Search

Normal‐anion‐gap metabolic acidosis (NAGMA) is a common but often under‐recognised and poorly understood condition, especially by less‐experienced clinicians. In adults, NAGMA might be an initial clue to a more significant underlying pathology, such as autoimmune diseases, hypergammaglobulinemia or drug toxicities. However, identifying the aetiology can be challenging due to the diverse processes involved in the development of acidosis. A better understanding of the pathophysiology of NAGMA can help treating physicians suspect and evaluate the condition early and reach the correct diagnosis. This article provides an overview of renal acid–base regulation, discusses the pathophysiological processes involved in developing NAGMA and provides a framework for evaluation to reach an accurate diagnosis. [ABSTRACT FROM AUTHOR]

Due to escalating environmental problems and challenges, ensuring sustainable development (SD) has become a matter of concern for organizations worldwide at a precinct scale. This study aims to integrate the variables, which are antecedents of SD through direct and indirect paths. The managers as participants of small‐ and medium‐sized enterprises have helped the researchers to explore the role of green knowledge management (GKM) and green dynamic capacity with the intervention of green innovation and competitive advantage in achieving SD. The results achieved through structural equation modeling revealed positive and significant direct and indirect relationships, however, the intervening role of green innovation and green competitive advantage between GKM and SD show insignificant results. Interestingly, we have also identified two significant moderators as a part of this study: large firm size and transformational leadership. This research has important implications and significant contributions to theory and practice. It can be considered innovative by using a range of antecedents in an integrated way, proposing and testing a theoretical model of SD in a developing country Pakistan, which is affirmed and committed to achieving SDGs by the year 2030. [ABSTRACT FROM AUTHOR]

Monoclonal gammopathy of undetermined significance (MGUS) is usually an asymptomatic pre‐malignant condition caused by the proliferation of clonal plasma cells. Often considered a benign condition, it has the potential to progress to malignant plasma cell or lymphoproliferative disorders. Moreover, MGUS can rarely cause glomerular disease by activating the alternative complement pathway resulting in immunoglobulin‐negative C3‐positive glomerulonephritis called C3 glomerulopathy. Because of its rarity, the diagnosis might not be considered by the treating physicians, leading to delayed diagnosis or misdiagnosis. Untreated C3 glomerulopathy can lead to irreversible glomerular damage and end‐stage renal failure, and a high index of suspicion is essential for timely diagnosis and management. Here, we present the case of a patient with a prior diagnosis of MGUS who presented with proteinuria and microscopic haematuria and was diagnosed with C3 glomerulopathy. The patient had complete resolution of the disease after receiving treatment with a combination of dexamethasone, lenalidomide and bortezomib for the underlying MGUS. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine how much celebrity endorsement stimulates skin color racism in the cosmetics industry. Design/Methodology/Approach: The data were collected from Google Scholar and Web of Science published articles, and researchers had chosen 45 research articles. Some of the research articles used a quantitative research approach while others had used qualitative research approach. And for the current study, content analysis has been used. Findings: The study finds that celebrity endorsement does influence and promote racism, implying that when celebrities promote fairness products, people perceive themselves inferior due to darker skin tone that gives birth to the notion of racism. Brand Image intervenes in the relationship between Celebrity Endorsement and Racism, and also, intervenes in the relationship between Celebrity Endorsement and Purchase Intention. Limitations: This study is only limited to Google Scholar and Web of Science directory. Only forty‐five articles were taken from 2001 to 2021 year. Real examples were taken from all over the world, but especially from the Less Developed countries like Pakistan and India due to the huge population, rising income, and surging cosmetics industry. Hence, the findings of this study cannot be generalized to the Technologically Advanced Countries. Implications: It is obvious that firms design advertisement campaigns that can get consumers' attention. For this purpose, they engage celebrities to evoke more interest and awareness as well as perception. The study will help the management of different brands to understand that how they can improve their advertisements in a way that does not promote racism. And the celebrities, signing contracts with brands that promote racism, will keep in mind the negative influence these endorsements have on society while companies will make sure that they are also not promoting racism by making such promotional campaigns. [ABSTRACT FROM AUTHOR]

