Notes

Myeloid Endoplasmic Reticulum Citizen Chaperone GP96 Helps Inflammation and Steatosis in Alcohol-Associated Liver Disease.
What does it take to successfully lead a Division of Geriatrics? Is it the same skill set today as it was two or three decades ago? Is it the same for each chief, given the wide spectrum of geriatrics programs across our nation? Early leaders in our field showcased and role-modeled the career and job satisfaction that accompanies leadership of traditional geriatrics academic programs. This has been well articulated in past issues of the Journal of the American Geriatrics Society in articles by Dr William Hazzard and Dr Greg Sachs. Gefitinib inhibitor How can we develop the next generation of geriatrics program leaders and ensure their success? Developed as a conversation between three generations of geriatrics division chiefs, this reflective article offers a shared perspective on what is required for success in advancing as a leader in our field and wholeheartedly enjoying the best job in the world.In this study, we have investigated the cheese starter culture as a microbial community through a question can the metabolic behaviour of a co-culture be explained by the characterized individual organism that constituted the co-culture? To address this question, the dairy-origin lactic acid bacteria Lactococcus lactis subsp. cremoris, Lactococcus lactis subsp. lactis, Streptococcus thermophilus and Leuconostoc mesenteroides, commonly used in cheese starter cultures, were grown in pure and four different co-cultures. We used a dynamic metabolic modelling approach based on the integration of the genome-scale metabolic networks of the involved organisms to simulate the co-cultures. The strain-specific kinetic parameters of dynamic models were estimated using the pure culture experiments and they were subsequently applied to co-culture models. Biomass, carbon source, lactic acid and most of the amino acid concentration profiles simulated by the co-culture models fit closely to the experimental results and the co-culture models explained the mechanisms behind the dynamic microbial abundance. We then applied the co-culture models to estimate further information on the co-cultures that could not be obtained by the experimental method used. This includes estimation of the profile of various metabolites in the co-culture medium such as flavour compounds produced and the individual organism level metabolic exchange flux profiles, which revealed the potential metabolic interactions between organisms in the co-cultures.
Omental milky spots (OMSs) are the primary lymphoid structures of the greater omentum. However, the presence of lymph nodes (LNs) has occasionally been mentioned as well. Understanding which lymphoid structures are present is of significance, especially in gastric tumor metastasis; tumor deposits in omental LNs suggest local lymphatic spread, whereas tumor deposits in OMSs suggest peritoneal spread and hence extensive disease. Since LNs and OMSs share morphological characteristics and OMSs might be wrongly identified as LNs, reliable hallmarks facilitating easy discrimination are needed.

A series of microscopic morphological hallmarks unique to LNs were selected as potential candidates and were assessed for their discriminative capacity 1) capsule, 2) trabeculae, 3) subcapsular sinus, 4) afferent lymphatic vessels, 5) distinct B- and T cell regions, and 6) a layered organization with, from the outside in a capsule, cortex, paracortex, and medulla. These hallmarks were visualized by multiple staining techniques.

Hallmarks 1, 2 5 and 6 were shown to be the most efficient as these were consistent and discriminative. They were best visualized by Picrosirius red, smooth muscle actin and a B-cell / T-cell double staining.

The presence of a capsule, trabeculae, distinct B- and T-cell regions and a layered organization represent consistent and reliable morphological features which allow to easily distinguish LNs from OMSs, especially when applied in combination.
The presence of a capsule, trabeculae, distinct B- and T-cell regions and a layered organization represent consistent and reliable morphological features which allow to easily distinguish LNs from OMSs, especially when applied in combination.
While the well-known DaVinci ® robotic system (Intuitive Surgical, Inc., Sunnyvale, CA) uses 8 mm articulated instruments, the Senhance ® robotic system (TransEnterix, Morrisville, NC), available since 2016, uses 5 mm instruments, which is the standard size in laparoscopy. We report here the first 43 procedures using 5 mm articulating instruments with the Senhance ® system (TransEnterix).

From September 9, 2019, to January 15, 2020, we performed 43 various robotic-assisted abdominal procedures. Before the first clinical intervention, the surgeons and surgical nurses were trained in the handling and operation of the articulating instruments. The main procedure was Inguinal Hernia Repair with the TAPP technique. We performed the operations with a 5 mm articulating bipolar forceps and a 5 mm articulating needle holder. In all cases, the Senhance ® (TransEnterix) articulating instruments were inserted through a 5 or 10 mm trocar, connected to the robotic arm and used for tissue dissection (inguinal hernia repsaw advantages with the use of 5 mm articulating instruments.

