389 research outputs found
Exploiting Inferential Structure in Neural Processes
Neural Processes (NPs) are appealing due to their ability to perform fast adaptation based on a context set. This set is encoded by a latent variable, which is often assumed to follow a simple distribution. However, in real-word settings, the context set may be drawn from richer distributions having multiple modes, heavy tails, etc. In this work, we provide a framework that allows NPsâ latent variable to be given a rich prior defined by a graphical model. These distributional assumptions directly translate into an appropriate aggregation strategy for the context set. Moreover, we describe a message-passing procedure that still allows for end-to-end optimization with stochastic gradients. We demonstrate the generality of our framework by using mixture and Student-t assumptions that yield improvements in function modelling and test-time robustness
Addressing the Medical and Support Service Needs of People Living with HIV (PLWH) through Program Collaboration and Service Integration (PCSI)
Background: Approximately 1.2 million Americans are living with HIV, and about 50,000 new infections occur each year. People living with HIV (PLWH) have numerous medical and psychosocial needs that impact HIV disease progression and challenge treatment outcomes. Purpose: Using CDCâs Program Collaboration and Service Integration (PCSI) framework, we examined strategies, challenges, and lessons learned from a local health departmentâs efforts to institute PCSI to address the diverse needs of their patients with HIV. Methods: We captured case study data through: 1) semi-structured interviews with key program administrators, 2) analysis of program documents, and 3) site observations and review of clinic procedures. Results: Findings highlight the importance of co-locating services, partnering to leverage resources, and conducting cross-training of staff. Providing co-located services reduced wait times and enhanced coordination of care. Partnering to leverage resources increased patient referrals and enhanced access to comprehensive services. Staff cross-training resulted in more coordinated care and efficient service delivery. Conclusion: The results show that PCSI is essential for optimal care for PLWH. Incorporating PCSI was a vital component of the health departmentâs comprehensive approach to addressing the multiple medical and support service needs of its HIV-infected clients
Prospective study of pediatric patients presenting with idiopathic infantile nystagmusâManagement and molecular diagnostics
Idiopathic infantile nystagmus (IIN) is an inherited disorder occurring in the first 6 months of life, with no underlying retinal or neurological etiologies and is predominantly caused by mutations in the FRMD7 gene. IIN poses a diagnostic challenge as underlying pre-symptomatic âmultisystemâ disorders varying from benign to life-threatening should first be ruled out before nystagmus can be labeled as idiopathic. A multidisciplinary approach including multimodal ocular investigations and next-generation sequencing with whole-genome sequencing (WGS) or targeted gene panel testing is required to delineate the exact etiology. We report the clinical and genetic outcomes of 22 patients, from 22 unrelated families of diverse ethnicities, with IIN seen in the ocular genetics service at Moorfields Eye Hospital NHS Foundation Trust between 2016 and 2022. Thirty-six percent (8/22) received a confirmed molecular diagnosis with eight mutations identified in two genes (seven in FRMD7 including one novel variant c.706_707del; p. [Lys236Alafs*66], and one in GPR143). This study expands the mutational spectrum of IIN and highlights the significant role of an integrated care pathway and broader panel testing in excluding underlying pathologies
Differentiation of primate primordial germ cell-like cells following transplantation into the adult gonadal niche.
A major challenge in stem cell differentiation is the availability of bioassays to prove cell types generated in vitro are equivalent to cells in vivo. In the mouse, differentiation of primordial germ cell-like cells (PGCLCs) from pluripotent cells was validated by transplantation, leading to the generation of spermatogenesis and to the birth of offspring. Here we report the use of xenotransplantation (monkey to mouse) and homologous transplantation (monkey to monkey) to validate our in vitro protocol for differentiating male rhesus (r) macaque PGCLCs (rPGCLCs) from induced pluripotent stem cells (riPSCs). Specifically, transplantation of aggregates containing rPGCLCs into mouse and nonhuman primate testicles overcomes a major bottleneck in rPGCLC differentiation. These findings suggest that immature rPGCLCs once transplanted into an adult gonadal niche commit to differentiate towards late rPGCs that initiate epigenetic reprogramming but do not complete the conversion into ENO2-positive spermatogonia
Analysis of Spontaneous Reports of Hypoglycemia and Hyperglycemia associated with marketed systemic fluoroquinolones made to the Canadian adverse drug reaction monitoring program
Hypoglycemia, an adverse effect that may develop rapidly and progress to cause potentially serious consequences over a short period of time, is difficult to monitor in both outpatients and inpatients, and may be associated with serious central nervous system sequelae. Four recently published cases of severe acute hypoglycemia with gatifloxacin stimulated a review of the published literature and spontaneous adverse drug reaction reports made in Canada on fluoroquinolone-induced hypoglycemia or hyperglycemia. A search of the English literature for published reports of hypoglycemia associated with ciprofloxacin, gatifloxacin, levofloxacin, and moxifloxacin revealed 2 published case reports of hypoglycemia attributed to the potential drugâdrug interaction of an oral hypoglycemic agent with ciprofloxacin; 4 such reports with gatifloxacin; and no reports with either levofloxacin or moxifloxacin. All spontaneously reported adverse drug reactions made to the Canadian Adverse Drug Reaction Monitoring Program (CADRMP) listed under the Metabolic and Nutritional Disorders category for the 3 marketed respiratory fluoroquinolones (gatifloxacin, levofloxacin, and moxifloxacin) were then obtained. Altogether, 25 (93%) of 27 reports in this category were due to either hypoglycemia or hyperglycemia with gatifloxacin; 4 (11%) of 35 reports, with levofloxacin; and 1 (10%) of 10 reports, with moxifloxacin. The number of case reports for hypoglycemia (x2 = 24; p < 0.001), hyperglycemia (x2 = 8; p < 0.05), and total (hypoglycemia, hyperglycemia, and both hypoglycemia and hyperglycemia) (x2 = 46; p < 0.001) was significantly higher for gatifloxacin than for either levofloxacin or moxifloxacin. The CADRMP reports for hypoglycemia or hyperglycemia with the respiratory fluoroquinolones may have identified a safety signal for gatifloxacin. A systematic analysis to determine causality, risk factors, and incidence of hypoglycemia or hyperglycemia may be warranted
How to do it: the difficult thyroid
There is a paucity of publications detailing how to deal with the difficult thyroid cancer. When compared to other cancers, it is relatively rare with several histopathological subtypes which run differing clinical courses and respond to different therapies. It is a condition predominately treated by specifically trained General and now ENT surgeons who already have a thorough knowledge of vocal fold assessment and rehabilitation as well as emergency airways management both to avoid and treat common complications should they occur
Obesity accelerates Helicobacter felis-induced gastric carcinogenesis by enhancing immature myeloid cell trafficking and TH17 response
Objective: To investigate the role of obesity-associated inflammation and immune modulation in gastric carcinogenesis during Helicobacter-induced chronic gastric inflammation.
