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Background Studies performed to calculate metabolic rate in stroke patients have conflicting results. The indirect calorimetry is the gold standard in measuring resting energy expenditure. We compared the intensive care unit (ICU) mortality and outcome in stroke patients receiving enteral nutrition based on energy requirement calculated by either indirect calorimetry or standard weight-based formula.

For antinuclear antibody (ANA) screening, the gold standard method is an indirect immunofluorescence assay (IIFA) using HEp-2 cells, and a serial dilution test is needed to determine the endpoint titer. We aimed to evaluate the accuracy of the estimated endpoint titer (eEPT) by the NOVA View system, by comparing it with the EPT by the serial dilution method (dEPT). The endpoint titers of a total of 1518 ANA positive cases with five major patterns including speckled, homogeneous, centromere, nucleolar, and nuclear dots patterns were determined using both the estimation function and the serial dilution method by the NOVA View system. A significant correlation between the light intensity unit (LIU) values and dEPTs was identified in all five patterns with high ρ values, ranging from 0.666 to 0.832. However, the overall exact match rate between dEPT and eEPT was 22.1% (336/1518), with the ±one-titer match rate being highest in the centromere pattern (62.8%, 81/129), and lowest in the homogeneous pattern (37.6%, 200/532). This suggests that while LIU values correlate well with dEPT, there are discrepancies in numerical agreement. Most cases that did not show an exact match, showed one-to-three-titer overestimations by eEPT. Therefore, adjusting eEPT downward significantly improved the concordance rates with dEPTs. Further investigation for an appropriate cutoff of LIU values for determining eEPT should be performed for clinical application and contribution to the standardization of the ANA titer. [ABSTRACT FROM AUTHOR]

As the world's transport infrastructure ages, the importance of bridge condition monitoring is becoming increasingly acknowledged. Large-scale deployment of existing inspection and monitoring techniques is infeasible due to cost and logistical challenges. The concept of using sensors located within vehicles for low cost 'drive-by' monitoring has become the focus of much attention in recent years. This paper presents a new data-driven approach for drive-by bridge monitoring. Machine learning techniques are leveraged to allow the influence of vehicle speed to be considered and the Operating Deflection Shape Ratio (ODSR) is presented as an alternative damage-sensitive feature to the commonly used frequency spectrum. Extensive laboratory experiments demonstrate that the method is capable of detecting midspan cracking and seized bearings. A statistical classification approach is adopted to classify damage indicators as either 'damaged' or 'healthy'. Classification accuracy is seen to vary between 65-96% and is similar whether using the frequency spectrum or ODSR. Based on the results of the laboratory testing, it is expected that this approach could be implemented on a large scale to act as an early warning tool for infrastructure owners to identify bridges presenting signs of distress or deterioration. [ABSTRACT FROM AUTHOR]

Background Studies performed to calculate metabolic rate in stroke patients have conflicting results. The indirect calorimetry is the gold standard in measuring resting energy expenditure. We compared the intensive care unit (ICU) mortality and outcome in stroke patients receiving enteral nutrition based on energy requirement calculated by either indirect calorimetry or standard weight-based formula. Methods Twenty ischemic stroke patients of older than 40 years requiring greater than 2 days of mechanical ventilation were prospectively enrolled. Demographic data, Glasgow Coma Scale (GCS), Canadian Neurological Scale, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were obtained. Patients were randomized to receive enteral nutrition based on energy requirement calculated either by indirect calorimeter (group REE IC) or by standard weight-based measurements (group REE ST). Daily ventilatory parameters, Sequential Organ Failure Assessment (SOFA) score, and blood parameters were noted. The ICU mortality/duration of stay/complication and duration of hospital stay were compared. Patient outcome at discharge was assessed using modified Rankin scale (MRS). Results Baseline characteristics were comparable. There were no ICU deaths in group REE IC. Patients in group REE IC had significantly (p < 0.01) more resting energy requirement and less maximum negative energy balance than those in group REE ST. The SOFA score at days 5, 7, and 9 and the total leukocyte count (TLC) at day 5 were higher in group REE ST. The duration of mechanical ventilation, ICU stay/complications, duration of hospital stay, and MRS at discharge were comparable. Conclusion Ischemic stroke patients receiving indirect calorimetry–guided enteral nutrition had lesser incidence of organ failure but similar ICU stay and mortality and neurological outcome as compared with those receiving standard weight-based enteral nutrition. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the fracture resistance of endodontically treated maxillary teeth using the same material as indirect and direct composite onlays and their modes of fracture. Methods: Ninety maxillary premolars were divided into six groups (n = 15) out of which 15 teeth were kept intact (negative control, Group 1). In the remaining 75 teeth, endodontic treatment was done and standardized mesio-occlusal-distal cavities were prepared. Fifteen teeth were kept unrestored (positive control, Group 2). The rest of the teeth were divided according to the type of restorations and the restorative material; Group 3: Ceram X sphereTEC™ one direct composite onlay, Group 4: Ceram X sphereTEC™ one indirect composite onlay, Group 5: Filtek Z 350 XT direct composite onlay, and Group 6: Filtek Z 350 XT indirect composite onlay. All the specimens were subjected to thermocycling and cyclic loading. The fracture resistance test was performed with the help of a universal testing machine and their modes of fracture were evaluated. Results: Mean fracture resistance values in the decreasing order are as: 1487.33N for Group 6, 1104.57N for Group 4, 933.87N for Group 1, 799.13N for Group 5, and 688.73N for Group 3, 265.23N for Group 2. Mean fracture resistance of Groups 6 and 4 was found to be significantly higher than Groups 1, 2, 3, and 5. Furthermore, there was a significant difference between Groups 1 and 3. Groups 1, 3, 4, 5, and 6 showed more number of favorable/restorable fractures, whereas Group 2 showed more unfavorable/unrestorable fracture. Conclusion: The indirect technique of fabrication of onlays improved the fracture resistance of endodontically treated maxillary premolars.

