Type 2 Inflammation in Eosinophilic Esophagitis: From Pathophysiology to Therapeutic Targets

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation, whose incidence is rising. It significantly affects patients’ quality of life and, if left untreated, results in fibrotic complications. Although broad consensus has been achieved on first-line therapy, a subset of patients remains non-responder to standard therapy. The pathogenesis of EoE is multifactorial and results from the complex, still mostly undefined, interaction between genetics and intrinsic factors, environment, and antigenic stimuli. A deep understanding of the pathophysiology of this disease is pivotal for the development of new therapies. This review provides a comprehensive description of the pathophysiology of EoE, starting from major pathogenic mechanisms (genetics, type 2 inflammation, epithelial barrier dysfunction, gastroesophageal reflux, allergens, infections and microbiota) and subsequently focusing on the single protagonists of type 2 inflammation (involved cells, cytokines, soluble effectors, surface proteins and transcription factors) that could represent present and future therapeutic targets, while summarizing previous therapeutic approaches in literature.

Risk Factors for Pancreatic Cancer: Emerging Role of Viral Hepatitis

Pancreatic cancer is one of the most aggressive malignant neoplastic diseases. The incidence and mortality rates of this disease vary depending on geographical area, which might be explained by the different exposure to risk factors. To improve the prognosis of patients with pancreatic cancer, different approaches are needed for an earlier diagnosis. Identification of risk factors and implementation of screening strategies are essential for a better prognosis. Currently, the risk factors for pancreatic cancer fall into two broad categories, namely extrinsic and intrinsic factors. Extrinsic factors include alcohol consumption, smoking, a diet rich in saturated fats, and viral infections such as chronic infection with hepatitis B and C viruses. The pathophysiological mechanisms explaining how these hepatotropic viruses contribute to the development of pancreatic cancer are not fully elucidated. The common origin of hepatocytes and pancreatic cells in the multipotent endodermal cells, the common origin of the blood vessels and biliary ducts of the pancreas and the liver, or chronic inflammatory changes may be involved in this interaction. A careful monitoring of patients with viral liver infections may contribute to the early diagnosis of pancreatic cancer and improve the prognosis of these patients.

Recording of Falls in Elderly Fallers in Northern Greece and Evaluation of Aging Health-Related Factors and Environmental Safety Associated with Falls: A Cross-Sectional Study

Background. Elderly falls constitute a global problem with huge social and economic aspects. Fall risk factors are both intrinsic (physical and psychological) and extrinsic (related with environmental safety). Aim. To record both intrinsic and extrinsic risk factors and their correlation in elderly fallers in order to suggest specific guidelines for their medical care and environmental modification inside and outside the home. Method. The study involved 150 elderly fallers (median age 70 (67-74)), who completed a record containing information on known risk factors related to their health status, as well as information on the conditions and causes that led to the fall. Each fall was considered an independent event, while measurements were performed regarding balance, strength, their functional ability, and the fear of a possible fall. Descriptive analysis and frequency analysis were used to record the health and activity status of the participants as well as the fall-related environmental factors. Severity of each fall event across a variety of locations was examined using the Kruskal-Wallis one-way analysis of variance. Multiple linear regression was applied to examine the effect of the mean values of functional tests and medical records on the number of fall events. Results. In the span of 12 months, a total of 304 fall events were recorded. Regarding location, 77.6% occurred indoors; more frequent were the bedroom (28.6%) and the bathroom (28%). The interior stairs (10.5%), the kitchen (4.9%), and the living room (3.3%) were the less frequent locations. Concerning danger, falling on the interior stairs caused the longest hospitalization, followed by the kitchen and the bathroom. Extrinsic factors that led to both indoor and outdoor falls were the administration of psychotropic medication, poor space ergonomics, lack of basic safety standards, and poor lighting conditions. Vision problems and dizziness resulted in more falls than other intrinsic factors. Furthermore, reduced performance in the FICSIT-4 test and the 30-Second Chair Stand Test, as well as high scores in the CONFbal–GREEK questionnaire and the Short FES-I, shows a linear relationship with an increased number of falls. Conclusions. Ergonomic interventions can help prevent indoor elderly falls. Poor construction and lack of adequate lighting mainly cause outdoor falls. Regular eye examinations, management of vertigo, improvement of the balance and strength of the lower limbs, and reduction of fear of impending falls are the intrinsic factors that help prevent falls the most.

Kompatibilitas Konsep Sustainable Development pada Laporan Corporate Social Responsibility

Intrinsic aspect that is owned by internal management on policies related to the corporation social responsibility (CSR) program leads to the results the company wants to achieve their purposes. Based on the context of intrinsic factors, this study intends to explore facts from the internal management of a company regarding the compatible concept for sustainable development (SD) as company achievements on CSR as a program that is run by the company. This research was conducted with a qualitative approach and strengthened by a triangulation process with supporting data from the company's Sustainability Report (SR). Monetary quantity parameter or economy aspect of corporate wealth (such as tangible assets be classified as internal features or extrinsic factor) have relatable impact to sustainable development (SD), with semantic analysis method revealed intrinsic factor have not it. The contribution to outcomes is to create a conceptual framework for categories associated with sustainable development through the CSR program that is required by the government for companies to implement in Indonesia. The implication of the research is found the CSR reporting supporting economic aspect, strengthen sustainable development in practices.

