Cells undergoing programmed cell death (apoptosis) are removed in situ by macrophages and dendritic cells (DCs) through a specialized form of phagocytosis (efferocytosis). In the lung, there are two ...primary DC subsets with the potential to migrate to the local lymph nodes (LNs) and initiate adaptive immune responses. In this study, we show that only CD103(+) DCs were able to acquire and transport apoptotic cells to the draining LNs and cross present apoptotic cell-associated antigen to CD8 T cells. In contrast, both the CD11b(hi) and the CD103(+) DCs were able to ingest and traffic latex beads or soluble antigen. CD103(+) DCs selectively exhibited high expression of TLR3, and ligation of this receptor led to enhanced in vivo cytotoxic T cell responses to apoptotic cell-associated antigen. The selective role for CD103(+) DCs was confirmed in Batf3(-/-) mice, which lack this DC subtype. Our findings suggest that CD103(+) DCs are the DC subset in the lung that captures and presents apoptotic cell-associated antigen under homeostatic and inflammatory conditions and raise the possibility for more focused immunological targeting to CD8 T cell responses.
Highlight the importance of teamwork in health care institutions by performing a review and discussion of the relevant literature.
Review paper.
A MEDLINE/Pubmed search was performed starting from ...1990, and the terms ‘team, teamwork, managers, healthcare, and cooperation’ were searched in titles, abstracts, keywords, and conclusions; other terms ‘patient safety, ethics, audits and quality of care’ were specifically searched in abstracts and were used as additional filters criteria to select relevant articles.
Thirty-three papers were found relevant; factors affecting the quality of care in health care institutions are multiple and varied, including issues related to individual profile, to administrative structure and to team-based effort. Issues affecting teamwork include mainly self-awareness, work environment, leadership, ethics, cooperation, communication, and competition. Moreover, quality improvement plans aiming to enhance and expand teams are essential in this context. Team monitoring and management are vital to achieve efficient teamwork with all the required qualities for a safer health system. In all cases, health managers' responsibility plays a fundamental role in creating and sustaining a teamwork atmosphere.
Teamwork is known to improve outcomes in medicine, whether at the clinical, organizational, or scientific level. Teamwork in health care institutions must increasingly be encouraged, given that individual effort is often insufficient for optimal clinical outcome.
•Quality of care depends on individual profile, administrative planning, and teamwork.•Team monitoring and management are vital to achieve efficient teamwork.•Ethics constitutes the fundamentals of efficient and sustained teamwork.
The immune system must distinguish viable cells from cells damaged by physical and infective processes. The damaged cell-recognition molecule Clec9A is expressed on the surface of the mouse and human ...dendritic cell subsets specialized for the uptake and processing of material from dead cells. Clec9A recognizes a conserved component within nucleated and nonnucleated cells, exposed when cell membranes are damaged. We have identified this Clec9A ligand as a filamentous form of actin in association with particular actin-binding domains of cytoskeletal proteins. We have determined the crystal structure of the human CLEC9A C-type lectin domain and propose a functional dimeric structure with conserved tryptophans in the ligand recognition site. Mutation of these residues ablated CLEC9A binding to damaged cells and to the isolated ligand complexes. We propose that Clec9A provides targeted recruitment of the adaptive immune system during infection and can also be utilized to enhance immune responses generated by vaccines.
► Dendritic cell receptor Clec9A recognizes the exposed cytoskeleton of damaged cells ► Clec9A recognizes actin filaments with actin-binding domains of cytoskeletal proteins ► The Clec9A structure reveals conserved tryptophans involved in ligand recognition
A 19-year-old man was admitted to the pediatric ICU because of shock, multiple organ failure, and rash. Twenty hours before admission, abdominal pain and nausea developed after he ate leftovers from ...a restaurant meal. Five hours before admission, purplish discoloration of the skin developed. Management decisions were made.
