2,026 research outputs found

    Multimodal ophthalmic imaging of staphylococcus aureus bacteremia associated with chorioretinitis, endocarditis, and multifocal brain abscesses

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    Purpose: Staphylococcus aureus bacteriemia (SAB) as critical condition for the life and occasionally involves the eyes. The aim of this report is to describe the ocular involvement with multimodal imaging. Observations: A patient admitted for evaluation of acute onset of confusion, disorientation, and generalized malaise and found to have methicillin-resistant staphylococcus aureus (MRSA)-associated endocarditis and multifocal brain abscesses was evaluated by the ophthalmology service. The patient's visual acuity was 20/20 OU without relative afferent pupillary defect and normal intraocular pressures. Bedside anterior segment examination was normal. Posterior segment examination revealed intraretinal hemorrhages and Roth spots in the posterior pole of the right eye, and two deep well-defined focal white chorioretinal infiltrates and a hemorrhagic pigment epithelium detachment in the temporal quadrant of the left eye. Multimodal imaging was utilized to document these findings and ensure adequate antibiotic therapy. Conclusion: SAB has the potential for poor visual outcomes as well as significant morbidity and mortality. Multimodal imaging of SAB-related chorioretinitis allows for accurate diagnosis as well as assessment of response to antimicrobial therapy

    Correlated Electrons Step-by-Step: Itinerant-to-Localized Transition of Fe Impurities in Free-Electron Metal Hosts

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    High-resolution photoemission spectroscopy and realistic ab-initio calculations have been employed to analyze the onset and progression of d-sp hybridization in Fe impurities deposited on alkali metal films. The interplay between delocalization, mediated by the free-electron environment, and Coulomb interaction among d-electrons gives rise to complex electronic configurations. The multiplet structure of a single Fe atom evolves and gradually dissolves into a quasiparticle peak near the Fermi level with increasing the host electron density. The effective multi-orbital impurity problem within the exact diagonalization scheme describes the whole range of hybridizations.Comment: 10 pages, 4 figure

    Interpreting the long-term variability of the changing-look AGN Mrk 1018

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    We present a thorough study of the Changing-Look Active Galactic Nucleus (CL-AGN) Mrk 1018, utilizing an extensive dataset spanning optical, UV, and X-ray spectro-photometric data from 2005 to 2019. We analysed X-ray spectra and broad-band photometry, and performed optical-to-X-ray spectral energy distribution (SED) fitting to comprehend the observed changing-look behaviour. We found that over the 14 years in analysis, significant changes in X-ray spectra occurred, as the hardness ratio increases by a factor of ~2. We validated also the broad-band dimming, with optical, UV, and X-ray luminosities decreasing by factors of >7, >24 and ~9, respectively. These dims are attributed to the declining UV emission. We described the X-ray spectra with a two-Comptonization model, revealing a consistent hot comptonizing medium but a cooling warm component. This cooling, linked to the weakening of the magnetic fields in the accretion disk, explains the UV dimming. We propose that the weakening is caused by the formation of a jet, in turn originated from the change of state of the inner accretion flow. Our optical-to-X-ray SED fitting supports this conclusion, as the normalised accretion rate is super-critical (μ=\mu=0.06>0.02) in the bright state and sub-critical (μ=\mu=0.01<0.02) in the faint state. Instabilities arising at the interface of the state-transition are able to reduce the viscous timescale to the observed ~10 years of Mrk 1018 variability. We explored a possible triggering mechanism for this state transition, involving gaseous clouds pushed onto the AGN sub-pc regions by a recent merging event or by cold chaotic accretion. This scenario, if validated by future simulations, could enhance our understanding of CL-AGN and raises questions about an accretion rate of ~0.02, coupled with minor disturbances in the accretion disk, being the primary factor in the changing-look phenomenon.Comment: 18 pages, 8 figure

    Multidimensional prognostic index and mortality in intermediate care facilities: A retrospective study