Design: C57BL/6 male mice were infected with H felis and placed on a high-fat diet (45% calories from fat). Study animals were analysed for gastric and adipose pathology, inflammatory markers in serum, stomach and adipose tissue, and immune responses in blood, spleen, stomach and adipose tissue.
Results: H felis-induced gastric carcinogenesis was accelerated in diet-induced obese mice compared with lean controls. Obesity increased bone marrow-derived immature myeloid cells in blood and gastric tissue of H felis-infected mice. Obesity also led to elevations in CD4 T cells, IL-17A, granulocyte macrophage colony-stimulating factor, phosphorylated STAT3 and prosurvival gene expression in gastric tissue of H felis-infected mice. Conversely, in adipose tissue of obese mice, H felis infection increased macrophage accumulation and expression of IL-6, C-C motif ligand 7 (CCL7) and leptin. Finally, the combination of obesity and gastric inflammation synergistically increased serum proinflammatory cytokines, including IL-6.
Conclusions: Here, we have established a model to study the molecular mechanism by which obesity predisposes individuals to gastric cancer. In H felis-infected mice, obesity increased proinflammatory immune responses and accelerated gastric carcinogenesis. Interestingly, gastric inflammation augmented obesity-induced adipose inflammation and production of adipose-derived factors in obese, but not lean, mice. Our findings suggest that obesity accelerates Helicobacter-associated gastric cancer through cytokine-mediated cross-talk between inflamed gastric and adipose tissues, augmenting immune responses at both tissue sites, and thereby contributing to a protumorigenic gastric microenvironment.National Institutes of Health (U.S.) (grant 5R01CA093405-11)Columbia University Medical Center (Naomi Berrie Diabetes Center, grant P30DK063608
Emotional Eating and Cardiovascular Risk Factors in the Police Force: The Carolina Blue Project
There is an association between emotional eating and cardiovascular disease (CVD) risk factors; however, little is known about this association in the police force. This study explores the associations between emotional eating and CVD risk factors in law enforcement officers in North Carolina. Four hundred and five officers completed The Emotional Eating Scale, and 221 of them completed the assessment for CVD-related markers. Descriptive statistics, Pearsonâs correlation, and multiple linear regression analyses were performed. Emotional eating in response to anger was significantly positively associated with body weight (β = 1.51, t = 2.07, p = 0.04), diastolic blood pressure (β = 0.83, t = 2.18, p = 0.03), and mean arterial pressure (β = 0.84, t = 2.19, p = 0.03) after adjusting for age and use of blood pressure medicine. Emotional eating in response to depression was significantly positively associated with triglycerides (β = 5.28, t = 2.49, p = 0.02), while the emotional eating in response to anxiety was significantly negatively associated with triglycerides (β = â11.42, t = â2.64, p = 0.01), after adjusting for age and use of cholesterol medicine. Our findings offer new insights to address emotional eating and lower CVD risk in law enforcement officers
Long-Time Tails and Anomalous Slowing Down in the Relaxation of Spatially Inhomogeneous Excitations in Quantum Spin Chains
Exact analytic calculations in spin-1/2 XY chains, show the presence of
long-time tails in the asymptotic dynamics of spatially inhomogeneous
excitations. The decay of inhomogeneities, for , is given in the
form of a power law where the relaxation time
and the exponent depend on the wave vector ,
characterizing the spatial modulation of the initial excitation. We consider
several variants of the XY model (dimerized, with staggered magnetic field,
with bond alternation, and with isotropic and uniform interactions), that are
grouped into two families, whether the energy spectrum has a gap or not. Once
the initial condition is given, the non-equilibrium problem for the
magnetization is solved in closed form, without any other assumption. The
long-time behavior for can be obtained systematically in a form
of an asymptotic series through the stationary phase method. We found that
gapped models show critical behavior with respect to , in the sense that
there exist critical values , where the relaxation time
diverges and the exponent changes discontinuously. At those points, a
slowing down of the relaxation process is induced, similarly to phenomena
occurring near phase transitions. Long-lived excitations are identified as
incommensurate spin density waves that emerge in systems undergoing the Peierls
transition. In contrast, gapless models do not present the above anomalies as a
function of the wave vector .Comment: 25 pages, 2 postscript figures. Manuscript submitted to Physical
Review
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