Pramipexole is a dopamine agonist used in the treatment of Parkinson’s disease and Restless legs syndrome. Although off-label, the use of Pramipexole as an adjunct therapy in treatment resistant depression has recent...Pramipexole is a dopamine agonist used in the treatment of Parkinson’s disease and Restless legs syndrome. Although off-label, the use of Pramipexole as an adjunct therapy in treatment resistant depression has recently been documented in the literature with promising results. We present a 75-year-old male with MDD who has failed trials of SSRIs, SNRIs, TCAs, SGA, TMS, Ketamine, and ECT who was initiated on Pramipexole. We discuss, based on existing literature, the probability of a favorable long-term response to Pramipexole and the potential side effects for our patient. We also highlight the need for future studies designed to test the efficacy of Pramipexole in geriatric patients with TRD.展开更多
Background: MenAfriVac<sup>TM</sup> is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C dur...Background: MenAfriVac<sup>TM</sup> is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C during 4 days. This new vaccination practice has already been used in some African countries. This article described the opinion and use of this new technique by actors on the field, during a mass vaccination campaign in Côte d’Ivoire, in December 2014. Methods: We conducted a crosssectional study on the practice of CTC by actors on the field and their perception on the new practice, during a mass vaccination campaign in 2 of 25 health districts in Côte d’Ivoire, in December 2014. Findings: As results, in Séguéla 98.25% of respondents expressed a favourable opinion of CTC, citing advantages such as vaccine carriers requiring no ice packs (29.2%), financial benefit (12.28%) and lighter vaccine carriers (5.26%). In Bouna, respondents gave the same advantages in, respectively, 34%, 2% and 8% of cases. The peak of the total of vials used for immunization sessions reached 376 vials at day one, then dropped to 235 vials at day three and 220 vials at day six. Discussion: Vaccinators found some benefits related to CTC practice, but on the field, they were cautious in using CTC technique.展开更多
Production of economically viable bioethanol is potentially an environmentally and financially worthwhile endeavor.One major source for fermentable sugars is lignocellulose.However,lignocellulosic biomass is difficult...Production of economically viable bioethanol is potentially an environmentally and financially worthwhile endeavor.One major source for fermentable sugars is lignocellulose.However,lignocellulosic biomass is difficult to degrade,owing to its inherent structural recalcitrance.Cellulosomes are complexes of cellulases and associated polysaccharide-degrading enzymes bound to a protein scaffold that can efficiently degrade lignocellulose.Integration of the enzyme subunits into the complex depends on intermodular cohesin-dockerin interactions,which are robust but nonetheless non-covalent.The modular architecture of these complexes can be used to assemble artificial designer cellulosomes for advanced nanotechnological applications.Pretreatments that promote lignocellulose degradation involve high temperatures and acidic or alkaline conditions that could dismember designer cellulosomes,thus requiring separation of reaction steps,thereby increasing overall process cost.To overcome these challenges,we developed a means of covalently locking cohesin-dockerin interactions by integrating the chemistry of SpyCatcher-SpyTag approach to target and secure the interaction.The resultant cohesin-conjugated dockerin complex was resistant to high temperatures,SDS,and urea while high affinity and specificity of the interacting modular components were maintained.Using this approach,a covalently locked,bivalent designer cellulosome complex was produced and demonstrated to be enzymatically active on cellulosic substrates.The combination of affinity systems with SpyCatcher-SpyTag chemistry may prove of general use for improving other types of protein ligation systems and creating unconventional,biologically active,covalently locked,affinity-based molecular architectures.展开更多
