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Kadomskіy, Kirill. "USING SEQUENTIAL CLUSTERING TO IDENTIFICATION OF HYBRID TIMED AUTOMATA FROM ANALOG IIOT DATA." Journal of Automation and Information sciences 5 (September 1, 2021): 31–44. http://dx.doi.org/10.34229/1028-0979-2021-5-3.
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In Industrial IoT (IIoT) systems, timed automata provide a highly useful abstraction for diagnosis and control tasks. Applying them requires automaton to be learned in passive online manner using positive samples only. Such kind of learning is supported by Hybrid timed Automata (HTA) and algorithm OTALA, but requireds a sequence of discrete events rather than continuous analog time series typically found in IIoT. Recent attempts to cover this gap, taken by A. von Birgelen, O. Niggemann, and others, involved pre-processing observations with a self-organized map (SOM) and watershed transform, yet resulting models have proven ineffective in some real-world systems. In this paper, incremental model-based clustering (IMCF) is employed to learn timed automaton from analog IIoT data. IMCF is a sequential algorithm that processes observed time-series online and splits them into a sequence of discrete states with either crisp or fuzzy transitions between them. Such transitions are then treated as events required for HTA identification with OTALA. Obtained models are evaluated in a case of IIoT system that has proved to be challenging for existing modelling techniques. Experimental results show 24,9–76,8% increase in model’s performance and suggest that discretizing obtained with IMCF has higher informativeness for HTA identification. Finally, wider perspectives of applying HTA in IIoT are discussed, and remaining principal limitations are identified as discrete nature of state transitions, and lack of long-term memory for transitions.
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Archilla, Ivan, Leire Pedrosa, Marta Garcia de Herreros, Laia Fernandez-Mañas, Francis Esposito, Pedro Jares, Carolina Figueras, et al. "An Immune-metabolic signature (IMMETCOLS) identifies three clusters in mCRC with different immune-phenotype distribution and potential clinical implications." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e15534-e15534. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e15534.
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e15534 Background: The overall response rate following immune check-point blockade (ICB) is < 5% in microsatellite stable (MSS) advanced colorectal cancer (mCRC), and between 30-35% in MSI mCRC. We here evaluate the relationship between our immune-metabolic signature (IMMETCOLS) distribution (cluster (IMC) 1; mesenchymal glycolytic, IMC 2; epithelial-non glycolytic and IMC 3; epithelial mitochondrial oxidative) with immune phenotypes (inflamed (IF), immune-excluded (IE) and immune-desert (ID)) in MSS and MSI mCRC patients (pts). Methods: We have analyzed IMMETCOLS in a retrospective cohort of 128 mCRC pts enriched with MSI-H and BRAF genotype using the nCounter platform (Nanostring Technologies, US). Immune phenotypes were evaluated by immunohistochemistry using 7 immune markers (CD68, CD163, CD8, CD3, FOXP3, PD-L1 and PD1) in a subset of 47 mCRC pts (27 MSS and 20 MSI), in TMAs containing 4 cores from the center of the tumor (CT) and invasive front (IF). The number of stained immune cells was counted using a computerized image analysis system, and PD-L1 was evaluated using CPS score (< 1 vs > 1). Patients having a CD3 cell count below 572 cells/mm2 and a CD8 density below 175 cells/mm2 in IF or CT were considered as ID. (Halama Nils, 2011). CD3 density was also semi-quantitatively estimated in peritumoral stroma and intra-tumoral (range 1-4), defining as IE those cases with a difference > 1 between the two regions in both IF and CT (Brooks JM, 2019). Results: Cluster distribution was similar between MSI (IMC1-40%, IMC2-20% and IMC-40%) and MSS (IMC1-34%, IMC2-24%, IMC3-43%) pts. Patients with high LDH levels (> 1.5ULN) were enriched with IMC3 phenotype (p < 0.0001). MSI have increased CD3 (p = 0.002), CD68 (p = 0.002) and CD163 (p = 0.001) in CT than MSS patients. IMC1 pts had increased CD163/CD68 ratio in CT (p = 0.004). 75% of MSI pts were IE and 25% IF. 55% of MSS pts were IE, 38% ID and 7% IF. IMMETCOLS/ immune-phenotype distribution was: IMC1 (16% ID/ 84% IE), IMC2 (12% ID/ 63% IE/ 25% IF) and IMC3 (35%ID/ 47% IE/ 18% IF). PD1 immuno-expression > 1% (IF and CT) and PD-L1 positivity was observed in 38%, 30% and 28% of pts respectively. There were no differences in PD-L1 (CPS) and PD1 expression between MSS and MSI tumors. Inflamed tumors show higher PD-L1 expression compared with IE and ID immune-phenotypes (p = 0.014). PD1 > 1% expression at IF was significatively lower in IMC1 vs IMC2 and IMC3 tumors (p = 0.032). Conclusions: IMC1 subtype is associated with low PD1 expression, high CD163/CD68 ratio and IE phenotype even in MSI-H mCRC patients. Therefore, IMMETCOLS testing would be of value to identify MSI mCRC pts that do not benefit to ICB therapy.
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Post, Richard F. "Resource Letter IMCF-1: Inertially and magnetically confined fusion." American Journal of Physics 68, no. 2 (February 2000): 105–14. http://dx.doi.org/10.1119/1.19397.
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Allen, Brian. "Stability of the PMT and RPI for asymptotically hyperbolic manifolds foliated by IMCF." Journal of Mathematical Physics 59, no. 8 (August 2018): 082501. http://dx.doi.org/10.1063/1.5035275.
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François, Aurélien, Nicolas Scelles, and Maurizio Valenti. "Gender Inequality in European Football: Evidence from Competitive Balance and Competitive Intensity in the UEFA Men’s and Women’s Champions League." Economies 10, no. 12 (December 11, 2022): 315. http://dx.doi.org/10.3390/economies10120315.
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Competitiveness of sporting contests is key to attract fan interest. However, limited research compared levels of competitiveness in men’s and women’s sports. This study focuses on the evolution of intra-match competitive balance (IMCB) and competitive intensity (IMCI) in the UEFA Men’s and Women’s Champions League (UMCL and UWCL). Data were initially collected for 3299 games over 2001–2019 (2314 in UMCL; 985 in UWCL) to analyse the evolution within and between each tournament. In addition, 989 matches played in UMCL over 1955–1973 were added to compare both competitions in their early stages. Results show a deterioration in IMCB and IMCI between 2001–2009 and 2009–2019 for the UMCL. Conversely, the UWCL benefitted from an increase in IMCB but not in IMCI, except for the final. The UWCL is still less competitive than the UMCL. This result holds true even when comparing the early stages of both competitions, i.e., replacing 2001–2019 by 1955–1973 for the UMCL. However, the UWCL has become closer to the UMCL in terms of IMCB and IMCI over time, a result linked to the development of women’s football. From a theoretical perspective, this article advances knowledge of IMCB and IMCI, appropriate for competitions with knockout stages. It underlines the role of the pool of players as an explanatory factor for the gap in competitiveness between European men’s and women’s football.
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Allen, Brian. "IMCF and the Stability of the PMT and RPI Under $$L^2$$ L 2 Convergence." Annales Henri Poincaré 19, no. 4 (December 8, 2017): 1283–306. http://dx.doi.org/10.1007/s00023-017-0641-7.
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Ferrier, Ever, Mariana Garrido, Gustavo Luján, and Camila Del Rosario Pagani. "P39 Evaluación de los resultados del tratamiento integral de la obesidad en pacientes de la Clínica Privada Vélez Sarsfield." Revista de la Sociedad Argentina de Diabetes 54, no. 3Sup (November 21, 2020): 144. http://dx.doi.org/10.47196/diab.v54i3sup.425.
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Introducción: la cirugía bariátrica produce una pérdida de peso sostenida a largo plazo y reduce la comorbilidad y mortalidad en pacientes con obesidad severa. La evaluación de la pérdida ponderal debe realizarse con las herramientas adecuadas desarrolladas: porcentaje de IMC perdido (PIMCP), porcentaje de exceso de IMC perdido (PEIMCP) y el IMC final (IMCF) esperable a los tres años de la cirugía.Objetivos: 1) evaluar la pérdida ponderal en los pacientes sometidos al tratamiento integral de la obesidad en la CPVS durante el período de agosto de 2012 a agosto de 2019; 2) determinar asociación entre los factores demográficos, comorbilidades y reducción de peso logrado; 3) determinar asociación entre el mantenimiento de la actividad física y plan alimentario, y resultado a largo plazo; 4) determinar factores de riesgo para reganancia de peso.Materiales y métodos: estudio observacional, longitudinal y analítico. Tipo de muestreo: consecutivo.Se analizó la historia clínica electrónica de los pacientes, posteriormente se realizó una entrevista telefónica y se obtuvieron las variables en la actualidad. Procedimiento quirúrgico: gastrectomía vertical en manga. El análisis estadístico: Infostat.
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Sawant, Miss Pratiksha Yuvraj, and Mr Mangesh D. Salunke. "Personalized Mobile App Recommendation by Learning User’s Interest from Social Media." International Journal for Research in Applied Science and Engineering Technology 10, no. 4 (April 30, 2022): 448–50. http://dx.doi.org/10.22214/ijraset.2022.41246.
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Abstract: In social media, user interests and knowledge are vital but often overlooked resources. There are a few ways to get a sense of what people are known for, such as Twitter lists and LinkedIn Skill Tags, but most people are untagged, so their interests and expertise are effectively hidden from applications like personalised recommendation and community detection and expert mining. We obtain personalised app recommendations by learning the interest's association between applications and tweets by introducing an unique generative model called IMCF+ to convert user interest from rich tweet information to sparse app usage. We analyse the performance of this technique predicts the top ten apps with an 82.5 percent success rate using only 10% training data. Furthermore, in the high sparsity situation and user cold-start scenario, this purpose technique outperforms the other six state-of-the-art algorithms by 4.7 percent and 10%, demonstrating the effectiveness of our technology. All of these findings show that our method can reliably extract user interests from tweets in order to aid in the solution of the personalised app recommendation problem. Keywords: Social Media, User Profile, deep learning, Privacy, matrix factorization,App recommendation.
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Nishiyama, Seiya, João da Providência, and Hiromasa Ohnishi. "Thermal resonating Hartree–Bogoliubov theory based on the projection method." International Journal of Modern Physics B 28, no. 20 (June 19, 2014): 1450131. http://dx.doi.org/10.1142/s0217979214501318.
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We propose a rigorous thermal resonating mean-field theory (Res-MFT). A state is approximated by superposition of multiple MF wavefunctions (WFs) composed of non-orthogonal Hartree–Bogoliubov (HB) WFs. We adopt a Res-HB subspace spanned by Res-HB ground and excited states. A partition function (PF) in a SO (2N) coherent state representation (CS Reps) |g 〉(N: Number of single-particle states) is expressed as Tr (e-βH) = 2N-1∫〈g|e-βH|g〉dg (β = 1/kBT). Introducing a projection operator P to the Res-HB subspace, the PF in the Res-HB subspace is given as Tr (Pe-βH), which is calculated within the Res-HB subspace by using the Laplace transform of e-βH and the projection method. The variation of the Res-HB free energy is made, which leads to a thermal HB density matrix [Formula: see text] expressed in terms of a thermal Res-FB operator [Formula: see text] as [Formula: see text]. A calculation of the PF by an infinite matrix continued fraction (IMCF) is cumbersome and a procedure of tractable optimization is too complicated. Instead, we seek for another possible and more practical way of computing the PF and the Res-HB free energy within the Res-MFT.