The reachable set of controlled dynamical systems is the set of all reachable states from an initial condition over a certain time horizon, subject to operational constraints and exogenous disturbances. In astrodynamics, rapid approximation of reachable sets is invaluable for trajectory planning, collision avoidance, and ensuring safe and optimal performance in complex dynamics. Leveraging the connection between minimum-time trajectories and the boundary of reachable sets, we propose a sampling-based method for rapid and efficient approximation of reachable sets for finite- and low-thrust spacecraft. The proposed method combines a minimum-time multi-stage indirect formulation with the celebrated primer vector theory. Reachable sets are generated under two-body and circular restricted three-body (CR3B) dynamics. For the two-body dynamics, reachable sets are generated for (1) the heliocentric phase of a benchmark Earth-to-Mars problem, (2) two scenarios with uncertainties in the initial position and velocity of the spacecraft at the time of departure from Earth, and (3) a scenario with a bounded single impulse at the time of departure from Earth. For the CR3B dynamics, several cislunar applications are considered, including L1 Halo orbit, L2 Halo orbit, and Lunar Gateway 9:2 NRHO. The results indicate that low-thrust spacecraft reachable sets coincide with invariant manifolds existing in multi-body dynamical environments. The proposed method serves as a valuable tool for qualitatively analyzing the evolution of reachable sets under complex dynamics, which would otherwise be either incoherent with existing grid-based reachability approaches or computationally intractable with a complete Hamilton–Jacobi–Bellman method. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the fracture resistance of endodontically treated maxillary teeth using the same material as indirect and direct composite onlays and their modes of fracture. Methods: Ninety maxillary premolars were divided into six groups ( n = 15) out of which 15 teeth were kept intact (negative control, Group 1). In the remaining 75 teeth, endodontic treatment was done and standardized mesio-occlusal-distal cavities were prepared. Fifteen teeth were kept unrestored (positive control, Group 2). The rest of the teeth were divided according to the type of restorations and the restorative material; Group 3: Ceram X sphereTEC™ one direct composite onlay, Group 4: Ceram X sphereTEC™ one indirect composite onlay, Group 5: Filtek Z 350 XT direct composite onlay, and Group 6: Filtek Z 350 XT indirect composite onlay. All the specimens were subjected to thermocycling and cyclic loading. The fracture resistance test was performed with the help of a universal testing machine and their modes of fracture were evaluated. Results: Mean fracture resistance values in the decreasing order are as: 1487.33N for Group 6, 1104.57N for Group 4, 933.87N for Group 1, 799.13N for Group 5, and 688.73N for Group 3, 265.23N for Group 2. Mean fracture resistance of Groups 6 and 4 was found to be significantly higher than Groups 1, 2, 3, and 5. Furthermore, there was a significant difference between Groups 1 and 3. Groups 1, 3, 4, 5, and 6 showed more number of favorable/restorable fractures, whereas Group 2 showed more unfavorable/unrestorable fracture. Conclusion: The indirect technique of fabrication of onlays improved the fracture resistance of endodontically treated maxillary premolars. [ABSTRACT FROM AUTHOR]

Solar energy has become an energy source for a wide range of uses, including in solar cookers, due to its availability, cleanliness, environmental friendliness, and sustainability. In this study, an indirect solar cooker was investigated by measuring its thermal performance using a Graphene Oxide (GO) nanofluid. Water, GO (250 ppm)-water, and GO (500 ppm)-water were used as heat transfer fluids. The experimental set-up consisted of the cooking part and a solar collector, which are the two essential elements in indirect solar cookers. The cooking part was a wooden box solar cooker, and the parabolic trough solar collector was a polished stainless steel structure. The solar cooker was assessed using the stagnation test and load test as well as energy and exergy measurements. According to the test results, the averaged F1 was 0.1 for the base fluid water, 0.11 for GO (250 ppm)-water, and 0.13 for GO (500 ppm)-water. In addition, using a GO nanofluid instead of water in the solar cooker, the system's thermal performance, energy, and exergy efficiency were improved. The use of the GO (250 ppm)-water and GO (500 ppm)-water nanofluids instead of water in the system improved the overall energy efficiency of the system by 3.3 and 4.2%. Moreover, using GO (500 ppm)-water allowed for achieving superior performance. [ABSTRACT FROM AUTHOR]

This study proposes the new condition monitoring concept of using features in the measured rotation, or 'pitch' signal, of a crossing vehicle as an indicator of the presence of foundation scour in a bridge. The concept is explored through two-dimensional vehicle–bridge interaction modelling, with a reduction in stiffness under a pier used to represent the effects of scour. A train consisting of three 10-degree-of-freedom carriages cross the model on a profiled train track, each train varying slightly in terms of mass and velocity. An analysis of the pitch of the train carriages can clearly identify when scour is present. The concept is further tested in a scaled laboratory experiment consisting of a tractor–trailer crossing a four-span simply supported bridge on piers. The foundation support is represented by four springs under each pier, which can be replaced with springs of a reduced stiffness to mimic the effect of scour. The laboratory model also consistently shows a divergence in vehicle pitch between healthy and scoured bridge states. [ABSTRACT FROM AUTHOR]

Objectives: Systemic arterial hypertension is a common occurrence and can have serious adverse consequences in cats. Therefore, measuring blood pressure is very important. There are many indirect blood pressure measurement devices available. This study compared Doppler, oscillometric (petMAP Graphic II, SunTech Vet20, the Cardell Insight-X0000) and high-definition oscillometry devices for the non-invasive measurement of blood pressure in conscious cats. Methods: In this prospective study, blood pressure was measured in 32 cats using the different devices according to the recommendations of the American College of Veterinary Internal Medicine Consensus Statement. Blood pressures (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP]), time to complete measurements, number of attempts needed, coefficient of variation (CV) between the blood pressure measurements of the different devices, ease of completing measurements and apparent stress level of the cat were assessed. Results: There was a significant difference between devices in the time taken to obtain blood pressure readings and the number of attempts necessary to obtain six reliable measurements. The CV of the Doppler device was significantly smaller than that of the rest of the devices, but there were no other differences between the devices. The mean SBP, DBP and MAP measured by the petMAP device were significantly higher than the measurements from the other devices. The perceived ease of measurement was not significantly different between the various machines. The perceived level of stress of measurement with the Doppler device was significantly higher compared with the other devices but did not lead to an increased SBP. Conclusions and relevance: Using a Doppler device to measure blood pressure in conscious cats is fast, relatively easy and gives reliable results. A disadvantage is that the Doppler device can only measure SBP, while oscillometric devices also provide DBP and MAP. However, in veterinary medicine, systolic hypertension is considered the most relevant. [ABSTRACT FROM AUTHOR]