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    Multidimensional prognostic index (MPI) is a frailty assessment tool used for stratifying prognosis in older hospitalized people, but data regarding older people admitted to intermediate care facilities (ICFs) are missing. The aim of this study is to evaluate whether MPI can predict mortality in older patients admitted to the ICFs. MPI was calculated using different domains explored by a standard comprehensive geriatric assessment and categorized into tertiles (MPI-1 ≤ 0.20, MPI 2 0.20–0.34, MPI 3 &gt; 0.34). A Cox’s regression analysis, taking mortality as the outcome, was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). In total, 653 older patients were enrolled (mean age: 82 years, 59.1% females). Patients in MPI-2 (HR = 3.66; 95%CI: 2.45–5.47) and MPI-3 (HR = 6.22; 95%CI: 4.22–9.16) experienced a higher risk of mortality, compared to MPI-1. The accuracy of MPI in predicting mortality was good (area under the curve (AUC) = 0.74, 95%CI: 0.70–0.78). In conclusion, our study showed that prognostic stratification, as assessed by the MPI, was associated with a significantly different risk of mortality in older patients admitted to the ICFs, indicating the necessity of using a CGA-based tool for better managing older people in this setting as well. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

    Highly Tunable Emission by Halide Engineering in Lead-Free Perovskite-Derivative Nanocrystals: The Cs2SnX6 (X = Cl, Br, Br/I, I) System

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    Nanocrystals of Cs2SnX6 (X = Cl, Br, Br0.5I0.5, and I) have been prepared by a simple, optimized, hot-injection method, reporting for the first time the synthesis of Cs2SnCl6, Cs2SnBr6, and mixed Cs2Sn(I0.5Br0.5)6 nanocrystalline samples. They all show a cubic crystal structure with a linear scaling of lattice parameter by changing the halide size. The prepared nanocrystals have spherical shape with average size from 3 to 6 nm depending on the nature of the halide and span an emission range from 444 nm (Cs2SnCl6) to 790 nm (Cs2SnI6) with a further modulation provided by mixed Br/I systems

    Test-retest analysis of a non-invasive method of quantifying [C-11]-PBR28 binding in Alzheimer's disease

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    Purpose: In order to maximise the utility of [11C]-PBR28 for use in longitudinal studies and clinical trials in Alzheimer’s disease (AD), there is a need to develop non-invasive metrics of tracer binding that do not require arterial cannulation. Recent work has suggested that standardised uptake value (SUV)-based methods may be sensitive to changes in translocator protein (TSPO) levels associated with neurodegeneration. However, the test-retest reliability of these approaches in AD over a time period relevant for clinical trials is unknown. In this study, the test-retest reliability of three SUV-based metrics was assessed in AD patients over 12 weeks. Methods: Five patients with mild AD and the high-affinity binding TSPO genotype underwent two [11C]-PBR28 PET scans approximately 12 weeks apart. The test-retest reliability (TRR) of the unadjusted SUV, SUV relative to cerebellar grey matter (SUVRC) and SUV normalised to whole brain activity (SUVRWB) in nine cortical and limbic regions of interest was assessed using the absolute variability and the intraclass correlation coefficient. Results: Of the three measures, SUVRWB performed best overall, showing low absolute variability (mean −0.13 %, SD 2.47 %) and high reliability (mean ICC = 0.83). Unadjusted SUV also performed well, with high reliability (ICC = 0.94) but also high variability (mean −1.24 %, SD 7.28 %). By comparison, the SUVRC showed higher variability (mean −3.98 %, SD 7.07 %) and low reliability (ICC = 0.65). Conclusions: In this AD sample, we found that SUV-derived metrics of [11C]-PBR28 binding showed high stability over 12 weeks. These results compare favourably with studies reporting TRR of absolute quantification of [11C]-PBR28. Pending further validation of SUV-based measures of [11C]-PBR28, semi-quantitative methods of [11C]-PBR28 analysis may prove useful in longitudinal studies of AD