Investigating the combined effects of elevated CO2 concentration and water‐deficit on weed plants is crucial to gaining a thorough understanding of plant performance and modifying agricultural processes under changing climate conditions. This study examined the effect of elevated CO2 concentration and water‐deficit conditions on leaf gas exchange, water use efficiency, carboxylation efficiency and the photosystem II (PSII) activity of two Salvia verbenaca L., varieties. These varieties were grown under two CO2 concentrations (ambient conditions of 400 ppm and elevated conditions of 700 ppm) and two water regimes (well‐watered [100% field capacity] and water‐deficit conditions [60% field capacity]) in laboratory growth chambers. For 12 days, at 2‐day intervals, (i) leaf gas exchange parameters (photosynthesis rate, stomatal conductance, transpiration rate (E) and intercellular CO2 concentration (Ci)), (ii) water use efficiency (WUE), (iii) intrinsic water use efficiency (IWUE), (iv) instantaneous carboxylation efficiency and (v) PSII activity (fluorescence, quantum yield of PSII, photochemical efficiency of PSII, photochemical quenching and photosynthetic electron transport) were measured. Water‐deficit conditions had negative effects on studied parameters of both varieties, whereas elevated CO2 concentration had positive effects on the gas exchange, water use efficiency and PSII activity of both. Salvia verbenaca varieties grown under water‐deficit conditions from Day 0 to Day 5 showed a partial recovery in most of the parameters when the resumption of the well‐watered regime was reinstituted on Day 6. Salvia verbenaca varieties grown under water‐deficit conditions were re‐watered on day 6 and indicated a partial recovery in all the parameters. A comparison of the two varieties showed that var. vernalis recorded higher values of gas exchange, quantum yield of PSII and photochemical efficiency of PSII than var. verbenaca, but the water use efficiency of var. verbenaca was higher than that of var. vernalis. These differences serve to illustrate the complexity of such studies and suggest that a detailed understanding of the nature of weed infestations is essential if optimum management control is to be practiced. Elevated CO2 concentration mitigated the adverse effects of water‐deficit conditions and thereby enhanced the adaptive mechanism of this weed by improving its water use efficiency. It is thus likely that S. verbenaca has the potential to take advantage of climate change by increasing its relative competitiveness with other plants in drought‐prone areas, suggesting that it could significantly expand its invasive range under such conditions. [ABSTRACT FROM AUTHOR]

Summary: Myeloma patients frequently respond poorly to bacterial and viral vaccination. A few studies have reported poor humoral immune responses in myeloma patients to COVID‐19 vaccination. Using a prospective study of myeloma patients in the UK Rudy study cohort, we assessed humoral and interferon gamma release assay (IGRA) cellular immune responses to COVID‐19 vaccination post second COVID‐19 vaccine administration. We report data from 214 adults with myeloma (n = 204) or smouldering myeloma (n = 10) who provided blood samples at least three weeks after second vaccine dose. Positive Anti‐spike antibody levels (> 50 iu/ml) were detected in 189/203 (92.7%), positive IGRA responses were seen in 97/158 (61.4%) myeloma patients. Only 10/158 (6.3%) patients were identified to have both a negative IGRA and negative anti‐spike protein antibody response. In all, 95/158 (60.1%) patients produced positive results for both anti‐spike protein serology and IGRA. After adjusting for disease severity and myeloma therapy, poor humoral immune response was predicted by male gender. Predictors of poor IGRA included anti‐CD38/anti‐BCMA (B‐cell maturation antigen) therapy and Pfizer‐BioNTech vaccination. Further work is required to understand the clinical significance of divergent cellular response to vaccination. [ABSTRACT FROM AUTHOR]

Because of their rarity, diseases characterized by chronic hypophosphatemia can be underrecognized and suboptimally managed, resulting in poor clinical outcomes. Moreover, serum phosphate may not be measured routinely in primary care practice. Authors participated in several working sessions to advance the understanding of phosphate homeostasis and the causes, consequences, and clinical implications of chronic hypophosphatemia. Phosphate levels are regulated from birth to adulthood. Dysregulation of phosphate homeostasis can result in hypophosphatemia, which becomes chronic if phosphate levels cannot be normalized. Chronic hypophosphatemia may be underrecognized as serum phosphate measurement is not always part of routine analysis in the primary care setting and results might be misinterpreted, for instance, due to age‐specific differences not being accounted for and circadian variations. Clinical consequences of chronic hypophosphatemia involve disordered endocrine regulation, affect multiple organ systems, and vary depending on patient age and the underlying disorder. Signs and symptoms of chronic hypophosphatemic diseases that manifest during childhood or adolescence persist into adulthood if the disease is inadequately managed, resulting in an accumulation of clinical deficits and a progressive, debilitating impact on quality of life. Early identification and diagnosis of patients with chronic hypophosphatemia is crucial, and clinical management should be started as soon as possible to maximize the likelihood of improving health outcomes. Furthermore, in the absence of a universally accepted description for "chronic hypophosphatemia," a definition is proposed here that aims to raise awareness of these diseases, facilitate diagnosis, and guide optimal phosphate management strategies by improving monitoring and assessment of patient response to treatment. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]

