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1.
Pediatr Dev Pathol ; : 10935266241255723, 2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38794944

RESUMO

BACKGROUND: Transnasal endoscopy (TNE) does not require general anesthesia, an attractive characteristic for monitoring eosinophilic esophagitis (EoE). We evaluated the adequacy of TNE-obtained esophageal biopsies using the EoE Histology Scoring System (EoEHSS). METHODS: The Cincinnati Center for Eosinophilic Disorders database was searched for esophageal biopsies obtained by the same endoscopist, using either TNE or conventional endoscopy (CE). Whole-slide biopsy images were evaluated. The Mann-Whitney test was used for median (interquartile range) values and Fisher exact test for categorical variables. P ≤ .05 was considered significant. RESULTS: Median age (P = .82) or height (P = .83) did not differ between TNE (n = 17) and CE (n = 17) groups. Although median largest piece size (mm2) differed between the groups (TNE: 0.59 (0.45, 0.86), CE: 2.24 (1.09, 2.82), P < .001), all 8 EoEHSS features were evaluated in each group; only 1 feature (lamina propria fibrosis) was missing in both groups (TNE: 19/34, CE: 11/34, P = .09). The median peak eosinophil count/high-power field differed (TNE: 3 (0, 29), CE: 16 (1, 66), P = .03), but overall grade (TNE: 0.17 (0.10, 0.29), CE: 0.22 (0.14, 0.46), P = .12), stage (TNE: 0.14 (0.10, 0.24), CE: 0.20 (0.10, 0.43), P = .15), and non-eosinophil-related individual EoEHSS scores did not differ. CONCLUSIONS: TNE- and CE-obtained esophageal biopsies are similarly sufficient for evaluation of key pathological features in EoE.

2.
Nature ; 627(8002): 64-66, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38448696

RESUMO

Planetary magnetic fields provide a window into the otherwise largely inaccessible dynamics of a planet's deep interior. In particular, interaction between fluid flow in electrically conducting interior regions and the magnetic field there gives rise to observable secular variation (time dependency) of the externally observed magnetic field. Secular variation of Jupiter's field has recently been revealed1-3 and been shown to arise, in part, from an axisymmetric, equatorial jet2. Whether this jet is time dependent has not previously been addressed, yet it is of critical importance for understanding the dynamics of the planet's interior. If steady, it would probably be a manifestation of deep dynamo convective flow (and jets are anticipated as part of that flow4-9) but if time dependent on a timescale much shorter than the convective turnover timescale of several hundred years, it would probably have a different origin. Here we show that the jet has a wavelike fluctuation with a period of roughly 4 years, strongly suggestive of the presence of a torsional oscillation10 (a cylindrically symmetric oscillating flow about the rotation axis) or a localized Alfvén wave in Jupiter's metallic hydrogen interior. This opens a pathway towards revealing otherwise hidden aspects of the magnetic field within the metallic hydrogen region and hence constraining the dynamo that generates Jupiter's magnetic field.

3.
PLoS One ; 19(1): e0285651, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38180986

RESUMO

Calcium/calmodulin-dependent protein kinase II (CaMKII) is a complex multifunctional kinase that is highly expressed in central nervous tissues and plays a key regulatory role in the calcium signaling pathway. Despite over 30 years of recombinant expression and characterization studies, CaMKII continues to be investigated for its impact on signaling cooperativity and its ability to bind multiple substrates through its multimeric hub domain. Here we compare and optimize protocols for the generation of full-length wild-type human calcium/calmodulin-dependent protein kinase II alpha (CaMKIIα). Side-by-side comparison of expression and purification in both insect and bacterial systems shows that the insect expression method provides superior yields of the desired autoinhibited CaMKIIα holoenzymes. Utilizing baculovirus insect expression system tools, our results demonstrate a high yield method to produce homogenous, monodisperse CaMKII in its autoinhibited state suitable for biophysical analysis. Advantages and disadvantages of these two expression systems (baculovirus insect cell versus Escherichia coli expression) are discussed, as well as purification optimizations to maximize the enrichment of full-length CaMKII.


