Objectives: Recent studies have highlighted the potential of analyses of genomic sharing to produce insight into the demographic processes affecting human populations. We study runs of homozygosity (ROH) in 18 Jewish populations, examining these groups in relation to 123 non-Jewish populations sampled worldwide. Methods: By sorting ROH into 3 length classes (short, intermediate, and long), we evaluate the impact of demographic processes on genomic patterns in Jewish populations. Results: We find that the portion of the genome appearing in long ROH - the length class most directly related to recent consanguinity - closely accords with data gathered from interviews during the 1950s on frequencies of consanguineous unions in various Jewish groups. Conclusion: The high correlation between 1950s consanguinity levels and coverage by long ROH explains differences across populations in ROH patterns. The dissection of ROH into length classes and the comparison to consanguinity data assist in understanding a number of additional phenomena, including similarities of Jewish populations to Middle Eastern, European, and Central and South Asian non-Jewish populations in short ROH patterns, relative lengths of identity-by-descent tracts in different Jewish groups, and the "population isolate" status of the Ashkenazi Jews.
Hum Hered 2016;82:87-102
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Πέμπτη 14 Σεπτεμβρίου 2017
A Signal Decomposition Method for Ultrasonic Guided Wave Generated from Debonding Combining Smoothed Pseudo Wigner-Ville Distribution and Vold–Kalman Filter Order Tracking
Carbon fibre composites have a promising application future of the vehicle, due to its excellent physical properties. Debonding is a major defect of the material. Analyses of wave packets are critical for identification of the defect on ultrasonic nondestructive evaluation and testing. In order to isolate different components of ultrasonic guided waves (GWs), a signal decomposition algorithm combining Smoothed Pseudo Wigner-Ville distribution and Vold–Kalman filter order tracking is presented. In the algorithm, the time-frequency distribution of GW is first obtained by using Smoothed Pseudo Wigner-Ville distribution. The frequencies of different modes are computed based on summation of the time-frequency coefficients in the frequency direction. On the basis of these frequencies, isolation of different modes is done by Vold–Kalman filter order tracking. The results of the simulation signal and the experimental signal reveal that the presented algorithm succeeds in decomposing the multicomponent signal into monocomponents. Even though components overlap in corresponding Fourier spectrum, they can be isolated by using the presented algorithm. So the frequency resolution of the presented method is promising. Based on this, we can do research about defect identification, calculation of the defect size, and locating the position of the defect.
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Sparse Signal Inversion with Impulsive Noise by Dual Spectral Projected Gradient Method
We consider sparse signal inversion with impulsive noise. There are three major ingredients. The first is regularizing properties; we discuss convergence rate of regularized solutions. The second is devoted to the numerical solutions. It is challenging due to the fact that both fidelity and regularization term lack differentiability. Moreover, for ill-conditioned problems, sparsity regularization is often unstable. We propose a novel dual spectral projected gradient (DSPG) method which combines the dual problem of multiparameter regularization with spectral projection gradient method to solve the nonsmooth optimization functional. We show that one can overcome the nondifferentiability and instability by adding a smooth regularization term to the original optimization functional. The advantage of the proposed functional is that its convex duality reduced to a constraint smooth functional. Moreover, it is stable even for ill-conditioned problems. Spectral projected gradient algorithm is used to compute the minimizers and we prove the convergence. The third is numerical simulation. Some experiments are performed, using compressed sensing and image inpainting, to demonstrate the efficiency of the proposed approach.
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Analysis of Adverse Events during Intrahospital Transportation of Critically Ill Patients
Purpose. To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. Method. Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the World Health Organization following the degree of damage. The level of significance was set at 5%. Results. A total of 293 patients were analyzed with follow-up of 143 patient transportations and records of 86 adverse events. Of these events, 44.1% were related to physiological alterations, 23.5% due to equipment failure, 19.7% due to team failure, and 12.7% due to delays. Half of the events were classified as moderate. The mean time of hospital stay of the group with adverse events was higher compared to patients without adverse events (31.4 versus 16.6 days, resp., ). Conclusions. Physiological alterations were the most frequently encountered events, followed by equipment and team failures. The degree of damage associated with adverse events was classified as moderate and associated with an increase in the length of hospital stay.
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Propyl Gallate Exerts an Antimigration Effect on Temozolomide-Treated Malignant Glioma Cells through Inhibition of ROS and the NF-κB Pathway
In this study, we demonstrated that temozolomide (TMZ) and propyl gallate (PG) combination enhanced the inhibition of migration in human U87MG glioma cells. PG inhibited the TMZ-induced reactive oxygen species (ROS) generation. The mitochondrial complex III and NADPH oxidase are two critical sites that can be considered to regulate antimigration in TMZ-treated U87MG cells. PG can enhance the antimigration effect of TMZ through suppression of metalloproteinase-2 and metalloproteinase-9 activities, ROS generation, and the NF-κB pathway and possibly provide a novel prospective strategy for treating malignant glioma.
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Diffuse Idiopathic Skeletal Hyperostosis: Persistent Sore Throat and Dysphagia in an Elderly Smoker Male
Diffuse idiopathic skeletal hyperostosis (DISH) is rarely symptomatic. However, it can present with dyspnea, hoarseness, dysphagia, and stridor. An 80-year-old chronic smoker male presented with 6-month history of sore throat and progressive dysphagia. Computed tomography of the neck revealed bulky anterior bridging syndesmophytes along the anterior aspect of the cervical spine and facet effusion involving four contiguous vertebrae consistent with DISH. Dysphagia secondary to DISH was diagnosed. Fiberoptic laryngoscopy showed bilateral vocal cord paralysis. Patient's airway became compromised requiring tracheostomy tube placement. After discussion of therapeutic options, patient agreed on a percutaneous endoscopic gastrostomy tube insertion for nutritional support. Osteophytectomy was left to be discussed further.
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Does the Somatosensory Temporal Discrimination Threshold Change over Time in Focal Dystonia?
Background. The somatosensory temporal discrimination threshold (STDT) is defined as the shortest interval at which an individual recognizes two stimuli as asynchronous. Some evidence suggests that STDT depends on cortical inhibitory interneurons in the basal ganglia and in primary somatosensory cortex. Several studies have reported that the STDT in patients with dystonia is abnormal. No longitudinal studies have yet investigated whether STDT values in different forms of focal dystonia change during the course of the disease. Methods. We designed a follow-up study on 25 patients with dystonia (15 with blepharospasm and 10 with cervical dystonia) who were tested twice: upon enrolment and 8 years later. STDT values from dystonic patients at the baseline were also compared with those from a group of 30 age-matched healthy subjects. Results. Our findings show that the abnormally high STDT values observed in patients with focal dystonia remained unchanged at the 8-year follow-up assessment whereas disease severity worsened. Conclusions. Our observation that STDT abnormalities in dystonia remain unmodified during the course of the disease suggests that the altered activity of inhibitory interneurons—either at cortical or at subcortical level—responsible for the increased STDT does not deteriorate as the disease progresses.
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Crop Evaluation System Optimization: Attribute Weights Determination Based on Rough Sets Theory
The present study is mainly a continuation of our previous study, which is about a crop evaluation system development that is based on grey relational analysis. In that system, the attribute weight determination affects the evaluation result directly. Attribute weight is usually ascertained by decision-makers experience knowledge. In this paper, we utilize rough sets theory to calculate attribute significance and then combine it with weight given by decision-maker. This method is a comprehensive consideration of subjective experience knowledge and objective situation; thus it can acquire much more ideal results. Finally, based on this method, we improve the system based on ASP.NET technology.
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Assessment of Elementary School Teachers’ Level of Knowledge and Attitude regarding Traumatic Dental Injuries in the United Arab Emirates
Introduction. In this cross-sectional study, the level of knowledge and attitude of elementary school teachers regarding traumatic dental injuries (TDI) were assessed. Materials and Methods. A questionnaire was distributed to 330 elementary school teachers in 30 randomly selected schools in the Emirates of Sharjah and Dubai. The questionnaire collected information on participants' demographic characteristics, first aid training, and attitude about emergency management of TDI. Results. 292 teachers (88%) completed the questionnaires; of these, 95% were females, and 50% of the participants had first aid training. Knowledge about tooth avulsion was inadequate, and first aid training was not associated with correct responses to management of avulsed teeth . A significantly higher percentage of younger teachers expressed the need for future education on TDI management. A significantly higher percentage of participants who had an educational position (95%) indicated that they did not have enough knowledge regarding TDI compared to physical education teachers (79%) and administrators (87%) . Conclusions. Elementary school teachers in the UAE have a low level of knowledge regarding the management of dental trauma. Educational programs that address TDI are needed and could improve the elementary school teachers' level of knowledge in emergency management of TDI.
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Akt/mTOR Role in Human Foetoplacental Vascular Insulin Resistance in Diseases of Pregnancy
Insulin resistance is characteristic of pregnancies where the mother shows metabolic alterations, such as preeclampsia (PE) and gestational diabetes mellitus (GDM), or abnormal maternal conditions such as pregestational maternal obesity (PGMO). Insulin signalling includes activation of insulin receptor substrates 1 and 2 (IRS1/2) as well as Src homology 2 domain-containing transforming protein 1, leading to activation of 44 and 42 kDa mitogen-activated protein kinases and protein kinase B/Akt (Akt) signalling cascades in the human foetoplacental vasculature. PE, GDM, and PGMO are abnormal conditions coursing with reduced insulin signalling, but the possibility of the involvement of similar cell signalling mechanisms is not addressed. This review aimed to determine whether reduced insulin signalling in PE, GDM, and PGMO shares a common mechanism in the human foetoplacental vasculature. Insulin resistance in these pathological conditions results from reduced Akt activation mainly due to inhibition of IRS1/2, likely due to the increased activity of the mammalian target of rapamycin (mTOR) resulting from lower activity of adenosine monophosphate kinase. Thus, a defective signalling via Akt/mTOR in response to insulin is a central and common mechanism of insulin resistance in these diseases of pregnancy. In this review, we summarise the cell signalling mechanisms behind the insulin resistance state in PE, GDM, and PGMO focused in the Akt/mTOR signalling pathway in the human foetoplacental endothelium.
