High-throughput and contact-free trapping of single nano-objects in an aqueous solution is of substantial interest for fundamental and applied research. One of the several trapping methods is geometry-induced electrostatic (GIE) trapping that allows for passive spatial confinement of single nanoparticles in nanofluidic devices. In aqueous environments (pH > 2) glass and silicon dioxide surfaces acquire a net negative surface charge density due to the self-dissociation of terminal silanol groups. Thus, with native glass/silicon-based GIE-trapping devices only negatively charged nano-objects can be trapped, limiting the applications of this method. In this work, we have performed surface modifications of glass-based GIE-trapping nanofluidic devices to enable the trapping of positively charged nanoparticles. For surface functionalization of the devices, a layer transfer of poly(ethyleneimine) electrolytes were used which provides a net positive surface charge density. We demonstrate the successful confinement of positively charged 60 nm gold nanoparticles inside the functionalized devices, and present a comparison study between trapping of negatively- and positively charged particles in native and functionalized devices, respectively. (C) 2017 Elsevier B.V. All rights reserved.
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Δευτέρα 18 Σεπτεμβρίου 2017
Single positively charged particle trapping in nanofluidic systems
X-ray micro computed tomography for the visualization of an atherosclerotic human coronary artery
Atherosclerosis refers to narrowing or blocking of blood vessels that can lead to a heart attack, chest pain or stroke. Constricted segments of diseased arteries exhibit considerably increased wall shear stress, compared to the healthy ones. One of the possibilities to improve patient's treatment is the application of nano-therapeutic approaches, based on shear stress sensitive nano-containers. In order to tailor the chemical composition and subsequent physical properties of such liposomes, one has to know precisely the morphology of critically stenosed arteries at micrometre resolution. It is often obtained by means of histology, which has the drawback of offering only two-dimensional information. Additionally, it requires the artery to be decalcified before sectioning, which might lead to deformations within the tissue. Micro computed tomography (muCT) enables the three-dimensional (3D) visualization of soft and hard tissues at micrometre level. muCT allows lumen segmentation that is crucial for subsequent flow simulation analysis. In this communication, tomographic images of a human coronary artery before and after decalcification are qualitatively and quantitatively compared. We analyse the cross section of the diseased human coronary artery before and after decalcification, and calculate the lumen area of both samples.
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LATITUDE, STAMPEDE and ARASENS trials discussed by our expert panel, looking at the future of #prostatecancer care… https://t.co/KxGLxZPYz5
LATITUDE, STAMPEDE and ARASENS trials discussed by our expert panel, looking at the future of #prostatecancer care… https://t.co/KxGLxZPYz5
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RT @ecancer_patient : What are the preventive methods and treatments for #throatcancer? https://t.co/ETrxBXGmJB https://t.co/x1MdR5V7ij
RT @ecancer_patient : What are the preventive methods and treatments for #throatcancer? https://t.co/ETrxBXGmJB https://t.co/x1MdR5V7ij
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Adding AMD3100 significantly enhances anti-VEGF #cancer therapy and alleviates the reduction in T cells @PNASNews … https://t.co/QCLJ7WAHoi
Adding AMD3100 significantly enhances anti-VEGF #cancer therapy and alleviates the reduction in T cells @PNASNews … https://t.co/QCLJ7WAHoi
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Can diffusion-weighted imaging distinguish between benign and malignant pediatric liver tumors?
Abstract
Background
There are limited data on utility of diffusion-weighted imaging (DWI) in the evaluation of pediatric liver lesions.
Objective
To determine whether qualitative and quantitative DWI can be used to differentiate benign and malignant pediatric liver lesions.
Materials and methods
We retrospectively reviewed MRIs in children with focal liver lesions to qualitatively evaluate lesions noting diffusion restriction, T2 shine-through, increased diffusion, hypointensity on DWI and apparent diffusion coefficient (ADC) maps, and intermediate signal on both, and to measure ADC values. Pathology confirmation or a combination of clinical, laboratory and imaging features, and follow-up was used to determine final diagnosis.
Results
We included 112 focal hepatic lesions in 89 children (median age 11.5 years, 51 female), of which 92 lesions were benign and 20 malignant. Interobserver agreement was almost perfect for both qualitative (kappa 0.8735) and quantitative (intraclass correlation coefficient [ICC] 0.96) diffusion assessment. All malignant lesions showed diffusion restriction. Most benign lesions other than abscesses were not restricted. There was significant association of qualitative restriction with malignancy and non-restriction with benignancy (Fisher exact test P<0.0001). Mean normalized ADC values of malignant lesions (1.23x10−3 mm2/s) were lower than benign lesions (1.62x10−3 mm2/s; Student's t-test, P<0.015). However, there was significant overlap of ADC between benign and malignant lesions, with wide range for each diagnosis. Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.63 for predicting malignancy using an ADC cut-off value of ≤1.20x10−3 mm2/s, yielding a sensitivity of 78% and a specificity of 54% for differentiating malignant from benign lesions.
Conclusion
Qualitative diffusion restriction in pediatric liver lesions is a good predictor of malignancy and can help to differentiate between benign and malignant lesions, in conjunction with conventional MR sequences. Even though malignant lesions demonstrated significantly lower ADC values than benign lesions, the use of quantitative diffusion remains limited in its utility for distinguishing them because of the significant overlap and wide ranges of ADC values.
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A novel, in-frame KMT2B deletion in a patient with apparently isolated, generalized dystonia
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A glimmer of light at the end of the tunnel?
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Limitations of workers diagnosed with cancer evaluated with Work Role Functioning Questionnaire-Br
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Proteins regulating the intercellular transfer and function of P-glycoprotein in multidrug-resistant cancer
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Non-stick properties of thin-film coatings on dental-restorative instruments
The non-stick properties of thin-film coatings on dental-restorative instruments were investigated by static contact-angle measurement using dental filler resin as well as by scanning electron microscopy of the amount of sticking dental restorative material. Furthermore, using a customized dipping measurement set-up, non-stick properties were evaluated by measuring force-by-time when the instrument was pulled out of restorative material. Minor improvements in non-stick properties were obtained with commercial diamond-like carbon and commercial polytetrafluoroethylene-based coatings. Major improvements were obtained with an in-house fabricated superhydrophobic coating prepared by a multistep process consisting of surface microstructuring by etching in hydrogen fluoride (HF): hydrogen peroxide (H2O2) (1:1; vol/vol), atomic layer deposition of a 7 nm coating of aluminium oxide and titanium oxide, and a self-assembled monolayer of fluorinated organosilicon. Superhydrophobic coatings provide a possible future solution to prevent unwanted adnerence of composite restorative material to dental instruments.
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A technique for intraoperative maxillomandibular fixation
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Fear and trembling, from The Great Quake to Quakeland
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From Virus to vector to medicine: Foreword by guest editors
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Cholinergic basal forebrain structures are not essential for mediation of the arousing action of glutamate
Summary
The cholinergic basal forebrain contributes to cortical activation and receives rich innervations from the ascending activating system. It is involved in the mediation of the arousing actions of noradrenaline and histamine. Glutamatergic stimulation in the basal forebrain results in cortical acetylcholine release and suppression of sleep. However, it is not known to what extent the cholinergic versus non-cholinergic basal forebrain projection neurones contribute to the arousing action of glutamate. To clarify this question, we administered N-methyl-D-aspartate (NMDA), a glutamate agonist, into the basal forebrain in intact rats and after destruction of the cholinergic cells in the basal forebrain with 192 immunoglobulin (Ig)G-saporin. In eight Han–Wistar rats with implanted electroencephalogram/electromyogram (EEG/EMG) electrodes and guide cannulas for microdialysis probes, 0.23 μg 192 IgG-saporin was administered into the basal forebrain, while the eight control animals received artificial cerebrospinal fluid. Two weeks later, a microdialysis probe targeted into the basal forebrain was perfused with cerebrospinal fluid on the baseline day and for 3 h with 0.3 mmNMDA on the subsequent day. Sleep–wake activity was recorded for 24 h on both days. NMDA exhibited a robust arousing effect in both the intact and the lesioned rats. Wakefulness was increased and both non-REM and REM sleep were decreased significantly during the 3-h NMDA perfusion. Destruction of the basal forebrain cholinergic neurones did not abolish the wake-enhancing action of NMDA. Thus, the cholinergic basal forebrain structures are not essential for the mediation of the arousing action of glutamate.