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Yousif, Hayder A., Abdul Rahim Norasmadi, Ahmad Faizal Bin Salleh, Zakaria Ammar, and Khudhur A. Alfarhan. "Assessment of Muscles Fatigue during 400-Meters Running Strategies Based on the Surface EMG Signals." Journal of Biomimetics, Biomaterials and Biomedical Engineering 42 (July 2019): 1–13. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.42.1.
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The aim of this research work is to assess the muscles fatigue of the male runner during 400 meters (m) running with three types of running strategies. The Electromyography (EMG) signals from the Rectus Femoris (RF), Biceps Femoris (BF), Gluteus Maximus (GM), Gastrocnemius Lateralis (GL), and Gastrocnemius Medialis (GMS) were collected by using bipolar electrodes from the right lower extremity’s muscles. EMG signals were collected during the run on the tartan athletic track. Five subjects (non-athletes) had run 400m with three various types of running strategies. The first type: the first 200m running 85-93% of full speed and the last 200m sprinting (full speed), second type: the first 300m running 85-93% of sprinting and the last 100m sprinting, and third type: running 85-93% of sprinting for 400m. The EMG signals were transformed to the time-frequency domain using Short Time Fourier Transform to calculate the instantaneous mean frequency (IMNF) and instantaneous median frequency (IMDF). The less index fatigues were during 1st strategy, while the RF, BF, GM, and GL muscles got recovered with IMNF and IMDF with the three strategies, and the GMS muscle has less negative regression slope value with IMNF with 1st strategy during the 4th 100m of the 400m running event. From the results, it can be concluded the running with the 1st strategy get less fatigues compared with the 2nd and 3rd strategy based on the results of time-frequency domain features (IMNF and IMDF).
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Estrada-Cortés, Eliab, Jorge Urrutia-Morales, Eugenio Villagómez-Amezcua, Mario A. Espinosa-Martínez, Héctor Jiménez-Severiano, Mario Cárdenas-León, and Héctor R. Vera-Ávila. "Concentraciones de LH en periodos de transición reproductiva en cabras criollas x Nubia con diferente condición nutricional." Revista Mexicana de Ciencias Pecuarias 6, no. 2 (May 6, 2015): 137. http://dx.doi.org/10.22319/rmcp.v6i2.4059.
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Se determinó el efecto de las reservas corporales de energía (IMC) y el consumo diario de alimento (CA), sobre la LH sérica durante las transiciones hacia época anovulatoria (TA) y reproductiva (TR). Doce cabras Criollas/Nubia, ovariectomizadas con implantes s.c. de 17-b estradiol, se dividieron en dos grupos (n=6), uno de IMC alto (IMCA) y otro bajo (IMCB). Dentro de grupo de IMC se establecieron dos subgrupos (n=3); con restricción de alimento (CRCA) y sin restricción temporal (SRCA). Se determinó la frecuencia de pulsos (FPLH), concentración media (CMLH) y basal de LH (CBLH). Durante TA se observó disminución gradual de FPLH, CMLH y CBLH (2.08, 1.41, 0.41 pulsos/6 h; 2.1, 1.21, 0.51 ng/ml; 1.3, 0.8, 0.4 ng/ml; P<0.01). En TR aumentaron CMLH y CBLH (1.01, 1.58, 1.87 ng/ml; 0.57, 0.98, 1.04 ng/ml; P<0.01). Cabras con IMCA presentaron mayor FPLH que las de IMCB durante TA (2.05 vs 0.55 pulsos/6 h; P<0.05) y TR (3.2 vs 0.9 pulsos/6 h; P<0.01) y mayor CMLH durante TR (2.1 vs 0.87 ng/ml; P<0.01). Durante TA, la restricción en CA provocó disminución más temprana de CMLH y CBLH en cabras con IMCA (P<0.05), haciéndolas similares a cabras con IMCB. Independientemente del IMC, durante TR la restricción en CA disminuyó FPLH y CBLH (P<0.05). En cabras criollas cruzadas, la secreción de LH es modulada por el IMC y el CA durante los periodos de transición reproductiva. A su vez durante TA, la restricción temporal en CA puede disminuir la secreción de LH aún en cabras con IMC alto.
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Chen, Chen-Kang, Po-Wen Chen, Huan-Jung Wang, and Mei-Yu Yeh. "Alkyl Chain Length Effects of Imidazolium Ionic Liquids on Electrical and Mechanical Performances of Polyacrylamide/Alginate-Based Hydrogels." Gels 7, no. 4 (October 5, 2021): 164. http://dx.doi.org/10.3390/gels7040164.
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Conductive hydrogels with stretchable, flexible and wearable properties have made significant contributions in the area of modern electronics. The polyacrylamide/alginate hydrogels are one of the potential emerging materials for application in a diverse range of fields because of their high stretch and toughness. However, most researchers focus on the investigation of their mechanical and swelling behaviors, and the adhesion and effects of the ionic liquids on the conductivities of polyacrylamide/alginate hydrogels are much less explored. Herein, methacrylated lysine and different alkyl chain substituted imidazole-based monomers (IMCx, x = 2, 4, 6 and 8) were introduced to prepare a series of novel pAMAL-IMCx-Ca hydrogels. We systematically investigated their macroscopic and microscopic properties through tensile tests, electrochemical impedance spectra and scanning electron microscopy, as well as Fourier transform infrared spectroscopy, and demonstrated that an alkyl chain length of the IMCx plays an important role in the designing of hydrogel strain sensors. The experiment result shows that the hexyl chains of IMC6 can effectively entangle with LysMA through hydrophobic and electrostatic interactions, which significantly enhance the mechanical strength of the hydrogels. Furthermore, the different strain rates and the durability of the pAMAL-IMC6-Ca hydrogel were investigated and the relative resistance responses remain almost the same in both conditions, making it a potential candidate for wearable strain sensors.
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Praet, S. F. E., R. A. M. Jonkers, G. Schep, C. D. A. Stehouwer, H. Kuipers, H. A. Keizer, and L. J. van Loon. "Long-standing, insulin-treated type 2 diabetes patients with complications respond well to short-term resistance and interval exercise training." European Journal of Endocrinology 158, no. 2 (February 2008): 163–72. http://dx.doi.org/10.1530/eje-07-0169.
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ObjectiveTo determine the feasibility and the benefits of combined resistance and interval exercise training on phenotype characteristics and skeletal muscle function in deconditioned, type 2 diabetes (T2D) patients with polyneuropathy.DesignShort-term, single-arm intervention trial.MethodsEleven male T2D patients (age: 59.1±7.5 years; body mass index: 32.2±4.0 kg/m2) performed progressive resistance and interval exercise training thrice a week for 10 weeks. Besides primary diabetes outcome measures, muscle strength (MUST), maximal workload capacity (Wmax), whole-body peak oxygen uptake (VO2peak) and muscle oxidative capacity (MUOX), intramyocellular lipid (IMCL) and glycogen (IMCG) storage, and systemic inflammation markers were determined before and after training. Daily exogenous insulin requirements (EIR) and historic individualized EIR were gathered and analysed.ResultsMUST and Wmax increased with 17% (90% confidence intervals 9–24%) and 14% (6–21) respectively. Furthermore, mean arterial blood pressure declined with 5.5 mmHg (−9.7 to −1.4). EIR dropped with 5.0 IU/d (−11.5 to 1.5) compared with baseline. A decline of respectively −0.7 mmol/l (−2.9 to 1.5) and −147 μmol/l (−296 to 2) in fasting plasma glucose and non-esterified fatty acids concentrations were observed following the intervention, but these were not accompanied by changes in VO2peak, MUOX, IMCL or IMCG, and blood glycolysated haemoglobin, adiponectin, tumor necrosis factor-α and/or cholesterol concentrations.ConclusionShort-term resistance and interval exercise training is feasible in deconditioned T2D patients with polyneuropathy and accompanied by moderate improvements in muscle function and blood pressure. Such a specific exercise regimen may provide a better framework for future exercise intervention programmes in the treatment of deconditioned T2D patients.
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Schumny, Harald. "Compositional data objects, the IMC/IMCL reference manual." Computer Standards & Interfaces 15, no. 2-3 (July 1993): 319. http://dx.doi.org/10.1016/0920-5489(93)90018-m.
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KARTHICK, P. A., G. VENUGOPAL, and S. RAMAKRISHNAN. "ANALYSIS OF SURFACE EMG SIGNALS UNDER FATIGUE AND NON-FATIGUE CONDITIONS USING B-DISTRIBUTION BASED QUADRATIC TIME FREQUENCY DISTRIBUTION." Journal of Mechanics in Medicine and Biology 15, no. 02 (April 2015): 1540028. http://dx.doi.org/10.1142/s021951941540028x.
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In this paper, an attempt has been made to analyze surface electromyography (sEMG) signals under non-fatigue and fatigue conditions using time-frequency based features. The sEMG signals are recorded from biceps brachii muscle of 50 healthy volunteers under well-defined protocol. The pre-processed signals are divided into six equal epochs. The first and last segments are considered as non-fatigue and fatigue zones respectively. Further, these signals are subjected to B-distribution based quadratic time-frequency distribution (TFD). Time frequency based features such as instantaneous median frequency (IMDF) and instantaneous mean frequency (IMNF) are extracted. The expression of spectral entropy is modified to obtain instantaneous spectral entropy (ISPEn) from the time-frequency spectrum. The results show that all the extracted features are distinct in both conditions. It is also observed that the values of all features are higher in non-fatigue zone compared to fatigue condition. It appears that this method is useful in analysing various neuromuscular conditions using sEMG signals.
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Devries, Michaela C., Stuart A. Lowther, Alexander W. Glover, Mazen J. Hamadeh, and Mark A. Tarnopolsky. "IMCL area density, but not IMCL utilization, is higher in women during moderate-intensity endurance exercise, compared with men." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 293, no. 6 (December 2007): R2336—R2342. http://dx.doi.org/10.1152/ajpregu.00510.2007.
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Women use more fat during endurance exercise as evidenced by a lower respiratory exchange ratio (RER). The contribution of intramyocellular lipid (IMCL) to lipid oxidation during endurance exercise is controversial, and studies investigating sex differences in IMCL utilization have found conflicting results. We determined the effect of sex on net IMCL use during an endurance exercise bout using an ultrastructural evaluation. Men ( n = 17) and women ( n = 19) completed 90-min cycling at 63% V̇o2peak. Biopsies were taken before and after exercise and fixed for electron microscopy to determine IMCL size, # IMCL/area, IMCL area density, and the % IMCL touching mitochondria. Women had a lower RER and carbohydrate oxidation rate and a higher lipid oxidation rate during exercise ( P < 0.05), compared with men. Women had a higher # IMCL/area and IMCL area density ( P < 0.05), compared with men. Women, but not men, had a higher % IMCL touching mitochondria postexercise ( P = 0.03). Exercise decreased IMCL area density ( P = 0.01), due to a decrease in the # IMCL/area ( P = 0.02). There was no sex difference in IMCL size or net use. In conclusion, women have higher IMCL area density compared with men, due to an increased # IMCL and not an increased IMCL size, as well as an increased % IMCL touching mitochondria postexercise. Endurance exercise resulted in a net decrease in IMCL density due to decreased number of IMCL, not decreased IMCL size, in both sexes.