    Schistosomal appendicitis: Case series and systematic literature review

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    Background Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. Methods We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. Findings A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatientsAUwith: schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to PerPLOSstyle; sufferingfrom2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction &lt; 0.0001). Conclusions Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019AU(COVID-19): PleasenotethatCOVIDera where the majority19hasbeendefinedasCoof attention and funds are used to fight the pandemic

    Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis

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    Introduction: The objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis. Methods: Medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI). Results: From the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k = 10, n = 2992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD + 4.75% (95% CI 3.45, 6.05); total hip: MD + 2.72% (95% CI 2.06; 3.37); femoral neck: MD + 2.26% (95% CI 1.67; 2.85). Denososumab (k = 2, n = 242), Teriparatide (k = 2, n = 309) and Abaloparatide (k = 2, n = 248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures. Conclusions: Medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women

    Regulation of miR-483-3p by the O-linked N-acetylglucosamine transferase links chemosensitivity to glucose metabolism in liver cancer cells

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    The miR-483-3p is upregulated in several tumors, including liver tumors, where it inhibits TP53-dependent apoptosis by targeting the pro-apoptotic gene BBC3/PUMA. The transcriptional regulation of the miR-483-3p could be driven by the β-catenin/USF1 complex, independently from its host gene IGF2, and we previously demonstrated that in HepG2 hepatoblastoma cells carrying wild-type TP53 the upregulation of the miR-483-3p overcomes the antitumoral effects of the tumor-suppressor miR-145-5p by a mechanism involving cellular glucose availability. Here we demonstrate that in HepG2 cells, the molecular link between glucose concentration and miR-483-3p expression entails the O-linked N-acetylglucosamine (O-GlcNAc) transferase (OGT), which stabilizes the transcriptional complex at the miR-483 promoter. HepG2 cells showed reduced miR-483-3p expression and increased susceptibility to 5-fluorouracil (5-FU)-induced apoptosis in presence of the inhibitor of glycolysis 2-deoxy-D-glucose (2-DG). However, in vivo experiments showed that HepG2 cells with higher miR-483-3p expression were selected during tumor progression regardless of 5-FU treatment. Furthermore, treatment with 2-DG alone did not significantly reduce HepG2 xenograft load in immunodeficient mice. In conclusion, we show that in HepG2 cells glucose uptake increases the expression of the oncogenic miR-483-3p through the OGT pathway. This suggests that depletion of the miR-483-3p may be a valuable therapeutic approach in liver cancer patients, but the use of inhibitors of glycolysis to achieve this purpose could accelerate the selection of resistant neoplastic cell clones

    Healthy Aging and Dietary Patterns

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    A number of factors contribute to the complex process of aging, which finally define whether someone will or not develop age-associated chronic diseases in late life. These determinants comprise genetic susceptibility as well as various behavioral, environmental, and dietary factors, all of which have been shown to influence specific pathways regulating the aging process and the extension of life, which makes longevity a multidimensional phenomenon. Although a “miraculous elixir” or a “nutrition pill” are not plausible, researchers agree on the notion that nutritional factors have major impact on the risk of age-associated chronic non-communicable diseases and mortality. In recent years nutrition research in relation to health outcomes has considerably changed from focusing exclusively on single nutrients to considering combinations of foods rather than nutrients in isolation. Although research on specific nutrients is scientifically valid providing crucial evidence on the mechanisms by which nutrition impacts health, the recent switch targeting the multifaceted synergistic interplay among nutrients, other dietary constituents, and whole foods, has promoted emerging interest on the actions of total dietary patterns. This narrative review aims to describe some specific dietary patterns with evidence of associations with reduction in the incidence of chronic diseases allowing older adults to live a long-lasting and healthier life, and confirming the powerful impact nutrition can exert on healthy aging. © 2022 by the authors. Licensee MDPI, Basel, Switzerland
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