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Trajectories of Postload Plasma Glucose in the Development of Type 2 Diabetes in Japanese Adults
We aimed to clarify how the trajectories of 1-hour postload plasma glucose (PG) and 2-hour PG were different in the development of type 2 diabetes. Using data of repeated health checkups in Japanese workers from April 2006 to March 2016, longitudinal changes of fasting, 1-hour, and 2-hour PG on the oral glucose tolerance test were analyzed with a linear mixed effects model. Of the 1464 nondiabetic subjects at baseline, 112 subjects progressed to type 2 diabetes during the observation period (progressors). In progressors, 1-hour PG and 2-hour PG showed gradual increases with slopes of 1.33 ± 0.2 and 0.58 ± 0.2 mg/dL/year, respectively, followed by a steep increase by which they attained diabetes. Until immediately before the diabetes transition, age- and sex-adjusted mean level of 2-hour PG was 149 ± 2.7 mg/dL, 34 ± 2.7 (30%) higher compared to nonprogressors, while that of 1-hour PG was 206 ± 4.1 mg/dL, 60 ± 4.3 mg/dL (41%) higher compared to nonprogressors. In conclusion, diabetes transition was preceded by a mild elevation of 2-hour PG for several years or more. The elevation in 1-hour PG was larger than that of 2-hour PG until immediately before the transition to diabetes.
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IJMS, Vol. 18, Pages 1877: Mitochondrial Biogenesis in Response to Chromium (VI) Toxicity in Human Liver Cells
IJMS, Vol. 18, Pages 1877: Mitochondrial Biogenesis in Response to Chromium (VI) Toxicity in Human Liver Cells
International Journal of Molecular Sciences doi: 10.3390/ijms18091877
Authors: Xiali Zhong Rita de Cássia da Silveira e Sá Caigao Zhong
Hexavalent chromium (Cr(VI)) is a ubiquitous environmental pollutant, which poses a threat to human public health. Recent studies have shown that mitochondrial biogenesis can be activated by inflammatory and oxidative stress. However, whether mitochondrial biogenesis is involved in Cr(VI)-induced hepatotoxicity is unclear. Here, we demonstrated the induction of inflammatory response and oxidative stress, as indicated by upregulation of inflammatory factors and reactive oxygen species (ROS). Subsequently, we demonstrated that mitochondrial biogenesis, comprising the mitochondrial DNA copy number and mitochondrial mass, was significantly increased in HepG2 cells exposed to low concentrations of Cr(VI). Expression of genes related to mitochondrial function complex I and complex V was upregulated at low concentrations of Cr(VI). mRNA levels of antioxidant enzymes, including superoxide dismutase 1 and 2 (SOD1 and SOD2, respectively), kech like ECH associate protein 1 (KEAP1) and nuclear respiratory factor 2 (NRF-2), were also upregulated. Consistent with the above results, mRNA and protein levels of key transcriptional regulators of mitochondrial biogenesis such as the peroxisome-proliferator-activated receptor γ coactivator-1α (PGC-1α), NRF-1 and mitochondrial transcription factor A (TFAM) were increased by low concentrations of Cr(VI) in HepG2 cells. Moreover, we found that PGC-1α and NRF-1 tended to translocate into the nucleus. The expression of genes potentially involved in mitochondrial biogenesis pathways, including mRNA level of silent information regulator-1 (SIRT1), forkhead box class-O (FOXO1), threonine kinase 1 (AKT1), and cAMP response element-binding protein (CREB1), was also upregulated. In contrast, mitochondrial biogenesis was inhibited and the expression of its regulatory factors and antioxidants was downregulated at high and cytotoxic concentrations of Cr(VI) in HepG2 cells. It is believed that pretreatment with α-tocopherol could be acting against the mitochondrial biogenesis imbalance induced by Cr(VI). In conclusion, our study suggests that the homeostasis of mitochondrial biogenesis may be an important cellular compensatory mechanism against Cr(VI)-induced toxicity and a promising detoxification target.
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Lull pgm System: a suitable technique to improve the regenerative potential of autologous fat grafting
ABSTRACT
Autologous fat grafting and methods of purification of harvested tissue have become one of the most current themes in regenerative medicine. The aim of this study was to evaluate the in vitro regenerative potential of abdomen lipoaspirates subjected to a combined washing-decantation purifying procedure, the Lull pgm System (Lull). Blood cells and stromal-vascular fraction (SVF) cells contained in the aspirates were investigated and compared with those obtained through more conventional fat-processing methods, i.e. the decantation and Coleman's centrifugation techniques. The lowest number of erythrocytes, which are proinflammatory cells, was observed in the Lull samples, corresponding to about 50% of those isolated by decantation and centrifugation. The highest amount of SVF cells were isolated from the Lull samples whose number of colony forming units, representative of the amount of adipose-derived stem cells (ADSCs), was about four-fold and six-fold higher than in the decantation and centrifugation samples, respectively. Adipocyte and osteoblast commitment of SVF cells obtained from all the three procedures also confirmed that the subpopulation of ADSCs was actively represented in the processed aspirates. Moreover, the growth rate of the SVF cells was more accentuated in the samples obtained from decantation and Lull than centrifugation. In conclusion, Lull seems to be the best processing technique for adipose tissue graft with respect to decantation and centrifugation, because it clears more efficiently the fat from proinflammatory blood cells and provides the greatest number of proliferating SFV cells and ADSCs. This article is protected by copyright. All rights reserved.
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Motivating parent support for physical activity: the role of framed persuasive messages
Abstract
Parent support for physical activity (PA) is a behavior unto itself that requires motivation. Persuasive messages may be one method for motivating parent support for their children's PA. Message framing is one strategy for optimizing the impact of messages. The current study examined the relative effectiveness of gain- versus loss-framed messages for encouraging parent support for children's PA. Regardless of message frame, parents had an increase in social cognitive antecedents (e.g. perceived behavioral control, intentions) and support for children's PA following message exposure.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2x3HMFs
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Effect of educational package on lifestyle of primiparous mothers during postpartum period: a randomized controlled clinical trial
Abstract
A healthy lifestyle is important for mothers during the postpartum period. This study was conducted to determine the effects of a lifestyle educational package in primiparous women. This randomized clinical trial was conducted on 220 mothers assigned to two groups using block randomization. In the intervention group, the mothers received face-to-face, phone and SMS counseling and a booklet in addition to routine postpartum training; in the control group, the mothers received only routine training. The Health Behaviors Questionnaire, a Food Frequency Questionnaire and the International Physical Activity Questionnaire were used for data collection. There were no significant differences between the two groups 6 weeks after delivery in terms of physical activity level and nutritional status (P > 0.05) except for the mean consumption of milk and dairy, which was higher in the intervention group (P = 0.041). Training significantly improved certain health behaviors in the intervention group compared to the controls, such as the first time brushing the teeth after delivery, the frequency of sun exposure, the frequency of ventilating the home, keeping warm and iron supplementation. The training provided positively affected certain health behaviors in the mothers; however, it failed to improve their physical activity level and nutritional status.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wr8FzI
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Socio-cultural norms and roles in the use and abuse of alcohol among members of a rural community in Southeast Nigeria
Abstract
Social influences together with local cultural norms are central factors that can influence the use of alcohol. The study, therefore, identified socio-cultural norms and roles capable of influencing alcohol use among young people in an alcohol producing community, in Nigeria. We used qualitative technique – focused group discussions among selected key persons in the area of study. Three groups; adult males, adult females and youths were engaged in discussions around the themes of socio-cultural; norms, roles, beliefs, values and practices that influences alcohol abuse. The focus group discussions lasted for 60–90 min and each group comprised 8–10 participants. The discussions took place in February 2016. Nine socio-cultural themes emerged following a thematic analysis of the findings, one of which is: Involvement of those who should control drinking in palm wine business hinder control of abuse. Using Vygotsky's Socio-cultural theory guide, the researchers were able to provide the scaffolding that supported the expression of the harmful effect of alcohol abuse and suggestions for improving control by participants.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2x3kuQk
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Strengthening teachers’ abilities to implement a vision health program in Taiwanese schools
Abstract
We designed a school-based, nationwide program called the 'New Era in Eye Health' to strengthen teacher training and to examine whether the existence of a government vision care policy influenced teachers' vision care knowledge and students' behavior. Baseline data and 3-month follow-up data were compared. A random sample of teachers (n = 660) from school vision health clusters in 22 cities/counties in Taiwan were invited to participate in our study and 436 agreed to participate (response rate = 66.1%). The mean age of participant teachers was 41.2 years, while the length of service mean was 14.6 years. For monitoring teacher outcomes, five cities/counties were selected as the intensely monitored group based on certain criteria. Sunlight diaries (n = 5434) were distributed and 3342 (61.5%) were returned. Teachers showed significant improvements in knowledge and behavior on the school vision health questionnaire. At the 3-month follow-up, the number of recesses as recorded by students' 'sunlight diary' increased. When teachers had better knowledge and behavior, recesses also increased. This study provided valuable insights to guide dissemination efforts for school vision health interventions and to help teachers implement research into their school vision health activities.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wqTp64