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Plate, Joost D. J., Linda M. Peelen, Luke P. H. Leenen, Roderick M. Houwert, and Falco Hietbrink. "A Proposal for an Intermediate Care Unit-Quality Measurement Framework." Critical Care Research and Practice 2018 (July 29, 2018): 1–7. http://dx.doi.org/10.1155/2018/4560718.
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Rationale,Aims,and Objectives. The Intermediate Care Unit (IMCU) is a hospital unit which is logistically situated between the hospital ward and the Intensive Care Unit (ICU). There is debate regarding the value of the IMCU. Understanding its value is compromised by the lack of adequate quality indicators. Therefore, this study identifies currently used IMCU indicators and evaluates their usefulness.Methods. Through a systematic literature search, currently used quality indicators were identified and evaluated for their importance using a proposed IMCU-specific quality measurement framework.Results. From 4034 titles and abstracts, 168 articles were selected for full-text review. Of these, 22 articles were included, which reported IMCU quality at the level of the IMCU (n = 12), the ICU (n = 5), both IMCU and ICU (n = 3) or hospital level (n = 2). At the IMCU, the IMCU mortality (n = 16), discharge-to-ICU rate (n = 7), in-hospital IMCU mortality (n = 7), and length of stay (n = 6) were most frequently reported. Three studies compared the effect of different structures of the IMCU on its utilization or hospital outcome.Conclusions. Current focus in IMCU quality research is towards measuring quality at the IMCU itself. Since the influence of the structure of IMCUs on its utilization and its effects on hospital outcome are only rarely investigated, attention should shift towards these important issues in further research. The proposed IMCU quality measurement framework can thereby serve as a helpful tool.
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Nakata, Yusuke, Motoki Kurasawa, Tomihito Hashimoto, Kenji Miki, and Ikuo Shohji. "A Study on Reliability of Pillar-Shaped Intermetallic Compounds Dispersed Lead-Free Solder Joint." Materials Science Forum 941 (December 2018): 2087–92. http://dx.doi.org/10.4028/www.scientific.net/msf.941.2087.
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A pillar shaped intermetallic compounds (IMCs) dispersed solder joint is a highly durable joint to achieve large area joining. The aim of this study is to investigate the ideal dispersion amount of pillar shaped IMCs. The dispersion rate of pillar shaped IMCs depend on the joining temperature. Pillar shaped IMCs dispersion rates are 3.5% and 5.5% when the joining temperature are 300 °C and 330 °C, respectively. Longitudinal elastic modulus are improved by forming pillar shaped IMCs. As a result of examination of the durability by the thermal cycle test, the durability of the joint with the dispersion rate of 3.5% was similar to that without pillar shaped IMCs, while that with the dispersion rate of 5.5% was remarkably improved. In the case of the dispersion rate of 3.5%, pillar shaped IMCs unevenly distributed and cracks tend to progress. On the other hand, in the case of the dispersion rate of 5.5%, pillar shaped IMCs were uniformly dispersed throughout the joint and suppressed crack propagation. Comparison of durability between pillar shaped IMCs solder and indium added solder to verify the effect of pillar shaped IMCs demonstrated that pillar shaped IMCs solder were more durable than indium added solder.
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Yuliarni, Eza, Nurhayati Siregar, and Yofa Sukmawati. "An Overview of the Knowledge and Motivation of IMCI Staff Regarding the Implementation of IMCI at the Lubuk Buaya Public Health Center, Padang." Basic and Applied Nursing Research Journal 2, no. 1 (September 28, 2021): 12–16. http://dx.doi.org/10.11594/banrj.02.01.03.
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Introduction: Indonesia is one of the developing countries with a high under-five mortality rate due to the rough handling of Integrated Management of Childhood Illness (IMCI). Diseases that cause death can generally be treated at the hospital level, but it is still difficult at the public health center level. Public Health Centers have implemented (IMCI). Suppose they meet the criteria for implementing/implementing the IMCI approach at least 60% of the number of visits by sick toddlers. This study aimed to describe the knowledge and motivation of IMCI implementers regarding the implementation of IMCI at Lubuk Buaya Public Health Center, Padang, in 2014. Method: This research is descriptive. This research was conducted at the Lubuk Buaya Health Center Padang in May 2014. The population in this study were all IMCI implementers who were actively working at the Lubuk Buaya Public Health Center, Padang, with 37 people. Sampling with total sampling technique and analyzed univariately. Results: From 37 staff implementing IMCI, it was found that 31 (83.8%) staff had implemented IMCI well, 36 (97.3%) staff had high knowledge, and 23 (62.2%) staff had high motivation. Conclusions: This study shows that the knowledge and motivation of IMCI implementers are good in implementing IMCI. It is hoped that every IMCI implementer will further increase knowledge about IMCI and its performance so that all sick toddlers get the best IMCI services to prevent death in these toddlers.
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Asai, Akira, Hidetaka Yasuoka, Hideko Ohama, Yusuke Tsuchimoto, Shinya Fukunishi, Makiko Kobayashi, Kazuhide Higuchi, and Fujio Suzuki. "Immature myeloid cells (IMCs) increased in the peripheral blood of patients with alcohol use disorder (AUD) suppress the bactericidal activity of monocytes." Journal of Immunology 198, no. 1_Supplement (May 1, 2017): 131.23. http://dx.doi.org/10.4049/jimmunol.198.supp.131.23.
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Abstract AUD patients have an increased risk of serious opportunistic infections. IMCs have been described as suppressor cells for host antibacterial defenses. In this study, IMCs isolated from AUD patients were examined for their inhibitory functions on the bactericidal activity of healthy donor (HD) monocytes. IMCs and monocytes were isolated from the peripheral blood of 10 AUD patients admitted to Osaka Medical Collage and 5 HD. HD monocytes (1 × 105 cells/ml) were stimulated with heat-killed Enterococcus faecalis, then cultured in media supplemented with the conditioned media of patient IMCs (24 hr-culture fluids, 10% v/v, 1 × 106 cells/ml). Twenty-four hrs after the cultivation, monocytes were harvested and tested for their bactericidal activities against E. faecalis. In some cases, patient IMCs, cultured with 5 μg/ml of retinoic acid (RA) for 24 hrs, were utilized for the experiments. Also, both groups of IMCs were analyzed for RA receptor (RAR) expression by flow cytometry. In the results, as compared to HD peripheral blood IMCs, the numbers of IMCs increased in AUD patients. HD monocytes were shown to be bactericidal against E. faecalis. However, the bactericidal activity of HD monocytes was not demonstrated when they were cultured with media supplemented with the conditioned media of patient IMCs. HD IMCs differentiated to monocytes or dendritic cells after cultivation with RA. However, AUD patient IMCs were shown to be not susceptible to RA treatment (patient IMCs, RAR−; HD IMCs, RAR+). These results suggest that, through the production of some soluble factors active against killing functions of monocytes, patient IMCs increase the susceptibility of AUD patients to opportunistic infections.
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Ramos, Joao Gabriel Rosa, Gabriel Machado Naus dos Santos, Marina Chetto Coutinho Bispo, Renata Cristina de Almeida Matos, Gil Mario Lopes Santos de Carvalho, Rogerio da Hora Passos, Juliana Ribeiro Caldas, Andre Luiz Nunes Gobatto, Suzete Nascimento Farias da Guarda, and Paulo Benigno Pena Batista. "Unplanned Transfers From Intermediate Care Units to Intensive Care Units: A Cohort Study." American Journal of Critical Care 30, no. 5 (September 1, 2021): 397–400. http://dx.doi.org/10.4037/ajcc2021453.
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This study evaluated unplanned transfers from the intermediate care unit (IMCU) to the intensive care unit (ICU) among urgent admissions. This retrospective, observational study was conducted in 2 ICUs and 1 IMCU. Three patterns of urgent admission were assessed: admissions to the ICU only, admissions to the IMCU only, and admissions to the IMCU with subsequent transfer to the ICU. Of 5296 admissions analyzed, 1396 patients (26.4%) were initially admitted to the IMCU. Of these, 172 (12.3%) were transferred from the IMCU to the ICU. Mortality was higher in patients transferred from the IMCU to the ICU than in the 3900 ICU-only patients (odds ratio, 3.22; 95% CI, 1.52-6.80). Most transfers from the IMCU to the ICU (135; 78.5%) were due to deterioration of the condition for which the patient was admitted. Patient transfers from the IMCU to the ICU were common, were associated with increased hospital mortality, and were mostly due to deterioration in the condition that was the reason for admission.
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Kovaleva, Mariya A., Bonnie M. Jennings, Carolyn Clevenger, Mi-Kyung Song, Patricia C. Griffiths, and Ken Hepburn. "DEMENTIA FAMILY CAREGIVERS’ EXPERIENCES WITH A NURSE-LED MEMORY CARE CLINIC." Innovation in Aging 3, Supplement_1 (November 2019): S109—S110. http://dx.doi.org/10.1093/geroni/igz038.408.
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Abstract The Integrated Memory Care Clinic (IMCC) at Emory Healthcare is a patient-centered medical home led by advanced practice registered nurses (APRNs) who provide both dementia care and primary care. We explored the experiences of informal caregivers of persons living with dementia at the IMCC during their first year post-enrollment. Twelve caregivers completed semi-structured telephone interviews that lasted 29 minutes on average. The data were analyzed via directed content analysis guided by attention only to caregivers’ accounts of their experience at the IMCC. Caregivers’ experiences clustered around two major considerations: the strengths of the IMCC, and ways to enhance the IMCC. Overall, caregivers’ viewed the IMCC as their wished-for care model. Caregivers felt a sense of belonging to the IMCC team, as they understood that the IMCC personnel incorporate caregivers’ input to deliver care. Participants valued APRNs’ competence in dementia care and having direct telephone access to an on-duty APRN around the clock. Caregivers appreciated the care organization at the IMCC with adequate time dedicated for in-person visits. Areas for the IMCC improvement included clarifying the IMCC scope of practice, explaining dementia progression, involving physicians, and providing more medical and non-medical resources at the IMCC. Caregivers’ willingness to have more resources provided by the IMCC emphasizes how many unmet needs caregivers and their persons have. Clarification of the clinics’ scope of practice – what can be done to manage dementia, its symptoms, and comorbidities – highlighted the need to educate caregivers about ways in which dementia, albeit incurable, can be managed.
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Mukherjee, Sudipto, Karan Kanhai, David Kauffman, Rabecka Martin, Jeremy S. Paige, Anirvan Ghosh, Hannah Kannan, Francis Shupo, and David Fajgenbaum. "Emerging morbidities and health care resource utilization in idiopathic multicentric Castleman disease patients: A population-level analysis using health claims-based dataset." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e18792-e18792. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e18792.