All patients who had had a previous infection had a robust antibody response to the first dose of COVID-19 vaccine and 60% of patients had an optimal immune response to the first dose of COVID-19 vaccination. COVID symptoms, testing, shielding impact on patient-reported outcomes and early vaccine responses in individuals with multiple myeloma Keywords: myeloma; COVID-19; vaccination; wellbeing; shielding EN myeloma COVID-19 vaccination wellbeing shielding 95 98 4 12/27/21 20220101 NES 220101 Patients with myeloma have been shielded and self-isolated since the start of the COVID-19 pandemic, due to the concern for and subsequent reports of higher risk of severe COVID-19 disease and mortality.1 In addition, guidelines have encouraged attenuation of myeloma therapeutics or a switch to oral therapies, ostensibly to reduce hospital foot-fall, facilitate shielding and potentially to limit further treatment-related immune suppression.2 Myeloma requires ongoing immune-suppressive chemotherapy, frequent medical visits and has previously demonstrated universally poor response to vaccinations.3 The protective titre of antibodies required to prevent re-infection is unclear, as is the ability to protect patients from SARS-CoV-2 virus variants of concern (VoC). [Extracted from the article]

The availability of anti‐osteoporosis medications with rapid onset and high potency requires tools to identify patients at high imminent fracture risk (IFR). There are few tools that predict a patient's IFR. We aimed to develop and validate tools for patients with a recent fracture and for patients initiating oral bisphosphonate therapy. Models for two separate cohorts, those with incident fragility fracture (IFx) and with incident oral bisphosphonate prescription (OBP), were developed in primary care records from Spain (SIDIAP database), UK (Clinical Practice Research Datalink GOLD), and Denmark (Danish Health Registries). Separate models were developed for hip, major, and any fracture outcomes. Only variables present in all databases were included in Lasso regression models for the development and logistic regression models for external validation. Discrimination was tested using area under curve (AUC) and calibration was assessed using observed versus predicted risk plots stratified by age, sex, and previous fracture history. The development analyses included 35,526 individuals in the IFx and 41,401 in the OBP cohorts, with 671,094 in IFx and 330,256 in OBP for the validation analyses. Both the IFx and OBP models demonstrated similarly good performance for hip fracture at 1 year (with AUCs of 0.79 [95% CI 0.75 to 0.82] and 0.87 [0.83 to 0.91] in Spain, 0.71 [0.71 to 0.72] and 0.73 [0.72 to 0.74] in the UK, and 0.70 [0.70 to 0.70] and 0.69 [0.68 to 0.70] in Denmark), and lower discrimination for major osteoporotic and any fracture sites. Calibration was good across all three countries. Discrimination and calibration for the 2‐year models was similar. The proposed IFR prediction models could be used to identify more precisely patients at high imminent risk of fracture and inform anti‐osteoporosis treatment selection. The freely available model parameters permit local validation and implementation. © 2021 American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]

The article presents a case study of a patient who developed acute tubular necrosis (ATN) as a delayed consequence of Covid-19 infection, highlighting that Covid-19 can lead to kidney complications even after the initial infection has resolved. It presents that a patient who experienced acute kidney injury (AKI) six weeks after a mild Covid-19 infection and provides insights into the potential mechanisms underlying such delayed renal complications.

This paper describes the progress of dryland farming development by comparing the ridge‐furrow plastic film mulching (RFM) system with conventional cultivation in the Chinese Loess Plateau, where the climate is cool and semi‐arid or subhumid prone to drought, and dryland farming dominates. The barren soil dominated by eolian sedimentary loess is loose and erosive. For thousands of years, increasing human population pressure and high‐intensity disordered land use have led to serious ecosystem degradation. Since the 1950s, large‐scale and long‐term construction of terraced fields have effectively reduced the soil erosion potential, and such fields have become more and more convenient for mechanized large‐area production. Since the beginning of the 21st century, the crop cultivation system based on the RFM has been widely promoted. Compared with previous cropping systems, the crop productivity in the RFM system is double or multiple times greater. Soil moisture has become favorable. Soil organic C content has been controlled or increased. Most importantly, the RFM system has promoted the coordinated development of grain, forage, and livestock, and favorable market results. It has vigorously promoted the fight against poverty and the realization of the goal of building a moderately prosperous society in dryland areas. Therefore, ridge‐furrow mulching is the key basis for the sustainable development of the dryland farming system on the Loess Plateau. [ABSTRACT FROM AUTHOR]

