IJERPH, Vol. 14, Pages 1048: Health Effects of Ambient Air Pollution in Developing Countries

IJERPH, Vol. 14, Pages 1048: Health Effects of Ambient Air Pollution in Developing Countries

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14091048

Authors: Pier Mannucci Massimo Franchini

The deleterious effects of ambient air pollution on human health have been consistently documented by many epidemiologic studies worldwide, and it has been calculated that globally at least seven million deaths are annually attributable to the effects of air pollution. The major air pollutants emitted into the atmosphere by a number of natural processes and human activities include nitrogen oxides, volatile organic compounds, and particulate matter. In addition to the poor ambient air quality, there is increasing evidence that indoor air pollution also poses a serious threat to human health, especially in low-income countries that still use biomass fuels as an energy resource. This review summarizes the current knowledge on ambient air pollution in financially deprived populations.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2h1nu6q
via IFTTT

Angelman Syndrome due to a Maternally Inherited Intragenic Deletion Encompassing Exons 7 and 8 of the UBE3A Gene

Angelman syndrome (AS) is characterised by developmental delay, lack of speech, seizures, a characteristic behavioural profile with a happy demeanour, microcephaly, and ataxia. More than two-thirds of cases are due to an approximately 5-Mb interstitial deletion of the imprinted region 15q11.2q13, which is usually de novo. The rest are associated with point mutations in the UBE3A gene, imprinting defects, and paternal uniparental disomy. Small intragenic UBE3A deletions have rarely been described. They are usually maternally inherited, increasing the recurrence risk to 50%, and may be missed by conventional testing (methylation studies and UBE3A gene sequencing). We describe a boy with AS due to an 11.7-kb intragenic deletion. The deletion was identified by array-CGH and was subsequently detected in his affected first cousin and unaffected maternal grandfather, mother, and aunt, confirming the silencing of the paternal allele. The patient had developmental delay, speech impairment, a happy demeanour, microcephaly, and an abnormal EEG, but no seizures by the age of 4 years. Delineation of the underlying genetic mechanism is of utmost importance for reasons of genetic counselling, as well as appropriate management and prognosis. Alternative techniques, such as array-CGH and MLPA, are necessary when conventional testing for AS has failed to identify the underlying genetic mechanism.
Cytogenet Genome Res

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wmkVSa
via IFTTT

Chaos ist da, aber es ist nicht alles. Interview: Reinhard Kramm, Christa Amstutz

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2ffNDyp
via IFTTT

Basler Kunstwissenschaft aus Genfer Sicht

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wUkylY
via IFTTT

Global Ethics Applied: Global Ethics, Economic Ethics

Global Ethics Applied' in four volumes is a reader of 88 selected articles from the author on 13 domains: Vol. 1 Global Ethics, Economic Ethics; Vol. 2 Environmental Ethics; Vol. 3 Development Ethics, Political Ethics, Dialogue and Peace Ethics, Innovation and Research Ethics, Information and Communication Ethics; Vol. 4 Bioethics and Medical Ethics, Family Ethics and Sexual Ethics, Leadership Ethics, Theological Ethics and Ecclesiology, Methods of Ethics. It concludes with the extended Bibliography of the author. Most of the articles are in English, some in German or French with English summaries. The articles focus on concrete current topics and are addressed to practitioners, decision-makers in all sectors as well as academic teachers and students.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2feK3of
via IFTTT

Editorial Board

Publication date: November 2017
Source:Microbiological Research, Volume 204





from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xtQxds
via IFTTT

How important is the role of real-world evidence in developing sustainable cancer care? https://t.co/1IOj1J5QWK https://t.co/ZRq9JfwHzm

How important is the role of real-world evidence in developing sustainable cancer care? https://t.co/1IOj1J5QWK https://t.co/ZRq9JfwHzm

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://twitter.com/ecancer/status/907522996956532736
via IFTTT

Metabolic Links between Plasma Cell Survival, Secretion, and Stress

Publication date: Available online 11 September 2017
Source:Trends in Immunology
Author(s): Wing Y. Lam, Deepta Bhattacharya
Humoral immunity is generated and maintained by antigen-specific antibodies that counter infectious pathogens. Plasma cells are the major producers of antibodies during and after infections, and each plasma cell produces some thousands of antibody molecules per second. This magnitude of secretion requires enormous quantities of amino acids and glycosylation sugars to properly build and fold antibodies, biosynthetic substrates to fuel endoplasmic reticulum (ER) biogenesis, and additional carbon sources to generate energy. Many of these processes are likely to be linked, thereby affording possibilities to improve vaccine design and to develop new therapies for autoimmunity. We review here aspects of plasma cell biology with an emphasis on recent studies and the relationships between intermediary metabolism, antibody production, and lifespan.



from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wXsxhu
via IFTTT

Leaf thermotolerance in tropical trees from a seasonally dry climate varies along the slow-fast resource acquisition spectrum

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ffO0Jf
via IFTTT

Comparison of soil analytical methods for estimating wheat potassium fertilizer requirements in response to contrasting plant K demand in the glasshouse

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2feGD4y
via IFTTT

A mesocosm study of oxygen and trace metal dynamics in sediment microniches of reactive organic material

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wU5UeB
via IFTTT

Dynamic oropharyngeal and faecal microbiota during treatment in infants hospitalized for bronchiolitis compared with age-matched healthy subjects

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wU1Z1m
via IFTTT

Rapid global ocean-atmosphere response to Southern Ocean freshening during the last glacial

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2fexPMe
via IFTTT

Conservation performance of different conservation governance regimes in the Peruvian Amazon

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wU1TXy
via IFTTT

Urea deep placement reduces yield-scaled greenhouse gas (CH4 and N2O) and NO emissions from a ground cover rice production system

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ffNBGJ
via IFTTT

Large manipulative experiments revealed variations of insect abundance and trophic levels in response to the cumulative effects of sheep grazing

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wUeoSO
via IFTTT

Seed germination of Caragana species from different regions is strongly driven by environmental cues and not phylogenetic signals

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2feE6r5
via IFTTT

Unexpected viscoelastic deformation of tight sandstone: Insights and predictions from the fractional Maxwell model

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wUhrdP
via IFTTT

Urban heat island impacted by fine particles in Nanjing, China

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2fflV4P
via IFTTT

Analysis and comparison of the wolf microbiome under different environmental factors using three different data of Next Generation Sequencing

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ffWOyE
via IFTTT

Propolis envelope in Apis mellifera colonies supports honey bees against the pathogen, Paenibacillus larvae

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wUgCla
via IFTTT

Earth system feedback statistically extracted from the Indian Ocean deep-sea sediments recording Eocene hyperthermals

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2feE5Dx
via IFTTT

Orbital bistatic radar observations of asteroid Vesta by the Dawn mission

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ff6WI0
via IFTTT

Resources Scheduling Algorithm in Power Wireless Private Network Based on SDON

With the increasing of the business carried by the power wireless private network and the continuous development of the new network technology, the problems in the traditional mode of power wireless private network are becoming more and more obvious. In order to solve the problems such as poor business service quality, low system throughput, and fairness problems in the uplink resource scheduling process of power wireless private network, a dynamic uplink resource scheduling algorithm is proposed on the basis of Software Defined Optical Network (SDON). By studying the business characteristics of the uplink transmission of power wireless network, the priority of the service is evaluated before the resource scheduling is carried out. According to the characteristics of OFDM resource allocation and the numerical control separation and programmable feature of SDON, different scheduling methods are designed for different services. Simulation analysis shows that this algorithm can effectively improve the system throughput, guarantee QoS, and improve the transmission performance of different services.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2gYOebm
via IFTTT

Benign Effect of Extremely Low-Frequency Electromagnetic Field on Brain Plasticity Assessed by Nitric Oxide Metabolism during Poststroke Rehabilitation

Nitric oxide (NO) is one of the most important signal molecules, involved in both physiological and pathological processes. As a neurotransmitter in the central nervous system, NO regulates cerebral blood flow, neurogenesis, and synaptic plasticity. The aim of our study was to investigate the effect of the extremely low-frequency electromagnetic field (ELF-EMF) on generation and metabolism of NO, as a neurotransmitter, in the rehabilitation of poststroke patients. Forty-eight patients were divided into two groups: ELF-EMF and non-ELF-EMF. Both groups underwent the same 4-week rehabilitation program. Additionally, the ELF-EMF group was exposed to an extremely low-frequency electromagnetic field of 40 Hz, 7 mT, for 15 min/day. Levels of 3-nitrotyrosine, nitrate/nitrite, and TNFα in plasma samples were measured, and NOS2 expression was determined in whole blood samples. Functional status was evaluated before and after a series of treatments, using the Activity Daily Living, Geriatric Depression Scale, and Mini-Mental State Examination. We observed that application of ELF-EMF significantly increased 3-nitrotyrosine and nitrate/nitrite levels, while expression of NOS2 was insignificantly decreased in both groups. The results also show that ELF-EMF treatments improved functional and mental status. We conclude that ELF-EMF therapy is capable of promoting recovery in poststroke patients.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vQSzQz
via IFTTT

Ubiquitin-Specific Protease 2 Modulates the Lipopolysaccharide-Elicited Expression of Proinflammatory Cytokines in Macrophage-like HL-60 Cells

