Disseminated Mycobacterium scrofulaceum infection in a child with interferon-γ receptor 1 deficiency

Summary Disseminated disease caused by non-tuberculous, environmental mycobacteria (EM) reflects impaired host immunity. Disseminated disease caused by Mycobacterium scrofulaceum has primarily been reported in patients with AIDS. Moreover, observing M. scrofulaceum as the agent of localized disease in childhood has become increasingly rare. We report the first case of disseminated disease caused by M. scrofulaceum in a child with inherited interferon-γ receptor 1 (IFN-γR1) complete deficiency. As in this case, mycobacterial bone infections in IFN-γR1 deficiency can sometimes mimic the clinical picture of chronic recurrent multifocal osteomyelitis

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking

Circadian rhythms and the liver

This narrative review briefly describes the mammalian circadian timing system, the specific features of the liver clock, also by comparison with other peripheral clocks, the role of the liver clock in the preparation of food intake, and its relationship with energy metabolism. It then goes on to provide a chronobiological perspective of the pathophysiology and management of several types of liver disease, with a particular focus on metabolic-associated fatty liver disease (MAFLD), decompensated cirrhosis and liver transplantation. Finally, it provides some insight into the potential contribution of circadian principles and circadian hygiene practices in preventing MAFLD, improving the prognosis of advanced liver disease and modulating liver transplantation outcomes

Working Memory in Patients with Varying Degree of Hepatic Encephalopathy (HE): A Pilot EEG-fNIRS Study

It is known that patients with covert hepatic encephalopathy (CHE) exhibit working memory abnormalities, but to date there is no study comparing patients with cirrhosis with/without CHE and controls with both electrophysiological and hemodynamic data collected at the same time.Here we collected behavioral [accuracy and reaction times (RTs), electrophysiological (evoked potentials) and hemodynamic (oxygenated and deoxygenated haemoglobin) correlates of an n-back task [formed by a control (0-back) condition, a low (1-back) and a high (2-back) working memory load conditions] in patients with cirrhosis with/without CHE: (1) at baseline (n = 21, males = 15, 58 +/- 8 yrs), and by comparison with controls (n = 21, males = 15, 57 +/- 11 yrs) and (2) after a 3-month course of rifaximin (n = 18, males = 12, 61 +/- 11 yrs), and by comparison to baseline.All patients showed slower RTs (p < 0.0001) and lower P2 amplitude compared with controls (p = 0.018); moreover, patients with CHE showed reduced accuracy (p < 0.0001) compared with controls, and patients without CHE showed higher oxygenated haemoglobin in the central dorsolateral prefrontal cortex in the 2-back compared with patients with CHE. Post-rifaximin, oxygenated haemoglobin increased in the central frontopolar cortex. In addition, in patients without CHE the RTs of the 2-back became comparable to those of the 0-back and P3 showed higher amplitude.In conclusion, the presence of cirrhosis seemed to have more effects than CHE on working memory at baseline. A course of treatment with rifaximin was more beneficial to patients without CHE, who probably had more room for improvement in this complex task

An original look into Pulsating Heat Pipes: Inverse heat conduction approach for assessing the thermal behavior

A promising solution in the field of passive two-phase heat transfer devices is represented by Pulsating Heat Pipes (PHPs). These relatively new devices, which achieves resounding interest in terms of high heat transfer capability, efficient thermal control, flexibility and low cost, have been extensively studied in the last years by many researchers. Several studies have been carried out to deeply characterize the thermal behavior of Pulsating Heat Pipes. Although many authors have investigated the heat flux values for these devices, almost all of them have presented the results only in terms of the mean values at the evaporator and the condenser area. High-speed and high-resolution infrared imaging is performed on a single loop PHP designed with sapphire inserts. Sapphire, being almost transparent in the IR-spectrum, allows to measure the temperature of the fluid inside the pipe by means of IR analysis. The sapphire tube is partially coated with a highly emissive paint, allowing in this way to determine at the same time the external wall temperature and the fluid temperature. In this work a novel approach to investigate the local heat flux in PHPs is presented and tested: the temperature distributions on the external wall of the PHP were used as input data for the inverse heat conduction problem in the wall under a solution approach based on the Tikhonov regularization method. Heat is released from the fluid to the sapphire wall when a two-phase flow is pushed with a high temperature from the evaporator; increasing the wall tube temperature. On the contrary, when a cold flow is pushed back from the condenser, the tube releases the heat previously accumulated; thereby decreasing its temperature. This approach allows to analyze the thermal behavior of the device by investigating the direct interconnection between the thermo-fluid dynamic phenomena within the PHP and the local heat flux measurements. The results proposed in this work could be a breakthrough for developing and validating advanced lumped parameter models and emerging CFD simulations of PHPs