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The cost-effectiveness and return-on-investment of a combined social and physical environmental intervention in office employees
Abstract
This study explored the cost-effectiveness and return-on-investment of a combined social and physical environmental worksite health promotion program compared with usual practice, and of both intervention conditions separately. Participants were randomized to the combined intervention (n = 92), social environmental intervention (n = 118), physical environmental intervention (n = 96), or control group (n = 106). The social environmental intervention consisted of group motivational interviewing and the physical environmental intervention of workplace modifications. Both interventions were aimed at improving physical activity and relaxation. Effects included need for recovery (NFR), general vitality and job satisfaction. Cost-effectiveness analyses were performed from the societal and employer's perspective, and return-on-investment analyses from the employer's perspective. Compared with usual practice, the combined intervention was significantly more effective in improving NFR (–8.4;95% CI:–14.6;–2.2) and significantly more expensive to the employer (3102; 95%CI:598;5969). All other between-group differences were non-significant. For NFR, the combined intervention became the preferred option at willingness-to-pays of ≥€170/point improvement (society) and ≥€300/point improvement (employer). For general vitality and job satisfaction, the interventions' maximum probabilities of cost-effective were low (≤0.55). All interventions had a negative return-on-investment. The combined intervention may be cost-effective for NFR depending on the decision-makers' willingness-to-pay. Both separate interventions are not cost-effective for NFR. All interventions were neither cost-effective for general vitality and job satisfaction, nor cost-saving to the employer.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2x3DUo7
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A clustered randomized controlled trial to determine impacts of the Harvest of the Month program
Abstract
The study purpose was to examine the impact of the Harvest of the Month (HOTM) program on fruit and vegetable (FV) consumption, FV preferences, other eating behaviors, physical activity and other variables related to healthy eating. A clustered randomized controlled trial was employed in 28 elementary schools. After parental consent was obtained, students in grades 4-6 were randomly assigned to treatment and control conditions (Intervention= 127, Control= 148). Students in the intervention group participated in HOTM, a widely used school-based nutrition promotion and obesity prevention program. Control group schools continued their usual practice. Participants completed baseline and follow-up surveys measuring fruit and vegetable (FV) consumption, FV preferences, other eating behaviors, physical activity, FV knowledge and self-efficacy to eat, prepare and ask for FV. No impacts of HOTM were found for FV consumption or other nutritional behaviors, physical activity, FV knowledge, or self-efficacy. A positive impact of the program was only found for FV preferences. This study suggests that the HOTM program did not affect eating behaviors or physical activity behaviors. The evidence base regarding school-based nutrition education programs including HOTM could be strengthened by the use of more rigorous impact evaluations to examine their effectiveness prior to wide-spread use.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wrkhTa
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Adolescents and young adults’ perceptions of electronic cigarettes as a gateway to smoking: a qualitative study in Switzerland
Abstract
Electronic cigarettes (ECs) acting as a gateway to smoking traditional cigarettes (TCs) is a growing public health concern of EC use among youths. To gather the opinions and perceptions of adolescents and young adults (AYAs) on whether and how EC can act as a gateway to smoking TC among youths. A qualitative method included 42 AYAs. Participants identified a significant risk of EC acting as a gateway to TC use, several factors contributing to this phenomenon such as a facilitated transition to smoking or its perception as a harmless toy. Participants considered an even greater gateway threat regarding very young adolescents. A minority did not identify the gateway risk and some believed that it was nicotine-dependent. This potential gateway effect brought forth several recommendations: health professionals should screen adolescents (even very young ones) for EC use and inform consumers of the potential gateway effect; this possible effect should be acknowledged to end the harmless perception many might have; there is an urge for better preventive and regulatory policies directed at protecting adolescents and children who never smoked and support those who have quit.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2x48P3H
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Impact of patient education on influenza vaccine uptake among community-dwelling elderly: a randomized controlled trial
Abstract
This randomized controlled trial aimed to test the effectiveness of brief face-to-face patient education in increasing influenza vaccination rate among elderly in the community. Recruitment and intervention were conducted at two general outpatient clinics in Hong Kong. 529 eligible patients were randomly assigned to intervention or control group with 1:1 allocation ratio. Patients in the intervention group received 3-min one-on-one verbal education by medical students and a pamphlet regarding influenza vaccination. Neither verbal health education nor pamphlet was given to the control group. Intention-to-treat analysis showed significantly higher vaccination rate in the intervention group compared with the control group (33.6 versus 25.0%) and the adjusted relative risk was 1.34 (95% CI 1.04–1.72; P = 0.021). Hence, brief face-to-face patient education was effective in increasing influenza vaccine uptake rate of community-dwelling elderly patients. Participants who were undecided whether to receive vaccination seemed to demonstrate larger beneficial effect (RR = 7.84; 95% CI 1.06–57.76) compared with patients who were certain of either receiving (RR = 1.16; 95% CI 0.90–1.48) or not receiving (RR = 2.18; 95% CI 0.68–6.99) the vaccine. The study also revealed that patients' intention for vaccination may not translate into action, reasons for which should be explored in future research.from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wrsVkD
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Psychoneuroimmunologie und Krebs
Zusammenfassung
Es verdichten sich die Hinweise, dass psychische Belastungen (Distress) den Verlauf von Krebserkrankungen beeinflussen können. Bei der Aufklärung möglicher Pathomechanismen hat die Erforschung des autonomen Nervensystems mit dem Fokus auf Katecholamine und β‑Blocker die bisher wichtigsten Ergebnisse erbracht. In diesem Beitrag sollen die Entwicklung psychoneuroimmunologischer Arbeitsmodelle nachvollzogen, aktuelle Forschungsschwerpunkte skizziert und klinische Implikationen diskutiert werden.
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Aktuelle Systemtherapie des metastasierten Harnblasenkarzinoms
Zusammenfassung
Im November 2016 wurden Studiendaten zur Zweitlinientherapie des metastasierten Urothelkarzinoms mit dem PD-1-Antikörper Pembrolizumab publiziert, die einen Vorteil im Gesamtüberleben (OS) gegenüber einer konventionellen Chemotherapie mit Paclitaxel, Docetaxel oder Vinflunin zeigen. Andere PD-1/PD-L1-Inhibitoren werden in Phase-III-Studien für verschiedene Stadien des Urothelkarzinoms geprüft. In Europa wurde am 02.06.2017 mit Nivolumab der erste PD-1-/PD-L1-Antikörper zur Zweitlinientherapie des metastasierten Urothelkarzinoms zugelassen, weitere Zulassungen werden noch in diesem Jahr erwartet. Die Substanzklasse der PD-1-/PD-L1-Inhibitoren dürfte somit der neue Standard in der Zweitlinientherapie des metastasierten Urothelkarzinoms sein. Aktuelle Studien überprüfen den Einsatz von PD-1-/PD-L1-gerichteten Substanzen auch in der Erstlinientherapie des metastasierten Urothelkarzinoms. Dabei werden verschiedene Therapiestrategien verfolgt: Monotherapien mit PD-1-/PD-L1-Inhibitoren sowie deren Kombinationen mit CTLA-4-Inhibitoren oder konventioneller Chemotherapie. Es liegen bereits Daten aus einarmigen Phase-II-Studien zur Monotherapie vor. Erste Daten aus randomisierten Studien werden für Ende 2017 erwartet. Ein neuer Therapieansatz verfolgt den Einsatz von PD-1/PD-L1-Inhibitoren in der perioperativen Behandlung bei Patienten mit einem muskelinvasiven Urothelkarzinom nach chirurgischer R0-Resektion (radikale Zystektomie oder Nephroureterektomie). Zwei internationale Phase-III-Studien überprüfen derzeit eine adjuvante Immuntherapie mit Nivolumab oder Atezolizumab. Die Studienrekrutierung wird voraussichtlich Mitte 2018 beendet sein.
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Detecting Congenital Central Hypothyroidism by Newborn Screening: Difficulty in Distinguishing from Congenital Thyroxine-Binding Globulin Deficiency
Background/Aims: Congenital central hypothyroidism (CH-C) can be detected on newborn screening (NBS) by programs using thyroxine (T4)-reflex thyroid-stimulating hormone (TSH) test approach. CH-C must be distinguished from T4-binding globulin (TBG) deficiency. We sought to determine whether thyroid function tests reliably separate CH-C from TBG deficiency. Methods: We analyzed NBS and serum free and total T4, T3 resin uptake (T3RU) or TBG, and TSH for infants in the Northwest Regional NBS Program (NWRSP) between the years 2008 and 2015 with either CH-C or TBG deficiency. Results: We discovered a significant overlap in T3RU and TBG levels amongst 21 cases of CH-C and 250 cases of TBG deficiency. Mean serum TBG levels were lower in CH-C cases (20.3 µg/mL, range 14.2–33.3) than what is reported in healthy infants (28.6 µg/mL, range 19.1–44.6). Serum free T4 was lower in CH-C cases than TBG deficiency but did not always differentiate between the two conditions. Conclusion: CH-C benefits from detection on NBS but must be distinguished from TBG deficiency. The diagnosis of CH-C rests solely on subnormal serum free T4, but is supported by the demonstration of other pituitary hormone deficiencies. As an overlap exists, serum TBG (or T3RU) levels do not play a role in the diagnosis of CH-C.