The celebrated Bardeen-Cooper-Schrieffer (BCS) theory has been successful in explaining metallic superconductors, yet many believe that it must be modified to deal with the newer high-temperature ...superconductors. A possible extension is provided by the BCS-Bose-Einstein condensate (BEC) theory1, describing a smooth evolution from a system of weakly interacting pairs to a BEC of molecules of strongly bound fermions. Despite its appeal, spectroscopic evidence for the BCS-BEC crossover has never been observed in solids. Here we report electronic structure measurements in FeSexTe1-x showing that these materials are in the BCS-BEC crossover regime. Above the superconducting transition temperature, Tc, we find multiple bands with remarkably small values for the Fermi energy straight epsilonF. Yet, in the superconducting state, the gap Δ is comparable to straight epsilonF. The ratio Δ/straight epsilonFapproximate0.5 is much larger than found in any previously studied superconductor, resulting in an anomalous dispersion of the coherence peak very similar to that found in cold Fermi gas experiments2, in agreement with the predictions of the BCS-BEC crossover theory. PUBLICATION ABSTRACT
Tooth segmentation on cone-beam computed tomographic (CBCT) imaging is a labor-intensive task considering the limited contrast resolution and potential disturbance by various artifacts. Fully ...automated tooth segmentation cannot be achieved by merely relying on CBCT intensity variations. This study aimed to develop and validate an artificial intelligence (AI)-driven tool for automated tooth segmentation on CBCT imaging.
A total of 433 Digital Imaging and Communications in Medicine images of single- and double-rooted teeth randomly selected from 314 anonymized CBCT scans were imported and manually segmented. An AI-driven tooth segmentation algorithm based on a feature pyramid network was developed to automatically detect and segment teeth, replacing manual user contour placement. The AI-driven tool was evaluated based on volume comparison, intersection over union, the Dice score coefficient, morphologic surface deviation, and total segmentation time.
Overall, AI-driven and clinical reference segmentations resulted in very similar segmentation volumes. The mean intersection over union for full-tooth segmentation was 0.87 (±0.03) and 0.88 (±0.03) for semiautomated (SA) (clinical reference) versus fully automated AI-driven (F-AI) and refined AI-driven (R-AI) tooth segmentation, respectively. R-AI and F-AI segmentation showed an average median surface deviation from SA segmentation of 9.96 μm (±59.33 μm) and 7.85 μm (±69.55 μm), respectively. SA segmentations of single- and double-rooted teeth had a mean total time of 6.6 minutes (±76.15 seconds), F-AI segmentation of 0.5 minutes (±8.64 seconds, 12 times faster), and R-AI segmentation of 1.2 minutes (±33.02 seconds, 6 times faster).
This study showed a unique fast and accurate approach for AI-driven automated tooth segmentation on CBCT imaging. These results may open doors for AI-driven applications in surgical and treatment planning in oral health care.
Blood-borne pathogens can cause systemic inflammatory response syndrome (SIRS) followed by protracted, potentially lethal immunosuppression. The mechanisms responsible for impaired immunity post-SIRS ...remain unclear. We show that SIRS triggered by pathogen mimics or malaria infection leads to functional paralysis of conventional dendritic cells (cDCs). Paralysis affects several generations of cDCs and impairs immunity for 3–4 weeks. Paralyzed cDCs display distinct transcriptomic and phenotypic signatures and show impaired capacity to capture and present antigens in vivo. They also display altered cytokine production patterns upon stimulation. The paralysis program is not initiated in the bone marrow but during final cDC differentiation in peripheral tissues under the influence of local secondary signals that persist after resolution of SIRS. Vaccination with monoclonal antibodies that target cDC receptors or blockade of transforming growth factor β partially overcomes paralysis and immunosuppression. This work provides insights into the mechanisms of paralysis and describes strategies to restore immunocompetence post-SIRS.
