Obesity and Gall stones

To evaluate the performance of selected host immunological biomarkers in differentiating tuberculosis (TB) disease from latent TB infection (LTBI) in HIV uninfected and infected individuals enrolled in TB low-burden countries.
Participants with TB disease (N=85) and LTBI (N=150) were recruited from prospective cohorts at hospitals in Norway and Denmark. Plasma concentrations of 54 host markers were assessed by Luminex multiplex immunoassays. Using receiver operator characteristic curves and general discriminant analysis, we determined the abilities of individual and combined biomarkers to discriminate between TB disease and LTBI including when patients were stratified according to HIV infection status.
Regardless of the groups compared, CCL1 and IL-2Ra were the most accurate single biomarkers in differentiating TB disease from LTBI. Regardless of HIV status, a 4-marker signature (CCL1+RANTES+CRP+MIP-1α) derived from a training set (n=155) differentiated TB disease from LTBI in the test set (n=67) with a sensitivity of 56.0% (95% CI, 34.9-75.6) and a specificity of 85.7% (95% CI, 71.5-94.6). A 5-marker signature derived from the HIV uninfected group (CCL1+RANTES+MIP-1α+procalcitonin+IP-10) performed in HIV-infected individuals with a sensitivity of 75.0% and a specificity of 96.7% after leave-one-out cross validation. A 2-marker signature (CCL1+TNF-α) identified in HIV-infected persons performed in HIV-uninfected with a sensitivity and specificity of 66.7% and 100% respectively in the test set.
Plasma CCL1 and IL-2Ra have potential as biomarkers for differentiating TB disease from LTBI in low TB burden settings unaffected by HIV infection. Combinations between these and other biomarkers in bio-signatures for global use warrant further exploration.
Plasma CCL1 and IL-2Ra have potential as biomarkers for differentiating TB disease from LTBI in low TB burden settings unaffected by HIV infection. Combinations between these and other biomarkers in bio-signatures for global use warrant further exploration.Four new C-11 monosaccharide attached dammarane triterpenoid glycosides cypaliurusides SV (1-4), along with nine known dammarane triterpenoid glycosides (5-13) were isolated from a CHCl3-soluble extract of the leaves of Cyclocarya paliurus. All characterized compounds were assayed for their cytotoxicities against HepG2 cells and 10 compounds were evaluated for the agonistic effects on sirtuin1 (SIRT1). The results showed that compounds 1, 5 and 6 were strongly cytotoxic in HepG2 cell line. Two dammarane triterpenoid glycosides 3 and 10 exhibited agonistic activities on SIRT1 with IC50 of 10 μM and 20 μM, respectively.
IgE to galactose alpha-1,3 galactose (alpha-gal) causes alpha-gal syndrome (delayed anaphylaxis after ingestion of mammalian meat). Development of sensitization has been attributed to tick bites; however, the possible role of other parasites has not been well studied.
Our aims were to assess the presence, relative abundances, and site of localization of alpha-gal-containing proteins in common ectoparasites and endoparasites endemic in an area of high prevalence of alpha-gal syndrome, as well as to investigate the ability of ascaris antigens to elicit a reaction in a humanized rat basophil invitro sensitization model.
Levels of total IgE, Ascaris-specific IgE, and alpha-gal IgE were measured in sera from patients with challenge-proven alpha-gal syndrome and from controls without allergy. The presence, concentration, and localization of alpha-gal in parasites were assessed by ELISA, Western blotting, and immunohistochemistry. The ability of Ascaris lumbricoides antigen to elicit IgE-dependent reactivity wng proteins in parasites. The activation of RS-ATL8 IgE reporter cells primed with serum from subjects with alpha-gal syndrome on exposure to non-alpha-gal-containing A lumbricoides proteins indicates a possible role of exposure to A lumbricoides in alpha-gal sensitization and clinical reactivity.
The genetic basis of a considerable fraction of hypertrophic cardiomyopathy (HCM) cases remains unknown. Whether the gene encoding RNA Binding Motif Protein 20 (RBM20) is implicated in HCM and the correlation of clinical characteristics of RBM20 heterozygotes with HCM remain unresolved. Talazoparib PARP inhibitor We aimed to investigate the association between RBM20 variants and HCM.
We compared rare variants in the RBM20 gene by exome sequencing in 793 HCM patients and 414 healthy controls. Based on a case-control approach, we used SKAT-O to explore whether RBM20 is associated with HCM. The genetic distribution of RBM20 rare variants was then compared between HCM heterozygotes and dilated cardiomyopathy (DCM) heterozygotes. Clinical features and prognosis of RBM20 heterozygotes were compared with non-heterozygotes.
Gene-based association analysis implicated RBM20 as a susceptibility gene for developing HCM. Patients with RBM20 variants displayed a higher prevalence of sudden cardiac arrest (SCA) (6.7% vs. 0.9%, p = 0.001), increased sudden cardiac death (SCD) risk factor counts and impaired left ventricle systolic function. Further survival analysis revealed that RBM20 heterozygotes had higher incidences of resuscitated cardiac arrest, recurrent non-sustained ventricular tachycardia and malignant arrhythmias. Mendelian randomization suggested that RBM20 expression in left ventricle was causally associated with HCM and DCM with opposite effects.
This study identified RBM20 as a potential causal gene of HCM. RBM20 variants are associated with increased risk for SCA in HCM.
