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BackgroundCeliac disease (CD) is an immune-mediated disorder induced by the ingestion of gluten in genetically susceptible persons. The prevalence of CD in Malaysia is unknown. We aim to determine the seroprevalence of CD antibodies and also investigate the correlation between H. pylori infection and CD in the young and healthy multiracial Malaysian population.MethodsHealthy young adult volunteers between the ages of 18-30 years were consecutively recruited from June 2012 to May 2014 at the University of Malaya Medical Centre (UMMC), Kuala Lumpur. Serum samples from all the participants were tested for anti-gliadin antibody immunoglobulin A/immunoglobulin G (IgA/IgG) and anti-tissue transglutaminase antibody (tTG) IgA/IgG. Samples positive for both anti-gliadin and anti-tTG were further validated for anti-human endomysial IgA antibodies (EmA). Serological diagnosis of CD was made when anti-gliadin, anti-tTG and anti-EmA were positive.Results562 qualified participants with mean age 24 ± 2.4 years old were recruited into our study. CD was found in 7 participants where most of them were asymptomatic and unaware of their CD status. The median of anti-gliadin and anti-tTG IgA/IgG value was 38.2 U/ml (interquartile range, 28.3-60.4 U/ml) and 49.2 U/ml (interquartile range, 41.1-65.9 U/ml), respectively. Seroprevalence of CD antibodies was 1.9% (6 out of 324) in female while only 0.4% (1 out of 238) in male. Seroprevalence among Malay was 0.8% (2 of 236), Chinese was 1.7% (3 of 177) and Indian was 1.3% (2 of 149). Overall, seroprevalence of CD antibodies in healthy asymptomatic adults in the Malaysian population was 1.25% (95% CI, 0.78%-1.72%). No significant relationship was discovered between CD and H. pylori infection.ConclusionsThe seroprevalence of CD antibodies in healthy young adults in the Malaysian population was 1.25% (1 in 100). CD is underdiagnosed and it could be a much greater problem in Malaysia than previously thought.

Electrospun electret filter material is widely studied because of its excellent removal effect on particulate matter from air streams. Here, a kind of high efficiency and low pressure drop nanofiber (NF) membrane with both electret effect and magnetic effect is developed, and compounded it with glass fiber mesh and polyester (polyethylene terephthalate) mesh to prepare a sandwich structure of NF anti‐haze window screen. Under the synergistic effect of magnetic particles, when the density is 2.06 g m−2, the filtration efficiency of NF anti‐haze window screen can reach 99.95% for the fine particles below 0.3 µm, while the filtration pressure drop is only 58.5 Pa, with good light transmittance and excellent breaking strength (6.32 MPa). Therefore, polyvinylidene fluoride/Fe3O4 composite NF membrane has a potential application prospect in the field of air filtration. [ABSTRACT FROM AUTHOR]

