Critical digital ischemia secondary to ulnar artery thrombosis in suspected antiphospholipid syndrome

Antiphospholipid syndrome (APS) is known to cause critical limb ischemia leading to limb loss or death from arterial occlusion. We reported a 45-year-old woman with critical digital ischemia and was suspected secondary to APS. This woman presented to the Emergency Department (ED) for the third time because of recurrent pain and numbness in the fingertips of her left hand with bluish discoloration of the left little finger. Her ulnar artery became faint on palpation, and her left fifth finger was cool, cyanotic, with prolonged capillary refill time (CRT) and unrecognised signal in SpO2. Angiography and ultrasound showed proximal thrombosis of the ulnar artery. Thrombectomy was performed twice because graft thrombosis had occurred during the first operation. The rheumatology team treated her as APS and administered antiplatelet drugs. We hope this case report will raise awareness among emergency physicians for early recognition and provide optimal treatment

Enhanced magnetic Purcell effect in room-temperature masers

Recently, the world’s first room-temperature maser was demonstrated. The maser consisted of a sapphire ring housing a crystal of pentacene-doped p-terphenyl, pumped by a pulsed rhodamine-dye laser. Stimulated emission of microwaves was aided by the high quality factor and small magnetic mode volume of the maser cavity yet the peak optical pumping power was 1.4 kW. Here we report dramatic miniaturization and 2 orders of magnitude reduction in optical pumping power for a room-temperature maser by coupling a strontium titanate resonator with the spin-polarized population inversion provided by triplet states in an optically excited pentacene-doped p-terphenyl crystal. We observe maser emission in a thimble-sized resonator using a xenon flash lamp as an optical pump source with peak optical power of 70 W. This is a significant step towards the goal of continuous maser operation

H3S28P Antibody Staining of Okinawan Oikopleura dioica Suggests the Presence of Three Chromosomes [version 2; peer review: 2 approved]

Oikopleura dioica is a ubiquitous marine zooplankton of biological interest owing to features that include dioecious reproduction, a short life cycle, conserved chordate body plan, and a compact genome. It is an important tunicate model for evolutionary and developmental research, as well as investigations into marine ecosystems. The genome of north Atlantic O. dioica comprises three chromosomes. However, comparisons with the genomes of O. dioica sampled from mainland and southern Japan revealed extensive sequence differences. Moreover, historical studies have reported widely varying chromosome counts. We recently initiated a project to study the genomes of O. dioica individuals collected from the coastline of the Ryukyu (Okinawa) Islands in southern Japan. Given the potentially large extent of genomic diversity, we employed karyological techniques to count individual animals’ chromosomes in situ using centromere-specific antibodies directed against H3S28P, a prophase-metaphase cell cycle-specific marker of histone H3. Epifluorescence and confocal images were obtained of embryos and oocytes stained with two commercial anti-H3S28P antibodies (Abcam ab10543 and Thermo Fisher 07-145). The data lead us to conclude that diploid cells from Okinawan O. dioica contain three pairs of chromosomes, in line with the north Atlantic populations. The finding facilitates the telomere-to-telomere assembly of Okinawan O. dioica genome sequences and gives insight into the genomic diversity of O. dioica from different geographical locations. The data deposited in the EBI BioImage Archive provide representative images of the antibodies’ staining properties for use in epifluorescent and confocal based fluorescent microscopy

A comparison of intrauterine haemopoietic cell transplantation and lentiviral gene transfer for the correction of severe β-thalassaemia in a HbbTh3/+ murine model

Major haemoglobinopathies place tremendous strain on global resources. Intrauterine haemopoietic cell (IUHCT) and gene (IUGT) therapies can potentially reduce perinatal morbidities with greater efficacy than postnatal therapy alone. We performed both procedures in the thalassaemic HbbTh3/+ murine model. Intraperitoneal delivery of coisogenic cells at E13-14 produced dose-dependent chimerism. High-dose adult bone marrow (BM) cells maintained 0.2-3.1% chimerism over ~24 weeks and treated heterozygotes demonstrated higher chimerism than wild-type pups (1.6 vs. 0.7%). Fetal liver cells produced higher chimerism compared to adult BM when transplanted at the same doses, maintaining 1.8-2.4% chimerism over ~32 weeks. We boosted transplanted mice postnatally with adult BM cells following busulfan conditioning. Engraftment was maintained at >1% only in recipients which were chimeric prior to boosting. IUHCT-treated non-chimeras and non-IUHCT mice showed micro- or no chimerism. Additional fludarabine treatment produced higher chimerism than busulfan alone. Engraftment was more effective following higher starting chimerism prior to boosting and in heterozygotes. Chimeric heterozygotes expressed 2.2-15.1% donor cells with eventual decline at 24 weeks (vs. <1% in non-chimeras) and demonstrated improved haematological indices and smaller spleens compared to untreated heterozygotes. Intravenous delivery of GLOBE lentiviral-vector expressing HBB (human β-globin) resulted in vector concentration of 0.001-0.6 copies/cell. Most haematological indices were higher in treated than untreated heterozygotes including haemoglobin and mean corpuscular volume, though still lower than in wild-types. Thus both direct IUGT and IUHCT strategies can be used to achieve haematological improvement but require further dose optimisation. IUHCT will be useful combined with postnatal transplantation to further enhance engraftment