ObjectivesA perception derived from cross-sectional studies of small systemic lupus erythematosus (SLE) cohorts is that there is a marked discrepancy between antinuclear antibody (ANA) assays, which impacts on clinicians' approach to diagnosis and follow-up. We compared three ANA assays in a longitudinal analysis of a large international incident SLE cohort retested regularly and followed for 5 years.MethodsDemographic, clinical and serological data was from 805 SLE patients at enrolment, year 3 and 5. Two HEp-2 indirect immunofluorescence assays (IFA1, IFA2), an ANA ELISA, and SLE-related autoantibodies were performed in one laboratory. Frequencies of positivity, titres or absorbance units (AU), and IFA patterns were compared using McNemar, Wilcoxon and kappa statistics, respectively.ResultsAt enrolment, ANA positivity (≥1:80) was 96.1% by IFA1 (median titre 1:1280 (IQR 1:640-1:5120)), 98.3% by IFA2 (1:2560 (IQR 1:640-1:5120)) and 96.6% by ELISA (176.3 AU (IQR 106.4 AU-203.5 AU)). At least one ANA assay was positive for 99.6% of patients at enrolment. At year 5, ANA positivity by IFAs (IFA1 95.2%; IFA2 98.9%) remained high, while there was a decrease in ELISA positivity (91.3%, p91% agreement in ANA positivity at all time points and ≥71% agreement in IFA patterns between IFA1 and IFA2.ConclusionIn recent-onset SLE, three ANA assays demonstrated commutability with a high proportion of positivity and titres or AU. However, over 5 years follow-up, there was modest variation in ANA assay performance. In clinical situations where the SLE diagnosis is being considered, a negative test by either the ELISA or HEp-2 IFA may require reflex testing.

This research aimed to create an innovative digital-android learning media product tailored for students and teachers, integrating direct and indirect assistance approaches, jigsaw methods, and design elements in written, visual, and audio-visual formats. Following the Research and Development methodology, the Borg and Gall development research model was the guiding framework, encompassing ten meticulous stages. Preliminary Research (Data Collection and Analysis): The initial phase involved extensive data collection and analysis to identify critical components for effective learning media. Media Planning and Analysis: A comprehensive plan for the learning media was formulated, incorporating direct and indirect assistance strategies, jigsaw methods, and multimedia design principles. Product Development: The creation of learning media commenced, with validation sought from media and subject matter experts to ensure quality and relevance. Small-Group Trials: 1) Preliminary Research (data collection and analysis). 2) Make a plan and an analysis of the media to be produced. 3) Product development begins with the creation of learning media and is validated by media and material experts. 4) Run small-group trials. 5) Product Improvement. 6) Carry out field trials. 7) Go over the final product again. 8) Evaluate the product's effectiveness using data from gymnastics skill tests in experimental and control classes. The assessment results up to the third revision stage revealed positive criteria, with an average score of 4.33 for both theoretical and practical materials. The learning media scored 4.67, indicating a "very good" category. Subsequent field trials demonstrated a significant improvement in gymnastics skills in the experimental class compared to the control class, with a mean value of 76.37 (experiment) surpassing 64.28 (control). [ABSTRACT FROM AUTHOR]

Aim: This study aimed to compare the estimated and measured resting metabolic rates of patients with type 1 and type 2 diabetes mellitus in an outpatient clinical setting. Material and methods: Participants were categorized into three groups that included type 1 diabetes, type 2 diabetes, and individuals without diabetes. Bland–Altman analysis was used to identify the equation that most accurately predicted the measured resting metabolic rates. Multiple regression analysis was used to identify the factors affecting resting metabolic rates. Results: Resting metabolic rates was observed to be higher in subjects with type 2 diabetes compared to that of the other groups. There was a proportional bias between predicted and measured resting metabolic rates. Type 1 diabetes, type 2 diabetes, male sex, body weight, waist circumference, and triglyceride level were factors that positively predicted resting metabolic rates, and age was a factor that negatively predicted it. Conclusions: Although there was a bias between estimated and measured RMR, the most accurate results were achieved with the Mifflin–St Jeor equation for women with type 1 diabetes, with the Owen equation for men with type 1 diabetes, with the Harris Benedict equation for women with type 2 diabetes, and with the Ikeda equation for men with type 2 diabetes as well as for women and men in the control group.

Indirect immunofluorescence is usually restricted to 3-5 markers per preparation, limiting analysis of coexistence. A solution containing 2-mercaptoethanol and sodium dodecyl sulfate (2-ME/SDS) can elute indirect immunofluorescence labelling (i.e. primary antisera followed by fluorophore-conjugated secondary antisera) and has been used for sequential staining of sections. The aim of this study was to test whether 2-ME/SDS is effective for eluting indirect immunofluorescent staining (with primary antisera visualised by fluorophore-coupled secondary antisera) in wholemount preparations. We also analysed how 2-ME/SDS may work and used this understanding to devise additional uses for immunofluorescence in the nervous system. 2-ME/SDS appears to denature unfixed proteins (including antisera used as reagents) but has much less effect on antigenicity of formaldehyde-fixed epitopes. Moieties linked by strong biotin-streptavidin bonds are highly resistant to elution by 2-ME/SDS. Two primary antisera raised in the same species can be applied without spurious cross-reactivity, if a specific order of labelling is followed. The first primary antiserum is followed by a biotinylated secondary, then a tertiary of fluorophore-conjugated streptavidin. The preparation is then exposed to 2-ME/SDS, which has minimal impact on labelling by the first primary/secondary/tertiary combination. However, when this is followed by a second primary antiserum (raised in the same species), followed by a fluorophore-conjugated secondary antiserum, the intervening 2-ME/SDS exposure prevents cross-reactivity between primary and secondary antisera of the two layers. A third property of 2-ME/SDS is that it reduces lipofuscin autofluorescence, although it also raises background fluorescence and strongly enhances autofluorescence of erythrocytes. In summary, 2-ME/SDS is easy to use, cost-effective and does not require modified primary antisera. It can be used as the basis of a multi-layer immunohistochemistry protocol and allows 2 primary antisera raised in the same species to be used together.

