From the spleen cells of BALB/c mice primed with bee venom phospholipase A2 (PLA2), we established seven T cell hybridomas which constitutively secreted glycosylation inhibiting factor (GIF), expressed both CD3 and TCR alpha beta, and responded to antigen-pulsed antigen presenting cells (APC) for the formation of IgE-binding factor. Upon stimulation with antigen-pulsed APC, four of the seven hybridomas produced GIF having affinity for native PLA2. The antigen-binding GIF could suppress the anti-hapten antibody response of BALB/c mice to dinitrophenyl (DNP)-PLA2 conjugates in a carrier-specific manner and bound to immunosorbents coupled with either the mAb 14-12 or anti-TCR alpha chain, H28-710. Analysis of the epitope specificity of the TCR on the GIF-producing T hybridomas indicated that all of the hybridomas which could produce antigen-binding GIF upon antigenic stimulation recognized the synthetic peptide representing amino acid residues 19-34 in PLA2 molecules in the context of the product of the I-Ad subregion and the antigen-binding GIF formed by the cells had affinity for the peptide. The 3-D structure of bee venom PLA2 indicates that the sequence of amino acid 14-24 forms a loop in the PLA2 molecule and represents an external structure of the antigen, while peptide 25-37 forms an alpha helix. Evidence was obtained which suggests that the sequence of 25-34 contains amino acid residues interacting with Ia molecules, while peptide 19-24 contains residues involved in the interaction of p19-34-Ia complexes with TCR on the hybridomas. It was also found that not only the synthetic peptide 19-34, but also the peptides 13-28 and 19-30 inhibited the binding of antigen-binding GIF to PLA2-coupled Sepharose, while peptide 25-40 failed to do so. The results collectively indicate that the antigen-binding GIF and TCR on the cell source of the factor interact with a common epitope which is exposed on the surface of a nominal antigen.

Interactive documents for use with the World Wide Web have been developed for viewing multi-dimensional radiographic and visual images of human anatomy, derived from the Visible Human Project. Emphasis has been placed on user-controlled features and selections. The purpose was to develop an interface which was independent of host operating system and browser software which would allow viewing of information by multiple users. The interfaces were implemented using HyperText Markup Language (HTML) forms, C programming language and Perl scripting language. Images were pre-processed using ANALYZE and stored on a Web server in CompuServe GIF format. Viewing options were included in the document design, such as interactive thresholding and two-dimensional slice direction. The interface is an example of what may be achieved using the World Wide Web. Key applications envisaged for such software include education, research and accessing of information through internal databases and simultaneous sharing of images by remote computers by health personnel for diagnostic purposes.

A Philips (Eindhoven, The Netherlands) 430 (300 keV) high resolution transmission electron microscope has been modified for in situ study of gas-solid interactions at elevated temperatures. This microscope can be best described as a synthesis, processing, and characterization laboratory for nano-size materials. A differentially pumped environmental cell (E-cell), capable of handling up to 20 torr of gas pressure, is fitted in the objective lens pole-piece gap. Single-tilt or double-tilt heating holders can be used to heat the samples up to 1,300 degrees C and 850 degrees C, respectively. The system can handle any non-corrosive gases such as H2, O2, N2, NH3, CO, water vapor. Electron diffraction patterns are used to elucidate the reaction path and to identify stable and/or metastable phases formed. Time, temperature, and pressure resolved electron diffraction patterns can also be used to estimate the thermodynamical conditions for the onset of a reaction and the stability range of different phases observed during the process can also be determined. The high resolution imaging capabilities enable elucidation of the basic structural mechanisms involved at near atomic level. The TV rate camera/video recording system is used to measure the reaction rates (kinetics of the reaction). A post projector energy filter (Gatan Imaging Filter, GIF) is attached at the bottom of the microscope in order to filter the inelastic scattering from the gases/thick samples as well as to obtain energy filtered images (chemical maps). The GIF can also be used as a parallel electron energy loss spectrometer (PEELS) to obtain changes in the sample composition during the reactions. The changes in the near-edge structures of PEELS spectrum is used to monitor changes in bonding and/or chemical environment elements during reaction. The chemical maps obtained can also be used to identify preferred regions of gas reactions, e.g., grain boundaries or surfaces, etc. Various modifications of the microscope are described in detail, with suitable examples showing the performance.