As illustrated by the outcomes of recent corporate scandals, crimes of obedience—an individuals' passive response to unethical requests from organizational leaders—can pose a significant threat. How can this threat be avoided? A study based on data collected from employees in public and private sector organizations in Pakistan shows how unethical leadership can influence crimes of obedience and how this effect can be moderated by a sense of moral awareness. The study showed that unethical leadership positively influences the tendency for employees to commit crimes of obedience, but that a sense of moral awareness dampened this effect. Through theoretical justification and empirical testing, the study offers guidance to employers concerning ways to prevent employees committing crimes of obedience and, in addition, contributes to the emerging debate about the influence of unethical leadership in organizations. [ABSTRACT FROM AUTHOR]

This study aimed to determine if having an overweight or obese range body mass index (BMI) at time of beginning school is associated with increased fracture incidence in childhood. A dynamic cohort was created from children presenting for routine preschool primary care screening, collected in the Information System for Research in Primary Care (SIDIAP) platform in Catalonia, Spain. Data were collected from 296 primary care centers representing 74% of the regional pediatric population. A total of 466,997 children (48.6% female) with a validated weight and height measurement within routine health care screening at age 4 years (±6 months) between 2006 and 2013 were included, and followed up to the age of 15, migration out of region, death, or until December 31, 2016. BMI was calculated at age 4 years and classified using WHO growth tables, and fractures were identified using previously validated ICD10 codes in electronic primary care records, divided by anatomical location. Actuarial lifetables were used to calculate cumulative incidence. Cox regression was used to investigate the association of BMI category and fracture risk with adjustment for socioeconomic status, age, sex, and nationality. Median follow‐up was 4.90 years (interquartile range [IQR] 2.50 to 7.61). Cumulative incidence of any fracture during childhood was 9.20% (95% confidence interval [CI] 3.79% to 14.61%) for underweight, 10.06% (9.82% to 10.29%) for normal weight, 11.28% (10.22% to 12.35%) for overweight children, and 13.05% (10.69% to 15.41%) for children with obesity. Compared with children of normal range weight, having an overweight and obese range BMI was associated with an excess risk of lower limb fracture (adjusted hazard ratio [HR] = 1.42 [1.26 to 1.59]; 1.74 [1.46 to 2.06], respectively) and upper limb fracture (adjusted HR = 1.10 [1.03 to 1.17]; 1.19 [1.07 to 1.31]). Overall, preschool children with an overweight or obese range BMI had increased incidence of upper and lower limb fractures in childhood compared with contemporaries of normal weight. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Oral bisphosphonates (oBPs) have been associated with reduced fractures and mortality. However, their risks and benefits are unclear in patients with moderate–severe CKD. This study examined the association between oBPs and all‐cause mortality in G3B‐5D CKD. This is a population‐based cohort study including all subjects with an estimated glomerular filtration rate (eGFR) <45/mL/min/1.73 m2 (G3B: eGFR <45/mL/min/1.73 m2 G4: eGFR 15–29/mL/min/1.73 m2 G5: eGFR <15/mL/min/1.73 m2 G5D: hemodialysis) aged 40+ years from the UK Clinical Practice Research Datalink (CPRD) and the Catalan Information System for Research in Primary Care (SIDIAP). Previous and current users of other anti‐osteoporosis drugs were excluded. oBP use was modeled as a time‐varying exposure to avoid immortal time bias. Treatment episodes in oBP users were created by concatenating prescriptions until patients switched or stopped therapy or were censored or died. A washout period of 180 days was added to (date of last prescription +180 days). Propensity scores (PSs) were calculated using prespecified predictors of mortality including age, gender, baseline eGFR, socioeconomic status, comorbidities, previous fracture, co‐medications, and number of hospital admissions in the previous year. Cox models were used for PS adjustment before and after PS trimming (the first and last quintiles). In the CPRD, of 19,351 oBP users and 210,954 non‐oBP users, 5234 (27%) and 85,105 (40%) deaths were recorded over 45,690 and 915,867 person‐years of follow‐up, respectively. oBP users had 8% lower mortality risk compared to non‐oBP users (hazard ratio [HR] 0.92; 95% CI, 0.89 to 0.95). Following PS trimming, this became nonsignificant (HR 0.98; 95% CI, 0.94 to 1.04). In the SIDIAP, of 4146 oBP users and 86,127 non‐oBP users, 1330 (32%) and 36,513 (42%) died, respectively. oBPs were not associated with mortality in PS adjustment and trimming (HR 1.04; 95% CI, 0.99 to 1.1 and HR 0.95; 95% CI, 0.89 to 1.01). In this observational, patient‐based cohort study, oBPs were not associated with increased mortality among patients with moderate–severe CKD. However, further studies are needed on other effects of oBPs in CKD patients. © 2020 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Despite the development of novel teaching strategies and the abundance of adjunct teaching web resources, students and early career physicians have continuously reported difficulties in learning and clinically applying neuroanatomy. Differences in instructional design of these resources, the lack of assessment of their capacity to meet intended educational goals, and a poor understanding of the user's perspective may have hindered their success in increasing understanding and retention of neuroanatomical knowledge. To decipher the limitations of existing web resources, an online search for neuroanatomy web resources was performed and distilled through a strict filtration rubric. A selection of resources were analyzed by a panel of educators and rated using Likert scales, focusing on the identification of features influencing their usefulness in learning the anatomy of the spinal pathways. The top three ranked web resources were subsequently evaluated by a panel of medical and neuroscience students to assess how specific features aided in their learning of the subject. This detailed analysis has identified features of neuroanatomy web resources that are valued by both educators and users with regard to instructional design. One resource was rated highest by end users and educators on a series of Likert scale questions in terms of clarity of explanation, step‐wise teaching design, summarization of information, control of instructional‐pace, integration with neurophysiology, neuroradiology and clinical correlates, deployment of a wide array of pedagogical tools, and factors for visualizing neuroanatomical inter‐relationships. These results have provided a novel user perspective on the influence of specific elements of neuroanatomy web resources to improve instructional design and enhance learner performance. [ABSTRACT FROM AUTHOR]

