Memory regulatory T cells reside in human skin Sanchez Rodriguez, Robert; Pauli, Mariela L; Neuhaus, Isaac M ...
The Journal of clinical investigation,
03/2014, Letnik:
124, Številka:
3
Journal Article
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Regulatory T cells (Tregs), which are characterized by expression of the transcription factor Foxp3, are a dynamic and heterogeneous population of cells that control immune responses and prevent ...autoimmunity. We recently identified a subset of Tregs in murine skin with properties typical of memory cells and defined this population as memory Tregs (mTregs). Due to the importance of these cells in regulating tissue inflammation in mice, we analyzed this cell population in humans and found that almost all Tregs in normal skin had an activated memory phenotype. Compared with mTregs in peripheral blood, cutaneous mTregs had unique cell surface marker expression and cytokine production. In normal human skin, mTregs preferentially localized to hair follicles and were more abundant in skin with high hair density. Sequence comparison of TCRs from conventional memory T helper cells and mTregs isolated from skin revealed little homology between the two cell populations, suggesting that they recognize different antigens. Under steady-state conditions, mTregs were nonmigratory and relatively unresponsive; however, in inflamed skin from psoriasis patients, mTregs expanded, were highly proliferative, and produced low levels of IL-17. Taken together, these results identify a subset of Tregs that stably resides in human skin and suggest that these cells are qualitatively defective in inflammatory skin disease.
The kidney is a highly integrated system of specialized differentiated cells that are responsible for fluid and electrolyte balance in the body. While much of today's research focuses on isolated ...nephron segments or cells from nephron segments grown in tissue culture, an often overlooked technique that can provide a unique view of many cell types in the kidney is slice culture. Here, we describe techniques that use freshly excised kidney tissue from rats to perform a variety of experiments shortly after isolating the tissue. By slicing the rat kidney in a "bread loaf" format, multiple studies can be performed on slices from the same tissue in parallel. Cryosectioning and staining of the tissue allow for the evaluation of physiological or biochemical responses in a wide variety of specific nephron segments. The procedures described within this chapter can also be extended to human or mouse kidney tissue.
Conventional knowledge of the flood hazard alone (extent and frequency) is not sufficient for informed decision-making. The public safety community needs tools and guidance to adequately undertake ...flood hazard risk assessment in order to estimate respective damages and social and economic losses. While many complex computer models have been developed for flood risk assessment, they require highly trained personnel to prepare the necessary input (hazard, inventory of the built environment, and vulnerabilities) and analyze model outputs. As such, tools which utilize open-source software or are built within popular desktop software programs are appealing alternatives. The recently developed Rapid Risk Evaluation (ER2) application runs scenario based loss assessment analyses in a Microsoft Excel spreadsheet. User input is limited to a handful of intuitive drop-down menus utilized to describe the building type, age, occupancy and the expected water level. In anticipation of local depth damage curves and other needed vulnerability parameters, those from the U.S. FEMA’s Hazus-Flood software have been imported and temporarily accessed in conjunction with user input to display exposure and estimated economic losses related to the structure and the content of the building. Building types and occupancies representative of those most exposed to flooding in Fredericton (New Brunswick) were introduced and test flood scenarios were run. The algorithm was successfully validated against results from the Hazus-Flood model for the same building types and flood depths.
BACKGROUND:There is a growing concern for microbial resistance as a result of overuse of antibiotics. Although guidelines have focused on the use of antibiotics for surgery in general, few have ...addressed plastic surgery specifically. The objective of this expert consensus conference was to evaluate the evidence for efficacy and safety of antibiotic prophylaxis in plastic surgical procedures.
METHODSTHE AUTHORSsearched for existing high-quality systematic reviews for antibiotic prophylaxis in the literature from the MEDLINE, Cochrane Library, and Embase databases. All synonyms for antibiotics were combined with terms for relevant plastic surgery procedures. The searches were not limited by language, and included all study designs. In addition, supplemental hand searches were performed of bibliographies of relevant articles, and extensive “related articles.” Meta-analyses were performed and reviewed by experts selected by the American Association of Plastic Surgeons to reach consensus recommendations.
RESULTS:Database searches identified 4300 articles, from which 2042 full-text articles were identified for eligibility. De novo meta-analyses were performed for each plastic surgical category. In total, 67 studies met the inclusion criteria, including nine for breast surgery, 17 for head and neck surgery, 10 for orthognathic surgery, seven for rhinoplasty/septoplasty, 19 for hand surgery, five for skin surgery, and two for abdominoplasty.
CONCLUSIONS:Systemic antibiotic prophylaxis is recommended for clean breast surgery and for contaminated surgery of the hand or the head and neck. It is not recommended to reduce infection in clean surgical cases of the hand, skin, head and neck, or abdominoplasty.
