In this pragmatic, randomized trial comparing one-step screening for gestational diabetes mellitus with two-step screening, one-step screening resulted in more diagnoses of gestational diabetes ...mellitus but did not affect the incidence of adverse perinatal and maternal outcomes.
Patients with cerebral aneurysms often undergo MR imaging after microsurgical clipping. Ultra-high-field MR imaging at 7T may provide high diagnostic capability in such clinical situations. However, ...titanium alloy clips have safety issues such as adverse interactions with static magnetic fields and radiofrequency-induced heating during 7T MR imaging. The purpose of this study was to quantitatively assess temperature increases on various types of titanium alloy aneurysm clips during 7T MR imaging.
Five types of titanium alloy aneurysm clips were tested, including combinations of short, long, straight, angled, and fenestrated types. Each clip was set in a phantom filled with gelled saline mixed with polyacrylic acid and underwent 7T MR imaging with 3D T1WI with a spoiled gradient recalled acquisition in the steady-state technique. Temperature was chronologically measured at the tips of the clip blade and head, angled part of the clip, and 5 mm from the tip of the clip head using MR imaging-compatible fiber-optic thermometers.
Temperature increases at all locations for right-angled and short straight clips were <1°C. Temperature increases at the angled part for the 45° angled clip and the tip of the clip head for the straight fenestrated clip were >1°C. Temperature increases at all locations for the long straight clip were >2°C.
Temperature increases on the right-angled and short straight clips remained below the regulatory limit during 7T MR imaging, but temperature increases on the 45° angled, straight fenestrated, and long straight clips exceeded this limit.
Due to its potential application in luminescence technologies, the complete understanding on pressure dependence of ruby is especially important. Up to recently, the theoretical prediction on the ...structural properties of ruby under pressure has been made involving the empirical parameters. Therefore, here we performed a non-empirical study on the pressure dependence of ruby bond length. Due to the Cr3+ substitution and the applied external pressure, the local structure of α-Al2O3: Cr3+ was changed. We estimated this effect by performing the first-principles band-structure calculations using Cambridge Serial Total Energy Package (CASTEP) method and compared with the Shannon's crystal radii method. The two different bond lengths; Cr-1st nearest neighbour oxygen (d1) and Cr-2nd nearest neighbour oxygen (d2) were investigated in detail. The results show that under 0-110 GPa the d1 and d2 decreased ca. 0.172 and 0.145 Å, respectively. These results were slightly smaller than the d1 and d2 decreases in the case of pure α-Al2O3 crystal, they were observed to be ca. 0.167 Å for d1 and 0.177 Å for d2. In the other words, the d1-d2 differences were larger at the higher pressure, ca. 0.052-0.080 Å for 0-110 GPa.
Shock parameters at Earth’s bow shock, in rare instances, can approach the Mach numbers predicted at astrophysical shocks and supernova remnants. We present our analysis of a high Alfv ́en Mach ...number (MA= 27) shock, by utilizing multipoint measurements from the Magnetospheric Multiscale (MMS) spacecraft during a crossing of Earth’s quasi-perpendicular bow shock. We find that the shock dynamics are mostly driven by reflected ions, perturbations that they generate, and nonlinear amplification of the perturbations. Our analyses indicate that reflected ions create modest magnetic enhancements upstream of the shock front which evolve in a nonlinear manner as they traverse the shock foot. They can transform into proto-shocks that propagate at small angles to the magnetic field and towards the bow shock. The nonstationary bow shock shows signatures of both reformation and surface ripples. Our observations indicate that although shock reformation occurs, the main shock layer never disappears. These observations are at high plasmaβ, a parameter regime which has not been well explored by numerical models.
We report on the time evolution of energetic neutral atom (ENA) emissions measured by the Interstellar Boundary Explorer (IBEX) during instances of compressed and expanded dayside magnetosheath. The ...ENA observations, taken during the passage of a corotating interaction region on 27 and 28 November 2010, are compared with in situ observations from the Time History of Events and Macroscale Interactions during Substorms (THEMIS) spacecraft. IBEX's field of view (6.5° full width at half maximum) covered a wide region of the dayside magnetosheath for several days, providing continuous information from that region. The high sensitivity and high‐energy resolution of IBEX instruments enabled unprecedented remote‐sensing diagnostics of dayside magnetosheath ENA spectra at energies between ~0.1 and ~6 keV, which can be directly compared with various upstream parameters. The inferred plasma spectra from ENA observations showed characteristic suprathermal tails described by kappa distributions that correlate well with the solar wind cone angle and are in agreement with in situ observations, suggesting that the shock angle contributed to magnetosheath particle heating. Simultaneous in situ ion measurements in the dayside magnetosheath provided by THEMIS agree reasonably well with IBEX‐inferred spectra, demonstrating synergy between remote IBEX ENA observations (global) and in situ measurements (local) for studying localized magnetospheric processes.
