Adipocyte HSL is required for maintaining circulating vitamin A and RBP4 levels during fasting.

Vitamin A (retinol) is distributed via the blood bound to its specific carrier protein, retinol-binding protein 4 (RBP4). Retinol-loaded RBP4 is secreted into the circulation exclusively from hepatocytes, thereby mobilizing hepatic retinoid stores that represent the major vitamin A reserves in the body. The relevance of extrahepatic retinoid stores for circulating retinol and RBP4 levels that are usually kept within narrow physiological limits is unknown.

What is the diagnostic accuracy of neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio in detecting acute periprosthetic joint infections? A gender-specific analysis.

Purpose: The accurate and timely diagnosis of periprosthetic joint infection (PJI) is critical for guiding optimal treatment management and success, highlighting the requirement of readily available inexpensive serum biomarkers to increase the diagnostic accuracy for PJI. Many studies have investigated the diagnostic accuracy of neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR). However, there is a lack of existing literature regarding optimal thresholds for acute PJI.

Takotsubo Syndrome: An Epidemiologic Evaluation.

Takotsubo syndrome is characterized by regional wall motion abnormalities that reflect impairment of myocardial contractility in the absence of culprit epicardial coronary artery disease. The pathophysiologic mechanisms responsible for Takotsubo syndrome remain unknown and predominately occur in postmenopausal females suffering either a psychological or physical stressor. This study used the Hospital Corporation of America (HCA) Healthcare database evaluating demographic distribution of patients with Takotsubo syndrome to identify what comorbid conditions were most prevalent in patients found to have Takotsubo syndrome in the United States population and compare them to the traditional patient population with the condition.

Academic data science: Transdisciplinary and extradisciplinary visions.

As a nascent field within the academy, the contours, attributes, and bounties of data science are still indeterminate and contested. We studied how participants in an initiative to establish data science at a large American research university defined data science and articulated their relationships to the field. We discuss two contrasting visions for data science among our research participants.

Antithrombotics and Gastrointestinal Prophylaxis: A Systematic Review.

Antithrombotic medications include both antiplatelet and anticoagulants and are used for a wide variety of cardiovascular conditions. A common complication of antithrombotic use is gastrointestinal bleeding. As a result, gastrointestinal prophylaxis is a common consideration for patients on a single or combination antithrombotic regimen.

Acute retinol mobilization by retinol-binding protein 4 in mouse liver induces fibroblast growth factor 21 expression.

Hepatocytes secrete retinol-binding protein 4 (RBP4) into circulation, thereby mobilizing vitamin A from the liver to provide retinol for extrahepatic tissues. Obesity and insulin resistance are associated with elevated RBP4 levels in the blood. However, in a previous study, we observed that chronically increased RBP4 by forced Rbp4 expression in the liver does not impair glucose homeostasis in mice.

Hepatic p53 is regulated by transcription factor FOXO1 and acutely controls glycogen homeostasis.

The tumor suppressor p53 is involved in the adaptation of hepatic metabolism to nutrient availability. Acute deletion of p53 in the mouse liver affects hepatic glucose and triglyceride metabolism. However, long-term adaptations upon the loss of hepatic p53 and its transcriptional regulators are unknown.

Serotonin Syndrome Induced Tako-Tsubo Syndrome.

Tako-tsubo syndrome is characterized by temporary systolic dysfunction of the left ventricle in the absence of coronary artery disease. Serotonin syndrome is a life-threatening condition associated with increased serotonergic activity in the central nervous system (CNS). We report a case of Tako-tsubo syndrome following seizures secondary to serotonin syndrome.

Retinoid Homeostasis and Beyond: How Retinol Binding Protein 4 Contributes to Health and Disease.

Retinol binding protein 4 (RBP4) is the specific transport protein of the lipophilic vitamin A, retinol, in blood. Circulating RBP4 originates from the liver. It is secreted by hepatocytes after it has been loaded with retinol and binding to transthyretin (TTR).

Gravitational Bremsstrahlung and Hidden Supersymmetry of Spinning Bodies.

The recently established formalism of a worldline quantum field theory, which describes the classical scattering of massive bodies (black holes, neutron stars, or stars) in Einstein gravity, is generalized up to quadratic order in spin, revealing an alternative N=2 supersymmetric description of the symmetries inherent in spinning bodies. The far-field time domain waveform of the gravitational waves produced in such a spinning encounter is computed at leading order in the post-Minkowskian (weak field, but generic velocity) expansion, and exhibits this supersymmetry. From the waveform we extract the leading-order total radiated angular momentum in a generic reference frame, and the total radiated energy in the center-of-mass frame to leading order in a low-velocity approximation.

Chest Pain from Pneumopericardium with Gastropericardial Fistula.

Introduction: Gastropericardial fistula, a connection between the upper gastrointestinal tract and pericardium, is a rare clinical finding most commonly associated with postsurgical complications, as well as direct tissue invasion from gastric cancer. . We report a case of a 58-year-old Caucasian woman with metastatic colon cancer treated with FOLFOX, a combination chemotherapy regimen, and bevacizumab who presented with chest pain.

Repeat Biopsy to Assess Duodenal Healing in Children With Celiac Disease and Eosinophilic Gastrointestinal Disorders.

Unlabelled: The aim of the study was to determine the correlation between duodenal mucosal biopsies and tissue transglutaminase immunoglobulin A (tTG-IgA) levels in pediatric patients with biopsy-confirmed celiac disease (CD) and eosinophilic gastrointestinal disorders (EGID) who have had repeat duodenal biopsies after initiating a gluten-free diet.

Methods: A retrospective chart review was performed of children with CD and EGID seen at the Children's Hospital of Philadelphia between 2003 and 2018. Data collected included duodenal biopsy pathology, celiac serology including tTG-IgA, and symptom reports.