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e18792 Background: Idiopathic multicentric Castleman disease (iMCD) is a hematologic disorder characterized by systemic inflammation, polyclonal lymphoproliferation, and multi-organ dysfunction due to hypercytokinemia often including interleukin-6 (IL-6). iMCD patients have had historically poor outcomes, particularly prior to the advent of anti-IL-6 therapy. We recently found that ̃90% of iMCD patients did not have any claims for anti-IL-6 therapy. One potential reason for inadequate treatment is limited understanding of associated morbidities that can be controlled with therapy. We aimed to assess emergent morbidities in iMCD patients using a large administrative claims database. Methods: An iMCD cohort was identified using an administrative health claims dataset that enrolled 30.7 million US patients between January 1, 2017 and December 2, 2020. This is an updated analysis from a previously published health claims study ( Mukherjee et al, 2022). iMCD patients were identified based on CD-specific ICD-10 diagnosis code (D47·Z2), negative HHV-8 and HIV status, and diagnostic or laboratory claims for ≥2 minor criteria. Post-diagnosis hospitalizations, emergency room (ER) visits, and emergent morbidities in iMCD patients were identified in claims data and compared to non-iMCD cohort matched (1:50) by age group (0-17, 18-44, 45-54, 55-64, > 65 years), sex, insurance type, database history, and region. The iMCD cohort was further stratified by age (0-44 years, 45-60 years, > 60 years) or treatment (iMCD-directed therapy, steroid only, and no treatment) for subgroup analyses of morbidity rates. Results: We identified 271 individuals likely to have iMCD (iMCD patients) (mean age: 50·8 years; 59·4% female), including 191 patients previously reported (ASH, 2021). We found significantly higher odds of organ dysfunction (n = 116, OR = 6·5, 95% CI = 4·9, 8·5) and thrombotic events (n = 79, OR = 4·8, 95% CI = 3·4, 6·7) in iMCD patients compared to a matched non-iMCD cohort. We observed increasing proportions of morbidities with advancing age in iMCD and matched non-iMCD cohorts. Similar morbidity trends were observed in all three iMCD treatment cohorts. A high proportion of iMCD patients required an ER visit (47.8% and 42.6% in the year before and after initial diagnosis), dropping to 13.5% in the second year after diagnosis. A similar pattern was observed in inpatient stays, with a marked increase in patients hospitalized for > 5 days increasing from 6·2% two years prior to diagnosis to 34·3% and 15·6% in the two subsequent years. Conclusions: We report high odds of organ dysfunction and thrombotic events in iMCD patients from this population analysis of patient-claims data. In this iMCD cohort with previously reported low use of iMCD-directed therapies, a high proportion of patients required ER visits and inpatient hospitalizations.
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Jiménez Flores, Paloma, Arturo Jiménez Cruz, and Montserrat Bacardi Gascón. "Insatisfacción con la imagen corporal en niños y adolescentes: revisión sistemática." Nutrición Hospitalaria 34, no. 2 (March 30, 2017): 479. http://dx.doi.org/10.20960/nh.455.
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Introducción: la diferencia de la percepción entre la silueta percibida y la deseada se ha definido como insatisfacción con la imagen corporal (IMCO).Objetivo: evaluar los métodos utilizados para medir la IMCO y la frecuencia de la IMCO en niños y adolescentes.Metodología: se buscaron artículos registrados en las bases de datos de PubMed, EBSCOhost y Scielo, de estudios transversales en inglés y español, que valoraran la IMCO en niños y adolescentes publicados de abril de 2010 al mes de abril de 2015. Se registraron, edad, sexo, tamaño muestral, estado de peso, tipo de método para valorar la IMCO y estimación de la IMCO.Resultados: cumplieron con los criterios de inclusión 16 estudios que valoraron la IMCO en niños y adolescentes de 5 a 19 años de edad. De los artículos analizados se encontraron 9 métodos de valoración de la IMCO. En la mayoría se realizaron pruebas de estabilidad temporal y validez. La frecuencia de IMCO por tener sobrepeso u obesidad, osciló de 44% a 83% y por bajo peso, de 1,7% a 37%. La IMCO aumentó de acuerdo al IMC, y en algunos estudios se asoció con la edad. Fue más frecuente en las mujeres, y en algunos casos se presenta IMCO en los niños delgados.Conclusión: la IMCO se presenta con mayor frecuencia en el sexo femenino y se asocia positivamente con el IMC. A pesar de la variedad de métodos utilizados para evaluar la IMCO, los resultados son consistentes.
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Levi, Michela, Laura Peña, Angela Alonso-Díez, Barbara Brunetti, Luisa Vera Muscatello, Cinzia Benazzi, Maria Dolores Pérez-Alenza, and Giuseppe Sarli. "P-Glycoprotein and Breast Cancer Resistance Protein in Canine Inflammatory and Noninflammatory Grade III Mammary Carcinomas." Veterinary Pathology 56, no. 6 (September 16, 2019): 840–47. http://dx.doi.org/10.1177/0300985819868647.
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P-glycoprotein (P-gp/ABCB1) and breast cancer resistance protein (BCRP/ABCG2) expression are frequently related to multidrug resistance (MDR) in neoplastic cells. Canine inflammatory and grade III noninflammatory mammary carcinomas (IMC and non-IMC) are aggressive tumors that could benefit from chemotherapy. This study describes the immunohistochemical detection of P-gp and BCRP in 20 IMCs and 18 non-IMCs from dogs that had not received chemotherapy. Our aim was to determine if P-gp and BCRP expression was related to the “inflammatory” phenotype, to establish a basis for future studies analyzing the response to chemotherapy in dogs with highly malignant mammary cancer. Immunolabeling was primarily membranous for P-gp with a more intense labeling in emboli, and immunolabeling was membranous and cytoplasmic for BCRP. P-gp was expressed in 17 of 20 (85%) IMCs compared to 7 of 18 (39%) non-IMCs ( P = 0.006). BCRP was expressed within emboli in 15 of 19 (79%) emboli in IMC, 12 of 15 (80%) primary IMCs, and 12 of 18 (67%) non-IMCs, without statistically significant differences ( P > .05). All IMCs and 67% of non-IMCs expressed at least 1 of the 2 transporters, and 63% (12/19) of IMCs and 39% (7/18) of non-IMCs expressed both P-gp and BCRP. P-gp and BCRP evaluation might help select patients for chemotherapy. P-gp, expressed in a significantly higher percentage of IMCs vs non-IMCs, might play a specific role in the chemoresistance of IMC.
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Nurmawati, Ida. "Desain Aplikasi Android-Based Integrated Management of Chilhood Illness (IMCI)." Jurnal Penelitian Kesehatan "SUARA FORIKES" (Journal of Health Research "Forikes Voice") 11, no. 4 (June 11, 2020): 425. http://dx.doi.org/10.33846/sf11422.
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Integrated management of Chilhood Illness (IMCI) is an integrated approach in the management of children illness aged 0-59 months or less than 5 years as a whole. The development of technology and information allows the development of IMCI into information system can easy use for user. This study was an operational research that aimed to design android-based IMCI applications. Application design was done by creating flowchart, data flow diagram (DFD), entity relationship diagram (ERD), and IMCI application interface. IMCI application design results allowed the user to perform automatic disease assessment and classification as well as giving first action for childhood illness automatically. Design IMCI application was also integrated with web applications in first-level health services to produce reports. The design of android-based IMCI applications was expected to help the discovery of sick chilhood quickly. Therefore it is necessary to empower health cadres who have been trained to help find sick chilhood in the neighborhood.
Keywords: android; childhood illness; IMCI
ABSTRAK
Manajemen terpadu balita sakit atau Integrated Management of Childhood Illnes (IMCI) merupakan suatu pendekatan terpadu atau terintegrasi dalam penatalaksanaan balita sakit dengan fokus kepada kesehatan anak usia 0-59 bulan atau kurang dari 5 tahun secara menyeluruh. Perkembangan teknologi dan informasi memungkinkan pengembangan MTBS ke dalam sistem informasi yang mudah digunakan pengguna. Penelitian ini merupakan operational research yang bertujuan untuk merancang aplikasi IMCI berbasis android. Perancangan aplikasi dilakukan dengan membuat flowchart, data flow diagram (DFD), entity relationship diagram (ERD), dan interface aplikasi IMCI. Hasil perancangan aplikasi IMCI memungkinkan user untuk melakukan penilaian dan klasifikasi penyakit secara otomatis serta pemberian tindakan pertama bagi balita sakit secara otomatis. Perancangan aplikasi IMCI juga diintegrasikan dengan aplikasi web dimana admin pelayanan kesehatan tingkat pertama sebagai usernya untuk menghasilkan laporan berupa data balita, resep, dan penyakit. Perancangan aplikasi IMCI berbasis android ini diharapkan mampu membantu penemuan balita sakit secara cepat. Oleh karena itu perlu memberdayakan kader kesehatan yang telah dilatih untuk membantu menemukan balita sakit di lingkungan sekitar.
Kata kunci: android; balita sakit; IMCI
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Nasrallah, Rania, Joseph Zimpelmann, Sonia Singh, and Richard L. Hébert. "Molecular and biochemical characterization of prostacyclin receptors in rat kidney." American Journal of Physiology-Renal Physiology 280, no. 2 (February 1, 2001): F266—F277. http://dx.doi.org/10.1152/ajprenal.2001.280.2.f266.
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The prostacyclin (IP) message was detected by RT-PCR in the renal cortex, outer (OM) and inner medulla (IM), and in freshly isolated (IMCD-f) and cultured inner medullary collecting duct (IMCD-c), and also the E-prostanoid (EP)1,3,4 receptor subtypes, but not EP2. Digoxigenin in situ hybridization localized IP mRNA in the tubules of the OM and IM, and the vasculature, and also in the glomeruli, arteries, and tubules of the cortex. IP splice variants or subtypes could not be detected by RT-PCR followed by TA cloning, though several nonfunctional point mutations or single base pair deletions were observed. Iloprost (ILP), cicaprost (CCP), PGE2, and arginine vasopressin (AVP) stimulated cAMP in both IMCD preparations. In addition, AVP-stimulated cAMP in IMCD-f was inhibited by all three prostanoids, but not in IMCD-c. Calcium experiments were performed on IMCD-c or microdissected IMCD (IMCD-m). CCP, ILP, and PGE2 did not alter intracellular calcium concentration ([Ca2+]i) in IMCD-c. However, on IMCD-m, both PGE2 and ILP increased [Ca2+]i levels equipotently and CCP had no effect. Pretreatment with the EP1 antagonist AH-6809 indicates that the response to ILP and PGE2 is mediated via EP1. These results suggest that IP receptors in the rat IMCD mediate the cAMP but not calcium signaling linked to PGI2; to date no subtypes or splice variants have been identified.
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Zhu, Bing, Jennifer Kennedy, Yue Wang, Carolina Sandoval Garcia, Wassim Elyaman, Sheng Xiao, and Samia Khoury. "The activation state of Ly-6Chi inflammatory monocytes determines their immune regulatory function (98.23)." Journal of Immunology 184, no. 1_Supplement (April 1, 2010): 98.23. http://dx.doi.org/10.4049/jimmunol.184.supp.98.23.
