Ill. electric company equips 240 trucks with AEDs

According to the American Heart Association, people who go into cardiac arrest while at work have only a 5-7 percent chance of surviving when an AED is not present

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Morphological description and morphometric analyses of the Upper Palaeolithic human remains from Dzudzuana and Satsurblia caves, western Georgia

Publication date: December 2017
Source:Journal of Human Evolution, Volume 113
Author(s): Cristiana Margherita, Gregorio Oxilia, Veronica Barbi, Daniele Panetta, Jean-Jacques Hublin, David Lordkipanidze, Tengiz Meshveliani, Nino Jakeli, Zinovi Matskevich, Ofer Bar-Yosef, Anna Belfer-Cohen, Ron Pinhasi, Stefano Benazzi




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Pleistocene fossil woods from the Okote Member, site FwJj 14 in the Ileret region, Koobi Fora Formation, northern Kenya

Publication date: Available online 4 September 2017
Source:Journal of Human Evolution
Author(s): Marion K. Bamford
On the eastern side of Lake Turkana in northern Kenya are extensive Plio-Pleistocene deposits containing a rich diversity of fossil mammals, hominins and flora within the radiometrically dated tuffaceous, lacustrine and fluvial sequence. Reconstruction of this landscape and paleoenvironment are part of an ongoing multinational and multidisciplinary human evolution project in the eastern Turkana Basin. Today there is a huge lake in the Rift Valley but it has fluctuated since the early Pliocene. Silicified wood is fairly common in some areas of the Koobi Fora Formation. One such site is FwJj 14E, alongside one of the tributaries of the Ileret River. Hominin hand and arm bones have been excavated from here in the Okote Member and dated at 1.56–1.36 Ma. The fossils are associated with hominin and bovid footprints. Sixty of the over 100 wood specimens collected have been sectioned and studied. In general the woods have large vessels and an average vulnerability index of 40, which implies a mesic megathermal environment with no water stress. Taxonomically the woods belong to large African families: Caesalpiniaceae (Didelotia idae), Combretaceae (Anogeissus sp.), Putranjivaceae (Euphorbiaceae; Drypetes sp.), Lamiaceae (cf Premna sp.), Malvaceae (Heritiera sp.) and Sapindaceae (Sapindoxylon sp.). Most of these taxa do not occur in the area today because now it is much drier and the local vegetation is predominantly Acacia-Commiphora-Salvadora shrubland. The reconstruction of the paleovegetation supports the interpretation from the fauna, namely, a tall riverine forest with shady refuge trees, possibly some edible fruits, and wooded grassland and more open bushland in the vicinity.



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Protective Effect of 1,25-Dihydroxy Vitamin D3 on Pepsin–Trypsin-Resistant Gliadin-Induced Tight Junction Injuries

Abstract

Background

Tight junction (TJ) injuries induced by pepsin–trypsin-resistant gliadin (PT–G) play an important role in the pathogenesis of celiac disease. Previously, 1,25-dihydroxy vitamin D3 (VD3) was reported to be a TJ regulator that attenuates lipopolysaccharide- and alcohol-induced TJ injuries. However, whether VD3 can attenuate PT–G-induced TJ injuries is unknown.

Aim

The aim of this study was to evaluate the effects of VD3 on PT–G-induced TJ injuries.

Methods

Caco-2 monolayers were used as in vitro models. After being cultured for 21 days, the monolayers were treated with PT–G plus different concentrations of VD3. Then, the changes in trans-epithelial electrical resistance and FITC-dextran 4000 (FD-4) flux were determined to evaluate the monolayer barrier function. TJ protein levels were measured to assess TJ injury severity, and myeloid differentiation factor 88 (MyD88) expression and zonulin release levels were determined to estimate zonulin release signaling pathway activity. Additionally, a gluten-sensitized mouse model was established as an in vivo model. After the mice were treated with VD3 for 7 days, we measured serum FD-4 concentrations, TJ protein levels, MyD88 expression, and zonulin release levels to confirm the effect of VD3.

Results

Both in vitro and in vivo, VD3 significantly attenuated the TJ injury-related increase in intestinal mucosa barrier permeability. Moreover, VD3 treatment up-regulated TJ protein expression levels and significantly decreased MyD88 expression and zonulin release levels.

Conclusions

VD3 has protective effects against PT–G-induced TJ injuries both in vitro and in vivo, which may correlate with the disturbance of the MyD88-dependent zonulin release signaling pathway.

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Clinical Course of Partial Virologic Response with Prolonged Tenofovir Therapy in Nuclos(t)ides-Naïve Patients with Chronic Hepatitis B

Abstract

Background/Aims

The clinical course of chronic hepatitis B (CHB) patients with partial virologic response (PVR) during tenofovir disoproxil fumarate (TDF) therapy remains unclear.

