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Roundabouts promise potential safety and efficiency benefits in the homogenous environment of conventional vehicles. However, their performance can deteriorate if high and/or imbalanced traffic exists. The advent of connected and automated vehicles (CAVs) has provided great opportunities to make transportation infrastructures more efficient. The purpose of this study is to develop a model to optimally control CAVs at roundabouts under a fully CAV environment. A two‐stage optimization model is proposed to optimize vehicle trajectories. At the first stage, a mixed‐integer linear programming model is formulated that optimizes vehicle arrival time at the roundabout. Then the optimal arrival time is fed to the second stage model to optimize vehicle trajectories, which is a non‐linear programming model. CAVs are guaranteed to pass the roundabout safely without stops. Simulation tests are carried out with different demand levels and turning ratios. To evaluate the performance of the proposed model, delay and throughput are compared with a conventional strategy in which the roundabout is controlled by the yielding rules. Sensitivity analysis is conducted to investigate the impact of control zone length and roundabout diameters. The results show the advantages of the proposed model in terms of delay and throughput in both high and imbalanced traffic.

Efforts to cure HIV have focused on reactivating latent proviruses to enable elimination by CD8+ cytotoxic T-cells. Clinical studies of latency reversing agents (LRA) in individuals treated with antiretroviral therapy (ART) have shown increases in HIV transcription, but without reductions in virologic measures, or evidence that HIV-specific CD8+ T-cells were productively engaged. Here, we show that the SARS-CoV-2 mRNA vaccine BNT162b2 activates the RIG-I/TLR – TNF – NFκb axis, resulting in transcription of HIV proviruses with minimal perturbations of T-cell activation and host transcription. T-cells specific for the early gene-product HIV-Nef uniquely increased in frequency and acquired effector functon(granzyme-B) in ART-treated individuals following SARS-CoV-2 mRNA vaccination. These parameters of CD8+ T-cell induction correlated strongly with significant decreases in cell-associated HIV mRNA, suggesting killing or suppression of cells transcribing HIV. These results are, to our knowledge, the first observation of an intervention-induced reduction in a measure of HIV persistence, accompanied by precise immune correlates, in ART-suppressed individuals. However, we did not observe significant depletions of intact proviruses, underscoring challenges to achieving (or measuring) HIV reservoir reductions. Overall, our results support prioritizing the measurement of granzyme-B-producing Nef-specific responses in latency reversal studies and add impetus to developing HIV-targeted mRNA therapeutic vaccines that leverage built-in LRA activity.

Introduction: The aim of this study is evaluation of chin deformities and their role in rhinoplasty cosmetic surgery outcomes via photogrammetry of chin. Materials and Methods: The study is a cross sectional one. All photos of rhinoplasty surgery candidates of three hospitals (Amir Aalam, Imam Khomeini and Razi of Tehran) which were taken in standard lateral position via SLR cameras were assessed through Adobe Photoshop CS, in order to determine four different aesthetic measurements. Except for excluded photos due to our excluding criteria or technical problems, all photographs were evaluated carefully. Results: 144 photos of patients were enrolled. The oldness of patients ranges between below 20 up to above; 65.99 patients were female (68.8%) and 45 were male. 73 patients (50.7%) had an abnormal silver condition. Moreover 9 patients (6.3%) with abnormal nasomental, 124 patients with abnormal status of Gonzalez-Ulloa (93.8%), 63 patients (43.8%) with unusual status of Ricketts’ E line/upper and 49 patients (34%) with abnormal Ricketts’ E line/lower status can be demonstrated. Discussion: Performing a photogrammetric study for candidates of cosmetic rhinoplasty also a chin examination as a mandatory preoperative assessment seems to be essential. Due to the lack of studies in this field, more studies are necessary.