We investigated the regulatory roles of USP2 in mRNA accumulation of proinflammatory cytokines in macrophage-like cells after stimulation with a toll-like receptor (TLR) 4 ligand, lipopolysaccharide (LPS). Human macrophage-like HL-60 cells, mouse macrophage-like J774.1 cells, and mouse peritoneal macrophages demonstrated negative feedback to USP2 mRNA levels after LPS stimulation, suggesting that USP2 plays a significant role in LPS-stimulated macrophages. USP2 knockdown (KD) by short hairpin RNA in HL-60 cells promoted the accumulation of transcripts for 25 of 104 cytokines after LPS stimulation. In contrast, limited induction of cytokines was observed in cells forcibly expressing the longer splice variant of USP2 (USP2A), or in peritoneal macrophages isolated from Usp2a transgenic mice. An ubiquitin isopeptidase-deficient USP2A mutant failed to suppress LPS-induced cytokine expression, suggesting that protein ubiquitination contributes to USP2-mediated cytokine repression. Although USP2 deficiency did not accelerate TNF receptor-associated factor (TRAF) 6-nuclear factor-κB (NF-κB) signaling, it increased the DNA binding ratio of the octamer binding transcription factor (Oct)-1 to Oct-2 in TNF, CXCL8, CCL4, and IL6 promoters. USP2 decreased nuclear Oct-2 protein levels in addition to decreasing the polyubiquitination of Oct-1. In summary, USP2 modulates proinflammatory cytokine induction, possibly through modification of Oct proteins, in macrophages following TLR4 activation.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vRDvlN
via IFTTT

Improved Discrete Techniques of Time-Delay and Order Estimation for Large-Scale Interconnected Nonlinear Systems

The selection of a suitable model structure is an essential step in system modeling. Model structure is defined by determining the class, the time delay, and the model order. This paper proposes improved structural estimation procedures for large-scale interconnected nonlinear systems which are composed of a set of interconnected Single-Input Single-Output (SISO) Hammerstein structures and described by discrete-time stochastic models with unknown time-varying parameters. An extensive Determinant Report (DR) algorithm is developed to determine the order of the process. An improved discrete-time technique based on Recursive Extended Least Squares with Varying Time (RELSVT) delay method is proposed to estimate the time delays of the considered system. The developed theoretical analysis and simulation results prove the validity and performance of the proposed algorithms.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vRjnjn
via IFTTT

The Evaluation of Oxidative Stress Parameters in Serum Patients with Relapsing-Remitting Multiple Sclerosis Treated with II-Line Immunomodulatory Therapy

Objectives. The assessment of oxidative stress (OS) in serum relapsing-remitting multiple sclerosis patients treated with II-line immunomodulatory therapy (fingolimod, natalizumab) compared to newly diagnosed patients (de novo group) treated with interferon (IFN) beta and controls. The relationship between OS parameters and gender, age, disease duration, Expanded Disability Status Scale, annualized relapse rate, MRI lesions in patients treated with II-line. Materials and Methods. One hundred and twenty-one patients with RRMS were enrolled in the study. Patients were divided into groups: de novo group, IFN, fingolimod (FG), natalizumab (NT), and controls. Lipid hydroperoxides (LHP), malondialdehyde (MDA), lipofuscin (LPS), and total oxidative status (TOS) were determined. Results. LHP, MDA, and TOS were lower in NT and FG groups compared to the de novo group. Levels of OS were different between NT and FG patients and the IFN group. Women treated with FG and NT had lower MDA, LPH, and TOS than women who were not treated while in men only LPH was lowered. Positive correlations were found between MDA, LHP, TOS, and ARR in the NT group. Conclusion. The II-line immunomodulatory treatment decreased OS particularly among women. No difference in OS levels was observed between II-line therapy and IFN beta.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2gZhgI3
via IFTTT

The Predictive Value of PITX2 DNA Methylation for High-Risk Breast Cancer Therapy: Current Guidelines, Medical Needs, and Challenges

High-risk breast cancer comprises distinct tumor entities such as triple-negative breast cancer (TNBC) which is characterized by lack of estrogen (ER) and progesterone (PR) and the HER2 receptor and breast malignancies which have spread to more than three lymph nodes. For such patients, current (inter)national guidelines recommend anthracycline-based chemotherapy as the standard of care, but not all patients do equally benefit from such a chemotherapy. To further improve therapy decision-making, predictive biomarkers are of high, so far unmet, medical need. In this respect, predictive biomarkers would permit patient selection for a particular kind of chemotherapy and, by this, guide physicians to optimize the treatment plan for each patient individually. Besides DNA mutations, DNA methylation as a patient selection marker has received increasing clinical attention. For instance, significant evidence has accumulated that methylation of the PITX2 (paired-like homeodomain transcription factor 2) gene might serve as a novel predictive and prognostic biomarker, for a variety of cancer diseases. This review highlights the current understanding of treatment modalities of high-risk breast cancer patients with a focus on recommended treatment options, with special attention on the future clinical application of PITX2 as a predictive biomarker to personalize breast cancer management.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2h0BsJh
via IFTTT

Valsalva-Related Subretinal Hemorrhage as a Presenting Symptom of Polypoidal Choroidal Vasculopathy

Purpose. To describe a case of Valsalva-related subretinal hemorrhage as a presenting symptom of polypoidal choroidal vasculopathy (PCV). The patient refrained from treatment against our best advice, and thus this is also a rare case of the natural course of an untreated PCV. Methods. Case report. Results. A 66-year-old female with a respiratory infection coughed intensely until exhaustion, after which she developed visual symptoms on the right eye. Primary care ophthalmologist examined the patient on the same day of the onset of symptoms and referred her to our tertiary medical retinal service for detailed retinal diagnosis including fluorescein and indocyanine green angiography. The right eye had a large subretinal hemorrhage and pigment epithelium detachment in the lower temporal arcade with foveal involvement. Against our best advice, the patient refused treatment. In the following 9 months, the BCVA decreased from 68 to 55 ETDRS letters, the subretinal hemorrhage almost regressed, pigment epithelium detachments persisted, and macular edema, intraretinal cysts, and subretinal fibrosis developed. Conclusions. Although classic Valsalva retinopathy with preretinal hemorrhage in most cases can be managed by careful observation and no treatment, this case demonstrates that Valsalva-related subretinal hemorrhage needs different attention and approach.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vRDjmz
via IFTTT

Portland Cement Hydration Behavior at Low Temperatures: Views from Calculation and Experimental Study

Environmental condition affects the property of construction materials. This study gives an initial understanding of Portland cement hydration under low temperatures from the views of laboratory experiments (including electrical resistivity, degree of hydration (DoH), and maturity) as well as thermodynamic calculation. The hydrates of Portland cement at the given period were detected with X-ray diffraction (XRD), and their microstructure was observed by scanning electron microscope (SEM). Experiment result (i.e., DoH and electrical resistivity) indicated that the hydration of Portland cement was delayed by low temperature without hydration stopping at −5°C. Based on a basic kinetics model, the thermodynamic calculation predicted that the final hydrate differs in dependence on environmental temperatures. The mechanical behavior trend of Portland cement paste affected by low temperatures potentially is linked to the appearing of aluminate compounds and reduction of portlandite.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2h0Bl0j
via IFTTT

Failed electric buses remind us that roads not taken do matter

Human actions rather than technology undermined London's electric buses 100 years ago, showing there's plenty to be learned by revisiting the past

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vRmc48
via IFTTT

Cancers, Vol. 9, Pages 123: Anaplastic Lymphoma Kinase in Cutaneous Malignancies

Cancers, Vol. 9, Pages 123: Anaplastic Lymphoma Kinase in Cutaneous Malignancies

Cancers doi: 10.3390/cancers9090123

Authors: Severine Cao Vinod Nambudiri

Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase that has been implicated in the pathogenesis of a variety of neoplasms. As suggested by its name, ALK was first described as part of a translocation product in cases of anaplastic large-cell lymphoma, with other genetic and cytogenetic ALK mutations subsequently coming to attention in the development of many other hematologic and solid organ malignancies. ALK has now been shown to play a role in the pathogenesis of several cutaneous malignancies, including secondary cutaneous systemic anaplastic large-cell lymphoma (ALCL) and primary cutaneous ALCL, melanoma, spitzoid tumors, epithelioid fibrous histiocytoma, Merkel cell carcinoma, and basal cell carcinoma. The characterization of ALK-positivity in these cutaneous malignancies presents exciting opportunities for utilizing ALK-targeted inhibitors in the treatment of these diseases.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xtBlwT
via IFTTT

Author’s reply to Hawkins

In answer to Hawkins,12 long term treatment of people assigned male at birth with oestrogens at a dose sufficient to give typically premenopausal oestrogen concentrations slightly raises their risk...

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2jkvQdK
via IFTTT

IJMS, Vol. 18, Pages 1953: Physiological and Transcriptomic Responses of Chinese Cabbage (Brassica rapa L. ssp. Pekinensis) to Salt Stress

IJMS, Vol. 18, Pages 1953: Physiological and Transcriptomic Responses of Chinese Cabbage (Brassica rapa L. ssp. Pekinensis) to Salt Stress

International Journal of Molecular Sciences doi: 10.3390/ijms18091953

Authors: Nianwei Qiu Qian Liu Jingjuan Li Yihui Zhang Fengde Wang Jianwei Gao

Salt stress is one of the major abiotic stresses that severely impact plant growth and development. In this study, we investigated the physiological and transcriptomic responses of Chinese cabbage "Qingmaye" to salt stress, a main variety in North China. Our results showed that the growth and photosynthesis of Chinese cabbage were significantly inhibited by salt treatment. However, as a glycophyte, Chinese cabbage could cope with high salinity; it could complete an entire life cycle at 100 mM NaCl. The high salt tolerance of Chinese cabbage was achieved by accumulating osmoprotectants and by maintaining higher activity of antioxidant enzymes. Transcriptomic responses were analyzed using the digital gene expression profiling (DGE) technique after 12 h of treatment by 200 mM NaCl. A total of 1235 differentially expressed genes (DEGs) including 740 up- and 495 down-regulated genes were identified. Functional annotation analyses showed that the DEGs were related to signal transduction, osmolyte synthesis, transcription factors, and antioxidant proteins. Taken together, this study contributes to our understanding of the mechanism of salt tolerance in Chinese cabbage and provides valuable information for further improvement of salt tolerance in Chinese cabbage breeding programs.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2h0xhcS
via IFTTT

PACS upgrades can be a rocky road

Radiologists need to be early birds for optimal PACS upgrades, and this means...