Assuntos
Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina , Cálcio , Humanos , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética , Baculoviridae/genética , Biofísica , Sinalização do Cálcio , Escherichia coli/genética
4.
Mikrochim Acta ; 191(1): 46, 2023 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-38129631

RESUMO

Immobilization of proteins and enzymes on solid supports has been utilized in a variety of applications, from improved protein stability on supported catalysts in industrial processes to fabrication of biosensors, biochips, and microdevices. A critical requirement for these applications is facile yet stable covalent conjugation between the immobilized and fully active protein and the solid support to produce stable, highly bio-active conjugates. Here, we report functionalization of solid surfaces (gold nanoparticles and magnetic beads) with bio-active proteins using site-specific and biorthogonal labeling and azide-alkyne cycloaddition, a click chemistry. Specifically, we recombinantly express and selectively label calcium-dependent proteins, calmodulin and calcineurin, and cAMP-dependent protein kinase A (PKA) with N-terminal azide-tags for efficient conjugation to nanoparticles and magnetic beads. We successfully immobilized the proteins on to the solid supports directly from the cell lysate with click chemistry, forgoing the step of purification. This approach is optimized to yield low particle aggregation and high levels of protein activity post-conjugation. The entire process enables streamlined workflows for bioconjugation and highly active conjugated proteins.


Assuntos
Azidas , Nanopartículas Metálicas , Ouro , Proteínas/metabolismo , Catálise
5.
Curr Gastroenterol Rep ; 25(11): 289-298, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37658151

RESUMO

PURPOSE OF REVIEW: This review presents and summarizes the existing studies on the treatment goals and options for pediatric eosinophilic esophagitis utilizing rigorous peer-reviewed literature. RECENT FINDINGS: In addition to traditional treatments, emerging biologic therapies continue to evolve the approach to treating pediatric eosinophilic esophagitis. Well defined treatment goals will aid the continued development of new therapies. Further, innovative assessment tools have changed how the clinician is able to assess the effectiveness of therapies with a trend toward less invasive options. The management of pediatric eosinophilic esophagitis continues to evolve with the advent of both novel treatment options and assessment tools. Treatment choices, with benefits and risks involved, should be presented to families upon diagnosis and tailored towards the individual patient and likelihood of adherence and success. Biologic therapy for EoE presents an exciting option for both first line therapy and escalation for those with severe or unresponsive disease.


Assuntos
Esofagite Eosinofílica , Criança , Humanos , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/terapia , Terapia Biológica
6.
Lancet Gastroenterol Hepatol ; 8(9): 803-815, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37336228