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Dentist thanks community for support after A 1,000 damage
Owner Kashif Aftab received a call on Sunday informing him of the damage, which he estimates cost about A 1,000. Members of the Baxenden Watch have been sharing information to try and help the dental practice in the aftermath of the attack.
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It’s time to fund health and social care properly
Majeed correctly points out that restrictions on prescribing and reduced availability of drug treatments on the NHS, as well as stopping prescription of gluten free food products for patients with...
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Variability in Glycemic Control with Temperature Transitions during Therapeutic Hypothermia
Purpose. Patients treated with therapeutic hypothermia (TH) and continuous insulin may be at increased risk of hyperglycemia or hypoglycemia, particularly during temperature transitions. This study aimed to evaluate frequency of glucose excursions during each phase of TH and to characterize glycemic control patterns in relation to survival. Methods. Patients admitted to a tertiary care hospital for circulatory arrest and treated with both therapeutic hypothermia and protocol-based continuous insulin between January 2010 and June 2013 were included. Glucose measures, insulin, and temperatures were collected through 24 hours after rewarming. Results. 24 of 26 patients experienced glycemic excursions. Hyperglycemic excursions were more frequent during initiation versus remaining phases (36.3%, 4.3%, 2.5%, and 4.0%, ). Hypoglycemia occurred most often during rewarming (0%, 7.7%, 23.1%, and 3.8%, ). Patients who experienced hypoglycemia had higher insulin doses prior to rewarming (16.2 versus 2.1 units/hr, ). Glucose variation was highest during hypothermia and trended higher in nonsurvivors compared to survivors (13.38 versus 9.16, ). Frequency of excursions was also higher in nonsurvivors (32.3% versus 19.8%, ). Conclusions. Glycemic excursions are common and occur more often in nonsurvivors. Excursions differ by phase but risk of hypoglycemia is increased during rewarming.
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Sonographic Signs of Adenomyosis Are Prevalent in Women Undergoing Surgery for Endometriosis and May Suggest a Higher Risk of Infertility
Objectives. To determine the prevalence of ultrasound features suggestive of adenomyosis in women undergoing surgery for endometriosis compared with a control group of healthy women without endometriosis. Methods. Retrospective case-control study comparing women with intractable pain or infertility, who underwent transvaginal ultrasound and subsequent laparoscopic surgery, with a control group of healthy women without a previous history of endometriosis. A diagnosis of adenomyosis on TVUS was made based on asymmetrical myometrial thickening, linear striations, myometrial cysts, hyperechoic islands, irregular endometrial-myometrial junction, parallel shadowing, and localized adenomyomas and analyzed for one sign and for three or more signs. Results. The study and control groups included 94 and 60 women, respectively. In the study group, women were younger and had more dysmenorrhea and infertility symptoms. The presence of any sonographic feature of adenomyosis, as well as three or more signs, was found to be more prevalent in the study group, which persisted after controlling for age, for all features but linear striations. Women in the study group who had five or more sonographic features of adenomyosis had more than a threefold risk of suffering from infertility (OR = 3.19, , 95% CI; 1.25–8.17). There was no association with disease severity at surgery. Conclusions. Sonographic features of adenomyosis are more prevalent in women undergoing surgery for endometriosis compared to healthy controls. Women with more than five features had an increased risk of infertility.
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Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter
Introduction. Xanthogranulomatous pyelonephritis (XGP) is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare. Case Presentation. A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT) revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed. Conclusion. We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter.
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Histopathologic and Cytologic Follow-Up in High Risk Male Patients with Unsatisfactory Anal Cytology
Objective. Anal cytology is being increasingly used as part of anal cancer screening in patients at high risk for anal neoplasia. Most studies in anal cytology have focused on correlating the abnormal anal Pap smear with histopathologic outcomes. The aim of this study was to document histopathologic or repeat anal cytology outcomes in patients with unsatisfactory cytology. Materials and Methods. Unsatisfactory anal Pap tests in high risk male patients were correlated with follow-up histopathologic diagnoses or cytology. Results. 1205 anal tests were performed during the study period and 214 (17.8%) were unsatisfactory. Adequate follow-up cytology was available in 75 cases and revealed epithelial cell abnormality (ECA) in 40% [30/75] (atypical squamous cells of undetermined significance (ASCUS) [20%] and low-grade squamous intraepithelial lesions (LGSIL) [20%]) and was negative for intraepithelial lesion or malignancy (NILM) in 60% [45/75] of cases. 28.7% of unsatisfactory Pap smears had unsatisfactory repeat cytology. Histopathological follow-up on these unsatisfactory Pap smears revealed anal intraepithelial neoplasia (AIN) 1 and AIN 2/3 or 2/3+ in 39% and 18% of the total number of biopsy cases, respectively. Conclusions. High risk male patients with unsatisfactory Pap smears are at significant risk of epithelial cell abnormality and histopathologically verifiable anal intraepithelial lesions.
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Obtaining Natural Sit-to-Stand Motion with a Biomimetic Controller for Powered Knee Prostheses
Standing up from a seated position is a common activity in people's daily life. However, for transfemoral (i.e., above-knee) amputees fitted with traditional passive prostheses, the sit-to-stand (STS) transition is highly challenging, due to the inability of the prosthetic joints in generating torque and power output. In this paper, the authors present a new STS control approach for powered lower limb prostheses, which is able to regulate the power delivery of the prosthetic knee joint to obtain natural STS motion similar to that displayed by healthy subjects. Mimicking the dynamic behavior of the knee in the STS, a unified control structure provides the desired control actions by combining an impedance function with a time-based ramp-up function. The former provides the gradual energy release behavior desired in the rising phase, while the latter provides the gradual energy injection behavior desired in the loading phase. This simple and intuitive control structure automates the transition between the two phases, eliminating the need for explicit phase transition and facilitating the implementation in powered prostheses. Human testing results demonstrated that this new control approach is able to generate a natural standing-up motion, which is well coordinated with the user's healthy-side motion in the STS process.
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Adherence to Integrated Management of Childhood Illnesses Guideline in Treating South Sudanese Children with Cough or Difficulty in Breathing
Background. Pneumonia substantially kills children aged 2–59 months in South Sudan. However, information on health workers adherence to Integrated Management of Childhood Illnesses (IMCI) guideline in treating children with cough/difficulty in breathing remains scarce. This study assessed factors associated with adherence to IMCI guideline in Aweil East County, South Sudan. Methods. This cross-sectional study involved 232 health workers from 36 health facilities. Data collected using structured questionnaire and checklist was double-entered in EpiData and analyzed with STATA at 5% significance level using logistic regression. Results. Respondents mean age was years, 154 (66.4%) were males, 104 (44.8%) reached secondary education, and 190 (81.9%) had certificate. 23 (9.9%, 95% CI: 6.4–14.5) adhered to IMCI guideline. Holding diploma (adjusted odds ratio (AOR) = 6.97; 95% Confidence Interval (CI): 1.82–26.67; ), shorter time to follow guideline steps (AOR = 12.0; 95% CI: 2.73–61.66; ), and nondifficult use (AOR = 27.7; 95% CI: 5.40–142.25; ) were associated with adherence. Conclusion. Adherence was low. Academic qualifications, guideline complexity, and availability of IMCI drugs were associated factors.
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Association between Nicotinamide N-Methyltransferase Gene Polymorphisms and Obesity in Chinese Han Male College Students
Some reports have shown that nicotinamide N-methyltransferase (NNMT) is associated with the body mass index (BMI) and energy metabolism. Here we explored the association between NNMT gene polymorphisms and obesity. The subjects were recruited from male Chinese Han college student. 289 of them (19 ≤ body fat percentage (BF%)) were selected as the high body fat group (HBFG), 494 of them (3 ≤ BF%
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Energy recovery from wastewater treatment plants through sludge anaerobic digestion: effect of low-organic-content sludge
Abstract
During anaerobic digestion, low-organic-content sludge sometimes is used as feedstock, resulting in deteriorated digestion performance. The operational experience of conventional anaerobic digestion cannot be applied to this situation. To investigate the feature of low-organic-content sludge digestion and explain its intrinsic mechanism, batch experiments were conducted using designed feedstock having volatile solids (VS) contents that were 30–64% of total solids (TS). The results showed that the accumulative biogas yield declined proportionally from 173.7 to 64.8 ml/g VS added and organic removal rate decreased from 34.8 to 11.8% with decreasing VS/TS in the substrate. The oligotrophic environment resulting from low-organic-content substrates led to decreased microbial activity and a switch from butyric fermentation to propionic fermentation. A first-order model described the biogas production from the batch experiments very well, and the degradation coefficient decreased from 0.159 to 0.069 day−1, exhibiting a positive relation with organic content in substrate. The results observed here corroborated with data from published literature on anaerobic digestion of low-organic-content sludge and showed that it may not be feasible to recover energy from sludge with an organic content lower than 50% through mono digestion.
