St. Peter’s Basilica as Templum Dei: The Continuation of the Ancient Near Eastern Temple Tradition in the Christian Cathedral

Inscribed on the entrance to St. Peter’s Basilica in Rome is the inscription Templum Vaticani (Latin for Temple of the Vatican). Upon entering St. Peter’s one can see many reflections of Solomon’s Temple in the architecture and orientation of the building. Even more striking are the similarities between the political and religious roles of St. Peter’s Basilica and those of an ancient Near Eastern temple. John M. Lundquist has developed a typology of elements that permeate temple traditions throughout the ancient Near East.1 Basing my research on this typology I set out to study Christian holy space, specifically the early structures of St. Peter’s Basilica. My hypothesis was that the holy space of the ancient Near East was related in specific ways to Christian holy space. I found my hypothesis to be true. The Christian Cathedral, like the ancient Near Eastern temple is a central, organizing, unifying institution in society; is associated with the realm of the dead; is interrelated to the law; and both the temple and cathedral play a legitimizing political role

Insulin resistance in adolescents with Down syndrome: a cross-sectional study

BACKGROUND: The prevalence of diabetes mellitus is higher in individuals with Down syndrome (DS) than in the general population; it may be due to the high prevalence of obesity presented by many of them. The aim of this study was to evaluate the insulin resistance (IR) using the HOMA (Homeostasis Model Assessment) method, in DS adolescents, describing it according to the sex, body mass index (BMI) and pubertal development. METHODS: 15 adolescents with DS (8 males and 7 females) were studied, aged 10 to 18 years, without history of disease or use of medication that could change the suggested laboratory evaluation. On physical examination, the pubertal signs, acanthosis nigricans (AN), weight and height were evaluated. Fasting plasma glucose and insulin were analysed by the colorimetric method and RIA-kit LINCO, respectively. IR was calculated using the HOMA method. The patients were grouped into obese, overweight and normal, according to their BMI percentiles. The EPIINFO 2004 software was used to calculate the BMI, its percentile and Z score. RESULTS: Five patients were adults (Tanner V or presence of menarche), 9 pubertal (Tanner II – IV) and 1 prepubertal (Tanner I). No one had AN. Two were obese, 4 overweight and 9 normal. Considering the total number of patients, HOMA was 1.7 ± 1.0, insulin 9.3 ± 4.8 μU/ml and glucose 74.4 ± 14.8 mg/dl. The HOMA values were 2.0 ± 1.0 in females and 1.5 ± 1.0 in males. Considering the nutritional classification, the values of HOMA and insulin were: HOMA: 3.3 ± 0.6, 2.0 ± 1.1 and 1.3 ± 0.6, and insulin: 18.15 ± 1.6 μU/ml, 10.3 ± 3.5 μU/ml and 6.8 ± 2.8 μU/ml, in the obese, overweight and normal groups respectively. Considering puberty, the values of HOMA and insulin were: HOMA: 2.5 ± 1.3, 1.4 ± 0.6 and 0.8 ± 0.0, and insulin: 13.0 ± 5.8 μU/ml, 7.8 ± 2.9 μU/ml and 4.0 ± 0.0 μU/ml, in the adult, pubertal and prepubertal groups respectively. CONCLUSION: The obese and overweight, female and adult patients showed the highest values of HOMA and insulin

Transient integral boundary layer method to calculate the translesional pressure drop and the fractional flow reserve in myocardial bridges

BACKGROUND: The pressure drop – flow relations in myocardial bridges and the assessment of vascular heart disease via fractional flow reserve (FFR) have motivated many researchers the last decades. The aim of this study is to simulate several clinical conditions present in myocardial bridges to determine the flow reserve and consequently the clinical relevance of the disease. From a fluid mechanical point of view the pathophysiological situation in myocardial bridges involves fluid flow in a time dependent flow geometry, caused by contracting cardiac muscles overlying an intramural segment of the coronary artery. These flows mostly involve flow separation and secondary motions, which are difficult to calculate and analyse. METHODS: Because a three dimensional simulation of the haemodynamic conditions in myocardial bridges in a network of coronary arteries is time-consuming, we present a boundary layer model for the calculation of the pressure drop and flow separation. The approach is based on the assumption that the flow can be sufficiently well described by the interaction of an inviscid core and a viscous boundary layer. Under the assumption that the idealised flow through a constriction is given by near-equilibrium velocity profiles of the Falkner-Skan-Cooke (FSC) family, the evolution of the boundary layer is obtained by the simultaneous solution of the Falkner-Skan equation and the transient von-Kármán integral momentum equation. RESULTS: The model was used to investigate the relative importance of several physical parameters present in myocardial bridges. Results have been obtained for steady and unsteady flow through vessels with 0 – 85% diameter stenosis. We compare two clinical relevant cases of a myocardial bridge in the middle segment of the left anterior descending coronary artery (LAD). The pressure derived FFR of fixed and dynamic lesions has shown that the flow is less affected in the dynamic case, because the distal pressure partially recovers during re-opening of the vessel in diastole. We have further calculated the wall shear stress (WSS) distributions in addition to the location and length of the flow reversal zones in dependence on the severity of the disease. CONCLUSION: The described boundary layer method can be used to simulate frictional forces and wall shear stresses in the entrance region of vessels. Earlier models are supplemented by the viscous effects in a quasi three-dimensional vessel geometry with a prescribed wall motion. The results indicate that the translesional pressure drop and the mean FFR compares favourably to clinical findings in the literature. We have further shown that the mean FFR under the assumption of Hagen-Poiseuille flow is overestimated in developing flow conditions

Gravity modeling of the Muertos Trough and tectonic implications (north-eastern Caribbean)

The Muertos Trough in the northeast Caribbean has been interpreted as a subduction zone from seismicity, leading to infer a possible reversal subduction polarity. However, the distribution of the seismicity is very diffuse and makes definition of the plate geometry difficult. In addition, the compressive deformational features observed in the upper crust and sandbox kinematic modeling do not necessarily suggest a subduction process. We tested the hypothesized subduction of the Caribbean plate’s interior beneath the eastern Greater Antilles island arc using gravity modeling. Gravity models simulating a subduction process yield a regional mass deficit beneath the island arc independently of the geometry and depth of the subducted slab used in the models. This mass deficit results from sinking of the less dense Caribbean slab beneath the lithospheric mantle replacing denser mantle materials and suggests that there is not a subducted Caribbean plateau beneath the island arc. The geologically more realistic gravity model which would explain the N–S shortening observed in the upper crust requires an overthrusted Caribbean slab extending at least 60 km northward from the deformation front, a progressive increase in the thrusting angle from 8 to 30 reaching a maximum depth of 22 km beneath the insular slope. This new tectonic model for the Muertos Margin, defined as a retroarc thrusting, will help to assess the seismic and tsunami hazard in the region. The use of gravity modeling has provided targets for future wide-angle seismic surveys in the Muertos Margin

Methylene Blue in Sepsis and Septic Shock – A Systematic Review and Meta-Analysis

Systematic review and meta-analysis aimed to understand the potential benefits and harms associated with administration of methylene blue in patients with sepsis and septic shock