A simple vibration sensor is proposed and demonstrated based on an optical fiber Fabry-Perot interferometer (FPI) with an in-fiber collimator. The device was fabricated by splicing a quarter-pitch graded index fiber (GIF) with a section of a hollow-core fiber (HCF) interposed between single mode fibers (SMFs). The static displacement sensitivity of the FPI with an in-fiber collimator was 5.17 × 10^-4 μm^-1, whereas the maximum static displacement sensitivity of the device without collimator was 1.73 × 10^-4 μm^-1. Moreover, the vibration sensitivity of the FPI with the collimator was 60.22 mV/g at 100 Hz, which was significantly higher than the sensitivity of the FPI without collimator (11.09 mV/g at 100 Hz). The proposed FPI with an in-fiber collimator also exhibited a vibration sensitivity nearly one order of magnitude higher than the device without the collimator at frequencies ranging from 40 to 200 Hz. This low-cost FPI sensor is highly-sensitive, robust and easy to fabricate. It could potentially be used for vibration monitoring in remote and harsh environments.

Gait ignition failure (GIF) classifications all had major limitations. Few years ago, a new and simpler classification was proposed by Liston. The aim of this paper is to discuss three GIF patients with respect to this new classification. All three patients presented with hesitation to start walking and turning and their neurological examination revealed start and turn hesitation without any other abnormality. We classified our patients according to Liston's classification as ignition apraxia, which enabled us to approach the patients in a practical way. This classification helps to understand the underlying pathologies and combines clinical characteristics and pathophysiology. We reported our experience with pergolide in the treatment of patients suffering from primary GIF and underline the fact that more research is needed on the treatment of this condition.

BACKGROUND

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas may extend to other organs. However, it is rare for a histopathologically benign IPMN to rupture other organs, particularly multiple organs. There has been no report of a benign IPMN rupturing both the stomach and duodenum.

OBJECTIVE

We experienced a very rare case and make personal remarks based on bibliographical consideration.

METHODS

Case report.

METHODS

National Defense Medical College.

METHODS

A patient with IPMN.

METHODS

EGD, ERCP, and pancreatoduodenectomy.

CONCLUSIONS

We report a case of benign IPMN of the pancreas extending to two adjacent organs. A 77-year-old male who was diagnosed as having IPMN by CT, MRI, upper GIF, and ERCP underwent pancreatoduodenectomy for a mass of 4.2 cm in diameter. Pathological examinations revealed that the IPMN was composed of adenoma. Intraluminal nodular growth was observed in the duodenal gland tissue, and abnormal growth was observed in the fistula to the stomach. According to a literature review based on PubMed data up until March 2009, it is rare for a benign IPMN to penetrate two adjacent organs.

BACKGROUND

Gastric Carcinoma is one of the most lethal cancer around the world, and is also the most common cancers in Eastern Asia. A lot of differentially expressed genes have been detected as being associated with Gastric Carcinoma (GC) progression, however, little is known about the underlying dysfunctional regulation mechanisms. To address this problem, we previously developed a differential networking approach that is characterized by involving differential coexpression analysis (DCEA), stage-specific gene regulatory network (GRN) modelling and differential regulation networking (DRN) analysis.

RESULTS

In order to implement differential networking meta-analysis, we developed a novel framework which integrated the following steps. Considering the complexity and diversity of gastric carcinogenesis, we first collected three datasets (GSE54129, GSE24375 and TCGA-STAD) for Chinese, Korean and American, and aimed to investigate the common dysregulation mechanisms of gastric carcinogenesis across racial groups. Then, we constructed conditional GRNs for gastric cancer corresponding to normal and carcinoma, and prioritized differentially regulated genes (DRGs) and gene links (DRLs) from three datasets separately by using our previously developed differential networking method. Based on our integrated differential regulation information from three datasets and prior knowledge (e.g., transcription factor (TF)-target regulatory relationships and known signaling pathways), we eventually generated testable hypotheses on the regulation mechanisms of two genes, XBP1 and GIF, out of 16 common cross-racial DRGs in gastric carcinogenesis.

CONCLUSIONS

The current cross-racial integrative study from the viewpoint of differential regulation networking provided useful clues for understanding the common dysfunctional regulation mechanisms of gastric cancer progression and discovering new universal drug targets or biomarkers for gastric cancer.