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Released fraction of polychlorinated biphenyls from soil–biosolid system using a leaching procedure and its comparison with bioavailable fraction determined by wheat plant uptake
Abstract
The bioavailability of polychlorinated biphenyls (PCBs) in soils amended with biosolids was estimated using an aqueous leaching process of the compounds combined with rotating disk sorptive extraction (RDSE), and compared with bioavailability determined through of PCB absorption in wheat plants growing in the same soil–biosolid matrix. The matrices consisted of soil amended with biosolids at doses of 30, 90, and 200 Mg/ha, which increase concomitantly the organic matter content of the matrix. Considering that PCBs were natively absent in both the biosolids and soil used, the compounds were spiked in the biosolids and aged for 10 days. For each biosolid dose, the aqueous leaching profile was studied and equilibrium time was calculated to be 33 h. The leaching fractions determined by RDSE, considering total PCBs studied, were 12, 7, and 6% and the bioavailable fractions absorbed by the wheat root were found to be 0.5, 0.3, and 0.2% for 30, 90, and 200 Mg/ha doses, respectively. Both fractions leachable and bioavailable decrease with both increasing hydrophobicity of the compound (Kow) and increasing in the biosolid dose. It was found that both fractions (leaching and bioavailable) correlated according to the bivariate least squares regression, represented by a coefficient of correlation of 0.86. Therefore, the application of the chemical method involving a leaching procedure is an alternative to estimate the bioavailable fraction of PCBs in wheat plants in a simpler and in a shorter time.
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Effect of lower and higher alcohol fuel synergies in biofuel blends and exhaust treatment system on emissions from CI engine
Abstract
The present study deals with performance, emission and combustion studies in a single cylinder CI engine with lower and higher alcohol fuel synergies with biofuel blends and exhaust treatment system. Karanja oil methyl ester (KOME), widely available biofuel in India, and orange oil (ORG), a low carbon biofuel, were taken for this study, and equal volume blend was prepared for testing. Methanol (M) and n-pentanol (P) was taken as lower and higher alcohol and blended 20% by volume with KOME-ORG blend. Activated carbon-based exhaust treatment indigenous system was designed and tested with KOME-ORG + M20 and KOME-ORG + P20 blend. The tests were carried out at various load conditions at a constant speed of 1500 rpm. The study revealed that considering performance, emission and combustion studies, KOME-ORG + M20 + activated carbon are found optimum in reducing NO, smoke and CO2 emission. Compared to KOME, for KOME-ORG + M20 + activated carbon, NO emission is reduced from 10.25 to 7.85 g/kWh, the smoke emission is reduced from 49.4 to 28.9%, and CO2 emission is reduced from 1098.84 to 580.68 g/kWh. However, with exhaust treatment system, an increase in HC and CO emissions and reduced thermal efficiency is observed due to backpressure effects.
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Oxidative Stress in Atherosclerosis
Abstract
Purpose of Review
Atherosclerosis is now considered a chronic inflammatory disease. Oxidative stress induced by generation of excess reactive oxygen species has emerged as a critical, final common mechanism in atherosclerosis. Reactive oxygen species (ROS) are a group of small reactive molecules that play critical roles in the regulation of various cell functions and biological processes. Although essential for vascular homeostasis, uncontrolled production of ROS is implicated in vascular injury. Endogenous anti-oxidants function as checkpoints to avoid these untoward consequences of ROS, and an imbalance in the oxidant/anti-oxidant mechanisms leads to a state of oxidative stress. In this review, we discuss the role of ROS and anti-oxidant mechanisms in the development and progression of atherosclerosis, the role of oxidized low-density lipoprotein cholesterol, and highlight potential anti-oxidant therapeutic strategies relevant to atherosclerosis.
Recent Findings
There is growing evidence on how traditional risk factors translate into oxidative stress and contribute to atherosclerosis. Clinical trials evaluating anti-oxidant supplements had failed to improve atherosclerosis. Current studies focus on newer ROS scavengers that specifically target mitochondrial ROS, newer nanotechnology-based drug delivery systems, gene therapies, and anti-miRNAs. Synthetic LOX-1 modulators that inhibit the effects of Ox-LDL are currently in development.
Summary
Research over the past few decades has led to identification of multiple ROS generating systems that could potentially be modulated in atherosclerosis. Therapeutic approaches currently being used for atheroslcerotic vascular disease such as aspirin, statins, and renin-angiotensin system inhibitors exert a pleiotropic antioxidative effects. There is ongoing research to identify novel therapeutic modalities to selectively target oxidative stress in atherosclerosis.
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Cannabis-Associated Asthma and Allergies
Abstract
Inhalation of cannabis smoke is its most common use and the pulmonary complications of its use may be the single most common form of drug-induced pulmonary disease worldwide. However, the role of cannabis consumption in asthma patients and allergic clinical situations still remains controversial. To review the evidence of asthma and allergic diseases associated with the use of marijuana, we conducted a search of English, Spanish, and Portuguese medical using the search terms asthma, allergy, marijuana, marihuana, and cannabis. Entries made between January 1970 and March 2017 were retrieved. Several papers have shown the relationship between marijuana use and increase in asthma and other allergic diseases symptoms, as well as the increased frequency of medical visits. This narrative review emphasizes the importance to consider cannabis as a precipitating factor for acute asthma and allergic attacks in clinical practice. Although smoking of marijuana may cause respiratory symptoms, there is a need for more studies to elucidate many aspects in allergic asthma patients, especially considering the long-term use of the drug. These patients should avoid using marijuana and be oriented about individual health risks, possible dangers of second-hand smoke exposure, underage use, safe storage, and the over smoking of marijuana.
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Non-Muscular Structures Can Limit the Maximal Joint Range of Motion during Stretching
Abstract
Stretching is widely used in sport training and clinical practice with the aim of increasing muscle-tendon extensibility and joint range of motion. The underlying assumption is that extensibility increases as a result of increased passive tension applied to muscle-tendon units. In some stretching protocols, this condition is not always met sufficiently to trigger adaptation within the muscle-tendon unit. For example, there is experimental evidence that both acute and chronic stretching interventions may increase the maximal range of motion in the absence of changes in the passive torque-angle curve. We contend that these results are partly explained by the influence of non-muscular structures that contribute only marginally to the passive torque. The potential candidates are the nervous system and fasciae, which would play an important role in the perception of the stretch and in the limitation of the range of motion of the maximal joints. At least in part, this may explain the lack of a significant effect of some chronic stretching interventions to change passive muscle tension.
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Management of Nasal Fractures in Sports
Abstract
Nasal fractures represent approximately 60% of all maxillofacial injuries that occur in athletic activities; however, there are no current guidelines regarding immediate sideline management of these injuries. Therefore, the purpose of this article was to (1) summarize the anatomy, etiology, and incidence of nasal fractures, and (2) evaluate the current body of literature regarding immediate on-field and subsequent outpatient management. It is imperative to establish that the athlete's airway is not compromised and there are no other severe concomitant injuries, such as a concussion, ocular injury, or leakage of cerebrospinal fluid. Immediate closed reduction should not be attempted unless there is airway compromise or the practitioner has experience in performing it. The majority of athletes with these injuries in isolation may return to play; however, in our practice, we recommend they wear a face mask for 6 weeks after their injury. Despite our recommendations, we know there is a paucity of clinical studies on immediate sideline and longer-term management. Future studies should focus on establishing therapeutic algorithms that will allow physicians to make treatment recommendations to patients with strong evidence to support their decision.