Start-up firms are notoriously resource and time poor. One way of addressing these deficits is to develop strategic capability to access, activate and co-shape resources with other firms in the ...start-up's network. The capability literature assumes such a development is inevitable, provided a start-up survives. But developing network capability depends on the managers of other firms, the deepening managerial understanding of business relationships, and the ability of the start-up managers to adjust to and understand interdependence in networks. We present a processual model of how managerial understanding of network capability develops, comprising of three parts each building on the earlier: (i) in relationships, (ii) through relationships and (iii) in the network. The model was inductively developed from a longitudinal study of a start-up firm. Also, two sensemaking processes were found to predominate – problem solving and social-cognitive processes. Our model highlights the role of the start-up manager in sensemaking with managers across a number of firms to resolve commercial problems. Thus, the independence many start-up managers seek must turn towards interdependence. Second, managers' temporal horizons and the specific temporal profile of events and activities inside the involved business relationships are important in understanding and developing, with other firms, network capability.
•Network capability is not innate for the start-up firm and requires time to develop.•Inductive study of a start-up manager developing understanding of network capability.•Problem-solving and sensemaking processes leading to new understanding and ability.•Network capability: in relationships, through relationships, in the network•A temporal study that detects change processes within a dynamic network
In New Brunswick flooding occurs typically during the spring freshet, though, in recent years, midwinter thaws have led to flooding in January or February. Municipalities are therefore facing a ...pressing need to perform risk assessments in order to identify communities at risk of flooding. In addition to the identification of communities at risk, quantitative measures of potential structural damage and societal losses are necessary for these identified communities. Furthermore, tools which allow for analysis and processing of possible mitigation plans are needed. Natural Resources Canada is in the process of adapting Hazus-MH to respond to the need for risk management. This requires extensive data from a variety of municipal, provincial, and national agencies in order to provide valid estimates. The aim is to establish a data warehouse to store relevant flood prediction data which may be accessed thru Hazus. Additionally, this data warehouse will contain tools for On-Line Analytical Processing (OLAP) and knowledge discovery to quantitatively determine areas at risk and discover unexpected dependencies between datasets. The third application of the data warehouse is to provide data for online visualization capabilities: web-based thematic maps of Hazus results, historical flood visualizations, and mitigation tools; thus making flood hazard information and tools more accessible to emergency responders, planners, and residents. This paper represents the first step of the process: locating and collecting the appropriate datasets.
A clinical consensus paper on jejunal tube feeding in children McGrath, Kathleen H.; Collins, Tanya; Comerford, Annabel ...
JPEN. Journal of parenteral and enteral nutrition,
April 2024, 2024-Apr, 2024-04-00, 20240401, Letnik:
48, Številka:
3
Journal Article
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Background
Feeding problems are common in children with complex medical problems or acute critical illness and enteral nutrition may be required. In certain situations, gastric tube feeding is poorly ...tolerated or may not be feasible. When feed intolerance persists despite appropriate adjustments to oral and gastric enteral regimens, jejunal tube feeding can be considered as an option for nutrition support.
Methods
A multidisciplinary expert working group of the Australasian Society of Parenteral and Enteral Nutrition was convened. They identified topic questions and five key areas of jejunal tube feeding in children. Literatures searches were undertaken on Pubmed, Embase, and Medline for all relevant studies, between January 2000 and September 2022 (n = 103). Studies were assessed using National Health and Medical Research Council guidelines to generate statements, which were discussed as a group, followed by voting on statements using a modified Delphi process to determine consensus.
Results
A total of 24 consensus statements were created for five key areas: patient selection, type and selection of feeding tube, complications, clinical use of jejunal tubes, follow‐up, and reassessment.
Conclusion
Jejunal tube feeding is a safe and effective means of providing nutrition in a select group of pediatric patients with complex medical needs, who are unable to be fed by gastric tube feeding. Appropriate patient selection is important as complications associated with jejunal tube feeding are not uncommon, and although mostly minor, can be significant or require tube reinsertion. All children receiving jejunal tube feeding should have multidisciplinary team assessment and follow‐up.
Aim
Exclusive enteral nutrition (EEN) is recommended as a first‐line therapy for active luminal paediatric Crohn's disease, by many contemporary consensus guidelines. However, EEN protocols vary ...internationally. A key enabler for the use of EEN therapy has been identified as the standardisation of protocols. The aim of this study was to develop an optimal care pathway for use of EEN in children with active luminal Crohn's disease.
Methods
A working group of 11 paediatric gastroenterology dietitians and one paediatric gastroenterologist from Australia and New Zealand was convened to develop a standard optimal care pathway. Seven key areas were identified; clinical indications, workup assessments, EEN prescription, monitoring, food reintroduction, partial enteral nutrition and maintenance enteral nutrition. Recent literature was reviewed, assessed according to the National Health and Medical Research Council guidelines, and consensus statements were developed and voted on. Consensus opinion was used where literature gaps existed.
Results
A total of nineteen consensus statements from the seven key areas were agreed upon. The consensus statements informed the optimal care pathway for children with active luminal undertaking EEN in Australia and New Zealand.
Conclusion
This study developed an EEN optimal care pathway to facilitate standardisation of clinical care for children with active luminal Crohn's disease, and hopefully improve clinical outcomes and identify areas for future research.
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