or during a nosocomial outbreak. Challenges to effective immunoprophylaxis included the following: multidisciplinary variations in identifying candidates with CHD and prophylaxis compliance; limited awareness of severe disease risks/burden; and limited knowledge of respiratory syncytial virus seasonal patterns in subtropical/tropical regions.
Evidence-based immunoprophylaxis recommendations were formulated for subgroups of children with CHD, but more data are needed to guide use in tropical/subtropical countries and in children with certain co-morbidities.
The designs of inertial confinement fusion (ICF) targets, which field on ShenGuang III, are becoming more complex and more stringent in terms of assembly precision. A key specification of these targets is the spatial angle alignment accuracy. To meet these needs, we present a new spatial angle assembly method, using target part’s 3D model-based dual orthogonal camera vision, which is better suited for the flexible automation of target assembly processes. The two-hands structure micromanipulate system and dual orthogonal structure visual feedback system were investigated by considering the kinematics, spatial angle measuring, and motion control in an integrated way. In this paper, we discuss the measurement accuracy of spatial angle assembly method, which compared the real-time image acquisition with the redrawing 2D projection. The result shows that the assembly method proposed is very effective and meets the requirements of angle assembly accuracy, which is less than
. Also, this work is expected to contribute greatly to the advancement of other target microassembly equipments.
The vortex force is studied for a flat plate at arbitrarily large angle of attack. A suitable vortex force approach, adapted from a previous work, is used to study the vortex force and to build a vortex force line map to identify the force effect of any potential vortex. This map can be used exactly for a potential point vortex and approximately for a concentrated leading-edge vortex (LEV) or trailing-edge vortex (TEV); the latter are shown to have a non-potential vortex core. By means of this map, we identify a force-producing critical region, due to pressure suction, above the front and rear parts of the plate for an LEV and a TEV, respectively. The impulsively started flow problem is used as an application, with validation by computational fluid dynamics. The force variation in time is decomposed into four repeatable stages (force release, force enhancement, stall and force recovery) in close relation to the individual and combined effect by an LEV and a TEV. A pressure distribution analysis shows that force enhancement is due to pressure suction by an LEV, while stall and force recovery are respectively due to the upwash effect (which reduces the pressure below the plate) of a new TEV right off the plate and the pressure suction of this TEV having now moved above the plate. A viscous effect causes a small-amplitude oscillation on the force curves by promoting multiple small-scale LEVs.
The purpose of this study is to highlight the effectiveness and necessity of the computational methods applications for architecture conceptual designs and improve the use of advanced simulation tools in urban planning. The results can provide the urban designers, planners and other decision makers with useful design information for assessing human wind comfort of the surrounding open spaces of public buildings in an urban area. Among different kinds of public buildings, museum architecture is of significant social value and importance for the augmentation of urban image. Using the Guggenheim Museum Bilbao for the case study, this investigation performed CFD simulations of the airflow over the museum to characterize the wind environments around the buildings. The predicted wind speed distributions were used to determine the wind comfort level of the featured spots around the museum for evaluating the suitability allowing visitors to sit or stand at the pedestrian plane for extended periods.
This study investigated the effects of glycinin on the growth, intestinal oxidative status, tight junction components, cytokines and apoptosis signalling factors of fish. The results showed that an 80 g/kg diet of glycinin exposure for 42 d caused poor growth performance and depressed intestinal growth and function of juvenile Jian carp (Cyprinus carpio var. Jian). Meanwhile, dietary glycinin exposure induced increases in lipid peroxidation and protein oxidation; it caused reductions in superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx) activities; and it increased MnSOD, CuZnSOD, GPx1b and GPx4a mRNA levels, suggesting an adaptive mechanism against stress in the intestines of fish. However, dietary glycinin exposure decreased both the activity and mRNA levels of nine isoforms of glutathione-S-transferase (GST) (α, μ, π, ρ, θ, κ, mGST1, mGST2 and mGST3), indicating toxicity to this enzyme activity and corresponding isoform gene expressions. In addition, glycinin exposure caused partial disruption of intestinal cell–cell tight junction components, disturbances of cytokines and induced apoptosis signalling in the distal intestines>mid intestines>proximal intestines of fish. Glycinin exposure also disturbed the mRNA levels of intestinal-related signalling factors Nrf2, Keap1a, Keap1b, eleven isoforms of protein kinase C and target of rapamycin/4E-BP. Interestingly, glutamine was observed to partially block those negative influences. In conclusion, this study indicates that dietary glycinin exposure causes intestinal oxidative damage and disruption of intestinal physical barriers and functions and reduces fish growth, but glutamine can reverse those negative effects in fish. This study provides some information on the mechanism of glycinin-induced negative effects.
This study amends the inviscid Wagner lift model for starting flow at relatively large angles of attack to account for the influence of additional leading edge and trailing edge vortices. Two methods are provided for starting flow of a flat plate. The first method is a modified Wagner function, which assumes a planar trajectory of the trailing edge vortex sheet accounting for a temporal offset from the original Wagner function given release of leading edge vortices and a concentrated starting point vortex at the initiation of motion. The second method idealizes the trailing edge sheet as a series of discrete vortices released sequentially. The models presented are shown to be in good agreement with high-fidelity simulations. Through the present theory, a vortex force line map is generated, which clearly indicates lift enhancing and reducing directions and, when coupled with streamlines, allows one to qualitatively interpret the effect of the sign and position of vortices on the lift and to identify the origins of lift oscillations and peaks. It is concluded that leading edge vortices close to the leading edge elevate the Wagner lift curve while a strong leading edge vortex convected to the trailing edge is detrimental to lift production by inducing a strong trailing edge vortex moving in the lift reducing direction. The vortex force line map can be employed to understand the effect of the different vortices in other situations and may be used to improve vortex control to enhance or reduce the lift.