Diagnostic performance of transthyretin measurement in fat tissue of patients with ATTR amyloidosis

In this article, the diagnostic performance of a transthyretin (TTR) ELISA for detection and characterization of transthyretin-derived (ATTR) amyloid in abdominal subcutaneous fat tissue was studied. Fat tissue specimens were analyzed of 38 patients with ATTR amyloidosis, 70 controls, and 17 carriers of a TTR mutation. Amyloid amount was graded semi-quantitatively in Congo red-stained specimens (0-4+). Amyloid was extracted from tissue in guanidine, and the TTR concentration was measured using a sandwich TTR-ELISA. The TTR concentration of patients with ATTR amyloidosis (mean 0.84 ng/mg fat tissue) was significantly higher than controls (p<0.001). With a TTR concentration of 0.13 ng/mg fat tissue as cut-off value, 32 of the 38 ATTR patients were identified resulting in a sensitivity of 84%. Sixty-seven of the 70 controls had values below the cut-off value resulting in a specificity of 96%. Thus, measuring TTR in fat tissue is useful for detecting ATTR amyloidosis and for characterizing amyloid as ATTR type

Cross Section Measurement of Long Cylindrical Products without Contact using Long Cylindrical Coils

The impedance Z of a solenoid with a conducting piece near it when capacity effects are neglected is Z = R + jωL with (1) R=Re−NωφosinϕIo (2) L=NωφocosϕIo where Re is the resistance of the wire of the coil, N is the number of single turns of the coil, Φo is the amplitude of the mean magnetic flux crossing the coil, Io is the amplitude of the current I circulating in the coil, ω is the pulsation of the current and ϕ is the phase of the flux relative to the current

Increased frequency of circulating IL-21 producing Th-cells in patients with granulomatosis with polyangiitis (GPA).

INTRODUCTION: The present study aimed to explore a possible role for IL-21 producing Th-cells in the immunopathogenesis of granulomatosis with polyangiitis (GPA). METHODS: Peripheral blood from 42 GPA patients in remission and 29 age-matched healthy controls (HCs) were stimulated in vitro, and the frequencies of IL-21 producing Th-cells were determined by flow cytometry. Since Th17-cells produce a low level of IL-21, IL-17 was also included in the analysis. Given that IL-21 is a hallmark cytokine for T follicular helper cells (T(FH)), we next evaluated the expression of their key transcription factor BCL-6 by RT-PCR and flow cytometry. To investigate the effect of IL-21 on autoantibody-production, PBMCs from GPA patients were stimulated in vitro with BAFF/IL-21 and total IgG and ANCA levels were measured in supernatants. In addition, the expression of IL-21-receptor on B-cells was analyzed. RESULTS: Percentages of IL-21 producing Th-cells were significantly elevated in GPA-patients compared to HCs, and were restricted to ANCA-positive patients. The expression of BCL-6 was significantly higher in ANCA-positive GPA-patients, as compared with ANCA-negative patients and HCs. IL-21 enhanced the production of IgG and ANCA in vitro in stimulated PBMCs from GPA patients. No difference was found in the expression of the IL-21-receptor on B-cells between ANCA-negative patients, ANCA-positive patients, and HCs. CONCLUSION: The increased frequency of circulating IL-21 producing Th-cells in ANCA-positive GPA patients and the stimulating capacity of IL-21 on ANCA-production suggest a role for these cells in the immunopathogenesis of GPA. Blockade of IL-21 could constitute a new therapeutic strategy for GPA

Consequences of cervical pessary for subsequent pregnancy : follow-up of randomized clinical trial (ProTWIN)

Funding Information: B.W.M. is supported by a NHMRC Investigator grant (GNT1176437). B.W.M. reports consultancy for ObsEva and has received research funding from Guerbet, Ferring and Merck. The original ProTWIN trial was funded by ZonMW grant 200310004. We did not receive any funding for this follow‐up research.Peer reviewedPublisher PD

Visuele beperkingen bij ouderen in Nederland – risicogroepen en mogelijkheden tot interventie