The ruthenium(II) complex cis-[Ru(6, 6'-Cl(2)bpy)(2)(OH(2))(2)](CF(3)SO(3))(2) (1) is a robust catalyst for C-H bond oxidations of hydrocarbons, including linear alkanes, using tert-butyl hydroperoxide (TBHP) as terminal oxidant. Alcohols can be oxidized by the "1 + TBHP" protocol to the corresponding aldehydes/ketones with high product yields at ambient temperature. Oxidation of 1 with Ce(IV) in aqueous solution affords cis-[Ru(VI)(6, 6'-Cl(2)bpy)(2)O(2)](2+), which is isolated as a green/yellow perchlorate salt (2). Complex 2 is a powerful stoichiometric oxidant for cycloalkane oxidations under mild conditions. Oxidation of cis-decalin is highly stereoretentive; cis-decalinol is obtained in high yield, and formation of trans-decalinol is not observed. Mechanistic studies showing a large primary kinetic isotope effect suggest a hydrogen-atom abstraction pathway. The relative reactivities of cycloalkanes toward oxidation by 2 have been examined through competitive experiments, and comparisons with Gif-type processes are presented.

The epidermis of Mastacembelus armatus is equipped with secretorily active gland cells which are found in large numbers in both the middle and outermost epidermal layers. The middle layer is formed by sacciform glandular cells characterized by an enormous secretion occupying the bulk of the gland cell that pushes the nucleus along with the cytoplasm to cell periphery. This secretion consists of coarse granules that probably transform into the homogeneous material prior to its extrusion to the exterior via the apical pore. The histochemical reactions indicate the presence of total proteins aromatic proteins, tyrosine and tryptophan in addition to the 5-hydroxytryptamine(5-HT) histochemically detectable by both diazo-safranin, alkaline diazo-reactions and histofluorescence procedures (FIF and GIF techniques). In the outermost layer are present numerous flask-shaped mucous cells (globlet cells) which secrete copious amounts of strongly acidic mucous glycoproteins containing O-acetylated sialic acids detected by some recent sophisticated methods in addition to the routine enzyme extraction techniques based on the use of neuraminidase. A mucous coating at the surface epidermal layer could be not located and the profuse secretions of the goblet cell mucins can affect the modalities of the cutaneous respiration of this fish provided with high vascular adaptations of the dermis. The presence of biogenic amines and especially of 5-HT could be correlated with a possible irritating action to produce the predator repellant or intimately connected with the synthesis and release of the integumentary products of fish skin. Its function, remains to be solved with biochemical methods suitable to investigate thoroughly the chemical nature of the proteinaceous product in each species showed with sacciform cells.

BACKGROUND

Conversion of glucose into lipid (de novo lipogenesis; DNL) is a possible fate of carbohydrate administered during nutritional support. It cannot be detected by conventional methods such as indirect calorimetry if it does not exceed lipid oxidation.

OBJECTIVE

The objective was to evaluate the effects of carbohydrate administered as part of continuous enteral nutrition in critically ill patients.

METHODS

This was a prospective, open study including 25 patients nonconsecutively admitted to a medicosurgical intensive care unit. Glucose metabolism and hepatic DNL were measured in the fasting state or after 3 d of continuous isoenergetic enteral feeding providing 28%, 53%, or 75% carbohydrate.

RESULTS

DNL increased with increasing carbohydrate intake (f1.gif" BORDER="0"> +/- SEM: 7.5 +/- 1.2% with 28% carbohydrate, 9.2 +/- 1.5% with 53% carbohydrate, and 19.4 +/- 3.8% with 75% carbohydrate) and was nearly zero in a group of patients who had fasted for an average of 28 h (1.0 +/- 0.2%). In multiple regression analysis, DNL was correlated with carbohydrate intake, but not with body weight or plasma insulin concentrations. Endogenous glucose production, assessed with a dual-isotope technique, was not significantly different between the 3 groups of patients (13.7-15.3 micromol * kg(-1) * min(-1)), indicating impaired suppression by carbohydrate feeding. Gluconeogenesis was measured with [(13)C]bicarbonate, and increased as the carbohydrate intake increased (from 2.1 +/- 0.5 micromol * kg(-1) * min(-1) with 28% carbohydrate intake to 3.7 +/- 0.3 micromol * kg(-1) * min(-1) with 75% carbohydrate intake, P: < 0. 05).