As the basis for the study,this manuscript was written at a time when the energy crisis is affecting most parts of the world and most es-pecially the prevailing and rampant electricity crisis in most developing countr...As the basis for the study,this manuscript was written at a time when the energy crisis is affecting most parts of the world and most es-pecially the prevailing and rampant electricity crisis in most developing countries.As a result,50 combined cooling,heating and power(CCHP)systems studies were reviewed,which included the internal combustion engine(ICE),Stirling engine,biomass,micro turbine,solar and biogas,photovoltaic(PV)and gas turbine,wind turbine,PV and micro-turbine,solid-oxide and phosphoric-acid fuel cells(FCs),ICE and thermoelectric generator,low-temperature(LT)polymer electrolyte membrane(PEM),inlet air throttling gas turbine,ground source heat pump(GSHP)micro gas turbine and PV,ICE and GSHP,ICE with dehumidification and refrigeration,5-kW PEM FC,thermoelectric cooler and LT-PEM FC,Stirling engine and molten carbonate FC,thermo-acoustic organic Rankine cycle,solar-thermal,geothermal,integrated energy systems,power-and heat-storage systems,energy-conversion systems,thermodynamic and thermo-economic optimization strategies,working fluids based on hydrogen,helium as well as ammonia,H_(2)O,CO_(2) etc.Of these reviewed CCHP systems,FC-based CCHP systems were of the greatest interest,particularly the PEM FC.Consequently,FCs were further investigated,whereby the seven popular types of FCs identified and classified were summarily compared with each other,from which the PEM FC was preferred due to its practical popularity.However,PEM FCs,like all FCs,are susceptible to the fuel-starvation phenomenon;therefore,six FC-assisted schemes were examined,from which the FC assisted with the supercapacitor and battery technique was the most widely applied.In sum,the significance of the study entails assorted CCHP systems,FCs,their highlights,their applications and their pros and cons in a single reference document that anyone can easily use to holistically understand the characteristics of the CCHP systems.The study concludes with our perspective,by which we formulate and propose an alternative innovative unique CCHP sys展开更多
Natural hydrogels are one of the most promising biomaterials for tissue engineering applications,due to their biocompatibility,biodegradability,and extracellular matrix mimicking ability.To surpass the limitations of ...Natural hydrogels are one of the most promising biomaterials for tissue engineering applications,due to their biocompatibility,biodegradability,and extracellular matrix mimicking ability.To surpass the limitations of conventional fabrication techniques and to recapitulate the complex architecture of native tissue structure,natural hydrogels are being constructed using novel biofabrication strategies,such as textile techniques and three-dimensional bioprinting.These innovative techniques play an enormous role in the development of advanced scaffolds for various tissue engineering applications.The progress,advantages,and shortcomings of the emerging biofabrication techniques are highlighted in this review.Additionally,the novel applications of biofabricated natural hydrogels in cardiac,neural,and bone tissue engineering are discussed as well.展开更多
AIM： TO study if T-cell activation related to portasystemic shunting causes osteoclast-mediated bone loss through RANKL-dependent pathways. We also investigated if T-cell inhibition using rapamycin would protect agai...AIM： TO study if T-cell activation related to portasystemic shunting causes osteoclast-mediated bone loss through RANKL-dependent pathways. We also investigated if T-cell inhibition using rapamycin would protect against bone loss in rats. METHODS： Portasystemic shunting was performed in male Sprague-Dawley rats and rapamycin 0.1 mg/kg was administered for 15 wk by gavage. Rats received powderized chow and supplemental feeds to prevent the effects of malnutrition on bone composition. Weight gain and growth was restored after surgery in shunted animals. At termination, biochemical parameters of bone turnover and quantitative bone histology were assessed. Markers of T-cell activation, inflammatory cytokine production, and RANKL-dependent pathways were measured. In addition, the roles of IGF-1 and hypogonadism were investigated. RESULTS： Portasystemic shunting caused low turnover osteoporosis that was RANKL independent. Bone resorbing cytokine levels, including IL-1, IL-6 and TNFα, were not increased in serum and TNFα and RANKL expression were not upregulated in PBMC. Portasystemic shunting increased the circulating CD8＋ T-cell population. Rapamycin decreased the circulating CD8＋ T-cell population, increased CD8＋ CD25＋ T-regulatory cell population and improved all parameters of bone turnover. CONCLUSION： Osteoporosis caused by portasystemic shunting may be partially ameliorated by rapamycin in the rat model of hepatic osteodystrophy.展开更多
