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Alcoholic hepatitis (AH) is an acute inflammatory liver condition with high early mortality rate. Steroids improve short-term survival but nonresponders have the worst outcomes. There is a clinical need to identify these high-risk individuals at the time of presentation. T cells are implicated in AH and steroid responsiveness. We measured ex vivo T cell cytokine expression as a candidate biomarker of outcomes in patients with AH. Consecutive patients (bilirubin >80 μmol/L and ratio of aspartate aminotransferase to alanine aminotransferase >1.5 who were heavy alcohol consumers with discriminant function [DF] ≥32), were recruited from University Hospitals Plymouth NHS Trust. T cells were obtained and stimulated ex vivo. Cytokine expression levels were determined by flow cytometry and protein multiplex analysis. Twenty-three patients were recruited (10 male; median age 51 years; baseline DF 67; 30% 90-day mortality). Compared to T cells from nonsurvivors at day 90, T cells from survivors had higher baseline baseline intracellular interleukin (IL)-10:IL-17A ratio (0.43 vs 1.20, p=0.02). Multiplex protein analysis identified interferon γ (IFNγ) and tumor necrosis factor-α (TNF-α) as independent predictors of 90-day mortality (p=0.04, p=0.01, respectively). The ratio of IFNγ to TNF-α was predictive of 90-day mortality (1.4 vs 0.2, p=0.03). These data demonstrate the potential utility of T cell cytokine release assays performed on pretreatment blood samples as biomarkers of survival in patients with severe AH. Our key findings were that intracellular IL-10:IL-17A and IFNγ:TNF-α in culture supernatants were predictors of 90-day mortality. This offers the promise of developing T cell-based diagnostic tools for risk stratification. (Gut Liver 2020;14:265-268)
We report a case of pseudoaneurysm of the anterior ascending branch of the left pulmonary artery, following a left upper lobectomy for pulmonary aspergillosis, for which we have done an endovascular treatment. This is the first case where complete pseudoaneurysm occlusion was accomplished after a transcatheter intra-aneurysmal N-butyl 2-cyanoacrylate (glue) injection.
Groove pancreatitis is a rare form of chronic pancreatitis that affects the groove area adjacent to the second part of the duodenum. Clinical and biochemical features often overlap with other subsets of chronic pancreatitis, while the imaging features resemblethat of carcinoma of the head of pancreas. We present a 38-year-old man with abdominal pain, nausea, vomiting, and loss ofweight who underwent 18F-FDG PET/CT to rule out a pancreatic malignancy. PET/CT imaging features of groove pancreatitisare distinct from the other subsets of chronic pancreatitis, such as alcoholic and autoimmune pancreatitis, and helpful in thediagnosis and planning further management of the patient.
This paper proposes a method of distinguishing edible mushrooms from non-edible mushrooms using Principal Component Analysis (PCA) algorithm. This system functions by projecting a mushroom image onto a feature space that spans the significant variations among known set of mushroom images. Mushrooms possess certain significant features such as its stalk size, cap shape etc, and PCA extracts these dominant features and these are the eigenvectors of the set of mushrooms. The projection operation characterizes individual mushroom images by a weighted sum of the eigenvector features and hence to recognize a particular mushroom, so it is necessary only to compare these weights to those individual ones. The performance of the proposed method showed around 85% ~96% success rate that increases with the number of training images, and hence proves to be a reliable algorithm for the recognition of mushrooms.
The purpose of this paper is to examine settings for the Open Innovation Arena. In greater depth, this paper aims to analyse and reveal which factors inﬂuence the formation of an appropriate arena for doing open innovation and furthermore to prescribe how a ﬁrm can create an effective arena to gain access to external knowledge. This paper presents a review on open innovation literature with the purpose of examining the current understanding of factors inﬂuencing a ﬁrm’s capacity to embrace and practice open innovation as well as understanding what is critical when ﬁtting outside systems. It presents the results of a survey conducted among 25 researchers from INESC TEC, the Portuguese Institute for Systems and Computer Engineering, Technology, and Science. The study concludes that conditions, namely culture, leadership and strategy, are the main drivers to an open innovation arena, highlighting culture as the most important one.