CONCLUSIONS

Carbohydrate feeding fails to suppress endogenous glucose production and gluconeogenesis, but stimulates DNL in critically ill patients.

This study examines structural features and aspects of reactivity of Gif-type reagents, which depend on O2/Zn to mediate oxidation of hydrocarbons. The reagents investigated derive from the use of iron complexes with the anion of the weak carboxylic acid Me3CCO2H (pivalic acid (PivH)) in pyridine/PivH. In these solutions, the known compound [Fe3O(O2CCMe3)6(py)3] is reduced by Zn to generate yellow-green [FeII(O2CCMe3)2(py)4], which readily reverts to [Fe3O(O2CCMe3)6(py)3], and eventually to [Fe3O(O2CCMe3)6(py)3]+, upon exposure to dioxygen. All three species are equally well suited to mediate Gif-like oxygenation of substrates supported by O2/Zn. [FeIII3O(O2CCMe3)6(L)3]+ (L = H2O, py) is converted by H2O2 to afford the hexairon(III) peroxo compounds [Fe6(O2)(O)2(O2CCMe3)12(L)2] (L = Me3CCO2H, py), which feature a [Fe6(eta 2-mu 4-O2)(mu 3-O)2] core previously documented in the closely related [Fe6(O2)(O)2(O2CPh)12(H2O)2]. A similar peroxo species, [Fe6(O2)(O)2(O2CCMe3)2(O2CCF3)10(H2O)2], is obtained upon replacing all pivalate ligands by trifluoroacetate groups with the exception of those pivalates that bridge between the two [Fe3O(O2CCF3)5(H2O)]2+ units. The structure of the [Fe6(O2)(O)2] core in these peroxo species is found to range from a recliner to a butterfly-type conformation. Reduction of [Fe6(O2)(O)2(O2CCMe3)12(HO2CCMe3)2] with NaBH4 generates [Na2Fe4(O)2(O2CCMe3)10(L)(L')] (L = CH3CN, L' = Me2CO; L = L' = Me3CCO2H), which feature a [Na2Fe4(O)2] core possessing a bent butterfly conformation of the [Fe4(O)2] unit. Oxidation of the same peroxo complex by CeIV or NOBF4 regenerates the oxo-bridged [Fe3O(O2CCMe3)6(solv)3]+ (solv = EtOH, H2O, thf). Employment of the sterically encumbered 2-Me-5-Etpyridine provides the tetrairon compound [Fe4(O)2(O2CCMe3)8(2-Me-5-Etpy)2], which can be readily transformed upon treatment with H2O2 to the asymmetric peroxo complex [Fe6(O2)(O)2(O2CCMe3)12(2-Me-5-Etpy)2]. The peroxo-containing complexes oxidize both cis-stilbene and adamantane in either benzene or py/PivH, but only under forceful conditions and at very low yields. The low reactivity and high selectivity (tert/sec = 8) obtained in the oxidation of adamantane suggests that the present type of peroxo species is not directly involved in catalytic Gif-type oxygenations of adamantane.

An Internet web page is described for organizing and analyzing information about lepidopteran sex pheromone components. Hypertext markup language (HTML) with JavaScript program code is used to draw moth pheromone analogs by combining GIF bitmap images for viewing by web browsers such as Netscape or Microsoft Intemet Explorer. Straight-chain hydrocarbons of 5-22 carbons with epoxides or unsaturated positions of E or Z geometrical configuration with several altemative functional groups can be drawn by simply checking menu bars or checkboxes representing chain length, E/Z unsaturation points, epoxide position and chirality, and optional functional groups. The functional group can be an aldehyde, alcohol, or ester of formate, acetate, propionate, or butyrate. The program is capable of drawing several million structures and naming them [e.g., (E,E)-8,10-dodecadien-1-ol and abbreviated as E8E10-12:OH]. A Java applet program run from the same page searches forthe presently drawn structure in an intemal database compiled from the Pherolist, and if the component is found, provides a textarea display of the families and species using the component. Links are automatically specified for drawn components if found in the Pherolist web site (maintained by H. Am). Windowed links can also be made to two other JavaScript programs that allow searches of a web site database with over 5900 research citations on lepidopteran semiochemicals and a calculator of vapor pressures of some moth sex pheromone analogs at a specified temperature. Various evolutionary and biosynthetic aspects are discussed in regard to the diversity of moth sex pheromone components.