How T cells differentiate in the neonate may critically determine the ability of the infant to cope with infections, respond to vaccines and avert allergies. Previously, we found that naïve cord blood CD4+ T cells differentiated toward an IL-4-expressing phenotype when activated in the presence of TGF-β and monocyte-derived inflammatory cytokines, the latter are more highly secreted by infants who developed food allergy. Here, we show that in the absence of IL-2 or IL-12, naïve cord blood CD8+ T cells have a natural propensity to differentiate into IL-4-producing non-classic TC2 cells when they are activated alone, or in the presence of TGF-β and/or inflammatory cytokines. Mechanistically, non-classic TC2 development is associated with decreased expression of IL-2 receptor alpha (CD25) and glycolysis, and increased fatty acid metabolism and caspase-dependent cell death. Consequently, the short chain fatty acid, sodium propionate (NaPo), enhanced IL-4 expression, but exogenous IL-2 or pan-caspase inhibition prevented IL-4 expression. In children with endoscopically and histologically confirmed non-inflammatory bowel disease and non-infectious pediatric idiopathic colitis, the presence of TGF-β, NaPo, and IL-1β or TNF-α promoted TC2 differentiation in vitro. In vivo, colonic mucosa of children with colitis had significantly increased expression of IL-4 in CD8+ T cells compared with controls. In addition, activated caspase-3 and IL-4 were co-expressed in CD8+ T cells in the colonic mucosa of children with colitis. Thus, in the context of colonic inflammation and limited IL-2 signaling, CD8+ T cells differentiate into non-classic TC2 that may contribute to the pathology of inflammatory/allergic diseases in children. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Rigid esophagoscopy is performed less frequently by resident trainees. Nonetheless, it remains important for certain indications, including foreign body extraction. This study describes the construction of a simulator and evaluates its utility in training residents.Study Design: Simulator development, fabrication, and procedural evaluation of postgraduate trainees.Methods: A simulator was developed and constructed in collaboration with a biomedical engineering team. Residents with varied experience in upper aerodigestive procedures performed rigid esophagoscopy on the model. Key steps and Accreditation Council for Graduate Medical Education's Objective Structured Assessment of Technical Skills (OSATS) criteria for rigid esophagoscopy were evaluated by a faculty surgeon. Pressure measurements were obtained from force sensors at the tip of the endoscope and incisors.Results: Fourteen trainees were evaluated. Operative rigid esophagoscopy and direct laryngoscopy case numbers were noted for each subject. OSATS scores and key steps of the procedure correlated with resident experience (R(2)  = 0.75, P < .0001 and R(2)  = 0.66, P < .001, respectively). Maximal pressure exerted on the simulator esophagus by the esophagoscope was inversely correlated with case number and was statistically significant (R(2)  = 0.51, P = .02), whereas length of procedure did not correlate (R(2)  = 0.04, P = .49). Maximal pressure on the incisors did not correlate (R(2)  = 0.25, P = .15).Conclusions: A simulator for training residents to perform rigid esophagoscopy was developed and utilized by a faculty proctor to objectively evaluate trainees. OSATS scores, performance of key procedural steps, and pressure exerted on the simulator tissue correlated with upper aerodigestive cases performed, demonstrating validity of the simulator.Level Of Evidence: NA Laryngoscope, 126:616-619, 2016. [ABSTRACT FROM AUTHOR]

Tidal power is pollution-free renewable energy and an effective way to reduce coal consumption and guarantee normal social electricity consumption in China. Bidirectional bulb turbine is widely used in tidal power station. Scholars at home and abroad have carried out extensive researches in bidirectional tubular turbine in terms of internal blade clearance flow, the occurrence and location of cavitation and blade airfoil optimization .Scholars in China firstly put forward improving the operating efficiency of the bidirectional tubular turbine under the reverse working condition by means of setting rear guide vanes. In order to solve the low efficiency problem under the reverse condition in bidirectional bulb turbine, how blade tail affected the units' hydraulic performance under reverse working condition by studying bade tails of different shapes and different thickness on the basis of a bidirectional bulb turbine unit with rear vanes was analyzed. The profile of computational domain was built with modeling software UG and the grid division was done with software ICEM, also the grid independence verification for runner parts was conducted. Based on the CFX software, the SST turbulence model was adopted to conduct numerical simulation on runners with blade tails of different shapes and thickness. Results showed, under reverse conditions, the efficiency of the units with circular blade tail was 59.55%, which was higher than 58.4% and 58.01% of units with rectangular and arched tailing edge respectively, indicating that the impact loss of runner with rectangular tail and curved tail was bigger. Moreover, increasing the thickness of the blade tail could improve the efficiency of the turbine relatively obvious under the reverse condition, and the efficiency could reach at 79%, but the method no longer worked when the blade tail thickness increased to a certain degree. The increase of the tail thickness changed pressure distribution on the blade suction surface, and the minimum pressure value reduced by 1 200 000 Pa under reverse condition on the blade tail, which greatly affected the cavitation performance under the reverse condition. Increasing the thickness of blade tail caused squeezing action to the passage channel, which increased the positive condition efficiency but the effect was not obvious. However, the increase of blade's tail thickness decreased the frequency of the Karman vortex at the tail outlet under positive conditions, as the frequency of the unit components was usually low frequency, the probability of the occurrence of Karman vortices on positive condition was increased. The results showed that compared with rectangular blade tail and arched blade tail, the unit with circular blade tail performed the best under reversal conditions. We can conclude that in order to improve the units efficiency under the reverse condition, thickness of blade tail can be appropriately increased. But that could been donein the premise of ensuring Karman vortices resonance wouldn't occur with other components of the unit under positive conditions. The research results provided references for optimization design of blade tail shape under the reverse condition in bidirectional turbine. [ABSTRACT FROM AUTHOR]