We investigated the indirect puncture method using a novel arc puncture-guided device in percutaneous transforaminal puncture to improve puncture accuracy and reduce the fluoroscopy, puncture, and operation times. We have designed a novel arc puncture-guided device consisting of a 90° arc block and a 30° arc block. Punctures were performed on 8 fresh goat lumbar spine specimens. A senior doctor performed indirect punctures on the left side of the L2-L3, L3-L4, and L4-L5 levels using the novel device (group A) and on the right side of the L2-L3, L3-L4, and L4-L5 levels using the conventional method (group B). We recorded the fluoroscopy, puncture, and operation times. In group A, the first puncture could successfully reach the target after 1–3 punctures, and the one-time success rate of the second needle puncture was 91.67%. The total fluoroscopy time was 14.88 ± 0.99 minutes in group A and 16.08 ± 2.22 minutes in group B (P = 0.027). The puncture times were 3.00 ± 0.66 minutes in group A and 6.04 ± 2.13 minutes in group B (P < 0.01). The operation time was 273.75 ± 30.19 minutes in group A and 361.25 ± 69.57 minutes in group B (P < 0.01). The differences in fluoroscopy times, puncture times, and operation times between the 2 groups were statistically significantly (P < 0.05). Indirect puncture using the novel arc puncture-guided device for percutaneous transforaminal puncture can significantly improve puncture accuracy and reduce the fluoroscopy, puncture, and operation times. Indirect puncture using the novel device in percutaneous transforaminal endoscopic discectomy is a potential and practical puncture method. [ABSTRACT FROM AUTHOR]

The doubly labeled water (DLW) method measures total energy expenditure (TEE) in free-living subjects. Several equations are used to convert isotopic data into TEE. Using the International Atomic Energy Agency (IAEA) DLW database (5,756 measurements of adults and children), we show considerable variability is introduced by different equations. The estimated rCO2 is sensitive to the dilution space ratio (DSR) of the two isotopes. Based on performance in validation studies, we propose a new equation based on a new estimate of the mean DSR. The DSR is lower at low body masses (

The reachable set of controlled dynamical systems is the set of all reachable states from an initial condition over a certain time horizon, subject to operational constraints and exogenous disturbances. In astrodynamics, rapid approximation of reachable sets is invaluable for trajectory planning, collision avoidance, and ensuring safe and optimal performance in complex dynamics. Leveraging the connection between minimum-time trajectories and the boundary of reachable sets, we propose a sampling-based method for rapid and efficient approximation of reachable sets for finite- and low-thrust spacecraft. The proposed method combines a minimum-time multi-stage indirect formulation with the celebrated primer vector theory. Reachable sets are generated under two-body and circular restricted three-body (CR3B) dynamics. For the two-body dynamics, reachable sets are generated for (1) the heliocentric phase of a benchmark Earth-to-Mars problem, (2) two scenarios with uncertainties in the initial position and velocity of the spacecraft at the time of departure from Earth, and (3) a scenario with a bounded single impulse at the time of departure from Earth. For the CR3B dynamics, several cislunar applications are considered, including L1 Halo orbit, L2 Halo orbit, and Lunar Gateway 9:2 NRHO. The results indicate that low-thrust spacecraft reachable sets coincide with invariant manifolds existing in multi-body dynamical environments. The proposed method serves as a valuable tool for qualitatively analyzing the evolution of reachable sets under complex dynamics, which would otherwise be either incoherent with existing grid-based reachability approaches or computationally intractable with a complete Hamilton–Jacobi–Bellman method.

This study proposes the new condition monitoring concept of using features in the measured rotation, or ‘pitch’ signal, of a crossing vehicle as an indicator of the presence of foundation scour in a bridge. The concept is explored through two-dimensional vehicle–bridge interaction modelling, with a reduction in stiffness under a pier used to represent the effects of scour. A train consisting of three 10-degree-of-freedom carriages cross the model on a profiled train track, each train varying slightly in terms of mass and velocity. An analysis of the pitch of the train carriages can clearly identify when scour is present. The concept is further tested in a scaled laboratory experiment consisting of a tractor–trailer crossing a four-span simply supported bridge on piers. The foundation support is represented by four springs under each pier, which can be replaced with springs of a reduced stiffness to mimic the effect of scour. The laboratory model also consistently shows a divergence in vehicle pitch between healthy and scoured bridge states.

It is the aim of this paper to present data on the survival of direct and indirect restorations in anterior teeth. Two sources of information are used: previously-published analysis of data from 1990 to 2006 from a 13 million restoration dataset from England and Wales; and evidence from published literature from 2011 to the time of writing (March 2022). The findings suggest that: (1) directly-placed resin composite materials may provide satisfactory survival of restorations in anterior teeth; (2) crowns provide better survival to re-intervention: however, crowning an incisor or canine tooth, as opposed to placement of a direct restoration, will lead to an earlier time to extraction of the restored tooth; (3) veneers perform more favourably than other restorations in terms of time to extraction of the restored tooth, but may have a less favourable time to re-intervention than crowns; (4) lithium disilicate crowns may be considered to perform satisfactorily with regard to time to re-intervention when placed in anterior teeth, but less satisfactorily in posterior teeth; and (5) operator factors influence survival of restorations. [ABSTRACT FROM AUTHOR]

Maintaining a healthy body weight requires an exquisite balance between energy intake and energy expenditure. To understand the genetic and environmental factors that contribute to the regulation of body weight, an important first step is to establish the normal range of metabolic values and primary sources contributing to variability. Energy metabolism is measured by powerful and sensitive indirect calorimetry devices. Analysis of nearly 10,000 wild-type mice from two large-scale experiments revealed that the largest variation in energy expenditure is due to body composition, ambient temperature, and institutional site of experimentation. We also analyze variation in 2329 knockout strains and establish a reference for the magnitude of metabolic changes. Based on these findings, we provide suggestions for how best to design and conduct energy balance experiments in rodents. These recommendations will move us closer to the goal of a centralized physiological repository to foster transparency, rigor and reproducibility in metabolic physiology experimentation.