RESUMO

BACKGROUND: In eosinophilic gastrointestinal diseases, the role of eosinophils in disease pathogenesis and the effect of eosinophil depletion on patient outcomes are unclear. Benralizumab, an eosinophil-depleting monoclonal antibody that targets the interleukin-5 receptor α, might eliminate gastric tissue eosinophils and improve outcomes in eosinophilic gastritis. We aimed to assess the efficacy and safety of benralizumab in patients with eosinophilic gastritis. METHODS: We conducted a single-site, randomised, double-blind, placebo-controlled, phase 2 trial at Cincinnati Children's Hospital Medical Center (Cincinnati, OH, USA). Individuals aged 12-60 years with symptomatic, histologically active eosinophilic gastritis (peak gastric eosinophil count ≥30 eosinophils per high-power field [eos/hpf] in at least five hpfs) and blood eosinophilia (>500 eosinophils per µL [eos/µL]) were randomly assigned (1:1, block size of four) to benralizumab 30 mg or placebo, stratified by the use of glucocorticoids for gastric disease. Investigators, study staff, and study participants were masked to treatment assignment; statisticians were unmasked when analysing data. Treatments were administered subcutaneously once every 4 weeks for a 12-week double-blind period (three total injections). The primary endpoint was the proportion of patients who achieved histological remission (peak gastric eosinophil count <30 eos/hpf) at week 12. Key secondary endpoints were the changes from baseline to week 12 in peak gastric eosinophil count, blood eosinophil count, eosinophilic gastritis histology (total, inflammatory, and structural feature scores), Eosinophilic Gastritis Endoscopic Reference System (EG-REFS) score, and patient-reported outcome symptom measures (Severity of Dyspepsia Assessment [SODA] and Patient-Reported Outcome Measurement Information System [PROMIS] short-form questionnaire). After the 12-week double-blind period, patients were eligible for entry into two open-label extension (OLE) periods up to week 88, in which all patients received benralizumab. Efficacy was analysed in the intention-to-treat (ITT) population and safety was assessed in all patients who received at least one dose of study drug. The trial was registered on ClinicalTrials.gov, NCT03473977, and is completed. FINDINGS: Between April 23, 2018, and Jan 13, 2020, 34 patients were screened, and 26 were subsequently randomly assigned to benralizumab (n=13) or placebo (n=13) and included in the ITT and safety populations (mean age 19·5 years [SD 7·3]; 19 [73%] male patients and seven [27%] female patients). At week 12, ten (77% [95% CI 50 to 92]) of 13 patients who received benralizumab and one (8% [1 to 33]) of 13 who received placebo achieved histological remission (difference 69 percentage points [95% CI 32 to 85]; p=0·0010). Changes from baseline to week 12 were significantly greater in the benralizumab group versus the placebo group for peak gastric eosinophil counts (mean -137 eos/hpf [95% CI -186 to -88] vs -38 eos/hpf [-94 to 18]; p=0·0080), eosinophilic gastritis histology total score (mean -0·31 [-0·42 to -0·20] vs -0·02 [-0·16 to 0·12]; p=0·0016), histology inflammatory score (mean -0·46 [-0·60 to -0·31] vs -0·04 [-0·22 to 0·13]; p=0·0006), and blood eosinophil counts (median -1060 eos/µL [IQR -1740 to -830] vs -160 eos/µL [-710 to 120]; p=0·0044). Changes were not significantly different between the groups for eosinophilic gastritis histology structural score (mean -0·07 [95% CI -0·19 to 0·05] vs 0·03 [-0·09 to 0·15]; p=0·23), EG-REFS score (mean -1·0 [-2·3 to 0·3] vs -0·5 [-2·0 to 1·0]; p=0·62), or in patient-reported outcomes (SODA and PROMIS). During the double-blind period, treatment-emergent adverse events occurred in 11 (85%) of 13 patients in the benralizumab group and six (46%) of 13 in the placebo group; the most common treatment-emergent adverse events were headache (six [46%] vs two [15%] patients), nausea (three [23%] vs two [15%]), and vomiting (two [15%] vs three [23%]). There were no treatment-related deaths. Two patients had serious adverse events (dizziness and rhabdomyolysis in one patient; aspiration in one patient) during the OLE periods, which were considered unrelated to study treatment. INTERPRETATION: Benralizumab treatment induced histological remission, as defined by absence of tissue eosinophilia, in most patients with eosinophilic gastritis. However, the persistence of histological, endoscopic, and other features of the disease suggest a co-existing, eosinophil-independent pathogenic mechanism and the need for broader targeting of type 2 immunity. FUNDING: AstraZeneca and the Division of Intramural Research (National Institute of Allergy and Infectious Diseases, US National Institutes of Health).


Assuntos
Asma , Eosinofilia , Estados Unidos , Criança , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Asma/complicações , Asma/tratamento farmacológico , Progressão da Doença , Eosinofilia/tratamento farmacológico
7.
Nat Commun ; 14(1): 2707, 2023 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-37221170

RESUMO

Our knowledge about the fine structure of lightning processes at Jupiter was substantially limited by the time resolution of previous measurements. Recent observations of the Juno mission revealed electromagnetic signals of Jovian rapid whistlers at a cadence of a few lightning discharges per second, comparable to observations of return strokes at Earth. The duration of these discharges was below a few milliseconds and below one millisecond in the case of Jovian dispersed pulses, which were also discovered by Juno. However, it was still uncertain if Jovian lightning processes have the fine structure of steps corresponding to phenomena known from thunderstorms at Earth. Here we show results collected by the Juno Waves instrument during 5 years of measurements at 125-microsecond resolution. We identify radio pulses with typical time separations of one millisecond, which suggest step-like extensions of lightning channels and indicate that Jovian lightning initiation processes are similar to the initiation of intracloud lightning at Earth.