Horm Res Paediatr
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Horm Res Paediatr
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The evaluation of protective effect of lycopene against genotoxic influence of X-irradiation in human blood lymphocytes
Abstract
Many studies suggest that exogenous antioxidants may protect cells against DNA damage caused with ionizing radiation. One of the most powerful antioxidants is lycopene (LYC), a carotenoid derived from tomatoes. The aim of this study was to investigate, using the comet assay, whether LYC can act as protectors/modifiers and prevent DNA damage induced in human blood lymphocytes, as well as to mitigate the effects of radiation exposure. In this project, LYC, dissolved in DMSO at a concentration of 10, 20 or 40 μM/ml of cell suspension, was added to the isolated lymphocytes from human blood at appropriate intervals before or after the X-irradiation at doses of 0.5, 1 and 2 Gy. Cell viability in all groups was maintained at above 70%. The results showed the decrease of DNA damage in cells treated with various concentrations of LYC directly and 1 h before exposure to X-rays compared to the control group exposed to irradiation alone. Contrary results were observed in cells exposed to LYC immediately after exposure to ionizing radiation. The studies confirmed the protective effect of LYC against DNA damage induced by ionizing radiation, but after irradiation the carotenoid did not stimulate of DNA repair and cannot act as modifier. However, supplementation with LYC, especially at lower doses, may be useful in protection from radiation-induced oxidative damage.
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Decision-making about healthcare related tests and diagnostic strategies: International guidelines show variability in their approaches.
Source:Journal of Clinical Epidemiology
Author(s): Reem A. Mustafa, Wojtek Wiercioch, Ingrid Arevalo-Rodriguez, Adrienne Cheung, Barbara Prediger, Liudmila Ivanova, Matthew Ventresca, Jan Brozek, Nancy Santesso, Patrick Bossuyt, Amit X. Garg, Nancy Lloyd, Monika Lelgemann, Diedrich Bühler, Holger Schünemann
ObjectiveTo describe and compare current practices in developing guidelines about the use of health care related tests and diagnostic strategies (HCTDS)Study Design and SettingWe sampled 37 public health and clinical practice guidelines about HCTDS from various sources without language restrictions.ResultsDetailed descriptions of the systems used to assess the quality of evidence and develop recommendations were challenging to find within guidelines. We observed much variability among and within organizations with respect to how they develop recommendations about HCTDS. Twenty-four percent of the guidelines did not consider health benefits and harms but based decisions solely on test accuracy. We did not identify guidelines that described the main potential care pathways involving tests for a healthcare problem. In addition, we did not identify guidelines that systematically assessed, described and referenced the evidence that linked test accuracy and patient-important outcomes.ConclusionThere is considerable variability among the processes used and factors considered in developing recommendations about the use of tests. This variability may be the cause for the disagreement we observed in recommendations about testing for the same condition.
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Long-term treatment costs for aggressive periodontitis in a German population
Abstract
Aim
This study assessed the long-term annual costs for treating aggressive periodontitis (AgP) patients.
Methods
A cohort of compliant AgP patients was retrospectively evaluated. Costs for active periodontal therapy (APT, including scaling and root planning, open flap debridement, root resections, but not pocket-elimination or regenerative surgery) and supportive periodontal therapy (SPT, including also costs for restorative, endodontic, prosthetic and surgical treatments) were estimated from a mixed payer-perspective in Germany. The impact of tooth- and patient-level factors on annual costs were assessed using mixed-modelling.
Results
52 patients (mean [SD] age: 35.2/6.8 years), with 26.5 (4.0) teeth (38% with bone loss>50%) were treated. Mean follow-up (retention) time was 16.9 (5.4) years. Total treatment costs per patient and per tooth were 6998 (3807) and 267 (148) Euro, respectively. 87% of the costs were generated during SPT, 13% during APT. Annual patient- and tooth-level costs were 536 (209) and 20.1 (65.0) Euro, respectively. Annual tooth-level costs were significantly increased in patients aged 34 years or older, male patients, former or current smokers, teeth with furcation involvement degree II/III, and bone loss 50-70%.
Conclusions
Annual treatment costs for treating AgP patients were similar to those found for chronic periodontitis patients. Certain parameters might predict costs.
This article is protected by copyright. All rights reserved.
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Current practice of allergy diagnosis and the potential impact of regulation in Europe
Abstract
In the European Union (EU), the regulatory framework regarding diagnostic allergen extracts is currently in the process of being implemented at the national level. Due to these regulations, the initial and periodic renewal expenses for the registration of diagnostic allergen extracts may render extract production unprofitable. Consequently, many extracts may be at risk of removal from the market. The current survey, which was conducted by a task force of the European Academy of Allergy and Clinical Immunology, aimed to assess the current practice of allergy diagnosis in Europe. This survey revealed that skin tests continue to be the main diagnostic procedure and are used as the first option in almost 2/3 of all types of allergic diseases and in 90% of individuals suffering from respiratory allergies. Therefore, there is a need to ensure the availability of high-quality allergen extracts to maintain the common diagnostic procedures used by EU professionals. To reach this goal, it is necessary to align efforts and establish active partnerships between manufacturers, relevant scientific societies, consumer organizations and authorities to maintain the availability of these diagnostic tools.
This article is protected by copyright. All rights reserved.
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Corrigendum
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Asthma management: A new phenotype-based approach using presence of eosinophilia and allergy
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Corrigendum
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IJERPH, Vol. 14, Pages 1060: Development and Evaluation of a Manganese and Iron Food Frequency Questionnaire for Pediatrics
IJERPH, Vol. 14, Pages 1060: Development and Evaluation of a Manganese and Iron Food Frequency Questionnaire for Pediatrics
International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14091060
Authors: Frida Zipkin Grace Falciglia Pierce Kuhnell Erin Haynes
Manganese (Mn) is an essential nutrient, but overexposure can lead to neurotoxicity. Given the essentiality of Mn in the diet, particularly during children's growth and development, it is imperative to quantify dietary Mn intake in populations that may be exposed to industrial sources of Mn. Dietary absorption of Mn is inversely associated with iron (Fe) stores, yet there is currently no food frequency questionnaire (FFQ) to assess dietary Mn and Fe intake. The study objective was to develop and evaluate the validity of a FFQ to measure dietary Mn and Fe intake in pediatrics by comparing the estimated intakes of Mn and Fe with biomarkers: Mn in blood and hair and Fe in serum. This study utilized a subset of the Communities Actively Researching Exposure Study (CARES) population residing in Guernsey County, Ohio. Dietary Mn was not correlated with either blood or hair Mn; however, dietary Mn and serum ferritin were significantly correlated, with a correlation coefficient of 0.51, p < 0.01. Moreover, dietary Fe and serum ferritin were also significantly correlated, with a correlation coefficient of 0.51, p < 0.01. This FFQ is a valid measurement tool for Fe intake as measured by serum ferritin; however, Mn intake did not correlate with either blood or hair Mn.
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Biallelic variants in WARS2 encoding mitochondrial tryptophanyl-tRNA synthase in six individuals with mitochondrial encephalopathy
Abstract
Mitochondrial protein synthesis involves an intricate interplay between mitochondrial DNA encoded RNAs and nuclear DNA encoded proteins, such as ribosomal proteins and aminoacyl-tRNA synthases. Eukaryotic cells contain 17 mitochondria-specific aminoacyl-tRNA synthases. WARS2 encodes mitochondrial tryptophanyl-tRNA synthase (mtTrpRS), a homodimeric class Ic enzyme (mitochondrial tryptophan-tRNA ligase; EC 6.1.1.2). Here, we report six individuals from five families presenting with either severe neonatal onset lactic acidosis, encephalomyopathy and early death or a later onset, more attenuated course of disease with predominating intellectual disability. Respiratory chain enzymes were usually normal in muscle and fibroblasts, while a severe combined respiratory chain deficiency was found in the liver of a severely affected individual. Exome sequencing revealed rare biallelic variants in WARS2 in all affected individuals. An increase of uncharged mitochondrial tRNATrp and a decrease of mtTrpRS protein content were found in fibroblasts of affected individuals. We hereby define the clinical, neuroradiological and metabolic phenotype of WARS2 defects. This confidently implicates that mutations in WARS2 cause mitochondrial disease with a broad spectrum of clinical presentation.
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Cover Image, Volume 38, Issue 10
On the cover: This cover image, by Stephanie N. Oprescu et al., is based on the Research Article Compound heterozygosity for loss-of-function GARS variants results in a multisystem developmental syndrome that includes severe growth retardation, Pages 1412–1420. DOI: 10.1002/humu.23287.
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Should Google offer an online screening test for depression?
Yes— Ken DuckworthUntil recently, patients had to see a doctor to learn their blood pressure and blood sugar levels. Now, measurement tools are readily available at home, and raised public awareness...
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Patient Commentary: Online screening for depression—old (paternalistic) wine in new (digital) bottles
When you are in mental and emotional distress, part of the agony is because the mind cannot make sense of what is happening inside or outside.1 In this situation I have wanted a diagnosis to help...
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β-Naphthoflavone-Induced Mitochondrial Respiratory Damage in Cyp1 Knockout Mouse and in Cell Culture Systems: Attenuation by Resveratrol Treatment
A number of xenobiotic-inducible cytochrome P450s (CYPs) are now known to be localized in the mitochondrial compartment, though their pharmacological or toxicological roles remain unclear. Here, we show that BNF treatment markedly inhibits liver mitochondrial O2 consumption rate (OCR), ADP-dependent OCR, and also reserve OCR, in wild-type mice but not in Cyp1a1/1a2(−/−) double knockout mice. BNF treatment markedly affected mitochondrial complex I and complex IV activities and also attenuated mitochondrial gene expression. Furthermore, under in vitro conditions, BNF treatment induced cellular ROS production, which was inhibited by mitochondria-targeted antioxidant Mito-CP and CYP inhibitor proadefin, suggesting that most of the ROS production was intramitochondrial and probably involved the catalytic activity of mitochondrial CYP1 enzymes. Interestingly, our results also show that the AHR antagonist resveratrol, markedly attenuated BNF-induced liver mitochondrial defects in wild-type mice, confirming the role of AHR and AHR-regulated CYP1 genes in eliciting mitochondrial dysfunction. These results are consistent with reduced BNF-induced mitochondrial toxicity in Cyp1a1/1a2(−/−) mice and elevated ROS production in COS cells stably expressing CYP1A1. We propose that increased mitochondrial ROS production and respiratory dysfunction are part of xenobiotic toxicity. Resveratrol, a chemopreventive agent, renders protection against BNF-induced toxicity.