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•Blood infections cause severe inflammation followed by protracted immunosuppression•Impaired immunity is due to formation of paralyzed conventional dendritic cells (cDCs)•Local secondary signals that persist after resolution of infection induce paralysis•Therapies that overcome or reduce the duration of cDC paralysis restore immunocompetence
Ashayeripanah et al. show that severe inflammation triggered by blood infections such as malaria induces formation of functionally impaired (paralyzed) dendritic cells for weeks after resolution of infection. Paralysis causes immune suppression. Transcriptomic, phenotypic, and functional characterization of paralysis leads to designing treatments that restore dendritic cell function and immunocompetence.
The objective of this study is the development and validation of a novel artificial intelligence driven tool for fast and accurate mandibular canal segmentation on cone beam computed tomography ...(CBCT).
A total of 235 CBCT scans from dentate subjects needing oral surgery were used in this study, allowing for development, training and validation of a deep learning algorithm for automated mandibular canal (MC) segmentation on CBCT. Shape, diameter and direction of the MC were adjusted on all CBCT slices using a voxel-wise approach. Validation was then performed on a random set of 30 CBCTs - previously unseen by the algorithm - where voxel-level annotations allowed for assessment of all MC segmentations.
Primary results show successful implementation of the AI algorithm for segmentation of the MC with a mean IoU of 0.636 (± 0.081), a median IoU of 0.639 (± 0.081), a mean Dice Similarity Coefficient of 0.774 (± 0.062). Precision, recall and accuracy had mean values of 0.782 (± 0.121), 0.792 (± 0.108) and 0.99 (± 7.64×10−05) respectively. The total time for automated AI segmentation was 21.26 s (±2.79), which is 107 times faster than accurate manual segmentation.
This study demonstrates a novel, fast and accurate AI-driven module for MC segmentation on CBCT.
Given the importance of adequate pre-operative mandibular canal assessment, Artificial Intelligence could help relieve practitioners from the delicate and time-consuming task of manually tracing and segmenting this structure, helping prevent per- and post-operative neurovascular complications.
Islam in World Politics Nelly Lahoud, A.H. Johns / Nelly Lahoud, A.H. Johns
2005, 20121012, 2012, 2012-10-12
eBook
The essays in this collection examine the emergence of Islam as a force in today's international political arena. Driven by a concern to understand factors leading to, and the implications of, this ...heightened political profile the contributors go beyond polemics and apologetics. The book critically examines some of the major events, movements and trends in the Islamic world over the past fifty years and their impact on the international scene. Reflecting the diversity and heterogeneity of the Muslim world, the book covers issues including:
the challenge of Islamism to the Muslim world
the use of Islam as a political tool on the international scene
Islam's contribution to the theory and practice of global finance
Islam's role in gender discourse
Islam's articulations in the Indian Sub-continent, Southeast Asia, Central Asia and the Arab world.
Very little of the current literature deals with political Islam globally, and very few books go much beyond the Middle East and its terrorist groups. This volume fills that gap, providing a compelling cross-national, cross-cultural and interdisciplinary analysis of Islam as a potent political force.
The utility of tumour biomarkers has increased considerably in the era of personalised medicine and individualised therapy in oncology. Biomarkers may be prognostic or predictive, and only a handful ...of markers are currently US Food and Drug Administration (FDA)-approved for clinical use. Tumour markers have a wide array of uses such as screening, establishing a differential diagnosis, assessing risk, prognosis, and treatment response, as well as monitoring disease status. Major overlap exists between biomarkers and their associated pathologies; therefore, despite suggestive imaging features, establishing a differential diagnosis may be challenging for the radiologist. We review common biomarkers that are of interest to radiologists such as carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), prostate-specific antigen (PSA), beta human chorionic gonadotropin (β-hCG), carbohydrate antigen 19–9 (CA 19–9), alpha fetoprotein (AFP), and carbohydrate or cancer antigen 125 (CA 125), as well as their associated malignant and non-malignant pathologies. We also present relevant case examples from our practice.
•Elevated tumor markers may correlate with either malignant or benign conditions.•Biomarkers should never be used alone as the sole diagnostic predictors.•Biomarkers complement radiological, clinical, and pathological evidence.
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