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Abstract We reported that CD11b+Ly-6ChiLy-6G- inflammatory monocytes (IMCs) obtained after EAE immunization strongly induced apoptosis in pre-activated CD4 T cells through the production of nitric oxide. However, it was recently reported that transfer of wild type IMCs worsened EAE disease in GM-CSF-/- or CCL2-/- recipients, suggesting a pathogenic function of IMCs. We hypothesized that the immune function of IMCs depends on their activation state. We found that ex vivo purified IMCs induced antigen-specific proliferation of naïve TCR transgenic CD4 T cells, suggesting that these IMCs can function as antigen presenting cells. In contrast, when the same IMCs were first activated with IFN-γ, LPS and GM-CSF, they strongly suppressed T cell proliferation induced by professional APCs, which could be rescued by NOS2 inhibition. Similar dichotomy of T cell regulatory function was observed in inflammatory dendritic cells (IDCs) differentiated from IMCs with GM-CSF. In addition, IMCs isolated from the central nervous system (CNS) of MOG-immunized B6 mouse before EAE onset supported T cell proliferation, survival and Th1/Th17 differentiation, but CNS IMCs obtained at EAE peak suppressed T cell proliferation and differentiation. Furthermore, transfer of in vitro activated IMC and IDCs markedly suppressed EAE severity and reduced CNS inflammation. In summary, we demonstrate that the immune function of IMCs and IDCs is plastic and dependent on their activation state.
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Amaral, João, Eleanor Gouws, Jennifer Bryce, Álvaro Jorge Madeiro Leite, Antonio Ledo Alves da Cunha, and Cesar G. Victora. "Effect of Integrated Management of Childhood Illness (IMCI) on health worker performance in Northeast-Brazil." Cadernos de Saúde Pública 20, suppl 2 (2004): S209—S219. http://dx.doi.org/10.1590/s0102-311x2004000800016.
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A multi-country evaluation is being carried out in Brazil and four other countries to determine the effectiveness, cost, and impact of the Integrated Management of Childhood Illness (IMCI). We examine the effect of IMCI on the quality of health care provided to children under five visiting health facilities. A health facility survey was conducted at 24 facilities (12 with IMCI) in each of four States in the Northeast. We assessed the quality of care provided to children between 2 months and 5 years attending the facilities. Health workers trained in IMCI provided significantly better care than those not trained. Significant differences between health workers who were trained or not trained in IMCI were found in the assessment of the child, disease classification, treatment, and caretaker communication. Nurses trained in IMCI performed as well as, and sometimes better than, medical officers trained in IMCI. We conclude that while there is room for further improvement, IMCI case management training significantly improves health worker performance, and that parts of Brazil that have not yet introduced IMCI should be encouraged to do so.
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Plate, Joost D. J., Linda M. Peelen, Luke P. H. Leenen, and Falco Hietbrink. "The intermediate care unit as a cost-reducing critical care facility in tertiary referral hospitals: a single-centre observational study." BMJ Open 9, no. 6 (June 2019): e026359. http://dx.doi.org/10.1136/bmjopen-2018-026359.
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ObjectivesTo determine whether and to what extent the surgical intermediate care unit (IMCU) reduces healthcare costs.DesignRetrospective cohort study.SettingThe mixed-surgical IMCU of a tertiary academic referral hospital.ParticipantsAll admissions (n=2577) from 2012 to 2015.Primary and secondary outcome measuresThe outcome measure was the hypothetical cost savings due to the presence of the IMCU. For this, each admission day was classified as either low-acuity or high-acuity, based on the Therapeutic Intervention Scoring System-28, the required specific nursing interventions and the indication for admission at the IMCU. Costs (2018) used were €463 per hospital ward, €1307 per IMCU and €2224 per intensive care unit (ICU) admission day. Savings were calculated by subtracting the actual IMCU costs from the hypothetical costs in the absence of the IMCU.ResultsThere were 9037 admission days (n=2577 admissions) at the IMCU. The proportion of high-acuity admissions was 87.6%. Total costs at the IMCU were €11.808 888. Total hypothetical costs in absence of the IMCU were €18.115 284. Total cost savings were thus €6.306 395, or €1.576 599, per year.ConclusionsThe surgical IMCU may substantially reduce societal healthcare costs, making it a cost saving alternative to ICU care. Constant adequate triage is essential to optimise its potential.
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Hoffert, Jason D., Bas W. M. van Balkom, Chung-Lin Chou, and Mark A. Knepper. "Application of difference gel electrophoresis to the identification of inner medullary collecting duct proteins." American Journal of Physiology-Renal Physiology 286, no. 1 (January 2004): F170—F179. http://dx.doi.org/10.1152/ajprenal.00223.2003.
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In this study, we present a standardized approach to purification of native inner medullary collecting duct (IMCD) cells from rat kidney for proteomic analysis and apply the approach to identification of abundant proteins utilizing two-dimensional difference gel electrophoresis (DIGE) coupled with matrix-assisted laser desorption-ionization-time of flight mass spectrometry. Fractionation of inner medullary cell suspensions by low-speed centrifugation gave a highly purified IMCD cell fraction in which aquaporin-2 was enriched 10-fold. When DIGE was initially applied to rat inner medullas fractionated into IMCD cells (labeled with Cy3) and non-IMCD cells (labeled with Cy5), we identified 50 highly abundant proteins expressed in the IMCD cells. These proteins, identifiable without subcellular fractionation, included chiefly enzymes, structural proteins, and signaling intermediates. An additional 35 proteins were found predominantly in the non-IMCD cell types. Proteins that were highly enriched in the IMCD fraction included cytokeratin 8, cytokeratin 18, transglutaminase II, aminopeptidase B, T-plastin, heat shock protein (HSP) 27, HSP70, and lactate dehydrogenase A. Semiquantitative immunoblotting and immunohistochemistry confirmed relative expression levels and distribution of selected proteins. An additional 40 IMCD proteins were identified in separate experiments aimed at further enrichment of proteins through optimization of sample loading. These studies document the applicability of a standardized approach to purification of IMCD cells for proteomic analysis of IMCD proteins and demonstrate the feasibility of largescale identification of proteins in the native IMCD cell.
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Rubenstein, Ayelet I., Sheila K. Pierson, and David C. Fajgenbaum. "Red Blood Cell Morphological Changes and Enlarged Platelets Found in Idiopathic Multicentric Castleman Disease." Blood 138, Supplement 1 (November 5, 2021): 3795. http://dx.doi.org/10.1182/blood-2021-146568.
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Abstract BACKGROUND Idiopathic multicentric Castleman disease (iMCD) is a rare polyclonal lymphoproliferative disorder characterized by systemic inflammatory symptoms, cytopenias, generalized lymphadenopathy, and multiple organ system dysfunction. iMCD is subclassified into iMCD-TAFRO, with thrombocytopenia, anasarca, fever/elevated C-reactive protein, reticulin myelofibrosis/renal failure, and organomegaly, and iMCD-NOS (not otherwise specified), with high platelet counts and hypergammaglobulinemia. Despite recent diagnostic guidelines, iMCD diagnosis remains challenging because many of the histopathologic features and clinical/laboratory abnormalities are non-specific. Characterization of easily measurable findings from minimally invasive procedures, such as peripheral blood smear, could help to improve the accuracy of diagnosis as well as potentially providing insights into disease pathogenesis. Peripheral blood smears are often performed during routine clinical evaluation and enable morphologic evaluation of red blood cells (RBCs) and white blood cells (WBCs). In this study, we systematically characterized peripheral blood smear morphologic findings in iMCD for the first time. METHODS Peripheral blood smear morphologic findings in medical records from 68 iMCD patients, who were enrolled in an international registry for CD patients and had been confirmed to meet iMCD criteria by an expert panel, were reviewed and analyzed. Patients were also categorized into iMCD-TAFRO (N=39) or iMCD-NOS (N=29) based on clinical and laboratory data. Two-sample proportion tests were used to compare the frequency of features between iMCD-TAFRO and iMCD-NOS, when the abnormality was present in ≥ 5 subjects in both subtypes. P-value correction was not performed as findings are preliminary and hypothesis generating. RESULTS Among the 68 iMCD patients, average age was 35.8 years (14-61); 46% were female, 54% were male; racial distribution was 62% white; 10% Black; 15% Asian; 13% other. The most common peripheral blood smear findings across all iMCD patients included abnormalities in RBC size and color, with anisocytosis (58.8%), polychromasia (57.4%), hypochromia (55.9%), and microcytosis (50.0%) being the most prevalent findings in the overall cohort (Table 1). Other RBC abnormalities were observed but less frequently, including abnormalities in shape such as poikilocytosis (44.1%). Giant or large platelets were found in 47% of iMCD cases. Abnormalities in WBCs, including toxic granulation, atypical lymphocytes, and toxic vacuolization, were detected less frequently. When comparing the two clinical subtypes, patients with iMCD-TAFRO had more frequent anisocytosis (p=0.043), hypochromia (p=0.002), polychromasia (p=0.022), and giant/large platelets (p<0.001) versus iMCD-NOS. DISCUSSION Here, we have characterized peripheral blood morphologic abnormalities in iMCD for the first time. The most common findings in this cohort included abnormalities in RBC size and color. These abnormalities can be found in a number of conditions, including myelofibrosis, autoimmune diseases, and other inflammatory conditions. In iMCD, they are likely related to cytokine-driven anemia of chronic inflammation. The presence of large or giant platelets in nearly half of iMCD patients, with significantly more in iMCD-TAFRO than iMCD-NOS, is particularly notable since this has not been described in iMCD. These enlarged platelets, which can be found in immune thrombocytopenic purpura, myeloproliferative disorders, pseudothrombocytopenia, and inherited platelet disorders, may reflect hyperactivity of megakaryocytes and/or early release from the bone marrow in response to peripheral platelet sequestration. Though less common in this cohort, there are additional changes in RBC shape and WBC features that may be more specific to iMCD and potentially informative in increasing the index of suspicion for iMCD. These findings suggest that the peripheral blood smear may be able to support the diagnosis of iMCD and result in faster treatment administration. Future work is needed to determine whether the constellation of findings in the peripheral blood identified herein is unique to iMCD or seen in various other infectious, malignant, and autoimmune diseases. Figure 1 Figure 1. Disclosures Fajgenbaum: Pfizer: Other: Study drug for clinical trial of sirolimus; EUSA Pharma: Research Funding; N/A: Other: Holds pending provisional patents for 'Methods of treating idiopathic multicentric Castleman disease with JAK1/2 inhibition' and 'Discovery and validation of a novel subgroup and therapeutic target in idiopathic multicentric Castleman disease'.
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Pasztoi, Maria, and Caspar Ohnmacht. "Tissue Niches Formed by Intestinal Mesenchymal Stromal Cells in Mucosal Homeostasis and Immunity." International Journal of Molecular Sciences 23, no. 9 (May 6, 2022): 5181. http://dx.doi.org/10.3390/ijms23095181.