8.
J Allergy Clin Immunol ; 152(1): 136-144, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36754294

RESUMO

BACKGROUND: Eosinophilic gastritis (EoG) associates with type 2 immunity. However, the type 2 cytokine cellular source, gastric T-cell composition, and gastric T-cell relationship (or relationships) with disease pathology remain understudied. OBJECTIVE: We defined gastric T-cell populations and their association with histologic and endoscopic EoG pathology. METHODS: Gastric biopsy samples (n = 6 EoG, n = 7 control) were subjected to histologic, endoscopic, and flow cytometry analyses. In a complementary cohort (n = 83 EoG), IL4, IL5, and IL13 mRNA levels were correlated with EoG pathologic parameters. RESULTS: Gastric biopsy samples contained CD3+ T cells that were mainly CD8+; the CD8/CD4 ratio was comparable in EoG and control biopsy samples (5.7 ± 3.0 and 4.3 ± 0.6, respectively; P = .28). Gastric regulatory T (CD3+CD4+FOXP3+) and TH2 (CD3+CD4+GATA3+) cell levels were increased in EoG versus controls (2-fold, P < .05 and 10-fold, P < .001, respectively) and correlated with gastric eosinophil levels (r = 0.63, P < .05 and r = 0.85, P < .001, respectively), endoscopic pathology (r = 0.56, P < .01; r = 0.84, P < .001, respectively), and histopathology (r = 0.72, P < .01; r = 0.82, P < .01, respectively). Cytokine-positive, most notably IL-4+, TH2 cell levels strongly correlated with histologic and endoscopic scores (r = 0.82, P < .0001 and r = 0.78, P < .0001, respectively). In an independent EoG cohort (n = 83), bulk gastric IL4, IL5, and IL13 mRNA levels correlated with histologic score (r = 0.22, P < .005; r = 0.54, P < .0001; and r = 0.36, P < .0001, respectively) and endoscopic score (r = 0.27, P < .001; r = 0.40, P < .0001; and r = 0.35, P < .0001, respectively). CONCLUSIONS: EoG is a TH2 cell-associated disease featuring increased gastric type 2 cytokine-producing CD3+CD4+GATA3+TH2 cells that strongly correlate with disease pathologies.


Assuntos
Interleucina-13 , Interleucina-4 , Humanos , Interleucina-5 , Citocinas , RNA Mensageiro
9.
Curr Opin Gastroenterol ; 38(6): 541-548, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36165008

RESUMO

PURPOSE OF REVIEW: This review will present what is known from recent research on the involvement of mast cells in eosinophilic esophagitis and identify questions requiring further investigation. RECENT FINDINGS: In the adults and children with eosinophilic esophagitis, there is increasing evidence that mastocytosis can persist, despite resolution of eosinophilia and is associated with persistent mucosal abnormalities and symptoms. Despite, treatment mast cells have an activated transcriptome. Mast cells likely contribute to epithelial barrier dysfunction, smooth muscle hypertrophy and contraction, and subepithelial fibrosis. It remains unclear whether targeting MCs alone has therapeutic efficacy to improve tissue damage. SUMMARY: Mast cells appear to play a key role in eosinophilic esophagitis and serve as a biomarker of mucosal healing in conjunction with eosinophils. Excessive mast cell activation likely contributes to tissue damage in eosinophilic esophagitis and need to be considered as a target of therapy along with eosinophils.


Assuntos
Enterite , Esofagite Eosinofílica , Adulto , Criança , Eosinofilia , Esofagite Eosinofílica/tratamento farmacológico , Eosinófilos , Gastrite , Humanos , Mastócitos/fisiologia
10.
Nat Commun ; 13(1): 4632, 2022 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-36042221

RESUMO

The Juno spacecraft has been collecting data to shed light on the planet's origin and characterize its interior structure. The onboard gravity science experiment based on X-band and Ka-band dual-frequency Doppler tracking precisely measured Jupiter's zonal gravitational field. Here, we analyze 22 Juno's gravity passes to investigate the gravity field. Our analysis provides evidence of new gravity field features, which perturb its otherwise axially symmetric structure with a time-variable component. We show that normal modes of the planet could explain the anomalous signatures present in the Doppler data better than other alternative explanations, such as localized density anomalies and non-axisymmetric components of the static gravity field. We explain Juno data by p-modes having an amplitude spectrum with a peak radial velocity of 10-50 cm/s at 900-1200 µHz (compatible with ground-based observations) and provide upper bounds on lower frequency f-modes (radial velocity smaller than 1 cm/s). The new Juno results could open the possibility of exploring the interior structure of the gas giants through measurements of the time-variable gravity or with onboard instrumentation devoted to the observation of normal modes, which could drive spacecraft operations of future missions.

