Hypothyroidism and nephrotic syndrome: why, when and how to treat

Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free tri-iodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine-binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition. In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies

Timelines Are Expressive Enough to Capture Action-Based Temporal Planning

Planning problems are usually expressed by specifying which actions can be performed to obtain a given goal. In temporal planning problems, actions come with a time duration and can overlap in time, which noticeably increase the complexity of the reasoning process. Action-based temporal planning has been thoroughly studied from the complexity-theoretic point of view, and has been proved to be EXPSPACE-complete in its general formulation. Conversely, timeline-based planning problems are represented as a collection of variables whose time-varying behavior is governed by a set of temporal constraints, called synchronization rules. Timelines provide a unified framework to reason about planning and execution under uncertainty. Timeline-based systems are being successfully employed in real-world complex tasks, but, in contrast to action-based planning, little is known on their computational complexity and expressiveness. In particular, a comparison of the expressiveness of the action- and timeline-based formalisms is still missing. This paper contributes a first step in this direction by proving the EXPSPACE-completeness of timeline-based planning with no temporal horizon and bounded temporal relations only. The result is shown via a reduction from action-based temporal planning, thus proving that timelines are expressive enough to capture it

Complexity of Safety and coSafety Fragments of Linear Temporal Logic

Linear Temporal Logic (LTL) is the de-facto standard temporal logic for system specification, whose foundational properties have been studied for over five decades. Safety and cosafety properties define notable fragments of LTL, where a prefix of a trace suffices to establish whether a formula is true or not over that trace. In this paper, we study the complexity of the problems of satisfiability, validity, and realizability over infinite and finite traces for the safety and cosafety fragments of LTL. As for satisfiability and validity over infinite traces, we prove that the majority of the fragments have the same complexity as full LTL, that is, they are PSPACE-complete. The picture is radically different for realizability: we find fragments with the same expressive power whose complexity varies from 2EXPTIME-complete (as full LTL) to EXPTIME-complete. Notably, for all cosafety fragments, the complexity of the three problems does not change passing from infinite to finite traces, while for all safety fragments the complexity of satisfiability (resp., realizability) over finite traces drops to NP-complete (resp., ${\Pi}^P_2$-complete)

A Game-Theoretic Approach to Timeline-Based Planning with Uncertainty

In timeline-based planning, domains are described as sets of independent, but interacting, components, whose behaviour over time (the set of timelines) is governed by a set of temporal constraints. A distinguishing feature of timeline-based planning systems is the ability to integrate planning with execution by synthesising control strategies for flexible plans. However, flexible plans can only represent temporal uncertainty, while more complex forms of nondeterminism are needed to deal with a wider range of realistic problems. In this paper, we propose a novel game-theoretic approach to timeline-based planning problems, generalising the state of the art while uniformly handling temporal uncertainty and nondeterminism. We define a general concept of timeline-based game and we show that the notion of winning strategy for these games is strictly more general than that of control strategy for dynamically controllable flexible plans. Moreover, we show that the problem of establishing the existence of such winning strategies is decidable using a doubly exponential amount of space

Membrane-seeded autologous chondrocytes: cell viability and characterization at surgery

The implantation of chondrocytes, seeded on matrices such as hyaluronic acid or collagen membranes, is a method that is being widely used for the treatment of chondral defects. The aim of the present study was to evaluate the distribution, viability and phenotype expression of the cells seeded on a collagen membrane just at the time of the implantation. Twelve patients who were suffering from articular cartilage lesions were treated by the MACI(®) procedure. The residual part of each membrane was tested by colorimetric assay (MTT) and histochemical and ultrastructural analyses were carried out. In all of the samples a large number of viable cells, quite homogenously distributed, was detected. The cells expressed the markers of the differentiated hyaline chondrocytes. These data reassure in that the MACI procedure provides a suitable engineered tissue for cartilage repair, in line with the clinical evidences emerging in the literature

Renal parenchymal thickness is both related to vascular endothelial growth factor and intrarenal stiffness in systemic sclerosis

Questa Letter con dati originali dimostra che nei pazienti sclerodermia lo spessore parenchima, valutato ecograficamente, dipende sia dalla stiffess intrarenale , valutata mediante Doppler delle arterie renali, che dall'angiogenesi, valutata mediante il dosaggio sferico del vascular endothelial growth factor (VEGF). Lo spessore parenchima renale nella sclerosi sistemica mostra una correlazione lineare negativa sia con l'indice di resistenza renale che con l dosaggio sferico del VEGF. E' ipotizzabile che la ridotta neoangiogenesi e l'aumento degli indici di resistenza renale siano la causa di una riduzione dello spessore parenchima renale

Skin perfusion of hands is associated with parasympathetic activity in systemic sclerosis

Changes in the activity or responsiveness of neuroendothelial mecha-nisms may trigger vascular injury with im-balance of angiogenesi