Read more on AuntMinnieEurope.com

Related Reading:

Why Europeans must care more about AI, machine learning

Is enterprise imaging on a slow road to mediocrity?

Update: Record retention in vendor-neutral archive

Paperless hospitals: VNA suppliers can learn from PACS

PACS to PACS images & report sharing in clinical networks

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xhHj3f
via IFTTT

Living systematic reviews: 2. Combining human and machine effort

Publication date: Available online 11 September 2017
Source:Journal of Clinical Epidemiology
Author(s): James Thomas, Anna Noel-Storr, Iain Marshall, Byron Wallace, Steven McDonald, Chris Mavergames, Paul Glasziou, Ian Shemilt, Anneliese Synnot, Tari Turner, Julian Elliott
New approaches to evidence synthesis, which use human effort and machine automation in mutually reinforcing ways, can enhance the feasibility and sustainability of living systematic reviews. Human effort is a scarce and valuable resource, required when automation is impossible or undesirable, and includes contributions from online communities ("crowds") as well as more conventional contributions from review authors and information specialists. Automation can assist with some systematic review tasks, including searching, eligibility assessment, identification and retrieval of full-text reports, extraction of data, and risk of bias assessment. Workflows can be developed in which human effort and machine automation can each enable the other to operate in more effective and efficient ways, offering substantial enhancement to the productivity of systematic reviews. This paper describes and discusses the potential—and limitations—of new ways of undertaking specific tasks in living systematic reviews, identifying areas where these human/machine "technologies" are already in use, and where further research and development is needed. While the context is living systematic reviews, many of these enabling technologies apply equally to standard approaches to systematic reviewing.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wWbpXT
via IFTTT

Shrinkage in oral squamous cell carcinoma: An analysis of tumor and margin measurements in vivo, post-resection, and post-formalin fixation

Publication date: Available online 12 September 2017
Source:American Journal of Otolaryngology
Author(s): Lauren A. Umstattd, Jonathan C. Mills, William A. Critchlow, Gregory J. Renner, Robert P. Zitsch
PurposeTo quantify changes in tumor size and tumor-free margins following surgical resection and formalin fixation of oral cavity squamous cell carcinoma.Materials and methodsNineteen patients were studied via cohort design. Between May and December 2011, measurements of tumor size and tumor-free margin were made in patients with squamous cell carcinoma of the oral cavity. Mucosal reference points were marked with sutures, representing tumor diameter and two separate resection margins. Measurements were recorded immediately before resection, after resection, and following fixation in formalin.ResultsThe overall mean shrinkage in tumor size was 10.7% (95% CI 3.4–18.0, p=0.006). When comparing mean tumor measurements, most of the tumor size decrease (6.4%, 95% CI 0.4–12.4, p=0.039) occurred between pre- and post-excision measurements. To a lesser extent, tumor size decreased following formalin fixation. Comparison of tumor-free margin measurements revealed a pre-excision to post-fixation mean decrease of 11.3% (95% CI 2.9–19.6%, p=0.011), with a statistically significant decrease of 14.9% (95% CI 8.5–21.3%, p<0.001) occurring between pre- and post-excision, and no significant decrease from post-excision to post-formalin fixation.ConclusionMucosal dimensions of both tumor and tumor-free margins in oral cavity squamous cell carcinoma specimens decrease between surgical resection and pathologic analysis. Most of this decrease occurs prior to fixation, especially for margins, and may be due to intrinsic tissue properties rather than formalin effects.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jm8tRg
via IFTTT

The placebo effect on bradykinesia in Parkinson's disease with and without prior drug conditioning

Abstract

Background: Placebo effects represent a major drawback in clinical trials, and their magnitude hampers the development of new treatments. Previous research showed that prior exposure to active treatments increases the placebo response for muscle rigidity in Parkinson's disease.

Methods: We investigated the effects of prior exposure to apomorphine on the placebo response of another cardinal symptom of Parkinson's disease, bradykinesia, by a movement time analyzer.

Results: We found no placebo response if the placebo was given for the first time, whereas the placebo response was substantial after prior pharmacological conditioning with apomorphine.

Conclusions: These findings indicate that prior exposure to drugs is a critical factor in the occurrence and magnitude of placebo effects. These learning effects should be carefully assessed in clinical trials in which patients receive the active treatment first and then are randomized. Indeed, this sequence may generate high placebo responders. © 2017 International Parkinson and Movement Disorder Society

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wWseSi
via IFTTT

Early leaflet thrombosis complicating transcatheter implantation of a Sapien 3 valve in a native right ventricular outflow tract

A 59-year-old female with Tetralogy of Fallot had a previous complete repair with RVOT patch enlargement. She developed subsequent severe symptomatic (NYHA III) pulmonary regurgitation with severe RV dilatation. She had a concomitant interstitial lung disease secondary to hypersensitivity pneumonitis that precluded her from cardiac surgery. After preprocedural assessment using computed tomography, echocardiography and invasive angiography we decided to implant a 29 mm Edwards Sapien 3 valve without pre-stenting. The Sapien 3 valve was implanted in a satisfactory position using rapid RV pacing. The valve appeared well expanded with good circularity on fluoroscopy. A transthoracic echocardiography on the following day showed no pulmonary regurgitation with a peak gradient of 14 mmHg across the prosthesis. At 4 weeks follow-up, the patient felt a marked improvement (NYHA II) but a CT scan showed bileaflet valve thickening with preserved stent expansion. A concomitant echo-doppler showed a significant increase of peak pulmonary gradient to 26 mmHg. After a six weeks course of warfarin therapy, the transpulmonary valve peak gradient came down to 16 mmHg and leaflet thickening resolved on CT.

The Sapien 3 system helped achieve a successful transfemoral percutaneous pulmonary valve implantation in a challenging native RVOT anatomy. This case was complicated by early valve thrombosis as documented by CT and was successfully treated with oral anticoagulation.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vQNE29
via IFTTT

Right ventricle outflow tract prestenting: In vitro testing of rigidity and corrosion properties

Abstract

Background

The aim of this study was to assess the resistance to compression (stiffness) of frequently used stents for right ventricular outflow tract prestenting. In addition, to assess the corrosion potential when different types of stent alloys come into contact with each other.

Method

Different stents were tested in vitro in various combinations at specialized metallurgic laboratories. A bench compression test was used to assess resistance to compression of singular and joined combinations of stents. Corrosion was evaluated by standardized electrochemical galvanic tests in physiological solutions at 37°C. Single stents and combinations of stents were evaluated over a period of 4–12 weeks.

Results

Relative stiffness of the stents Optimus/Andrastent XXL/Intrastent LD Max/8zig Cheatham-Platinum, expressed as load per length to deform the stent for 1 mm at 22 mm was 100/104/161/190. Adding additional stents to a single stent significantly strengthened the joined couples (P < 0.001). The lowest galvanic corrosion rates (about 0.000001 mm/year) were observed for the joined CP-Andrastent, Andra-Sapien, and Andra-SapienXT. The corrosion rate for coupled CP-Sapien and CP-SapienXT was somewhat higher (about 0.000003 mm/year). The materials with the highest corrosion rates resulted in material losses of, respectively, 17 and 24 µg/year, which is negligible over a lifetime.

Conclusion

Adding stents to a single stent significantly increases stiffness which will reduce the risk of metal fatigue failure. Corrosion of individual stents or stent combinations occurs, but is negligible over a human lifetime with low risk of biological effects. No mechanical integrity problems are thus expected as there is only 0.3% of the initial diameter of the struts of a stent that will be lost as a consequence of corrosion after 100 years.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vRge33
via IFTTT

Coronary angiography with or without percutaneous coronary intervention in patients with hemophilia—Systematic review

Abstract

Objectives

We aimed to summarize the evidence for periprocedural and long-term strategies to both minimize the bleeding risk and ensure sufficient anticoagulation and antiaggregation in hemophilia patients undergoing coronary angiography with or without percutaneous coronary interventions (PCI).

Background

Hemophilia patients undergoing coronary angiography and PCI are at risk of bleeding due to deficiency of the essential clotting factors VIII or IX combined with the need of peri-interventional anticoagulation and antiaggregation and dual antiplatelet therapy (DAPT) after PCI.

Methods

We report on a patient with moderate hemophilia B undergoing single-vessel PCI with administration of factor IX concentrate during the procedure and during the 1-month DAPT period. In addition, a systematic review of patients (n = 54, mean age 58 ± 10 years) with hemophilia A (n = 45, 83%) or B (n = 9, 17%) undergoing coronary angiography with or without PCI is presented.

Results

Peri-interventional factor substitution was performed in the majority (42 of 54, 78%) but not all patients. In 38 of 54 (70%) patients undergoing coronary angiography, PCI with balloon dilation (n = 5), bare metal (n = 31), or drug-eluting stents (n = 2) was performed. For PCI unfractioned heparin (n = 24), low molecular weight heparin (n = 2), bivalirudin (n = 4), or no periprocedural anticoagulation at all (n = 8) were used. PCI was successful in all cases. After stenting, the majority (28 of 33; 85%) was treated with DAPT (median duration 1 month). Major periprocedural bleeding episodes occurred in 3 of 54 (6%) patients. Bleeding during follow-up occurred in 11 of 54 (20%) patients.

Conclusions

Coronary angiography and PCI in patients with hemophilia are effective and safe when applying individualized measures to prevent bleeding.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2gXNrr4
via IFTTT

Incidence and outcome of infective endocarditis following percutaneous versus surgical pulmonary valve replacement

Abstract

Objectives

To provide a comparison of the outcome of infective endocarditis (IE) in patients undergoing transcatheter pulmonary valve replacement (TPVR) versus surgical pulmonary valve replacement (SPVR).