11.
J Allergy Clin Immunol ; 149(6): 2062-2077, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35304158

RESUMO

BACKGROUND: Mast cells (MCs) are pleiotropic cells that accumulate in the esophagus of patients with eosinophilic esophagitis (EoE) and are thought to contribute to disease pathogenesis, yet their properties and functions in this organ are largely unknown. OBJECTIVES: This study aimed to perform a comprehensive molecular and spatial characterization of esophageal MCs in EoE. METHODS: Esophageal biopsies obtained from patients with active EoE, patients with EoE in histologic remission, and individuals with histologically normal esophageal biopsies and no history of esophageal disease (ie, control individuals) were subject to single-cell RNA sequencing, flow cytometry, and immunofluorescence analyses. RESULTS: This study probed 39,562 single esophageal cells by single-cell RNA sequencing; approximately 5% of these cells were MCs. Dynamic MC expansion was identified across disease states. During homeostasis, TPSAB1highAREGhigh resident MCs were mainly detected in the lamina propria and exhibited a quiescent phenotype. In patients with active EoE, resident MCs assumed an activated phenotype, and 2 additional proinflammatory MC populations emerged in the intraepithelial compartment, each linked to a proliferating MKI67high cluster. One proinflammatory activated MC population, marked as KIThighIL1RL1highFCER1Alow, was not detected in disease remission (termed "transient MC"), whereas the other population, marked as CMA1highCTSGhigh, was detected in disease remission where it maintained an activated state (termed "persistent MC"). MCs were prominent producers of esophageal IL-13 mRNA and protein, a key therapeutic target in EoE. CONCLUSIONS: Esophageal MCs comprise heterogeneous populations with transcriptional signatures associated with distinct spatial compartmentalization and EoE disease status. In active EoE, they assume a proinflammatory state and locally proliferate, and they remain activated and poised to reinitiate inflammation even during disease remission.


Assuntos
Esofagite Eosinofílica , Proliferação de Células , Esofagite Eosinofílica/genética , Esofagite Eosinofílica/metabolismo , Humanos , Mastócitos/patologia , Análise de Sequência de RNA
12.
J Med Chem ; 65(5): 4291-4317, 2022 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-35179904

RESUMO

Glucokinase (GK) is a key regulator of glucose homeostasis, and its small-molecule activators represent a promising opportunity for the treatment of type 2 diabetes. Several GK activators have been advanced into clinical trials and have demonstrated promising efficacy; however, hypoglycemia represents a key risk for this mechanism. In an effort to mitigate this hypoglycemia risk while maintaining the efficacy of the GK mechanism, we have investigated a series of amino heteroaryl phosphonate benzamides as ''partial" GK activators. The structure-activity relationship studies starting from a "full GK activator" 11, which culminated in the discovery of the "partial GK activator" 31 (BMS-820132), are discussed. The synthesis and in vitro and in vivo preclinical pharmacology profiles of 31 and its pharmacokinetics (PK) are described. Based on its promising in vivo efficacy and preclinical ADME and safety profiles, 31 was advanced into human clinical trials.


Assuntos
Azetidinas , Diabetes Mellitus Tipo 2 , Hipoglicemia , Organofosfonatos , Azetidinas/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucoquinase , Humanos , Hipoglicemia/tratamento farmacológico , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Organofosfonatos/farmacologia , Organofosfonatos/uso terapêutico
13.
Clin Gastroenterol Hepatol ; 20(9): 1971-1976.e2, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34954340

