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Carpal tunnel syndrome of mild to moderate severity can often be effectively treated in a primary care environment. Workplace task modification and wrist splints can reduce or defer referral to [...]

Most countries exclude human immunodeficiency virus (HIV)‐positive patients from organ donation because of concerns regarding donor‐derived HIVtransmission. The Swiss Federal Act on Transplantation has allowed organ transplantation between HIV‐positive donors and recipients since 2007. We report the successful liver transplantation from an HIV‐positive donor to an HIV‐positive recipient. Both donor and recipient had been treated for many years with antiretroviral therapy and harbored multidrug‐resistant viruses. Five months after transplantation, HIVviremia remains undetectable. This observation supports the inclusion of appropriate HIV‐positive donors for transplants specifically allocated to HIV‐positive recipients. The authors report the first liver transplant from an HIV‐positive donor to an HIV‐positive recipient with a successful outcome at 6 months, and argue that the medical and social advances represented by this case call for legal and political progress. See the editorial from Fishman and Feng on page 2252.

The aim of this paper is to investigate the ethical and responsible use of AI chatbots in education in support of critical thinking, cognitive flexibility and self-regulation in terms of their potential to enhance and motivate teaching and learning in contemporary education environments. AI chatbots such as ChatGPT by OpenAI appear to be improving in conversational and other capabilities and this paper explores such advances using version 4. Based on a review of the research literature, a conceptual framework is formulated for responsible use of AI chatbots in education supporting cognitive flexibility in AI-rich learning environments. The framework is then operationalized for use in this paper through the development of exemplars for math, english language arts (ELA), and studying with ChatGPT to close learning gaps in an effort to foster more ethical and responsible approaches to the design and development of AI chatbots for application and use in teaching and learning environments. This paper extends earlier foundational work on cognitive flexibility and AI chatbots as well as work on cognitive flexibility in support of creativity and innovation with AI chatbots in urban civic spaces.

Abstract: flt3 ligand (FL) is a growth factor that induces hematopoietic progenitor cell and dendritic cell (DC) expansion when administered to mice. Lymphoid-related (CD8α+) and myeloid-related (CD8α−) DC are transiently expanded in multiple tissues. Treatment of tumor-bearing mice with FL results in slower tumor growth and, in some cases, tumor rejection and the development of tumor-specific T cell immunity. The clinical use of DC as cellular vehicles for tumor antigen presentation to generate a tumor-specific T cell response is under investigation. DC are currently generated ex vivo, pulsed with antigen, and then infused into patients, and much effort is being directed toward optimizing each of these steps. Administration of FL to humans induces a profound increase in circulating DC. The availability of a large number of DC generated in vivo has important implications for tumor immunotherapy approaches.

Although pseudomyxoma peritonei is comparatively rare, the simultaneous occurrence in this condition of mucinous tumours of ovary and appendix is common and has been termed pseudomyxoma peritonei ovarii et appendicis. Four closely followed patients in a small series showed only 25% 6-year survival. This paper presents a further case with a 14-month follow-up.

IL-7 receptor-deficient (IL-7R^-/-) mice are lymphopenic as a result of defective cell production at early steps in both B and T lymphopoiesis. In the bone marrow, there is an incomplete block in B cell development at the transition from the pro-B to the pre-B cell stage. As a consequence, peripheral lymphoid organs of IL-7R^-/- mice contain abnormally low numbers of mature surface (s) Ig-expressing B cells and this is accompanied by a relative increase in immature sig^- B cells. Transgenic expression of the anti-apoptotic protein Bcl-2 in IL-7R^-/- mice rescues the defect in T cell development and in mature T cell function. The present report shows that constitutive expression of Bcl-2 is incapable of rescuing B lymphopoiesis in IL-7R^-/- mice but can enhance survival of those mature B cells which escape the developmental arrest. Thus the essential role of IL-7R signaling in B lymphoid cells cannot be replaced by Bcl-2, indicating that in B lymphopoiesis IL-7R signaling is necessary for promoting cell division and/or for inhibiting a Bcl-2-insensitive pathway to apoptosis.
Keywords:bone marrow, Ig production, IL-7R, pre-B cells

Dendritic cells (DC) are the most efficient APC for T cells. The clinical use of DC as vectors for anti-tumor and infectious disease immunotherapy has been limited by their trace levels and accessibility in normal tissue and terminal state of differentiation. In the present study, daily injection of human Flt3 ligand (Flt3L) into mice results in a dramatic numerical increase in cells co-expressing the characteristic DC markers-class II MHC, CD11c, DEC205, and CD86. In contrast, in mice treated with either GM-CSF, GM-CSF plus IL-4, c-kit ligand (c-kitL), or G-CSF, class II+ CD11c+ cells were not significantly increased. Five distinct DC subpopulations were identified in the spleen of Flt3L-treated mice using CD8 alpha and CD11b expression. These cells exhibited veiled and dendritic processes and were as efficient as rare, mature DC isolated from the spleens of untreated mice at presenting allo-Ag or soluble Ag to T cells, or in priming an Ag-specific T cell response in vivo. Dramatic numerical increases in DC were detected in the bone marrow, gastro-intestinal lymphoid tissue (GALT), liver, lymph nodes, lung, peripheral blood, peritoneal cavity, spleen, and thymus. These results suggest that Flt3L could be used to expand the numbers of functionally mature DC in vivo for use in clinical immunotherapy.

