Circulating human leucine-rich a-2-glycoprotein 1 mRNA and protein levels to detect acute appendicitis in patients with acute abdominal pain

Background Elevated levels of circulating plasma and urine leucine-rich-2-glycoprotein-1 (LRG1) protein has been found in patients with acute appendicitis (AA) and may be useful for diagnosis. This study aimed to investigate whether combined tests including circulating LRG1 mRNA levels improve the early diagnosis of AA. Methods Between December 2011 and October 2012, a prospective study was conducted on patients aged 18 years or older presenting to the ED with acute abdominal pain (< 7 days of symptom onset). Levels of whole blood LRG1 mRNA and plasma LRG1 protein taken from these patients within 24 h of arrival (mean 12.4 h) were analyzed. The primary outcome was AA. Results Eighty-four patients (40 (47.6%) with AA and 44 (52.4%) without AA; mean age 35 years; 41.6% males) were recruited. Median whole blood LRG1 mRNA and plasma LRG1 levels were higher in AA patients than in non-AA. Of 40 AA patients, 13 (32.5%) were diagnosed as complicated AA. In ROC analysis of LRG1 mRNA (normalized to GAPDH), LRG1 protein and Alvarado score for discriminating AA and non-AA, the areas under the curve (AUC) were 0.723, 0.742 and 0.805 respectively. The AUC of combination of normalized LRG1 mRNA, LRG1 protein and Alvarado score was 0.845. Conclusion A combination of modified whole blood LRG1 mRNA levels, plasma LRG1 protein and Alvarado score at the ED may be useful to diagnose simple and complicated AA from other causes of abdominal pain

Non-linear Yang-Mills instantons from strings are π\pi-stable D-branes

We show that B-type $\Pi$-stable D-branes do not in general reduce to the (Gieseker-) stable holomorphic vector bundles used in mathematics to construct moduli spaces. We show that solutions of the almost Hermitian Yang--Mills equations for the non-linear deformations of Yang--Mills instantons that appear in the low-energy geometric limit of strings exist iff they are $\pi$-stable, a geometric large volume version of $\Pi$-stability. This shows that $\pi$-stability is the correct physical stability concept. We speculate that this string-canonical choice of stable objects, which is encoded in and derived from the central charge of the string-\emph{algebra}, should find applications to algebraic geometry where there is no canonical choice of stable \emph{geometrical} objects.Comment: v3: Minor revision; 14 page

Trajectory of functional outcome and health status after moderate-to-major trauma in Hong Kong: A prospective 5 year cohort study

Background Trauma care systems in Asia have been developing in recent years, but there has been little long-term outcome data from injured survivors. This study aims to evaluate the trajectory of functional outcome and health status up to five years after moderate to major trauma in Hong Kong. Methods We report the five year follow up results of a multicentre, prospective cohort from the trauma registries of three regional trauma centres in Hong Kong. The original cohort recruited 400 adult trauma patients with ISS ≥ 9. Telephone follow up was conducted longitudinally at seven time points, and the extended Glasgow Outcome Scale (GOSE) and Short-Form 36 (SF36) were tracked. Results 119 out of 309 surviving patients (39%) completed follow up after 5 years. The trajectory of GOSE, PCS and MCS showed gradual improvements over the seven time points. 56/119 (47.1%) patients reported a GOSE = 8 (upper good recovery), and the mean PCS and MCS was 47.8 (95% CI 45.8, 49.9) and 55.8 (95% CI 54.1, 57.5) respectively at five years. Univariate logistic regression showed change in PCS - baseline to 1 year and 1 year to 2 years, and change in MCS - baseline to 1 year were associated with GOSE = 8 at 5 years. Linear mixed effects model showed differences in PCS and MCS were greatest between 1-month and 6-month follow up. Conclusions After injury, the most rapid improvement in PCS and MCS occurred in the first six to 12 months, but further recovery was still evident for MCS in patients aged under 65 years for up to five years

Interaction Properties of the Periodic and Step-like Solutions of the Double-Sine-Gordon Equation

The periodic and step-like solutions of the double-Sine-Gordon equation are investigated, with different initial conditions and for various values of the potential parameter $\epsilon$. We plot energy and force diagrams, as functions of the inter-soliton distance for such solutions. This allows us to consider our system as an interacting many-body system in 1+1 dimension. We therefore plot state diagrams (pressure vs. average density) for step-like as well as periodic solutions. Step-like solutions are shown to behave similarly to their counterparts in the Sine-Gordon system. However, periodic solutions show a fundamentally different behavior as the parameter $\epsilon$ is increased. We show that two distinct phases of periodic solutions exist which exhibit manifestly different behavior. Response functions for these phases are shown to behave differently, joining at an apparent phase transition point.Comment: 17pages, 15 figure