Mesenchymal stem cells (MSCs) exhibit beneficial effects on autoimmune dacryoadenitis. However, the underlying mechanisms are not fully understood. In this study, we investigated the therapeutic effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) on rabbit autoimmune dacryoadenitis, an animal model of Sjögrens syndrome (SS) dry eye, and explored whether the effects of MSCs were related to their modulation on macrophage polarization. We have showed that systemic infusion of hUC-MSCs after disease onset efficiently diminished the chronic inflammation in diseased LGs and improved the clinical symptoms. Further analysis revealed that hUC-MSC treatment significantly inhibited the expression of pro-inflammatory M1 macrophage markers iNOS, TNF-α and IL-6, and promoted the expression of anti-inflammatory M2 macrophage markers Arg1, CD206, IL-10, IL-4 and TGF-β in LGs. Mechanistically, hUC-MSCs activated AKT pathway in macrophages, resulting in upregulation of M2-associated molecule Arg1, which was partly abolished by PI3K inhibitor, LY294002. Together, our data indicated that hUC-MSCs can skew macrophages into an M2 phenotype via affecting AKT pathway. These data may provide a new insight into the mechanisms of hUC-MSCs in the therapy of SS dry eye.

It has been suggested that beige fat thermogenesis is tightly controlled by epigenetic regulators that sense environmental cues such as temperature. Here, we report that subcutaneous adipose expression of the DNA demethylase TET1 is suppressed by cold and other stimulators of beige adipocyte thermogenesis. TET1 acts as an autonomous repressor of key thermogenic genes, including Ucp1 and Ppargc1a, in beige adipocytes. Adipose-selective Tet1 knockout mice generated by using Fabp4-Cre improves cold tolerance and increases energy expenditure and protects against diet-induced obesity and insulin resistance. Moreover, the suppressive role of TET1 in the thermogenic gene regulation of beige adipocytes is largely DNA demethylase-independent. Rather, TET1 coordinates with HDAC1 to mediate the epigenetic changes to suppress thermogenic gene transcription. Taken together, TET1 is a potent beige-selective epigenetic breaker of the thermogenic gene program. Our findings may lead to a therapeutic strategy to increase energy expenditure in obesity and related metabolic disorders.

Abstract Background Globally, foodborne diseases result in a significant disease burden with low- and middle-income countries disproportionately affected. Estimates of healthcare costs related to foodborne disease can aid decision makers to take action to mitigate risks and prevent illness. However, only limited data on the African continent are available, especially related to more severe sequelae. We provide estimates of direct and indirect (non)-medical costs of patients with diarrhoea, Guillain-Barré syndrome (GBS), and invasive non-typhoidal salmonellosis (iNTS) in three healthcare facilities in Gondar, Ethiopia. Methods We used healthcare data from patient records, interviews with family caregivers and 2020 healthcare resource unit costs. Descriptive statistical analysis was performed. For diarrhoea, differences in mean and median transformed costs between healthcare facilities and etiologies (Campylobacter spp., enterotoxigenic Escherichia coli, non-typhoidal Salmonella enterica) were analysed with ANOVA and chi squared tests. Contribution of healthcare facility, dehydration severity, sex, age and living area to transformed costs was identified with linear regression. Results are in 2020 USD per patient. To extrapolate to national level, 2017 national incidence estimates were used. Results Mean direct medical costs were 8.96 USD for diarrhoea (health centre 6.50 USD, specialised hospital 9.53 USD, private clinic 10.56 USD), 267.70 USD for GBS, and 47.79 USD for iNTS. Differences in costs between diarrhoea patients were mainly associated with healthcare facility. Most costs did not differ between etiologies. Total costs of a diarrhoea patient in the specialised hospital were 67 USD, or 8% of gross national income per capita. For direct medical plus transport costs of a GBS and iNTS patient in the specialised hospital, this was 33% and 8%, respectively. Of the 83.9 million USD estimated national non-typhoidal Salmonella enterica related cost, 12.2% was due to iNTS, and of 187.8 million USD related to Campylobacter spp., 0.2% was due to GBS. Conclusion Direct medical costs per patient due to GBS and iNTS were 30 respectively five times those due to diarrhoea. Costs of a patient with diarrhoea, GBS or iNTS can be a substantial part of a household’s income. More severe sequalae can add substantially to cost-of-illness of foodborne hazards causing diarrheal disease.

Solar desalination systems are a promising solution to the water scarcity problem since the majority of the earth's water resources are salty. With the increasing focus on desalination research, many innovative methods are being developed to extract salts from saline water. Energy consumption is a significant concern in desalination, and renewable energy, particularly solar energy, is considered a viable alternative to fossil fuel energy. In this review, we will focus on direct and indirect solar desalination methods, specifically traditional direct solar desalination methods such as solar still and humidification dehumidification (HDH) desalination systems. We will also briefly discuss a recent advancement in the desalination method known as the fogging process, which is a development of the HDH desalination system. [ABSTRACT FROM AUTHOR]

The objective is to evaluate the long-term clinical survival and performance of direct and indirect resin composite restorations replacing cusps in vital upper premolars. Between 2001 and 2007, 176 upper premolars in 157 patients were restored with 92 direct and 84 indirect resin composite restorations as part of an RCT. Inclusion criteria were fracture of the buccal or palatal cusp of vital upper premolars along with a class II cavity or restoration in the same tooth. Forty patients having 23 direct and 22 indirect composite restorations respectively, were lost to follow-up (25.6%). The cumulative Kaplan-Meier survival rates were 63.6% (mean observation time: 15.3 years, SE 5.6%) with an AFR of 2.4% for direct restorations and 54.5% (mean observation time: 13.9 years, SE: 6.4%) with an AFR of 3.3% for indirect restorations. The Cox regression analysis revealed a statistically significant influence of the patient's age at placement on the survival of the restoration (HR 1.036, p = 0.024), the variables gender, type of upper premolar, type of restoration, and which cusp involved in the restoration had no statistically significant influence. Direct composite restorations failed predominantly due to tooth fracture, indirect restorations primarily by adhesive failure (p < 0.05). There was no statistically significant difference in survival rates between direct and indirect composite cusp-replacing restorations. Both direct and indirect resin composite cusp-replacing restorations are suitable options to restore compromised premolars. The longer treatment time and higher costs for the indirect restoration argue in favor of the direct technique. [ABSTRACT FROM AUTHOR]