Background Hyperacusis can be defined as an intolerance of certain everyday sounds, which are perceived as too loud or uncomfortable and which cause significant distress and impairment in the individual's day-to-day activities. It is important to assess symptoms of sound intolerance and their impact on the patient's life, so as to evaluate the need for treatment and to assess the effectiveness of treatments. Purpose The aim was to evaluate the psychometric properties of the Hyperacusis Impact Questionnaire (HIQ), and the Sound Sensitivity Symptoms Questionnaire (SSSQ). The 8-item HIQ focuses on assessing the impact of hyperacusis on the patient, while the 5-item SSSQ is designed to assess the type and severity of sound intolerance symptoms. Research Design This was a retrospective cross-sectional study. Study Sample In total, 266 consecutive patients who attended a Tinnitus and Hyperacusis Therapy Clinic in the United Kingdom within a 6-month period. Fifty-five percent were female. The average age was 54 years (standard deviation = 16 years). Data Collection and Analysis Data were collected retrospectively from the records of patients held at the audiology department. Audiological measures were pure-tone audiometry and Uncomfortable Loudness Levels (ULLs). Questionnaires administered in addition to the HIQ and SSSQ were: Tinnitus Handicap Inventory, Hyperacusis Questionnaire (HQ), and Screening for Anxiety and Depression in Tinnitus. Results Exploratory factor analysis suggested one-factor solutions for both the HIQ and SSSQ. Multiple-causes multiple-indicators (MIMIC) models showed some small influences of gender but negligible effects of age for both the HIQ and SSSQ. Receiver Operating Characteristic (ROC) analysis showed no significant effects of covariates on the ROC curves. Cronbach's α was 0.93 for the HIQ, and 0.87 for the SSSQ, indicating high internal consistency. Convergent validity was supported by moderate correlations between HQ and HIQ scores and between SSSQ scores and ULLs. Conclusion The HIQ and SSSQ are internally consistent questionnaires that can be used in clinical and research settings.

Background and Purpose The aim of this study was to assess whether the severity of tinnitus, as measured using ratings of tinnitus loudness, annoyance, and effect on life, was influenced by the lockdown related to the coronavirus disease 2019 (COVID-19) pandemic. Research Design This was a retrospective study. Study Sample The data for 105 consecutive patients who were seen at a tinnitus clinic in an audiology department in the United Kingdom during the COVID-19 lockdown between April and June 2020 and 123 patients seen in the same period of the previous year, prior to the COVID-19 pandemic were included. Data Collection Demographic data for the patients, results of their pure-tone audiometry, and their score on visual analog scale (VAS) of tinnitus loudness, annoyance, and effect on life were imported from their records held at the audiology department. This was a retrospective survey comparing ratings on the VAS of tinnitus loudness, annoyance, and effect on life for consecutive patients seen during the COVID-19 lockdown and consecutive patients seen in the same period of the previous year, prior to the COVID-19 pandemic. Patients seen prior to lockdown used a pen and paper version of the VAS, while the patients who were assessed during the COVID-19 lockdown used an adapted version of the VAS, via telephone. All patients were seeking help for their tinnitus for the first time. Results The mean scores for tinnitus loudness, annoyance, and effect on life did not differ significantly for the groups seen prior to and during lockdown. Conclusion Any changes in psychological well-being or stress produced by the lockdown did not significantly affect ratings of the severity of tinnitus.

Staphylococcus aureus (SA) and especially methicillin-resistant staphylococcus aureus (MRSA) remains a major cause of healthcare-associated infections worldwide. Health care workers (HCWs) may act as reservoirs for transmission of MRSA to patients and other HCWs. The aim of this systematic review was to investigate the prevalence of SA and MRSA colonization among HCWs in Iran. The used keywords for searching were: “Iran”, “S. aureus” and “MRSA” conducted in PubMed, and Google Scholar, and two national scientific databases and proceedings of recent national conferences. The studies related to SA or MRSA prevalence in Iran published from 1993 to 2018 were included for review. Meta-analysis was performed using the Open Meta (Analyst) software. Results showed that the prevalence of SA among HCWs was 26% (95% CI=19.4-32.6%). The ratios of MRSA/total isolated SA and MRSA/total HCWs were obtained 35.4% (95% CI=29.6-41.1%) and 7.6% (95% CI= 6.4-8.8%), respectively. Older studies showed a higher prevalence compared to recent studies. The prevalence of nasal MRSA carriage among Iranian HCWs was in a range between the rates reported in the U.S/European and African countries.