RESUMO

BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is a patchy disease of the esophagus with significant variability in intraepithelial eosinophilia. Three biopsies each from distal and proximal esophagus are recommended for identification of active EoE. Recent work suggests 3 biopsy sites are more optimal. We sought to evaluate 2-site vs 3-site esophageal biopsy combinations for utility to identify active EoE. METHODS: We prospectively obtained 3-site esophageal biopsies based on rigorous endoscopic measurements of the proximal, mid, and distal esophagus and gastroesophageal junction. Biopsies were reviewed by a pathologist, and those with at least 15 eosinophils per high-power field were considered active EoE. The sensitivity of one or more sites to identify active EoE was determined, and endoscopic measurements were correlated to height and age. RESULTS: Five hundred ninety-six endoscopies were performed in 217 patients; of these, 304 endoscopies in 167 patients had active EoE. Among the initial esophagogastroduodenoscopies with active EoE, distal biopsies had greater than 80% sensitivity, whereas mid and proximal biopsies had sensitivity of 65% and 62%, respectively, and distal + proximal biopsies had the highest diagnostic sensitivity for a 2-site combination. Among the 304 endoscopies with active EoE, 9 had focal eosinophilia restricted to the mid esophagus, and 8 were restricted to the proximal esophagus. For patients with multiple endoscopies with active EoE, nearly one fourth had reduced sites with eosinophilia at the second time point. Endoscopic measurements strongly correlated with height and age. CONCLUSIONS: This study supports endoscopic measurement-guided 3-site biopsies for optimal disease assessment of active EoE in children.


Assuntos
Esofagite Eosinofílica , Biópsia , Criança , Enterite , Eosinofilia , Eosinófilos , Gastrite , Humanos
14.
Science ; 374(6570): 964-968, 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34709940

RESUMO

Jupiter's Great Red Spot (GRS) is the largest atmospheric vortex in the Solar System and has been observed for at least two centuries. It has been unclear how deep the vortex extends beneath its visible cloud tops. We examined the gravity signature of the GRS using data from 12 encounters of the Juno spacecraft with the planet, including two direct overflights of the vortex. Localized density anomalies due to the presence of the GRS caused a shift in the spacecraft line-of-sight velocity. Using two different approaches to infer the GRS depth, which yielded consistent results, we conclude that the GRS is contained within the upper 500 kilometers of Jupiter's atmosphere.

15.
J Allergy Clin Immunol ; 148(4): 964-983, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34384610

RESUMO

Mast cells and eosinophils are commonly found, expectedly or unexpectedly, in human tissue biopsies. Although the clinical significance of their presence, absence, quantity, and quality continues to be investigated in homeostasis and disease, there are currently gaps in knowledge related to what constitutes quantitatively relevant increases in mast cell and eosinophil number in tissue specimens for several clinical conditions. Diagnostically relevant thresholds of mast cell and eosinophil numbers have been proposed and generally accepted by the medical community for a few conditions, such as systemic mastocytosis and eosinophilic esophagitis. However, for other mast cell- and eosinophil-associated disorders, broad discrepancies remain regarding diagnostic thresholds and how samples are processed, routinely and/or specially stained, and interpreted and/or reported by pathologists. These discrepancies can obfuscate or delay a patient's correct diagnosis. Therefore, a work group was assembled to review the literature and develop a standardized consensus for assessing the presence of mast cells and eosinophils for a spectrum of clinical conditions, including systemic mastocytosis and cutaneous mastocytosis, mast cell activation syndrome, eosinophilic esophagitis, eosinophilic gastritis/enteritis, and hypereosinophilia/hypereosinophilic syndrome. The intent of this work group is to build a consensus among pathology, allergy, dermatology, hematology/oncology, and gastroenterology stakeholders for qualitatively and quantitatively assessing mast cells and eosinophils in skin, gastrointestinal, and bone marrow pathologic specimens for the benefit of clinical practice and patients.


Assuntos
Medula Óssea/patologia , Eosinófilos/imunologia , Trato Gastrointestinal/patologia , Mastócitos/imunologia , Pele/patologia , Biópsia , Contagem de Células , Enterite/diagnóstico , Eosinofilia/diagnóstico , Esofagite Eosinofílica/diagnóstico , Gastrite/diagnóstico , Humanos , Síndrome Hipereosinofílica/diagnóstico , Mastocitose/diagnóstico
16.
Sci Adv ; 7(28)2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34244139

RESUMO

Jupiter's rapidly rotating, strong magnetic field provides a natural laboratory that is key to understanding the dynamics of high-energy plasmas. Spectacular auroral x-ray flares are diagnostic of the most energetic processes governing magnetospheres but seemingly unique to Jupiter. Since their discovery 40 years ago, the processes that produce Jupiter's x-ray flares have remained unknown. Here, we report simultaneous in situ satellite and space-based telescope observations that reveal the processes that produce Jupiter's x-ray flares, showing surprising similarities to terrestrial ion aurora. Planetary-scale electromagnetic waves are observed to modulate electromagnetic ion cyclotron waves, periodically causing heavy ions to precipitate and produce Jupiter's x-ray pulses. Our findings show that ion aurorae share common mechanisms across planetary systems, despite temporal, spatial, and energetic scales varying by orders of magnitude.