The deinstitutionalization of care for the mentally ill has been in vogue for about fifty years. Broadly speaking, this transition can be seen to exhibit the following main trends: a dramatic decline in the inpatient population of psychiatric hospitals, coupled with a corresponding increase in community facilities such as psychiatric units in general hospitals, day hospitals, and day centres. It has been claimed that deinstitutionalization ends previously enforced seclusion, enhances human dignity and allows individual privacy. The deinstitutionalization movement has inevitably led both to large numbers of former long‐stay patients being cared for in the community and to significant numbers of individuals developing enduring mental illness in the community without ever having had a long inpatient tenure. The findings of recent studies (Gould 1992, Brockington et al.1993) suggest that there is a positive public attitude towards the mentally ill. However, Kelly (1997), while carrying out Quality of Life research, found that over half of the community‐based long‐term mentally ill he surveyed reported that they had experienced harassment/victimization. This paper is not a report on the Quality of Life research but a discussion on the theme of victimization that has emerged from the study. The extent of the problem is discussed as are the implications for mental health professionals.

The detailed analysis of a series of acoustic measurements taken near several large wind turbines (100 kW and above) has identified the maximum acoustic energy as being concentrated in the low-frequency audible and subaudible ranges, usually less than 100 Hz. These measurements have also shown any reported community annoyance associated with turbine operations has often been related to the degree of coherent impulsiveness present and the subsequent harmonic coupling of acoustic energy to residential structures. Thus, one technique to assess the annoyance potential of a given wind turbine design is to develop a method which quantifies this degree of impulsiveness or coherency in the radiated acoustic energy spectrum under a wide range of operating conditions. Experience has also shown the presence of annoying conditions is highly time dependent and nonstationary, and, therefore, any attempts to quantify or at least classify wind turbine designs in terms of their noise annoyance potential must be handled within the proper probabilistic framework. A technique is described which employs multidimensional, joint probability analysis to establish the expected coincidence of acoustic energy levels in a contiguous sequence of octave frequency bands which have been chosen because of their relationship to common structural resonant frequencies in residential buildings. Evidence is presented to justify the choice of these particular bands. Comparisons of the acoustic performance and an estimate of the annoyance potential of several large wind turbine designs using this technique is also discussed.

The low-affinity receptor for leukemia inhibitory factor (LIFR) interacts with gp130 to induce an intracellular signal cascade. The LIFR-gp130 heterodimer is implicated in the function of diverse systems. Normal placentation is disrupted in LIFR mutant animals, which leads to poor intrauterine nutrition but allows fetuses to continue to term. Fetal bone volume is reduced greater than three-fold and the number of osteoclasts is increased six-fold, resulting in severe osteopenia of perinatal bone. Astrocyte numbers are reduced in the spinal cord and brain stem. Late gestation fetal livers contain relatively high stores of glycogen, indicating a metabolic disorder. Hematologic and primordial germ cell compartments appear normal. Pleiotropic defects in the mutant animals preclude survival beyond the day of birth.

The introduction of clonal assays and long-term culture systems has resulted in considerable progress in the understanding of the early events that control self-renewal and commitment to differentiation of pluripotent hematopoietic stem cells (PHSC). Relatively little is known about the factors that control the commitment of PHSC to the lymphoid lineages, especially the T cell lineage. In the present study, the expression of the proto-oncogene c-kit was used to isolate and study the capacity of highly purified day 14 colony-forming units-spleen (CFU-S) to reconstitute the thymus of sublethally irradiated Thy-1 congenic recipient mice. We demonstrate here that one c-kit positive (c-kitpos) stem cell upon intrathymic transfer can effectively reconstitute the thymus of a sublethally irradiated recipient. After a lag phase of 15 d, high levels of donor-derived thymocytes (Thy-1.1pos) could be detected until 65 d after transplantation in Thy-1.2pos host mice. Donor-derived cells were only detected in the lobe of the thymus in which cells were previously injected and not in the noninjected lobe. These data suggest that c-kitpos stem cells do not migrate from one lobe to another and that they do not re-seed the thymus after having migrated to the bone marrow. The level and duration of reconstitution was found to be cell dose dependent, suggesting that, over time, endogenous stem cells compete with donor stem cells for available sites in the thymus microenvironment. The data presented in this paper demonstrate that commitment of purified adult bone marrow-derived c-kitpos stem cells to the T cell differentiation pathway can occur in the thymus and does not have to happen in the bone marrow.

A 6-year study of bacteria isolated from swabs taken from clinically apparent infections of the stump of the umbilical cord showed an overall infection rate of 0.7% (200/27,107), with a preponderance of Gram-negative organisms as compared with Gram-positive organisms (171/118), an excess which was statistically significant.

A four-year study of the bacteria isolated from neonatal eye swabs at Royal Women's Hospital. Brisbane has been carried out. Of infants admitted to nurseries 2.7% (571/21217) had positive cultures. The incidence of infection in premature and non-premature nurseries was 9.7% (221/2273) and 1.8% (350/18944) respectively, a highly significant difference. There was a preponderance of Gramnegative organisms in the former (67%) and of Gram-positive organisms in the latter (69%), each a statistically significant difference.

Presents a humorous look at Sylvia, the Gutter Guru, who gives holistic and mechanical readings from driveway oil spots.

Cytomorphology with clinical, colposcopic and histological confirmation was used to identify squamous papilloma of uterine cervix in 27 patients from 147,813 consecutive cervical smears, an incidence of 1:5,475. The patients were young women (16-35), 63% of whom were pregnant. When this group was compared with a matched control group, a statistically significant increase in trichomonad infection, and a reduction in fungal infection was observed. There were no false negatives in the series, however 30%, of smears with this pattern were false positives.