BACKGROUND:Vascular anomalies currently are classified according to their clinical and histological characteristics. Recent advances in molecular genetics have enabled the identification of somatic ...mutations in most types of vascular anomalies. The purpose of this study was to collate information regarding the genetic basis of vascular anomalies.
METHODS:The PubMed literature was reviewed for all citations that identified a mutation in a vascular anomaly between 1994 and 2017. Search terms included “vascular anomaly,” “mutation,” “gene,” “hemangioma,” “pyogenic granuloma,” “kaposiform hemangioendothelioma,” “capillary malformation,” “venous malformation,” lymphatic malformation,” “arteriovenous malformation,” and “syndrome.” Articles that identified both germline and somatic mutations in vascular anomalies were analyzed. Mutations were categorized by type (germline or somatic), gene, signaling pathway, and cell(s) enriched for the mutation.
RESULTS:The majority of vascular anomalies had associated mutations that commonly affected tyrosine kinase receptor signaling through the RAS or PIK3CA pathways. Mutations in PIK3CA and G-protein–coupled receptors were most frequently identified. Specific types of vascular anomalies usually were associated with a single gene. However, mutations in the same gene occasionally were found in different vascular lesions, and some anomalies had a mutation in more than one gene. Mutations were most commonly enriched in endothelial cells.
CONCLUSIONS:Identification of somatic mutations in vascular anomalies is changing the paradigm by which lesions are diagnosed and understood. Mutations and their pathways are providing potential targets for the development of novel pharmacotherapy. In the future, vascular anomalies will be managed based on clinical characteristics and molecular pathophysiology.
As the COVID-19 pandemic continues to unfold, the infection-fatality risk (ie, risk of death among all infected individuals including those with asymptomatic and mild infections) is crucial for ...gauging the burden of death due to COVID-19 in the coming months or years. Here, we estimate the infection-fatality risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New York City, NY, USA, the first epidemic centre in the USA, where the infection-fatality risk remains unclear.
In this model-based analysis, we developed a meta-population network model-inference system to estimate the underlying SARS-CoV-2 infection rate in New York City during the 2020 spring pandemic wave using available case, mortality, and mobility data. Based on these estimates, we further estimated the infection-fatality risk for all ages overall and for five age groups (<25, 25–44, 45–64, 65–74, and ≥75 years) separately, during the period March 1 to June 6, 2020 (ie, before the city began a phased reopening).
During the period March 1 to June 6, 2020, 205 639 people had a laboratory-confirmed infection with SARS-CoV-2 and 21 447 confirmed and probable COVID-19-related deaths occurred among residents of New York City. We estimated an overall infection-fatality risk of 1·39% (95% credible interval 1·04–1·77) in New York City. Our estimated infection-fatality risk for the two oldest age groups (65–74 and ≥75 years) was much higher than the younger age groups, with a cumulative estimated infection-fatality risk of 0·116% (0·0729–0·148) for those aged 25–44 years and 0·939% (0·729–1·19) for those aged 45–64 years versus 4·87% (3·37–6·89) for those aged 65–74 years and 14·2% (10·2–18·1) for those aged 75 years and older. In particular, weekly infection-fatality risk was estimated to be as high as 6·72% (5·52–8·01) for those aged 65–74 years and 19·1% (14·7–21·9) for those aged 75 years and older.
Our results are based on more complete ascertainment of COVID-19-related deaths in New York City than other places and thus probably reflect the true higher burden of death due to COVID-19 than that previously reported elsewhere. Given the high infection-fatality risk of SARS-CoV-2, governments must account for and closely monitor the infection rate and population health outcomes and enact prompt public health responses accordingly as the COVID-19 pandemic unfolds.
National Institute of Allergy and Infectious Diseases, National Science Foundation Rapid Response Research Program, and New York City Department of Health and Mental Hygiene.
Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common benign tumor of infancy. Most IHs are small, innocuous, self-resolving, and require no treatment. However, ...because of their size or location, a significant minority of IHs are potentially problematic. These include IHs that may cause permanent scarring and disfigurement (eg, facial IHs), hepatic or airway IHs, and IHs with the potential for functional impairment (eg, periorbital IHs), ulceration (that may cause pain or scarring), and associated underlying abnormalities (eg, intracranial and aortic arch vascular abnormalities accompanying a large facial IH). This clinical practice guideline for the management of IHs emphasizes several key concepts. It defines those IHs that are potentially higher risk and should prompt concern, and emphasizes increased vigilance, consideration of active treatment and, when appropriate, specialty consultation. It discusses the specific growth characteristics of IHs, that is, that the most rapid and significant growth occurs between 1 and 3 months of age and that growth is completed by 5 months of age in most cases. Because many IHs leave behind permanent skin changes, there is a window of opportunity to treat higher-risk IHs and optimize outcomes. Early intervention and/or referral (ideally by 1 month of age) is recommended for infants who have potentially problematic IHs. When systemic treatment is indicated, propranolol is the drug of choice at a dose of 2 to 3 mg/kg per day. Treatment typically is continued for at least 6 months and often is maintained until 12 months of age (occasionally longer). Topical timolol may be used to treat select small, thin, superficial IHs. Surgery and/or laser treatment are most useful for the treatment of residual skin changes after involution and, less commonly, may be considered earlier to treat some IHs.