Background

Although TPVR is thought to be associated with a higher risk of IE than SPVR, there is paucity of data to support this.

Methods

Patients who underwent TPVR or SPVR at UCLA between October 2010 and September 2016 were included and retrospectively analyzed.

Results

Three hundred forty-two patients underwent PVR at UCLA including 134 SPVR and 208 TPVR. Patients undergoing TPVR were more likely to have had a history of endocarditis than those undergoing SPVR (5.3% vs. 0.7%, P = 0.03) and a right ventricle to pulmonary artery (RV to PA) conduit (37% vs. 17%, P = 0.0001). Two SPVR and seven TPVR patients developed IE with a 4-year freedom from endocarditis of 94.0% in the SPVR versus 84% in the TPVR group (P = 0.13). In patients who underwent TPVR and developed endocarditis, the mean gradient across the RVOT prior to intervention was higher (28.1 ± 4.5 vs. 17.4 ± 0.6 mmHg, P = 0.02) and were more likely to have a conduit (71% vs. 36%, P = 0.049).

Conclusions

In this study, patients undergoing TPVR were not at a higher risk of IE than patients undergoing SPVR. TPVR patients were more likely to have had a prior history of IE and RV-PA conduit. The patients at highest risk were those with stenotic RV to PA conduits who were treated with TPVR.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2vRDgHm
via IFTTT

Usefulness of the SYNTAX score II to validate 2-year outcomes in patients with complex coronary artery disease undergoing percutaneous coronary intervention: A large single-center study

Abstract

Objective

This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice.

Background

Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI.

Methods

We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013. Patients were stratified according to SS-II for PCI tertiles as follows: SS-II ≤ 20 (n = 1474); SS-II 20–26 (n = 1462); and SS-II > 26 (n = 1462). The predictive ability for 2-year mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.

Results

Mortality was significantly higher in the upper tertile than in the intermediate or lower tertiles during the 2-year follow-up (2.7% vs 1.7% vs 0.5%, respectively; P < 0.001). Multivariate analysis showed that SS-II was an independent predictor of 2-year mortality (hazard ratio: 1.66, 95% confidence interval: 1.03–2.68; P = 0.04). After adjusting for multivariable factors, SS-II had better prediction of 2-year mortality than baseline SS (C-index: SS-II = 0.740 vs baseline SS = 0.620; P < 0.001).

Conclusions

As a risk score combining both anatomical and clinical variables, SS-II demonstrated superiority compared with the purely angiographic SS to predict 2-year mortality in a clinical population of patients with severe CAD undergoing temporary PCI.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2gZsETX
via IFTTT

New ASCO guideline aims to improve clinician communication with patients

Effective clinician communication is a core element of all patient-centered oncology care. The complexities of cancer, and its ever-present association with mortality, require specialised communication skills. A new guideline from the American Society...

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wY1keB
via IFTTT

miR-128 Is Implicated in Stress Responses by Targeting MAFG in Skeletal Muscle Cells

MAFG (v-Maf avian musculoaponeurotic fibrosarcoma oncogene homolog G) is a bZIP-type transcriptional regulator that belongs to the small MAF (sMAFs) protein family. By interacting with other bZIP transcription factors, sMAFs can form homo- and heterodimers governing either repressive or activating transcriptional functions. As heterodimeric partner of Nrf2, MAFG positively influences the ARE-dependent antioxidant/xenobiotic pathways, at least in condition of a correct MAFG:Nrf2 balance. MicroRNAs (miRs) participate to different regulatory networks being involved as fine-tuning regulators of gene expression. However, the connections between cellular surveillance to stresses mediated by MAFG:Nrf2 and miR regulations are not well understood. Here, we explored the impact of miR-128 in expression of genes related to stress response. Bioinformatic predictions coupled with functional analysis revealed the presence of miR-128 binding site in the 3′UTR of MAFG. Ectopic miR-128 expression correlated with reduced expression of endogenous MAFG-dependent genes and negatively affected ARE-mediated molecular phenotype based on Nrf2 activity. Indeed, miR-128 impairs redox-dependent pathways induced in response to oxidative stress. Moreover, in condition of hypoxia, MAFG induction correlated with reduced levels of miR-128. This lead to increased mRNA levels of HMOX-1 and x-CT for blunting stress. Overall, these findings identify MAFG as novel direct target of miR-128.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xugklY
via IFTTT

Oxidative Stress in Hemodialysis Patients: A Review of the Literature

Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se. HD patients manifest excessive OS status due to retention of a plethora of toxins, subsidized under uremia, nutrition lacking antioxidants and turn-over of antioxidants, loss of antioxidants during renal replacement therapy, and leukocyte activation that leads to accumulation of oxidative products. Duration of dialysis therapy, iron infusion, anemia, presence of central venous catheter, and bioincompatible dialyzers are several factors triggering the development of OS. Antioxidant supplementation may take an overall protective role, even at early stages of CKD, to halt the deterioration of kidney function and antagonize systemic inflammation. Unfortunately, clinical studies have not yielded unequivocal positive outcomes when antioxidants have been administered to hemodialysis patients, likely due to their heterogeneous clinical conditions and underlying risk profile.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2y1GuJI
via IFTTT

Benchmark Solution for Free Vibration of Moderately Thick Functionally Graded Sandwich Sector Plates on Two-Parameter Elastic Foundation with General Boundary Conditions

The free vibration analysis of moderately thick functionally graded (FG) sector plates resting on two-parameter elastic foundation with general boundary conditions is presented via Fourier-Ritz method, which is composed of the modified Fourier series approach and the Ritz procedure. The material properties are assumed to vary continuously along the thickness according to the power-law distribution. The bilayered and single-layered functionally graded sector plates are obtained as the special cases of sandwich plates. The first-order shear deformation theory (FSDT) is adopted to construct the theoretical model. Under current framework, regardless of boundary conditions, each displacement and each rotation of plates is represented by the modified Fourier series consisting of a standard Fourier cosine series and several closed-form auxiliary functions introduced to ensure and accelerate the convergence of the series representation. Then, the accurate solutions are obtained by using the Ritz procedure based on the energy function of sector plates. The present method shows good convergence, reliability, and accuracy by comprehensive investigation with some selected classical boundary conditions. Numerous new vibration results for moderately thick FG sandwich sector plates are provided. The effects of the elastic restraint parameters and so forth on free vibration characteristic of sector plates are presented.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xuhAFy
via IFTTT

Analysis of the Seismic Performance of Site-Bolted Beam to Column Connections in Modularized Prefabricated Steel Structures

This paper proposes a site-bolted connection that is suitable for modularized prefabricated steel structures. Excellent ductility is achieved by various structural measures. Six connection specimens with different parameters were subjected to quasi-static loading tests and finite element analysis (FEA) to determine the seismic performance of the proposed connection (e.g., hysteretic behavior, skeleton curve, ductility, and failure mode). The results of the tests and FEA showed that the connection underwent sufficient plastic deformation under cyclic loading and that its ultimate rotation angle could reach 0.09 rad. A clear plastic hinge formed on the beam before the connection failed, which suggests a ductile failure mode. The connection exhibited a wide hysteresis loop, which indicated good seismic performance. The results also showed that the connection does not slip under small earthquakes and could dissipate energy through slippage in the connection region under a moderate earthquake and through slippage in the connection region as well as plastic deformation at the beam end under a severe earthquake. The number of bolts was the main parameter that affected the seismic performance of the connection. The test and FEA results demonstrated that all six specimens had excellent seismic and ductile performance and an exceptional plastic rotation capacity.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xtAhsO
via IFTTT

Simvastatin Ameliorates Diabetic Cardiomyopathy by Attenuating Oxidative Stress and Inflammation in Rats

Simvastatin is a lipid-lowering agent used to treat hypercholesterolemia and to reduce the risk of heart disease. This study scrutinized the beneficial effects of simvastatin on experimental diabetic cardiomyopathy (DCM), pointing to the role of hyperglycemia-induced oxidative stress and inflammation. Diabetes was induced by intraperitoneal injection of streptozotocin and both control and diabetic rats received simvastatin for 90 days. Diabetic rats showed significant cardiac hypertrophy, body weight loss, hyperglycemia, and hyperlipidemia. Serum creatine kinase MB (CK-MB) and troponin I showed a significant increase in diabetic rats. Simvastatin significantly improved body weight, attenuated hyperglycemia and hyperlipidemia, and ameliorated CK-MB and troponin I. Simvastatin prevented histological alterations and deposition of collagen in the heart of diabetic animals. Lipid peroxidation and nitric oxide were increased in the heart of diabetic rats whereas antioxidant defenses were decreased. These alterations were significantly reversed by simvastatin. In addition, simvastatin decreased serum inflammatory mediators and expression of NF-κB in the diabetic heart. Cardiac caspase-3 was increased in the diabetic heart and decreased following treatment with simvastatin. In conclusion, our results suggest that simvastatin alleviates DCM by attenuating hyperglycemia/hyperlipidemia-induced oxidative stress, inflammation, and apoptosis.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xuigdY
via IFTTT

Cell Signaling with Extracellular Thioredoxin and Thioredoxin-Like Proteins: Insight into Their Mechanisms of Action

Thioredoxins are small thiol-oxidoreductase enzymes that control cellular redox homeostasis. Paradoxically, human thioredoxin (TXN1) was first identified as the adult T cell leukemia-derived factor (ADF), a secreted protein. ADF has been implicated in a wide variety of cell-to-cell communication systems acting as a cytokine or a chemokine. TRX80 is a truncated TXN1 protein with cytokine activity. The unconventional secretion mechanism of these extracellular thioredoxins is unknown. The thioredoxin system is relying on glucose metabolism through the pentose phosphate pathway that provides reducing power in the form of NADPH, the cofactor of thioredoxin reductase (TXNRD). While a complete extracellular TXN system is present in the blood in the form of circulating TXN1 and TXNDR1, the source of extracellular NADPH remains a mystery. In the absence of redox regenerating capacity, extracellular thioredoxins may rather be prooxidant agents. Rod-derived cone viability factor (RdCVF) is the product of intron retention of the nucleoredoxin-like 1 (NXNL1) gene, a secreted truncated thioredoxin-like protein. The other product encoded by the gene, RdCVFL, is an enzymatically active thioredoxin. This is a very singular example of positive feedback of a superthioredoxin system encoded by a single gene likely emerging during evolution from metabolic constraints on redox signaling.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2y1XPlS
via IFTTT

