Autoimmune pancreatitis is characterised by raised serum levels of IgG4 and IgG4-bearing plasma cells in the inflammatory tissue. 1 Similar pathology can also occur in the larger bile ducts, ...resembling sclerosing cholangitis. 2 We report a patient with hepatitis and chronic cholecystitis, raised IgG4 level, and IgG4-bearing plasma cells in the liver and gall bladder wall, but no evident pancreatic disease. Raised serum IgG4 concentration and IgG4-bearing plasma cell infiltrates have a high sensitivity and specificity for the diagnosis of autoimmune pancreatitis 1 and associated diseases, including sclerosing cholangitis. 2 In the present case, the clinical and histological criteria for definite autoimmune hepatitis were met and, additionally, both biopsies showed hepatitis with abundant IgG4-bearing plasma cells in the liver and gallbladder.
Progression of silent brain infarctions (SBIs) and white-matter lesions (WMLs) seen on brain MRI is associated with an increased risk of cognitive impairment, but their relation to endothelial and ...inflammatory markers is unknown in type 2 diabetes mellitus.
In 190 type 2 diabetic outpatients (mean age 62.7 years), the authors related baseline levels of soluble intercellular adhesion molecule-1 (sICAM-1) and high-sensitivity C-reactive protein (hs-CRP) to subsequent brain MRI findings and cognitive function. The authors assessed incident SBIs and changes in periventricular and subcortical WMLs (PVWMLs and SCWMLs) on MRI performed at baseline and 3 and 6 years. Neuropsychological tests were administered to 83 patients older than 65 years at 6 years. This present study represents an extension of the authors' previously published study.
SBIs were observed in 46 patients (24.2%), PVWMLs in 93 (48.9%) and SCWMLs in 87 (45.8%) on baseline MRI. After adjustment for age, gender, hypertension, duration of diabetes, baseline MRI findings and medication use, the relative odds associated with a 1SD increase in sICAM-1 levels at baseline were 1.67 (95% CI 1.02 to 3.05) for SBI progression and 2.17 (95% CI 1.29 to 3.62) for PVWML progression at 6 years. In contrast, baseline hs-CRP levels were significantly associated with SBI progression only at 3 years. Significant trends were observed between quartiles of sICAM-1 at baseline and scores in Digit Symbol substitution (p for trend=0.01).
The findings suggest that higher sICAM-1 levels are associated with SBI and PVWML progression, and may predict impairment in psychomotor function in type 2 diabetes.
In patients with ischemic stroke, DWI lesions can occasionally be reversed by reperfusion therapy. This study aimed to ascertain the relationship between ADC levels and DWI reversal in patients with ...acute ischemic stroke who underwent recanalization treatment.
We conducted a retrospective cohort study in patients with acute ischemic stroke who underwent endovascular mechanical thrombectomy with successful recanalization between April 2017 and March 2021. DWI reversal was assessed through follow-up MR imaging approximately 24 hours after treatment.
In total, 118 patients were included. DWI reversal was confirmed in 42 patients. The ADC level in patients with reversal was significantly higher than that in patients without reversal. Eighty-three percent of patients with DWI reversal areas had mean ADC levels of ≥520 × 10
mm
/s, and 71% of patients without DWI reversal areas had mean ADC levels of <520 × 10
mm
/s. The mean ADC threshold was 520 × 10
mm
/s with a sensitivity and specificity of 71% and 83%, respectively. In multivariate analysis, the mean ADC level (OR, 1.023; 95% CI, 1.013-1.033;
< .0001) was independently associated with DWI reversal. Patients with DWI reversal areas had earlier neurologic improvement (NIHSS at 7 days) than patients without reversal areas (
< .0001).
In acute ischemic stroke, the ADC value is independently associated with DWI reversal. Lesions with a mean ADC of ≥520 × 10
mm
/s are salvageable by mechanical thrombectomy, and DWI reversal areas regain neurologic function. The ADC value is easily assessed and is a useful tool to predict viable lesions.
Autoimmune pancreatitis is characterised by irregular narrowing of the main pancreatic duct, swelling of the pancreas, histological evidence of lymphoplasmacytic inflammation, and high serum ...immunoglobulin G4 (IgG4) concentration. 1- 4 Although the human leucocyte antigen DRB1*0405-DQB1*0401 haplotype has been associated with autoimmune pancreatitis, 5 the role of genetic factors has not yet been fully defined. A new family of genes called Fc receptor-like genes (FCRLs), which have high structural homology with classical FcGAMMA receptor genes, has recently been identified. 6, 7 FCRL3 polymorphisms have been shown to be associated with various autoimmune diseases, such as rheumatoid arthritis, autoimmune thyroid disease, and systemic lupus erythematosus, in Japanese populations. 8, 9 These polymorphisms alter the binding affinity of nuclear factor κB and regulate FCRL3 expression.
This exploratory study investigates the association between technology transfer, technical exchange, and supplier performance within Greater Jakarta, Indonesia, focusing on the moderating role of ...link duration in the buyer-supplier relationship in the automotive industry. The data collection involved site visits and the administration of Likert-scale questionnaires to middle to upper-level management personnel responsible for relevant processes. The sampled population comprised 99 companies, including six assembler companies, 59 tier-1 companies, and 34 tier-2 companies. Smart PLS 3.2.7 software was employed to conduct partial least squares multi-group analysis (PLS-MGA) to process and analyze the data. The analysis was divided into two groups: the first exploration consisted of buyer-supplier relationships of less than five years and more than five years. Next, the second exploration consisted of buyer-supplier relationships of less than and more than ten years. The findings revealed that technology transfer has significant importance in relationships lasting over five but less than ten years, while technical exchange becomes significant in relationships exceeding five years. The research contributes valuable insights into the dynamics of supplier-buyer collaboration in the automotive industry, particularly in the Indonesian context.