Key Points
Direct comparison of ENA inferred spectra and in‐situ observations
Showed consistency between IBEX and THEMIS with a variety of upstream conditions
Found possible correlation between IMF angle and magnetosheath spectral index
Background and purpose
A transient ischemic attack (TIA) can occur without self‐awareness of symptoms. We aimed to investigate characteristics of patients with a tissue‐based diagnosis of TIA but ...having no self‐awareness of their symptoms and whose symptoms were witnessed by bystanders.
Methods
We used data from the multicenter registry of 1414 patients with a clinical diagnosis of TIA. For patients without evidence of ischemic lesions on imaging, clinical characteristics were compared between patients with and without self‐awareness of their TIA symptoms.
Results
Among 896 patients (559 men, median age of 70 years), 59 (6.6%) were unaware of their TIA symptoms, but had those symptoms witnessed by bystanders. Patients without self‐awareness of symptoms were older and more frequently female, and more likely to have previous history of stroke, premorbid disability, and atrial fibrillation, but less likely to have dyslipidemia than those with self‐awareness. Patients without self‐awareness of symptoms arrive at hospitals earlier than those with self‐awareness (P < 0.001). ABCD2 score was higher in patients without self‐awareness of symptoms than those with self‐awareness (median 5 vs. 4, P = 0.002). Having no self‐awareness of symptoms was a significant predictor of ischemic stroke within 1 year after adjustment for sex, ABCD2 score, and onset to arrival time (hazard ratio = 2.44, 95% confidential interval: 1.10–4.83), but was not significant after further adjustment for arterial stenosis or occlusion.
Conclusions
Patients with a TIA but having no self‐awareness of their symptoms might have higher risk of subsequent ischemic stroke rather than those with self‐awareness, suggesting urgent management is needed even if patients have no self‐awareness of symptoms.
Graphical Table of Contents Among 896 patients (559 men, median age of 70 years) with diagnosis of a tissue‐based transient ischemic attack (TIA), 59 (6.6%) were unaware of their symptoms but had their symptoms witnessed by bystanders. The cumulative incidence rate of occurrence of ischemic stroke after 1 year from TIA was higher in patients without self‐awareness than those with self‐awareness (16.3% vs. 6.9%, log‐rank; P = 0.010).
Background and Objectives
The occurrence of D− is approximately 0·5% in Japanese, but DEL in apparently D− individuals is relatively common compared with that in Caucasian populations. On the basis ...of molecular genetics, we examined D− Japanese blood donors.
Methods
A standard serological technique was used for RhD typing, and we selected 3526 D− blood samples. Genomic DNA obtained from whole blood was used for RHD analysis by polymerase chain reaction (PCR) and sequencing. Multiplex PCR to detect all of the RHD exons and use of PCR‐sequence‐specific primer (PCR‐SSP) to detect RHD deletion (RHD*01N.01) and c.1227G>A mutation (for RHD*01EL.01) were performed.
Results
Multiplex PCR and PCR‐SSP revealed that 3091 of 3526 D− individuals (87·7%) were homozygous for RHD*01N.01, and 318 individuals (9·0%) had the RHD*01EL.01/RHD*01N.01 or RHD*01EL.01/RHD*01EL.01 genotype. The other 103 in the 3526 individuals (2·9%) had the known D‐CE‐D hybrid allele, RHD*01N.04, and the association of RHCE*Ce with RHD*01EL.01 as well as RHD*01N.04 was observed. The remaining 14 individuals had RHD*01N.01 hemizygous with one of the following alleles: RHD*01N.06 (3), RHD*01N.07 (1), RHD*04N.01 (1), RHD*DEL8 (1), RHD with c.761C>G (p.Ser254Ter) (2), RHD with c.1252T>A (p.Ter418Lysex26) (2) and apparently common RHD (4). Adsorption and elution tests with anti‐D revealed that the individuals with c.761C>G mutation were D− while the individuals with c.1252T>A mutation were DEL.