Ionic liquids (ILs) have gained wide‐spread focus owing to its negligible vapor pressure, low heat capacity, high thermal stability, and structural diversity. The solubility and selectivity toward carbon dioxide has made ILs a unique platform that possess the potential in gas separations. In particularly, combining functional ILs with membranes and porous supports is an efficient way to design task‐specific materials for CO2 separations. This minireview summarizes the developments and advances of ionic liquids‐based membranes for CO2 separations in recent three years, with an emphasis on the strategy of incorporating ionic liquids and CO2 separation performance. [ABSTRACT FROM AUTHOR]

Urgent-start peritoneal dialysis (USPD) is increasingly seen as a viable alternative to hemodialysis through a central venous catheter for late-presenting end-stage renal disease patients. However, concerns remain about starting dialysis early following the surgical implantation of the peritoneal dialysis (PD) catheter; urgent PD is often thought to be a safe option only after minimally invasive percutaneous catheter insertions. Analysis of the cumulative data from published literature presented in this review appears to negate this general perception and shows that compared to the percutaneous catheter insertions, starting PD urgently following surgically placed catheter is not associated with more catheter leaks, dysfunctions, or other complications. The outcome of USPD is independent of the mode of catheter insertion. Instead, measures to minimize intra-peritoneal pressure including using the low initial dwell volume based on patient's weight and body habitus and keeping patients in strict supine posture during exchanges in the first 2 weeks of treatment are the two most important factors ensuring a minimization of the risk of catheter-related complications. [ABSTRACT FROM AUTHOR]