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The gastrointestinal tract is the largest mucosal surface in our body and accommodates the majority of the total lymphocyte population. Being continuously exposed to both harmless antigens and potentially threatening pathogens, the intestinal mucosa requires the integration of multiple signals for balancing immune responses. This integration is certainly supported by tissue-resident intestinal mesenchymal cells (IMCs), yet the molecular mechanisms whereby IMCs contribute to these events remain largely undefined. Recent studies using single-cell profiling technologies indicated a previously unappreciated heterogeneity of IMCs and provided further knowledge which will help to understand dynamic interactions between IMCs and hematopoietic cells of the intestinal mucosa. In this review, we focus on recent findings on the immunological functions of IMCs: On one hand, we discuss the steady-state interactions of IMCs with epithelial cells and hematopoietic cells. On the other hand, we summarize our current knowledge about the contribution of IMCs to the development of intestinal inflammatory conditions, such as infections, inflammatory bowel disease, and fibrosis. By providing a comprehensive list of cytokines and chemokines produced by IMCs under homeostatic and inflammatory conditions, we highlight the significant immunomodulatory and tissue niche forming capacities of IMCs.
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Wiendyasari, RR Anugrah, Hari Kusnanto, and Tunjung Wibowo. "The Effectiveness of IMCI (Integrated Management of Childhood Illness) Mini Training in Improving Health Workers’ Skills in Primary Health Centers in Bantul." Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) 1, no. 3 (December 9, 2018): 129. http://dx.doi.org/10.22146/rpcpe.41697.
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ABSTRACTBackground: At the Community and Primary Health Care Center in Bantul, the number of paramedics receiving Integrated Management of Childhood Illness (IMCI) training is very limited and not evenly distributed. With the low number of IMCI trained officers, this affects the skill of the officers in conducting the IMCI. Fewer skills affect the handling of sick children including the recognition of general danger signs, classification, designing appropriate action, as well as providing treatment and counseling.Objective: This study aimed to know the effectiveness of IMCI Mini Training intervention to improve health workers’ skills in handling sick children with IMCI.Methods: This research was a quasi-experimental study with a non-equivalent pre-post control group design. The sample of this study was a group of health workers who implement IMCI in daily work at 20 Community and Primary Health Care Centers in Bantul. Data were collected by observing 20 health workers in the control group and 20 health workers in IMCI treatment group before and after receiving IMCI Mini Training. Data results were analyzed using univariate, bivariate and multivariate statistical tests.Results: Using t-test analysis the mean value of health worker’s pretest and posttest skill scores in implementing IMCI in control group showed no significant difference (p=0.857) while in the treatment group, the mean value of pretest and posttest score showed a significant difference (p=0.000). In the treatment group, the improvement of sign recognition skills was significant (p=0.000) compared with the classification (p=0.148), treatment (p=0.009), communication and counseling (p=0.005). Multivariate analysis of linear regression showed that IMCI Mini Training was significant in improving the skill of health workers (p=0.000) compared with variables: age (p=0.970), duty (p=0.425), IMCI training history (p=0.686), category of Community and Primary Health Care Center (p=0.409) and education (p= 0.474). IMCI Mini Training improved significantly the sign recognition skills (p=0.000), classification (p=0.001) as well as communication and counseling (p=0.011) but was not significant in treatment skill (p=0.093). IMCI Mini Training can be done in a shorter time and more interactive method by using ICATT.Conclusion: This study showed that IMCI Mini Training increased health workers’ skills in IMCI implementation with the advantages of shorter course time, lower cost, and more interactive methods. The IMCI skills were enhanced by the provision of IMCI Mini Training which includes skills in the recognition of common signs, classifications as well as providing appropriate communication and counseling.
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De Bock, K., T. Dresselaers, B. Kiens, E. A. Richter, P. Van Hecke, and P. Hespel. "Evaluation of intramyocellular lipid breakdown during exercise by biochemical assay, NMR spectroscopy, and Oil Red O staining." American Journal of Physiology-Endocrinology and Metabolism 293, no. 1 (July 2007): E428—E434. http://dx.doi.org/10.1152/ajpendo.00112.2007.
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The study compared the net decline of intramyocellular lipids (IMCL) during exercise ( n = 18) measured by biochemical assay (BIO) and Oil Red O (ORO) staining on biopsy samples from vastus lateralis muscle and by1H-MR spectroscopy (MRS) sampled in an 11 × 11 × 18-mm3voxel in the same muscle. IMCL was measured before and after a 2-h cycling bout (∼75% V̇o2 peak). ORO and MRS measurements showed substantial IMCL use during exercise of 31 ± 12 and 47 ± 6% of preexercise IMCL content. In contrast, use of BIO for IMCL determination did not reveal an exercise-induced breakdown of IMCL (2 ± 9%, P = 0.29) in young healthy males. Correlations between different measures of exercise-induced IMCL degradation were low. Coefficients were 0.48 for MRS vs. ORO ( P = 0.07) and were even lower for BIO vs. MRS ( r = 0.38, P = 0.13) or ORO ( r = 0.08, P = 0.78). This study demonstrates that different methods to measure IMCL in human muscles can result in different conclusions with regard to exercise-induced IMCL changes. MRS has the advantage that it is noninvasive, however, not fiber type specific and hampered by an at least 30-min delay in measurements after exercise completion and may overestimate IMCL use. BIO is the only quantitative method but is subject to variation when biopsies have different fiber type composition. However, BIO yields lower IMCL breakdown compared with ORO and MRS. ORO has the major advantage that it is fiber type specific, and it therefore provides information that is not available with the other methods.
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Sumiyoshi, R., T. Koga, and A. Kawakami. "POS1353 SERUM PROTEOMICS REVEALS INSULIN-LIKE GROWTH FACTOR BINDING PROTEINS-1 AS BIOMARKERS FOR IDIOPATHIC MULTICENTRIC CASTLEMAN’S DISEASE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 959.1–959. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2246.
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Background:Castleman’s disease (CD) is a lymphoproliferative disorder1 and presents as two distinct clinical entities: the localized form, unicentric CD (UCD) and the multicentric form, multicentric CD (MCD)2. MCD without human herpesvirus-8 (HHV-8) infection is defined idiopathic MCD (iMCD)3 and most MCDs in Japan are iMCDs. TAFRO syndrome is a group of disease that present with T: thrombocytopenia, A: anasarca, F: fever, R: reticulin fibrosis/renal dysfunction, O: organomegaly4. iMCD-TAFRO is present in the TAFRO syndrome and it is thought that pathology of lymph node biopsy shows an MCD-like appearance, and some clinical features overlap with MCD5. That do not belong to any of the above categories is classified as iMCD-not otherwise specified (iMCD-NOS). No biomarkers stratifying iMCD-NOS and iMCD-TAFRO have been identified, and no biomarkers defining treatment response have been identified for iMCD.Objectives:We will identify biomarkers that discriminate iMCD-NOS and iMCD-TAFRO or predict the treatment responsiveness.Methods:We performed a comprehensive analysis of serum proteins using the L-Series Human Antibody Array L-507 on the 4 iMCD-NOS and 2 iMCD-TAFRO patients from which pre- and post-tocilizumab treatment samples were obtained. An analysis by L-507 identified insulin-like growth factor binding proteins-1 (IGFBP-1) as a protein with a high rate of reduction post treatment. Sera from 28 healthy controls, 8 patients with iMCD-NOS, and 6 patients with iMCD-TAFRO were used to validate IGFBP-1 by ELISA. The mean ages of healthy controls, iMCD-NOS, and iMCD-TAFRO used in the validation ELISA were 50, 56, and 47 years, respectively, with no significant differences among the groups. The ratio of male to female was almost 1:1.Results:The 4 patients who responded well to treatment with tocilizumab all had a high rate of IGFBP-1 reduction by L-507 serum protein arrays. In ELISA, serum IGFBP-1 was significantly higher (p=0.0016) before the introduction of treatment in iMCD patients than healthy controls. In addition, serum IGFBP-1 level of iMCD-TAFRO was significantly higher than iMCD-NOS (p=0.024). Furthermore, post-treatment serum IGFBP-1 was decreased in many cases.Conclusion:Serum IGFBP-1 may play a particularly important role in the pathogenesis of iMCD-TAFRO and may be useful in discriminating between iMCD-NOS and iMCD-TAFRO. In the future, we will accumulate more cases, compare it with other inflammatory diseases, and examine the difference in response to treatment.References:[1]CASTLEMAN, et al. 1954. CASE records of the Massachusetts General Hospital Weekly Clinicopathological Exercises: Case 40011. N Engl J Med, 250, 26-30.[2]WATERSTON, et al. 2004. Fifty years of multicentric Castleman’s disease. Acta Oncol, 43, 698-704.[3]FAJGENBAUM D, et al. 2014. HHV-8-negative, idiopathic multicentric castleman disease (iMCD): A description of clinical features and therapeutic options through a systematic literature review. Blood (ASH Annual Meeting Abstracts), 124, 4861.[5]TAKAI K, et al. 2010. Thrombocytopenia with mild bone marrow fibrosis accompanied by fever, pleural effusion, ascites and hepatosplenomegaly [in Japanese]. Rinsho Ketsueki, 51, 320-325.[6]IWAKI N, et al. 2016. Clinicopathologic analysis of TAFRO syndrome demonstrates a distinct subtype of HHV-8-negative multicentric Castleman disease. Am J Hematol, 91, 220-226.Disclosure of Interests:None declared
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Hayati, Wirda, Sri Supar Yati Soenarto, Fitri Haryanti, and Yayi Suryo Prabandari. "DEVELOPING TEACHING LEARNING FOR INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI): A QUALITATIVE STUDY IN ACEH INDONESIA." Belitung Nursing Journal 3, no. 5 (October 30, 2017): 555–68. http://dx.doi.org/10.33546/bnj.198.
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Background: Integrated Management of Childhood Illness (IMCI) is an integrated guideline in dealing with infants and sick children at the community health center. However, many students cannot apply this guideline because they are not being exposed.Objective: This study aims to explore the perspectives of nurse educators and clinical instructors regarding the effectiveness of teaching learning process of IMCI in diploma nursing students.Methods: This was a qualitative study with interpretive approach. There were 9 informants selected using purposive sampling, which consisted of nurse educators and clinical instructors. Data collection was conducted in December 2016 - February 2017 using focus group discussions and in-depth interviews. Data were analyzed using Colaizzi process.Result: There were four themes emerged from data, namely 1) Competency of IMCI for Diploma Nursing Students, 2) Deepening of IMCI Material, 3) Learning methods of IMCI in the class and clinic should be active and structured, 4) Student confidence in the application of IMCI in clinical setting.Conclusion: The learning process of IMCI will have an impact on the improvement of knowledge, skills and attitude in the application of IMCI in the clinical setting.
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Kohan, D. E., and E. Padilla. "Endothelin-1 production by rat inner medullary collecting duct: effect of nitric oxide, cGMP, and immune cytokines." American Journal of Physiology-Renal Physiology 266, no. 2 (February 1, 1994): F291—F297. http://dx.doi.org/10.1152/ajprenal.1994.266.2.f291.