An original look into pulsating heat pipes:Inverse heat conduction approach for assessing the thermal behaviour

A promising solution in the field of passive two-phase heat transfer devices is represented by Pulsating Heat Pipes (PHPs). These relatively new devices, which achieve resounding interest in terms of high heat transfer capability, efficient thermal control, adaptability and low cost, have been extensively studied in the last years by many researchers. Many authors have investigated the heat fluxes at the evaporator and the condenser area only in terms of the mean values. In this work a novel approach to investigate the local heat flux in PHPs is presented and tested: the temperature distributions on the external wall of the PHP acquired with a high-speed and high-resolution infrared camera were used as input data for the inverse heat conduction problem in the wall under a solution approach based on the Tikhonov regularization method. Infrared imaging is performed on a single loop PHP designed with sapphire inserts partially coated with a highly emissive paint, allowing to determine at the same time the external wall temperature and the fluid temperature. Results show that the technique is able to show when heat is transfer from the fluid to the sapphire wall, when the hot fluid is pushed from the evaporator towards the condenser; increasing the wall tube temperature. On the contrary, when a cold fluid flows back from the condenser, the tube releases the heat previously accumulated, thereby decreasing its temperature. This approach allows to analyze the thermal behavior of the device by investigating the direct interconnection between the thermo-fluid dynamic phenomena within the PHP and the local heat flux measurements. The results proposed in this work are a breakthrough for the improvement and validation of both VOF-based DNS simulations, for local physical phenomena, and 1D simulations of the global PHP behaviour

A Circadian Hygiene Education Initiative Covering the Pre-pandemic and Pandemic Period Resulted in Earlier Get-Up Times in Italian University Students: An Ecological Study

The aims of the present study were to obtain sleep quality and sleep timing information in a group of university students and to evaluate the effects of a circadian hygiene education initiative. All students of the University of Padova (approximately 64,000) were contacted by e-mail (major campaigns in October 2019 and October 2020) and directed to anwebsite for collection of demographics and sleep quality/timing information. Participants (= 5,740) received one of two sets of circadian hygiene advice ("A regular life" or "Bright days and dark nights"). Every month, they were then asked how easy it had been to comply and provided with the advice again. At any even month from joining, they completed the sleep quality/timing questionnaires again. Information on academic performance was obtained, together with representative samples of lecture (= 5,972) and examination (= 1,800) timings, plus lecture attendances (= 25,302). Fifty-two percent of students had poor sleep quality, and 82% showed signs of social jetlag. Those who joined in October 2020, after several months of lockdown and distance learning, had better sleep quality, less social jetlag, and later sleep habits. Over approximately a year, the "Bright days and dark nights" advice resulted in significantly earlier get-up times compared with the "A regular life" advice. Similarly, it also resulted in a trend toward earlier midsleep (i.e., the midpoint, expressed as clock time, between sleep onset and sleep offset) and toward a decrease in the latency between wake-up and get-up time, with no impact on sleep duration. Significant changes in most sleep quality and sleep timing variables (i.e., fewer night awakenings, less social jetlag, and delayed sleep timing during lock-down) were observed in both advice groups over approximately a year, mostly in association with pandemic-related events characterizing 2020. Early chronotype students had better academic performances compared with their later chronotype counterparts. In a multivariate model, sleep quality, chronotype and study subject (science and technology, health and medical, or social and humanities) were independent predictors of academic performance. Taken together, these results underlie the importance of designing circadian-friendly university timetables