Gaucher Disease and Myelofibrosis: A Combined Disease or a Misdiagnosis?

Background: Gaucher disease (GD) and primary myelofibrosis (PMF) share similar clinical and laboratory features, such as cytopenia, hepatosplenomegaly, and marrow fibrosis, often resulting in a misdiagnosis. Case Report: We report here the case of a young woman with hepatosplenomegaly, leukopenia, and thrombocytopenia. Based on bone marrow (BM) findings and on liver biopsy showing extramedullary hematopoiesis, an initial diagnosis of PMF was formulated. The patient refused stem cell transplantation from an HLA-identical sibling. Low-dose melphalan was given, without any improvement. Two years later, a BM evaluation showed Gaucher cells. Low glucocerebrosidase and high chitotriosidase levels were indicative for GD. Molecular analysis revealed N370S/complex I mutations. Enzyme replacement therapy with imiglucerase was commenced, resulting in clinical and hematological improvements. Due to an unexpected and persistent organomegaly, PMF combined with GD were suspected. JAK2V617F, JAK2 exon 12, MPL, calreticulin, and exon 9 mutations were negative, and BM examination showed no marrow fibrosis. PMF was excluded. Twenty years after starting treatment, the peripheral cell count and liver size were normal, whereas splenomegaly persisted. Conclusion: In order to avoid a misdiagnosis, a diagnostic algorithm for patients with hepatosplenomegaly combined with cytopenia is suggested

3D printing of optical materials: an investigation of the microscopic properties

3D printing technologies are currently enabling the fabrication of objects with complex architectures and tailored properties. In such framework, the production of 3D optical structures, which are typically based on optical transparent matrices, optionally doped with active molecular compounds and nanoparticles, is still limited by the poor uniformity of the printed structures. Both bulk inhomogeneities and surface roughness of the printed structures can negatively affect the propagation of light in 3D printed optical components. Here we investigate photopolymerization-based printing processes by laser confocal microscopy. The experimental method we developed allows the printing process to be investigated in-situ, with microscale spatial resolution, and in real-time. The modelling of the photo-polymerization kinetics allows the different polymerization regimes to be investigated and the influence of process variables to be rationalized. In addition, the origin of the factors limiting light propagation in printed materials are rationalized, with the aim of envisaging effective experimental strategies to improve optical properties of printed materials.Comment: 8 pages, 3 figure

Educating primary care clinicians about health disparities

Racial and ethnic health disparities inarguably exist in the United States. It is important to educate primary care clinicians regarding this topic because they have the ability to have an impact in the reduction of health disparities. This article presents the evidence that disparities exist, how clinicians contribute to these disparities, and what primary care clinicians can do to reduce disparities in their practice. Clinicians are able to impact health disparities by receiving and providing cross-cultural education, communicating effectively with patients, and practicing evidence-based medicine. The changes suggested herein will have an impact on the current state of health of our nation

Charge form factor of π\pi and KK mesons

The charge form factor of $\pi$ and $K$ mesons is evaluated adopting a relativistic constituent quark model based on the light-front formalism. The relevance of the high-momentum components of the meson wave function, for values of the momentum transfer accessible to $CEBAF$ energies, is illustrated. The predictions for the elastic form factor of $\pi$ and $K$ mesons are compared with the results of different relativistic approaches, showing that the measurements of the pion and kaon form factors planned at $CEBAF$ could provide information for discriminating among various models of the meson structure.Comment: 8 pages, latex, 4 figures available as separate .uu fil

Acculturation and self-reported health among Hispanics using a socio-behavioral model: the North Texas Healthy Heart Study

<p>Abstract</p> <p>Background</p> <p>Acculturation is a continuous, firsthand contact with other cultures functioning at both group and individual levels and is reflected in our culturally diverse society, calling for a greater understanding of the environmental and cultural impact on health. Self-reported health (SRH), a robust and well validated predictor of future mortality for all racial/ethnic groups, has been differentially reported by Hispanics compared to whites, especially based on their acculturation status. This study investigated the relationship between acculturation and SRH among Hispanics. An adapted Andersen framework was used to develop logistic regression models to assess for an association between acculturation and general health status.</p> <p>Methods</p> <p>Hispanic participants (n = 135), as part of the North Texas Healthy Heart Study, were administered standardized questionnaires on acculturation, psychosocial measures which included sense of control, stress, depression and social support and a single item SRH measure. In addition, physiological measurements and demographic characteristics including age, gender, body mass index, medical history, and socioeconomic status were also obtained.</p> <p>Results</p> <p>Bivariate analyses found Mexican-oriented participants 3.16 times more likely to report fair/poor SRH compared to Anglo-oriented Hispanics. Acculturation was also associated with SRH in multiple regression models controlling for enabling, need, and predisposing factors together (OR: 3.53, 95% CI: 1.04, 11.97).</p> <p>Conclusions</p> <p>Acculturation status was associated with SRH after accounting for other underlying factors. Medical and public health professionals should promote the use of acculturation measures in order to better understand its role in Hispanic behaviors, health outcomes and health care use. Such research findings will contribute to the design of culturally sensitive prevention and treatment strategies for diverse and immigrant populations.</p