Objective: The neural mechanisms of pain in knee osteoarthritis (OA) are not fully understood, and some patients have neuropathic‐like pain associated with central sensitization. To address this, we undertook the present study in order to identify central sensitization using neuroimaging and PainDETECT and to relate it to postarthroplasty outcome. Methods: Patients awaiting arthroplasty underwent quantitative sensory testing, psychological assessment, and functional magnetic resonance imaging (fMRI). Neuroimaging (fMRI) was conducted during punctate stimulation (n = 24) and cold stimulation (n = 20) to the affected knee. The postoperative outcome was measured using the Oxford Knee Score, patient‐reported moderate‐to‐severe long‐term pain postarthroplasty, and a range of pain‐related questionnaires. Results: Patients with neuropathic‐like pain presurgery (identified using PainDETECT; n = 14) reported significantly higher pain in response to punctate stimuli and cold stimuli near the affected joint (P < 0.05). Neural activity in these patients, compared to those without neuropathic‐like pain, was significantly lower in the rostral anterior cingulate cortex (P < 0.05) and higher in the rostral ventromedial medulla (RVM) during punctate stimulation (P < 0.05), with significant functional connectivity between these two areas (r = 0.49, P = 0.018). Preoperative neuropathic‐like pain and higher neural activity in the RVM were associated with moderate‐to‐severe long‐term pain after arthroplasty (P = 0.0356). Conclusion: The psychophysical and neuroimaging data suggest that a subset of OA patients have centrally mediated pain sensitization. This was likely due to supraspinally mediated reductions in inhibition and increases in facilitation of nociceptive signaling, and was associated with a worse outcome following arthroplasty. The neurobiologic confirmation of central sensitization in patients with features of neuropathic pain, identified using PainDETECT, provides further support for the investigation of such bedside measures for patient stratification, to better predict postsurgical outcomes. [ABSTRACT FROM AUTHOR]

The present study was conducted to evaluate the toxic potential of five indigenous plant oils: black pepper (Piper nigrum), Chinese cinnamon (Cinnamomum cassia), garlic (Allium sativum), river red gum (Eucalyptus camaldulensis), and yellow oleander (Thevetia peruviana), against laboratory reared Sitophilus oryzae adults. The bioassays were done by the diet incorporation method with concentrations ranging from 50 ppm to 500 ppm. Based on lethal concentrations to kill 50% (LC50) of the subjected weevils, T. peruviana proved to be the most toxic having the lowest LC50 values, 414.58, 201.94, and 129.52 ppm, after 7, 14, and 21 days of exposure, respectively, followed by E. camaldulensis (475.51, 366.65, and 251.28 ppm, respectively). The rest of the plant oils also showed toxic potential, but these were less toxic compared with T. peruviana and E. camaldulensis. With respect to the time taken to cause 50% mortality (LT50) of the exposed weevils, T. peruviana had LT50 at 14.54 days followed by P. nigrum (22.09 days), E. camaldulensis (24.29 days), and C. cassia (28.71 days). Whereas, A. sativum took the longest time (44.47 days) to cause 50% mortality of the exposed weevils. In conclusion, the result revealed toxic potential of tested plant oils, and suggests further studies under simulated‐field conditions should be included in the management plan for S. oryzae. [ABSTRACT FROM AUTHOR]

1q24q25 deletions cause a distinctive phenotype including proportionate short stature, microcephaly, brachydactyly, dysmorphic facial features and intellectual disability. We present a mother and son who have a 672 kb microdeletion at 1q24q25. They have the typical skeletal features previously described but do not have any associated intellectual disability. We compare the genes within our patients' deletion to those in the deletions of previously reported cases. This indicates two genes that may be implicated in the intellectual disability usually associated with this deletion syndrome; PIGC and C1orf105. In addition, our cases provide supporting evidence to recent published work suggesting that the skeletal features may be linked to the microRNAs miR199 and miR214, encoded within intron 14 of the Dynamin‐3 gene. [ABSTRACT FROM AUTHOR]

Recent studies have highlighted a fear or difficulty with the study and understanding of neuroanatomy among medical and healthcare students. This has been linked with a diminished confidence of clinical practitioners and students to manage patients with neurological conditions. The underlying reasons for this difficulty have been queried among a broad cohort of medical, dental, occupational therapy, and speech and language sciences students. Direct evidence of the students' perception regarding specific difficulties associated with learning neuroanatomy has been provided and some of the measures required to address these issues have been identified. Neuroanatomy is perceived as a more difficult subject compared to other anatomy topics (e.g., reproductive/pelvic anatomy) and not all components of the neuroanatomy curriculum are viewed as equally challenging. The difficulty in understanding neuroanatomical concepts is linked to intrinsic factors such as the inherent complex nature of the topic rather than outside influences (e.g., lecture duration). Participants reporting high levels of interest in the subject reported higher levels of knowledge, suggesting that teaching tools aimed at increasing interest, such as case-based scenarios, could facilitate acquisition of knowledge. Newer pedagogies, including web-resources and computer assisted learning (CAL) are considered important tools to improve neuroanatomy learning, whereas traditional tools such as lecture slides and notes were considered less important. In conclusion, it is suggested that understanding of neuroanatomy could be enhanced and neurophobia be decreased by purposefully designed CAL resources. This data could help curricular designers to refocus attention and guide educators to develop improved neuroanatomy web-resources in future. Anat Sci Educ 11: 81-93. © 2017 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

