Predictive analysis of severe hypocalcemia following total parathyroidectomy for renal secondary hyperparathyroidism.

OBJECTIVE: This study aimed to evaluate the incidence and identify risk factors for severe hypocalcemia following total parathyroidectomy (TPTX) in patients with renal secondary hyperparathyroidism (SHPT). PATIENTS AND METHODS: We included patients undergoing maintenance hemodialysis or peritoneal dialysis who underwent TPTX from January 1, 2018, to April 30, 2023. Participants were categorized into groups based on postoperative corrected serum calcium levels: severe hypocalcemia (<1.8 mmol/L) and non-severe hypocalcemia (≥1.8 mmol/L). We conducted univariate analyses of demographic and laboratory data to identify potential risk factors, which were further analyzed using a binary logistic regression model. RESULTS: Significant associations were observed with age, dialysis duration exceeding five years, type of dialysis (peritoneal dialysis), lower preoperative corrected serum calcium, elevated preoperative intact parathyroid hormone (iPTH), and increased preoperative alkaline phosphatase (ALP) levels (all p<0.05). Age, preoperative iPTH, and ALP levels were identified as independent risk factors for severe hypocalcemia post-TPTX. CONCLUSIONS: Younger patients with renal SHPT who have elevated preoperative iPTH and ALP levels are at an increased risk of experiencing severe hypocalcemia following TPTX. These findings underscore the importance of careful preoperative assessment and monitoring to mitigate the risk of this complication.

Heterogeneous Responses to Changes in Inhibitory Synaptic Strength in Networks of Spiking Neurons.

How does the dynamics of neurons in a network respond to changes in synaptic weights? Answer to this question would be important for a full understanding of synaptic plasticity. In this article, we report our numerical study of the effects of changes in inhibitory synaptic weights on the spontaneous activity of networks of spiking neurons with conductance-based synapses. Networks with biologically realistic features, which were reconstructed from multi-electrode array recordings taken in a cortical neuronal culture, and their modifications were used in the simulations. The magnitudes of the synaptic weights of all the inhibitory connections are decreased by a uniform amount subjecting to the condition that inhibitory connections would not be turned into excitatory ones. Our simulation results reveal that the responses of the neurons are heterogeneous: while the firing rate of some neurons increases as expected, the firing rate of other neurons decreases or remains unchanged. The same results show that heterogeneous responses also occur for an enhancement of inhibition. This heterogeneity in the responses of neurons to changes in inhibitory synaptic strength suggests that activity-induced modification of synaptic strength does not necessarily generate a positive feedback loop on the dynamics of neurons connected in a network. Our results could be used to understand the effects of bicuculline on spiking and bursting activities of neuronal cultures. Using reconstructed networks with biologically realistic features enables us to identify a long-tailed distribution of average synaptic weights for outgoing links as a crucial feature in giving rise to bursting in neuronal networks and in determining the overall response of the whole network to changes in synaptic strength. For networks whose average synaptic weights for outgoing links have a long-tailed distribution, bursting is observed and the average firing rate of the whole network increases upon inhibition suppression or decreases upon inhibition enhancement. For networks whose average synaptic weights for outgoing links are approximately normally distributed, bursting is not found and the average firing rate of the whole network remains approximately constant upon changes in inhibitory synaptic strength.

Precision Measurement of the (e

We present a measurement of the cosmic ray (e^{+}+e^{-}) flux in the range 0.5 GeV to 1 TeV based on the analysis of 10.6 million (e^{+}+e^{-}) events collected by AMS. The statistics and the resolution of AMS provide a precision measurement of the flux. The flux is smooth and reveals new and distinct information. Above 30.2 GeV, the flux can be described by a single power law with a spectral index γ=-3.170±0.008(stat+syst)±0.008(energy scale).

Electron and positron fluxes in primary cosmic rays measured with the alpha magnetic spectrometer on the international space station.

Precision measurements by the Alpha Magnetic Spectrometer on the International Space Station of the primary cosmic-ray electron flux in the range 0.5 to 700 GeV and the positron flux in the range 0.5 to 500 GeV are presented. The electron flux and the positron flux each require a description beyond a single power-law spectrum. Both the electron flux and the positron flux change their behavior at ∼30 GeV but the fluxes are significantly different in their magnitude and energy dependence. Between 20 and 200 GeV the positron spectral index is significantly harder than the electron spectral index. The determination of the differing behavior of the spectral indices versus energy is a new observation and provides important information on the origins of cosmic-ray electrons and positrons.

Deformation induced microtwins and stacking faults in aluminum single crystal.

Microtwins and stacking faults in plastically deformed aluminum single crystal were successfully observed by high-resolution transmission electron microscope. The occurrence of these microtwins and stacking faults is directly related to the specially designed crystallographic orientation, because they were not observed in pure aluminum single crystal or polycrystal before. Based on the new finding above, we propose a universal dislocation-based model to judge the preference or not for the nucleation of deformation twins and stacking faults in various face-centered-cubic metals in terms of the critical stress for dislocation glide or twinning by considering the intrinsic factors, such as stacking fault energy, crystallographic orientation, and grain size. The new finding of deformation induced microtwins and stacking faults in aluminum single crystal and the proposed model should be of interest to a broad community.

[Subclasses of antibodies to hepatitis B core antigen in chronic HBV infections: changes during treatment with interferons and predictors of response].

Response to interferon therapy in chronic hepatitis B virus (HBV) carrier is preceded by the appearance of IgM class anti-HBc (antibody to hepatitis B core antigen). The temporal relationship and magnitude of the IgM anti-HBc response is variable, suggesting that the antibody is not directly involved in hepatocyte lysis, but is merely a marker of a changed state of immunity to the nucleocapsid proteins induced by interferon. IgG 1, 2, 3 and 4 did not change during therapy. IgG anti-HBc of all subclasses was absent in two Chinese HBV carriers. Lower than normal titres of anti-HBc (P less than 0.001) were detected in human immunodeficiency virus antibody positive (anti-HIV) carriers. These data indicate the presence of altered immunity to the nucleocapsid antigens in these two types of chronic HBV carrier that are known to respond poorly to antiviral therapy.