Searching for Ammonia-Oxidizing Archaea

The Colorado River Basin runs through multiple states in the West of the United States and is a prime water source for about 30 million people in our nation and is used for much of the farmland and agricultural needs in this area. Using cultures derived from the Colorado River Basin a multitude of tests were run in order to determine more about the microbes that are thriving within the river, specifically from archeal phylum Thaumarchaeota. These are ammonia-oxidizing archaea (AOA) who perform nitrification by converting ammonia into nitrite, a process that was previously thought to only be achieved by ammonia oxidizing bacteria (AOB). Currently there is limited information about Thaumarchaeota, during this research further exploration of the microbe was hoping to reveal more information. While the research did not reveal any new information about the archaea, it did reveal that there were bacteria surviving in the extreme conditions within the lab kept cultures. As a result, further research is still needed but the progress that is being made allows scientists a way to continue providing the nation with more information about their natural resources

Space-like and time-like pion electromagnetic form factor and Fock state components within the Light-Front dynamics

The simultaneous investigation of the pion electromagnetic form factor in the space- and time-like regions within a light-front model allows one to address the issue of non-valence components of the pion and photon wave functions. Our relativistic approach is based on a microscopic vector meson dominance (VMD) model for the dressed vertex where a photon decays in a quark-antiquark pair, and on a simple parametrization for the emission or absorption of a pion by a quark. The results show an excellent agreement in the space like region up to -10 $(GeV/c)^2$, while in time-like region the model produces reasonable results up to 10 $(GeV/c)^2$.Comment: 74 pages, 11 figures, use revtex

Systematic Review of Ambulatory Transitional Care Management (TCM) Visits on Hospital 30-Day Readmission Rates

To reduce readmission rates and prevent adverse outcomes after discharge, hospitals have begun implementing transitional care initiatives. This systematic review identifies research on the particular set of services now reimbursable by Medicare (transitional care management [TCM]) and evaluates the studies for program effectiveness. Results of 3 databases were screened for peer-reviewed journal articles published between January 2004 and 2015 that report on readmissions of adults in the US health care system under the Medicare TCM bundle. ClinicalTrials.gov was queried for funded studies. Of 969 identified studies, 77 met inclusion criteria for relevance to transitional care and appropriateness of population and setting. Of these, only 3 articles incorporated all required elements for TCM service. Although 2 were program improvement designs and none were randomized controlled studies, each report reduced readmission rates. Evidence for TCM effectiveness is limited. Additional study of TCM implementation and programmatic support for TCM is warranted

Electromagnetic form factors in the light-front formalism and the Feynman triangle diagram: spin-0 and spin-1 two-fermion systems

The connection between the Feynman triangle diagram and the light-front formalism for spin-0 and spin-1 two-fermion systems is analyzed. It is shown that in the limit q+ = 0 the form factors for both spin-0 and spin-1 systems can be uniquely determined using only the good amplitudes, which are not affected by spurious effects related to the loss of rotational covariance present in the light-front formalism. At the same time, the unique feature of the suppression of the pair creation process is maintained. Therefore, a physically meaningful one-body approximation, in which all the constituents are on their mass-shells, can be consistently formulated in the limit q+ = 0. Moreover, it is shown that the effects of the contact term arising from the instantaneous propagation of the active constituent can be canceled out from the triangle diagram by means of an appropriate choice of the off-shell behavior of the bound state vertexes; this implies that in case of good amplitudes the Feynman triangle diagram and the one-body light-front result match exactly. The application of our covariant light-front approach to the evaluation of the rho-meson elastic form factors is presented.Comment: corrected typos in the reference