Senhance ® (TransEnterix) 5 mm articulating instruments are technically stable and can be safely used in various abdominal procedures. The initial results suggest that these 5 mm articulating instruments can be a supportive tool in further robotic surgery, providing advantages in suturing and dissection with less risk of injury to surrounding tissue.
Senhance ® (TransEnterix) 5 mm articulating instruments are technically stable and can be safely used in various abdominal procedures. The initial results suggest that these 5 mm articulating instruments can be a supportive tool in further robotic surgery, providing advantages in suturing and dissection with less risk of injury to surrounding tissue.Laser Interstitial Thermal Therapy (LITT) is used to treat patients with intracranial lesions such as epileptogenic foci, radiation necrosis, cavernomas and brain tumors in the United States. The approval for this treatment in Europe has first been granted in 2018, with the first treatment(s) in the Nordic countries - in the form of 3 brain tumor patients - performed at the Karolinska University Hospital in 2019. In this article we briefly describe our initial experience in the context of current literature.
Hypocalcemia and low parathyroid hormone levels have been commonly suggested as factors able to induce central nervous system disturbances. However, evidences on the occurrence of cognitive impairment are limited or underestimated. The aim of this review is, therefore, to systematically summarize the available evidence concerning the occurrence of cognitive impairment among subjects suffering from idiopathic or secondary hypoparathyroidism.

A systematic selection of the available literature was performed by searching the online databases PubMed, Scopus and Web of Knowledge.

The present systematic review included sixteen case report articles and one cross-sectional controlled study. Case reports were the most representative literature sources and involved ten women and seven men. The presence of cognitive impairment was mostly discussed in association with idiopathic hypoparathyroidism (HPT); five articles described the occurrence of cognitive impairment following postsurgical HPT. The case-controlled study reported a significant presence of peculiar cognitive deficits (e.g. reduced inhibitory control, impairment in visuo-spatial functioning among, and psychomotor retardation) among HPT subjects compared to healthy controls, with serum total calcium and its product with phosphorus as independent predictors of neuropsychological dysfunctions.

Even though mostly based on single case reports, the presence of neuropsychological dysfunctions in the context of HPT appears to be a consistent core finding.
Even though mostly based on single case reports, the presence of neuropsychological dysfunctions in the context of HPT appears to be a consistent core finding.
Methotrexate (MTX) constitutes the first-line therapy in rheumatoid arthritis (RA), yet approximately 30% of the patients do not benefit from MTX. Recently, we reported a prognostic multivariable prediction model for insufficient clinical response to MTX at 3 months of treatment in the treatment in the Rotterdam Early Arthritis Cohort (tREACH), including baseline predictors Disease activity score 28 (DAS28), Health Assessment Questionnaire (HAQ), erythrocyte folate, single-nucleotide polymorphisms (SNPs; ABCB1, ABCC3), smoking, and BMI. The purpose of the current study was (1) to externally validate the model and (2) to enhance the model's clinical applicability.

Erythrocyte folate and SNPs were assessed in 91 early disease-modifying antirheumatic drug (DMARD)-naïve RA patients starting MTX in the external validation cohort (U-Act-Early). Insufficient response (DAS28 > 3.2) was determined after 3months and non-response after 6months of therapy. The previously developed prediction model was considered sly is registered at ClinicalTrials.gov. number NCT01034137. tREACH is registered retrospectively at ISRCTN registry, number ISRCTN26791028 at 23 August 2007.
The U-Act-Early is registered at ClinicalTrials.gov. number NCT01034137. tREACH is registered retrospectively at ISRCTN registry, number ISRCTN26791028 at 23 August 2007.Organ-effective modulation (OEM) is a computed tomography scanning technique that reduces the exposure dose to organs at risk. Ultrasonography is commonly used for prenatal imaging, but its reliability is reported to be limited. Radiography and computed tomography (CT) are reliable but pose risk of radiation exposure to the pregnant woman and her fetus. Although there are many reports on the exposure dose associated with fetal CT scans, no reports exist on OEM use in fetal CT scans. We measured the basic characteristics of organ-effective modulation (X-ray output modulation angle, maximum X-ray output modulation rate, total X-ray output modulation rate, and noise modulation) and used them in a Monte Carlo simulation to evaluate the effect of this technique on fetal CT scans in terms of image quality and exposure dose to the pregnant woman and fetus. Using ImPACT MC software, Monte Carlo simulations of OEMON and OEMOFF were run on 8 cases involving fetal CT scans. We confirmed that the organ-effective modulation X-ray output modulation angle was 160°; the X-ray output modulation rate increased with increasing tube current; and no modulation occurred at tube currents of 80 mA or below. Our findings suggest that OEM has only a minimal effect in reducing organ exposure in pregnant women; therefore, it should be used on the anterior side (OEMON,front) to reduce the exposure dose to the fetus.Schizophrenia (SZ) is a severe disorder of the human brain which disturbs behavioral characteristics such as interruption in thinking, memory, perception, speech and other living activities. If the patient suffering from SZ is not diagnosed and treated in the early stages, damage to human behavioral abilities in its later stages could become more severe. Therefore, early discovery of SZ may help to cure or limit the effects. Electroencephalogram (EEG) is prominently used to study brain diseases such as SZ due to having high temporal resolution information, and being a noninvasive and inexpensive method. This paper introduces an automatic methodology based on transfer learning with deep convolutional neural networks (CNNs) for the diagnosis of SZ patients from healthy controls. First, EEG signals are converted into images by applying a time-frequency approach called continuous wavelet transform (CWT) method. Then, the images of EEG signals are applied to the four popular pre-trained CNNs AlexNet, ResNet-18, VGG-19 and Inception-v3.
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