The performance of organ dysfunction scores for the early prediction and management of severity in acute pancreatitis: an exploratory phase diagnostic study

Objective: To evaluate contemporary organ dysfunction scoring systems for early prediction of severity in acute pancreatitis (AP). Methods: In a consecutive cohort of 181 patients with AP, organ dysfunction scores (logistic organ dysfunction system [LODS] score, Marshall organ dysfunction score, and sequential organ failure assessment score) were collected at 24 and 48 hours. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated on admission and 24 and 48 hours and C-reactive protein level measured at 48 hours. Patients who died or used critical care facilities (level 2/3) during admission were classed as severe. Results: Area under curve for APACHE II score at admission was 0.78 (95% confidence interval, 0.69-0.86). At 24 hours, area under curve for LODS, Marshall organ dysfunction system, sequential organ failure assessment, and APACHE II scores were 0.82, 0.80, 0.80, and 0.82, respectively. The LODS score at cutoff of 1 achieved 90% sensitivity and 69% specificity, corresponding to a positive predictive value of 38%. Acute Physiology and Chronic Health Evaluation II score as a rule-out for selection of mild cases at a test threshold of 9 (scores <= 8 being selected) gives homogeneity of 91% and efficiency of 79%. Conclusions: Contemporary organ dysfunction scoring systems provides an objective guide to stratification of management, but there is no perfect score. All scores evaluated here perform equivalently at 24 hours. Acute Physiology and Chronic Health Evaluation II may have practical clinical value as a rule-out test

Luminosity-Colours relations for thin disc main-sequence stars

In this study we present the absolute magnitude calibrations of thin disc main-sequence stars in the optical ($M_{V}$), and in the near-infrared ($M_{J}$). Thin disc stars are identified by means of Padova isochrones, and absolute magnitudes for the sample are evaluated via the newly reduced Hipparcos data. The obtained calibrations cover a large range of spectral types: from A0 to M4 in the optical and from A0 to M0 in the near-infrared. Also, we discuss the of effects binary stars and evolved stars on the absolute magnitude calibrations. The usage of these calibrations can be extended to the estimation of galactic model parameters for the thin disc individually, in order to compare these parameters with the corresponding ones estimated by $\chi{^2}_{min}$ statistics (which provides galactic model parameters for thin and thick discs, and halo simultaneously) to test any degeneracy between them. The calibrations can also be used in other astrophysical researches where distance plays an important role in that study.Comment: 8 pages, including 12 figures and 4 tables, accepted for publication in MNRA

The viscosity parameter alpha and the properties of accretion disc outbursts in close binaries

The physical mechanisms driving angular momentum transport in accretion discs are still unknown. Although it is generally accepted that, in hot discs, the turbulence triggered by the magneto-rotational instability is at the origin of the accretion process in Keplerian discs, it has been found that the values of the stress-to-pressure ratio (the alpha "viscosity" parameter) deduced from observations of outbursting discs are an order of magnitude higher than those obtained in numerical simulations. We test the conclusion about the observation-deduced value of alpha using a new set of data and comparing the results with model outbursts. We analyse a set of observations of dwarf-nova and AM CVn star outbursts and from the measured decay times determine the hot-disc viscosity parameter alpha_h. We determine if and how this method is model dependent. From the dwarf-nova disc instability model we determine an amplitude vs recurrence-time relation and compare it to the empirical Kukarkin-Parenago relation between the same, but observed, quantities. We found that all methods we tried, including the one based on the amplitude vs recurrence-time relation, imply alpha_h ~ 0.1 - 0.2 and exclude values an order of magnitude lower. The serious discrepancy between the observed and the MRI-calculated values of the accretion disc viscosity parameter alpha is therefore real since there can be no doubt about the validity of the values deduced from observations of disc outbursts.Comment: Astronomy and Astrophysics, in press. (In Fig. 3b the upper sequence of numbers and symbols is an artefact of the compilation on astro-ph) and should be ignored.

Idiopathic eosinophilic parotitis in an eight-year-old boy: a case report

<p>Abstract</p> <p>Introduction</p> <p>A number of medical conditions, some of them recently reported, are associated with an increased production of eosinophils. We report the first case of eosinophilic parotitis in the literature.</p> <p>Case presentation</p> <p>The patient was an eight-year-old Caucasian boy who presented with a two-year history of recurring acute parotitis with no fever. He had had a total of five episodes with no response to antibiotics, but remission had been achieved with oral corticosteroid therapy. We performed allergy tests for inhalant and food allergens and for haptens, but the results were all negative. The results of echography ruled out sialodochitis. Instead, a swab from the parotid duct led to the detection of a high number of eosinophils.</p> <p>Conclusions</p> <p>This report is first in the literature to describe a case of eosinophilic parotitis, and we suggest that a cytological assessment, which is quite simple yet rarely used by physicians, be performed when patients with parotitis of uncertain origin are under evaluation.</p