AIM: To investigate the safety profile of acquiring additional intestinal biopsies for research purposes in children undergoing a medically indicated colonoscopy. METHODS: A retrospective review of 122 pediatric patie...AIM: To investigate the safety profile of acquiring additional intestinal biopsies for research purposes in children undergoing a medically indicated colonoscopy. METHODS: A retrospective review of 122 pediatric patients who underwent colonoscopy over a 9 mo time period was completed. 38/122 participants consented to a research study in which 4 additional biopsies were obtained, in addition to routine biopsies. The outcomes after colonoscopy were measured in the research participants, and compared to 84 control participants who did not consent for the study. Groups were compared with regard to number of biopsies obtained, underlying diagnosis, and both serious and minor adverse outcomes. Data was collected including: age, gender, race, indication, diagnosis, number of biopsies obtained per case and post procedure adverse events. Medical records were reviewed and a questionnaire was completed by each of the ten gastroenterologists who performed procedures during the study. Physicians were asked about individual patient outcomes to ensure that all adverse events, such as perforation, excessive bleeding, infection, and minor gastrointestinal outcomes, were captured and included.RESULTS: The research group had more biopsies obtained(mean = 13.58 ± 4.21) compared to controls(mean = 9.33 ± 4.40), P ≤ 0.0001, however there was no difference in adverse events. Serious outcomes, defined as perforation, bleeding and infection, did not occur, in either group. As such, the relationship between serious adverse events and number of biopsies obtained was not determined. Minor gastrointestinal outcomes, such as abdominal pain, diarrhea or vomiting, were reported in 21 patients(8 research participants and 13 control participants) however the incidence of minor gastrointestinal outcomes between the two groups did not vary significantly, P = 0.45. Additionally, the meannumber of biopsies obtained in patients who had a minor outcome(mean = 12.1 ± 0.77), compared to those with no adverse outcome(mean = 10.34 ± 0.5), revealed no展开更多
Vector-borne plant diseases have significant ecological and economic impacts,affecting farm profitability and forest composition throughout the world.Bacterial vector-borne pathogens have evolved sophisticated strateg...Vector-borne plant diseases have significant ecological and economic impacts,affecting farm profitability and forest composition throughout the world.Bacterial vector-borne pathogens have evolved sophisticated strategies to interact with their hemipteran insect vectors and plant hosts.These pathogens reside in plant vascular tissue,and their study represents an excellent opportunity to uncover novel biological mechanisms regulating intracellular pathogenesis and to contribute to the control of some of the world's most invasive emerging diseases.In this perspective,we highlight recent advances and major unanswered questions in the realm of bacterial vector-borne disease,focusing on liberibacters,phytoplasmas,spiroplasmas,and Xylella fastidiosa.展开更多
The diagnosis of nonalcoholic fatty liver disease (NAFLD)is underrecognized. The aim of this study was to develop a scoring system that separates NAFLD diagnosis as a cause of chronic hepatitis from controls by using ...The diagnosis of nonalcoholic fatty liver disease (NAFLD)is underrecognized. The aim of this study was to develop a scoring system that separates NAFLD diagnosis as a cause of chronic hepatitis from controls by using clinical features and liver ultrasound. A retrospective review of consecutive NAFLD cases and other liver disease controls was undertaken selecting patients from an abnormal liver function test code. To qualify for analysis all patients had to have elevated liver injury tests for more then 6 months, a biopsy-confirmed diagnosis, and an ultrasound as part of the evaluation. There were 84 cases of NAFLD and 75 liver disease controls. The NAFLD group had a larger body mass index (BMI) (34.9 versus 26.1; P ≤0.0001), a larger liver span (9.8 versus 8.1 cm; P ≤0.0001), and higher triglycerides (252 versus 142.6; P ≤0.0001). The ultrasound reports recorded features consistent with fatty infiltration in 65.5%of NAFLD cases, compared to 5.3%of other liver diseases (P ≤0.0001). Diabetes mellitus was found in 35%of NAFLD and 6.7%of other cases (P ≤0.0001). The BMI was >30 in 79.8%of NAFLD cases and 22.7%of other liver disease cases (P ≤0.0001). The liver span was >8 cm in 78.6%of NAFLD cases and in only 16%of controls (P = 0.0001). On multivariate analysis using logistic regression, the odds ratio of having ultrasound report findings suggestive of fatty infiltration was 15.9 (CI, 4.1-60). The odds ratio was 9.4 (CI, 2.3-37.9) for diabetes, 5.0 (CI, 1.7-14.6) for BMI >30, and 2.3 for liver span > 8 cm (CI, 1.36-3.90). A scoring system using clinical features and ultrasound was shown to reliably separate NAFLD from other cases of chronic hepatitis.展开更多