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Heme Oxygenase Induction Suppresses Hepatic Hepcidin and Rescues Ferroportin and Ferritin Expression in Obese Mice
Hepcidin, a phase II reactant secreted by hepatocytes, regulates cellular iron levels by increasing internalization of ferroportin-a transmembrane protein facilitating egress of cellular iron. Chronic low-grade inflammatory states, such as obesity, have been shown to increase oxidative stress and enhance hepcidin secretion from hepatocytes and macrophages. Heme-heme oxygenase (HO) is a stress response system which reduces oxidative stress. We investigated the effects of HO-1 induction on hepatic hepcidin levels and on iron homeostasis in hepatic tissues from lean and obese mice. Obese mice exhibited hyperglycemia (); increased levels of proinflammatory cytokines (MCP-1, IL-6, ); oxidative stress (); and increased hepatic hepcidin levels (). Enhancement of hepcidin was reflected in the reduced expression of ferroportin in obese mice (). However, this effect is accompanied by a significant decline in ferritin expression. Additionally, there are reduced insulin receptor phosphorylation and attenuation of metabolic regulators pAMPK, pAKT, and pLKB1. Cobalt protoporphyrin- (CoPP-) induced HO-1 upregulation in obese mice reversed these alterations (), while attenuating hepatic hepcidin levels. These effects of CoPP were prevented in obese mice concurrently exposed to an inhibitor of HO (SnMP) (). Our results highlight a modulatory effect of HO on iron homeostasis mediated through the suppression of hepatic hepcidin.
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NLRP3 Inflammasome Activation-Mediated Pyroptosis Aggravates Myocardial Ischemia/Reperfusion Injury in Diabetic Rats
The reactive oxygen species- (ROS-) induced nod-like receptor protein-3 (NLRP3) inflammasome triggers sterile inflammatory responses and pyroptosis, which is a proinflammatory form of programmed cell death initiated by the activation of inflammatory caspases. NLRP3 inflammasome activation plays an important role in myocardial ischemia/reperfusion (MI/R) injury. Our present study investigated whether diabetes aggravated MI/R injury through NLRP3 inflammasome-mediated pyroptosis. Type 1 diabetic rat model was established by intraperitoneal injection of streptozotocin (60 mg/kg). MI/R was induced by ligating the left anterior descending artery (LAD) for 30 minutes followed by 2 h reperfusion. H9C2 cardiomyocytes were exposed to high glucose (HG, 30 mM) conditions and hypoxia/reoxygenation (H/R) stimulation. The myocardial infarct size, CK-MB, and LDH release in the diabetic rats subjected to MI/R were significantly higher than those in the nondiabetic rats, accompanied with increased NLRP3 inflammasome activation and increased pyroptosis. Inhibition of inflammasome activation with BAY11-7082 significantly decreased the MI/R injury. In vitro studies showed similar effects, as BAY11-7082 or the ROS scavenger N-acetylcysteine, attenuated HG and H/R-induced H9C2 cell injury. In conclusion, hyperglycaemia-induced NLRP3 inflammasome activation may be a ROS-dependent process in pyroptotic cell death, and NLRP3 inflammasome-induced pyroptosis aggravates MI/R injury in diabetic rats.
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A TOU Pricing Mechanism to Promote Renewable Energy Consumption: The Case of the Western Inner Mongolia Grid in China
The curtailment of wind power and photovoltaic power is becoming increasingly serious from the year 2012 to present in China. And the small installed capacity captive coal-fired power plants have been developed rapidly aiming to cut production costs. Therefore, by the substitution of renewable energy for captive coal-fired power plants, this paper establishes a time-of-use (TOU) pricing mechanism with a linkage between the supply side and the demand side to promote renewable energy consumption, which is applied to the Western Inner Mongolia grid in China. The results show that the benefits to the grid company, electricity users, renewable energy producers, and social environment are influenced by the quantity of renewable energy purchased in the market, the market price for renewable energy, the quantity of electricity from grid to peak shaving, the carbon price, and the quantity of electricity generated by captive coal-fired power plants shifting to grid, in which the first factor has the greatest influence on the benefits of stakeholders. Furthermore, improving the accuracy of renewable energy generation forecast and optimizing using electricity behaviors by considering the renewable energy generation characteristics could ensure the TOU mechanism implementation successfully.
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On Fuzzy Portfolio Selection Problems: A Parametric Representation Approach
Fuzzy portfolio selection problem is a major issue in the financial field and a special case of constrained fuzzy-valued optimization problems (CFOPs). In this respect, the present paper aims to investigate the CFOP with regard to the features of the parametric representation of fuzzy numbers named as convex constraint function (CCF) which is proposed by Chalco-Cano et al. in 2014. Furthermore, relying on this parametric representation, some proper conditions are provided for the existence of solutions to a CFOP. To this end, by the increasing representation of CCF, the main problem is converted to a parametric multiobjective programming problem and some solution concepts from a similar framework in the multiobjective programming are proposed for the CFOP. Eventually to illustrate the proposed results, the fuzzy portfolio selection problem is discussed.
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Cross-Sectional Information on Pore Structure and Element Distribution of Sediment Particles by SEM and EDS
The interaction between pollutants and sediment particles often occurs on the particle surface, so surface properties directly affect surface reaction. The physical and chemical processes occurring on sediment particle surfaces are microscopic processes and as such need to be studied from a microscopic perspective. In this study, field emission scanning electron microscopy (SEM) and energy dispersive X-ray spectrometer (EDS) were adopted to observe and analyze the pore structure and element distribution of sediment particles. In particular, a special method of sample preparation was used to achieve the corresponding cross-sectional information of sediment particles. Clear images of a particle profile and pore microstructure were obtained by high-resolution SEM, while element distribution maps of sediment particles were obtained by EDS. The results provide an intuitive understanding of the internal microenvironment and external behavior of sediment particles, in addition to revealing a significant role of pore microstructure in the adsorption and desorption of pollutants. Thus, a combination of different experimental instruments and observation methods can provide real images and information on microscopic pore structure and element distribution of sediment particles. These results should help to improve our understanding of sediment dynamics and its environmental effects.
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Impact of Spasticity on Balance Control during Quiet Standing in Persons after Stroke
Background. Balance impairments, falls, and spasticity are common after stroke, but the effect of spasticity on balance control after stroke is not well understood. Methods. In this cross-sectional study, twenty-seven participants with stroke were divided into two groups, based on ankle plantar flexor spasticity level. Fifteen individuals with high spasticity (Modified Ashworth Scale (MAS) score of ≥2) and 12 individuals with low spasticity (MAS score
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Accelerating the HyperLogLog Cardinality Estimation Algorithm
In recent years, vast amounts of data of different kinds, from pictures and videos from our cameras to software logs from sensor networks and Internet routers operating day and night, are being generated. This has led to new big data problems, which require new algorithms to handle these large volumes of data and as a result are very computationally demanding because of the volumes to process. In this paper, we parallelize one of these new algorithms, namely, the HyperLogLog algorithm, which estimates the number of different items in a large data set with minimal memory usage, as it lowers the typical memory usage of this type of calculation from to . We have implemented parallelizations based on OpenMP and OpenCL and evaluated them in a standard multicore system, an Intel Xeon Phi, and two GPUs from different vendors. The results obtained in our experiments, in which we reach a speedup of 88.6 with respect to an optimized sequential implementation, are very positive, particularly taking into account the need to run this kind of algorithm on large amounts of data.
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Mesh penetrating the cecum and bladder following inguinal hernia surgery: a case report
Tension-free repair using mesh is a common inguinal hernia surgical procedure. However, various complications such as mesh-related infection and recurrence may develop as a result. Moreover, although rare, the...
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Tandem thiotepa with autologous hematopoietic cell rescue in patients with recurrent, refractory, or poor prognosis solid tumor malignancies
Abstract
Background: The purpose of this study was to determine the feasibility and tolerability of tandem courses of high-dose thiotepa with autologous hematopoietic cell rescue (AHCR) in patients with recurrent, refractory solid tumors who were ineligible for a single course of high-dose therapy due to greater than minimal residual disease. Patients with decreased hearing or poor renal function were eligible. Procedure: Thiotepa was administered intravenously at a dose of 200 mg/m2/day (6.67 mg/kg/day) daily for 3 days followed by AHCR. A second course of thiotepa was given 4 weeks later provided blood counts recovered sufficiently without evidence of tumor progression. Results: Fifty-eight patients received 96 courses. Thirty-eight (65%) patients received two courses of therapy. Twenty-seven courses (28%) were administered completely in the outpatient setting. A toxic mortality rate of 3.4% was observed. Five of 26 patients with medulloblastoma were alive at a median of 35 months, whereas 21 patients died at a median of 11.7 months. Four of five patients with central nervous system germ cell tumors (CNS GCT) were alive 68–103 months following AHCR. Conclusions: Two cycles of high-dose thiotepa with AHCR were well tolerated even in these heavily pretreated patients. This therapy may provide prolonged survival in patients with recurrent malignant brain tumors, particularly medulloblastoma and CNS GCT.