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ObjectiveThe spectrum of antinuclear antibodies (ANAs) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change is occurring in terminology to anticellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anticellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort.MethodsAnticellular antibodies were detected by IIF on HEp-2000 substrate using the baseline serum. Three serologic subsets were examined: ANA positive (presence of either nuclear or mixed nuclear/CMP staining), anticellular antibody negative (absence of any intracellular staining), and isolated CMP staining. The odds of being anticellular antibody negative versus ANA or isolated CMP positive was assessed by multivariable analysis.ResultsA total of 1,137 patients were included; 1,049 (92.3%) were ANA positive, 71 (6.2%) were anticellular antibody negative, and 17 (1.5%) had an isolated CMP. The isolated CMP-positive group did not differ from the ANA-positive or anticellular antibody-negative groups in clinical, demographic, or serologic features. Patients who were older (odds ratio [OR] 1.02 [95% confidence interval (95% CI) 1.00, 1.04]), of white race/ethnicity (OR 3.53 [95% CI 1.77, 7.03]), or receiving high-dose glucocorticoids at or prior to enrollment (OR 2.39 [95% CI 1.39, 4.12]) were more likely to be anticellular antibody negative. Patients on immunosuppressants (OR 0.35 [95% CI 0.19, 0.64]) or with anti-SSA/Ro 60 (OR 0.41 [95% CI 0.23, 0.74]) or anti-U1 RNP (OR 0.43 [95% CI 0.20, 0.93]) were less likely to be anticellular antibody negative.ConclusionIn newly diagnosed systemic lupus erythematosus, 6.2% of patients were anticellular antibody negative, and 1.5% had an isolated CMP. The prevalence of anticellular antibody-negative systemic lupus erythematosus will likely decrease as emerging nomenclature guidelines recommend that non-nuclear patterns should also be reported as a positive ANA.

Human RPE cell lines, especially the ARPE-19 cell line, are widely-used in eye research, as well as general epithelial cell studies. In comparison with primary RPE cells, they offer relative convenience and consistency, but cultures derived from these lines are typically not well differentiated. We describe a simple, rapid method to establish cultures from ARPE-19 cells, with significantly improved epithelial cell morphology and cytoskeletal organization, and RPE-related functions. We identify the presence of nicotinamide, a member of the vitamin B family, as an essential factor in promoting the observed differentiation, indicating the importance of metabolism in RPE cell differentiation.

Aim: To compare the shear bond strength and adhesive remnant index of a new indirect bonding isolation method for different adhesive systems with the direct bonding technique. Methods: 100 premolar and 10 centrally extracted human teeth were bonded with one direct and four indirect bonding methods, and then subjected to 1000 thermal cycles between 5°C and 55°C. ARI was analyzed by the chi-square test. The Shear Bond strength was analyzed by the analysis of variance (ANOVA) and the Tukey multiple comparison (HSD) test. The bracket-enamel interface area of two teeth from each group was examined under SEM. Results: All groups provided clinically acceptable bond strengths. In the traditional isolation + light-cured bonding group with the highest bonding values identified, the scores for all failures were recorded as 3 and this group differs from all other groups in respect of ARI scores (p

Copyright of Journal of Anbar University for Languages & Literature / Magallat Gami'at Al-Anbar Li-Lugat Wa-al-Adabl is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Microscopic examination of sputum using the Ziehl-Neelsen stain is the gold standard for Tuberculosis (TB), but it must be performed by experts with special skills. The purpose of this study is to accelerate the determination of the microscopic results using the Ziehl-Neelsen stain. This research is an experimental method in which the test sample is treated and the sputum sample is controlled with up to 25 samples. The method development is very important to increase the sensitivity and specificity of the results of TB examination using microscopes. This observation shows that the indirect cytospin method has a narrower reading range on a circle with a diameter of only 7 mm, making it easier for a bacterial count compared to the traditional direct method with a size of 2 x 3 cm oval shape. The results of the microscopic examination were 21 positive specimens and 4 negative specimens. Mycobacterium tuberculosis with Ziehl-Neelsen staining gave the same results with a sensitivity and specificity of 100%.

We studied the role of sodium/proton exchanger 8 (NHE8) in retinal pigment epithelium (RPE) and photoreceptor cells of adult mouse retina by using the clustered regularly interspaced short palindromic repeats (CRISPR)-associated endonuclease (Cas)9 from Neisseria meningitidis (Nm). Specific single guide RNAs (sgRNAs) were designed to knockdown the Slc9a8 gene, which encodes the NHE8. Nuclease null NmCas9 and sgRNAs were packaged respectively using adeno-associated viral vector (AAV), and delivered into mouse eyes in vivo by subretinal injection on wild-type mice of about four-week-old when mouse retina is fully developed. Eye samples were collected four weeks after injection for phenotype examination. Real-time PCR analysis demonstrated ∼38% reduction of NHE8 transcripts in retinas injected with AAV-knockdown sgRNA and AAV-Cas9. Loss of photoreceptor cells was found in eyes injected with AAV-knockdown sgRNA and AAV-Cas9 under either the human rhodopsin promoter or the minimal chicken β-actin promoter, while normal morphology was observed in control eyes injected with AAV-Cas9 and AAV-control sgRNA; immunostaining data showed degenerating photoreceptor cells and RPE cells in eyes injected with knockdown sgRNA and Cas9 AAVs. We further determined that mutant M120K-NHE8 displayed altered intracellular pH regulation in human RPE and primary mouse RPE cells using genetically encoded pH sensor pHluorin and that primary cultured NHE8 mutant RPE cells showed different pH titration curves. These results indicate that NHE8 plays essential function in both RPE and photoreceptor cells. NHE8 dysfunction either in photoreceptor or RPE is sufficient to cause retinal degeneration in adult mice at any age.

