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titutional protocol for antenatal late preterm corticosteroids was rapid. Compared with historic controls, neonates exposed to antenatal late preterm corticosteroid experienced increased odds of hypoglycemia, without significant improvements in respiratory morbidities.Forensic science is currently undergoing a transformation and expansion to include modern types of evidence, such as evidence generated by digital investigations. This development is said to raise a series of challenges, both in operational and conceptual dimensions. This paper reviews and discusses a series of convoluted conceptual hurdles that are encountered in connection with the use of digital evidence as part of evidence and proof processes at trial, in contradistinction to investigative uses of such types of evidence. As a recent example raising such hurdles, we analyse and discuss assertions and proposals made in the article "Digital Evidence Certainty Descriptors (DECDs)" by Graeme Horsman (32 Forensic Science International Digital Investigation (2020) 200896).Implantable vascular devices typically interface with blood and vascular tissues. Physical properties of device materials and coatings, independent of chemical composition, can significantly influence cell responses and implant success. Here, we analyzed the effect of various polymer processing regimes, using a single implant polymer - poly(ε-caprolactone) (PCL), on vascular endothelial cell (EC), smooth muscle cell (SMC), and platelet response. PCL films were formed by varying three parameters 1) formation method - solvent casting, melt pressing or spin coating; 2) molecular weight - 50 or 100 kDa; and 3) solvent type - dichloromethane (DCM) or tetrahydrofuran (THF). We quantified the relationship of polymer processing choice to surface roughness, wettability, and bulk stiffness; and to EC adhesion, SMC adhesion, and platelet activity state (PAS). Multiple regression analysis identified which processing method signficantly impacted (F-ratio>p-value; p less then 0.1) polymer physical properties and vascular csing choices, specifically film formation method (p less then 0.03). However, only SMC adhesion had a model that fit well (F-ratio=4.13; p=0.05) to the physical properties directly, specifically roughness and wettability (p less then 0.04).
Cases of exacerbation of pre-existing neuromuscular diseases induced by immune checkpoint inhibitors (ICIs) have rarely been reported because patients with autoimmune diseases have generally been excluded from ICI therapy due to the increased risk of exacerbation. We describe the first case of an elderly patient who experienced exacerbation of a previously undiagnosed sporadic inclusion body myositis (sIBM), the most common myopathy in the geriatric population, which was triggered by anti-programmed cell death-1 therapy.
A 75-year-old man who was receiving pembrolizumab presented with limb weakness. Three years prior, he had noticed slowly progressive limb weakness, but he received no diagnosis. After the first infusion of pembrolizumab, his creatine kinase (CK) levels had increased. The neurological examination and muscle biopsy findings confirmed the diagnosis of sIBM and suggested exacerbation of sIBM induced by pembrolizumab. After the patient's CK levels decreased, pembrolizumab was restarted. The tumor progressed after its treatment with pembrolizumab. The patient died after 15 months of follow-up.
In patients with slowly progressive limb weakness, sIBM should be explored before ICI therapy. In addition, if patients show high CK levels after ICI introduction, it is necessary to confirm whether they have sIBM in order to avoid unnecessary immunosuppressive therapies and assess whether they can tolerate ICI reintroduction.
In patients with slowly progressive limb weakness, sIBM should be explored before ICI therapy. In addition, if patients show high CK levels after ICI introduction, it is necessary to confirm whether they have sIBM in order to avoid unnecessary immunosuppressive therapies and assess whether they can tolerate ICI reintroduction.
In patients with relapsing polychondritis (RP), organ involvement developed in those with progressive and/or long disease courses. For their management, elucidation of a subgroup suggesting disease progression is awaited.
We previously conducted a physician's questionnaire-based retrospective study to elucidate major clinical features of Japanese patients with RP. We here evaluated organ involvement at disease onset and at the last follow-up. We then counted cumulative numbers of involved organs at the last follow-up in 229 RP patients and compared them with involved organ numbers at disease onset, as possible indicators of disease progression. We assigned their prognosis at the last follow-up into "patient prognostic stages" from no medication (stage 1) to death (stage 5). We utilized nonparametric tests for group comparisons.
Involved organ numbers per-patient were 1.13 ± 0.03 at disease onset and 3.25 ± 0.10 at the last follow-up (disease duration was 4.69 ± 0.33 years), and increased along with the is of RP than AO subgroups, especially AO subgroups without respiratory involvement throughout. All RP patients deserve careful monitoring but special attention should be paid to MO patients because of their diverse and accelerated disease progression.
Allocation of patients to RO and MO subgroups was suggested to associate with poorer prognosis of RP than AO subgroups, especially AO subgroups without respiratory involvement throughout. All RP patients deserve careful monitoring but special attention should be paid to MO patients because of their diverse and accelerated disease progression.