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Effects of Altitude/Hypoxia on Single- and Multiple-Sprint Performance: A Comprehensive Review
Abstract
Many sport competitions, typically involving the completion of single- (e.g. track-and-field or track cycling events) and multiple-sprint exercises (e.g. team and racquet sports, cycling races), are staged at terrestrial altitudes ranging from 1000 to 2500 m. Our aim was to comprehensively review the current knowledge on the responses to either acute or chronic altitude exposure relevant to single and multiple sprints. Performance of a single sprint is generally not negatively affected by acute exposure to simulated altitude (i.e. normobaric hypoxia) because an enhanced anaerobic energy release compensates for the reduced aerobic adenosine triphosphate production. Conversely, the reduction in air density in terrestrial altitude (i.e. hypobaric hypoxia) leads to an improved sprinting performance when aerodynamic drag is a limiting factor. With the repetition of maximal efforts, however, repeated-sprint ability is more altered (i.e. with earlier and larger performance decrements) at high altitudes (>3000–3600 m or inspired fraction of oxygen <14.4–13.3%) compared with either normoxia or low-to-moderate altitudes (<3000 m or inspired fraction of oxygen >14.4%). Traditionally, altitude training camps involve chronic exposure to low-to-moderate terrestrial altitudes (<3000 m or inspired fraction of oxygen >14.4%) for inducing haematological adaptations. However, beneficial effects on sprint performance after such altitude interventions are still debated. Recently, innovative 'live low-train high' methods, in isolation or in combination with hypoxic residence, have emerged with the belief that up-regulated non-haematological peripheral adaptations may further improve performance of multiple sprints compared with similar normoxic interventions.
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The Reproducibility of Blood Acid Base Responses in Male Collegiate Athletes Following Individualised Doses of Sodium Bicarbonate: A Randomised Controlled Crossover Study
Abstract
Background
Current evidence suggests sodium bicarbonate (NaHCO3) should be ingested based upon the individualised alkalotic peak of either blood pH or bicarbonate (HCO3−) because of large inter-individual variations (10–180 min). If such a strategy is to be practical, the blood analyte response needs to be reproducible.
Objective
This study aimed to evaluate the degree of reproducibility of both time to peak (TTP) and absolute change in blood pH, HCO3− and sodium (Na+) following acute NaHCO3 ingestion.
Methods
Male participants (n = 15) with backgrounds in rugby, football or sprinting completed six randomised treatments entailing ingestion of two doses of 0.2 g·kg−1 body mass (BM) NaHCO3 (SBC2a and b), two doses of 0.3 g·kg−1 BM NaHCO3 (SBC3a and b) or two control treatments (CON1a and b) on separate days. Blood analysis included pH, HCO3− and Na+ prior to and at regular time points following NaHCO3 ingestion over a 3-h period.
Results
HCO3− displayed greater reproducibility than pH in intraclass correlation coefficient (ICC) analysis for both TTP (HCO3− SBC2 r = 0.77, P = 0.003; SBC3 r = 0.94, P < 0.001; pH SBC2 r = 0.62, P = 0.044; SBC3 r = 0.71, P = 0.016) and absolute change (HCO3− SBC2 r = 0.89, P < 0.001; SBC3 r = 0.76, P = 0.008; pH SBC2 r = 0.84, P = 0.001; SBC3 r = 0.62, P = 0.041).
Conclusion
Our results indicate that both TTP and absolute change in HCO3− is more reliable than pH. As such, these data provide support for an individualised NaHCO3 ingestion strategy to consistently elicit peak alkalosis before exercise. Future work should utilise an individualised NaHCO3 ingestion strategy based on HCO3− responses and evaluate effects on exercise performance.
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Evidence-Based Prerequisites and Precursors of Athletic Talent: A Review
Abstract
Extensive findings related to nature and nurture in determining athletic talent (AT) have been reviewed. Available data demonstrate the important contribution of hereditary factors as well as the crucial importance of environmental prerequisites for identifying and developing AT. Recent publications provide examples of contemporary approaches intended to solve the problem of how to discover and nurture AT. A number of cross-sectional and longitudinal studies highlighted possibilities of revealing a predisposition to certain sports among youthful prospects, but were unable to predict attainment of world-class status. Data pertaining to Olympic champions indicate that their superiority compared with other elite athletes is determined by high intrinsic motivation, determination, dedication, persistence, and creativity. These salient manifestations of personality could be successfully recognized even in the initial stages of their preparation, where exceptionally gifted individuals manifested high learnability and a high rate of athletic improvement. Moreover, future champions were characterized by an exceptional attitude to training and a willingness to perform more voluminous and high-quality training routines. Exceptionally talented athletes in endurance, power, and combat sports attained world-class status after 4–7 years of specialized preparation, accumulating 3000–7000 h of purposeful training. This stands in contradiction to Ericsson's theory of deliberate practice and the 10-year rule. In contrast, Olympic artistic gymnastics champions attained world-class status following an average of 9.7 years of specialized preparation, accumulating an average of 8918 h of specialized training. Apparently, the theory of 10,000 h of deliberate practice and the 10-year rule are selectively applicable to highly coordinative esthetic sports but not to general preparation trends in endurance, power, and combat sports.
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Sudden Arrhythmic Death During Exercise: A Post-Mortem Genetic Analysis
Abstract
Background
Sudden cardiac death is a natural and unexpected death that occurs within 1 h of the first symptom. Most sudden cardiac deaths occur during exercise, mostly as a result of myocardial infarction. After autopsy, some cases, especially in the young, are diagnosed as cardiomyopathies or remain without a conclusive cause of death. In both situations, genetic alterations may explain the arrhythmia.
Objective
Our aim was to identify a genetic predisposition to sudden cardiac death in a cohort of post-mortem cases of individuals who died during exercise, with a structurally normal heart, and were classified as arrhythmogenic death.
Methods
We analyzed a cohort of 52 post-mortem samples from individuals <50 years old who had a negative autopsy. Next-generation sequencing technology was used to screen genes associated with sudden cardiac death.
Results
Our cohort showed a male prevalence (12:1). Half of the deaths occurred in individuals 41–50 years of age. Running was the most common exercise activity during the fatal event, accounting for 46.15% of cases. Genetic analysis identified 83 rare variants in 37 samples (71.15% of all samples). Of all rare variants, 36.14% were classified as deleterious, being present in 53.84% of all cases.
Conclusions
A comprehensive analysis of sudden cardiac death-related genes in individuals who died suddenly while exercising enabled the identification of potentially causative variants. However, many genetic variants remain of indeterminate significance, thus further work is needed before clinical translation. Nonetheless, comprehensive genetic analysis of individuals who died during exercise enables the detection of potentially causative variants and helps to identify at-risk relatives.
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Prima consensus conference italiana sulle neoplasie timiche
18 settembre 2017
Aula Magna G.Bonadonna
Istituto Nazionale dei Tumori
Via Venezian1, 20133 - Milano
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Sacrificial virgin spiders let their nieces eat them alive
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Tonsillectomy-Comparative Study of Various Techniques and Changing Trend
Abstract
Tonsillectomy is a major surgical procedure in terms of volume in the general otolaryngological practice. It is a 3000-year-old surgical operation, referred in Hindu medicine. There has been a conceptual change in the indications and surgical technique in the last 40 years. A comparative study between the various methods of tonsillectomy was done. The study was carried out in the single institutional set up by the same surgeon but using different techniques. The study aimed at comparing the intra-operative factors (blood loss, time taken for surgery), postoperative results (pain, bleeding, dehydration, time taken for complete healing), and other complications like vomiting and hospitalization time between different groups of surgical methods. This study was done in 2500 patients undergoing tonsillectomy with or without adenoid removal in a period of 35 years (1979–2013). The majority of the patients (approximately 41%) in the first half of this period underwent cold steel tonsillectomy whereas 39% underwent microdebrider assisted tonsillectomy. Microdebrider assisted tonsil surgery was done as day care procedure in 90%. In 21% of the patients, other methods viz coblation, radio frequency and laser were used. Microdebrider intracapsular tonsillectomy is associated with lower mortality and morbidity as compared to cold steel, coblation, electrodissection, laser and radio frequency.