We present the case of a 36-year-old woman who underwent 18F-FDG PET/CT with suspicion of a primary breast malignancy. However, PET/CT detected an occult renal cell carcinoma with metastases to the thyroid, breast, lungs and lymph nodes. Thyroidand breast metastases are atypical metastatic sites of renal cell carcinoma. Breast metastases from extra mammary tissue areextremely rare, more so from renal cell carcinoma. Histopathologic confirmation of the breast lesions is imperative to avoidunnecessary mastectomy and imaging can help in raising the suspicion of metastatic involvement versus primary breastmalignancy.
Non-ischemic cardiomyopathies are a heterogeneous group of diseases of the myocardium that have a distinct proclivity to ventricular arrhythmias. Of these, ventricular tachycardias pose significant management challenges with the risk of sudden cardiac death and morbidity from multiple causes. Catheter ablation of ventricular tachycardias is becoming an increasingly utilised intervention that has been found to have significant benefits with improving symptoms, reducing anti-arrhythmic drug burden and debilitating device therapies, thereby improving quality of life. Nonetheless, the approach to the ablation of ventricular tachycardias in non-ischemic cardiomyopathies is governed heavily by the disease process, with several distinct differences from ischemic cardiomyopathy including a preponderance to epicardial and deep intramural substrate. This contemporary review aims to present the various disease processes within non-ischemic cardiomyopathies, catheter ablation techniques which have been developed to target ventricular tachycardia and more novel adjunctive therapeutic measures.
Matrix Converter, a direct AC/AC Converter replaces the multiple conversion stages and the intermediate energy storage element of the indirect converters by a single power conversion stage, thus being a single stage converter. Matrix Converters employ an array of controlled bidirectional switches as the main power elements to create a variable output voltage system with unrestricted frequency. This paper attempts to give an overview of Matrix Converters and examines the types, features, merits and limitations of such Converters. It presents the basic operating principle of a Single Phase Matrix Converter, Two Phase to Single Phase Matrix Converter, Three Phase to Single Phase Matrix Converter and Three Phase to Three Phase Matrix Converter. The paper also introduces a topology of a Single Phase Matrix Converter , Two Phase to Single Phase Matrix Converter, Three Phase to Single Phase Matrix Converter and Three Phase to Three Phase Matrix Converter in PSIM software environment and analyses the output of the converter for different frequencies. Further, it examines the output voltage of a Single Phase Matrix Converter synthesized using the Sinusoidal Pulse Width Modulation (SPWM) technique. All simulations have been carried out in POWERSIM.
Keeping the global warming and climate change issues in mind, various efforts are being taking placeworldwide to separate/capture CO2 fromflue gas mixture in order to reduce its emission in theatmosphere. Therefore, in this work, we improve the gas transport properties of polyetherimide (PEI)membrane for CO2/N2 separation by embedding three differentfillers of two-dimensional materials suchas graphene oxide (GO), molybdenum disulfide (MoS2), and hexagonal boron nitride (h-BN) in its matrix. Additionally, the effect of different weight fraction (0.5,1.5, and 2.5 wt.%) of thesefillers on the CO2/N2 gasseparation performance have been investigated. Membrane morphology, variation in the chemical bondsand membrane surface roughness were observed by employing Field Emission Gun Scanning ElectronMicroscopy (FEG-SEM), Fourier Transform Infrared Spectroscopy (FTIR), and Atomic Force Microscopy(AFM) analysis. Results obtained from the gas permeation showed that PEI embodied with GO exhibitedhigher gas permeation compared to when embodied with h-BN and MoS2. However, the maximumseparation was achieved with MoS2 particles.