Classical Gravitational Bremsstrahlung from a Worldline Quantum Field Theory.

Using the recently established formalism of a worldline quantum field theory description of the classical scattering of two spinless black holes, we compute the far-field time-domain waveform of the gravitational waves produced in the encounter at leading order in the post-Minkowskian (weak field but generic velocity) expansion. We reproduce the previous results of Kovacs and Thorne in a highly economic way. Then, using the waveform, we extract the leading-order total radiated angular momentum and energy (including differential results).

Pharmacological inhibition of adipose tissue adipose triglyceride lipase by Atglistatin prevents catecholamine-induced myocardial damage.

Aims: Heart failure (HF) is characterized by an overactivation of β-adrenergic signalling that directly contributes to impairment of myocardial function. Moreover, β-adrenergic overactivation induces adipose tissue lipolysis, which may further worsen the development of HF. Recently, we demonstrated that adipose tissue-specific deletion of adipose triglyceride lipase (ATGL) prevents pressure-mediated HF in mice.

Biological Functions of RBP4 and Its Relevance for Human Diseases.

Retinol binding protein 4 (RBP4) is a member of the lipocalin family and the major transport protein of the hydrophobic molecule retinol, also known as vitamin A, in the circulation. Expression of RBP4 is highest in the liver, where most of the body's vitamin A reserves are stored as retinyl esters. For the mobilization of vitamin A from the liver, retinyl esters are hydrolyzed to retinol, which then binds to RBP4 in the hepatocyte.

A regional analysis of payer and provider views on cholesterol management: PCSK9 inhibitors as an illustrative alignment model.

Multiple barriers exist for appropriate use of the proprotein convertase subtilisin/kexin type 9 enzyme inhibitors (PCSK9i) in patients with atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH) with inadequately controlled hypercholesterolemia despite standard therapies. Among these barriers, high payer rejection rates and inadequate prior authorization (PA) documentation by providers hinder optimal use of PCSK9i. To (a) identify and discuss provider and payer discordances on barriers to authorization and use of PCSK9i based on clinical and real-world evidence and (b) align understanding and application of clinical, cost, safety, and efficacy data of PCSK9i.

Gravitational Spin-Orbit Coupling through Third-Subleading Post-Newtonian Order: From First-Order Self-Force to Arbitrary Mass Ratios.

Exploiting simple yet remarkable properties of relativistic gravitational scattering, we use first-order self-force (linear-in-mass-ratio) results to obtain arbitrary-mass-ratio results for the complete third-subleading post-Newtonian (4.5PN) corrections to the spin-orbit sector of spinning-binary conservative dynamics, for generic (bound or unbound) orbits and spin orientations. We thereby improve important ingredients of models of gravitational waves from spinning binaries, and we demonstrate the improvement in accuracy by comparing against aligned-spin numerical simulations of binary black holes.

The Pediatric Endurance Athlete.

Youth sports participation numbers continue to grow in the United States. A shift toward sport specialization has caused an increase in sport training frequency and intensity that places the growing athlete at risk for overtraining, nutritional deficits, and injuries. Individuals who participate in endurance sports are at especially high risk.

Effects of Neutron-Star Dynamic Tides on Gravitational Waveforms within the Effective-One-Body Approach.

Extracting the unique information on ultradense nuclear matter from the gravitational waves emitted by merging neutron-star binaries requires robust theoretical models of the signal. We develop a novel effective-one-body waveform model that includes, for the first time, dynamic (instead of only adiabatic) tides of the neutron star as well as the merger signal for neutron-star-black-hole binaries. We demonstrate the importance of the dynamic tides by comparing our model against new numerical-relativity simulations of nonspinning neutron-star-black-hole binaries spanning more than 24 gravitational-wave cycles, and to other existing numerical simulations for double neutron-star systems.

Hypertension and mild chronic kidney disease persist following severe haemolytic uraemic syndrome caused by Shiga toxin-producing Escherichia coli O104:H4 in adults.

Background: Shiga toxin-producing, enteroaggregative Escherichia coli was responsible for the 2011 outbreak of haemolytic uraemic syndrome (HUS). The present single-centre, observational study describes the 1-year course of the disease with an emphasis on kidney function. Outcome data after 1 year are associated with treatment and patient characteristics at onset of HUS.

Effects of a dexamethasone-releasing implant on cochleae: A functional, morphological and pharmacokinetic study.

Aim: This study evaluated the impact of a dexamethasone-releasing silicone implant on hearing function preservation, cochlear morphology and perilymph pharmacokinetics after cochlear implantation.

Methods: Guinea pigs were implanted unilaterally with silicone rods containing either 2% dexamethasone (DEXA group, n = 18) or no dexamethasone (control group, n = 17). Auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAEs) were measured preoperatively and over 6 months postoperatively.

[Diabetic nephropathy: current diagnostics and treatment].

Diabetic kidney disease is a leading cause of renal failure in Germany. Albuminuria is an early diagnostic indicator of renal damage in diabetes and, aside from renal failure, a major risk factor of cardiovascular disease. An early diagnosis of diabetic kidney disease is of great importance to reduce associated cardiovascular mortality; glycemic control should aim for HbA1c levels of < 7 %.

Lack of difference in acute nephrotoxicity of intravenous bisphosphonates zoledronic acid and ibandronate in women with breast cancer and bone metastases.

Background: More than 50% of patients with advanced breast cancer develop bone metastases that may lead to multiple complications such as pathological fractures, bone pain or hypercalcaemia. The standard treatment, besides endocrine, targeted-therapy or chemotherapy, is the use of bisphosphonates. However, one of their main adverse side-effects is bisphosphonate-induced nephrotoxicity.