Alpha-fetoprotein(AFP)-producing adenocarcinoma,histologically mimicking hepatocellular carcinoma(HCC),is a distinct entity known as hepatoid adenocarcinoma(HAC).Reported cases of HAC arising from the esophagus are ex...Alpha-fetoprotein(AFP)-producing adenocarcinoma,histologically mimicking hepatocellular carcinoma(HCC),is a distinct entity known as hepatoid adenocarcinoma(HAC).Reported cases of HAC arising from the esophagus are extremely rare.Due to common liver metastasis and elevated AFP levels in patients with esophageal HAC,differentiation of HAC with liver metastasis from HCC could be challenging.We describe a case of esophageal HAC that presented with a liver mass showing hepatoid features and elevated serum AFP levels.Initial presentation was suspicious for HCC.Upon further diagnostic work-up,the patient was diagnosed with esophageal HAC with liver metastasis.The distinction between these two entities is particularly important because HAC is more aggressive,and its therapeutic options are very limited.展开更多
Objective: Determine whether waist- to- height ratio (WHtR) or sex- and ag e- specific percentiles of body mass index (BMI)- better identifies cardiovasc ular risk. Study design: The third National Health and Nutritio...Objective: Determine whether waist- to- height ratio (WHtR) or sex- and ag e- specific percentiles of body mass index (BMI)- better identifies cardiovasc ular risk. Study design: The third National Health and Nutrition Examination Sur vey (NHANES III) provided measurements on 7657 participants statistically weight ed to represent 50.05 million youth 4 to 17 years of age. We estimated the subpo pulations corresponding to BMI strata that were normal ( < 85th percentile), at risk for overweight (85th to < 95th percentile), and overweight (≥ 95th percent ile). We chose WHtR cutoff points (0.490 and 0.539) so that subpopulation sizes in the three WHtR strata would equal those in the three BMI strata. For 13 cardi ovascular risk factors we compared mean levels among youth discordant for their BMI and WHtR strata. Results: 726 participants (representing 3.69 million youth) were identified as having WHtR stratum > BMI stratum. Compared with the 603 par ticipants (representing 3.70 million youth) who were discordant in the opposite direction, weighted analyses showed they had higher mean levels of heart rate, l ow- density lipoprotein (LDL) cholesterol, fasting triglycerides, and total cho lesterol (P < .015, adjusted for sex, age, and race- ethnicity). Their mean sys tolic blood pressure was lower, but this difference was eliminated after adjustm ent for their shorter stature. Conclusion: WHtR, a simpler anthropometric index than sex- and age- specific BMI percentiles, better identi- fies youth with a dverse cardiovascular risk factors.展开更多
文摘Pramipexole is a dopamine agonist used in the treatment of Parkinson’s disease and Restless legs syndrome. Although off-label, the use of Pramipexole as an adjunct therapy in treatment resistant depression has recently been documented in the literature with promising results. We present a 75-year-old male with MDD who has failed trials of SSRIs, SNRIs, TCAs, SGA, TMS, Ketamine, and ECT who was initiated on Pramipexole. We discuss, based on existing literature, the probability of a favorable long-term response to Pramipexole and the potential side effects for our patient. We also highlight the need for future studies designed to test the efficacy of Pramipexole in geriatric patients with TRD.
文摘Background: MenAfriVac<sup>TM</sup> is the first of the World Health Organization (WHO)’s pre-qualified vaccines to be allowed to mass vaccination campaign at a temperature below or equal to 40°C during 4 days. This new vaccination practice has already been used in some African countries. This article described the opinion and use of this new technique by actors on the field, during a mass vaccination campaign in Côte d’Ivoire, in December 2014. Methods: We conducted a crosssectional study on the practice of CTC by actors on the field and their perception on the new practice, during a mass vaccination campaign in 2 of 25 health districts in Côte d’Ivoire, in December 2014. Findings: As results, in Séguéla 98.25% of respondents expressed a favourable opinion of CTC, citing advantages such as vaccine carriers requiring no ice packs (29.2%), financial benefit (12.28%) and lighter vaccine carriers (5.26%). In Bouna, respondents gave the same advantages in, respectively, 34%, 2% and 8% of cases. The peak of the total of vials used for immunization sessions reached 376 vials at day one, then dropped to 235 vials at day three and 220 vials at day six. Discussion: Vaccinators found some benefits related to CTC practice, but on the field, they were cautious in using CTC technique.