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Sacrificial virgin spiders let their nieces eat them alive
In one species of spider, unmated females not only care for other spiders' offspring, they allow the tiny spiderlings to devour their insides
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The NHS is using a chatbot to do tedious corporate team-building
The UK's National Health Service and 10 big firms are experimenting with CoachBot, which replaces "coaching and development" staff with an automated chatbot
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Issue Information
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Issue Information
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On the Degrees of Freedom of Mixed Matrix Regression
With the increasing prominence of big data in modern science, data of interest are more complex and stochastic. To deal with the complex matrix and vector data, this paper focuses on the mixed matrix regression model. We mainly establish the degrees of freedom of the underlying stochastic model, which is one of the important topics to construct adaptive selection criteria for efficiently selecting the optimal model fit. Under some mild conditions, we prove that the degrees of freedom of mixed matrix regression model are the sum of the degrees of freedom of Lasso and regularized matrix regression. Moreover, we establish the degrees of freedom of nuclear-norm regularization multivariate regression. Furthermore, we prove that the estimates of the degrees of freedom of the underlying models process the consistent property.
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Analysis of Drag Reduction Methods and Mechanisms of Turbulent
Turbulent flow is a difficult issue in fluid dynamics, the rules of which have not been totally revealed up to now. Fluid in turbulent state will result in a greater frictional force, which must consume great energy. Therefore, it is not only an important influence in saving energy and improving energy utilization rate but also an extensive application prospect in many fields, such as ship domain and aerospace. Firstly, bionic drag reduction technology is reviewed and is a hot research issue now, the drag reduction mechanism of body surface structure is analyzed, such as sharks, earthworms, and dolphins. Besides, we make a thorough study of drag reduction characteristics and mechanisms of microgrooved surface and compliant wall. Then, the relevant drag reduction technologies and mechanisms are discussed, focusing on the microbubbles, the vibrant flexible wall, the coating, the polymer drag reduction additives, superhydrophobic surface, jet surface, traveling wave surface drag reduction, and the composite drag reduction methods. Finally, applications and advancements of the drag reduction technology in turbulence are prospected.
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Ileostomy Prolapse in Children with Intestinal Dysmotility
Background. A relationship between intestinal motility and ileostomy prolapse has been suggested but not demonstrated objectively. Aims. This study evaluated the association between ileostomy prolapse and intestinal dysmotility in children. Methods. IRB-approved retrospective review of 163 patients with ileostomies (1998–2014) at a single institution. Patients were categorized as having clinical dysmotility as a primary diagnosis (), clinically suspected dysmotility based on underlying diagnosis (), or intestinal dysmotility unlikely () at the time of ileostomy present. Intestinal manometry was categorized as normal () or abnormal (). Primary outcome was pathologic stoma prolapse. Multivariate analysis using a logistic regression model and log-rank test to compare stoma prolapse rates over time between motility groups were used. Results. Clinical diagnosis of dysmotility () and manometric findings of dysmotility () were independently associated with stoma prolapse. Clinical dysmotility correlated with manometric findings (). Prolapse occurred in 42% of patients with dysmotility, 34% of patients with suspected dysmotility, and 24% of patients with normal motility. One-year prolapse-free stoma "survival" was 45% for dysmotility, 72% for suspected dysmotility, and 85% for intestinal dysmotility unlikely groups (). Conclusions. Children with intestinal dysmotility are at great risk for stoma prolapse. Intestinal manometry could help identify these patients preoperatively.
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Efficient and Fast Differentiation of Human Neural Stem Cells from Human Embryonic Stem Cells for Cell Therapy
Stem cell-based therapies have been used for repairing damaged brain tissue and helping functional recovery after brain injury. Aberrance neurogenesis is related with brain injury, and multipotential neural stem cells from human embryonic stem (hES) cells provide a great promise for cell replacement therapies. Optimized protocols for neural differentiation are necessary to produce functional human neural stem cells (hNSCs) for cell therapy. However, the qualified procedure is scarce and detailed features of hNSCs originated from hES cells are still unclear. In this study, we developed a method to obtain hNSCs from hES cells, by which we could harvest abundant hNSCs in a relatively short time. Then, we examined the expression of pluripotent and multipotent marker genes through immunostaining and confirmed differentiation potential of the differentiated hNSCs. Furthermore, we analyzed the mitotic activity of these hNSCs. In this report, we provided comprehensive features of hNSCs and delivered the knowledge about how to obtain more high-quality hNSCs from hES cells which may help to accelerate the NSC-based therapies in brain injury treatment.
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The Research on Information Representation of Φ-OTDR Distributed Vibration Signals
This paper mainly focuses on the representable problem of -OTDR distributed vibration signals. The research included a signal extraction part and a signal representation part. Firstly, in order to extract the better -OTDR signal, the time-domain data should be fully preserved. The 2D-TESP method is used to extract data in this paper. There are 29 characters in the traditional TESP method. The characters' number is reduced from 29 to 13 and the characters' dimension is expanded from 1 to 2 in the 2D-TESP method. Secondly, in order to represent -OTDR signal better, the characteristics of -OTDR data and damped vibration signals are combined in the paper. The EMD method and the NMF method are combined to form the new method in the paper. Some parameters in the proposed method are optimized and adjusted by GA method. After -OTDR data is represented by the proposed method, there is excellent performance both on the length dimension and on the time dimension. Lastly, some experiments are carried out according to the physical truth in this paper. The experiments are carried out in the semianechoic room. The methods of the paper have better performance. The methods are proved to be effective through these experiments.
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Neural Networks Approximator Based Robust Adaptive Controller Design of Hypersonic Flight Vehicles Systems Coupled with Stochastic Disturbance and Dynamic Uncertainties
A neural network robust control is proposed for a class of generic hypersonic flight vehicles with uncertain dynamics and stochastic disturbance. Compared with the present schemes of dealing with dynamic uncertainties and stochastic disturbance, the outstanding feature of the proposed scheme is that only one parameter needs to be estimated at each design step, so that the computational burden can be greatly reduced and the designed controller is much simpler. Moreover, by introducing a performance function in controller design, the prespecified transient and performance of tracking error can be guaranteed. It is proved that all signals of closed-loop system are uniformly ultimately bounded. The simulation results are carried out to illustrate effectiveness of the proposed control algorithm.
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Knowledge and Attitude towards Exclusive Breast Feeding among Mothers Attending Antenatal and Immunization Clinic at Dabat Health Center, Northwest Ethiopia: A Cross-Sectional Institution Based Study
Introduction. To assess knowledge and attitude towards exclusive breast feeding among mothers attending antenatal care and immunization clinic in Dabat Health Center, Northwest Ethiopia, 2016. Methodology. Institutional based descriptive cross-sectional study was conducted. The data was collected by using pretested, structured interview based questionnaires. The data were entered and analyzed using SPSS version 20. Result. A total of 384 participants were included in the study with a response rate of 100%. The majority were in the age groups of 20–30 (66.9%) and the mean age was 27.65; 325 (84.6%) were Orthodox Christianity followers. Majority were of Amhara ethnicity 370 (96.4%). Based on knowledge score, 268 (69.8%) were grouped as having good knowledge and regarding attitudinal score, 92 (24%) of the study participants were categorized as having negative attitude towards exclusive breast feeding (EBF) and the remaining 292 (76%) were categorized as having positive attitude. Conclusion. In this study, the knowledge of study participant mothers towards EBF is low which is less than three-fourths; however positive attitude towards EBF is more than three-fourths in this study. The authors recommend that health care workers who work in the areas of maternal and child health clinic should give appropriate information about EBF.
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Tonsillectomy-Comparative Study of Various Techniques and Changing Trend
Abstract
Tonsillectomy is a major surgical procedure in terms of volume in the general otolaryngological practice. It is a 3000-year-old surgical operation, referred in Hindu medicine. There has been a conceptual change in the indications and surgical technique in the last 40 years. A comparative study between the various methods of tonsillectomy was done. The study was carried out in the single institutional set up by the same surgeon but using different techniques. The study aimed at comparing the intra-operative factors (blood loss, time taken for surgery), postoperative results (pain, bleeding, dehydration, time taken for complete healing), and other complications like vomiting and hospitalization time between different groups of surgical methods. This study was done in 2500 patients undergoing tonsillectomy with or without adenoid removal in a period of 35 years (1979–2013). The majority of the patients (approximately 41%) in the first half of this period underwent cold steel tonsillectomy whereas 39% underwent microdebrider assisted tonsillectomy. Microdebrider assisted tonsil surgery was done as day care procedure in 90%. In 21% of the patients, other methods viz coblation, radio frequency and laser were used. Microdebrider intracapsular tonsillectomy is associated with lower mortality and morbidity as compared to cold steel, coblation, electrodissection, laser and radio frequency.
