Persistent Correlation of Ghrelin Plasma Levels with Body Mass Index Both in Stable Weight Conditions and during Gastric-bypass-induced Weight Loss

Background: Studies done on serial changes in plasma ghrelin levels after gastric bypass (GBP) have yielded contrasting results since decreased, unchanged, or increased levels have been reported in the literature. This study investigates whether or not GBP has an inhibitory effect on fasting ghrelin levels independently of weight loss. Methods: Fasting ghrelin levels were measured in 115 stable body weight females, classified as normal body weight (NW; body mass index (BMI) 50kg/m2). Results: Each obese subgroup showed significantly lower ghrelin levels as compared to both NW (p < 0.0001) and OW subjects (p < 0.05 or 0.005); however, no significant differences were observed within the three obese subgroups. Forty-nine obese patients underwent a GBP. Plasma ghrelin, measured at 3, 6, and 12months after GBP, significantly increased from the sixth month on (p < 0.0001). When patients were classified, at each postoperative time point, according to their actual BMI, ghrelin was significantly (p = 0.0002) related to postoperative BMI and not significantly different from ghrelin measured in stable body weight conditions. Conclusions: Fasting ghrelin displays an inversely significant correlation with BMI in both stable body weight conditions and after GBP. No evidence was found that GBP had an effect on fasting ghrelin levels, independent of weight los

The role of posterior fossa decompression in acute cerebellitis

Background: We present two cases of children who were diagnosed with cerebellitis with acute cerebellar swelling. This rare pathology is potentially fatal, and no clear treatment guidelines are described in the literature. Discussion: Considering our experience, we discuss the different therapeutic strategies and propose aggressive surgical measures consisting of external ventricular drainage and posterior fossa decompression in case of failure of early response to medical treatment to limit secondary cerebellar and brainstem lesion

The effect of insulin on cardiac autonomic balance predicts weight reduction after gastric bypass

Aims/hypothesis: The aim of this study was to assess the predictive role of autonomic reactivity in body weight loss induced by gastric bypass. Methods: A group of 22 morbidly obese subjects, who were due to undergo a gastric bypass, were submitted, before surgery, to a euglycaemic-hyperinsulinaemic clamp, during which a continuous recording of the ECG was performed. The effect of insulin on cardiac autonomic balance was evaluated by performing power spectral analysis of heart rate variability. The low-to-high frequency ratio was calculated before and during the clamp and its modifications were expressed as % delta low-to-high frequency ratio (%Δ L: H). Results: Preoperative %Δ L: H showed a significant (p=0.0009, r 2=0.43), positive relationship to the reduction of body weight, measured 1 year after surgery and expressed as % excess weight loss (% EWL). Preoperative BMI was also significantly (p=0.0009, r 2=0.43) negatively related to the 12-month % EWL. In a multiple regression analysis, %Δ L: H remained a significant (p=0.003), independent predictor of body weight loss, even when preoperative BMI or age, % fat mass, insulinaemia and glucose disposal were taken into account. Conclusions/interpretation: The best correction of excess body weight was achieved by those obese subjects who had a preserved capacity to shift their cardiac autonomic balance towards a sympathetic prevalence in response to an euglycaemic-hyperinsulinaemic clamp. Further studies are needed to elucidate the mechanisms through which the autonomic nervous system influences weight reductio

Functional characterization of infiltrating T lymphocytes in human hepatic allografts

We have employed recently developed techniques in T-cell culturing to study the nature and function of infiltrating hepatic allograft T cells. Using the rationale that intragraft T cells are activated during cell mediated damage to the allograft, we were able to show that these cells would propagate and remain functionally active in the presence of the T-cell growth factor, IL-2. In several instances, phenotyiic analysis of cells grown in this manner was very similar to that found within the graft. Both proliferative and cytotoxic responses could be detected from the cultured cell lines. The majority of the proliferative responses were donor-directed and immunogenetic analysis could define donor-directed HLA reactivity, to either class I or class II antigens, or both. Monoclonal anti-HLA antibodies inhibition profiles verified the apparent HLA reactivity. In a smaller percentage of cases, only IL-2 responsiveness could be detected, and no HLA reactivity could be determined. Cytotoxicity could be detected against both class I and class II antigens, however, those cells which demonstrated a greater magnitude of donor-directed cytotoxicity appeared to be directed against class I antigens. A significant correlation between donor-directed proliferation of biopsy cultured lymphocytes and cellular rejection was found. This model appears to be useful in delineating functions of the intragraft T-cell population during rejection. © 1986

X-ray emission during the muonic cascade in hydrogen

We report our investigations of X rays emitted during the muonic cascade in hydrogen employing charge coupled devices as X-ray detectors. The density dependence of the relative X-ray yields for the muonic hydrogen lines (K_alpha, K_beta, K_gamma) has been measured at densities between 0.00115 and 0.97 of liquid hydrogen density. In this density region collisional processes dominate the cascade down to low energy levels. A comparison with recent calculations is given in order to demonstrate the influence of Coulomb deexcitation.Comment: 5 pages, Tex, 4 figures, submitted to Physical Review Letter