The primary energy substrate of the lens is glucose and uptake of glucose from the aqueous humor is dependent on glucose transporters. GLUT1, the facilitated glucose transporter encoded by Slc2a1 is expressed in the epithelium of bovine, human and rat lenses. In the current study, we examined the expression of GLUT1 in the mouse lens and determined its role in maintaining lens transparency by studying effects of postnatal deletion of Slc2a1. In situ hybridization and immunofluorescence labeling were used to determine the expression and subcellular distribution of GLUT1 in the lens. Slc2a1 was knocked out of the lens epithelium by crossing transgenic mice expressing Cre recombinase under control of the GFAP promoter with Slc2a1loxP/loxP mice to generate Slc2a1loxP/loxP;GFAP-Cre+/0 (LensΔGlut1) mice. LensΔGlut1 mice developed visible lens opacities by around 3 months of age, which corresponded temporally with the total loss of detectable GLUT1 expression in the lens. Spectral domain optical coherence tomography (SD-OCT) imaging was used to monitor the formation of cataracts over time. SD-OCT imaging revealed that small nuclear cataracts were first apparent in the lenses of LensΔGlut1 mice beginning at about 2.7 months of age. Longitudinal SD-OCT imaging of LensΔGlut1 mice revealed disruption of mature secondary fiber cells after 3 months of age. Histological sections of eyes from LensΔGlut1 mice confirmed the disruption of the secondary fiber cells. The structural changes were most pronounced in fiber cells that had lost their organelles. In contrast, the histology of the lens epithelium in these mice appeared normal. Lactate and ATP were measured in lenses from LensΔGlut1 and control mice at 2 and 3 months of age. At 2 months of age, when GLUT1 was still detectable in the lens epithelium, albeit at low levels, the amount of lactate and ATP were not significantly different from controls. However, in lenses isolated from 3-month-old LensΔGlut1 mice, when GLUT1 was no longer detectable, levels of lactate and ATP were 50% lower than controls. Our findings demonstrate that in vivo, the transparency of mature lens fiber cells was dependent on glycolysis for ATP and the loss of GLUT1 transporters led to cataract formation. In contrast, lens epithelium and cortical fiber cells have mitochondria and could utilize other substrates to support their anabolic and catabolic needs.

PurposeTo investigate the roles of Aquaporin 0a (Aqp0a) and Aqp0b in zebrafish lens development and transparency.MethodsCRISPR/Cas9 gene editing was used to generate loss-of-function deletions in zebrafish aqp0a and/or aqp0b. Wild type (WT), single mutant, and double mutant lenses were analyzed from embryonic to adult stages. Lens transparency, morphology, and growth were assessed. Immunohistochemistry was used to map protein localization as well as to assess tissue organization and distribution of cell nuclei.Resultsaqp0a-/- and/or aqp0b-/- cause embryonic cataracts with variable penetrance. While lenses of single mutants of either gene recover transparency in juveniles, double mutants consistently form dense cataracts that persist in adults, indicating partially redundant functions. Double mutants also reveal redundant Aqp0 functions in lens growth. The nucleus of WT lenses moves from the anterior pole to the lens center with age. In aqp0a-/- mutants, the nucleus fails to centralize as it does in WT or aqp0b-/- lenses, and in double mutant lenses there is no consistent lens nuclear position. In addition, the anterior sutures of aqp0a-/-, but not aqp0b-/- mutants, are unstable resulting in failure of suture maintenance at older stages and anterior polar opacity. Conclusions. Zebrafish Aqp0s have partially redundant functions, but only Aqp0a promotes suture stability, which directs the lens nucleus to centralize, failure of which results in anterior polar opacity. These studies support the hypothesis that the two Aqp0s subfunctionalized during fish evolution and that Aqp0-dependent maintenance of the anterior suture is essential for lens transparency.

Myo/Nog cells, named for their expression of MyoD and noggin, enter the eye during early stages of embryonic development. Their release of noggin is critical for normal morphogenesis of the lens and retina. Myo/Nog cells are also present in adult eyes. Single nucleated skeletal muscle cells designated as myofibroblasts arise from Myo/Nog cells in cultures of lens tissue. In this report we document the presence of Myo/Nog cells in the lens, ciliary body and on the zonule of Zinn in mice, rabbits and humans. Myo/Nog cells were rare in all three structures. Their prevalence increased in the lens and ciliary body of rabbits 24 h following cataract surgery. Rabbits developed posterior capsule opacification (PCO) within one month of surgery. The number of Myo/Nog cells continued to be elevated in the lens and ciliary body. Myo/Nog cells containing alpha smooth muscle actin and striated muscle myosin were present on the posterior capsule and overlaid deformations in the capsule. Myo/Nog cells also were present on the zonule fibers and external surface of the posterior capsule. These findings suggest that Myo/Nog contribute to PCO and may use the zonule fibers to migrate between the ciliary processes and lens.

Purpose:We examined outer retinal remodeling of the euthermic and torpid cone-dominant 13-lined ground squirrel (13-LGS) retina using optical coherence tomography (OCT) imaging and histology. Methods:Retinas and corneas of living 13-LGSs were imaged during euthermic and torpid physiological states using OCT. Retinal layer thickness was measured at the visual streak from registered and averaged vertical B-scans. Following OCT, some retinas were collected immediately for postmortem histologic comparison using light microscopy, immunofluorescence, or transmission electron microscopy. Results:Compared to OCT images from euthermic retinae, OCT images of torpid retinae revealed significantly thicker inner and outer nuclear layers, as well as increases in the distances between outer retinal reflectivity bands 1 and 2, and bands 3 and 4. A significant decrease in the distance between bands 2 and 3 also was seen, alongside significant thinning of the choriocapillaris and choroid. OCT image quality was reduced in torpid eyes, partly due to significant thickening of the corneal stroma during this state. Conclusions:The torpid retina of the hibernating 13-LGS undergoes structural changes that can be detected by OCT imaging. Comparisons between in vivo OCT and ex vivo histomorphometry may offer insight to the origin of hyperreflective OCT bands within the outer retina of the cone-dominant 13-LGS.