A 1% potassium peroxymonosulphate-based environmental disinfectant (PPED) produces sodium hypochlorite when combined with sodium chloride, which functions as a disinfectant. However, little is known ...about the impact of hospital cleaning with PPED on hospital-onset Clostridioides difficile infection (HO-CDI).
To reduce HO-CDI, we promoted antimicrobial stewardship and hospital ward cleaning with PPED: this study was conducted to evaluate their impact.
We began a promotion of post-prescription review with feedback for broad-spectrum antimicrobials and hospital ward cleaning with PPED. We reviewed the ratio of HO-CDI, PPED consumption, and days of therapy (DOT) of broad-spectrum antimicrobials between July 2014 and March 2018, dividing this time into the pre-promotion (July 2014 to June 2015) and post-promotion periods (July 2015 to March 2018).
Using interrupted time series analysis, an immediate significant change in HO-CDI was observed after intervention (P=0.03), although a downward trend was not observed over this period (P=0.19). Trends in PPED consumption significantly changed over this period (P=0.02). DOT of carbapenems decreased immediately after the intervention began (P<0.01). A Poisson regression analysis showed that PPED consumption and DOT of carbapenems were independent factors affecting HO-CDI (P=0.039 and 0.016, respectively).
We revealed that DOT of carbapenems and use of PPED were associated with the HO-CDI ratio and that both interventions reduced the rate of HO-CDI. This is the first report on the impact of hospital ward cleaning with PPED on the reduction of HO-CDI.
Abstract
Background
Air pollution is a serious problem in India. According to World Bank's data in 2015, about 660 million people were categorized as poor (US$3.20 per day per capita) in India and ...the proportion to total the population was 50.4 %. Even though the number and proportion are large, the effects on the poor people have not been studied very well. We measured the effects of air pollution on children of the poor and compared between urban and rural area in West Bengal, India.
Methods
24 male students (12.5 ± 0.8 years) in urban area (Kolkata) and 20 male students (12.5 ± 0.5 years) in rural area (Jata) were recruited. We measured fractional exhaled nitric oxide (FeNO), which was index of airway inflammation and checked allergic symptoms. The survey was conducted in January (dry season) and August (rainy season) 2019 to confirm a seasonal difference. Air quality index (AQI) in each area was used for index of air pollution.
Results
Average AQI was 335 (Kolkata) and 155 (Haldia: near Jata) for 2 months from December 2018 to January 2019, while average AQI was 51 (Kolkata) and 38 (Haldia) for 2 months from July to August 2019. As for FeNO in dry season, the value in Kolkata was 24.9 ± 16.1 and the value in Jata was 11.7 ± 3.5. As for FeNO in rainy season, the value in Kolkata was 22.3 ± 17.5 and the value in Jata was 16.8 ± 6.7. The value of FeNO in Kolkata was higher than Jata in either season. Although a seasonal difference was not detected in Kolkata, the value in dry season was lower than in rainy season in Jata. The prevalence of allergic symptoms in dry season was higher than in rainy season in Kolkata. On the other hand, there was no difference in the prevalence between dry and rainy season in Jata.
Conclusions
Even though AQI and the prevalence of allergic symptoms decreased, the value of FeNO did not decrease in Kolkata. Because AQI decreased, indoor air pollution might have influenced on airway. It is supposed that prevention of indoor air pollution is important.
Key messages
Airway of children in urban area may be influenced on by air pollution more than in rural area. Indoor air pollution may influence on children of the poor more than outdoor air pollution.
Poly(3‐hydroxybutyrate) (PHB), is one important biopolymer and a promising alternative to petroleum‐based plastics. In this article, formulations of PHB and triethyl citrate (TEC) as plasticizer were ...prepared by melt extrusion. The effect of TEC on the mechanical, thermal, and morphological properties of PHB was investigated by tensile tests, impact resistance, dynamic‐mechanical analysis, differential scanning calorimetry, polarized optical microscopy, and small‐ and wide‐angle X‐ray scattering. TEC acted as an efficient plasticizer for PHB, imparting gradual changes in the properties as the mass fraction of TEC increased. A reduction in the elastic modulus, an increase in the intensity of β relaxation indicated a higher capacity of mechanical energy dissipation for the formulations containing higher mass fractions of TEC. TEC reduced its glass transition and melting temperatures, contributing to the increase of the processing window of the temperature and minimizing thermal degradation of PHB. TEC had a strong influence on the kinetics of crystallization, the morphology of the spherulites, and the crystalline structural parameters, such as long period, crystalline lamella, and interlamellar amorphous region thicknesses. Our study clarifies how the morphology of the PHB crystalline phase evolves in the presence of the plasticizer and with the time of crystallization.
PHB is a stiff and brittle polymer that degrades at temperatures close to the melting. The addition of variable amount of the plasticizer triethyl citrate to PHB increased the flexibility and the impact resistance, improved the processability and reduced the thermal degradation. The results showed that triethyl citrate is among the most efficient plasticizers for PHB reported in the literature.
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