Association of Under-Approximation Techniques for Generating Tests from Models

International audienceIn this paper we present a Model-Based Testing approach with which we generate tests from an abstraction of a source behavioural model. We show a new algorithm that computes the abstraction as an under-approximation of the source model. Our first contribution is to combine two previous approaches proposed by Ball and Pasareanu et al. to compute May, Must+ and Must- abstract transition relations. Prooftechniques are used to compute these transition relations. The tests obtained by covering the abstract transitions have to be instantiated from the source model. So, following Pasareanu et al., our algorithm additionally computes a concrete transition relation: the tests obtained as sequences of concrete transitions need not be instantiated from the source model. Another contribution is to propose a choice of relevant paramaters and heuristics to pilot the tests computation. We experiment our approach and compare it with a previous approach of ours to compute tests from an abstraction that over-approximates the source model

BALANCING ACTS: EXPLORING THE DUAL ROLES OF MARRIED TEACHERS IN GEOGRAPHICALLY ISOLATED AND DISADVANTAGED AREAS (GIDA)

The purpose of this qualitative multiple-case research study was to unfold the multifaceted experiences, coping, and insights of educators during the full in-person education, focusing on their narratives and strategies to combat the challenges and opportunities brought about by this educational crisis during the pandemic. There were seven (7) teacher participants utilized in this study using the purposive sampling technique, and each of them underwent an in-depth interview using a semi-structured interview guide to gather data. The study presented a deep exploration of their perspectives and actions. The key findings emerged from the data: unity and collaboration in education, and supporting academically challenged learners through collaboration. The findings highlighted the importance of unity and collaboration within the educational community, the benefits of professional learning communities, interdisciplinary collaboration, mentorship, and fostering a positive school culture. The educational findings also probed strategies employed by teachers to support academically challenged learners during the pandemic and stressed the importance of combined efforts with parents and learner-centric approaches. They recognized the vital role of parents in creating conducive learning environments and emphasized the need for differentiated teaching strategies to accommodate diverse learning styles and abilities. This study would contribute valuable insights into the evolving environment of education during a global crisis. The narratives and experiences shared by educators offer practical implications for enhancing educational practices and resilience in the face of future challenges in the field of education.  Article visualizations

EMBRACING CHANGE: UNVEILING TEACHERS’ EXPERIENCES IN THE DEPARTMENT OF EDUCATION “OPLAN BAKLAS” BARE CLASSROOM WALLS POLICY

This phenomenological study explored the lived experiences of 10 purposively selected teachers in implementing the Department of Education’s “Oplan Baklas” Bare Classroom Walls Policy. Using a qualitative research design, data were gathered through in-depth interviews and analyzed using Colaizzi’s method for phenomenological analysis. The findings revealed several challenges faced by teachers, including the absence of visual learning materials, reduced learner engagement, difficulty in introducing new concepts, restricted creativity, and a diminished sense of community within the classroom. Participants also expressed concerns about emotional and financial burdens, although some acknowledged that the policy helped reduce classroom decoration expenses. To overcome these challenges, teachers demonstrated resilience and adaptability by reassessing their teaching strategies, becoming more resourceful, and integrating computer-aided instruction. They creatively maximized their learning spaces, leading to improved learner attention and a more focused environment. Some teachers embraced the policy as an opportunity to rethink conventional classroom norms and practices. Ultimately, this study underscores the importance of teacher adaptability and innovation in navigating systemic educational reforms, highlighting that even in the face of limitations, educators can transform challenges into meaningful opportunities for growth, creativity, and professional development.  Article visualizations

An Internet-Based Guided Self-Help Intervention for Panic Symptoms: Randomized Controlled Trial.

Background: Internet-based guided self-help is efficacious for panic disorder, but it is not known whether such treatment is effective for milder panic symptoms as well. Objective: To evaluate the effectiveness of Don't Panic Online, an Internet-based self-help course for mild panic symptoms, which is based on cognitive behavioral principles and includes guidance by email. Methods: A pragmatic randomized controlled trial was conducted. Participants (N=126) were recruited from the general population and randomized to either the intervention group or to a waiting-list control group. Inclusion criteria were a Panic Disorder Severity Scale-Self Report (PDSS-SR) score between 5-15 and no suicide risk. Panic symptom severity was the primary outcome measure; secondary outcome measures were anxiety and depressive symptom severity. Measurements were conducted online and took place at baseline and 12 weeks after baseline (T1). At baseline, diagnoses were obtained by telephone interviews. Results: Analyses of covariance (intention-to-treat) showed no significant differences in panic symptom reduction between groups. Completers-only analyses revealed a moderate effect size in favor of the intervention group (Cohen's d=0.73, P=.01). Only 27% of the intervention group finished lesson 4 or more (out of 6). Nonresponse at T1 was high for the total sample (42.1%). Diagnostic interviews showed that many participants suffered from comorbid depression and anxiety disorders. Conclusions: The Internet-based guided self-help course appears to be ineffective for individuals with panic symptoms. However, intervention completers did derive clinical benefits from the intervention