On-device Scalable Image-based Localization via Prioritized Cascade Search and Fast One-Many RANSAC.

We present the design of an entire on-device system for large-scale urban localization using images. The proposed design integrates compact image retrieval and 2D-3D correspondence search to estimate the location in extensive city regions. Our design is GPS agnostic and does not require network connection. In order to overcome the resource constraints of mobile devices, we propose a system design that leverages the scalability advantage of image retrieval and accuracy of 3D model-based localization. Furthermore, we propose a new hashing-based cascade search for fast computation of 2D-3D correspondences. In addition, we propose a new one-many RANSAC for accurate pose estimation. The new one-many RANSAC addresses the challenge of repetitive building structures (e.g. windows, balconies) in urban localization. Extensive experiments demonstrate that our 2D-3D correspondence search achieves state-of-the-art localization accuracy on multiple benchmark datasets. Furthermore, our experiments on a large Google Street View (GSV) image dataset show the potential of large-scale localization entirely on a typical mobile device

Late night salivary cortisol and cortisone should be the initial screening test for Cushing’s syndrome

Endogenous Cushing’s syndrome (CS) poses considerable diagnostic challenges. Although late night salivary cortisol (LNSC) is recommended as a first line screening investigation, it remains the least widely used test in many countries. The combined measurement of LNSC and late-night salivary cortisone (LNS cortisone) has shown to further improve diagnostic accuracy1. We present a retrospective study in a tertiary referral centre comparing LNSC, LNS cortisone, overnight dexamethasone suppression test, low dose dexamethasone suppression test and 24-hour urinary free cortisol results of patients investigated for CS. Patients were categorised into those who had CS (21 patients) and those who did not (33 patients).LNSC had a sensitivity of 95% and a specificity of 91%. LNS cortisone had a specificity of 100% and a sensitivity of 86%. With an optimal cut-off for LNS cortisone of >14.5 nmol/l the sensitivity was 95.2%, and the specificity was 100% with an area under the curve of 0.997, for diagnosing CS. Saliva collection is non-invasive and can be carried out at home.We therefore advocate simultaneous measurement of LNSC and LNS cortisone as the first-line screening test to evaluate patients with suspected CS

Peer trainers compared with basic life support trainers in delivering effective cardiopulmonary resuscitation training to secondary school students

Teaching cardiopulmonary resuscitation (CPR) skills to the public is essential in improving cardiac arrest survival. American Heart Association suggested to incorporate it into the school curriculum. Peer trainers is a low cost and effective method in achieving this. The objective of this 3 months prospective controlled study was to compare the effectiveness of teaching compression only CPR between peers and certified basic life support (BLS) trainers to secondary school students. Improvement in knowledge and psychomotor skills of CPR compression were the primary outcome evaluated. Twelve peer trainers aged 16-years-old and twelve certified BLS trainers were recruited into the study. Compression only CPR was taught to 36 randomized secondary school students by either peer trainers (Group P) or BLS trainers (Group B). A pre-test, immediate post-test and 3 months retention test on knowledge and psychomotor skill were conducted. There was no statistically a significant difference in the mean scores of knowledge and psychomotor at pre-test, post-test and 3 months retention between Group P and Group B. There was significant increase of knowledge score between pre-test and post-test in Group P (mean difference 5.8+2.7, p<0.001) and in Group B (mean difference 4.7+2.7, p<0.001). Psychomotor score was significantly increased between pre-test and post -test in Group P (mean difference 7.11+1.49, p<0.001) and Group B (mean difference 7.22+1.5, p<0.001). Peer trainers is non-inferior to BLS trainers in teaching CPR to secondary school students as both groups showed significant improvement at post-test