To describe early chest imaging abnormalities in patients with acute Puumala virus infection.
This retrospective study (2005-2017) comprised 64 patients who were admitted to the emergency department of a Belgian hospital. These patients were diagnosed with serologically confirmed acute Puumala virus infection and had at least one chest X-ray (CRX). Imaging studies were evaluated by two experienced chest radiologists reaching agreement by consensus, and abnormalities were reported according to the Fleischner Society glossary of terms for thoracic imaging. 2Aminoethanethiol When a patient underwent multiple CRX, only the findings of the first were recorded. Six patients underwent chest high-resolution computed tomography (HRCT).
CRX showed abnormal findings in 33 patients (51.5%). Most common findings were linear atelectasis (29.7%) and small pleural effusion (20.3%). HRCT showed interlobular septal thickening in four patients and crazy-paving pattern with consolidations in one patient with adult respiratory distress syndrome.
Early CRX commonly showed linear atelectasis and small pleural effusion in Puumala virus infected patients above 30 years of age. Chest HRCT most frequently showed atelectasis and smooth interlobular septal thickening. While uncommon, early and severe pulmonary involvement can be associated with Puumala virus infection, albeit these findings are not specific.
Early CRX commonly showed linear atelectasis and small pleural effusion in Puumala virus infected patients above 30 years of age. Chest HRCT most frequently showed atelectasis and smooth interlobular septal thickening. While uncommon, early and severe pulmonary involvement can be associated with Puumala virus infection, albeit these findings are not specific.Misunderstanding exists about what constitutes comprehension-based monitoring in speaking and what it empirically implies. Here, I make clear that the use of the speech comprehension system is the defining property of comprehension-based monitoring rather than conscious and deliberate processing, as maintained by Nozari (2020). Therefore, contrary to what Nozari claims, my arguments in Roelofs (2020) are suitable for addressing her criticisms raised against comprehension-based monitoring. Also, I indicate that Nozari does not correctly describe my view in a review of her paper. Finally, I further clarify what comprehension-based monitoring entails empirically, thereby dealing with Nozari's new criticisms and inaccurate descriptions of empirical findings. I conclude that comprehension-based monitoring remains a viable account of self-monitoring in speaking.Roelofs (2020) has put forth a rebuttal of the criticisms raised against comprehension-based monitoring and has also raised a number of objections against production-based monitors. In this response, I clarify that the model defended by Roelofs is not a comprehension-based monitor, but belongs to a class of monitoring models which I refer to as production-perception models. I review comprehension-based and production-perception models, highlight the strength of each, and point out the differences between them. I then discuss the limitations of both for monitoring production at higher levels, which has been the motivation for production-based monitors. Next, I address the specific criticisms raised by Roelofs (2020) in light of the current evidence. I end by presenting several lines of arguments that preclude a single monitoring mechanism as meeting all the demands of monitoring in a task as complex as communication. A more fruitful avenue is perhaps to focus on what theories are compatible with the nature of representations at specific levels of the production system and with specific aims of monitoring in language production.Speakers occasionally make speech errors, which may be detected and corrected. According to the comprehension-based account proposed by Levelt, Roelofs, and Meyer (1999) and Roelofs (2004), speakers detect errors by using their speech comprehension system for the monitoring of overt as well as inner speech. According to the production-based account of Nozari, Dell, and Schwartz (2011), speakers may use their comprehension system for external monitoring but error detection in internal monitoring is based on the amount of conflict within the speech production system, assessed by the anterior cingulate cortex (ACC). Here, I address three main arguments of Nozari et al. and Nozari and Novick (2017) against a comprehension-based account of internal monitoring, which concern cross-talk interference between inner and overt speech, a double dissociation between comprehension and self-monitoring ability in patients with aphasia, and a domain-general error-related negativity in the ACC that is allegedly independent of conscious awareness. I argue that none of the arguments are conclusive, and conclude that comprehension-based monitoring remains a viable account of self-monitoring in speaking.As all human activities, verbal communication is fraught with errors. It is estimated that humans produce around 16,000 words per day, but the word that is selected for production is not always correct and neither is the articulation always flawless. However, to facilitate communication, it is important to limit the number of errors. This is accomplished via the verbal monitoring mechanism. A body of research over the last century has uncovered a number of properties of the mechanisms at work during verbal monitoring. Over a dozen routes for verbal monitoring have been postulated. However, to date a complete account of verbal monitoring does not exist. In the current paper we first outline the properties of verbal monitoring that have been empirically demonstrated. This is followed by a discussion of current verbal monitoring models the perceptual loop theory, conflict monitoring, the hierarchical state feedback control model, and the forward model theory. Each of these models is evaluated given empirical findings and theoretical considerations.