Embracing additive manufacture: implications for foot and ankle orthosis design

<p>Abstract</p> <p>Background</p> <p>The design of foot and ankle orthoses is currently limited by the methods used to fabricate the devices, particularly in terms of geometric freedom and potential to include innovative new features. Additive manufacturing (AM) technologies, where objects are constructed via a series of sub-millimetre layers of a substrate material, may present the opportunity to overcome these limitations and allow novel devices to be produced that are highly personalised for the individual, both in terms of fit and functionality.</p> <p>Two novel devices, a foot orthosis (FO) designed to include adjustable elements to relieve pressure at the metatarsal heads, and an ankle foot orthosis (AFO) designed to have adjustable stiffness levels in the sagittal plane, were developed and fabricated using AM. The devices were then tested on a healthy participant to determine if the intended biomechanical modes of action were achieved.</p> <p>Results</p> <p>The adjustable, pressure relieving FO was found to be able to significantly reduce pressure under the targeted metatarsal heads. The AFO was shown to have distinct effects on ankle kinematics which could be varied by adjusting the stiffness level of the device.</p> <p>Conclusions</p> <p>The results presented here demonstrate the potential design freedom made available by AM, and suggest that it may allow novel personalised orthotic devices to be produced which are beyond the current state of the art.</p

Transport Through Andreev Bound States in a Graphene Quantum Dot

Andreev reflection-where an electron in a normal metal backscatters off a superconductor into a hole-forms the basis of low energy transport through superconducting junctions. Andreev reflection in confined regions gives rise to discrete Andreev bound states (ABS), which can carry a supercurrent and have recently been proposed as the basis of qubits [1-3]. Although signatures of Andreev reflection and bound states in conductance have been widely reported [4], it has been difficult to directly probe individual ABS. Here, we report transport measurements of sharp, gate-tunable ABS formed in a superconductor-quantum dot (QD)-normal system, which incorporates graphene. The QD exists in the graphene under the superconducting contact, due to a work-function mismatch [5, 6]. The ABS form when the discrete QD levels are proximity coupled to the superconducting contact. Due to the low density of states of graphene and the sensitivity of the QD levels to an applied gate voltage, the ABS spectra are narrow, can be tuned to zero energy via gate voltage, and show a striking pattern in transport measurements.Comment: 25 Pages, included SO

Collapse of superconductivity in a hybrid tin-graphene Josephson junction array

When a Josephson junction array is built with hybrid superconductor/metal/superconductor junctions, a quantum phase transition from a superconducting to a two-dimensional (2D) metallic ground state is predicted to happen upon increasing the junction normal state resistance. Owing to its surface-exposed 2D electron gas and its gate-tunable charge carrier density, graphene coupled to superconductors is the ideal platform to study the above-mentioned transition between ground states. Here we show that decorating graphene with a sparse and regular array of superconducting nanodisks enables to continuously gate-tune the quantum superconductor-to-metal transition of the Josephson junction array into a zero-temperature metallic state. The suppression of proximity-induced superconductivity is a direct consequence of the emergence of quantum fluctuations of the superconducting phase of the disks. Under perpendicular magnetic field, the competition between quantum fluctuations and disorder is responsible for the resilience at the lowest temperatures of a superconducting glassy state that persists above the upper critical field. Our results provide the entire phase diagram of the disorder and magnetic field-tuned transition and unveil the fundamental impact of quantum phase fluctuations in 2D superconducting systems.Comment: 25 pages, 6 figure

Altered thymic differentiation and modulation of arthritis by invariant NKT cells expressing mutant ZAP70

Various subsets of invariant natural killer T (iNKT) cells with different cytokine productions develop in the mouse thymus, but the factors driving their differentiation remain unclear. Here we show that hypomorphic alleles of Zap70 or chemical inhibition of Zap70 catalysis leads to an increase of IFN-gamma-producing iNKT cells (NKT1 cells), suggesting that NKT1 cells may require a lower TCR signal threshold. Zap70 mutant mice develop IL-17-dependent arthritis. In a mouse experimental arthritis model, NKT17 cells are increased as the disease progresses, while NKT1 numbers negatively correlates with disease severity, with this protective effect of NKT1 linked to their IFN-gamma expression. NKT1 cells are also present in the synovial fluid of arthritis patients. Our data therefore suggest that TCR signal strength during thymic differentiation may influence not only IFN-gamma production, but also the protective function of iNKT cells in arthritis

Neural processing of criticism and positive comments from relatives in individuals with schizotypal personality traits

Objectives. High negative expressed emotion by family members towards schizophrenia patients increases the risk of subsequent relapse. The study aimed to determine whether individuals with high schizotypy (HS) and low schizotypy (LS) would differ in activation of brain areas involved in cognitive control when listening to relative criticism

The role of venture capitalists in the regional innovation ecosystem : a comparison of networking patterns between private and publicly backed venture capital funds

This paper empirically examines the development of social networks among venture capitalists and other professionals of the regional innovation ecosystem. Using an online survey of venture capitalists, the article considers their networking behaviour, focusing particularly on the distinction between those employed by private and those employed by publicly backed venture capital funds, and on the composition and spatial search of their networks. It investigates whether the frequency of interaction between venture capitalists and other members of the innovation ecosystem is associated with the nature of the venture capital funds. The paper provides the first detailed investigation of the relationship between different types of venture capitalists and other players of the innovation ecosystem such as universities incubators, research institutes, and business support organisations. The results show that there are distinctive differences within the two seemingly similar professional groups (private and public venture capitalists), and public dependence of the venture capital fund is strongly and significantly associated with higher volumes of interactions. The more publicly dependent a fund is, the more it interacts with other players of the innovation system. This finding has important implications for both academics and practitioners and suggests that publicly backed funds have a wider role to play in mobilising the different players of the regional innovation ecosystem