Fulminant hyperpyrexia induced by bleomycin

Mild and self-limiting fever following bleomycin use is common, and a fatal hyperpyrexial response occurs rarely. In previously reported cases, such hyperpyrexia occurred either after the initial administration of the drug or during subsequent therapy following an initial pyrexial response. We describe a fatal hyperpyrexial reaction after bleomycin in a patient with T-cell lymphoma who had had no febrile response when she received her initial injection 3 weeks earlier. Since the occurrence of this hyperpyrexial response is unpredictable, health care workers as well as patients and relatives should always be alert to this potentially lethal complication and prompt measures should be taken in any patient who develops fever after bleomycin use.published_or_final_versio

Direct amplification of nodD from community DNA reveals the genetic diversity of Rhizobium leguminosarum in soil

Sequences of nodD, a gene found only in rhizobia, were amplified from total community DNA isolated from a pasture soil. The polymerase chain reaction (PCR) primers used, Y5 and Y6, match nodD from Rhizobium leguminosarum biovar trifolii, R. leguminosarum biovar viciae and Sinorhizobium meliloti. The PCR product was cloned and yielded 68 clones that were identified by restriction pattern as derived from biovar trifolii [11 restriction fragment length polymorphism (RFLP) types] and 15 clones identified as viciae (seven RFLP types). These identifications were confirmed by sequencing. There were no clones related to S. meliloti nodD. For comparison, 122 strains were isolated from nodules of white clover (Trifolium repens) growing at the field site, and 134 from nodules on trap plants of T. repens inoculated with the soil. The nodule isolates were of four nodD RFLP types, with 77% being of a single type. All four of these patterns were also found among the clones from soil DNA, and the same type was the most abundant, although it made up only 34% of the trifolii-like clones. We conclude that clover selects specific genotypes from the available soil population, and that R. leguminosarum biovar trifolii was approximately five times more abundant than biovar viciae in this pasture soil, whereas S. meliloti was rare

Generation of entangled states of two atoms inside a leaky cavity

An in-depth theoretical study is carried out to examine the quasi-deterministic entanglement of two atoms inside a leaky cavity. Two $\Lambda$-type three-level atoms, initially in their ground states, may become maximally entangled through the interaction with a single photon. By working out an exact analytic solution, we show that the probability of success depends crucially on the spectral function of the injected photon. With a cavity photon, one can generate a maximally entangled state with a certain probability that is always less than 50%. However, for an injected photon with a narrower spectral width, this probability can be significantly increased. In particular, we discover situations in which entanglement can be achieved in a single trial with an almost unit probability

PPAR-gamma induced AKT3 expression increases levels of mitochondrial biogenesis driving prostate cancer

Peroxisome Proliferator-Activated Receptor Gamma (PPARG) is one of the three members of the PPAR family of transcription factors. Besides its roles in adipocyte differentiation and lipid metabolism, we recently demonstrated an association between PPARG and metastasis in prostate cancer. In this study a functional effect of PPARG on AKT serine/threonine kinase 3 (AKT3), which ultimately results in a more aggressive disease phenotype was identified. AKT3 has previously been shown to regulate PPARG co-activator 1 alpha (PGC1α) localisation and function through its action on chromosome maintenance region 1 (CRM1). AKT3 promotes PGC1α localisation to the nucleus through its inhibitory effects on CRM1, a known nuclear export protein. Collectively our results demonstrate how PPARG over-expression drives an increase in AKT3 levels, which in turn has the downstream effect of increasing PGC1α localisation within the nucleus, driving mitochondrial biogenesis. Furthermore, this increase in mitochondrial mass provides higher energetic output in the form of elevated ATP levels which may fuel the progression of the tumour cell through epithelial to mesenchymal transition (EMT) and ultimately metastasis

‘The Coaching Needs of High Performance Female Athletes within the Coach-Athlete Dyad’

Within the research literature there is little work that has examined how coaches (and coaching) can positively influence female athletes’ continued participation and development in performance sport. With this in mind, utilising a grounded theory approach, this study focused on what are the coaching preferences of female athletes within the elite coachathlete dyad. Through interviews with 27 current high performance female athletes, four major coaching needs were found. These were: to be supported as person as well a performer, coaching to be a joint endeavour, the need for positive communication and finally, recognition of the salience of gender within the coach-athlete dyad. The findings provide evidence that the relational expertise of coaches is at the forefront of these women’s coaching needs. This study also demonstrates that for the participants, the coach-athlete relationship is at the heart of improving athletic training and performance, and that gender is an important influence on this relationship. Furthermore, the research highlights the strength of using an interpretive-qualitative paradigmatic approach to athlete preferences through foregrounding the women’s voices and experiences