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Nitric oxide (NO), guanosine 3',5'-cyclic monophosphate (cGMP), and endothelin-1 (ET-1) inhibit collecting duct sodium reabsorption. Because the inner medullary collecting duct (IMCD) synthesizes NO and ET-1, we examined NO and cGMP regulation of IMCD ET-1 production. S-nitroso-N-acetylpenicillamine (SNAP, 6 h) increased NO and cGMP and modestly reduced ET-1 release in cultured rat IMCD. Atrial natriuretic peptide or dibutyryl cGMP (6 h exposure to each) also mildly decreased IMCD ET-1 release. In long-term exposure studies, IMCD cells were incubated with tumor necrosis factor (TNF) and interferon-gamma (IFN) up to 72 h. IFN/TNF increased NO and cGMP production while reducing ET-1 release by 84%; N-monomethyl-L-arginine inhibited this effect only marginally, suggesting NO was not primarily involved. IFN alone greatly reduced IMCD ET-1 release and ET-1 mRNA levels. These data indicate that short- and long-term increases in NO and cGMP modestly reduce IMCD ET-1 production. Additionally, IFN potently inhibits IMCD ET-1 release by an undetermined mechanism.
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Johnson, N. A., S. R. Stannard, K. Mehalski, M. I. Trenell, T. Sachinwalla, C. H. Thompson, and M. W. Thompson. "Intramyocellular triacylglycerol in prolonged cycling with high- and low-carbohydrate availability." Journal of Applied Physiology 94, no. 4 (April 1, 2003): 1365–72. http://dx.doi.org/10.1152/japplphysiol.00833.2002.
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Vastus lateralis intramyocellular lipid (IMCL) content was assessed by1H-magnetic resonance spectroscopy before and after prolonged time trial cycling bouts of ∼3-h duration. Six highly trained male cyclists completed a double-blind, randomized, crossover design of two experimental trials after a strenuous exercise bout and 48 h of high (HC) (9.32 ± 0.08 g · kg−1 · day−1) and low (LC) (0.59 ± 0.21 g · kg−1 · day−1) dietary carbohydrate. Resting IMCL content was significantly higher after LC vs. HC ( P < 0.01) and was reduced during exercise by 64 and 57%, respectively. IMCL was not different between conditions after exercise ( P > 0.05). The approximately twofold increase in IMCL degradation in LC compared with HC suggests that higher rates of whole body lipid metabolism in LC were in part attributable to a greater IMCL utilization. Four subjects experienced reductions of IMCL in excess of 70% during exercise. To our knowledge, this is the first study to report near depletion of IMCL during prolonged cycling, indicating that IMCL, presumably the triacylglycerol component, may be exhausted by prolonged strenuous exercise.
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Décombaz, Jacques, Beat Schmitt, Michael Ith, Bernard Decarli, Peter Diem, Roland Kreis, Hans Hoppeler, and Chris Boesch. "Postexercise fat intake repletes intramyocellular lipids but no faster in trained than in sedentary subjects." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 281, no. 3 (September 1, 2001): R760—R769. http://dx.doi.org/10.1152/ajpregu.2001.281.3.r760.
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The hypotheses that postexercise replenishment of intramyocellular lipids (IMCL) is enhanced by endurance training and that it depends on fat intake were tested. Trained and untrained subjects exercised on a treadmill for 2 h at 50% peak oxygen consumption, reducing IMCL by 26–22%. During recovery, they were fed 55% (high fat) or 15% (low fat) lipid energy diets. Muscle substrate stores were estimated by 1H (IMCL)- and13C (glycogen)-magnetic resonance spectroscopy in tibialis anterior muscle before and after exercise. Resting IMCL content was 71% higher in trained than untrained subjects and correlated significantly with glycogen content. Both correlated positively with indexes of insulin sensitivity. After 30 h on the high-fat diet, IMCL concentration was 30–45% higher than preexercise, whereas it remained 5–17% lower on the low-fat diet. Training status had no significant influence on IMCL replenishment. Glycogen was restored within a day with both diets. We conclude that fat intake postexercise strongly promotes IMCL repletion independently of training status. Furthermore, replenishment of IMCL can be completed within a day when fat intake is sufficient.
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Wijsman, C. A., A. M. van Opstal, H. E. Kan, A. B. Maier, R. G. J. Westendorp, P. E. Slagboom, A. G. Webb, S. P. Mooijaart, and D. van Heemst. "Proton magnetic resonance spectroscopy shows lower intramyocellular lipid accumulation in middle-aged subjects predisposed to familial longevity." American Journal of Physiology-Endocrinology and Metabolism 302, no. 3 (February 2012): E344—E348. http://dx.doi.org/10.1152/ajpendo.00455.2011.
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Families predisposed to longevity show enhanced glucose tolerance and skeletal muscle insulin sensitivity compared with controls, independent of body composition and physical activity. Intramyocellular lipid (IMCL) accumulation in skeletal muscle has been associated with insulin resistance. Here, we assessed whether subjects enriched for familial longevity have lower IMCL levels. We determined IMCL levels in 48 subjects from the Leiden Longevity Study, comprising 24 offspring of nonagenarian siblings and 24 partners thereof as control subjects. IMCL levels were assessed noninvasively using short echo time proton magnetic resonance spectroscopy (1H-MRS) of the tibialis anterior muscle with a 7 Tesla human MR scanner. IMCL levels were calculated relative to the total creatine (tCr) CH3 signal. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). After correction for age, sex, BMI, and physical activity, offspring of long-lived nonagenarian siblings tended to show lower IMCL levels compared with controls (IMCL/tCr: 3.1 ± 0.5 vs. 4.5 ± 0.5, respectively, P = 0.051). In a pairwise comparison, this difference reached statistical significance ( P = 0.038). We conclude that offspring of nonagenarian siblings predisposed to longevity show lower IMCL levels compared with environmentally matched control subjects. Future research should focus on assessing what mechanisms may explain the lower IMCL levels in familial longevity.
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Bengele, H. H., E. R. McNamara, J. H. Schwartz, and E. A. Alexander. "Acidification adaptation along the inner medullary collecting duct." American Journal of Physiology-Renal Physiology 255, no. 6 (December 1, 1988): F1155—F1159. http://dx.doi.org/10.1152/ajprenal.1988.255.6.f1155.
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Chronic acid feeding (ACD) stimulates and chronic alkali (AKL) feeding suppresses acid secretion along the inner medullary collecting duct (IMCD) of the rat. The purpose of these experiments was to determine whether these stimuli produce IMCD acidification adaptation. We tested this hypothesis by acutely changing systemic PCO2 in rats chronically fed ACD or ALK. Microcatheterization was used to measure pH and PCO2 and samples were simultaneously obtained for measurement of bicarbonate, titratable acid (TA), and ammonium. In 10 ACD rats (arterial pH, 7.26 +/- 0.01; PCO2, 88 +/- 1 mmHg) acid secretion along the IMCD was 506 +/- 88 nmol/min. In 10 ALK rats with similar arterial gases (pH, 7.16 +/- 0.02; PCO2, 82 +/- 1 mmHg) IMCD acid secretion was only 284 +/- 57 nmol/min, P less than 0.05. In ACD rats made hypocarbic (pH, 7.26 +/- 0.03; PCO2, 24 +/- 1 mmHg), IMCD acid secretion was 163 +/- 55 nmol/min. These data were compared with previously studied rats eating a regular diet. Acute hypocarbia (pH, 7.54 +/- 0.02; PCO2, 20 +/- 1 mmHg) completely suppressed acid secretion, 4 +/- 23 nmol/min, along the IMCD. We conclude that chronic alterations in acid-base status provide an IMCD "set" where comparable stimuli produce significant differences in IMCD acidification. These data provide additional support for the concept of IMCD acidification adaptation.
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Zhang, Lei, Wen Liu, Fangyan Liu, Qun Wang, Mengjiao Song, Qi Yu, Kun Tang, et al. "IMCA Induces Ferroptosis Mediated by SLC7A11 through the AMPK/mTOR Pathway in Colorectal Cancer." Oxidative Medicine and Cellular Longevity 2020 (April 4, 2020): 1–14. http://dx.doi.org/10.1155/2020/1675613.
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Ferroptosis, implicated in several diseases, is a new form of programmed and nonapoptotic cell death triggered by iron-dependent lipid peroxidation after inactivation of the cystine/glutamate antiporter system xc–, which is composed of solute carrier family 7 membrane 11 (SLC7A11) and solute carrier family 3 membrane 2 (SLC3A2). Therefore, inducing ferroptosis through inhibiting the cystine/glutamate antiporter system xc– may be an effective way to treat cancer. In previous screening tests, we found that the benzopyran derivative 2-imino-6-methoxy-2H-chromene-3-carbothioamide (IMCA) significantly inhibited the viability of colorectal cancer cells. However, the impact of IMCA on ferroptosis remains unknown. Hence, this study investigated the effect of IMCA on ferroptosis and elucidated the underlying molecular mechanism. Results showed that IMCA significantly inhibited the cell viability of colorectal cancer cells in vitro and inhibited tumor growth with negligible organ toxicity in vivo. Further studies showed that IMCA significantly induced the ferroptosis of colorectal cancer cells. Mechanistically, IMCA downregulated the expression of SLC7A11 and decreased the contents of cysteine and glutathione, which resulted in reactive oxygen species accumulation and ferroptosis. Furthermore, overexpression of SLC7A11 significantly attenuated the ferroptosis caused by IMCA. In addition, IMCA regulated the activity of the AMPK/mTOR/p70S6k signaling pathway, which is related to the activity of SLC7A11 and ferroptosis. Collectively, our research provided experimental evidences on the activity and mechanism of ferroptosis induced by IMCA and revealed that IMCA might be a promising therapeutic drug for colorectal cancer.
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Plate, Joost D. J., Linda M. Peelen, Luke P. H. Leenen, and Falco Hietbrink. "Optimizing critical care of the trauma patient at the intermediate care unit: a cost-efficient approach." Trauma Surgery & Acute Care Open 3, no. 1 (October 2018): e000228. http://dx.doi.org/10.1136/tsaco-2018-000228.
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BackgroundThe aim of this study was to describe the case load, safety, and cost savings of critical care of the trauma patient provided at the surgical intermediate care unit (IMCU).MethodsThis cohort study included all trauma admissions between January 1, 2011 and January 7, 2015 at the general intensive care unit (ICU), stand-alone neuro(surgical) IMCU, and stand-alone (trauma) surgical IMCU. Trauma mechanism, Abbreviated Injury Scale score and Injury Severity Score (ISS), vital signs, laboratory parameters, admission duration, intubation duration, ICU transfer, and in-hospital mortality were prospectively collected. Hypothetical cost savings were calculated using the fixed cost price per IMCU (US$1500) and ICU (US$2500) admission day.ResultsA total of 1320 admissions were included, 675 (51.1%) at the IMCU and 645 (48.9%) at the ICU. Patients admitted at the IMCU had a median ISS of 17 (11, 22). Their median duration of admission was 32.8 hours (18.8, 62.5). At the IMCU, one patient died due to aneurogenic shock. A subsequent ICU transfer was required in 38 (5.6%) IMCU admissions. Of these transfers, four patients died due to neurological deterioration. At the ICU, the median ISS was 22 (14, 30). Nearly all (n=620, 96.3%) ICU trauma patients required mechanical ventilation. Expected total cost savings due to the presence of the IMCU were US$1 772 785.DiscussionA substantial amount of trauma patients in need of critical care can safely be admitted at the IMCU, without the need for further mechanical ventilation. Thereby, the IMCU could fulfill an essential cost-saving role in the management of severely injured trauma patients.Level of evidenceLevel IV.
