Abstract
Background
Hemophagocytic lymphohistiocytosis (HLH) is a rare clinical syndrome characterized by an infrequent but immune-mediated life-threatening disease, with confusing clinical ...manifestations, rapidly deteriorating health, high morbidity and mortality and challenging diagnosis.
Aim
The purpose of this study was to improve the recognition and understanding of HLH.
Design
Retrospective observational cross-sectional study.
Methods
Data were collected for all cases of adult patients diagnosed with HLH in a large cohort managed at a single medical center from January 2011 to December 2015.
Results
The median age was 52 years (range 18–90 years) and 123 (60.0%) were male. Over 95% patients manifested fever, hyperferritinemia and elevated lactate dehydrogenase. Underlying triggers of HLH were as follows: 119 (58.0%) malignancies, 83 (40.5%) infections, 14 (6.8%) unknown triggers and 14 (6.8%) autoimmune disorders. The median overall survival was 55 days. And elderly patients (age ≥60 years) had a markedly worse survival compared with young patients (age <60 years) (median overall survival 24 days vs. 159 days, respectively; P <0.001). In a multivariable analysis, platelet <40 × 109/l (HR = 2.534; 95% CI 1.152–5.573; P = 0.021), PT prolonged >3 s (HR = 1.909; 95% CI 1.127–3.234; P = 0.016) and malignancy (HR = 1.614; 95% CI 1.008–2.582; P = 0.046) were correlated with poor survival.
Conclusion
HLH adult patients had very complex clinical manifestations as well as underlying diseases. Patients with PLT <40 ×109/l, PT prolonged >3 s and malignancy had inferior survival. It is of great importance to improve our understanding of this syndrome.
The production of antibody is precisely controlled during the germinal center (GC) reaction. This process is dependent on the help from follicular T helper (Tfh) cells to germinal center (GC) B cells ...and is regulated by regulatory follicular T helper (Tfr) cells. How Tfr cells develop and how their suppressive activity functions are not well understood. Here, we found that Stat3 is indispensible for Tfr cell differentiation. After immunization with Sheep Red Blood Cells (SRBC), the loss of Tfr cells caused by deletion of Stat3 in Treg cells does not affect the size of Tfh or GC B cell population, but rather leads to strongly enhanced production of antigen-specific IgG1 and IgG2b. In Peyer's patches (PPs) in the gut, we found that Stat3 expression in Treg cells is also required for Tfr cell formation to commensal organisms. However, loss of Tfr cells in the gut did not affect the numbers of Tfh cells and GC B cells, nor affect IgG1 or IgA switching by GC B cells. Overall, our study has uncovered unique roles of Stat3 in Tfr cell differentiation and the regulation of the antibody response.
ABSTRACT
We report the phase-connected timing ephemeris, polarization pulse profiles, Faraday rotation measurements, and Rotating-Vector-Model (RVM) fitting results of 12 millisecond pulsars (MSPs) ...discovered with the Five-hundred-meter Aperture Spherical radio Telescope (FAST) in the Commensal Radio Astronomy FAST survey (CRAFTS). The timing campaigns were carried out with FAST and Arecibo over 3 yr. 11 of the 12 pulsars are in neutron star–white dwarf binary systems, with orbital periods between 2.4 and 100 d. 10 of them have spin periods, companion masses, and orbital eccentricities that are consistent with the theoretical expectations for MSP–Helium white dwarf (He WD) systems. The last binary pulsar (PSR J1912−0952) has a significantly smaller spin frequency and a smaller companion mass, the latter could be caused by a low orbital inclination for the system. Its orbital period of 29 d is well within the range of orbital periods where some MSP–He WD systems have shown anomalous eccentricities, however, the eccentricity of PSR J1912−0952 is typical of what one finds for the remaining MSP–He WD systems.