On the Use of Biobased Waxes to Tune Thermal and Mechanical Properties of Polyhydroxyalkanoates–Bran Biocomposites

In this work, processability and mechanical performances of bio-composites based on poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) containing 5, 10, and 15 wt % of bran fibers, untreated and treated with natural carnauba and bee waxes were evaluated. Wheat bran, the main byproduct of flour milling, was used as filler to reduce the final cost of the PHBV-based composites and, in the same time, to find a potential valorization to this agro-food by-product, widely available at low cost. The results showed that the wheat bran powder did not act as reinforcement, but as filler for PHBV, due to an unfavorable aspect ratio of the particles and poor adhesion with the polymeric matrix, with consequent moderate loss in mechanical properties (tensile strength and elongation at break). The surface treatment of the wheat bran particles with waxes, and in particular with beeswax, was found to improve the mechanical performance in terms of tensile properties and impact resistance of the composites, enhancing the adhesion between the PHBV-based polymeric matrix and the bran fibers, as confirmed by predictive analytic models and dynamic mechanical analysis results

Estatus oxidativo, antioxidante, del selenio, y aceptabilidad del consumidor de la carne de ave enriquecida con selenio dietari

The effect of selenium supplementation with an organic form (SeMet) and an inorganic form (SeNa) in the poultry finishing diet, on the oxidative and antioxidative status of Pectoralis and Gastrocnemius muscles, refrigerated at 2 °C during 0, 3 and 7 days, was studied. Also, selenium enrichment and sensory evaluation of each muscle was studied in fresh (0 days) meat. At 35 days old, chicks were distributed into three groups (30 birds each), and were fed with a corn-soybean basal diet without Se supplementation (Control) or with 0.30 ppm of selenium as selenomethionine (SeMet) or as sodium selenite (SeNa) until day 56 d-old. In Pectoralis muscle, significantly lower TBARS values were found at day 0 in meat from birds supplemented with both sources of Se (P<0.05). A higher GPx activity and selenium content was observed in meat from birds supplemented with SeMet compared with the Control (P<0.05). In SeMet raw meat from both muscles, selenium is increased and conserved after cooking in Gastrocnemius. The organic source enhanced the antioxidant enzyme activity in fresh Gastrocnemius muscle, and the inorganic source enhanced it in the fresh and in the refrigerated stored Pectoralis muscle (P<0.05). Inorganic selenium in poultry diet increase textural attributes as cohesiveness and chewed need to form a bolus. Perception of an aromatic aftertaste in Gastrocnemius (P<0.05) and Pectoralis (P<0.06) muscle felt as a metallic taste was perceived with SeMet diet. Swallowing ability was increased by SeNa and SeMet sources only in Gastrocnemius. In conclusion, selenium in the poultry diet improved antioxidant status, nutritional value by Se-enriching and textural and taste sensory perception in meat but differences are found depending on the muscle type.Se estudió el efecto de la suplementación con selenio con una forma orgánica (SeMet) y una forma inorgánica (SeNa) en la dieta de acabado de aves de corral, sobre el estado oxidativo y antioxidante de los músculos Pectoralis y Gastrocnemius, refrigerados a 2 ° C durante 0, 3 y 7 días. Además, se estudió el enriquecimiento de selenio y la evaluación sensorial de cada músculo en carne fresca (0 días). A los 35 días de edad, los polluelos se distribuyeron en tres grupos (30 aves cada uno), y fueron alimentados con una dieta basal de maíz y soja sin suplementos de Se (Control) o con 0,30 ppm de selenio como selenometionina (SeMet) o como selenito de sodio (SeNa) hasta el día 56 d-edad. En el músculo pectoral, se encontraron valores significativamente más bajos de TBARS en el día 0 en la carne de aves suplementadas con ambas fuentes de Se (P<0,05). Se observó una mayor actividad de GPx y contenido de selenio en la carne de aves suplementadas con SeMet en comparación con el Control (P<0,05). En la carne cruda SeMet de ambos músculos, el selenio se aumenta y se conserva después de la cocción en Gastrocnemius. La fuente orgánica mejoró la actividad de la enzima antioxidante en el músculo Gastrocnemius fresco, y la fuente inorgánica la mejoró en el músculo Pectoralis fresco y refrigerado almacenado (P<0.05). El selenio inorgánico en la dieta de las aves de corral aumenta los atributos texturales como la cohesión y la necesidad masticada de formar un bolo. La percepción de un regusto aromático en el músculo Gastrocnemius (P<0,05) y Pectoralis (P<0,06) se percibió como un sabor metálico con la dieta SeMet. La capacidad de deglución fue aumentada por las fuentes de SeNa y SeMet solo en Gastrocnemius. En conclusión, el selenio en la dieta avícola mejoró el estado antioxidante, el valor nutricional por el enriquecimiento de Se y la percepción sensorial textural y gustal en la carne, pero se encuentran diferencias según el tipo de músculo