Nonlinear Dynamics of a PI Hydroturbine Governing System with Double Delays

A PI hydroturbine governing system with saturation and double delays is generated in small perturbation. The nonlinear dynamic behavior of the system is investigated. More precisely, at first, we analyze the stability and Hopf bifurcation of the PI hydroturbine governing system with double delays under the four different cases. Corresponding stability theorem and Hopf bifurcation theorem of the system are obtained at equilibrium points. And then the stability of periodic solution and the direction of the Hopf bifurcation are illustrated by using the normal form method and center manifold theorem. We find out that the stability and direction of the Hopf bifurcation are determined by three parameters. The results have great realistic significance to guarantee the power system frequency stability and improve the stability of the hydropower system. At last, some numerical examples are given to verify the correctness of the theoretical results.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xuniHm
via IFTTT

Reply to the Comments by Mortazavi and Doss on “Solid Cancer Incidence among the Life Span Study of Atomic Bomb Survivors: 1958–2009” (Radiat Res 2017; 187:513–537)

Radiation Research, Volume 188, Issue 3, Page 370-371, September 2017.


from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2w3Kz2D
via IFTTT

Clinical predictors of multiple tympanostomy tube placements in Ontario children

Objectives

To characterize risk factors that predict the need for multiple tympanostomy tube (TT) procedures.

Study Design

Retrospective population-based cohort study of children aged 18 years and younger in Ontario, Canada, who underwent at least one TT placement between January 1, 1994, and October 31, 2013.

Methods

The relative risk (RR) of need for multiple TT procedures was determined using log-binomial regression.

Results

There were 193,880 children who underwent TT insertion included in this cohort. Of these, 28.58% underwent at least two separate TT procedures. Over time, the RR of undergoing multiple TT procedures is decreasing for all children. In general, the younger the child was at the first TT procedure, the more likely the child was to undergo multiple TT procedures. Significantly higher RR for multiple TT procedures also was associated with male sex, the second-highest neighborhood income quintile, asthma or reactive airways, gastrointestinal disease, prematurity, or cleft lip and/or palate. Significantly lower RR for multiple TT procedures was associated with adenoidectomy or tonsillectomy (with or without adenoidectomy) at first TT placement or within 3 years prior. Furthermore, the benefit of adjuvant adenoidectomy or tonsillectomy was present for children aged under 4 years, in addition to those aged 4 years and older.

Conclusion

Among Ontario children who have had TT placement, more than one in four will have multiple sets placed. These identified risk factors permit improved preoperative counseling and enable identification of children who need closer follow-up.

Level of Evidence

2b. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2f1znfB
via IFTTT

Preliminary results of tissue-engineered injection laryngoplasty material in a rabbit model

Objectives/Hypothesis

Design and test a novel biomaterial for injection laryngoplasty aimed to increase the duration of effectiveness of micronized acellular dermis.

Study Design

Animal model.

Methods

Injection laryngoplasty was performed in three groups (n = 5) of New Zealand White rabbits. Acellular dermis was either used alone as a control (group 1), was combined with undifferentiated stem cells (group 2), or with predifferentiated chondrocytic cells (group 3). Groups 2 and 3 were supplemented with growth factors. Animals were sacrificed 4 and 12 weeks after laryngoplasty and histologic analysis was completed. The major outcome measure was volume of tissue remaining.

Results

After 4 weeks, the mean volume of tissue remaining was 341 ± 89 mm³, 295 ± 102 mm³, and 133 ± 15 mm³, for groups 1 to 3, respectively. At the 12-week time point, volumes were 62 ± 62 mm³, 235 ± 35 mm³, and 107 ± 99 mm³. After 12 weeks, there was a significantly higher volume in group 2 compared to group 1 or 3 (P = .01, P = .04). Volumes between week 4 and week 12 were significantly lower in group 1 (P = .02), but not significantly different for groups 2 and 3 (P = .38, P = .74). Histologic evaluation revealed a robust lymphocytic infiltration in all cases as well as morphologic and immunophenotypic features suggestive of chondrogenic differentiation in a single animal.

Conclusions

Micronized acellular dermis combined with stem cells and growth factors showed significantly less resorption 12 weeks after injection laryngoplasty compared to micronized acellular dermis alone. Groups using novel tissue-engineered biomaterial showed a lower resorption rate over time compared with acellular dermis alone.

Level of Evidence

NA Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jkPfuZ
via IFTTT

Chemosensory function before and after multimodal treatment in chronic rhinosinusitis patients

Objectives/Hypothesis

Olfactory dysfunction is common among the general population, with chronic rhinosinusitis (CRS) as one of the leading causes. Patients affected by CRS often report changes in taste sensations; however, quantitative measurements have not been performed to date. Therefore, the present study aimed to investigate gustatory and olfactory function in CRS patients prior to and after multimodal treatment.

Study Design

Prospective cohort study.

Methods

Twenty-one patients suffering from CRS with nasal polyps (14 male, seven female) with a mean age of 48 ± 15 years were included in the study. Chemosensory function was assessed prior to and approximately 190 days after multimodal treatment, which included endoscopic sinus surgery, oral antibiotics for 5 days, oral steroids for 12 days, and at least 6 weeks of topical nasal steroids. Olfactory function was tested with the Sniffin' Sticks test battery, whereas gustatory function was measured with taste strips. A clinically relevant change in olfactory function was defined as a change of ≥5 points in the threshold, discrimination, and identification scores.

Results

Compared to normative data, patients baseline gustatory and olfactory function was impaired. After multimodal treatment, improvements were seen in olfactory function for eight patients (42%), remained stable in 10 patients (53%), and deteriorated in one patient (5%). Taste function remained unchanged following sinus surgery.

Conclusions

Patients suffering from CRS with polyps exhibit olfactory and taste dysfunctions. Multimodal treatment leads to an improvement in olfactory, but not gustatory functionality.

Level of Evidence

4. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2f0Ok1K
via IFTTT

Effect of aging and direction of impulse in video head impulse test

Objective

The aim of this study was to identify the difference of gain value in the video head impulse test (vHIT) according to the age of the patient and the direction of the impulse.

Method

All participants were subjected to vHIT with horizontal semicircular canal (HSCC). vHIT with vertical canal (posterior and anterior semicircular canal [PSCC and ASCC]) additionally was performed in 434 participants.

Results

The mean vestibulo-ocular reflex (VOR) gain was maintained in patients in the HSCC at below 70 years (1.025 ± 0.08) and in the vertical canal at below 80 years (PSCC: 0.965 ± 0.12, ASCC: 0.975 ± 0.14). However, the decrease of VOR gain was significant in patients over 70 years in the HSCC (0.978 ± 0.35, P < .001) and in patients over 80 years in the vertical canal (PSCC: 0.828 ± 0.16, ASCC: 0.851 ± 0.13, P < .001). In addition, a VOR gain of rightward impulse was higher than the leftward impulse, but there was no difference based on the direction of impulse in the vertical impulse test.

Conclusion

VOR gain declines with increasing age, over 70 years on the horizontal canal, and over 80 years on the vertical canal. Additionally, horizontal VOR gain of rightward impulse was higher than the leftward impulse in right-eye recordings only, but the vertical canal showed no difference of gain according to the direction of impulse.

Level of Evidence

2b. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jkYOdy
via IFTTT

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

Objectives

This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children.

Data Source

Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017.

Review Methods

Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers. The outcomes of interest were emergence agitation, postoperative pain intensity, rescue analgesic consumption, and other morbidities (nausea and vomiting and agitation).

Results

Fifteen studies with n = 1,552 met the inclusion criteria. Postoperative pain scores and the need for analgesics in the postanesthesia care unit (PACU) were significantly decreased in the dexmedetomidine group versus the control group. The incidence and degree of agitation and desaturation incidence in the PACU also were significantly lower in the dexmedetomidine group than in the control group. Additionally, there was no significant difference in the duration of staying PACU between both groups. In subgroup analyses by administration method (bolus injection or continuous injection), dexmedetomidine was shown to be effective at reducing postoperative morbidities regardless of administration method.

Conclusion

Perioperative administration of dexmedetomidine can provide pain and agitation relief without side effects in children undergoing adenotonsillectomy. Considering the high heterogeneity of results within some parameters; however, further clinical trials with robust research methodology should be conducted to confirm the results of this study. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2f0Ox4K
via IFTTT

Oncologic outcomes of KTP laser surgery versus radiation for T1 glottic carcinoma

Objectives/Hypothesis

To characterize outcomes for patients who underwent transoral microsurgery with potassium titanyl phosphate (KTP) laser resection of early glottic cancers and to compare outcomes with patients who received external beam radiation therapy.

Study Design

Retrospective cohort study.

Methods

The history of patients with T1 glottic carcinoma treated with curative primary radiation or transoral KTP laser resection was reviewed. Oncologic outcomes for both radiation and surgery cohorts including disease-free and overall survival were calculated.