Engineering Spiking Neurons Using Threshold Switching Devices for High-Efficient Neuromorphic Computing

Inspired by the human brain, the spike-based neuromorphic system has attracted strong research enthusiasm because of the high energy efficiency and powerful computational capability, in which the spiking neurons and plastic synapses are two fundamental building blocks. Recently, two-terminal threshold switching (TS) devices have been regarded as promising candidates for building spiking neurons in hardware. However, how circuit parameters affect the spiking behavior of TS-based neurons is still an open question. Here, based on a leaky integrate-and-fire (LIF) neuron circuit, we systematically study the effect of both the extrinsic and intrinsic factors of NbOx -based TS neurons on their spiking behaviors. The extrinsic influence factors contain input intensities, connected synaptic weights, and parallel capacitances. To illustrate the effect of intrinsic factors, including the threshold voltage, holding voltage, and high/low resistance states of NbOx devices, we propose an empirical model of the fabricated NbOx devices, fitting well with the experimental results. The results indicate that with enhancing the input intensity, the spiking frequency increases first then decreases after reaching a peak value. Except for the connected synaptic weights, all other parameters can modulate the spiking peak frequency under high enough input intensity. Also, the relationship between energy consumption per spike and frequency of the neuron cell is further studied, leading guidance to design neuron circuits in a system to obtain the lowest energy consumption. At last, to demonstrate the practical applications of TS-based neurons, we construct a spiking neural network (SNN) to control the cart-pole using reinforcement learning, obtaining a reward score up to 450. This work provides valuable guidance on building compact LIF neurons based on TS devices and further bolsters the construction of high-efficiency neuromorphic systems.

School psychologists’ supporting American Indian students on the path to academic success: a community cultural wealth approach

Purpose This study involves a content analysis of research published from 2000 to 2018 about American Indian students with the principal aim to identify investigations addressing the supportive factors that contribute to student academic success. Secondary aims involved better understanding the parameters of the investigations, such as sample tribal affiliations and journal outlets. Design/methodology/approach Out of 6,341 total articles published in PsycARTICLES, PsycINFO and Education Resources Information Center over the time period, 86 articles covering the pre-school to college age years were identified, almost evenly distributed between pre-college (n = 42, 48.8%); and college age samples (n = 44, 51.2%). The 86 articles account for a mere 1.4% of all published articles over the 19 year period. A community cultural wealth approach (Yosso, 2005) was used as a framework for understanding the myriad of strengths students bring to their school experiences and was used as a lens for interpreting the study findings. Findings When disaggregated, the most common supports for pre-college age youth were culturally-sensitive schooling, personal/intrinsic qualities along with family and social support. For college age students, the most common supports were university personnel, community-based supports and student intrinsic factors. Further results, study limitations and implications are discussed. Originality/value This research is original.

Compartment syndrome as a donor-site complication of anterolateral thigh free flap: a case report

Compartment syndrome (CS), a complication at the donor site of anterolateral thigh free flap (ALT-FF), has a low incidence. Our patient was a 26-year-old male, a professional soldier with large thigh muscles. His defect on the right ankle was reconstructed with a 30×10 cm2-sized ALT-FF. By the pinch test, the flap width was designed to be sufficient for primary closure of the donor. However, on the postoperative day 8, severe pain, tense and purulent discharge were found at the donor site. We diagnosed CS clinically, and immediately performed incision and drainage. There are various extrinsic or intrinsic factors that can influence the development of CS. Therefore, in patients with these contributing factors, such as a young man with high muscle mass, a higher level of suspicion for CS is needed. Moreover, it would be safer to design the flap width smaller than the pinch test or to cover the donor site with a skin graft.

Edible Coating

Postharvest losses are rampant due to lack of proper storage conditions and handling of the fresh food products. The perishable nature of fruits and vegetables makes their shelf life limited due to some extrinsic factors such as some environmental conditions and preservation conditions as well as some intrinsic factors such as respiration rate, ethylene production and transpiration. Among the other postharvest technologies available, edible coatings seems to be one novel method which has been verified to have a positive and safe approach to extending the shelf life of products. This type of packaging is made from various natural resources like polysaccharide, protein and lipid materials. Edible packaging materials can be divided into two main groups including edible coatings and edible films. It has so many benefits such as serving as a moisture barrier, oxygen scavenger, ethylene scavenger, antimicrobial properties among others. Different methods of application of the edible coating on the food materials include; dipping, spraying, brushing, layer by layer among others. There have been several verifications of the positive impact of edible coatings/films on pome fruits, Citrus fruits, Stone fruits, tropical and exotic fruits, berries, melon, tomatoes and others.