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36, 95% CI 1.05-1.76) and cardiovascular (HR 1.51, 95% CI 1.07-2.13) mortality. We found both higher SBP and faster RPR were independently associated with all-cause and cardiovascular mortality, and lower SBP was only associated with the increased risk of all-cause mortality in oldest old community-dwelling Chinese population. Our results demonstrate the prognostic importance of both SBP and RPR in the elderly.This systematic review examined the impact of exercise training interventions on energy intake (EI) and appetite control in adults with overweight/obesity (≥18 years including older adults). Articles were searched up to October 2019. Changes in EI, fasting appetite sensations, and eating behavior traits were examined with random effects meta-analysis, and other outcomes were synthesized qualitatively. Forty-eight articles were included (median [range] BMI = 30.6 [27.0-38.4] kg/m2 ). Study quality was rated as poor, fair, and good in 39, seven, and two studies, respectively. Daily EI was assessed objectively (N = 4), by self-report (N = 22), with a combination of the two (N = 4) or calculated from doubly labeled water (N = 1). In studies rated fair/good, no significant changes in pre-post daily EI were found and a small but negligible (SMD less then 0.20) postintervention difference when compared with no-exercise control groups was observed (five study arms; MD = 102 [1, 203] kcal). There were negligible-to-small pre-post increases in fasting hunger and dietary restraint, decrease in disinhibition, and some positive changes in satiety and food reward/preferences. Within the limitations imposed by the quality of the included studies, exercise training (median duration of 12 weeks) leads to a small increase in fasting hunger and a small change in average EI only in studies rated fair/good. Exercise training may also reduce the susceptibility to overconsumption (PROSPERO CRD42019157823).
To describe a case of Waterhouse-Friderichsen syndrome of adrenocortical failure in a cat with Klebsiella spp. infection.
A 12-year-old male neutered domestic short-haired cat was referred for respiratory failure requiring mechanical ventilation. The cat remained comatose despite successful weaning from the ventilator and developed a Klebsiella pneumoniae pneumonia. On day 4 of hospitalization, the cat acutely deteriorated with profound hypotension, azotemia, and hyperkalemia, which rapidly progressed to cardiac arrest. Necropsy findings revealed massive adrenal hemorrhage and intralesional bacteria, termed Waterhouse-Friderichsen syndrome. Waterhouse-Friderichsen syndrome was suspected to have been the cause of acquired adrenocortical insufficiency and sudden death of the cat.
To the authors' knowledge, this is the first report of sepsis causing Waterhouse-Friderichsen syndrome in a veterinary species.
To the authors' knowledge, this is the first report of sepsis causing Waterhouse-Friderichsen syndrome in a veterinary species.
To investigate intrinsic sensitivity of an electronic portal imaging device (EPID) and the ArcCHECK detector and to use this in assessing their performance in detecting delivery variations for lung SBRT VMAT. The effect of detector spatial resolution and dose matrix interpolation on the gamma pass rate was also considered.
Fifteen patients' lung SBRT VMAT plans were used. Delivery variations (errors) were introduced by modifying collimator angles, multi-leaf collimator (MLC) field sizes and MLC field shifts by ±5, ±2, and ±1 degrees or mm (investigating 103 plans in total). EPID and ArcCHECK measured signals with introduced variations were compared to measured signals without variations (baseline), using OmniPro-I'mRT software and gamma criteria of 3%/3mm, 2%/2mm, 2%/1mm, and 1%/1mm, to test each system's basic performance. The measurement sampling resolution for each was also changed to 1mm and results compared to those with the default detector system resolution.