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Gu, X., D. Yang, Y. C. Chan, and B. Y. Wu. "Effects of electromigration on the growth of intermetallic compounds in Cu/SnBi/Cu solder joints." Journal of Materials Research 23, no. 10 (October 2008): 2591–96. http://dx.doi.org/10.1557/jmr.2008.0331.
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In this study, the effects of electromigration (EM) on the growth of Cu–Sn intermetallic compounds (IMCs) in Cu/SnBi/Cu solder joints under 5 × 103 A/cm2 direct current stressing at 308, 328, and 348 K were investigated. For each Cu/SnBi/Cu solder joint under current stressing, the IMCs at the cathode side grew faster than that at the anode side. The growth of these IMCs at the anode side and the cathode side were enhanced by electric current. The growth of these IMCs at the cathode followed a parabolic growth law. The kinetics parameters of the growth of the IMCs were calculated from the thickness data of the IMCs at the cathode side at different ambient temperatures. The calculated intrinsic diffusivity (D0) of the Cu–Sn IMCs was 9.91 × 10−5 m2/s, and the activation energy of the growth of the total Cu–Sn IMC layer was 89.2 kJ/mol (0.92 eV).
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Nishimura, Midori Filiz, Takuro Igawa, Yuka Gion, Sakura Tomita, Dai Inoue, Akira Izumozaki, Yoshifumi Ubara, Yoshito Nishimura, Tadashi Yoshino, and Yasuharu Sato. "Pulmonary Manifestations of Plasma Cell Type Idiopathic Multicentric Castleman Disease: A Clinicopathological Study in Comparison with IgG4-Related Disease." Journal of Personalized Medicine 10, no. 4 (December 10, 2020): 269. http://dx.doi.org/10.3390/jpm10040269.
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Plasma cell type idiopathic multicentric Castleman disease (PC-iMCD) occasionally manifests as parenchymal lung disease. This study aimed to elucidate the detailed clinicopathological features of lung lesions in PC-iMCD and compare the findings with those in immunoglobulin (Ig) G4-related disease (IgG4-RD), the most difficult differential diagnosis of PC-iMCD. We analyzed the clinicopathological findings and immunohistochemical expression patterns of interleukin-6 (IL-6) and Igs in lung specimens from 16 patients with PC-iMCD and 7 patients with IgG4-RD. Histologically, pulmonary PC-iMCD could not be differentiated from IgG4-RD based on lesion distribution patterns, the number of lymphoid follicles and obliterative vasculitis, or fibrosis types. The eosinophil count was higher in the IgG4-RD group than in the PC-iMCD group (p = 0.004). The IgG4/IgG-positive cell ratio was significantly higher in the IgG4-RD group (p < 0.001). The IgA-positive cell count and IL-6 expression intensity were higher in the PC-iMCD group than in the IgG4-RD group (p < 0.001). Based on these findings, we proposed a new diagnostic approach to differentiate lung lesions of PC-iMCD and IgG4-RD. Our approach can be utilized to stratify patients with suspected lung-dominant PC-iMCD to identify candidates for strong immunosuppressive treatment, including IL-6 blockade, at an early stage.
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Ujiie, K., H. Nonoguchi, K. Tomita, and F. Marumo. "Effects of ANF on cGMP synthesis in inner medullary collecting duct subsegments of rats." American Journal of Physiology-Renal Physiology 259, no. 3 (September 1, 1990): F535—F538. http://dx.doi.org/10.1152/ajprenal.1990.259.3.f535.
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The inner medullary collecting duct (IMCD) is thought to be a major target site for atrial natriuretic factor (ANF) action. The IMCD is divided into two subsegments (IMCD1, outer third; and IMCD2,3, inner two-thirds) based on differences in urea and water permeability. IMCD1 has similar characteristics to the outer medullary collecting duct (OMCD). To elucidate whether there are any differences among these segments in ANF actions, we investigated the effects of ANF on guanosine 3',5'-cyclic monophosphate (cGMP) synthesis in IMCD subsegments and the OMCD. We also examined the effects of arginine vasopressin (AVP) on adenosine 3',5'-cyclic monophosphate (cAMP) synthesis. IMCD subsegments (IMCD1,2,3) and OMCD were microdissected; and ANF-stimulated cGMP synthesis and AVP-stimulated cAMP synthesis were measured. cGMP synthesis stimulated by 10(-6) M ANF in IMCD1,2,3 (0.78 +/- 0.15, 0.81 +/- 0.19, 0.62 +/- 0.10 fmol.mm-1 x 3 min-1, mean +/- SE respectively, n = 10-11) was significantly (greater than 20-fold) higher than that in OMCD (0.03 +/- 0.02 fmol.mm-1 x 3 min-1, n = 7), and there was no difference among IMCD subsegments. On the other hand, cAMP synthesis stimulated by 10(-7) M AVP in IMCD subsegments was similar to that in OMCD. We conclude that IMCD is homogenous as a target site of ANF and is clearly distinguished from OMCD. In addition, more than half of ANF-stimulated cGMP synthesis in IMCD are considered to occur in IMCD1, simply because IMCD1 is dominant in population among IMCD subsegments. As target sites of AVP, IMCD subsegments are similar to OMCD.
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Zeidel, M. L., P. Silva, B. M. Brenner, and J. L. Seifter. "cGMP mediates effects of atrial peptides on medullary collecting duct cells." American Journal of Physiology-Renal Physiology 252, no. 3 (March 1, 1987): F551—F559. http://dx.doi.org/10.1152/ajprenal.1987.252.3.f551.
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Atrial natriuretic peptides (ANP) stimulate renal Na+ excretion by poorly understood mechanisms, possibly involving direct inhibition of Na+ transport in the renal medulla. We have previously shown that human ANP 4-28 (hANP) inhibits Na+ entry-dependent O2 consumption (QO2) in rabbit inner medullary collecting duct (IMCD) cells. Because ANP actions in other tissues appear to be mediated by guanosine 3',5'-cyclic monophosphate (cGMP), the present studies examined the role of cyclic nucleotides in IMCD cell responses to ANP. 8-Bromo-cGMP (8-BrcGMP) diminished QO2 by 23.5 +/- 1.2% (SE) in IMCD cells but had no effect in cells derived from outer medullary collecting duct (OMCD); dibutyryl-adenosine 3',5'-cyclic monophosphate (cAMP) was without effect in IMCD cells. The inhibitory effect of BrcGMP was not additive with ANP, amiloride, or ouabain. Amphotericin, which enhances Na+ entry into cells, prevented the inhibitory effect of 8-BrcGMP. These results indicate that 8-BrcGMP, like ANP, inhibited Na+ entry in IMCD cells. hANP stimulated a 10-fold increase in cGMP in IMCD cells without altering IMCD cAMP levels or OMCD cGMP levels. Isobutyl methylxanthine, which inhibits phosphodiesterase activity, enhanced both cGMP accumulation and inhibition of QO2 by submaximal levels (10(-9) M) of ANP. Nitroprusside raised cGMP levels in both IMCD and OMCD cells but inhibited QO2 only in IMCD cells. We conclude that cGMP mediates the transport effects of ANP in IMCD cells. Our results indicate that cGMP may play an important role in the regulation of sodium transport in renal epithelia.
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Roscoe, David, A. J. Roberts, D. Hulse, A. F. Shaheen, M. P. Hughes, and A. N. Bennet. "Effects of anterior compartment fasciotomy on intramuscular compartment pressure in patients with chronic exertional compartment syndrome." Journal of the Royal Army Medical Corps 164, no. 5 (April 24, 2018): 338–42. http://dx.doi.org/10.1136/jramc-2017-000895.
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BackgroundPatients with chronic exertional compartment syndrome (CECS) have pain during exercise that usually subsides at rest. Diagnosis is usually confirmed by measurement of intramuscular compartment pressure (IMCP) following exclusion of other possible causes. Management usually requires fasciotomy but reported outcomes vary widely. There is little evidence of the effectiveness of fasciotomy on IMCP. Testing is rarely repeated postoperatively and reported follow-up is poor. Improved diagnostic criteria based on preselection and IMCP levels during dynamic exercise testing have recently been reported.Objectives(1) To compare IMCP in three groups, one with classical symptoms and no treatment and the other with symptoms of CECS who have been treated with fasciotomy and an asymptomatic control group. (2) Establish if differences in IMCP in these groups as a result of fasciotomy relate to functional and symptomatic improvement.MethodsTwenty subjects with symptoms of CECS of the anterior compartment, 20 asymptomatic controls and 20 patients who had undergone fasciotomy for CECS were compared. All other possible diagnoses were excluded using rigorous inclusion criteria and MRI. Dynamic IMCP was measured using an electronic catheter wire before, during and after participants exercised on a treadmill during a standardised 15 min exercise challenge. Statistical analysis included t-tests and analysis of variance.ResultsFasciotomy results in reduced IMCP at all time points during a standardised exercise protocol compared with preoperative cases. In subjects responding to fasciotomy, there is a significant reduction in IMCP below that of preoperative groups (P<0.001). Postoperative responders to fasciotomy have no significant differences in IMCP from asymptomatic controls (P=0.182).ConclusionFasciotomy reduces IMCP in all patients. Larger studies are required to confirm that the reduction in IMCP accounts for differences in functional outcomes and pain reductions seen in postoperative patients with CECS.
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Mahmoudian-Dehkordi, Amin, and Somayeh Sadat. "A Generic Simulation Model of the Relative Cost-Effectiveness of ICU Versus Step-Down (IMCU) Expansion." Journal of Intensive Care Medicine 35, no. 2 (October 31, 2017): 191–202. http://dx.doi.org/10.1177/0885066617737303.
Full textAbstract:
Background: Many jurisdictions are facing increased demand for intensive care. There are two long-term investment options: intensive care unit (ICU) versus step-down or intermediate care unit (IMCU) capacity expansion. Relative cost-effectiveness of the two investment strategies with regard to patient lives saved has not been studied to date. Methods: We expand a generic system dynamics simulation model of emergency patient flow in a typical hospital, populated with empirical evidence found in the medical and hospital administration literature, to estimate the long-term effects of expanding ICU versus IMCU beds on patient lives saved under a common assumption of 2.1% annual increase in hospital arrivals. Two alternative policies of expanding ICU by two beds versus introducing a two-bed IMCU are compared over a ten-year simulation period. Russel equation is used to calculate total cost of patients’ hospitalization. Using two possible values for the ratio of ICU to IMCU cost per inpatient day and four possible values for the percentage of patients transferred from ICU to IMCU found in the literature, nine scenarios are compared against the baseline scenario of no capacity expansion. Results: Expanding ICU capacity by two beds is demonstrated as the most cost-effective scenario with an incremental cost-effectiveness ratio of 3684 (US $) per life saved against the baseline scenario. Sensitivity analyses on the mortality rate of patients in IMCU, direct transfer of IMCU-destined patients to the ward upon completing required IMCU length of stay in the ICU, admission of IMCU patient to ICU, adding two ward beds, and changes in hospital size do not change the superiority of ICU expansion over other scenarios. Conclusions: In terms of operational costs, ICU beds are more cost effective for saving patients than IMCU beds. However, capital costs of setting up ICU versus IMCU beds should be considered for a complete economic analysis.