This article presents an ac energy measurement frontend on 0.18 $\mu $ CMOS with integrated, condition-based monitoring capability that can continuously monitor and report on the accuracy of the full measurement system, including the external current and voltage sensors, without interruption of the measurement used for billing. This is achieved using a highly stable, digitally controlled, adaptive background accuracy monitoring (ABAM) system, which injects a small, known signal into the sensors and extracts it using digital signal processing, in the background while normal measurement is ongoing. The realized system is an energy metering frontend that can be used for utility metering applications capable of measuring rms current to 0.1% accuracy over a 1000:1 dynamic range and active energy to 0.25% accuracy over a 5000:1 dynamic range over the full supply and temperature range, while continuously monitoring the system accuracy in the background. The ABAM signal references and drivers used for monitoring the current and voltage channels independently achieve an absolute accuracy in the order of 0.1%, and the full ABAM system has been shown to track the relative accuracy of the full meter when subjected to interference and when trialed in the field to 0.1%.

Background Retrospective studies suggested that storage age of RBCs is associated with inflammation and thromboembolism. The Red Cell Storage Duration Study (RECESS) trial randomized subjects undergoing complex cardiac surgery to receive RBCs stored for shorter versus longer periods, and no difference was seen in the primary outcome of change in multiple organ dysfunction score. Study design and methods In the current study, 90 subjects from the RECESS trial were studied intensively using a range of hemostasis, immunologic, and nitric oxide parameters. Samples were collected before transfusion and on Days 2, 6, 28, and 180 after transfusion. Results Of 71 parameters tested, only 4 showed a significant difference after transfusion between study arms: CD8+ T-cell interferon-γ secretion and the concentration of extracellular vesicles bearing the B-cell marker CD19 were higher, and plasma endothelial growth factor levels were lower in recipients of fresh versus aged RBCs. Plasma interleukin-6 was higher at Day 2 and lower at Days 6 and 28 in recipients of fresh versus aged RBCs. Multiple parameters showed significant modulation after surgery and transfusion. Most analytes that changed after surgery did not differ based on transfusion status. Several extracellular vesicle markers, including two associated with platelets (CD41a and CD62P), decreased in transfused patients more than in those who underwent surgery without transfusion. Conclusions Transfusion of fresh versus aged RBCs does not result in substantial changes in hemostasis, immune, or nitric oxide parameters. It is possible that transfusion modulates the level of platelet-derived extracellular vesicles, which will require study of patients randomly assigned to receipt of transfusion to define.

Antiretroviral therapies (ARTs) abrogate HIV replication; however, infection persists as long-lived reservoirs of infected cells with integrated proviruses, which reseed replication if ART is interrupted. A central tenet of our current understanding of this persistence is that infected cells are shielded from immune recognition and elimination through a lack of antigen expression from proviruses. Efforts to cure HIV infection have therefore focused on reactivating latent proviruses to enable immune-mediated clearance, but these have yet to succeed in reducing viral reservoirs. Here, we revisited the question of whether HIV reservoirs are predominately immunologically silent from a new angle: by querying the dynamics of HIV-specific T cell responses over long-term ART for evidence of ongoing recognition of HIV-infected cells. In longitudinal assessments, we show that the rates of change in persisting HIV Nef-specific responses, but not responses to other HIV gene products, were associated with residual frequencies of infected cells. These Nef-specific responses were highly stable over time and disproportionately exhibited a cytotoxic, effector functional profile, indicative of recent in vivo recognition of HIV antigens. These results indicate substantial visibility of the HIV-infected cells to T cells on stable ART, presenting both opportunities and challenges for the development of therapeutic approaches to curing infection.