Intrinsic detector sensitivity analysiful gamma criteria and the choice of optimal QA device for site-specific dose verification.Anti-drug antibody (ADA) formation is a major complication in treatment of the X-linked bleeding disorder haemophilia B (deficiency in coagulation factor IX, FIX). Current clinical immune tolerance protocols are often not effective due to complications such as anaphylactic reactions against FIX. Plant-based oral tolerance induction may address this problem, as illustrated by the recent first regulatory approval of orally delivered plant cells to treat peanut allergy. Our previous studies showed that oral delivery of plant cells expressing FIX fused to the transmucosal carrier CTB (cholera toxin subunit B) in chloroplasts suppressed ADA in animals with haemophilia B. We report here creation of the first lettuce transplastomic lines expressing a coagulation factor, in the absence of antibiotic resistance gene. Stable integration of the CTB-FIX gene and homoplasmy (transformation of ~10 000 copies in each cell) were maintained in both T1 and T2 generation marker-free plants. CTB-FIX expression in lyophilized leaves of T1 and T2 marker-free plants was 1.0-1.5 mg/g dry weight, confirming that the marker excision did not affect antigen levels. Oral administration of CTB-FIX to Sprague Dawley rats at 0.25, 1 or 2.5 mg/kg did not produce overt adverse effects or toxicity. The no-observed-adverse-effect level (NOAEL) is at least 2.5 mg/kg for a single oral administration in rats. Oral administration of CTB-FIX at 0.3 or 1.47 mg/kg either mixed in food or as an oral suspension to Beagle dogs did not produce any observable toxicity. These toxicology studies should facilitate filing of regulatory approval documents and evaluation in haemophilia B patients.The vast majority of nanomaterials studied in light of their ability to transmit chirality to or amplify their chirality in a surrounding medium, constitute an achiral core with chirality solely installed at the surface by conjugation or encapsulation with optically active ligands. Here we present the inverse approach focusing on surface-modified cellulose nanocrystals (CNCs) with core chirality at both the molecular and the morphological level to quantify transmission and amplification of core chirality through space using a host nematic liquid crystal (N-LC) as reporter. We find that CNCs functionalized at the surface with achiral molecules, structurally related to the N-LC, exhibit better N-LC solubility, thereby serving as highly efficient chiral inducers. Moreover, functionalization with chiral molecules only marginally enhances the efficacy of helical distortion in the host N-LC matrix, indicating the high propensity of CNCs to transfer chirality from an inherently chiral core.
The use of ultrasound (US)-guided intradiscal injection has been described in the literature with the patient lying in the prone position; however, many patients are unable to lie in the prone position. learn more Therefore, we describe an innovative technique of US-guided platelet-rich plasma (PRP) administration in the lumbar intervertebral disc (IVD) of 3 patients with chronic lower back pain who failed to improve with conservative management.
For all the 3 patients, magnetic resonance imaging showed annular tears of the L5/S1 IVD with broad-based central posterior protrusions. PRP injection was performed with the patients in the lateral decubitus position or modified recovery position. With the transducer initially placed in the short axis to the lumbar spine, the needle was inserted in-plane to the IVD, with the needle trajectory clearly visualized. Once the needle entered the annulus fibrosus, placement of the needle was confirmed by turning the transducer along the long axis of the spine to validate the location of the needle tip inside the IVD. Discus stimulation was performed with contrast administered to elicit each patient's usual pain, and spread of the contrast was confirmed under fluoroscopy. Upon confirmation of the intradiscal location, 3ml of PRP was administered.
This report described a novel technique demonstrating that US-guided lumbar intradiscal needle placement for PRP administration in patients lying in the lateral decubitus position is feasible.
This report described a novel technique demonstrating that US-guided lumbar intradiscal needle placement for PRP administration in patients lying in the lateral decubitus position is feasible.
The current evidence regarding the alterations experienced by the alveolar ridge (hard tissue changes) after implant removal due to peri-implantitis is limited.
To assess the hard tissue dimensional changes following implant removal due to peri-implantitis.
Clinical records were examined to identify patients with implants that had to be removed due to a hopeless prognosis secondary to peri-implantitis due to expendability of peri-implantitis implants for functional reasons. Patients with preoperative and postoperative cone-beam computed tomography (CBCT) scans were included. Patient-related, implant-related, and surgery-related factors were assessed based on the clinical records. Linear measurements were made to evaluate the influence of bone plate thickness (BPT), ridge width (RW), and ridge height (RH) at various levels upon the outcome of implant removal. A descriptive statistical analysis of the quantitative and qualitative variables was performed. Correlations of the variables with the primary outcd the use of a removal kit may considerably reduce the impact upon the dimensional changes (NCT04534361).
Minimal hard tissue changes can be expected following implant removal due to peri-implantitis. Simultaneous bone regeneration procedures and the use of a removal kit may considerably reduce the impact upon the dimensional changes (NCT04534361).Illness as the result of ingesting bacterially contaminated foodstuffs represents a significant annual loss of human quality of life and economic impact globally. Significant research investment has recently been made in developing new materials that can be used to construct food contacting tools and surfaces that might minimize the risk of cross-contamination of bacteria from one food item to another. This is done to mitigate the spread of bacterial contamination and resultant foodborne illness. Internet-based literature search tools such as Web of Science, Google Scholar, and Scopus were utilized to investigate publishing trends within the last 10 years related to the development of antimicrobial and antifouling surfaces with potential use in food processing applications. Technologies investigated were categorized into four major groups antimicrobial agent-releasing coatings, contact-based antimicrobial coatings, superhydrophobic antifouling coatings, and repulsion-based antifouling coatings. The advantages for each group and technical challenges remaining before wide-scale implementation were compared. A diverse array of emerging antimicrobial and antifouling technologies were identified, designed to suit a wide range of food contact applications. Although each poses distinct and promising advantages, significant further research investment will likely be required to reliably produce effective materials economically and safely enough to equip large-scale operations such as farms, food processing facilities, and kitchens.
