540 research outputs found
Interferon Alpha in Systemic Lupus Erythematosus
The pleiotropic cytokine interferon alpha is involved in multiple aspects of lupus etiology and pathogenesis. Interferon alpha is important under normal circumstances for antiviral responses and immune activation. However, heightened levels of serum interferon alpha and expression of interferon response genes are common in lupus patients. Lupus-associated autoantibodies can drive the production of interferon alpha and heightened levels of interferon interfere with immune regulation. Several genes in the pathways leading to interferon production or signaling are associated with risk for lupus. Clinical and cellular manifestations of excess interferon alpha in lupus combined with the genetic risk factors associated with interferon make this cytokine a rare bridge between genetic risk and phenotypic effects. Interferon alpha influences the clinical picture of lupus and may represent a therapeutic target. This paper provides an overview of the cellular, genetic, and clinical aspects of interferon alpha in lupus
Mucoid degeneration of the anterior cruciate Ligament: a case report
We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). Mucoid degeneration of the ACL is a very rare cause of knee pain. There have been only some reported cases of mucoid degeneration of the ACL in the English literature. We reviewed previous reports and summarized clinical features and symptoms, including those found in our case. Magnetic Resonance Imaging is the most useful tool for differentiating mucoid degeneration of the ACL from an intraligamentous ganglion or other lesions in the knee joint. If this disease is considered preoperatively, it can be diagnosed easily based on characteristic findings.Key words: Anterior cruciate ligament, arthroscopy, Magnetic Resonance Imaging, mucoid degeneratio
Multi-band Superconductivity in the Chevrel Phases SnMo6S8 and PbMo6S8
Sub-Kelvin scanning tunnelling spectroscopy in the Chevrel Phases SnMo6S8 and
PbMo6S8 reveals two distinct superconducting gaps with Delta_1 = 3 meV, Delta_2
~ 1.0 meV and Delta_1 = 3.1 meV, Delta_2 ~ 1.4 meV respectively. The gap
distribution is strongly anisotropic, with Delta_2 predominantly seen when
scanning across unit-cell steps on the (001) sample surface. The spectra are
well-fitted by an anisotropic two-band BCS s-wave gap function. Our
spectroscopic data are confirmed by electronic heat capacity measurements which
also provide evidence for a twin-gap scenario.Comment: 5 pages, 4 figure
Superconducting transitions of intrinsic arrays of weakly coupled one-dimensional superconducting chains: the case of the extreme quasi-1D superconductor Tl(2)Mo(6)Se(6)
International audienceTl(2)Mo(6)Se(6) represents a model system for quasi-one-dimensional (quasi-1D) superconductors. We investigate its superconducting transition in detail by means of electrical transport experiments on high-quality single crystalline samples with onset T(c) = 6.8 K. Our measurements indicate a highly complex superconducting transition that occurs in different stages, with a characteristic bump in the resistivity and distinct plateau structures in the supercurrent gap imaged by V-I curves. We interpret these features as fingerprints of the gradual establishment of global phase coherence in an array of weakly coupled parallel 1D superconducting bundles. In this way, we demonstrate that superconducting Tl(2)Mo(6)Se(6) behaves like an intrinsic array of proximity or Josephson junctions, undergoing a complex superconducting phase-ordering transition at 4.5 K that shows many similarities to the Berezinskii-Kosterlitz-Thouless transition
Impact of an in-person small group surgical skills course for preclinical medical students in an era of increased e-learning.
Objective: The COVID-19 pandemic led to a dramatic decrease in face-to-face teaching. This can particularly impact medical students' skills development. This prompted development of an in-person surgical skills course as guided by the General Medical Council "Outcomes for Graduates" facilitated by tutors with surgical experience. This study aimed to primarily assess participant confidence in surgical skills following the course. Design: This was an interventional study assessing both qualitative and quantitative data collected prior to, during, and post course completion. Data were collected from students via online forms, which included a mixture of "Yes/No" responses, self-assessed confidence levels via Likert scales, and free type questions. Setting: The study assessed feedback for a 5-session surgical skills course delivered at the authors' institution. This is a newly designed course using low-cost materials which was free for all attendees. Participants: Participants were all in the first or second year of medical school. There was capacity for 60 students, and all attendees provided informed consent to participate. Results: A total of 446 students applied for the course with 58 participants in the final study, 31% of whom had prior surgical skills experience. There was a statistically significant increase in student confidence levels following the course for all taught surgical skills (P = .0001). Participants were also more confident that they possessed the skills required for clinical placements (P = .0001) and to work as a junior doctor (P = .01). Thematic qualitative analysis revealed a reliance on third parties for previous surgical experience; this course improved knowledge and skills for future practice. Limitations included session duration and equipment choice. Conclusion: This study demonstrates high demand and student satisfaction from this course, offering a potential framework to improve undergraduate surgical skills teaching. The results presented here have the potential to inform wider curricula development across medical schools in the future. Competencies: Medical knowledge; practice-based learning and Improvement