This study identified RBM20 as a potential causal gene of HCM. RBM20 variants are associated with increased risk for SCA in HCM.In recent years, artificial intelligence (AI) has found numerous applications in cardiology due in part to large digitized datasets and the evolution of high performance computing. link2 In the discipline of cardiac electrophysiology (EP), a number of clinical, imaging, and electrical waveform data are considered in the diagnosis, prognostication and management of arrhythmias, which lend themselves well to automation through AI. link3 But equally relevant, AI offers a unique opportunity to discover novel EP concepts and improve clinical care through its inherent, hierarchical tenets of self-learning. This review will focus on the application of AI in clinical EP and summarize state-of-the art, large, clinical studies in the following key domains (1) ECG-based arrhythmia and disease classification, (2) atrial fibrillation source detection, (3) substrate and risk assessment for atrial fibrillation and ventricular tachyarrhythmias, and (4) predicting outcomes after cardiac resynchronization therapy. Many are small, single-center, proof-of-concept investigations, but they still demonstrate groundbreaking performance of deep learning, a subdomain of AI, which surpasses traditional statistical analysis. Larger studies, for instance classifying arrhythmias from ECG recordings, have further provided external validation of their high accuracy. Ultimately, the performance of AI is dependent on the quality of the input data and the rigor of algorithm development. The field is still nascent and several barriers will need to be overcome, including prospective validation in large, well-labelled datasets and more seamless information technology-based data collection/integration, before AI can be adopted into broader clinical EP practice. This review will conclude with a discussion of these challenges and future work.
We developed a multi-axis lead (Max
) incorporating four electrodes arranged at the lead-tip organized in an equidistant tetrahedron. Here, we studied Max
performance in sensing, pacing and activation wavefront-direction analysis.
Sixteen explanted animal hearts (from 7 pigs, 7 sheep and 2 rabbits) were used. Pacing threshold was tested from all axes of Max
from RV apex before and after simulated dislodgement. Additionally, conduction-system pacing was performed in sheep heart preparations from all axes of Max
. Sensing via Max
positioned at RV apex was tested during sinus rhythm (SR), pacing from RV and LV free-wall, and ventricular fibrillation (VF). Max
-enabled voltage (Max
), defined as the largest span of the sensed electric field loop, was compared to traditional lead-tip voltage detection.
Pacing Max
minimized change in pacing threshold due to lead-dislodgement (average voltage change 0.2 mV, 95% CI (-0.5, 0.9)), using multiple bipoles available for pacing. In animals with high conduction system pacing thresholds (>2mV) in one or more bipoles (3/7), acceptable thresholds (<1 mV) were demonstrated in an average of 2.5 remaining bipoles. Sensing Max
of SR and VF was consistently higher than the highest bipolar voltage (voltage difference averaged -0.18 mV, 95% confidence interval (CI -0.28 to -0.07), p=0.001). Electric field loop geometry consistently differentiated ventricular activation in SR from that during pacing from RV and LV free walls.
The multi-axis Max
electrode showed advantages in pacing, sensing and mapping and has the potential to allow for improvements in lead/electrode technology for cardiac implanted electronic devices.
The multi-axis MaxLead electrode showed advantages in pacing, sensing and mapping and has the potential to allow for improvements in lead/electrode technology for cardiac implanted electronic devices.IgG4-related disease is an immune-mediated fibro-inflammatory disorder with multisystemic involvement. Aortitis and periaortitis are the most common cardiovascular manifestations of the disease. We present the case of a 65-year-old male with symptomatic severe aortic stenosis and concomitant IgG4 aortitis. The diagnosis was confirmed by IgG4 serum levels, positive PET-TC, and pathology from mediastinal dissection. Surgical aortic valve replacement (SAVR) was unfeasible due to extensive mediastinal fibrosis, and transcatheter aortic valve replacement (TAVR) was successfully performed. Since ascending aorta access for SAVR in IgG4 aortitis with long-run fibrosis entails a high mortality risk, TAVR could be considered in certain suitable patients.One of the very reliable, attractive, and cheapest techniques for synthesizing nanofibers for biomedical applications is electrospinning. Here, we have created a novel nanofibrous composite coated Ti plate to mimic an Extra Cellular Matrix (ECM) of native bone in order to enhance the bone tissue regeneration. An electrospun fibrous composite was obtained by the combination of minerals (Zn, Mg, Si) substituted hydroxyapatite (MHAP)/Polyethylene Glycol (PEG)/Cissus quadrangularis (CQ) extract. Fibrous composite's functionality, phase characteristics, and morphology were evaluated by FT-IR, XRD, and SEM techniques, respectively. The average fiber diameter of MHAP/PVA had decreased from ~274 to ~255 nm after incorporating PEG polymer. That further increased from ~255 to ~275 nm after adding CQ extract. Besides the bioactivity in SBF solution, the degradable nature was confirmed by immersing the fibrous composite in Tris-HCL solution. The degradable studies evaluate that the composite was degraded depending on time, and it degrades about 9.42% after 7 days of immersion. Osteoblasts like MG-63 cells differentiation, proliferation, and calcium deposition were also determined. These results show that this new fibrous composite exhibits advanced osteoblasts properties. Thus, we concluded that this new fibrous scaffold coated Ti implant could act as a better implant to mimic ECM of bone structure and to improve osteogenesis during bone regeneration.