We develop and discuss appropriate methods based on x-ray diffraction and generalized infrared spectroscopic ellipsometry to identify wurtizte and zinc-blende polymorphs, and quantify their volume ...fractions in mixed-phase epitaxial films taking InN as an example. The spectral signatures occurring in the azimuth polarization (Muller matrix) maps of mixed-phase epitaxial InN films are discussed and explained in view of polymorphism (zinc-blende versus wurtzite), volume fraction of different polymorphs and their crystallographic orientation, and azimuth angle. A comprehensive study of the structural, phonon and free electron properties of zinc-blende InN films containing inclusions of wurtzite InN is also presented. Thorough analysis on the formation of the zinc-blende and wurtzite phases is given and the structural evolution with film thickness is discussed in detail. The phonon properties of the two phases are determined and discussed together with the determination of the bulk free-charge carrier concentration, and electron accumulation at the mixed-phase InN film surfaces.
In this paper, we combine inertial sensing and sensor network technology to create a pedestrian dead reckoning system. The core of the system is a lightweight sensor-and-wireless-embedded device ...called NavMote that is carried by a pedestrian. The NavMote gathers information about pedestrian motion from an integrated magnetic compass and accelerometers. When the NavMote comes within range of a sensor network (composed of NetMotes), it downloads the compressed data to the network. The network relays the data via a RelayMote to an information center where the data are processed into an estimate of the pedestrian trajectory based on a dead reckoning algorithm. System details including the NavMote hardware/software, sensor network middleware services, and the dead reckoning algorithm are provided. In particular, simple but effective step detection and step length estimation methods are implemented in order to reduce computation, memory, and communication requirements on the Motes. Static and dynamic calibrations of the compass data are crucial to compensate the heading errors. The dead reckoning performance is further enhanced by wireless telemetry and map matching. Extensive testing results show that satisfactory tracking performance with relatively long operational time is achieved. The paper also serves as a brief survey on pedestrian navigation systems, sensors, and techniques.
Objective: To perform an evaluation of the risk to healthcare personnel of exposure to cisplatin during a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) procedure in an operating room environment.
...Methods: Breathing zone air samples were taken from the operating room (OR) before, during and after the procedure of HIPEC filter membrane adsorption and the liquid impact method was applied to collect air samples. The samples of surface wipe from the floor of the OR were taken after the procedure. Inductively coupled plasma mass spectrometry(ICP-MS) was used to detect the content of cisplatin in all the samples.
Results: Thirty-six air samples and three surface wipes were collected from three different locations of healthcare personnel breathing zones. All the breathing zone air samples were negative for cisplatin; however, cisplatin contamination was detected on three surface wipes from the floor, but in a lowconcentration(≤ 2.25 ng).
Conclusion: The results suggest that the risk of inhalation of cisplatin was extremely low for the healthcare personnel during the procedure of HIPEC, but the contamination of the OR floor should be taken into consideration.
•open technique increase the exposure of operating room personnel to chemotherapy.•risk was extremely low for the healthcare personnel during the procedure of HIPEC.•the contamination of the OR floor should be taken into consideration.•use Inductively coupled plasma mass spectrometry(ICP-MS) detect content of cisplatin.
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•An algorithm is developed for the design of multiphase composites based on BESO.•It is used to design composites with maximum stiffness or thermal conductivity.•The developed ...algorithm is computationally cost efficient.•It provides distinctive boundaries between constituent phases.
This paper introduces an alternative approach for the topological design of microstructures of materials that are composed of three or more constituent phases. It is assumed that the materials are made up of periodic microstructures. Bi-directional Evolutionary Structural Optimization (BESO) methodology is applied for designing materials’ microstructures with maximum bulk modulus, shear modulus or thermal conductivity. Constituent phases are divided into groups and sensitivity analyses are performed in order to estimate their effects on the variation of the objective function. Changing the elemental properties in the finite element model of the microstructure is performed based on this sensitivity analyses and by imposing volume constraints on the constituent phases. Numerical examples are presented to demonstrate the effectiveness of the algorithm in terms of identification of the phases’ boundaries and convergence speed. The proposed approach could potentially be used to design multiphase materials for functional properties other than stiffness and thermal conductivity.
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