Doel Het in kaart brengen van het aantal ouderen met een visuele beperking in Nederland, nu en in de toekomst. Mogelijkheden tot interventie worden aangegeven. Methode en materiaal De schattingen zijn gebaseerd op een recent onderzoek in opdracht van Stichting InZicht, ZonMw, waarin literatuur gegevens over prevalentie van blindheid en slechtziendheid en de oorzaken daarvan uit bevolkingsonderzoeken in Nederland, West Europa, de Verenigde Staten en Australië zijn gerelateerd aan de laatste demografische gegevens voor Nederland. Resultaten Van de 16,4 miljoen Nederlanders in 2008 zijn er 2,4 miljoen (14,7%) 65 jaar of ouder. Van deze laatste groep wonen 155.000 mensen in een verpleeg of verzorgingshuis, de rest woont zelfstandig. In 2008 zijn naar schatting 77.000 Nederlanders blind en 234.000 slechtziend. Van hen is 79% 65 jaar of ouder. Van de ouderen in instellingen is 20% blind (32.000) en 22% slechtziend (34.000). Bij 62% van hen is de visuele beperking te behandelen of was te voorkomen geweest (‘vermijdbaar’). Van de zelfstandig wonende ouderen is 1,2% blind (27.000) en 6,8% slechtziend (154.000). Bij 57% van hen is de aandoening vermijdbaar. Conclusie In 2008 hebben 247.000 ouderen een visuele beperking die bij 143.000 (58%) van hen te behandelen is of te voorkomen was geweest. Screening en behandeling van ouderen in instellingen lijkt aangewezen, evenals voorlichting aan en gerichte screening van zelfstandig wonende ouderen

The cost effectiveness of an early transition from hospital to nursing home for stroke patients: design of a comparative study

<p>Abstract</p> <p>Background</p> <p>As the incidence of stroke has increased, its impact on society has increased accordingly, while it continues to have a major impact on the individual. New strategies to further improve the quality, efficiency and logistics of stroke services are necessary. Early discharge from hospital to a nursing home with an adequate rehabilitation programme could help to optimise integrated care for stroke patients.</p> <p>The objective is to describe the design of a non-randomised comparative study evaluating early admission to a nursing home, with multidisciplinary assessment, for stroke patients. The study is comprised of an effect evaluation, an economic evaluation and a process evaluation.</p> <p>Methods/design</p> <p>The design involves a non-randomised comparative trial for two groups. Participants are followed for 6 months from the time of stroke. The intervention consists of a redesigned care pathway for stroke patients. In this care pathway, patients are discharged from hospital to a nursing home within 5 days, in comparison with 12 days in the usual situation. In the nursing home a structured assessment takes place, aimed at planning adequate rehabilitation. People in the control group receive the usual care. The main outcome measures of the effect evaluation are quality of life and daily functioning. In addition, an economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention as well as the experiences and opinions of patients and professionals.</p> <p>Discussion</p> <p>The results of this study will provide information about the cost effectiveness of the intervention and its effects on clinical outcomes and quality of life. Relevant strengths and weaknesses of the study are addressed in this article.</p> <p>Trial registration</p> <p>Current Controlled Trails ISRCTN58135104</p

Smart technologies for personalized experiences: a case study in the hospitality domain

Recent advances in the field of technology have led to the emergence of innovative technological smart solutions providing unprecedented opportunities for application in the tourism and hospitality industry.With intensified competition in the tourism market place, it has become paramount for businesses to explore the potential of technologies, not only to optimize existing processes but facilitate the creation of more meaningful and personalized services and experiences. This study aims to bridge the current knowledge gap between smart technologies and experience personalization to understand how smart mobile technologies can facilitate personalized experiences in the context of the hospitality industry. By adopting a qualitative case study approach, this paper makes a two-fold contribution; it a) identifies the requirements of smart technologies for experience creation, including information aggregation, ubiquitous mobile connectedness and real time synchronization and b) highlights how smart technology integration can lead to two distinct levels of personalized tourism experiences. The paper concludes with the development of a model depicting the dynamic process of experience personalization and a discussion of the strategic implications for tourism and hospitality management and research