17.
Cureus ; 13(2): e13438, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33758721

RESUMO

A 44-year-old woman with a history of factor V Leiden deficiency and recurrent pulmonary emboli was diagnosed with coronavirus disease 2019 (COVID-19) three weeks prior presented to her local ED with severe chest pain. She was found to have a large hemorrhagic pericardial effusion by cardiac MRI with echocardiographic signs of tamponade. She underwent the creation of a pericardial window and was treated with colchicine with improvement in symptoms.

18.
J Geophys Res Space Phys ; 126(9): e2021JA029469, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35846729

RESUMO

The dynamics of the Jovian magnetosphere are controlled by the interplay of the planet's fast rotation, its main iogenic plasma source and its interaction with the solar wind. Magnetosphere-Ionosphere-Thermosphere (MIT) coupling processes controlling this interplay are significantly different from their Earth and Saturn counterparts. At the ionospheric level, they can be characterized by a set of key parameters: ionospheric conductances, electric currents and fields, exchanges of particles along field lines, Joule heating and particle energy deposition. From these parameters, one can determine (a) how magnetospheric currents close into the ionosphere, and (b) the net deposition/extraction of energy into/out of the upper atmosphere associated to MIT coupling. We present a new method combining Juno multi-instrument data (MAG, JADE, JEDI, UVS, JIRAM and Waves) and modeling tools to estimate these key parameters along Juno's trajectories. We first apply this method to two southern hemisphere main auroral oval crossings to illustrate how the coupling parameters are derived. We then present a preliminary statistical analysis of the morphology and amplitudes of these key parameters for eight among the first nine southern perijoves. We aim to extend our method to more Juno orbits to progressively build a comprehensive view of Jovian MIT coupling at the level of the main auroral oval.

19.
Geophys Res Lett ; 48(23): e2021GL095756, 2021 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-35027778

RESUMO

Cloud-tracked wind observations document the role of eddies in putting momentum into the zonal jets. Chemical tracers, lightning, clouds, and temperature anomalies document the rising and sinking in the belts and zones, but questions remain about what drives the flow between the belts and zones. We suggest an additional role for the eddies, which is to generate waves that propagate both up and down from the cloud layer. When the waves break they deposit momentum and thereby replace the friction forces at solid boundaries that enable overturning circulations on terrestrial planets. By depositing momentum of one sign within the cloud layer and momentum of the opposite sign above and below the clouds, the eddies maintain all components of the circulation, including the stacked, oppositely rotating cells between each belt-zone pair, and the zonal jets themselves.

20.
J Geophys Res Space Phys ; 125(3)2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32874821

RESUMO

At Jupiter, tail reconnection is thought to be driven by an internal mass loading and release process called the Vasyliunas cycle. Galileo data have shown hundreds of reconnection events occurring in Jupiter's magnetotail. Here we present a survey of reconnection events observed by Juno during its first 16 orbits of Jupiter (July 2016-October 2018). The events are identified using Juno magnetic field data, which facilitates comparison to the Vogt et al. (2010, https://doi.org/10.1029/2009JA015098) survey of reconnection events from Galileo magnetometer data, but we present data from Juno's other particle and fields instruments for context. We searched for field dipolarizations or reversals and found 232 reconnection events in the Juno data, most of which featured an increase in |B θ |, the magnetic field meridional component, by a factor of 3 over background values. We found that most properties of the Juno reconnection events, like their spatial distribution and duration, are comparable to Galileo, including the presence of a ~3-day quasi-periodicity in the recurrence of Juno tail reconnection events and in Juno JEDI, JADE, and Waves data. However, unlike with Galileo we were unable to clearly define a statistical x-line separating planetward and tailward Juno events. A preliminary analysis of plasma velocities during five magnetic field reconnection events showed that the events were accompanied by fast radial flows, confirming our interpretation of these magnetic signatures as reconnection events. We anticipate that a future survey covering other Juno datasets will provide additional insight into the nature of tail reconnection at Jupiter.

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