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Consensus and controversies regarding the treatment of rhabdomyosarcoma
Abstract
Optimal treatment of rhabdomyosarcoma (RMS) requires multidisciplinary approach, incorporating chemotherapy with local control. Although current therapies are built on cooperative group trials, a comprehensive standard of care to guide clinical decision making has been lacking, especially for relapsed patients. Therefore, we assembled a panel of pediatric and adolescent and young adult sarcoma experts to develop treatment guidelines for managing RMS and to identify areas in which further research is needed. We created algorithms incorporating evidence-based care for patients with RMS, emphasizing the importance of clinical trials and close integration of all specialties involved in the care of these patients.
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Editorial Board
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Gelidibacter flavus sp. nov., Isolated from Activated Sludge of Seawater Treatment System
Abstract
A Gram-stain-negative bacterial strain designated Con4T was isolated from activated sludge in a seawater treatment system. The strain was rod-shaped, motile, aerobic, and formed yellow-colored colonies on agar medium. Cells contained carotenoid pigments, but flexirubin-type pigments were absent. Based on 16S rRNA gene sequence analysis, the strain was assigned to the genus Gelidibacter. Optimum growth occurred at 20 °C, pH 7.0, and 1–2% (w/v) NaCl. Prominent fatty acid types were iso-C15:0, anteiso-C15:0, and iso-C16:0 3OH. Diphosphatidylglycerol and phosphatidylethanolamine were present as the major polar lipids. MK-6 was present as major menaquinone. Strain Con4T showed the highest sequence similarity with Gelidibacter mesophilus KCTC 12106T (96.5%), Gelidibacter gilvus IC158T (96.4%), and Gelidibacter algens ACAM 536T (95.8%). The G+C mol% contents of the strain Con4T were 37.7%. Distinct morphological, physiological, and genotypic differences from the previously described taxa support the classification of strain Con4T as a representative of a novel species in the genus Gelidibacter, for which the name Gelidibacter flavus sp. nov. is proposed. The type strain is Con4T (=KEMB 41-198T = JCM 31135T).
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Efficacy of α-lipoic acid against cadmium toxicity on metal ion and oxidative imbalance, and expression of metallothionein and antioxidant genes in rabbit brain
Abstract
To explore the protective efficacy of α-lipoic acid (ALA) against Cd-prompted neurotoxicity, young male New Zealand rabbits (Oryctolagus cuniculus) were divided randomly into four groups. Group 1 (control) received demineralized water. Group 2 (Cd) administered cadmium chloride (CdCl2) 3 mg/kg bwt. Group 3 (ALA) administered ALA 100 mg/kg bwt. Group 4 (Cd + ALA) administered ALA 1 h after Cd. The treatments were administered orally for 30 consecutive days. Cd-induced marked disturbances in neurochemical parameters were indicated by the reduction in micro- and macro-elements (Zn, Fe, Cu, P, and Ca), with the highest reduction in Cd-exposed rabbits, followed by Cd + ALA group and then ALA group. In the brain tissues, Cd has significantly augmented the lipid hydroperoxides (LPO) and reduced the glutathione (GSH) and total antioxidant capacity (TAC), and glutathione peroxidase and glutathione S-transferase enzyme activities but had an insignificant effect on the antioxidant redox enzymes. Administration of ALA effectively restored LPO and sustained GSH and TAC contents. Moreover, Cd downregulated the transcriptional levels of Nrf2, MT3, and SOD1 genes, and upregulated that of Keap1 gene. ALA treatment, shortly following Cd exposure, downregulated Keap1, and upregulated Nrf2 and GPx1, while maintained MT3 and SOD1 mRNA gene expression in the rabbits' brain. These data indicated the ALA effectiveness in protecting against Cd-induced oxidative stress and the depletion of cellular antioxidants in the brain of rabbits perhaps due to its antioxidant, free radical scavenging, and chelating properties.
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Natural manganese ore catalyst for low-temperature selective catalytic reduction of NO with NH 3 in coke-oven flue gas
Abstract
Different types of manganese ore raw materials were prepared for use as catalysts, and the effects of different manganese ore raw materials and calcination temperature on the NO conversion were analyzed. The catalysts were characterized by XRF, XRD, BET, XPS, H2-TPR, NH3-TPD, and SEM techniques. The results showed that the NO conversion of calcined manganese ore with a Mn:Fe:Al:Si ratio of 1.51:1.26:0.34:1 at 450 °C reached 80% at 120 °C and 98% at 180~240 °C. The suitable proportions and better dispersibility of active ingredients, larger BET surface area, good reductibility, a lot of acid sites, contents of Mn4+ and Fe3+, and surface-adsorbed oxygen played important roles in improving the NO conversion.
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Moncton council to decide on whether to restore water fluoridation
Despite pleas from dentists to restore fluoride to the water supply in Moncton, N.B., at least one city councillor says he'll vote against it when council meets to make a decision next week. Moncton ended fluoride use in 2011, and dentist Suzanne Drapeau-McNally says she has seen a dramatic increase in tooth decay among young children ever since.
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Corrections
Source:The Lancet Infectious Diseases
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The unregulated use of melanotan-II is of public health interest to Australian dermatologists
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Clinical study of abnormal vagus nerve tension and basal ganglia cerebral infarction induced paroxysmal atrial fibrillation
Publication date: Available online 14 September 2017
Source:Asian Pacific Journal of Tropical Medicine
Author(s): Wen-Bo Cheng, Dong Li, Qin Yang, Yue-Mei Hou
ObjectiveTo investigate the relationship between basal ganglia cerebral infarction and paroxysmal atrial fibrillation caused by abnormal vagus nerve tension.MethodsA total of 1 483 cases of elder patients with cerebral infarction who received head CT or MRI examination during the period were enrolled, 830 patients were male, 613 patients were female, and the average age was 78 years. These cases were divided into basal infarction ganglia group (n = 1 045) and non-basal ganglia infarction group (n = 438) according to the anatomic site of cerebral infarction. The differences of the incidence of paroxysmal atrial fibrillation (PAF), left atrial diameter and heart rate variability were compared between the two groups.ResultsIn basal ganglia infarction group, the incidence rate of PAF was significantly higher than that of non-basal ganglia infarction group (P < 0.05). The incidence trend of cerebral infarction in basal ganglia was age-related, in the > 79 years basal ganglia cerebral infarction group, the incidence of PAF was significantly higher than that of non-basal ganglia infarction group (P < 0.05). There was no significant difference in the left atrial diameter between the basal ganglia infarction group and non-basal ganglia infarction group. Basal ganglia cerebral infarction patients with high PAF have higher Heart rate variability (HRV) than non-basal ganglia infarction group.ConclusionElderly patients with basal ganglia infarction have high incidence of PAF, cerebral basal ganglia of sympathetic nerve damage and increased vagal tension and cardiac vagal tension are the direct causes of paroxysmal atrial fibrillation. The results indicated that the increased central vagal nerve tension mediated PAF probably is a treatment indication of supplying sympathetic neurotransmitter or cardiac vagal denervation treatment.
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Phylogeography, genetic variability and structure of Acanthamoeba metapopulations in Iran inferred by 18S ribosomal RNA sequences; a systematic review and meta-analysis
Publication date: Available online 14 September 2017
Source:Asian Pacific Journal of Tropical Medicine
Author(s): Adel Spotin, Hamid Reza Moslemzadeh, Mahmoud Mahami-Oskouei, Ehsan Ahmadpour, Maryam Niyyati, Seyed Hossein Hejazi, Fatemeh Memari, Jafar Noori
ObjectiveTo verify phylogeography and genetic structure of Acanthamoeba populations among the Iranian clinical isolates and natural/artificial environments distributed in various regions of the country.MethodsWe searched electronic databases including Medline, PubMed, Science Direct, Scopus and Google Scholar from 2005 to 2016. To explore the genetic variability of Acanthamoeba sp, 205 sequences were retrieved from keratitis patients, immunosuppressed cases and environmental sources as of various geographies of Iran.ResultsT4 genotype was the predominant strain in Iran, and the rare genotypes belonged to T2, T3, T5 (Acanthamoeba lenticulata), T6, T9, T11, T13 and T15 (Acanthamoeba jacobsi). A total of 47 unique haplotypes of T4 were identified. A parsimonious network of the sequence haplotypes demonstrated star-like feature containing haplogroups IR6 (34.1%) and IR7 (31.2%) as the most common haplotypes. In accordance with the analysis of molecular variance (AMOVA), the high value of haplotype diversity (0.612 to 0.848) of Acanthamoeba T4 represented genetic variability within populations. Neutrality indices of the 18S ribosomal RNA (rRNA) demonstrated negative values in all populations which represented a considerable divergence from neutrality. The majority of genetic diversity belonged to the infected contact lens and dust samples in immunodeficiency and ophthalmology wards, which indicated potential routes for exposure to a pathogenic Acanthamoeba sp. in at-risk individuals. A pairwise fixation index (FST) was from low to high values (0.024 33 to 0.418 92). The statistically FST points out that T4 is genetically differentiated between north-west, north-south and central-south metapopulations, but not differentiated between west-central, west-south, central-south, and north-central isolates.ConclusionsAn occurrence of IR6 and IR7 displays that possibly a gene flow of Acanthamoeba T4 occurred after the founder effect or bottleneck experience through ecological changes or host mobility. This is the first systematic review and meta-analysis providing new approaches into gene migration and transmission patterns of Acanthamoeba sp, and targeting at the high-risk individuals/sources among the various regions of Iran.