McCann et al. describe the development and characterization of a new mouse model for studying HIV-specific T cell responses and testing various immunotherapeutic strategies, which they validate by demonstrating enhanced therapeutic effects of autologous HIV-specific T cells augmented with cytokine-loaded nanogels., HIV-specific CD8+ T cells partially control viral replication and delay disease progression, but they rarely provide lasting protection, largely due to immune escape. Here, we show that engrafting mice with memory CD4+ T cells from HIV+ donors uniquely allows for the in vivo evaluation of autologous T cell responses while avoiding graft-versus-host disease and the need for human fetal tissues that limit other models. Treating HIV-infected mice with clinically relevant HIV-specific T cell products resulted in substantial reductions in viremia. In vivo activity was significantly enhanced when T cells were engineered with surface-conjugated nanogels carrying an IL-15 superagonist, but it was ultimately limited by the pervasive selection of a diverse array of escape mutations, recapitulating patterns seen in humans. By applying mathematical modeling, we show that the kinetics of the CD8+ T cell response have a profound impact on the emergence and persistence of escape mutations. This “participant-derived xenograft” model of HIV provides a powerful tool for studying HIV-specific immunological responses and facilitating the development of effective cell-based therapies.

Antiretroviral therapies (ART) durably suppress HIV replication to undetectable levels – however, infection persists in the form of long-lived reservoirs of infected cells with integrated proviruses, that re-seed systemic replication if ART is interrupted. A central tenet of our current understanding of this persistence is that infected cells are shielded from immune recognition and elimination through a lack of antigen expression from proviruses. Efforts to cure HIV infection have therefore focused on reactivating latent proviruses to enable immune-mediated clearance, but these have yet to succeed in driving reductions in viral reservoirs. Here, we revisited the question of whether HIV reservoirs are predominately immunologically silent from a new angle, by querying the dynamics of HIV-specific T-cell responses over long-term ART for evidence of ongoing recognition of HIV-infected cells. We show that T-cell responses to autologous reservoir viruses persist over years, and that the maintenance of HIV-Nef-specific responses was uniquely associated with residual frequencies of infected cells. These responses disproportionately exhibited a cytotoxic, effector functional profile, indicative of recent in vivo recognition of HIV-infected cells. These results indicate substantial visibility of the HIV reservoir to T-cells on stable ART, presenting both opportunities and challenges for the development of therapeutic approaches to curing HIV infection.

Purpose of review 'Broadly neutralizing antibodies' (bNAbs), are rare HIV-specific antibodies which exhibit the atypical ability to potently neutralize diverse viral isolates. While efforts to elicit bNAbs through vaccination have yet to succeed, recent years have seen remarkable preclinical and clinical advancements of passive immunization approaches targeting both HIV prevention and cure. We focus here on the potential to build upon this success by moving beyond neutralization to additionally harness the diverse effector functionalities available to antibodies via fragment crystallizable-effector (Fc) functions. Recent findings Recent studies have leveraged the ability to engineer bNAb Fc domains to either enhance or abrogate particular effector functions to demonstrate that activities such as antibody-dependent cell-mediated cytotoxicity contribute substantially to in-vivo antiviral activity. Intriguingly, recent studies in both nonhuman primates and in humans have suggested that passive bNAb infusion can lead to durable immunity by enhancing virus-specific T-cell responses through a 'vaccinal effect'. Summary The combination of antibody engineering strategies designed to enhance effector functions, with the broad and potent antigen recognition profile of bNAbs, has the potential to give rise to powerful new therapeutics for HIV. We aim to provide a timely review of recent advances to catalyze this development.