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Effectiveness of a New Lead-Shielding Device and Additional Filter for Reducing Staff and Patient Radiation Exposure During Videofluoroscopic Swallowing Study Using a Human Phantom
Abstract
Interventional radiology procedures often involve lengthy exposure to fluoroscopy-derived radiation. We therefore devised a videofluoroscopic swallowing study (VFSS) procedure using a human phantom that proved to protect the patient and physician by reducing the radiation dose. We evaluated a new lead-shielding device and separately attached additional filters (1.0-, 2.0-, and 3.0-mm Al filters and a 0.5-mm Cu filter) during VFSS to reduce the patient's entrance skin dose (ESD). A monitor attached to the human phantom's neck measured the ESD. We also developed another lead shield (VFSS Shielding Box, 1.0-mm Pb equivalent) and tested its efficacy using the human phantom and an ionization chamber radiation survey meter with and without protection from scattered radiation at the physician's position on the phantom. We then measured the scattered radiation (at 90 and 150 cm above the floor) after combining the filters with the VFSS Shielding Box. With the additional filters, the ESD was reduced by 15.4–55.1%. With the VFSS Shielding Box alone, the scattered radiation was reduced by about 10% compared with the dose without additional shielding. With the VFSS Shielding Box and filters combined, the scattered radiation dose was reduced by a maximum of about 44% at the physician's position. Thus, the additional lead-shielding device effectively provided protection from scattered radiation during fluoroscopy. These results indicate that the combined VFSS Shielding Box and filters can effectively reduce the physician's and patient's radiation doses.
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Tonsillectomy-Comparative Study of Various Techniques and Changing Trend
Abstract
Tonsillectomy is a major surgical procedure in terms of volume in the general otolaryngological practice. It is a 3000-year-old surgical operation, referred in Hindu medicine. There has been a conceptual change in the indications and surgical technique in the last 40 years. A comparative study between the various methods of tonsillectomy was done. The study was carried out in the single institutional set up by the same surgeon but using different techniques. The study aimed at comparing the intra-operative factors (blood loss, time taken for surgery), postoperative results (pain, bleeding, dehydration, time taken for complete healing), and other complications like vomiting and hospitalization time between different groups of surgical methods. This study was done in 2500 patients undergoing tonsillectomy with or without adenoid removal in a period of 35 years (1979–2013). The majority of the patients (approximately 41%) in the first half of this period underwent cold steel tonsillectomy whereas 39% underwent microdebrider assisted tonsillectomy. Microdebrider assisted tonsil surgery was done as day care procedure in 90%. In 21% of the patients, other methods viz coblation, radio frequency and laser were used. Microdebrider intracapsular tonsillectomy is associated with lower mortality and morbidity as compared to cold steel, coblation, electrodissection, laser and radio frequency.
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Improving transitions of care: a resident-driven approach to address delays in patient care during the direct admission process
Background
The direct admission process is a complex system that can be aggravated by inherent gaps in communication leading to inefficient continuity of care and patient safety issues. Bypassing the emergency room, triage is often associated with long periods of unmonitored observation and significant delays in patient assessment. We identified significant communication gaps, delays in placement of admission orders and patient assessment during the direct admission process at our institution. To address this issue, we created and implemented a standardised direct admission flow diagram that consists of a step-by- step direct admission process, which includes a communication device and a triage power plan in the Electronic Medical Record.
MethodsWe used the Plan-Do-Study-Act (PDSA) model for Quality improvement to address communication gaps in the direct admission process Baseline measurement confirmed two critical gaps in communication: 1) communication to the Medical Admitting Resident (MAR), the central source of communication of all medicine admissions, and 2) delays in placement of orders and assessment of the patient.
ResultsTwo months after implementation of a standardised process that addressed the two major gaps in communication, we found that communication to the MAR increased from 16% (7/42) to 100% (15/15). Additionally, the average time for order placement and assessment of patient decreased from 153 minutes to 53 minutes (n=15).
ConclusionIn order to improve the safety of direct admissions, the entire process must be carefully analysed and potential delays in patient assessment should be minimised. A standardised flow diagram that identified and targeted specific communication gaps can minimise delays in patient care.
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The game of telephone: a sustained, low-cost, quality improvement initiative to enhance communication between patients and their resident physician
This multidisciplinary quality improvement project was designed to enhance telephone communication between patients and their resident physician while concomitantly creating a standardised telephone communication protocol for resident internal medicine continuity clinics. The plan, do, study, act (PDSA) quality improvement framework model was applied for four distinct cycles. Baseline data were collected regarding open telephone encounters. The initial intervention entailed targeted communication to specific individual residents with open telephone encounters more than one SD above the average. The next cycle involved developing a novel communication process map that was distributed to faculty preceptors and clinic anchor nurses. The faculty preceptors then disseminated the new policies and communication algorithm to resident physicians. Finally, new resident and anchor nurses were educated about the standardised processes through scheduled orientation activities. After 19 months of implementation of this project with four PDSA cycles, resident open telephone encounters decreased by 40.7%. Resident telephone communication in continuity clinics can be improved through targeted individualised communication, implementation of a standardised telephone communication protocol, dissemination of communication algorithms to clinic faculty, residents and nurses and ongoing education to all parties through orientation activities to instil a self-sustaining culture change.
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Trypanosoma evansi infection in a cat—a rare case
Abstract
A seventeen-month-old tom cat was presented to the hospital with the history of pyrexia, unable to stand with forelimbs and abnormal mentation. Trypanosoma evansi organisms were detected in the stained peripheral blood smears collected from the cat. The cat had anemia, hypoglycemia and hypoalbuminemia. The cat was successfully treated with injection diminazene aceturate along with other supportive medication and uneventfully recovery was noticed by the sixth day in his activities.
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The NHS is using a chatbot to do tedious corporate team-building
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Prostate cancer clinical presentation, incidence, mortality and survival in Guadeloupe over the period 2008–2013 from a population-based cancer registry
Abstract
Purpose
The Caribbean population of Guadeloupe has one of the highest incidence rates of prostate cancer worldwide. In 2008, a population-based cancer registry was set up for the monitoring of cancer incidence in the aftermath of the environmental pollution with chlordecone, a persistent organochlorine insecticide formerly used in banana plantations. We describe the clinical presentation, incidence, mortality and survival of prostate cancer for the period 2008–2013.
Methods
The Guadeloupe cancer registry has been routinely collecting all incident cases of cancer since 2008. We compared age-specific incidence rates between different populations, and calculated incidence and mortality rates standardized to the world population. Kaplan–Meier observed survival and estimated age-standardized net survival were calculated by category for age, PSA level, and Gleason score using the Pohar-Perme method.
Results
Overall, 3,295 cases of prostate cancer were recorded. World-standardized incidence and mortality were respectively 184.1 [177.8–190.4] and 23.9 [21.9–25.7] per 100,000 person-years. At diagnosis, the mean age of patients was 68 ± 9.6 years old and 22% were aged over 75. Median PSA level was 8.9 [IQR: 6.0–16.0] and 13.6% of the patients had a Gleason ≥ 8. Five-year observed and net survivals were, respectively, 79.6% [77.9–81.2] and 90.7% [88.6–92.8].
Conclusion
The incidence of prostate cancer in Guadeloupe is among the highest in the world, along with those of the neighboring Caribbean countries and US African-Americans. We observed no decrease in incidence rates, and a decreasing but non-significant trend in mortality rates, which nonetheless remain higher than in high-income countries. Many Genome-Wide Association Studies are conducted to identify genetic markers involved in prostate cancer risk. In the Caribbean, complementary studies on both lifestyle and behavioral factors should highlight potential common risks among populations who share both genetic and environmental characteristics.