Wheat, though a key crop plant with considerable influence on world food security, has nonetheless trailed behind other major cereals in the advancement of gene transformation technology for its improvement. New breeding technologies such as genome editing allow precise DNA manipulation, but their potential is limited by low regeneration efficiencies in tissue culture and the lack of transformable genotypes. We developed, in the hexaploid spring wheat cultivar "Fielder," a robust, reproducible Agrobacterium tumefaciens-mediated transformation system with transformation efficiencies of up to 33%. The system requires immature embryos as starting material and includes a centrifugation pretreatment before the inoculation with Agrobacterium. This high-throughput, highly efficient, and repeatable transformation system has been used effectively to introduce genes of interest for overexpression, RNA interference, and CRISPR-Cas-based genome editing. With slight modifications reported here, the standard protocol can be applied to the hexaploid wheat "Cadenza" and the tetraploid durum wheat "Kronos" with efficiencies of up to 4% and 10%, respectively. The system has also been employed to assess the developmental gene fusion GRF-GIF with outstanding results. In our hands, this technology combined with our transformation system improved transformation efficiency to 77.5% in Fielder. This combination should help alleviate the genotype dependence of wheat transformation, allowing new genome-editing tools to be used directly in more elite wheat varieties. © 2021 The Authors. Basic Protocol 1: Growing of donor plants Basic Protocol 2: Transformation of Agrobacterium with vector by electroporation Basic Protocol 3: Starting material collection, sterilization, and embryo inoculation Basic Protocol 4: Selection, regeneration, rooting, and acclimatization of transformants.

Keywords: Agrobacterium; CRISPR; genome editing; immature embryo; wheat transformation.

Two cases of primary and isolated gastroduodenal candidiasis are described. The diagnosis of the mycotic infection was based on the discovery of hyphae in the biopsy obtained through the gastroscope (Olympus GIF-K). Clinical, endoscopic and histologic appearances are discussed.

Gastrointestinal fistulas (GIFs) arise as a complication of the surgical treatment of a number of malignant and non-malignant diseases. Fluid loss and electrolyte and nutritional imbalance are related to increased morbidity and mortality in these patients. A multidisciplinary approach under the leadership of the surgeon is essential for successful therapy. Because complication rates are higher in malnourished patients with fistulas, enteral or total parenteral nutritional (TPN) support should be initiated after the patient has been stabilized with respect to fluid loss, acid-base, and sepsis. Pharmacotherapy with somatostatin and octreotide has been shown to reduce fistula output and shorten closure time.

BACKGROUND

Gastrointestinal fistula (GIF) in severe acute pancreatitis (SAP) is considered as a sparse episode and studied sporadically in the literature. There is paucity of data on the prediction of the effect on risk of GIF in patient with SAP. This study was aimed to investigate risk factors related to GIF in the development of SAP.

METHODS

The clinical data of 344 patients with SAP from 2011 to 2016 were reviewed retrospectively. All patients were divided into the GIF group and the non-GIF group, and their data analyzed with respect to 15 parameters were applied to explore potential risk factors for GIF in patients with SAP.

RESULTS

Of the 344 eligible patients, 52 (15.12%) progressed to GIF. Only occurrence of infected pancreatic and extra-pancreatic necrosis (IPN) (P = 0.004, OR = 3.012) and modified CT severity index (MCTSI) (P = 0.033, OR = 1.183) were proved to be independent risk factors for GIF in patients with SAP, and blood type B (P = 0.048, OR = 2.096, 95% CI: 0.748-3.562) indicated weaker association of risk factor for GIF. The early (48-72 h after admission) enteral nutrition (EEN) (P = 0.016, OR = 0.267) acted as a protective factor.

CONCLUSIONS

Occurrence of IPN and high MCTSI are independent risk factors for the development of GIF in patients with SAP, blood type B reveals a potential correlation with GIF in patients with SAP. EEN is helpful to prevent the progression of GIF secondary to SAP.