Host plant nutritional quality can directly and indirectly affect the third trophic levels. The aphid-parasitoid relationship provides an ideal system to investigate tritrophic interactions (as the parasitoids are completely dependent for their development upon their hosts) and assess the bottom up forces operating at different concentrations of nitrogen applications. The effects of varying nitrogen fertilizer on the performance of Aphidius colemani (V.) reared on Sitobion avenae (F.) and Aphidius rhopalosiphi (D.) reared on Rhopalosiphum padi (L.) were measured. Parasitism and percent emergence of parasitoids were positively affected by nitrogen fertilizer treatments while developmental duration (egg, larval, and pupal stages) was not affected by increasing nitrogen inputs. In males and females of both parasitoid species, adult longevity increased with the increasing nitrogen fertilizer. Hind tibia length andmummyweight of both parasitoid species increased with nitrogen fertilizer concentrations, as a result of larger aphids. This study showed that nitrogen application to the soil can have important consequences for aboveground multitrophic interactions. [ABSTRACT FROM AUTHOR]

ABSTRACT It is known that extracellular glutamate concentrations are increased in tendinopathy but the effects of glutamate upon human tendon derived cells are unknown. The primary purpose was to investigate the effect of glutamate exposure on human tendon-derived cells in terms of viability, protein, and gene expression. The second purpose was to assess whether NMDAR antagonism would affect the response of tendon-derived cells to glutamate exposure. Human tendon-derived cells were obtained from supraspinatus tendon tissue obtained during rotator cuff repair (tendon tear derived cells) and from healthy hamstring tendon tissue (control cells). The in vitro impact of glutamate exposure and NMDAR antagonism (MK-801) was measured using the Alamar blue cell viability assay, immunocytochemistry, and quantitative real-time PCR. Glutamate reduced cell viability at 24 h in tendon tear derived cells but not in control cells at concentrations of 7.5 mM and above. Cell viability was significantly reduced after 72 h of 1.875 mM glutamate in both cell groups; this deleterious effect was attenuated by NMDAR antagonism with 10 µM MK-801. Both 24 and 72 h of 1.875 mM glutamate exposure reduced Type 1 alpha 1 collagen (COL1A1) and Type 3 alpha 1 collagen (COL3A1) gene expression, but increased Aggrecan gene expression. We propose that these effects of glutamate on tendon derived cells including reduced cell viability and altered matrix gene expression contribute to the pathogenesis of tendinopathy. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 33:1515-1522, 2015. [ABSTRACT FROM AUTHOR]

SUMMARY Background Calciphylaxis is an uncommon and often under diagnosed condition affecting patients undergoing chronic dialysis. Its pathogenesis is poorly understood. The abnormalities of calcium, phosphate and parathyroid hormone homeostasis leading to vascular calcification and ischaemic skin necrosis are thought to be the central problem. Meticulous wound care and aggressive metabolic control remain the cornerstone of the treatment; however, the overall benefit of these treatment options remains low and mortality and morbidity remain very high. Sodium thiosulphate is an inorganic salt, which is used for treating acute cyanide poisoning, recurrent calcium urolithiasis and nephrocalcinosis. Recently, it has also been reported to be useful in treating severe cases of calciphylaxis with promising results. Methods A resistant case of calciphylaxis in a patient on long-term haemodialysis was treated with sodium thiosulphate (50 ml solution with 50% sodium thiosulphate) three times a week during the end of each dialysis session. Results The skin lesions started to heal after two weeks and completely resolved after five months of treatment. Conclusions Sodium thiosulphate can be a safe and effective treatment option for resistant and severe cases of calciphylaxis [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Rendered three-dimensional images of the fetal cranial vault permit the identification of sutures and measurement of the fontanelle surface area. The objective of this study was to establish the feasibility and repeatability of sphenoidal fontanelle area measurement. Method Head volumes were obtained using the biparietal diameter as the reference plane. These were displayed with maximum rendering and the surface area of the sphenoidal fontanelle was measured by one operator. Feasibility was expressed as the percentage of scans with a successful measurement at different gestational ages. Repeatability was expressed as coefficient of variation (CV), intraclass correlation coefficient (ICC) and Bland-Altman plots. Results Thirty women underwent 141 scans. Feasibility of sphenoidal fontanelle measurement is over 90% before 26 weeks, but drops gradually thereafter and becomes 0% at 34 weeks. Intraobserver repeatability of measurement on the same scan image demonstrated CV = 17.5% and ICC = 0.883; however, when measuring a newly acquired volume, the repeatability is poor, CV = 30.7% and ICC = 0.649. Conclusion Although it is feasible to visualize the sphenoidal fontanelle on rendered three dimensions, its surface area measurement is not reliable for clinical use. There is potential to overestimate repeatability when remeasuring the same volume. © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