The development of vaccines against malaria and serodiagnostic tests for detecting recent exposure requires tools for antigen discovery and suitable animal models. The protein microarray is a high-throughput, sample sparing technique, with applications in infectious disease research, clinical diagnostics, epidemiology, and vaccine development. We recently demonstrated Qdot-based indirect immunofluorescence together with portable optical imager ArrayCAM using single isotype detection could replicate data using the conventional laser confocal scanner system. We developed a multiplexing protocol for simultaneous detection of IgG, IgA, and IgM and compared samples from a controlled human malaria infection model with those from controlled malaria infections of Aotus nancymaae, a widely used non-human primate model of human malaria. IgG profiles showed the highest concordance in number of reactive antigens; thus, of the 139 antigens recognized by human IgG antibody, 111 were also recognized by Aotus monkeys. Interestingly, IgA profiles were largely non-overlapping. Finally, on the path toward wider deployment of the portable platform, we show excellent correlations between array data obtained in five independent laboratories around the United States using the multiplexing protocol (R2 : 0.60-0.92). This study supports the use of this platform for wider deployment, particularly in endemic areas where such a tool will have the greatest impact on global human health.

Purpose: To evaluate energy expenditure, energy intake, and nutrient adequacy of Indian junior soccer players. Method: Forty junior national-level soccer players (Under-12 and Under-16 age groups) were assessed for 3-day weighed food records and 3-day energy expenditure. Energy and nutrient intake was analyzed from food records, and energy expenditure was measured using a portable metabolic analyzer and activity records. Nutrient adequacy was determined by comparing intake with prevailing recommendations. Results: Players exhibited no significant difference between energy intake (boys = 3062 [340.9] and girls = 2243 [320.3] kcal·d−1) and expenditure (boys = 2875 [717.3] and girls = 2442 [350.3] kcal·d−1). Across age groups, the Under-12 boys showed positive energy balance as against energy deficits in Under-16. Girls showed energy deficits, although not significant. There were 58% of girls showing energy availability <30 kcal·kg−1 fat-free mass, of which 37% were Under-16 players. Carbohydrates contributed to >60% of energy expenditure among 95.2% boys and 73.7% girls. Among 52.4% boys and 47.4% girls, <25% of energy expenditure was contributed by fat. More than 95% players consumed <1 g·kg−1 carbohydrates pretraining and 100% of them consumed >1.2 g·kg−1 carbohydrates posttraining. Conclusion: Junior soccer players consumed more than recommended carbohydrates in the diet, although not aligning with the pretraining, during training, and posttraining meal requirements. Considering the energy deficits observed among Under-16 players, a suitable dietary modification is warranted. [ABSTRACT FROM AUTHOR]

Background: Globally, foodborne diseases result in a significant disease burden with low- and middle-income countries disproportionately affected. Estimates of healthcare costs related to foodborne disease can aid decision makers to take action to mitigate risks and prevent illness. However, only limited data on the African continent are available, especially related to more severe sequelae. We provide estimates of direct and indirect (non)-medical costs of patients with diarrhoea, Guillain-Barré syndrome (GBS), and invasive non-typhoidal salmonellosis (iNTS) in three healthcare facilities in Gondar, Ethiopia.Methods: We used healthcare data from patient records, interviews with family caregivers and 2020 healthcare resource unit costs. Descriptive statistical analysis was performed. For diarrhoea, differences in mean and median transformed costs between healthcare facilities and etiologies (Campylobacter spp., enterotoxigenic Escherichia coli, non-typhoidal Salmonella enterica) were analysed with ANOVA and chi squared tests. Contribution of healthcare facility, dehydration severity, sex, age and living area to transformed costs was identified with linear regression. Results are in 2020 USD per patient. To extrapolate to national level, 2017 national incidence estimates were used.Results: Mean direct medical costs were 8.96 USD for diarrhoea (health centre 6.50 USD, specialised hospital 9.53 USD, private clinic 10.56 USD), 267.70 USD for GBS, and 47.79 USD for iNTS. Differences in costs between diarrhoea patients were mainly associated with healthcare facility. Most costs did not differ between etiologies. Total costs of a diarrhoea patient in the specialised hospital were 67 USD, or 8% of gross national income per capita. For direct medical plus transport costs of a GBS and iNTS patient in the specialised hospital, this was 33% and 8%, respectively. Of the 83.9 million USD estimated national non-typhoidal Salmonella enterica related cost, 12.2% was due to iNTS, and of 187.8 million USD related to Campylobacter spp., 0.2% was due to GBS.Conclusion: Direct medical costs per patient due to GBS and iNTS were 30 respectively five times those due to diarrhoea. Costs of a patient with diarrhoea, GBS or iNTS can be a substantial part of a household's income. More severe sequalae can add substantially to cost-of-illness of foodborne hazards causing diarrheal disease. [ABSTRACT FROM AUTHOR]

Copyright of Central Asian Economic Review is the property of Narxoz University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Acute Respiratory Distress Syndrome (ARDS) is a heterogeneous syndrome that encompasses lung injury from a direct pulmonary or indirect systemic insult. Studies have shown that direct and indirect ARDS differ in their pathophysiologic process. In this study, we aimed to compare the different clinical characteristics and predictors of 28-day mortality between direct and indirect ARDS. Materials and Methods: The data of 1291 ARDS patients from September 2012 to December 2021 at the Second Affiliated Hospital of Chongqing Medical University were reviewed. We enrolled 451 ARDS patients in our study through inclusion and exclusion criteria. According to the risk factors, each patient was divided into direct (n = 239) or indirect (n = 212) ARDS groups. The primary outcome was 28-day mortality. Results: The patients with direct ARDS were more likely to be older (p < 0.001) and male (p = 0.009) and have more comorbidity (p < 0.05) and higher 28-day mortality (p < 0.001) than those with indirect ARDS. Age and multiple organ dysfunction syndrome (MODS) were predictors of 28-day mortality in the direct ARDS group, while age, MODS, creatinine, prothrombin time (PT), and oxygenation index (OI) were independent predictors of 28-day mortality in the indirect ARDS group. Creatinine, PT, and OI have interactions with ARDS types (all p < 0.01). Conclusions: The patients with direct ARDS were more likely to be older and male and have worse conditions and prognoses than those with indirect ARDS. Creatinine, PT, and OI were predictors of 28-day mortality only in the indirect ARDS group. The differences between direct and indirect ARDS suggest the need for different management strategies of ARDS. [ABSTRACT FROM AUTHOR]