The continuing spread of HIV/AIDS is predominantly fueled by sexual exposure to HIV-contaminated semen. Seminal plasma (SP), the liquid portion of semen, harbors a variety of factors that may favor HIV transmission by facilitating viral entry into host cells, eliciting the production of proinflammatory cytokines, and enhancing the translocation of HIV across the genital epithelium. One important and abundant class of factors in SP is extracellular vesicles (EVs), which, in general, are important intercellular signal transducers. Although numerous studies have characterized blood plasma-derived EVs from both uninfected and HIV-infected individuals, little is known about the properties of EVs from the semen of HIV-infected individuals. We report here that fractionated SP enriched for EVs from HIV-infected men induces potent transcriptional responses in epithelial and stromal cells that interface with the luminal contents of the female reproductive tract. Semen EV fractions from acutely infected individuals induced a more proinflammatory signature than those from uninfected individuals. This was not associated with any observable differences in the surface phenotypes of the vesicles. However, microRNA (miRNA) expression profiling analysis revealed that EV fractions from infected individuals exhibit a broader and more diverse profile than those from uninfected individuals. Taken together, our data suggest that SP EVs from HIV-infected individuals exhibit unique miRNA signatures and exert potent proinflammatory transcriptional changes in cells of the female reproductive tract, which may facilitate HIV transmission. IMPORTANCE Seminal plasma (SP), the major vehicle for HIV, can modulate HIV transmission risk through a variety of mechanisms. Extracellular vesicles (EVs) are extremely abundant in semen, and because they play a key role in intercellular communication pathways and immune regulation, they may impact the likelihood of HIV transmission. However, little is known about the properties and signaling effects of SP-derived EVs in the context of HIV transmission. Here, we conduct a phenotypic, transcriptomic, and functional characterization of SP and SP-derived EVs from uninfected and HIV-infected men. We find that both SP and its associated EVs elicit potent proinflammatory transcriptional responses in cells that line the genital tract. EVs from HIV-infected men exhibit a more diverse repertoire of miRNAs than EVs from uninfected men. Our findings suggest that EVs from the semen of HIV-infected men may significantly impact the likelihood of HIV transmission through multiple mechanisms.

This paper presents two approaches towards quantifying short‐term crude oil supply uncertainty. It provides some background information on the oil market and discusses different methods used in forecasting supply. Both approaches—semiquantitative (SQ) and Monte Carlo (MC)—are based on a risk matrix with likelihood and severity scores assigned. The result of the SQ approach is a risk band presented in percentage terms, whereas the MC method yields a probability distribution. The differences, advantages and disadvantages, as well as the potential expansions of both approaches are discussed. Both methods are applied to a set of major non‐OPEC oil producing countries, and the obtained results are compared.

OBJECTIVES/GOALS: HIV-specific CD8+ T-cells play a critical role in partially controlling viral replication in infected-individuals, but ultimately fail to eliminate infection. Enhancing these T-cell responses through lymphocyte engineering approaches has the potential as a novel therapy capable of achieving durable control or eradication of infection. METHODS/STUDY POPULATION: IL-15 Superagonist (IL-15SA) potently supports the in vivo persistence and antiviral activity of adoptively transferred CD8+ T-cells. The Deep-PrimingTM technology platform, developed by Torque, allows for loading of immunomodulators onto the surface of T-cells via electrostatic ‘nanogels’, which slowly release to deliver sustained autocrine immune stimulation without the harmful effects of systemic exposure. Here, we investigate the impact of IL-15SA Deep-Priming on HIV-specific CD8+ T-cells in a humanized mouse model of HIV infection. Humanized mice were generated by engrafting NOD-scid-IL2Rgnull mice with memory CD4+ T-cells isolated from an ARV-suppressed HIV+ donor. An autologous HIV-specific Cytotoxic T-Lymphocyte (CTL) clone was isolated, and killing potential confirmed. Four weeks post humanization, mice were infected with HIV and received an infusion of unmodified HIV-Specific CTLs, or IL-15SA Deep-Primed HIV-specific CTLs (CTL-DP). T-cell numbers and plasma viral loads were quantified weekly by flow cytometry and qRT-PCR. RESULTS/ANTICIPATED RESULTS: Mice receiving unmodified CTLs trended toward reduced viral loads compared to the No Treatment condition, while mice receiving CTL-DP saw significant, 2-Log10 reductions in VL (p < 0.01). At 41 days post-infection 100% (5/5) of the No Treatment, 66.7% (4/6) of the CTL treatment, and 16.7% (1/6) of CTL-DP treatment mice had detectable viremia. IL-15SA Deep-Priming increased CTL expansion and persistence in peripheral blood which correlated with improved CD4+T-cell preservation. DISCUSSION/SIGNIFICANCE OF IMPACT: Here we demonstrate the first in vivo analysis of IL-15SA Deep-Priming of HIV-Specific CTLs. These data suggest that Deep-Priming of patient T-cells can enhance in vivo function and persistence, leading to improved viral suppression; a significant advancement in the field of HIV cure research. CONFLICT OF INTEREST DESCRIPTION: Austin Boesch, Thomas Andresen, and Douglas Jones are employees of Torque. Darrell Irvine is a co-founder of Torque and Chairman of Torque’s Scientific Advisory Board.