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Outcome of intrahepatic portosystemic shunt diagnosed prenatally
Abstract
We analyzed the characteristics of the population with congenital portosystemic shunt diagnosed during the antenatal period and the organization of their perinatal care. This multicentric retrospective study included all the patients with a prenatal diagnosis of congenital portosystemic shunt. Between 1999 and 2015, 12 patients were included. Prenatal diagnosis was done at a median 26.5 weeks of gestation (21–34). All the patients presented intrahepatic CPSS, three of them had associated congenital cardiopathy, and one a Bannayan-Zonana syndrome. Ten patients had simple outcome on conservative treatment, eight of them having a spontaneous closure of their portosystemic shunt within the first 2 years of life. One patient had surgical treatment which failed and he developed a focal nodular hyperplasia. Another patient had radiological interventional closure of his shunt which was complicated by a venal portal thrombosis.
Conclusion: Outcome of intrahepatic portosystemic shunt diagnosed prenatally is good in the majority of cases.
| What is known: • Multiples studies exist on congenital porto systemic shunt but when the diagnosis is done after birth. • The evolution, management, and complication are well known. |
| What is new: • There is very few studies with only patients diagnosed in antenatal and it is a large series of cases. • Outcome of intrahepatic portosystemic shunt diagnosed prenatally is good in the majority of cases. |
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Evaluation of volumetric dimensional changes in posterior extraction sites with and without ARP using a novel imaging device
Abstract
Background
Alveolar ridge volume loss may be minimized when postextraction sockets are filled by bone substitutes.
Purpose
The aim of the study was to measure the effect of alveolar ridge preservation (ARP) in maintaining the external contour of the ridge after fresh socket grafting with or without particulate anorganic bovine bone mineral (BBM) and resorbable barrier covering.
Materials and methods
In the present controlled study, patients subjected to single-tooth extraction were allocated to 2 groups: postextraction sockets grafted with bovine bone mineral (bbm), and naturally healing sockets (nat). Before and at 5 months following tooth extraction, plaster cast contours of the sockets were acquired by means of an optical scanner; the 2 contours of each patient underwent voxelization and fusion using a matrix elaborator. Outcome variables at 5 months (volumetric, surface, and linear changes) were measured in digital fused plaster casts with a dental scan software analyzing a volume of interest ranging from residual papilla to 10 mm toward the apical point. Intra- and inter-group pair-wise variables' comparisons were conducted. Level of significance was set at 0.05.
Results
Twenty-four sites were enrolled: 12 ARP and 12 naturally healed. Five-month percentage of volume loss of the bbm-group (21.7% ± 7.4%) was significantly lower (Ps < .0003) than that of the naturally healing group (38.8% ± 7.9%). When tooth position was investigated, volume loss in percentage registered a significantly better (P values ≤ .0485) behavior in molars (ΔV% = −19.1% ± 6.5% and ΔV% = −35.6% ± 7.6%, respectively, for bbm and nat) than that in premolars (ΔV% = −26.9% ± 7.2% and ΔV% = −45.1% ± 4.2%, respectively, for bbm and nat), in both the preserved and naturally healing groups.
Conclusion
The dimensional loss in postextraction sockets grafted with anorganic bovine bone substitute and covered by a resorbable collagen barrier was lower than that of the naturally healing sites. However, ridge preservation was able to maintain almost 80% of the pristine bone.
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Effectiveness of etilefrine regimen for chylothorax after esophagectomy with thoracic duct resection
Abstract
Background
Management of postoperative chylothorax generally involves nutritional regimens as well as pharmacological and surgical therapies, but a clear consensus has yet to be reached.
Methods
Retrospective review of 371 patients who underwent esophagectomy for esophageal cancer was performed. They were patients with squamous cell carcinoma or adenocarcinoma of the esophagus including Siewert type I/II tumor of the esophagogastric junction who underwent subtotal esophagectomy. Of these patients, 19 patients who were diagnosed with chylothorax as a postoperative complication were enrolled in this study.
Results
Conservative treatment achieved cure in 16 patients among 19 patients. The duration of chylothorax tended to be longer in the no-etilefrine group (n = 5) than in the etilefrine group (n = 11) (27.8 vs. 11.6 days; p = 0.078). The 14 patients among 19 patients resected the thoracic duct. Etilefrine was used in 12 of these 14 patients. Among these 12 patients, 3 required surgical treatment and the remaining 9 patients were cured with conservative treatment. The duration of chylothorax was shorter in the conservative treatment group than in the surgical treatment group (11.9 vs. 36.3 days; p = 0.052). In addition, with the use of etilefrine as adjuvant therapy, cure was achieved in 9 patients (75%) without surgical intervention.
Conclusions
The findings of this study suggest that when used concurrently with conventional treatments, etilefrine facilitates early chest tube removal. In addition, post-thoracic duct resection chylothorax, which frequently requires surgical treatment because of the general less effectiveness of conservative treatments, showed high successful rate (75%) to etilefrine treatment.
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Numerical Analysis of Ground Motion Effects in the Loess Regions of Western China
Loess is widely distributed in the western part of China and its area comprises 6.6% of Chinese territory. Because of the characteristics of high porosity, low strength, and weak cementation, the loess is characterized by high seismic vulnerability which has been observed and confirmed by many researchers at home and abroad. The postquake field investigation and the laboratory study have shown that the ground motion effects, including the amplification effects and slope effects, were obvious in loess sites. Moreover, the causes of landslides, seismic subsidence, and liquefaction were mainly attributed to this special soil structure and properties. In this paper, based on the data of shear wave velocity of typical loess in Lanzhou region, combining the results of dynamic triaxial tests, the numerical analysis of ground motion effects in the loess regions is analyzed. The results reveal how the ground motion effects are checked and demonstrated the important role of numerical simulations while studying the characteristics of ground motions.
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Multimodal Imaging for the Detection of Brown Adipose Tissue Activation in Women: A Pilot Study Using NIRS and Infrared Thermography
Purpose. A clear link between obesity and brown adipose tissue (BAT) dysfunction has been recently demonstrated. The purpose of this pilot study is to determine if near-infrared spectroscopy (NIRS) 2D imaging together with infrared thermography (IRT) is capable of identifying thermal and vascular response in the supraclavicular (SCV) areas after the ingestion of an oral glucose load as a thermogenic stimulation. Method. We studied two groups of women (obese versus lean) for discerning their different responses. NIRS and IRT images were acquired on the neck in the left SCV region during a 3 h oral glucose tolerance test (OGTT) and immediately after a cold stimulation. Results. We detected a significant thermal response of BAT in SCV fossa in both groups. Both during OGTT and after cold stimulation, skin temperature was persistently higher in lean versus obese. This response was not coupled with changes in oxygen saturation of subcutaneous tissue in that area. Discussion and Conclusion. The results show that NIRS/IRT may be a novel, noninvasive, radiation-free, easy to use, and low-cost method for monitoring, during the standard clinical practice, the diet and pharmacological intervention which aims to stimulate BAT as a potential therapeutic target against obesity and diabetes.
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Novel Combined Training Approach Improves Sleep Quality but Does Not Change Body Composition in Healthy Elderly Women: A Preliminary Study
The aim of this study was to investigate the effects of a novel combined training protocol on sleep quality and body composition of healthy elderly women. The study sample consisted of 8 sedentary elderly individuals with mean (±SD) of 67 (±8) years of age, 96.0 (±7.8) mg/dL fasting blood glucose, 94.4 (±36.1) mg/dL triglycerides, 179.1 (±22.4) mg/dL total cholesterol, 57.2 (±15.7) mg/dL high-density lipoprotein (HDL), 103.1 (±25.2) mg/dL low-density lipoprotein (LDL), 125.3 (±8.4) mmHg systolic blood pressure, and 72.6 (±10.1) mmHg diastolic blood pressure. The training protocol consisted of resistance training exercises (approximately 18-minute duration) combined with aerobic exercises (approximately 26-minute duration), performed interspersed in the same session, for 8 weeks (3 times a week), with a 24-hour interval rest between each session. Continuous variables were expressed as the mean (±standard deviation) and the paired sample -test compares baseline with final measurement. The results showed a significant improvement in quality of sleep (4.9 ± 1.5 versus 3.8 ± 1.8 for total PSQI index) without body significant improvements in the fat-free mass (59.9 ± 4.0 versus 60.5 ± 4.4; ) and fat mass (40.1 ± 4.0 versus 39.5 ± 4.4; ) in healthy elderly women. In this sense, the novel combined training proposed may be an effective alternative or adjunct to present therapies aimed at improving the sleep quality in this population.
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Prognostic Significance of Preoperative and Postoperative Complement C3 Depletion in Gastric Cancer: A Three-Year Survival Investigation
Objectives. The role of complement system in predicting prognosis of gastric cancer (GC) remains obscured. This study aims to explore the incidence of complement C3 depletion and associated outcomes in GC patients. Methods. between August 2013 and December 2013, 106 patients with gastric adenocarcinoma were prospectively analyzed. Plasma levels of complement C3 and C4 were detected at baseline, one day before surgery, and postoperative day 3, respectively. Patients with low C3 levels (
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Extension of Wolfe Method for Solving Quadratic Programming with Interval Coefficients
Quadratic programming with interval coefficients developed to overcome cases in classic quadratic programming where the coefficient value is unknown and must be estimated. This paper discusses the extension of Wolfe method. The extended Wolfe method can be used to solve quadratic programming with interval coefficients. The extension process of Wolfe method involves the transformation of the quadratic programming with interval coefficients model into linear programming with interval coefficients model. The next step is transforming linear programming with interval coefficients model into two classic linear programming models with special characteristics, namely, the optimum best and the worst optimum problem.
