Tubulointerstitial nephritis in primary Sjögren syndrome: clinical manifestations and response to treatment

BACKGROUND: Primary Sjögren syndrome (pSS) is a common autoimmune condition which primarily affects epithelial tissue, often including the kidney causing either tubulointerstitial nephritis (TIN) or more rarely, an immune complex related glomerulonephritis. METHODS: We describe the clinical, biochemical and histological characteristics of 12 patients with pSS related TIN and their response to treatment with antiproliferative agents. All 12 patients were investigated and treated at the UCL Centre for Nephrology in London. RESULTS: All patients had TIN demonstrated via needle biopsy; immunophenotyping showed that the interstitial infiltrate was predominantly a CD4+ T-cell infiltrate. Urinary acidification testing demonstrated distal renal tubular acidosis in 8 patients. Proximal tubular dysfunction was present in 5 patients. All but 1 patient were treated with antiproliferative agents and most also with a reducing course of steroids. In the treated patients, there was a significant improvement in the serum creatinine and measured GFR. CONCLUSION: Patients with pSS TIN have significant renal impairment and other functional tubular defects. There is a mononuclear lymphocytic infiltrate on renal biopsy and this appears to be mainly a CD4+ T-cell infiltrate. Treatment with mycophenolate (and corticosteroids) improves the renal function in patients with pSS TIN

Improvement of Total Body Weight Loss in a Comprehensive Weight Loss Program at a Community Gastroenterology Practice with Consistent Support Group Attendance

Introduction Obesity-related gastrointestinal disorders, including non-alcoholic fatty liver disease (NAFLD), account for over 30% of visits to GI practices. Total body weight loss (TBWL) of 10% or more is associated with reversal of NAFLD-associated fibrosis and steatosis. Support groups have proven to help individuals recover from other lifestyle diseases. This study assesses the impact of support group attendance on a patient achieving 10% TBWL while enrolled in a community-based weight loss program. Methods Patients participated in a 6-month support group with weekly meetings. TBWL was calculated by taking the difference between the patient’s starting weight and their 6-month weight divided by starting weight. Data was collected retrospectively through chart review. By April 2023, 95 patients completed the support group program. Statistical analysis was performed using ANOVA and Tukey-Kramer post-hoc tests. Results The mean percent weight loss was 6.18% for patients with 0-49% attendance, 8.78% for patients with 50-74% attendance, and 13.24% for patients with 75-100% attendance. The ANOVA test revealed a statistically significant difference in mean percent weight loss across the three groups (F(2,92) = 10.299, p \u3c0.001). The Tukey-Kramer test revealed a statistically significant difference in mean percent weight loss between the 0-49% and 75-100% attendance groups (p\u3c0.001) and between the 50-74% and 75-100% attendance groups (p=0.003). Discussion The results indicate that patients with at least 75% support group attendance reported significantly higher percent weight loss than patients with lower attendance. This study supports the efficacy of support groups toward achieving weight loss

Maxillary Changes Following Facial Bipartition – A Three-Dimensional Quantification

INTRODUCTION: Children with Apert syndrome have hypertelorism and midfacial hypoplasia, which can be treated with facial bipartition (FB), often aided by rigid external distraction. The technique involves a midline osteotomy that lateralizes the maxillary segments, resulting in posterior cross-bites and midline diastema. Varying degrees of spontaneous realignment of the dental arches occurs postoperatively. This study aims to quantify these movements and assess whether they occur as part of a wider skeletal relapse or as dental compensation. METHODS: Patients who underwent FB and had high quality computed tomography scans at the preoperative stage, immediately postsurgery, and later postoperatively were reviewed. DICOM files were converted to three-dimensional bone meshes and anatomical point-to-point displacements were quantified using nonrigid iterative closest point registration. Displacements were visualized using arrow maps, thereby providing an overview of the movements of the facial skeleton and dentition. RESULTS: Five patients with Apert syndrome were included. In all cases, the arrow maps demonstrated initial significant anterior movement of the frontofacial segment coupled with medial rotation of the orbits and transverse divergence of the maxillary arches. The bony position following initial surgery was shown to be largely stable, with primary dentoalveolar relapse correcting the dental alignment. CONCLUSIONS: This study showed that spontaneous dental compensation occurs following FB without compromising the surgical result. It may be appropriate to delay active orthodontic for 6-months postoperatively until completion of this early compensatory phase

Competitor Intelligence and Product Innovation: The Role of Open-Mindedness and Interfunctional Coordination

Drawing on the central theme of open innovation and the inbound flow of knowledge for improving a firm’s innovation performance, this research investigates the application of external knowledge (i.e., competitor intelligence) in productinnovation through the mediators of interfunctional coordination and open-mindness. We examine the joint moderating effect of environmental uncertainty on results obtained from survey data involving 284 executives from Chinese small- and medium-sized enterprises (SMEs) within the information technology. Our resultsreveal that competitor intelligence has a positive and direct effect on product innovation and relationships can be further strengthened by interfunctional coordination and open-mindedness. In testing their interaction with dynamic external environments, we found that the level of environmental uncertainty interacts positively with open-mindedness, but negatively with the effect of interfunctional coordination on product innovation. We conclude that by building openly innovative and knowledge sharing culture, SME managers can improve their product innovation performance by obtaining and processing external knowledge relating to competitors. This article contributes to the open innovation literature, advancing understanding of the inflow of external knowledge for innovative output and, more importantly, sheds light on the research of open innovation practices in SMEs from emerging economies

A new paradigm for virtual knowledge sharing in product development based on emergent social software platforms

EPSRC; BAE Systems’ Electronic Systems Secto

The biological origin of linguistic diversity

In contrast with animal communication systems, diversity is characteristic of almost every aspect of human language. Languages variously employ tones, clicks, or manual signs to signal differences in meaning; some languages lack the noun-verb distinction (e.g., Straits Salish), whereas others have a proliferation of fine-grained syntactic categories (e.g., Tzeltal); and some languages do without morphology (e.g., Mandarin), while others pack a whole sentence into a single word (e.g., Cayuga). A challenge for evolutionary biology is to reconcile the diversity of languages with the high degree of biological uniformity of their speakers. Here, we model processes of language change and geographical dispersion and find a consistent pressure for flexible learning, irrespective of the language being spoken. This pressure arises because flexible learners can best cope with the observed high rates of linguistic change associated with divergent cultural evolution following human migration. Thus, rather than genetic adaptations for specific aspects of language, such as recursion, the coevolution of genes and fast-changing linguistic structure provides the biological basis for linguistic diversity. Only biological adaptations for flexible learning combined with cultural evolution can explain how each child has the potential to learn any human language