Conclusions
The RHD genotype of more than 96% of D− Japanese could be determined by conventional PCR‐SSP. In addition, we identified a novel DEL allele having c.1252T>A mutation and a novel RHD silencing allele having c.761C>G nonsense mutation.
Interferon regulatory factors (IRFs) constitute a family of transcription
factors that commonly possess a novel helix-turn-helix DNA-binding motif.
Following the initial identification of two ...structurally related members, IRF-1
and IRF-2, seven additional members have now been reported. In addition,
virally encoded IRFs, which may interfere with cellular IRFs, have also been
identified. Thus far, intensive functional analyses have been done on IRF-1,
revealing a remarkable functional diversity of this transcription factor in the
regulation of cellular response in host defense. Indeed, IRF-1 selectively
modulates different sets of genes, depending on the cell type and/or the nature
of cellular stimuli, in order to evoke appropriate responses in each. More
recently, much attention has also been focused on other IRF family members.
Their functional roles, through interactions with their own or other members of
the family of transcription factors, are becoming clearer in the regulation of
host defense, such as innate and adaptive immune responses and oncogenesis.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Bronchiolitis obliterans after lung transplantation is a major cause of postoperative mortality in which T cell–mediated immunity is known to play an important role. However, the exact contribution ...of natural killer (NK) cells, which have functions similar to CD8+ T cells, has not been defined. Here, we assessed the role of NK cells in murine bronchiolitis obliterans through heterotopic tracheal transplantations and found a greater percentage of NK cells in allografts than in isografts. Depletion of NK cells using an anti‐NK1.1 antibody attenuated bronchiolitis obliterans in transplant recipients compared with controls. In terms of NK cell effector functions, an improvement in bronchiolitis obliterans was observed in perforin‐KO recipient mice compared to wild type (WT). Furthermore, we found upregulation of NKG2D‐ligand in allografts and demonstrated the significance of this using grafts expressing Rae‐1, a murine NKG2D‐ligand, which induced severe bronchiolitis obliterans in WT and Rag‐1 KO recipients. This effect was ameliorated by injection of anti‐NKG2D blocking antibody. Together, these results suggest that cytotoxicity resulting from activation of NK cells through NKG2D leads to the development of murine bronchiolitis obliterans.
In a murine heterotopic tracheal transplant model, cytotoxicity of natural killer cells activated through NKG2D plays an important role in the development of bronchiolitis obliterans.
Adult patients with ischemic Moyamoya disease are advised to undergo selective revascularization surgery based on cerebral hemodynamics. The purpose of this study was to determine the diagnostic ...accuracy of arterial spin-labeling MR imaging using Hadamard-encoded multiple postlabeling delays for the detection of reduced CBF in such patients.
Thirty-seven patients underwent brain perfusion SPECT and pseudocontinuous arterial spin-labeling MR imaging using standard postlabeling delay (1525 ms) and Hadamard-encoded multiple postlabeling delays. For Hadamard-encoded multiple postlabeling delays, based on data obtained from the 7 sub-boluses with combinations of different labeling durations and postlabeling delays, CBF corrected by the arterial transit time was calculated on a voxel-by-voxel basis. Using a 3D stereotaxic template, we automatically placed ROIs in the ipsilateral cerebellar hemisphere and 5 MCA territories in the symptomatic cerebral hemisphere; then, the ratio of the MCA to cerebellar ROI was calculated.
The area under the receiver operating characteristic curve for detecting reduced SPECT-CBF ratios (<0.686) was significantly greater for the Hadamard-encoded multiple postlabeling delays-CBF ratios (0.885) than for the standard postlabeling delay-CBF ratios (0.786) (
= .001). The sensitivity and negative predictive value for the Hadamard-encoded multiple postlabeling delays-CBF ratios were 100% (95% confidence interval, 100%-100%) and significantly higher than the sensitivity (95% CI, 44%-80%) and negative predictive value (95% CI, 88%-97%) for the standard postlabeling delay-CBF ratio, respectively.
ASL MR imaging using Hadamard-encoded multiple postlabeling delays may be applicable as a screening tool because it can detect reduced CBF on brain perfusion SPECT with 100% sensitivity and a 100% negative predictive value in adult patients with ischemic Moyamoya disease.
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