RBC volume deficiency in patients with excessive orthostatic decrease in cerebral blood flow velocity

AbstractBackgroundOrthostatic intolerance (OI) is common but heterogeneous. There is a subgroup of OI patients who have excessive decrease in cerebral blood flow velocity (CBFV) of bilateral middle cerebral arteries (MCAs) during head-up tilt without systemic blood pressure change. This study evaluated the role of blood volume reduction in such patients.MethodsPatients with idiopathic OI who had excessive orthostatic decrease (>20% of the supine level) in mean CBFV of bilateral MCAs and who also received blood volume determination were collected. The chromium (51Cr) dilution method was used for red blood cell (RBC) volume determination in these patients. The blood volume was expressed as a percentage of the expected volume. These patients were further divided into two groups, those with postural tachycardia syndrome (POTS group) and those without (non-POTS group). The data of RBC volume were compared between the two groups. Besides, we used multivariate linear regression to evaluate the factors that predict RBC volume.ResultsTwenty-five patients (13 females, median age = 28 years) were enrolled in this study. Nine of these patients had POTS (5 females, median age = 26 years) and 16 did not (8 females, median age = 29.5 years). Compared with the expected volume, the RBC volume was significantly reduced in all patients (median = 82% of the expected volume). Moreover, the RBC volume was significantly lower in the POTS group than that in the non-POTS group (78% vs. 85% of the expected volume, p = 0.013). The orthostatic decrease of MCA flow velocity was 28.3% in the POTS group and 32.5% in the non-POTS group (p = 0.140). The orthostatic pulsatility index increment was 15.4% in the POTS group and 20.5% in the non-POTS group (p = 0.438). Moreover, basic demography and hemoglobin levels were not different between the two groups. After multivariate linear regression (dependent variables including age, sex, body surface, and groups), only the presence of POTS significantly predicted the RBC volume (p = 0.006).ConclusionThe results of our study indicated that low RBC volume may play an important role in the pathophysiology of OI in this group of patients. Moreover, its role seems even more relevant in patients with POTS than in those without. Further studies for mechanistic evaluation are needed in the future

Nemonoxacin (Taigexyn^®): A New Non-Fluorinated Quinolone

Nemonoxacin (Taigexyn®), a novel C-8-methoxy non-fluorinated quinolone, has been approved for use in community-acquired pneumonia (CAP) in Taiwan (2014) and mainland China (2016). The FDA granted nemonoxacin ‘qualified infectious disease product’ and ‘fast-track’ designations for CAP and acute bacterial skin and skin structure infection in December 2013. It possesses a broad spectrum of bactericidal activity against typical and atypical respiratory pathogens. In particular, nemonoxacin has activity against resistant Gram-positive cocci, including penicillin-resistant Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus. Oral nemonoxacin was compared with oral levofloxacin for efficacy and safety in three randomized, double-blinded, controlled Phase II–III clinical trials for the treatment of CAP. This article will review the microbiological profile of nemonoxacin against respiratory pathogens including S. pneumoniae and S. aureus, and microbiological outcome data from the three Phase II–III studies

Tailoring excitonic states of van der Waals bilayers through stacking configuration, band alignment and valley-spin

Excitons in monolayer semiconductors have large optical transition dipole for strong coupling with light field. Interlayer excitons in heterobilayers, with layer separation of electron and hole components, feature large electric dipole that enables strong coupling with electric field and exciton-exciton interaction, at the cost that the optical dipole is substantially quenched (by several orders of magnitude). In this letter, we demonstrate the ability to create a new class of excitons in transition metal dichalcogenide (TMD) hetero- and homo-bilayers that combines the advantages of monolayer- and interlayer-excitons, i.e. featuring both large optical dipole and large electric dipole. These excitons consist of an electron that is well confined in an individual layer, and a hole that is well extended in both layers, realized here through the carrier-species specific layer-hybridization controlled through the interplay of rotational, translational, band offset, and valley-spin degrees of freedom. We observe different species of such layer-hybridized valley excitons in different heterobilayer and homobilayer systems, which can be utilized for realizing strongly interacting excitonic/polaritonic gases, as well as optical quantum coherent controls of bidirectional interlayer carrier transfer either with upper conversion or down conversion in energy

Computed Tomographic Appearance of Internal Herniation Through the Sigmoid Mesocolon

The case of a patient with surgically proven internal herniation of a loop of ileum through the sigmoid mesocolon is described. This 66-year-old man presented clinically with acute lower abdominal pain and an elevated white blood cell count. A computed tomography (CT) scan showed a thickened bowel loop with “bird-beak” appearance in the pelvis, centered towards the medial side and lying aside the effaced sigmoid colon. We think this CT picture is highly suggestive of internal herniation of the ileum through the sigmoid mesocolon, which is a rare clinical entity

Multi-parameter Tests of General Relativity Using Bayesian Parameter Estimation with Principal Component Analysis for LISA

In the near future, space-borne gravitational wave (GW) detector LISA can open the window of low-frequency band of GW and provide new tools to test gravity theories. In this work, we consider multi-parameter tests of GW generation and propagation where the deformation coefficients are varied simultaneously in parameter estimation and the principal component analysis (PCA) method are used to transform posterior samples into new bases for extracting the most informative components. The dominant components can be better mesured and constrained and are more sensitive to potential departures from general relativity (GR). We extend previous works by employing Bayesian parameter estimation and performing both null tests and tests with injections of subtle GR-violated signals. We also apply multi-parameter tests with PCA in the phenomenological test of GW propagation. This work complements previous works and further demonstrates the enhancement provided by the PCA method. Considering a supermassive black hole binary system as the GW source, we find that $1\sigma$ bounds of the most dominant PCA parameter can be one order of magnitude tighter than the bounds of original deformation parameter of leading frequency order. The departures less than $1\sigma$ in original parameters can yield significant departures in first 5 dominant PCA parameters.Comment: 16 pages, 6 figure

Differentiation of Foot-and-Mouth Disease-Infected pigs from Vaccinated Pigs Using Antibody-Detecting Sandwich ELISA

The presence of serum antibodies for nonstructural proteins of the foot-and-mouth disease virus (FMDV) can differentiate FMDV-infected animals from vaccinated animals. In this study, a sandwich ELISA was developed for rapid detection of the foot-and-mouth disease (FMD) antibodies; it was based on an Escherichia coli-expressed, highly conserved region of the 3ABC nonstructural protein of the FMDV O/TW/99 strain and a monoclonal antibody derived from the expressed protein. The diagnostic sensitivity of the assay was 98.4%, and the diagnostic specificity was 100% for naïve and vaccinated pigs; the detection ability of the assay was comparable those of the PrioCHECK and UBI kits. There was 97.5, 93.4 and 66.6% agreement between the results obtained from our ELISA and those obtained from the PrioCHECK, UBI and CHEKIT kits, respectively. The kappa statistics were 0.95, 0.87 and 0.37, respectively. Moreover, antibodies for nonstructural proteins of the serotypes A, C, Asia 1, SAT 1, SAT 2 and SAT 3 were also detected in bovine sera. Furthermore, the absence of cross-reactions generated by different antibody titers against the swine vesicular disease virus and vesicular stomatitis virus (VSV) was also highlighted in this assay's specificit