Dual red imaging (DRI; Red Dichromatic Imaging (RDI)) is a new type of image-enhanced endoscopy composed of two long wavelengths that together can visualize vessels in the deep submucosa of the gastrointestinal wall. We treated a case of gastric ulcer bleeding in which the bleeding point could be clearly visualized using DRI. A 71-year-old man who was taking warfarin for atrial fibrillation noticed tarry stool, entered a state of hypovolemic shock, and underwent emergency esophagogastroduodenoscopy. The procedure was performed with a GIF-Y0058 prototype endoscope (Olympus Co., Tokyo, Japan) equipped with a DRI mode. An ulcer with active bleeding was found in the upper portion of the stomach, but the massive volume of the bleeding made it difficult to identify the bleeding point using white light imaging (WLI). Upon switching to DRI mode by pushing a button on the endoscope, the bleeding point could be identified rapidly and precisely, as it appeared in a deeper yellow than the surrounding area. Complete hemostasis was thereupon achieved. This case demonstrates that the DRI mode may be useful for detecting bleeding points that are difficult to detect using WLI.

OBJECTIVE

Gastrointestinal dysfunction and failure (GID and GIF) in critically ill patients are a common, relevant, and underestimated complications in ICU patients. The aims of this study were (1) to determine plasmatic levels of citrulline, glutamine, and arginine as markers of GID/GIF in critically ill patients with or without GID/GIF with or without multiple organ failure (MOF) and (2) to assess the role of intra-abdominal hypertension in these patient groups.

METHODS

This is a 1-year, monocentric (Italian hospital), prospective observational study. Inclusion criteria were adult patients with GID/GIF, with or without MOF. The GIF score was daily evaluated in 39 critically ill patients. Amino acids were measured at the time of GID or GIF.

RESULTS

We enrolled 39 patients. Nine patients developed GID and 7 GIF; 6 of patients with GID/GIF developed MOF. Citrulline was lower ( P < .001) in patients with GID/GIF (11.3 [4.4] µmol/L), compared to patients without GID/GIF (22.4 [6.8] µmol/L); likewise, glutamine was lower in patients with GID/GIF, whereas arginine was nonstatistically different between the 2 groups. Intra-abdominal pressure was higher in patients affected by MOF (13.0 [2.2] mm Hg) than in patients with GIF/GID without MOF (9.6 [2.6] mm Hg) and compared to patients without GID/GIF (7.2 [2.1] mm Hg).

CONCLUSIONS

Both GID and GIF in critically ill patients are associated with low levels of citrulline and glutamine, which could be considered as markers of small bowel dysfunction. The higher the GIF score, the lower the citrulline levels. Patients affected by MOF had higher levels of intra-abdominal pressure.

Gastrointestinal failure (GIF) is frequent in patients managed in the intensive care units and manifests as gut paralysis or ileus. GIF is often associated with sepsis or multiorgan failure. In critically ill patients, the precipitating causes of GIF include inflammation, sepsis, electrolyte abnormalities, and acidosis. It is possible that GIF is associated with an increase in bacterial translocation, especially in those with cirrhosis and portal hypertension, and this may play a significant pathogenic or prognostic role in acute-on-chronic liver failure (ACLF). The critical care literature suggests that GIF is associated with a higher mortality risk. In this review, we summarize the evidence for a potential association between GIF and ACLF and propose treatment options for the management of GIF. Moreover, we suggest GIF to be considered as another organ failure when the severity of ACLF is assessed.

This study presents AtheroCloud™ - a novel cloud-based smart carotid intima-media thickness (cIMT) measurement tool using B-mode ultrasound for stroke/cardiovascular risk assessment and its stratification. This is an anytime-anywhere clinical tool for routine screening and multi-center clinical trials. In this pilot study, the physician can upload ultrasound scans in one of the following formats (DICOM, JPEG, BMP, PNG, GIF or TIFF) directly into the proprietary cloud of AtheroPoint from the local server of the physician's office. They can then run the intelligent and automated AtheroCloud™ cIMT measurements in point-of-care settings in less than five seconds per image, while saving the vascular reports in the cloud. We statistically benchmark AtheroCloud™ cIMT readings against sonographer (a registered vascular technologist) readings and manual measurements derived from the tracings of the radiologist. One hundred patients (75 M/25 F, mean age: 68±11 years), IRB approved, Toho University, Japan, consisted of Left/Right common carotid artery (CCA) artery (200 ultrasound scans), (Toshiba, Tokyo, Japan) were collected using a 7.5MHz transducer. The measured cIMTs for L/R carotid were as follows (in mm): (i) AtheroCloud™ (0.87±0.20, 0.77±0.20); (ii) sonographer (0.97±0.26, 0.89±0.29) and (iii) manual (0.90±0.20, 0.79±0.20), respectively. The coefficient of correlation (CC) between sonographer and manual for L/R cIMT was 0.74 (P<0.0001) and 0.65 (P<0.0001), while, between AtheroCloud™ and manual was 0.96 (P<0.0001) and 0.97 (P<0.0001), respectively. We observed that 91.15% of the population in AtheroCloud™ had a mean cIMT error less than 0.11mm compared to sonographer's 68.31%. The area under curve for receiving operating characteristics was 0.99 for AtheroCloud™ against 0.81 for sonographer. Our Framingham Risk Score stratified the population into three bins as follows: 39% in low-risk, 70.66% in medium-risk and 10.66% in high-risk bins. Statistical tests were performed to demonstrate consistency, reliability and accuracy of the results. The proposed AtheroCloud™ system is completely reliable, automated, fast (3-5 seconds depending upon the image size having an internet speed of 180Mbps), accurate, and an intelligent, web-based clinical tool for multi-center clinical trials and routine telemedicine clinical care.