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Spatial-Temporal Similarity Correlation between Public Transit Passengers Using Smart Card Data
The increasing availability of public transit smart card data has enabled several studies to focus on identifying passengers with similar spatial and/or temporal trip characteristics. However, this paper goes one step further by investigating the relationship between passengers' spatial and temporal characteristics. For the first time, this paper investigates the correlation of the spatial similarity with the temporal similarity between public transit passengers by developing spatial similarity and temporal similarity measures for the public transit network with a novel passenger-based perspective. The perspective considers the passengers as agents who can make multiple trips in the network. The spatial similarity measure takes into account direction as well as the distance between the trips of the passengers. The temporal similarity measure considers both the boarding and alighting time in a continuous linear space. The spatial-temporal similarity correlation between passengers is analysed using histograms, Pearson correlation coefficients, and hexagonal binning. Also, relations between the spatial and temporal similarity values with the trip time and length are examined. The proposed methodology is implemented for four-day smart card data including 80,000 passengers in Brisbane, Australia. The results show a nonlinear spatial-temporal similarity correlation among the passengers.
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Endothelinergic Contractile Hyperreactivity in Rat Contralateral Carotid to Balloon Injury: Integrated Role for ETB Receptors and Superoxide Anion
Temporal consequences of neurocompensation to balloon injury on endothelinergic functionality in rat contralateral carotid were evaluated. Rats underwent balloon injury in left carotid and were treated with CP-96345 (NK1 antagonist). Concentration-response curves for endothelin-1 were obtained in contralateral (right) carotid at 2, 8, 16, 30, or 45 days after surgery in the absence or presence of BQ-123 ( antagonist), BQ-788 ( antagonist), or Tempol (superoxide-dismutase mimic). Endothelin-1-induced calcium mobilization was evaluated in functional assays carried out with BQ-123, BQ-788, or Tempol. Endothelin-1-induced NADPH oxidase-driven superoxide generation was measured by lucigenin chemiluminescence assays performed with BQ-123 or BQ-788. Endothelin-1-induced contraction was increased in contralateral carotid from the sixteenth day after surgery. This response was restored in CP-96345-treated rats. Endothelium removal or BQ-123 did not change endothelin-1-induced contraction in contralateral carotid. This response was restored by BQ-788 or Tempol. Contralateral carotid exhibited an increased endothelin-1-induced calcium mobilization, which was restored by BQ-788 or Tempol. Contralateral carotid exhibited an increased endothelin-1-induced lucigenin chemiluminescence, which was restored by BQ-788. We conclude that the NK1-mediated neurocompensatory response to balloon injury elicits a contractile hyperreactivity to endothelin-1 in rat contralateral carotid by enhancing the muscular -mediated NADPH oxidase-driven generation of superoxide, which activates calcium channels.
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Optogenetic Inhibition of Striatal Neuronal Activity Improves the Survival of Transplanted Neural Stem Cells and Neurological Outcomes after Ischemic Stroke in Mice
Neural stem cell (NSC) transplantation is a promising treatment to improve the recovery after brain ischemia. However, how the survival, proliferation, migration, and differentiation of implanted NSC are influenced by endogenous neuronal activity remains unclear. In this work, we used optogenetic techniques to control the activity of striatal neurons and investigated how their activity affected the survival and migration of transplanted NSCs and overall neurological outcome after ischemic stroke. NSCs cultured from transgenic mice expressing fluorescent protein were transplanted into the peri-infarct region of the striatum after transient middle cerebral artery occlusion (tMCAO) surgery. The striatal neurons were excited or inhibited for 15 minutes daily via implanted optical fiber after tMCAO. The results revealed that mice which received NSC transplantation and optogenetic inhibition had smaller brain infarct volume and increased NSC migration compared to the NSC alone or PBS group (). In contrast, mice which received NSC transplantation and optogenetic excitation showed no difference in infarct volume and neurological behavior improvement compared to the PBS control group. In vitro experiments further revealed that the conditioned media from excited GABAergic neurons reduced NSC viability through paracrine mechanisms. Conclusion. Optogenetic inhibition of striatal neuronal activity further improved neurological recovery after NSC transplantation at the subacute phase after brain ischemia.
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Successful Treatment of Hemophagocytic Lymphohistiocytosis Associated with Lupus Nephritis by Using Mycophenolate Mofetil
An estimated 0.9% to 2.4% of patients with systemic lupus erythematosus (SLE) also have hemophagocytic lymphohistiocytosis (HLH). HLH associated with autoimmune diseases is often refractory to corticosteroid treatment; thus, additional immunosuppressive drugs, such as cyclosporine, cyclophosphamide, or tacrolimus, are required. Here, we describe the case of a 44-year-old Japanese woman who developed HLH associated with lupus nephritis. Initially, her HLH was refractory to treatment with a corticosteroid, tacrolimus, and mizoribine. However, alternative treatment with a corticosteroid, mycophenolate mofetil, and tacrolimus improved both her HLH and lupus nephritis. This case suggests the possibility of mycophenolate mofetil as a key drug for treating HLH associated with SLE.
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IJMS, Vol. 18, Pages 1967: Biological Pathways Involved in Tumor Angiogenesis and Bevacizumab Based Anti-Angiogenic Therapy with Special References to Ovarian Cancer
IJMS, Vol. 18, Pages 1967: Biological Pathways Involved in Tumor Angiogenesis and Bevacizumab Based Anti-Angiogenic Therapy with Special References to Ovarian Cancer
International Journal of Molecular Sciences doi: 10.3390/ijms18091967
Authors: Vera Loizzi Vittoria Del Vecchio Giulio Gargano Maria De Liso Anila Kardashi Emanuele Naglieri Leonardo Resta Ettore Cicinelli Gennaro Cormio
The creation of new blood vessels from existing ones, which is a mechanism called "angiogenesis", is essential in cancer to supply cancerous growth. Moreover, the development and the progression of the tumor and its metastases are the result of an efficient vascular response. Cancer cells release and activate different angiogenic growth factors and their receptors in the tumor microenvironment to promote the angiogenic process. The most important pro-angiogenic factor is the "Vascular Endothelial Growth Factor" (VEGF) because of its mitogen activity on vascular endothelium. Bevacizumab is a monoclonal antibody that obstructs the binding of circulating vascular endothelial growth factor to its receptors and has been approved for the treatment of primary and recurrent ovarian cancer but also for many other solid tumors.
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Τετάρτη 13 Σεπτεμβρίου 2017
Role of Negative Vector Orbit in Orbital Blow-Out Fractures.
Background: Negative vector orbit is defined as the most anterior globe portion protrudes past the malar eminence. The aim of the study was to evaluate the relationship between negative vector orbit and blow-out fracture location analyzing the distance between the anterior corneal surface and orbital bone with facial soft tissue in medial and orbital floor blow out fractures using orbital computed tomography (CT). Methods: Seventy-seven patients diagnosed with blow-out fractures involving the medial or orbital floor were included. Distances from the anterior cornea to lower lid fat, inferior orbital wall, inferior orbital rim, and anterior cheek mass were measured using orbital CT scans. The proportion of negative vector orbit and measured distanced were compared between medial wall fracture and orbital floor fracture. Medical records including age, sex, concomitant ophthalmic diagnosis, and nature of injury were retrospectively reviewed. Results: Forty-three eyes from 43 patients diagnosed with medial wall fracture and 34 eyes from 34 patients diagnosed with orbital floor fracture were included. There was no significant difference in the distance from the anterior cornea to lower lid fat (P = 0.574), inferior orbital wall (P = 0.494), or orbital rim (P = 0.685). The distance from anterior cornea to anterior cheek mass was significantly different in medial wall fracture (-0.19 +/- 3.49 mm) compared with orbital floor fracture (-1.69 +/- 3.70 mm), P = 0.05. Negative vector orbit was significantly higher in orbital floor fracture patients (24 among 34 patients, 70.6%) compared with those with medial wall fractures (19 among 43 patients, 44.2%) (P = 0.04). Conclusions: Patients presenting with a negative vector orbit relationship when the most anterior portion of globe protruded past the anterior cheek mass and malar eminence were more likely to develop orbital floor fracture than medial wall fracture. (C) 2017 by Mutaz B. Habal, MD.
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The Americleft Project: A Modification of Asher-McDade Method for Rating Nasolabial Esthetics in Patients With Unilateral Cleft Lip and Palate Using Q-sort.
The purpose of this study was to investigate ways to improve rater reliability and satisfaction in nasolabial esthetic evaluations of patients with complete unilateral cleft lip and palate (UCLP), by modifying the Asher-McDade method with use of Q-sort methodology. Blinded ratings of cropped photographs of one hundred forty-nine 5- to 7-year-old consecutively treated patients with complete UCLP from 4 different centers were used in a rating of frontal and profile nasolabial esthetic outcomes by 6 judges involved in the Americleft Project's intercenter outcome comparisons. Four judges rated in previous studies using the original Asher-McDade approach. For the Q-sort modification, rather than projection of images, each judge had cards with frontal and profile photographs of each patient and rated them on a scale of 1 to 5 for vermillion border, nasolabial frontal, and profile, using the Q-sort method with placement of cards into categories 1 to 5. Inter- and intrarater reliabilities were calculated using the Weighted Kappa (95% confidence interval). For 4 raters, the reliabilities were compared with those in previous studies. There was no significant improvement in inter-rater reliabilities using the new method. Intrarater reliability consistently improved. All raters preferred the Q-sort method with rating cards rather than a PowerPoint of photos, which improved internal consistency in rating compared to previous studies using the original Asher-McDade method. All raters preferred this method because of the ability to continuously compare photos and adjust relative ratings between patients. (C) 2017 by Mutaz B. Habal, MD.
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