Altering the Microstructure Morphology by Ultrasound Melt Processing during 6XXX Aluminium DC-Casting
EPSRC (UK
Significant CD4, CD8, and CD19 Lymphopenia in Peripheral Blood of Sarcoidosis Patients Correlates with Severe Disease Manifestations
BACKGROUND: Sarcoidosis is a poorly understood chronic inflammatory condition. Infiltration of affected organs by lymphocytes is characteristic of sarcoidosis, however previous reports suggest that circulating lymphocyte counts are low in some patients with the disease. The goal of this study was to evaluate lymphocyte subsets in peripheral blood in a cohort of sarcoidosis patients to determine the prevalence, severity, and clinical features associated with lymphopenia in major lymphocyte subsets. METHODOLOGY/PRINCIPAL FINDINGS: Lymphocyte subsets in 28 sarcoid patients were analyzed using flow cytometry to determine the percentage of CD4, CD8, and CD19 positive cells. Greater than 50% of patients had abnormally low CD4, CD8, or CD19 counts (p<4x10(-10)). Lymphopenia was profound in some cases, and five of the patients had absolute CD4 counts below 200. CD4, CD8, and CD19 lymphocyte subset counts were significantly correlated (Spearman's rho 0.57, p = 0.0017), and 10 patients had low counts in all three subsets. Patients with severe organ system involvement including neurologic, cardiac, ocular, and advanced pulmonary disease had lower lymphocyte subset counts as a group than those patients with less severe manifestations (CD4 p = 0.0043, CD8 p = 0.026, CD19 p = 0.033). No significant relationships were observed between various medical therapies and lymphocyte counts, and lymphopenia was present in patients who were not receiving any medical therapy. CONCLUSIONS/SIGNIFICANCE: Significant lymphopenia involving CD4, CD8, and CD19 positive cells was common in sarcoidosis patients and correlated with disease severity. Our findings suggest that lymphopenia relates more to disease pathology than medical treatment
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Numerical modelling of acoustic streaming during the ultrasonic melt treatment of direct-chill (DC) casting
Acoustic streaming and its attendant effects in the sump of a direct-chill (DC) casting process are successfully predicted under ultrasonic treatment for the first time. The proposed numerical model couples acoustic cavitation, fluid flow, heat and species transfer, and solidification to predict the flow pattern, acoustic pressure, and temperature fields in the sump. The model is numerically stable with time steps of the order of 0.01 s and therefore computationally attractive for optimization studies necessitating simulation times of the order of a minute. The sump profile is altered by acoustic streaming, with the slurry region depressed along the centreline of the billet by a strong central jet. The temperature gradient in the transition zone is increased, potentially interfering with grain refinement. The cooling rate in the sump is also altered, thereby modifying the dendrite arm spacing of the as-cast billet. The relative position of the sonotrode affects the sump profile, with the sump depth decreased by around 5 mm when the sonotrode is moved above the graphite ring level by 100 mm. The acoustic streaming jet penetrates into the slurry zone and, as a result, the growth direction of dendritic grains in the off-centre position is altered
Multivariate epidemiologic analysis of type 2 diabetes mellitus risks in the Lebanese population
Background: The burden of diabetes in Lebanon requires well-targeted interventions for screening type 2 diabetes mellitus (T2DM) and prediabetes and prevention of risk factors. Newly recruited 998 Lebanese individuals, in addition to 7,292 already available, were studied to investigate the prevalence of diabetes, prediabetes and their associated risk factors. Methods: Participants had fasting blood sugar and glycohemoglobin tests in addition to a lipid profile. Clinical and demographic information were obtained from a detailed questionnaire. The relationship between T2DM, its risk factors, and its complications were tested. Comparisons of these risk factors among diabetics, healthy, and coronary artery disease (CAD) patients were performed. Results: The prevalence of T2DM significantly increased with increasing BMI (p < 0.0001). Exercise activity level negatively correlated with the disease (p = 0.002), whereas the prevalence of T2DM (p < 0.0001) and CAD family history (p = 0.006) positively correlated with the affection status. The mean levels of triglycerides and LDL-C were significantly higher in diabetics (1.87; 1.35) compared to individuals with prediabetes (1.63; 1.26) and unaffected controls (1.49; 1.19). People with T2DM showed a significant decrease in HDL-C levels. A strong correlation of overall hyperlipidemia with the diabetes affection status was shown (p < 0.0001). Other comorbid factors such as hypertension (p < 0.0001) and self-reported obesity (p < 0.0001) were highly associated with T2DM and prediabetes. Reproductive health of women showed a strong correlation between giving birth to a baby with a high weight and the occurrence of T2DM and prediabetes later in life (p < 0.0001). Retinopathy and peripheral neuropathy were significantly correlated with diabetes and prediabetes (p < 0.0001). Conclusions: The present study shows an alarming prevalence of diabetes and prediabetes in the studied subgroups representative of the Lebanese population. Electronic supplementary material The online version of this article (doi:10.1186/1758-5996-6-89) contains supplementary material, which is available to authorized users
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