SUMMARY Acute myocardial infarction is relatively uncommon in patients under the age of 40 years. Unlike the older patients where rupture of coronary artery atherosclerotic plaque is the main underlying pathology, the pathogenesis in younger patients can be varied and may require different diagnostic and therapeutic approaches. Hypercoagulable state associated with nephrotic syndrome and antiphospholipid syndrome can lead to the development of occlusive coronary artery thrombus in absence of atherosclerotic coronary artery disease. Acute myocardial infarction in such a setting can sometimes be the first manifestation of an underlying disease. We describe a case of myocardial infarction in a young man with both nephrotic and antiphospho-lipid syndromes and present a brief literature review. [ABSTRACT FROM AUTHOR]

Polymyalgia rheumatica (PMR) is a common chronic inflammatory disorder affecting patients over the age of 50. Renal involvement in PMR is extremely rare and very few cases of AA amyloidosis secondary to PMR have been described in literature. We present a case of a patient with history PMR who developed nephrotic range proteinuria and rapidly deteriorating renal function secondary to AA amyloidosis within 18 months of the onset of symptoms of PMR. This case reinforces the association of PMR with secondary AA amyloidosis and highlights the importance of monitoring renal function in patients with PMR. [ABSTRACT FROM AUTHOR]

Water extracts obtained from the roots, shoots, and fruits of mature wild onion ( Asphodelus tenuifolius) plants and soil taken from an A. tenuifolius field were used to determine their allelopathic effects on the germination and seedling growth of chickpea ( Cicer arietinum) in the laboratory. The roots, shoots, and fruits of A. tenuifolius were soaked individually in water in a ratio of 1:20 (w/v) for 24 h to prepare the extracts. Distilled water was used as the control. The germinated seeds were taken out from the Petri dishes and counted every day for 12 days. The seeds of chickpea were also sown in sand and in each of the controlled, normal soil and the soil taken from the A. tenuifolius-infested field in Petri dishes to record the length and weight of the roots and shoots 18 days after sowing. The mean germination time reached the maximum amount for the stem and fruit extracts. The fruit extract caused the most reduction in the germination index and the germination percentage of chickpea. The different wild onion organ extracts significantly reduced the root and shoot length and biomass of the chickpea seedlings compared with the distilled water. The fruit extract of wild onion proved to be the most detrimental to the root length, shoot length, and dry weight of the chickpea seedlings. The soil beneath the A. tenuifolius plants significantly reduced the emergence, root length, shoot length, shoot dry weight, and seedling dry weight but increased the root dry weight of the chickpea seedlings. It is suggested that A. tenuifolius releases phytotoxic compound(s). [ABSTRACT FROM AUTHOR]

There is increasing evidence to support the role of the intrauterine and early postnatal environment in determining adult bone mass and risk of fracture. The mechanisms by which this occurs are uncertain but include perturbations in several endocrine axes. Vitamin D is integrally involved in bone metabolism and is therefore an ideal candidate. This study assesses whether birthweight and weight at 1 year of age are associated with the calcium vitamin D axis in elderly women.Vitamin D metabolites, parathyroid hormone, bone mineral density and biochemical markers of bone turnover were measured in 129 healthy women (mean age 65.5 years) from the MRC Hertfordshire Cohort Study whose birthweight and weight at 1 year were available from records.Serum 1,25 (OH)2 vitamin D concentrations were reduced with increasing weight at 1 year (19.1% reduction between the lowest and highest tertiles,P < 0.01). A similar, but weaker trend was seen for birthweight. These associations were not explained by serum levels of serum calcium, phosphate, PTH, creatinine or sex hormones. The association of serum calcium with 1,25 (OH)2 vitamin D was greatest in the lowest tertile with little association in the highest tertile suggesting an increased sensitivity of renal 1-α hydroxylase in the lowest tertile. Highest levels of 1,25 (OH)2 vitamin D were associated with low BMD and high levels of urinary N-telopeptide suggesting that vitamin D metabolism may mediate the intrauterine and early postnatal environmental effects on adult BMD. [ABSTRACT FROM AUTHOR]