Background Several retrospective studies have suggested that transfusion with red blood cells (RBCs) stored for longer periods is associated with increased mortality. The Age of Blood Evaluation (ABLE) study randomized subjects to receive fresh vs. standard issue RBC units and showed no difference in the primary or secondary endpoints of mortality or change in multi-organ dysfunction syndrome (MODS) score. Methods In this study a subset of 100 ABLE subjects were enrolled to measure coagulation and immune parameters. Samples were collected pre-transfusion and on days 2, 6, 28, and 180 post-transfusion. Levels of 16 coagulation parameters, regulatory and functional T cells, 25 cytokines, and 16 markers of extracellular vesicles (EVs) were determined. Results Changes from baseline in levels of protein C, factor V, and EVs expressing phosphatidyl serine and CTLA-4 (CD152) differed between recipients of fresh and standard storage age RBC units, with the vast majority of coagulation and EV markers and all cytokines tested showing no difference between study arms. Although most analytes showed no difference between subjects in the fresh and standard arms of the study, 6 coagulation parameters, 15 cytokines, and 7 EV parameters changed significantly in the period post-transfusion. Discussion Transfusion of fresh vs. standard issue RBC units does not result in substantial changes in coagulation or immune parameters, up to day 35 of RBC storage. Furthermore, significant changes in multiple coagulation and immune parameters are detectable post-transfusion, though causality cannot be determined based on the current study.

Background: Historically, burn injuries have been accompanied by bad prognosis. With the advances in recovering fluids and the early excision of burn scars, the survival rate has increased for severe burn patients. Objectives: The study aimed to analyze the epidemiology of burn injuries in Zahedan, Eastern Iran. Patients and Methods: This retrospective study examined 2173 burn patients for eight years. The research data were extracted from patients’ files and analyzed by SPSS 22 using the chi square test, t test and ANOVA. Results: In sum, out of 2173 files, 2115 files were analyzed. About two-thirds (71%) of burns were due to flame, one-fifth (21.2%) to boiling water, and 8% to other means. There was a significant relationship between patients’ age, gender, burn percentage, burn degree, burn cause, burn occurrence season, hospitalization duration, and addiction or non-addiction status with rate of death (P < 0.001). Conclusions: In this region of Iran, burn is influenced by families’ culture, economy, urban service level, workplace, home heating devices, type of people’s clothing, and awareness. The statistical analysis of the existing data completely indicated the epidemiology of burns in Eastern Iran.

Millions of utility electricity meters are deployed globally to determine billable energy consumption. These devices are factory calibrated, and then perform measurement without interruption over their lifetime. Once in the field their accuracy is unknown due to component aging and high voltage/current events [1]. Meters are periodically replaced as a preventive measure, leading to the unnecessary replacement of perfectly good meters while some inaccurate meters may remain in field. This paper presents an energy-measurement front-end that enables continuous background Condition Base Monitoring (CbM) over the lifetime of a meter. Crucially it monitors the performance of its voltage and current sensors, which are typically the largest sources of inaccuracy and drift. During normal operation, small test signals (“stimuli”), with adaptable but well-defined characteristics are injected into the sensors. Their amplitudes at the front-end’s output are then extracted to determine the gain accuracy of the full signal chain. In order to do this, the system must meet 3 main challenges. First, it must be able to generate and inject highly stable and accurate stimuli signals into the sensors. Second, it must have a wide dynamic range in order to accurately extract the stimuli in the presence of unknown and significantly larger load signals. Third, it must incorporate all the digital signal processing involved with stimuli signal selection, extraction and removal. This paper describes the circuit techniques used to address the first two challenges.