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French study heralds change in lung cancer follow-up
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Knowledge about Tuberculosis: A Precursor to Effective TB Control—Findings from a Follow-Up National KAP Study on Tuberculosis among Nigerians
Tuberculosis (TB) constitutes a significant and major public health emergency globally. Nigeria is one of the 22 high burden Tuberculosis countries. A high level of community awareness and positive perception towards TB and its management is crucial for the success of any control strategy. A national baseline survey was conducted in 2008 and a follow-up study in 2012 to measure knowledge of TB among the general population. This study therefore evaluated the knowledge of the target population about Tuberculosis in the follow-up study. A cross-sectional study design was employed with a total of 3,021 respondents interviewed from six states selected randomly from each of the six geopolitical zones in the country. Quantitative and qualitative research methodologies were adopted. From the findings, about 60% of the respondents were aged between 21 and 40 years and more than half had secondary school education. Over 80% had ever heard about TB. Although there has been a significant improvement in correct knowledge of the cause of TB from baseline (19%) in 2008 to 26.5% in 2012 (), findings showed that prioritized interventions are needed to improve communication and information dissemination on Tuberculosis to the general public, to aid TB control and all prevention efforts.
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Development of a LC-MS/MS Method for the Simultaneous Detection of Tricarboxylic Acid Cycle Intermediates in a Range of Biological Matrices
It is now well-established that perturbations in the tricarboxylic acid (TCA) cycle play an important role in the metabolic transformation occurring in cancer including that of the prostate. A method for simultaneous qualitative and quantitative analysis of TCA cycle intermediates in body fluids, tissues, and cultured cell lines of human origin was developed using a common C18 reversed-phase column by LC-MS/MS technique. This LC-MS/MS method for profiling TCA cycle intermediates offers significant advantages including simple and fast preparation of a wide range of human biological samples. The analytical method was validated according to the guideline of the Royal Society of Chemistry Analytical Methods Committee. The limits of detection were below 60 nM for most of the TCA intermediates with the exception of lactic and fumaric acids. The calibration curves of all TCA analytes showed linearity with correlation coefficients . Recoveries were >95% for all TCA analytes. This method was established taking into consideration problems and limitations of existing techniques. We envisage that its application to different biological matrices will facilitate deeper understanding of the metabolic changes in the TCA cycle from in vitro, ex vivo, and in vivo studies.
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Systematic Standardized and Individualized Assessment of Masticatory Cycles Using Electromagnetic 3D Articulography and Computer Scripts
Masticatory movements are studied for decades in odontology; a better understanding of them could improve dental treatments. The aim of this study was to describe an innovative, accurate, and systematic method of analyzing masticatory cycles, generating comparable quantitative data. The masticatory cycles of 5 volunteers (Class I, 19 ± 1.7 years) without articular or dental occlusion problems were evaluated using 3D electromagnetic articulography supported by MATLAB software. The method allows the trajectory morphology of the set of chewing cycles to be analyzed from different views and angles. It was also possible to individualize the trajectory of each cycle providing accurate quantitative data, such as number of cycles, cycle areas in frontal view, and the ratio between each cycle area and the frontal mandibular border movement area. There was a moderate negative correlation (−0.61) between the area and the number of cycles: the greater the cycle area, the smaller the number of repetitions. Finally it was possible to evaluate the area of the cycles through time, which did not reveal a standardized behavior. The proposed method provided reproducible, intelligible, and accurate quantitative and graphical data, suggesting that it is promising and may be applied in different clinical situations and treatments.
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Assessment Method of Multipath Mitigation Performance for GNSS Antenna with Receiver Algorithms
Multipath is one of the most important sources of positioning error in GNSS. Well-designed antennas can mitigate multipath signals and enhance the performance of GNSS receivers. This paper concentrates on methods to assess multipath mitigation performance for GNSS antennas. We propose a model to describe multipath environment in GNSS ground stations. The model analyzes effects caused by inclined reflective surfaces and multipath mitigating algorithms in receivers. A method to assess multipath mitigation performance is put forward by analyzing pseudorange code phase errors caused by multipath signals after signal processing. Based on the model and method, principles in site selection for GNSS antenna are introduced to minimize effects caused by multipath.
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An Unsuspected Finding of t(9;22): A Rare Case of Philadelphia Chromosome-Positive B-Lymphoblastic Lymphoma
While rare, cases of isolated extramedullary disease of B-cell Lymphoblastic Lymphoma (B-LBL) without morphologic bone marrow involvement have been described. In this report, we illustrate the case of an elderly gentleman who presented with isolated testicular and vertebral LBL involvement but had no morphologic bone marrow involvement. The initial plan of treatment was to treat along the lines of Philadelphia negative B-ALL/LBL. During this time, fluorescence in situ hybridization (FISH) and PCR testing for BCR-ABL1 rearrangements were being performed on the marrow specimens as a part of routine diagnostic workup. While the FISH returned negative, PCR testing unexpectedly detected BCR-ABL1 fusion transcripts at a low level of 0.48%. Given their presence, we performed FISH for BCR/ABL1 rearrangement in both testicular and L5 vertebral specimens which were 80–90% positive. He subsequently received rituximab, hyper-CVAD, and dasatinib, along with prophylactic intrathecal prophylactic chemotherapy. The patient achieved a prolonged remission but eventually relapsed, 4 years later. Had it not been for this fortuitous discovery, the patient would not have been treated with tyrosine kinase inhibitors. We emphasize that FISH and PCR testing for BCR-ABL1 rearrangement are integral to arriving at an accurate diagnosis and should be routinely tested on B-LBL biopsy specimens.
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A Coordinate Descent Method for Total Variation Minimization
Total variation (TV) is a well-known image model with extensive applications in various images and vision tasks, for example, denoising, deblurring, superresolution, inpainting, and compressed sensing. In this paper, we systematically study the coordinate descent (CoD) method for solving general total variation (TV) minimization problems. Based on multidirectional gradients representation, the proposed CoD method provides a unified solution for both anisotropic and isotropic TV-based denoising (CoDenoise). With sequential sweeping and small random perturbations, CoDenoise is efficient in denoising and empirically converges to optimal solution. Moreover, CoDenoise also delivers new perspective on understanding recursive weighted median filtering. By incorporating with the Augmented Lagrangian Method (ALM), CoD was further extended to TV-based image deblurring (ALMCD). The results on denoising and deblurring validate the efficiency and effectiveness of the CoD-based methods.
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Triplane Fracture of the Proximal Tibia: A Case Report and Literature Review
Background. The triplane fracture, a unique transitional physeal injury, is classically described in the distal tibia. A small number of additional anatomic locations are documented in the orthopaedic literature. Methods. Available literature surrounding triplane fractures was reviewed. We describe a rare case of a proximal tibial triplane fracture in a thirteen-year-old girl, suffered during a skiing accident. Results. Using arthroscopically assisted percutaneous reduction techniques an anatomic reduction was achieved. Conclusion. We outline the surgical and postoperative techniques for management of this unique injury.
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IJMS, Vol. 18, Pages 2001: The Impact of Non-Lethal Single-Dose Radiation on Tumor Invasion and Cytoskeletal Properties
IJMS, Vol. 18, Pages 2001: The Impact of Non-Lethal Single-Dose Radiation on Tumor Invasion and Cytoskeletal Properties
International Journal of Molecular Sciences doi: 10.3390/ijms18092001
Authors: Tim Hohmann Urszula Grabiec Carolin Vogel Chalid Ghadban Stephan Ensminger Matthias Bache Dirk Vordermark Faramarz Dehghani
Irradiation is the standard therapy for glioblastoma multiforme. Glioblastoma are highly resistant to radiotherapy and the underlying mechanisms remain unclear. To better understand the biological effects of irradiation on glioblastoma cells, we tested whether nonlethal irradiation influences the invasiveness, cell stiffness, and actin cytoskeleton properties. Two different glioblastoma cell lines were irradiated with 2 Gy and changes in mechanical and migratory properties and alterations in the actin structure were measured. The invasiveness of cell lines was determined using a co-culture model with organotypic hippocampal slice cultures. Irradiation led to changes in motility and a less invasive phenotype in both investigated cell lines that were associated with an increase in a "generalized stiffness" and changes in the actin structure. In this study we demonstrate that irradiation can induce changes in the actin cytoskeleton and motility, which probably results in reduced invasiveness of glioblastoma cell lines. Furthermore, "generalized stiffness" was shown to be a profound marker of the invasiveness of a tumor cell population in our model.