The goal of this consensus conference, sponsored by the American Association of Plastic Surgeons, was to perform a systematic review and meta-analysis of controlled trials to examine both the ...benefits and risks of surgical treatment and surgical prevention of upper and lower extremity lymphedema.
The panel met in Boston for a 3-day, face-to-face meeting in July of 2017. After an exhaustive review of the existing literature, the authors created consensus recommendations using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Important directions for future research were also identified.
There is evidence to support that lymphovenous anastomosis can be effective in reducing severity of lymphedema (grade 1C). There is evidence to support that vascular lymph node transplantation can be effective in reducing severity of lymphedema (grade 1B). Currently, there is no consensus on which procedure (lymphovenous bypass versus vascular lymph node transplantation) is more effective (grade 2C). A few studies show that prophylactic lymphovenous bypass in patients undergoing extremity lymphadenectomy may reduce the incidence of lymphedema (grade 1B). More studies with longer follow-up are required to confirm this benefit. Debulking procedures such as liposuction are effective in addressing a nonfluid component such as fat involving lymphedema (grade 1C). There is a role for liposuction combined with physiologic procedures although the timing of each procedure is currently unresolved (grade 1C).
Many studies seem to support some efficacy of lymphovenous bypass and vascular lymph node transplantation. Many studies show the important role of lymphedema therapy and other procedures such as liposuction and debulking. The management of lymphedema is a challenging field with many promising advances. However, many questions remain unanswered.
Transposable elements (TEs) are powerful facilitators of genome evolution, and hence of phenotypic diversity as they can cause genetic changes of great magnitude and variety. TEs are ubiquitous and ...extremely ancient, and although harmful to some individuals, they can be very beneficial to lineages. TEs can build, sculpt, and reformat genomes by both active and passive means. Lineages with active TEs or with abundant homogeneous inactive populations of TEs that can act passively by causing ectopic recombination are potentially fecund, adaptable, and taxonate readily. Conversely, taxa deficient in TEs or possessing heterogeneous populations of inactive TEs may be well adapted in their niche, but tend to prolonged stasis and may risk extinction by lacking the capacity to adapt to change, or diversify. Because of recurring intermittent waves of TE infestation, available data indicate a compatibility with punctuated equilibrium, in keeping with widely accepted interpretations of evidence from the fossil record. We propose a general and holistic synthesis on how the presence of TEs within genomes makes them flexible and dynamic, so that genomes themselves are powerful facilitators of their own evolution
The use of hydrogels in load bearing applications is often limited by insufficient toughness. 2-Hydroxyethyl methacrylate (HEMA) based hydrogels are appealing for translational work, as they are ...affordable and the use of HEMA is FDA approved. Furthermore, HEMA is photopolymerizable, providing spatiotemporal control over mechanical properties. We evaluated the ability of vinyl methacrylate (VM), allyl methacrylate (AM), and 3-(Acryloyloxy)-2-hydroxypropyl methacrylate (AHPM) to tune hydrogel toughness and Young's modulus. The crosslinkers were selected due to their heterobifunctionality (vinyl and methacrylate) and similar size and structure to EGDMA, which was shown previously to increase toughness as compared to longer crosslinkers. Vinyl methacrylate incorporation into HEMA hydrogels gave rise to hydrogels with Young's moduli spanning ranges for ligament to cartilage, with a peak toughness of 519 ± 70 kJ/m3 under physiological conditions. We report toughness (work of extension) as a function of modulus and equilibrium water content for all formulations. The hydrogels exhibited 80%-100% cell viability, which suggests they could be used in tissue engineering applications.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Fluxgate magnetometers are an important tool for measuring space plasmas. In situ magnetic field investigations often involve measuring small perturbations of a large background field, so robust ...instrument calibration is critical to accurately resolving geophysical signals. Fluxgate instruments aboard recent space science missions have observed calibration anomalies that have been attributed to thermal gradients across the sensor. Here we present data from a laboratory experimental investigation of effects of thermal gradients on fluxgate calibration and performance. A purpose‐built laboratory apparatus fixed two thermal reservoirs at either end of a racetrack fluxgate sensor. Varying the reservoir temperatures allowed us to vary the sensor temperature and impose thermal gradients as large as 50°C across a racetrack fluxgate sensor. We find that changes in instrumental sensitivity, offset, and noise can be explained purely by changes in the average temperature of the sensor without a dependence on the difference in temperature across the sensor. We suggest that invoking concept of a static thermal gradient inducing thermoelectric currents within the fluxgate core or sensor may not be appropriate to explain changes in instrumental sensitivity, offset, and noise that have been observed on orbit.