Background Although a majority of the studies conducted to date on platelet (PLT) storage have been focused on PLT hemostatic function, the effects of 4°C PLTs on regulation of endothelial barrier permeability are still not known. In this study, we compared the effects of room temperature (22°C) stored and (4°C) stored PLTs on the regulation of vascular endothelial cell (EC) permeability in vitro and in vivo. Study design and methods Day 1, Day 5, and Day 7 leukoreduced apheresis PLTs stored at 4 or 22°C were studied in vitro and in vivo. In vitro, PLT effects on EC permeability and barrier function, adhesion, and impedance aggregometry were investigated. In vivo, using a mouse model of vascular leak, attenuation of vascular leak and circulating PLT numbers were measured. Results Treatment of EC monolayers with Day 5 or Day 7 PLTs, stored at both 22°C and 4°C, resulted in similar decreases in EC permeability on average. However, analysis of individual samples revealed significant variation that was donor dependent. Additional in vitro measurements revealed a decrease in inflammatory mediators, nonspecific PLT-endothelial aggregation and attenuated loss of aggregation over time to TRAP, ASPI, ADP, and collagen with 4°C storage. In mice, while 22°C and 4°C PLTs both demonstrated significant protection against vascular endothelial growth factor A (VEGF-A)-induced vascular leak 22°C PLTs exhibited increased protection compared to 4°C PLTs. Systemic circulating levels of 4°C PLTs were decreased compared to 22°C PLTs. Conclusions In vitro, 4°C-stored PLTs exhibit a greater capacity to inhibit EC permeability than 22°C-stored PLTs. In vivo, 22°C PLTs provide superior control of vascular leak induced by VEGF-A. This discrepancy may be due to increased clearance of 4°C PLTs from the systemic circulation.

BACKGROUND: Retrospective studies suggested that storage age of RBCs is associated with inflammation and thromboembolism. The Red Cell Storage Duration Study (RECESS) trial randomized subjects undergoing complex cardiac surgery to receive RBCs stored for shorter versus longer periods, and no difference was seen in the primary outcome of change in multiple organ dysfunction score. STUDY DESIGN AND METHODS: In the current study, 90 subjects from the RECESS trial were studied intensively using a range of hemostasis, immunologic, and nitric oxide parameters. Samples were collected before transfusion and on Days 2, 6, 28, and 180 after transfusion. RESULTS: Of 71 parameters tested, only 4 showed a significant difference after transfusion between study arms: CD8+ T-cell interferon-γ secretion and the concentration of extracellular vesicles bearing the B-cell marker CD19 were higher, and plasma endothelial growth factor levels were lower in recipients of fresh versus aged RBCs. Plasma interleukin-6 was higher at Day 2 and lower at Days 6 and 28 in recipients of fresh versus aged RBCs. Multiple parameters showed significant modulation after surgery and transfusion. Most analytes that changed after surgery did not differ based on transfusion status. Several extracellular vesicle markers, including two associated with platelets (CD41a and CD62P), decreased in transfused patients more than in those who underwent surgery without transfusion. CONCLUSIONS: Transfusion of fresh versus aged RBCs does not result in substantial changes in hemostasis, immune, or nitric oxide parameters. It is possible that transfusion modulates the level of platelet-derived extracellular vesicles, which will require study of patients randomly assigned to receipt of transfusion to define.

