Ribavirin Impairs Salivary gland function During Combination Treatment With Pegylated Interferon Alfa-2a In HEpatitis C patients

Background: Xerostomia is a common adverse event of unknown etiology observed during pegylated interferon (PegIFN)/Ribavirin (Rbv) treatment. Objectives: To assess the frequency and mechanisms of xerostomia during PegIFN/Rbv therapy. Patients and Methods: Thirty-one naive patients with chronic hepatitis C consecutively received PegIFN-alpha 2a (180 mu g/week) plus Rbv (800-1200 mg/day). The controls were 10 patients with chronic hepatitis B who received PegIFN-alpha 2a (180 mu g/week). During treatment and follow-up, all patients underwent basal and masticatory stimulated sialometry, otorhinolaryngoiatric (ORL) examination, and a questionnaire survey to subjectively assess symptoms of oral dryness. Results: Twenty-seven patients on PegIFN/Rbv and 4 on PegIFN (87% vs. 40%, P = 0.006) reported xerostomia. Thirty patients on PegIFN/Rbv combination therapy and 2 patients on monotherapy had ORL signs of salivary gland hypofunction (97% vs. 20%, P < 0.0001). Mean basal (A) and stimulated (B) salivary flow rates (mL/min) progressively decreased during PegIFN/Rbv treatment (A, 0.49 at baseline vs. 0.17 at the end of treatment, P < 0.0001; B,1.24 at baseline vs. 0.53 at the end of treatment, P = 0.0004). At week 24 following PegIFN/Rbv treatment, salivary flow rates were similar to baseline (A, 0.53 at the end of follow-up vs. 0.49 at baseline; B,1.19 at the end of follow-up vs. 1.24 at baseline). Salivary function was unaffected in monotherapy patients. Conclusions: Rbv causes salivary gland hypofunction in hepatitis C patients receiving PegIFN/Rbv therapy, which promptly reverts to normal upon cessation of treatment

Domain-specific regulation of cerebellar morphogenesis by Zfp423 / ZNF423, a gene implicated in Joubert syndrome and cerebellar vermis hypoplasia

The Zfp423 gene encodes a 30-Zn-finger transcription factor that acts as a scaffold for the assembly of complex transcriptional and cellular machineries regulating neural development. While null Zfp423 mutants feature a sharp decrease in the total number of cerebellar Purkinje cells (PCs), the underlying mechanisms remain unclear. Mutations of the human homolog ZNF423 have been identified in patients carrying cerebellar vermis hypoplasia (CVH) or Joubert Syndrome (JS), associated with other signs of classical ciliopathy outside the central nervous system. To further characterize the role of ZFP423 in cerebellar neurogenesis, we have performed morphological, cellular and molecular studies on two mutant mouse lines carrying allelic in-frame deletions of Zfp423. While both lines exhibit cerebellar hypoplasia, considerable differences are observed between the two mutants, with respect to neural progenitor differentiation, cell survival and morphogenesis. The results of this in vivo and in vitro structure-function analysis point to domain- and context-specific roles played by ZFP423 in different aspects of cerebellar development, and contribute to our understanding of its role as a disease / modifier gene in JS, CVH and other ciliopathies

Dopamine signaling enriched striatal gene set predicts striatal dopamine synthesis and physiological activity in vivo

The polygenic architecture of schizophrenia implicates several molecular pathways involved in synaptic function. However, it is unclear how polygenic risk funnels through these pathways to translate into syndromic illness. Using tensor decomposition, we analyze gene co-expression in the caudate nucleus, hippocampus, and dorsolateral prefrontal cortex of post-mortem brain samples from 358 individuals. We identify a set of genes predominantly expressed in the caudate nucleus and associated with both clinical state and genetic risk for schizophrenia that shows dopaminergic selectivity. A higher polygenic risk score for schizophrenia parsed by this set of genes predicts greater dopamine synthesis in the striatum and greater striatal activation during reward anticipation. These results translate dopamine-linked genetic risk variation into in vivo neurochemical and hemodynamic phenotypes in the striatum that have long been implicated in the pathophysiology of schizophrenia

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Predicting Stormwater Retention Capacity of Green Roofs: An Experimental Study of the Roles of Climate, Substrate Soil Moisture, and Drainage Layer Properties

Due to the ever-increasing degree of urbanization, blue and green infrastructures are becoming important tools for achieving stormwater management sustainability in urban areas. Concerning green roofs, although scientists have investigated their behaviors under different climates and building practices, their hydrological performance is still a thought-provoking field of research. An event scale analysis based on thirty-five rainfall-runoff events recorded at a new set of experimental green roofs located in Southern Italy has been performed with the aim of identifying the relative roles of climate, substrate moisture conditions, and building practices on retention properties. The retention coefficient showed a wide range of variability, which could not be captured by neither simple nor multiple linear regression analysis, relating the latter to rainfall characteristics and substrate soil water content. Significant improvements in the prediction of the retention coefficient were obtained by a preliminary identification of groups of rainfall-runoff events, based on substrate soil water content thresholds. Within each group, a primary role is played by rainfall. At the experimental site, building practices, particularly those concerning the drainage layer properties, appeared to affect the retention properties only for specific event types

Robust mean-variance portfolio through the weighted Lp depth function

Portfolios constructed by the classical mean-variance model are very sensitive to outliers. We propose the use of a non-parametric estimation method based on statistical data depth functions. Specifically, we exploit the notion of the weighted Lp depth function to obtain robust estimates of the mean and covariance matrix of the asset returns. This approach has the advantage to be independent of parametric assumptions, and less sensitive to changes in the asset return distribution than traditional techniques. The proposed procedure is evaluated and compared with standard and other robust techniques through simulated and real data. Results indicate effective improvements of the proposed method in terms of out-of-sample performance

Median constrained bucket order rank aggregation

The rank aggregation problem can be summarized as the problem of aggregating individual preferences expressed by a set of judges to obtain a ranking that represents the best synthesis of their choices. Several approaches for handling this problem have been proposed and are generally linked with either axiomatic frameworks or alternative strategies. In this paper, we present a new definition of median ranking and frame it within the Kemeny’s axiomatic framework. Moreover, we show the usefulness of our approach in a practical case about triage prioritization

Boosted-oriented probabilistic smoothing-spline clustering of series

Fuzzy clustering methods allow the objects to belong to several clusters simultaneously, with diferent degrees of membership. However, a factor that infuences the performance of fuzzy algorithms is the value of fuzzifer parameter. In this paper, we propose a fuzzy clustering procedure for data (time) series that does not depend on the defnition of a fuzzifer parameter. It comes from two approaches, theoretically motivated for unsupervised and supervised classifcation cases, respectively. The frst is the Probabilistic Distance clustering procedure. The second is the well known Boosting philosophy. Our idea is to adopt a boosting prospective for unsupervised learning problems, in particular we face with non hierarchical clustering problems. The global performance of the proposed method is investigated by various experiments