Results

Eighty-seven patients met inclusion criteria from 2011 to 2016; 47 patients (54%) received primary KTP laser ablation, and 40 patients (46%) received primary external beam radiotherapy. The average length of follow-up was 924 ± 529 days in the KTP laser group and 994 ± 603 days in the radiation group (P = .26). There were no significant differences between the two treatment groups in terms of medical or demographic variables. There were six recurrences in the KTP laser group (13%), versus six in the radiotherapy group (15%) (P = .77). The laryngeal preservation rate for the cohort of patients who initially received KTP laser treatment was 46 out of 47 patients (98%). Of the cohort that received primary radiation therapy, the laryngeal preservation rate was 36 out of 40 patients (90%, P = .18). Disease-free and overall survival were 88% and 98% in the KTP laser cohort and 85% and 95% in the radiation cohort (P = .78, P = .56), respectively.

Conclusions

KTP laser ablation is a modality equivalent to primary radiation therapy in oncologic outcomes for T1 glottic squamous cell carcinoma.

Level of Evidence

4 Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jmwBDl
via IFTTT

Perceptions of pain of laryngeal electromyography

Objective

To evaluate pain associated with laryngeal electromyography (LEMG).

Study Design

A prospective case series.

Methods

Adult patients scheduled for LEMG in a tertiary care laryngology practice were recruited between July 20, 2016, and March 1, 2017. Demographic and clinical data were extracted from the charts. Study participants reported their anticipated pain level using a visual analog scale (VAS) prior to the procedure. VAS was administered again within 10 minutes after the procedure, along with the validated McGill Pain Questionnaire, to gauge patient's pain perception after undergoing LEMG.

Results

Results were reviewed for 80 patients (mean age 48.2 ± 16.6 years, 37.5% male). Preprocedure VAS pain scores (4.59 ± 2.3 out of 10) were not significantly different than postprocedure VAS pain scores (4.61 ± 2.4) (P = 0.95). The McGill Pain Questionnaire reported a moderate pain level (32.1 ± 12.7 out of 78). Females anticipated a higher preprocedure VAS pain score (5.04 ± 2.3) than males (3.85 ± 2.2) (P = 0.02); however, postprocedure scores were not significantly different between genders. The following factors did not influence the pain scores: age, professional voice use, history of previous EMG, chronic pain diagnosis, psychiatric diagnosis, or current treatment with pain/psychiatric medications. All LEMGs were completed without any complications.

Conclusion

Patients appropriately anticipated their pain levels for the LEMG, which may be attributed to proper patient education and counselling before the procedure. Overall pain levels were mild to moderate, and all LEMGs were completed; thus, LEMG was well tolerated.

Level of Evidence

4. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2f0Olm2
via IFTTT

What is the optimal time for removing drains in uncomplicated head and neck surgery?

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2f1umnz
via IFTTT

Laryngeal EMG: Preferential damage of the posterior cricoarytenoid muscle branches especially in iatrogenic recurrent laryngeal nerve lesions

Objective

Laryngeal electromyography (LEMG) of the thyroarytenoid (TA) muscle alone may not be sufficient in all patients to characterize or prove a recurrent laryngeal nerve (RLN) lesion in cases of vocal fold immobility. LEMG of the posterior cricoarytenoid (PCA) muscle may provide additional information.

Study Design

Retrospective review.

Method

Between 2008 and 2016, 339 patients in our laryngeal paralysis clinic were examined by transcutaneous needle TA-LEMG and, if tolerated, by PCA-LEMG. LEMGs were rated and compared according to criteria of the European Laryngological Society. Etiology was categorized as iatrogenic, noniatrogenic, or malignancy related.

Results

A total of 282 out of 339 patients had a partial or complete RLN or vagal nerve lesion: 178 iatrogenic, 74 noniatrogenic, and 30 because of nerve involvement by malignancies. Of paralytic vocal folds, 35.7% had normal or near-normal TA innervation, whereas corresponding PCA traces (if present) were pathologic in 94.6%. Comparing pairs of TA and PCA-LEMGs in paralysis of less than 4 months duration showed a predominance of PCA branch injuries in iatrogenic lesions (71.7 %), while in noniatrogenic lesions this was less pronounced (44.4%). In the few malignancy cases, there was an almost even distribution. Synkinetic reinnervation was earlier in iatrogenic RLN lesions.

Conclusion

PCA-LEMG was better in proving an RLN lesion than TA-EMG alone. Our findings suggest etiology-dependent differences in the TA/PCA lesion pattern. To confirm this, larger sample sizes are needed. A preferential damage to PCA innervation in iatrogenic lesions could be relevant for further improvements of intraoperative neuromonitoring.

Level of Evidence

4. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jkaYTS
via IFTTT

Work-related musculoskeletal symptoms among otolaryngologists by subspecialty: A national survey

Objective

Given the high prevalence of work-related musculoskeletal symptoms, increased appreciation for workplace ergonomics is critical. The purpose of this study is to assess work-related musculoskeletal symptoms and injury among otolaryngologists across subspecialties, as well as to quantify the understanding and application of ergonomic principles in the operating room.

Study Design

Cross-sectional study.

Methods

An online REDCap survey was distributed electronically to University of Kansas faculty, alumni, and residents; members of the American Academy of Facial Plastic and Reconstructive Surgery; and residency program coordinators for distribution to residents and faculty between August 2016 and March 2017. The survey assessed caseload, ergonomic practices, and associated musculoskeletal symptoms by type of procedure and impact of symptoms on surgeon practice.

Results

The survey was distributed to 3,006 individuals. We received 377 responses (12.5%), with 63.9% reporting symptoms. The majority of respondents began to experience symptoms in residency or fellowship. Neck and shoulder were the most affected body areas across all types of surgeries. One-third of surgeons were formally taught or actively sought information on ergonomics principles. Among those who applied ergonomics in practice, 69.6% observed improvement in their symptoms.

Conclusion

Although musculoskeletal issues are prevalent among otolaryngologists, awareness of surgical ergonomics principles among otolaryngologists remains limited. Early instruction in ergonomic principles is important because work-related musculoskeletal symptoms commonly present in residency. Most respondents reporting the application of ergonomic principles also acknowledge symptom improvement.

Level of Evidence

NA. Laryngoscope, 2017

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2f2ngiC
via IFTTT

IJMS, Vol. 18, Pages 1949: The Role of Vitamin D in Thyroid Diseases

IJMS, Vol. 18, Pages 1949: The Role of Vitamin D in Thyroid Diseases

International Journal of Molecular Sciences doi: 10.3390/ijms18091949

Authors: Dohee Kim

The main role of vitamin D is regulating bone metabolism and calcium and phosphorus homeostasis. Over the past few decades, the importance of vitamin D in non-skeletal actions has been studied, including the role of vitamin D in autoimmune diseases, metabolic syndromes, cardiovascular disease, cancers, and all-cause mortality. Recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto's thyroiditis and Graves' disease, and impaired vitamin D signaling has been reported in thyroid cancers. This review will focus on recent data on the possible role of vitamin D in thyroid diseases, including autoimmune thyroid diseases and thyroid cancers.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2y1CY1Q
via IFTTT

IJMS, Vol. 18, Pages 1950: De Novo Assembly and Analysis of Polygonatum sibiricum Transcriptome and Identification of Genes Involved in Polysaccharide Biosynthesis

IJMS, Vol. 18, Pages 1950: De Novo Assembly and Analysis of Polygonatum sibiricum Transcriptome and Identification of Genes Involved in Polysaccharide Biosynthesis

International Journal of Molecular Sciences doi: 10.3390/ijms18091950

Authors: Shiqiang Wang Bin Wang Wenping Hua Junfeng Niu Kaikai Dang Yi Qiang Zhezhi Wang

Polygonatum sibiricum polysaccharides (PSPs) are used to improve immunity, alleviate dryness, promote the secretion of fluids, and quench thirst. However, the PSP biosynthetic pathway is largely unknown. Understanding the genetic background will help delineate that pathway at the molecular level so that researchers can develop better conservation strategies. After comparing the PSP contents among several different P. sibiricum germplasms, we selected two groups with the largest contrasts in contents and subjected them to HiSeq2500 transcriptome sequencing to identify the candidate genes involved in PSP biosynthesis. In all, 20 kinds of enzyme-encoding genes were related to PSP biosynthesis. The polysaccharide content was positively correlated with the expression patterns of β-fructofuranosidase (sacA), fructokinase (scrK), UDP-glucose 4-epimerase (GALE), Mannose-1-phosphate guanylyltransferase (GMPP), and UDP-glucose 6-dehydrogenase (UGDH), but negatively correlated with the expression of Hexokinase (HK). Through qRT-PCR validation and comprehensive analysis, we determined that sacA, HK, and GMPP are key genes for enzymes within the PSP metabolic pathway in P. sibiricum. Our results provide a public transcriptome dataset for this species and an outline of pathways for the production of polysaccharides in medicinal plants. They also present more information about the PSP biosynthesis pathway at the molecular level in P. sibiricum and lay the foundation for subsequent research of gene functions.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2w3e04N
via IFTTT

Retraction notice to “Effect of phentolamine on myocardial extracellular matrix of cardiac remodeling in rats” [Asian Pac J Trop Med (2014) 645–649]

Publication date: July 2017
Source:Asian Pacific Journal of Tropical Medicine, Volume 10, Issue 7
Author(s): Yi-Gang Yin, Ru-Zhu Wang, Zhong-Bao Ruan, Li Zhu




from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2y1SD1h
via IFTTT

Quantification of N -phenyl-2-naphthylamine by gas chromatography and isotope-dilution mass spectrometry and its percutaneous absorption ex vivo under workplace conditions