Methods

We retrospectively investigated the long-term clinical outcomes of TDF treatment in nucleos(t)ides-naïve CHB patients, particularly in those with PVR.

Results

A total of 391 patients treated with TDF therapy for more than 12 months were included. Virologic response (VR) was achieved in 341 patients (87.2%). PVR was evident in 127 (45.3%) of the 391 patients. Multivariate logistic regression analysis using selected baseline factors identified absolute HBV DNA levels at baseline (OR 0.496; 95% CI 1.369–1.969) and HBeAg positivity (OR 0.622; 95% CI 1.096–3.167) as factors significantly associated with PVR. During continuous prolonged TDF therapy, 127 (71.8%) of 177 patients with PVR achieved VR. The cumulative rates of VR in patients with PVR at 12, 24, and 36 months were 42.4, 79.7, and 90.2%, respectively. Serum HBV DNA level at week 24 was significantly associated with VR in patients with PVR.

Conclusions

The vast majority of CHB patients with PVR achieved VR through prolonged TDF therapy, although the time to achieve VR was delayed in those with PVR. This suggests that adjustment of TDF therapy in patients with PVR is unnecessary.

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Treatment Response and Outcome with Two Different Prednisolone Regimens in Autoimmune Hepatitis

Abstract

Background

Beyond available guidelines, therapy of autoimmune hepatitis (AIH) shows wide variation among physicians. We compared two regimens for treatment naive AIH: one recommended protocol with an initial prednisolone dose of 30 mg/day and our own 40 mg/day prednisolone with a slow dose tapering protocol. We analyzed the safety, response rates, and outcomes for two groups of treated patients.

Patients and Methods

We retrospectively evaluated data of 71 AIH patients including, group I (n = 32, prednisone 30 mg/day) and group II (n = 39, prednisone 40 mg/day). All patients also received azathioprine.

Results

The frequency of complete biochemical response was significantly higher in group II than in group I (69.2 vs. 43.8%, p = 0.031) after 3 months of therapy, but not after 6 and 12 months (79.5 vs. 59.4%, p = 0.065 and 89.5 vs. 80.6%, p = 0.30). In patients with severe interface hepatitis, the complete response rates were significantly higher in group II than in group I after 3 (63.6 vs. 23.1%, p = 0.02) and 6 months (72.7 vs. 38.5%, p = 0.046), but not after 12 months of therapy (86.4 vs. 69.2%, p = 0.221). Relapses were observed in 50% of group I and in 35.9% of group II during maintenance therapy (p = 0.23). Overall survival was significantly better in group II than in group I (100 vs. 87.5%, log-rank, p = 0.048). No severe steroid-related side effects were observed in either group.

Conclusions

Our real-world experience suggests that an initial prednisolone dose of 40 mg/day with a slower tapering protocol induces earlier biochemical response, tends to result in less relapses during maintenance, and is associated with a better disease outcome.

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A Prospective Evaluation of Ileocecal Valve Dysfunction and Intestinal Motility Derangements in Small Intestinal Bacterial Overgrowth

Abstract

Background

Small intestinal bacterial overgrowth (SIBO) is an increasingly recognized clinical syndrome; however, its etiophathogenesis is poorly understood. We hypothesized that loss of gastric acid, a delayed intestinal transit, and ileocecal valve dysfunction may contribute to the genesis of this syndrome.

Aims

Our primary aim was to assess these parameters using wireless motility capsule (WMC) testing and to correlate them with the presence or absence of SIBO.

Methods

We prospectively evaluated 30 consecutive patients at a tertiary care center with suspected SIBO, diagnosed by lactulose hydrogen breath testing (LBT), and small bowel aspirate microbiology. Patients underwent WMC testing to assess ileocecal junction pressure (ICJP), small bowel transit time (SBTT), and regional gastrointestinal pH.

Results

Thirty patients completed testing; 15 had a positive LBT, and 11 had a positive aspirate culture. As compared with LBT-negative patients, ICJP was lower (27.8 vs. 72.7 mmHg, p = 0.027), SBTT was longer (10.0 vs. 1.1 h, p = 0.004), gastric pH was higher (3.63 vs. 2.42, p < 0.01), and small bowel pH was higher (6.96 vs. 6.61, p = 0.05). A hypotensive ICJP (<46.61 mmHg) was more prevalent in LBT-positive patients as compared with LBT-negative patients (73.3 vs. 14.29%, p = 0.003). Logistic regression models were used to assess the magnitude of each measured WMC parameter and the presence of SIBO. p values ≤0.05 were considered statistically significant.

Conclusions

Patients with SIBO have significantly lower ICJP, prolonged SBTT, and a higher gastrointestinal pH as compared to those without SIBO. These abnormalities may play different roles in the pathogenesis of SIBO, facilitating more targeted treatment to prevent recurrences of SIBO.

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