文摘Production of economically viable bioethanol is potentially an environmentally and financially worthwhile endeavor.One major source for fermentable sugars is lignocellulose.However,lignocellulosic biomass is difficult to degrade,owing to its inherent structural recalcitrance.Cellulosomes are complexes of cellulases and associated polysaccharide-degrading enzymes bound to a protein scaffold that can efficiently degrade lignocellulose.Integration of the enzyme subunits into the complex depends on intermodular cohesin-dockerin interactions,which are robust but nonetheless non-covalent.The modular architecture of these complexes can be used to assemble artificial designer cellulosomes for advanced nanotechnological applications.Pretreatments that promote lignocellulose degradation involve high temperatures and acidic or alkaline conditions that could dismember designer cellulosomes,thus requiring separation of reaction steps,thereby increasing overall process cost.To overcome these challenges,we developed a means of covalently locking cohesin-dockerin interactions by integrating the chemistry of SpyCatcher-SpyTag approach to target and secure the interaction.The resultant cohesin-conjugated dockerin complex was resistant to high temperatures,SDS,and urea while high affinity and specificity of the interacting modular components were maintained.Using this approach,a covalently locked,bivalent designer cellulosome complex was produced and demonstrated to be enzymatically active on cellulosic substrates.The combination of affinity systems with SpyCatcher-SpyTag chemistry may prove of general use for improving other types of protein ligation systems and creating unconventional,biologically active,covalently locked,affinity-based molecular architectures.
文摘As the basis for the study,this manuscript was written at a time when the energy crisis is affecting most parts of the world and most es-pecially the prevailing and rampant electricity crisis in most developing countries.As a result,50 combined cooling,heating and power(CCHP)systems studies were reviewed,which included the internal combustion engine(ICE),Stirling engine,biomass,micro turbine,solar and biogas,photovoltaic(PV)and gas turbine,wind turbine,PV and micro-turbine,solid-oxide and phosphoric-acid fuel cells(FCs),ICE and thermoelectric generator,low-temperature(LT)polymer electrolyte membrane(PEM),inlet air throttling gas turbine,ground source heat pump(GSHP)micro gas turbine and PV,ICE and GSHP,ICE with dehumidification and refrigeration,5-kW PEM FC,thermoelectric cooler and LT-PEM FC,Stirling engine and molten carbonate FC,thermo-acoustic organic Rankine cycle,solar-thermal,geothermal,integrated energy systems,power-and heat-storage systems,energy-conversion systems,thermodynamic and thermo-economic optimization strategies,working fluids based on hydrogen,helium as well as ammonia,H_(2)O,CO_(2) etc.Of these reviewed CCHP systems,FC-based CCHP systems were of the greatest interest,particularly the PEM FC.Consequently,FCs were further investigated,whereby the seven popular types of FCs identified and classified were summarily compared with each other,from which the PEM FC was preferred due to its practical popularity.However,PEM FCs,like all FCs,are susceptible to the fuel-starvation phenomenon;therefore,six FC-assisted schemes were examined,from which the FC assisted with the supercapacitor and battery technique was the most widely applied.In sum,the significance of the study entails assorted CCHP systems,FCs,their highlights,their applications and their pros and cons in a single reference document that anyone can easily use to holistically understand the characteristics of the CCHP systems.The study concludes with our perspective,by which we formulate and propose an alternative innovative unique CCHP sys
基金the Ministry of Higher Education,Research and Innovation,France.A.Tamayol acknowledges the financial support from the National Institutes of Health,United States(GM126831,AR073822).
文摘Natural hydrogels are one of the most promising biomaterials for tissue engineering applications,due to their biocompatibility,biodegradability,and extracellular matrix mimicking ability.To surpass the limitations of conventional fabrication techniques and to recapitulate the complex architecture of native tissue structure,natural hydrogels are being constructed using novel biofabrication strategies,such as textile techniques and three-dimensional bioprinting.These innovative techniques play an enormous role in the development of advanced scaffolds for various tissue engineering applications.The progress,advantages,and shortcomings of the emerging biofabrication techniques are highlighted in this review.Additionally,the novel applications of biofabricated natural hydrogels in cardiac,neural,and bone tissue engineering are discussed as well.