Abstract

N-Phenyl-2-naphthylamine (P2NA) is an antioxidant used to protect rubbers from flex-cracking. P2NA can be converted in vivo to 2NA, one of the most potent bladder carcinogens. Here, we report the specific and ultra-sensitive quantification of P2NA in the receptor fluid of Franz diffusion cells by gas chromatography and isotope-dilution tandem-mass spectroscopy (GC–MS/MS). The experimental conditions were optimized to minimize losses of P2NA due to surface absorption on glass, plastic, and rubber material, and subsequently validated. Static and dynamic diffusion cell conditions were used to study the percutaneous penetration of P2NA into freshly prepared porcine skin. The experimental settings closely resembled those of the printing industry in the 1960s/1970s in Germany where P2NA-containing solutions in dichloromethane have been used. P2NA penetrated the skin at very low levels (0.02 ± 0.01 µg/cm²/h) with a cumulative penetrated amount of 0.80 ± 0.26 µg/cm², a lag time of 6.33 ± 2.21 h and under dynamic conditions. Compared to the receptor fluid, 10–40-fold higher concentrations were found in the skin, predominantly in the dermis and the stratum corneum. Dichloromethane acted as a penetration enhancer by increasing the cumulative penetrated amounts and the recovery of P2NA in both the receptor fluid and the skin, while shortening its lag time. However, the flux remained unaffected. Due to its accumulation in subcutaneous layers, we finally proved that P2NA is continuously released into the receptor fluid despite exposure cessation up to 160 h. Overall, the results show that close attention has to be paid to dermal absorption of P2NA in exposed workers.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2gZtOLA
via IFTTT

Two lives, one REBOA: Hemorrhage control for urgent cesarean hysterectomy in a Jehovah’s Witness with placenta percreta

No abstract available

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wRw9Te
via IFTTT

Distinct molecular subtypes of uterine leiomyosarcoma respond differently to chemotherapy treatment

Uterine leiomyosarcoma (ULMS) is an aggressive form of soft tissue tumors. The molecular heterogeneity and pathogenesis of ULMS are not well understood.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xhwGNX
via IFTTT

Determinants of short-term movement in a developing region and implications for disease transmission.

Background: Human mobility is important for infectious disease spread. However, little is known about how travel varies by demographic groups and how this heterogeneity influences infectious disease risk. Methods: We analyzed ten years of survey data from 15 communities in a remote but rapidly changing region in rural Ecuador where road development in the past 15-20 years has dramatically changed travel. We identify determinants of travel and incorporate them into an infection transmission model. Results: Individuals living in communities more remote at baseline had lower travel rates compared with less remote villages (adjusted odds ratio [OR]=0.51, 95% CI 0.38, 0.67). Our model predicts that less remote villages are, therefore, at increased disease risk. Though road building and travel increased for all communities, this risk differential remained over 10 years of observation. Our transmission model also suggests that travelers and non-travelers have different roles in disease transmission. Adults travel more than children (adjusted OR=1.73, 95% CI 1.30, 2.31) and therefore disseminate infection from population centers to rural communities. Children are more likely than adults to be infected locally (attributable fraction=0.24 and 0.09, respectively) and were indirectly affected by adult travel patterns. Conclusions: These results reinforce the importance of large population centers for regional transmission and show that children and adults may play different roles in disease spread. Changing transportation infrastructure and subsequent economic and social transitions are occurring worldwide, potentially causing increased regional risk of disease. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2wWegQs
via IFTTT

R Function for Additive Interaction Measures.

No abstract available

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xX5qkG
via IFTTT

Effects of PER3 clock gene polymorphisms on aging-related changes of the cerebral cortex

Abstract

Considerable evidence suggests that circadian rhythmicity is progressively disrupted in senescence. Among clock genes, Period3 (PER3) has been associated with circadian phenotypes, homeostatic regulation of sleep, and cognitive performance in young adults. However, the effects of PER3 genotype on aging-related changes in both cognitive function and cortical integrity remain largely unknown. To shed light into this issue, we have investigated differences in cognitive performance, patterns of cortical thickness, and cortical glucose consumption in normal elderly subjects homozygous carriers of the short (PER3^4/4, n = 32) and long repeat alleles (PER3^5/5, n = 32). Relationships between cognitive performance and cortical thickness/metabolism were further explored for each PER3 genotype. We found that PER3^5/5 carriers had poorer cognitive performance (attention, executive function, semantic memory, and verbal fluency) and lower cortical integrity (structural and functional) than PER3^4/4. PER3^5/5 further showed thinning of temporo–parietal areas, and reductions of glucose consumption in fronto–temporo–parietal regions bilaterally. Moreover, PER3^5/5 subjects exhibited significant correlations between decreased glucose metabolism in fronto–parietal regions and poorer cognitive flexibility, though only correlations with lower glucose consumption of the supramarginal gyrus distinguished PER3^5/5 from PER3^4/4 groups. Overall, these findings enhance our understanding on the gene–brain interaction in aging, and may have further implications for the detection of subclinical cognitive decline associated with PER3 genotypes in late life.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wWI0hE
via IFTTT

Group 2 Innate Lymphoid Cells Are Involved in Skewed Type 2 Immunity of Gastric Diseases Induced by Helicobacter pylori Infection

H. pylori induces a complicated local and systematic immune response and contributes to the carcinogenesis of gastric cancer. A primary type 1 immune response is evoked by H. pylori since its occurrence. However, it is not unusual that an inhibitory immunity is dominant in H. pylori-associated diseases, which are promoted by the formation of immunosuppressive microenvironment. But whether group 2 innate lymphoid cells (ILC2s) plays a critical role in H. pylori-induced skewed type 2 immunity is still unclear. In the present study, firstly, we confirmed that type 1 immunity was inhibited and type 2 immunity were undisturbed or promoted after H. pylori infection in vitro and in vivo. Secondly, GATA-3 was firstly found to be increased in the interstitial lymphocytes from H. pylori-associated gastric cancer, among them, Lin−GATA-3+ cells and Lin+GATA-3+ cells were also found to be enhanced, which indicated an important role for ILC2s in H. pylori infection. More importantly, ILC2s were found to be increased after H. pylori infection in clinical patients and animal models. In conclusion, our results indicated that ILC2-mediated innate immune response might play a potential role in dominant type 2 phenotype and immunosuppressive microenvironment in H. pylori infection.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2jjVZcF
via IFTTT

Effect of Surface Charge and Hydrophobicity Modulation on the Antibacterial and Antibiofilm Potential of Magnetic Iron Nanoparticles

Unmodified magnetic nanoparticles (MNPs) lack antibacterial potential. We investigated MNPs surface modifications that can impart antibacterial activity. Six MNPs species were prepared and characterized. Their antibacterial and antibiofilm potentials, surface affinity, and cytotoxicity were evaluated. Prepared MNPs were functionalized with citric acid, amine group, amino-propyl trimethoxy silane (APTMS), arginine, or oleic acid (OA) to give hydrophilic and hydrophobic MNPs with surface charge ranging from −30 to +30 mV. Prepared MNPs were spherical in shape with an average size of 6–15 nm. Hydrophobic (OA-MNPs) and positively charged MNPs (APTMS-MNPs) had significant concentration dependent antibacterial effect. OA-MNPs showed higher inhibitory potential against S. aureus and E. coli (80%) than APTMS-MNPs (70%). Both particles exhibited surface affinity to S. aureus and E. coli. Different concentrations of OA-MNPs decreased S. aureus and E. coli biofilm formation by 50–90%, while APTMS-MNPs reduced it by 30–90%, respectively. Up to 90% of preformed biofilms of S. aureus and E. coli were destroyed by OA-MNPs and APTMS-MNPs. In conclusion, surface positivity and hydrophobicity enhance antibacterial and antibiofilm properties of MNPs.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wXqf1R
via IFTTT

Optical Tests on a Curve Fresnel Lens as Secondary Optics for Solar Troughs

A curve Fresnel lens is developed as secondary concentrator for solar parabolic troughs to reduce the number of photovoltaic cells. Specific measurements and optical tests are used to evaluate the optical features of manufactured samples. The cylindrical Fresnel lens transforms the focal line, produced by the primary mirror, into a series of focal points. The execution of special laboratory tests on some secondary concentrator samples is discussed in detail, illustrating the methodologies tailored to the specific case. Focusing tests are performed, illuminating different areas of the lens with solar divergence light and acquiring images on the plane of the photocell using a CMOS camera. Concentration measurements are carried out to select the best performing samples of curve Fresnel lens. The insertion of the secondary optics within the concentrating photovoltaic (CPV) trough doubles the solar concentration of the system. The mean concentration ratio is 1.73, 2.13, and 2.09 for the three tested lenses. The concentration ratio of the solar trough is 140 and approaches 300 after the introduction of the secondary lens.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2jjVYFD
via IFTTT

Automatic Emergence Detection in Complex Systems

Complex systems consist of multiple interacting subsystems, whose nonlinear interactions can result in unanticipated (emergent) system events. Extant systems analysis approaches fail to detect such emergent properties, since they analyze each subsystem separately and arrive at decisions typically through linear aggregations of individual analysis results. In this paper, we propose a quantitative definition of emergence for complex systems. We also propose a framework to detect emergent properties given observations of its subsystems. This framework, based on a probabilistic graphical model called Bayesian Knowledge Bases (BKBs), learns individual subsystem dynamics from data, probabilistically and structurally fuses said dynamics into a single complex system dynamics, and detects emergent properties. Fusion is the central element of our approach to account for situations when a common variable may have different probabilistic distributions in different subsystems. We evaluate our detection performance against a baseline approach (Bayesian Network ensemble) on synthetic testbeds from UCI datasets. To do so, we also introduce a method to simulate and a metric to measure discrepancies that occur with shared/common variables. Experiments demonstrate that our framework outperforms the baseline. In addition, we demonstrate that this framework has uniform polynomial time complexity across all three learning, fusion, and reasoning procedures.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wX7rQd
via IFTTT

Involvement of WNT Signaling in the Regulation of Gestational Age-Dependent Umbilical Cord-Derived Mesenchymal Stem Cell Proliferation