BACKGROUND

The zoonotic Orf virus (ORFV; genus Parapoxvirus, Poxviridae family) occurs worldwide and is transmitted between sheep and goats, wildlife and man. Archived tissue samples from 16 Alaskan wildlife cases, representing mountain goat (Oreamnos americanus, n = 8), Dall's sheep (Ovis dalli dalli, n = 3), muskox (Ovibos moschatus, n = 3), Sitka black-tailed deer (Odocoileus hemionus sitkensis, n = 1) and caribou (Rangifer tarandus granti, n = 1), were analyzed.

RESULTS

Clinical signs and pathology were most severe in mountain goats, affecting most mucocutaneous regions, including palpebrae, nares, lips, anus, prepuce or vulva, as well as coronary bands. The proliferative masses were solid and nodular, covered by dark friable crusts. For Dall's sheep lambs and juveniles, the gross lesions were similar to those of mountain goats, but not as extensive. The muskoxen displayed ulcerative lesions on the legs. The caribou had two ulcerative lesions on the upper lip, as well as lesions on the distal part of the legs, around the main and dew claws. A large hairless spherical mass, with the characteristics of a fibroma, was sampled from a Sitka black-tailed deer, which did not show proliferative lesions typical of an ORFV infection. Polymerase chain reaction analyses for B2L, GIF, vIL-10 and ATI demonstrated ORFV specific DNA in all cases. Sequences from Dall's sheep formed a separate cluster, comparable to ORFV from domestic sheep. Sequences from the other species were different from the Dall's sheep sequences, but almost identical to each other.

CONCLUSIONS

This is the first major investigation of parapoxvirus infections in large Alaskan game species, and the first report of parapoxvirus infection in caribou and Sitka black-tailed deer. This study shows that most of the wild ruminant species in Alaska and from most parts of Alaska, can carry and be affected by ORFV. These findings call for attention to transmission of ORFV from wildlife to livestock and to hunters, subsistence harvesters, and wildlife biologists.

This study aimed to study the effect of early traditional Chinese medicine bundle therapy on the prevention of sepsis-associated acute gastrointestinal injury (AGI). This was a multicenter, prospective, observational, non-randomized cohort study of 296 consecutive patients with severe sepsis during 2013/3 and 2014/11; 150 patients received standard treatments (controls) and 146 received traditional Chinese medicine bundle therapy (intervention group) (herbal decoction gavage based on syndrome differentiation, Chinese acupuncture, application of mirabilite, and defecation mixture). D-lactic acid, diamine oxidase, endotoxin, gastrin, motilin, and intra-abdominal pressure were measured. AGI was categorized into four levels. Compared with controls, D-lactic acid, diamine oxidase, endotoxin, gastrin, and intra-abdominal pressure in the intervention group were decreased, and motilin was increased on day 7. AGI incidence in the intervention group was lower than in controls. GIF scores of the intervention AGI II and III groups were lower than in controls. The APACHE II scores of the intervention AGI II, III, and IV groups were lower than in controls. Compared with controls, mechanical ventilation time and ICU stay in the intervention group were shorter, and 28-day overall and AGI-attributed mortality were lower. For elderly patients with severe sepsis, early traditional Chinese medicine bundle therapy could decrease AGI incidence and improve prognosis.