文摘AIM： TO study if T-cell activation related to portasystemic shunting causes osteoclast-mediated bone loss through RANKL-dependent pathways. We also investigated if T-cell inhibition using rapamycin would protect against bone loss in rats. METHODS： Portasystemic shunting was performed in male Sprague-Dawley rats and rapamycin 0.1 mg/kg was administered for 15 wk by gavage. Rats received powderized chow and supplemental feeds to prevent the effects of malnutrition on bone composition. Weight gain and growth was restored after surgery in shunted animals. At termination, biochemical parameters of bone turnover and quantitative bone histology were assessed. Markers of T-cell activation, inflammatory cytokine production, and RANKL-dependent pathways were measured. In addition, the roles of IGF-1 and hypogonadism were investigated. RESULTS： Portasystemic shunting caused low turnover osteoporosis that was RANKL independent. Bone resorbing cytokine levels, including IL-1, IL-6 and TNFα, were not increased in serum and TNFα and RANKL expression were not upregulated in PBMC. Portasystemic shunting increased the circulating CD8＋ T-cell population. Rapamycin decreased the circulating CD8＋ T-cell population, increased CD8＋ CD25＋ T-regulatory cell population and improved all parameters of bone turnover. CONCLUSION： Osteoporosis caused by portasystemic shunting may be partially ameliorated by rapamycin in the rat model of hepatic osteodystrophy.
文摘AIM: To investigate the safety profile of acquiring additional intestinal biopsies for research purposes in children undergoing a medically indicated colonoscopy. METHODS: A retrospective review of 122 pediatric patients who underwent colonoscopy over a 9 mo time period was completed. 38/122 participants consented to a research study in which 4 additional biopsies were obtained, in addition to routine biopsies. The outcomes after colonoscopy were measured in the research participants, and compared to 84 control participants who did not consent for the study. Groups were compared with regard to number of biopsies obtained, underlying diagnosis, and both serious and minor adverse outcomes. Data was collected including: age, gender, race, indication, diagnosis, number of biopsies obtained per case and post procedure adverse events. Medical records were reviewed and a questionnaire was completed by each of the ten gastroenterologists who performed procedures during the study. Physicians were asked about individual patient outcomes to ensure that all adverse events, such as perforation, excessive bleeding, infection, and minor gastrointestinal outcomes, were captured and included.RESULTS: The research group had more biopsies obtained(mean = 13.58 ± 4.21) compared to controls(mean = 9.33 ± 4.40), P ≤ 0.0001, however there was no difference in adverse events. Serious outcomes, defined as perforation, bleeding and infection, did not occur, in either group. As such, the relationship between serious adverse events and number of biopsies obtained was not determined. Minor gastrointestinal outcomes, such as abdominal pain, diarrhea or vomiting, were reported in 21 patients(8 research participants and 13 control participants) however the incidence of minor gastrointestinal outcomes between the two groups did not vary significantly, P = 0.45. Additionally, the meannumber of biopsies obtained in patients who had a minor outcome(mean = 12.1 ± 0.77), compared to those with no adverse outcome(mean = 10.34 ± 0.5), revealed no
基金P.R.-C.,S.S.,and G.C.are supported by grants from the USDA CDRE(2019-70016-29796,2016-70016-24833)G.C.L.B.is supported by an INRAE Department of Plant Health and Environment(SPE)grant(VMP-ADAPT),grants from the University of Bordeaux,and SFR Integrative Biology and Ecology.M.H.and M.M.are supported by a grant from the USDA ARS CRIS(8062-22410-006-00-D)+1 种基金M.H.W.H.and S.A.H.were funded from the BBSRC Institute Strategy Program(BB/P012574/1)the John Innes Foundation.M.H.and M.M.are funded by USDA ARS project 8062-22410-006-00-D.R.P.P.A.was funded by the Pierce's Disease Research Program,California Department of Food and Agriculture.
文摘Vector-borne plant diseases have significant ecological and economic impacts,affecting farm profitability and forest composition throughout the world.Bacterial vector-borne pathogens have evolved sophisticated strategies to interact with their hemipteran insect vectors and plant hosts.These pathogens reside in plant vascular tissue,and their study represents an excellent opportunity to uncover novel biological mechanisms regulating intracellular pathogenesis and to contribute to the control of some of the world's most invasive emerging diseases.In this perspective,we highlight recent advances and major unanswered questions in the realm of bacterial vector-borne disease,focusing on liberibacters,phytoplasmas,spiroplasmas,and Xylella fastidiosa.