Mesenchymal stem cells (MSCs) are a heterogeneous cell population that is isolated initially from the bone marrow (BM) and subsequently almost all tissues including umbilical cord (UC). UC-derived MSCs (UC-MSCs) have attracted an increasing attention as a source for cell therapy against various degenerative diseases due to their vigorous proliferation and differentiation. Although the cell proliferation and differentiation of BM-derived MSCs is known to decline with age, the functional difference between preterm and term UC-MSCs is poorly characterized. In the present study, we isolated UC-MSCs from 23 infants delivered at 22–40 weeks of gestation and analyzed their gene expression and cell proliferation. Microarray analysis revealed that global gene expression in preterm UC-MSCs was distinct from term UC-MSCs. WNT signaling impacts on a variety of tissue stem cell proliferation and differentiation, and its pathway genes were enriched in differentially expressed genes between preterm and term UC-MSCs. Cell proliferation of preterm UC-MSCs was significantly enhanced compared to term UC-MSCs and counteracted by WNT signaling inhibitor XAV939. Furthermore, WNT2B expression in UC-MSCs showed a significant negative correlation with gestational age (GA). These results suggest that WNT signaling is involved in the regulation of GA-dependent UC-MSC proliferation.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2jk3qk0
via IFTTT

Regulation of Osteogenic Differentiation of Placental-Derived Mesenchymal Stem Cells by Insulin-Like Growth Factors and Low Oxygen Tension

Placental mesenchymal stem cells (PMSCs) are multipotent cells that can differentiate in vitro to multiple lineages, including bone. Insulin-like growth factors (IGFs, IGF-1 and IGF-2) participate in maintaining growth, survival, and differentiation of many stem cells, including osteoprogenitors. Low oxygen tension (PO2) can maintain stem cell multipotency and impede osteogenic differentiation. In this study, we investigated whether PMSC osteogenic differentiation is influenced by low PO2 and by IGFs. Our results indicated that low PO2 decreased osteogenic markers RUNX2 and OPN; however, re-exposure to higher oxygen tension (room air) restored differentiation. IGFs, especially IGF-1, triggered an earlier expression of RUNX2 and enhanced OPN and mineralization. RUNX2 was phosphorylated in room air and augmented by IGFs. IGF-1 receptor (IGF-1R) was increased in low PO2 and reduced by IGFs, while insulin receptor (IR) was increased in differentiating PMSCs and enhanced by IGF-1. Low PO2 and IGFs maintained higher IR-A which was switched to IR-B in room air. PI3K/AKT was required for osteogenic differentiation, while MEK/ERK was required to repress an RUNX2 and OPN increase in low PO2. Therefore, IGFs, specifically IGF-1, trigger the earlier onset of osteogenic differentiation in room air, whereas, reversibly, low PO2 impedes complete differentiation by maintaining higher multipotency and lower differentiation markers.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wXyyea
via IFTTT

Following Spinal Cord Injury Transected Reticulospinal Tract Axons Develop New Collateral Inputs to Spinal Interneurons in Parallel with Locomotor Recovery

The reticulospinal tract (RtST) descends from the reticular formation and terminates in the spinal cord. The RtST drives the initiation of locomotion and postural control. RtST axons form new contacts with propriospinal interneurons (PrINs) after incomplete spinal cord injury (SCI); however, it is unclear if injured or uninjured axons make these connections. We completely transected all traced RtST axons in rats using a staggered model, where a hemisection SCI at vertebra T10 is followed by a contralateral hemisection at vertebra T7. In one group of the animals, the T7 SCI was performed 2 weeks after the T10 SCI (delayed; dSTAG), and in another group, the T10 and T7 SCIs were concomitant (cSTAG). dSTAG animals had significantly more RtST-PrIN contacts in the grey matter compared to cSTAG animals (). These results were accompanied by enhanced locomotor recovery with dSTAG animals significantly outperforming cSTAG animals (BBB test; ). This difference suggests that activity in neuronal networks below the first SCI may contribute to enhanced recovery, because dSTAG rats recovered locomotor ability before the second hemisection. In conclusion, our findings support the hypothesis that the injured RtST forms new connections and is a key player in the recovery of locomotion post-SCI.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wWNYgU
via IFTTT

Reactive Path Planning Approach for Docking Robots in Unknown Environment

Autonomous robots need to be recharged and exchange information with the host through docking in the long-distance tasks. Therefore, feasible path is required in the docking process to guide the robot and adjust its pose. However, when there are unknown obstacles in the work area, it becomes difficult to determine the feasible path for docking. This paper presents a reactive path planning approach named Dubins-APF (DAPF) to solve the path planning problem for docking in unknown environment with obstacles. In this proposed approach the Dubins curves are combined with the designed obstacle avoidance potential field to plan the feasible path. Firstly, an initial path is planned and followed according to the configurations of the robot and the docking station. Then when the followed path is evaluated to be infeasible, the intermediate configuration is calculated as well as the replanned path based on the obstacle avoidance potential field. The robot will be navigated to the docking station with proper pose eventually via the DAPF approach. The proposed DAPF approach is efficient and does not require the prior knowledge about the environment. Simulation results are given to validate the effectiveness and feasibility of the proposed approach.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2jkS7rJ
via IFTTT

Stripy ponds in the Utah desert help green the bone-dry land

Multicoloured patchwork ponds in this desert play a key part in tapping sources of potassium chloride, a vital fertiliser

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2y1PMFG
via IFTTT

Ability of polymer-bound P-glycoprotein inhibitor ritonavir to overcome multidrug resistance in various resistant neuroblastoma cell lines.

Polymer prodrugs can considerably improve the treatment of tumors with multidrug resistance, often caused by overexpression of P-glycoprotein (P-gp). Here, we present the effect of the N-(2-hydroxypropyl) methacrylamide-based polymer conjugate with P-gp inhibitor ritonavir (RIT) on the increase of free doxorubicin (DOX) and polymer-bound DOX cytotoxicity in the human neuroblastoma 4 cell line and its resistant clones to different cytostatics. The increase in cytotoxicity after polymer-RIT conjugate pretreatment was higher for the lines overexpressing P-gp and less pronounced for those with decreased P-gp levels. Moreover, the effect of polymer conjugate containing inhibitor and DOX on the same polymer chain was lower than that of two individual polymer conjugates used sequentially. In conclusion, the polymer-RIT conjugate can significantly increase the cytotoxicity of free DOX and polymer-DOX conjugates in cells with various multidrug resistance origins and can thus be considered a suitable therapeutic enhancer of polymer prodrugs. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wXgelk
via IFTTT

Outcomes of Bone Anchored Hearing Aid Implant at Universiti Kebangsaan Malaysia Medical Centre (UKMMC)

Abstract

The cross sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Malaysia from August 2012 to December 2013. All patients implanted with in UKMMC from December 2001 until December 2012 was included. Glasgow Benefit Inventory (GBI) questionnaires and UKMMC questionnaires were used as part of the assessment tool. The GBI is a scoring which measures the change in health status produced by surgical interventions. UKMMC questionnaires was invented by our department to assess questions related to social and life style of patients and also the cosmetic perspective Baha implant and other daily related activities. The audiological assessment was assessed using hearing aid gain threshold. Complication with regards to skin reaction was graded using Holger Skin Classification. A total of 40 patients underwent Baha implant were recruited but only 35 patients fulfilled the criteria and included in this study for analysis. Age of patients ranged from 5 year old to 38 year old, with median of 13 years old. There were 22 patients (62.8%) were male and 13 patients (37.1%) were females. Almost all cases were canal atresia except one adult patient was a case of bilateral chronic discharging ear with chronic irritation with ear mould. Majority of patients 21 (60%) have hearing level of moderate to severe hearing loss (40–89 dB) and 14 patients (40%) have mild to moderate hearing loss (20–39 dB). The level of hearing was retested post operatively. All of the patients have improvement in their aided hearing with the range of 10–25 dBL which is statistically significant at p value of <0.05. The GBI was scored positively in all subscales. Majority of patients (91.4%) used BAHA more than 4 h per day and 88.6% agreed that BAHA is cosmetically acceptable. All patients experienced some form of skin irritation (Holger grade 1–2) however only 20% required surgical intervention. All our patients have range of 10–25 dB improvement of their aided hearing which is statistically significant at p value of <0.05. BAHA has been proven to show significant benefit in audiological improvement and quality of life.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xsxK25
via IFTTT

Free Fatty Acid Receptor 4 Mediates the Beneficial Effects of n-3 Fatty Acids on Body Composition in Mice

Abstract

As populations continue to age worldwide, sarcopenic obesity has heightened interest due to its medical importance. Although much evidence now indicates that n-3 fatty acids (FAs) may have beneficial effects on body composition including fat and muscle, their exact mechanisms have not yet been elucidated. Because free FA receptor 4 (FFA4) has been reported to be a receptor for n-3 FAs, we hypothesized that the protective role of n-3 FAs on body composition could be mediated by FFA4. To test this possibility, we generated mice overexpressing n-3 FAs but lacking FFA4 by crossing fat-1 transgenic (fat-1 ^Tg+) and FFA4 knockout (Ffar4 ^−/−) mice. Because fat-1 ^Tg+ mice, in which n-6 is endogenously converted into n-3 FAs, contain high n-3 FA levels, they could be a good animal model for studying the effects of n-3 FAs in vivo. Male and female littermates were included in high-fat-diet- (HFD) and ovariectomy-induced models, respectively. In the HFD model, male fat-1 ^Tg+ mice had a lower percentage of fat mass and a higher percentage of lean mass than their wild-type littermates only when they had the Ffar4 ^+/+ not the Ffar4 ^−/− background. Female fat-1 ^Tg+ mice showed less increase of fat mass percentage and less decrease of lean mass percentage after ovariectomy than wild-type littermates. However, these effects on body composition were attenuated in the Ffar4 ^−/− background. Taken together, our results indicate that the beneficial effects of n-3 FAs on body composition were mediated by FFA4 and thus suggest that FFA4 may be a potential therapeutic target for modulating sarcopenic obesity.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2gXZbtU
via IFTTT