Background It is well recognized that cardio- vascular risk factors lead to histological and functional changes in aorta, and aortic stiffness is the best predictor of cardiovascular morbidity and mortality. In this study we evaluated the relation of a less evaluated echocardiographic parameter of aortic stiffness, aortic propagation velocity (APV) with the presence and severity of CAD. Methods This cross sectional study was conducted from May 2015 to March 2016 in Imam Reza hospital, Mashhad, Iran. Seventy patients who were referred for elective coronary artery angiography were enrolled. Patients were divided into two sub-groups based on angiographic findings: patients with CAD (38 patients, 54.3%) and non-CAD (32 patients, 45.7%). Transthoracic echocardiography was performed using the conventional 2D and color M-Mode imaging. Aortic propagation velocity (APV), aortic strain (AS) and distensibility (AD) were measured. The presence and Severity of CAD (assessing by syntax score) and their relation with aortic stiffness indices were assessed. Results Aortic strain (6.23 ± 1.93% versus 11.66 ± 4.86%, P

Recommendation of media objects, such as audio and video clips, has been there for a while. Most user interfaces include a list of favourites or most popular media objects. On the other hand, recommendation of multimedia devices is limited to shopping websites. With the evolution of IoT, however, users these days are surrounded by many interconnected devices that can be used to accomplish the same task at any given time. For example, while at home, a user can choose to play a media le on a smartphone, tablet, laptop, TV, or home theatre. In this article we investigate the question of whether or not users are ready to accept automatic recommendation of physical things with a case study of media playback devices. We further investigate various factors that a ect user's choice of media playback device with a user study. The analysis shows that users like device recommendation in general. In addition, many users even prefer the playback to be automatically transferred directly to the most appropriate device, while other users just want a noti cation. We also found that user's gender, profession, age, and the duration of media le a ect the choice of playback device.

Extracellular vesicles (EVs) range in size from 50 nm to 1 µm. Flow cytometry (FCM) is the most commonly used method for analyzing EVs; however, accurate characterization of EVs remains challenging due to their small size and lack of discrete positive populations. Here we report the use of optimization techniques that are especially well-suited for analyzing EVs from a high volume of clinical samples. Utilizing a two pronged approach that included 1) pre-filtration of antibodies to remove aggregates, followed by 2) detergent lysis of a replicate sample to account for remaining false positive events, we were able to effectively limit false positive non-EV events. In addition, we show that lysed samples are a useful alternative to isotypes for setting gates to exclude background fluorescence. To reduce background, we developed an approach using filters to "wash" samples post-staining thus providing a faster alternative to ultracentrifugation and sucrose gradient fractionation. In conclusion, use of these optimized techniques enhances the accuracy and efficiency of EV detection using FCM.

With the introduction of new depth-sensing technologies, interactive hand-gesture devices (such as smart televisions and displays) have been rapidly emerging. However, given the lack of a common vocabulary, most hand-gesture control commands are device-specific, burdening the user into learning different vocabularies for different devices. In order for hand gestures to become a natural communication for users with interactive devices, a standardized interactive hand-gesture vocabulary is necessary. Recently, researchers have approached this issue by conducting studies that elicit gesture vocabularies based on users’ preferences. Nonetheless, a universal vocabulary has yet to be proposed. In this paper, a thorough design methodology for achieving such a universal hand-gesture vocabulary is presented. The methodology is derived from the work of Wobbrock et al. and includes four steps: 1) a preliminary survey eliciting users’ attitudes; 2) a broader user survey in order to construct the universal vocabulary via results of the preliminary survey; 3) an evaluation test to study the implementation of the vocabulary; and 4) a memory test to analyze the memorability of the vocabulary. The proposed vocabulary emerged from this methodology achieves an agreement score exceeding those of the existing studies. Moreover, the results of the memory test show that, within a 15-min training session, the average accuracy of the proposed vocabulary is 90.71%. Despite the size of the proposed gesture vocabulary being smaller than that of similar work, it shares the same functionality, is easier to remember and can be integrated with smart TVs, interactive digital displays, and so on.