文摘The diagnosis of nonalcoholic fatty liver disease (NAFLD)is underrecognized. The aim of this study was to develop a scoring system that separates NAFLD diagnosis as a cause of chronic hepatitis from controls by using clinical features and liver ultrasound. A retrospective review of consecutive NAFLD cases and other liver disease controls was undertaken selecting patients from an abnormal liver function test code. To qualify for analysis all patients had to have elevated liver injury tests for more then 6 months, a biopsy-confirmed diagnosis, and an ultrasound as part of the evaluation. There were 84 cases of NAFLD and 75 liver disease controls. The NAFLD group had a larger body mass index (BMI) (34.9 versus 26.1; P ≤0.0001), a larger liver span (9.8 versus 8.1 cm; P ≤0.0001), and higher triglycerides (252 versus 142.6; P ≤0.0001). The ultrasound reports recorded features consistent with fatty infiltration in 65.5%of NAFLD cases, compared to 5.3%of other liver diseases (P ≤0.0001). Diabetes mellitus was found in 35%of NAFLD and 6.7%of other cases (P ≤0.0001). The BMI was >30 in 79.8%of NAFLD cases and 22.7%of other liver disease cases (P ≤0.0001). The liver span was >8 cm in 78.6%of NAFLD cases and in only 16%of controls (P = 0.0001). On multivariate analysis using logistic regression, the odds ratio of having ultrasound report findings suggestive of fatty infiltration was 15.9 (CI, 4.1-60). The odds ratio was 9.4 (CI, 2.3-37.9) for diabetes, 5.0 (CI, 1.7-14.6) for BMI >30, and 2.3 for liver span > 8 cm (CI, 1.36-3.90). A scoring system using clinical features and ultrasound was shown to reliably separate NAFLD from other cases of chronic hepatitis.
文摘Alpha-fetoprotein(AFP)-producing adenocarcinoma,histologically mimicking hepatocellular carcinoma(HCC),is a distinct entity known as hepatoid adenocarcinoma(HAC).Reported cases of HAC arising from the esophagus are extremely rare.Due to common liver metastasis and elevated AFP levels in patients with esophageal HAC,differentiation of HAC with liver metastasis from HCC could be challenging.We describe a case of esophageal HAC that presented with a liver mass showing hepatoid features and elevated serum AFP levels.Initial presentation was suspicious for HCC.Upon further diagnostic work-up,the patient was diagnosed with esophageal HAC with liver metastasis.The distinction between these two entities is particularly important because HAC is more aggressive,and its therapeutic options are very limited.
文摘Objective: Determine whether waist- to- height ratio (WHtR) or sex- and ag e- specific percentiles of body mass index (BMI)- better identifies cardiovasc ular risk. Study design: The third National Health and Nutrition Examination Sur vey (NHANES III) provided measurements on 7657 participants statistically weight ed to represent 50.05 million youth 4 to 17 years of age. We estimated the subpo pulations corresponding to BMI strata that were normal ( < 85th percentile), at risk for overweight (85th to < 95th percentile), and overweight (≥ 95th percent ile). We chose WHtR cutoff points (0.490 and 0.539) so that subpopulation sizes in the three WHtR strata would equal those in the three BMI strata. For 13 cardi ovascular risk factors we compared mean levels among youth discordant for their BMI and WHtR strata. Results: 726 participants (representing 3.69 million youth) were identified as having WHtR stratum > BMI stratum. Compared with the 603 par ticipants (representing 3.70 million youth) who were discordant in the opposite direction, weighted analyses showed they had higher mean levels of heart rate, l ow- density lipoprotein (LDL) cholesterol, fasting triglycerides, and total cho lesterol (P < .015, adjusted for sex, age, and race- ethnicity). Their mean sys tolic blood pressure was lower, but this difference was eliminated after adjustm ent for their shorter stature. Conclusion: WHtR, a simpler anthropometric index than sex- and age- specific BMI percentiles, better identi- fies youth with a dverse cardiovascular risk factors.