Plain Language Summary
Fluxgate magnetometers are important tools for studying magnetic fields in space. However, when a fluxgate sensor is exposed to changing temperatures on‐orbit, the baseline measurement can be unstable, making it harder to accurately measure small magnetic fields. Some fluxgates experience on‐orbit instabilities that are related, not just to the average temperature of the sensor, but also to differences in temperature across the sensor. We use a laboratory testing method to explore the relationship of temperature differences across a sensor to changes in instability of the measurement. While we observe a strong relationship between changes in instability and the average temperature of the sensor, we do not observe a meaningful relationship between instability and differences in temperature across the sensor.
Key Points
Space based fluxgate measurements often observe calibration anomalies which are sometimes attributed to thermal gradients across the sensor
A low‐cost method for characterizing a fluxgate over changes in temperature and temperature gradient is presented
Imposing large thermal gradients across the sensor did not have a measurable effect on instrumental sensitivity, offset, or noise
Functional Properties of Vinegar Budak, Nilgün H; Aykin, Elif; Seydim, Atif C ...
Journal of food science,
20/May , Letnik:
79, Številka:
5
Journal Article
Recenzirano
A variety of natural vinegar products are found in civilizations around the world. A review of research on these fermented products indicates numerous reports of health benefits derived by ...consumption of vinegar components. Therapeutic effects of vinegar arising from consuming the inherent bioactive components including acetic acid, gallic acid, catechin, ephicatechin, chlorogenic acid, caffeic acid, p‐coumaric acid, and ferulic acid cause antioxidative, antidiabetic, antimicrobial, antitumor, antiobesity, antihypertensive, and cholesterol‐lowering responses. The aims of this article are to discuss vinegar history, production, varieties, acetic acid bacteria, and functional properties of vinegars.
BACKGROUND:Obesity is a risk factor for the development of secondary lymphedema after axillary lymphadenectomy and radiation therapy. The purpose of this study was to determine whether obesity ...influences the morbidity of lymphedema in patients who have the condition.
METHODS:Two cohorts of patients were comparedgroup 1, normal weight (body mass index ≤25 kg/m); and group 2, obese (body mass index ≥30 kg/m). Inclusion criteria were patients aged 21 years or older with lymphedema confirmed by lymphoscintigraphy. Covariates included age, sex, lymphedema type (primary or secondary), location, comorbidities, lymph node dissection, radiation therapy, lymphoscintigram result, and disease duration. Outcome variables were infection, hospitalization, and degree of limb overgrowth. The cohorts were compared using the Mann-Whitney U test, Fisher’s exact test, and multivariable logistic regression.
RESULTS:Sixty-seven patients were includedgroup 1, n = 33; and group 2, n = 34. Disease duration did not differ between groups (p = 0.72). Group 2 was more likely to have an infection (59 percent), hospitalization (47 percent), and moderate or severe overgrowth (79 percent), compared to group 1 (18, 6, and 40 percent, respectively; p < 0.001). Multivariable logistic regression showed that obesity was an independent risk factor for infection (OR, 7.9; 95 percent CI, 2.5 to 26.3; p < 0.001), hospitalization (OR, 30.0; 95 percent CI, 3.6 to 150.8; p < 0.001), and moderate to severe limb overgrowth (OR, 6.7; 95 percent CI, 2.1 to 23.0; p = 0.003).
CONCLUSIONS:Obesity negatively affects patients with established lymphedema. Obese individuals are more likely to have infections, hospitalizations, and larger extremities compared to subjects with a normal body mass index. Patients with lymphedema should be counseled about the negative effects of obesity on their condition.
CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, II.
For people with disordered eating, support groups can play an important role in treatment and recovery journeys. Such resources became crucial during COVID-19, as people with disordered eating ...reported increased isolation, symptomology, and decreased treatment access. This study examines participants' experiences of nine, rolling, clinician-led, free, virtual support groups for disordered eating. Participants (207 attenders and 70 nonattenders (individuals who signed up for groups and never attended)) completed an online survey. Codebook thematic analysis of open response items generated topics and themes including: reasons for signing up ("community connection and seeking support," "filling a treatment gap," "behavior and support changes due to COVID-19"), barriers to participation ("interpersonal dynamics," "accessibility factors," "group structure"), and benefits of attending group ("feeling less alone," "identifying new treatment needs," "coping skills and reduction of symptoms"). Participants discussed lack of accessible, identity-aware treatment options outside of these groups, particularly for those with minoritized identities. This paper highlights the role of groups in participants' eating disorder recoveries and explores how virtual clinician-led support groups fit into the constellation of eating disorder care that increasingly includes virtual resources. Group psychotherapy specialists could consider bringing skills to facilitate spaces for community-based healing to complement conventional treatment approaches.
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