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Competition for electrons between pyridine and quinoline during their simultaneous biodegradation
Abstract
Biodegradation of pyridine and quinoline is initiated with mono-oxygenation reactions that require an intracellular electron donor. Simultaneous biodegradation of both substrates should set up competition for the intracellular electron donor that may inhibit one or more of the mono-oxygenation steps. An internal circulation baffled biofilm reactor (ICBBR) was used to evaluate the impacts of competition during pyridine and quinoline biodegradation. Compared with independent biodegradation, pyridine and quinoline removal rates were slowed when biodegraded simultaneously, although the pyridine removal rate decreased more than for quinoline. The first mono-oxygenation of quinoline (to 2-hydroxyquinoline) always was faster than the first mono-oxygenation of pyridine (to 2-hydroxypyridine), and the difference was accentuated with pyridine and quinoline which were biodegraded simultaneously due to the competition for intracellular electron donor. Competition also existed between the second mono-oxygenations, and the removal rate of 2-hydroxypyridine was faster than the rate for 2-hydroxyquinoline, even though the rate was faster for quinoline than pyridine. Adding an exogenous electron donor accelerated all mono-oxygenations in proportion to the amount of donor added, but the increments were greater for quinoline due to its higher affinity for intracellular electron donors than pyridine. When actual coking wastewater was used as the background matrix, removals of pyridine and quinoline exhibited the same competitive trends.
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Fine particle matters induce DNA damage and G2/M cell cycle arrest in human bronchial epithelial BEAS-2B cells
Abstract
There is compelling evidence that exposure to particulate matter (PM) is linked to lung tumorigenesis. However, there is not enough experimental evidence to support the specific mechanisms of PM2.5-induced DNA damage and cell cycle arrest in lung tumorigenesis. In this study, we investigated the toxic effects and molecular mechanisms of PM2.5 on bronchial epithelial (BEAS-2B) cells. PM2.5 exposure reduced cell viability and enhanced LDH activity. The cell growth curves of BEAS-2B cells decreased gradually with the increase in PM2.5 dosage. A significant increase in MDA content and a decrease in GSH-Px activity were observed. The generation of ROS was enhanced obviously, while apoptosis increased in BEAS-2B cells exposed to PM2.5 for 24 h. DNA damage was found to be more severe in the exposed groups compared with the control. For in-depth study, we have demonstrated that PM2.5 stimulated the activation of HER2/ErbB2 while significantly upregulating the expression of Ras/GADPH, p-BRAF/BRAF, p-MEK/MEK, p-ERK/ERK, and c-Myc/GADPH in a dose-dependent manner. In summary, we suggested that exposure to PM2.5 sustained the activation of HER2/ErbB2, which in turn promoted the activation of the Ras/Raf/MAPK pathway and the expression of the downstream target c-Myc. The overexpression of c-Myc may lead to G2/M arrest and aggravate the DNA damage and apoptosis in BEAS-2B after exposure to PM2.5.
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Hepatoblastoma in children aged less than six months at diagnosis: A report from the SIOPEL group
Abstract
Background
The purpose of this study was to evaluate clinical characteristics, treatment, and survival of children, who were diagnosed with hepatoblastoma (HB) in their first 6 months of age, enrolled in the SIOPEL 2 and 3 protocols.
Methods
Seventy-nine patients, treated between 1994 and 2006, were analyzed after stratification into three age groups: <1 month, between 1 and 3 months, and between 3 and 6 months. All received preoperative chemotherapy.
Results
Clinical characteristics were similar in both trials: 4 patients had pulmonary metastases at diagnosis, 4 had α-fetoprotein <100 ng/ml, 68 were operated by partial hepatectomy, and 7 received liver transplant. Chemotherapy courses were delayed in 8.5%, 8.4%, and 11.8% of cycles in the three groups. Doses were calculated according to weight for children <5 and 5–10 kg, and further reduced in 18.1%, 6.8%, and 5.9% of cycles. Acute toxicity was manageable. Long-term hearing loss was the major problem at follow-up occurring in two-thirds of children. Ten patients experienced progression or relapse, and 5 of 10 died. After a median follow-up of 5.6 years, the 5-year overall survival (OS) and event-free survival (EFS) were 91% (95% confidence interval [CI]: 84–96%) and 87% (95% CI: 78–92%), respectively.
Conclusions
The 5-year OS and EFS of children <6 months of age affected by HB seem to be similar to those documented in the elder children. Dose reduction does not seem to jeopardize the long-term outcome and may explain the lower toxicity profile. Ototoxicity though appears as high as in the whole population of SIOPEL 2 and 3. The treatment for these children should be further explored in international studies, particularly focusing on prevention of hearing loss.
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Κυριακή 17 Σεπτεμβρίου 2017
Altered Structure and Intrinsic Functional Connectivity in Post-stroke Aphasia
Abstract
Previous studies have demonstrated that alterations of gray matter exist in post-stroke aphasia (PSA) patients. However, so far, few studies combined structural alterations of gray matter volume (GMV) and intrinsic functional connectivity (iFC) imbalances of resting-state functional MRI to investigate the mechanism underlying PSA. The present study investigated specific regions with GMV abnormality in patients with PSA (n = 17) and age- and sex- matched healthy controls (HCs, n = 20) using voxel-based morphometry. In addition, we examined whether there is a link between abnormal gray matter and altered iFC. Furthermore, we explored the correlations between abnormal iFC and clinical scores in aphasic patients. We found significantly increased GMV in the right superior temporal gyrus, right inferior parietal lobule (IPL)/supramarginal gyrus (SMG), and left middle occipital gyrus. Decreased GMV was found in the right caudate gyrus, bilateral thalami in PSA patients. Patients showed increased remote interregional FC between the right IPL/SMG and right precuneus, right angular gyrus, right superior occipital gyrus; while reduced FC in the right caudate gyrus and supplementary motor area, dorsolateral superior frontal gyrus. Moreover, iFC strength between the left middle occipital gyrus and the left orbital middle frontal gyrus was positively correlated with the performance quotient. We suggest that GMV abnormality contributes to interregional FC in PSA. These results may provide useful information to understand the pathogenesis of post-stroke aphasia.
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Comparative evolutionary genomics of Corynebacterium with special reference to codon and amino acid usage diversities
Abstract
The present study has been aimed to the comparative analysis of high GC composition containing Corynebacterium genomes and their evolutionary study by exploring codon and amino acid usage patterns. Phylogenetic study by MLSA approach, indel analysis and BLAST matrix differentiated Corynebacterium species in pathogenic and non-pathogenic clusters. Correspondence analysis on synonymous codon usage reveals that, gene length, optimal codon frequencies and tRNA abundance affect the gene expression of Corynebacterium. Most of the optimal codons as well as translationally optimal codons are C ending i.e. RNY (R-purine, N-any nucleotide base, and Y-pyrimidine) and reveal translational selection pressure on codon bias of Corynebacterium. Amino acid usage is affected by hydrophobicity, aromaticity, protein energy cost, etc. Highly expressed genes followed the cost minimization hypothesis and are less diverged at their synonymous positions of codons. Functional analysis of core genes shows significant difference in pathogenic and non-pathogenic Corynebacterium. The study reveals close relationship between non-pathogenic and opportunistic pathogenic Corynebaterium as well as between molecular evolution and survival niches of the organism.
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Space-time mapping of ground-level PM 2.5 and NO 2 concentrations in heavily polluted northern China during winter using the Bayesian maximum entropy technique with satellite data
Abstract
The accurate and informative space-time mapping of air pollutants is a crucial component of many human exposure studies. In the present work, space-time maps of daily distributions of PM2.5 and NO2 concentrations were generated in the severely polluted northern China region using the Bayesian maximum entropy (BME) method. This method can incorporate hard PM2.5 and NO2 data (obtained at ground-level monitoring sites), and various kinds of soft (uncertain) data, including satellite data processed in terms of machine learning techniques, meteorological variables, and geographical predictors. The BME maps of space-time PM2.5 and NO2 concentrations over northern China generated during the winter season (when severe haze episodes occur frequently) were realistic and informative. As regards their numerical accuracy, for the space-time PM2.5 estimates, the tenfold cross-validation R 2 and the RMSE were, respectively, 0.86 and 14.37 μg/m3; for the space-time NO2 estimates, the R 2 and RMSE values were, respectively, 0.85 and 6.93 μg/m3. Lastly, it was shown that the BME method performed better than the mainstream spatiotemporal ordinary kriging technique in terms of the higher R 2 values of both the predicted PM2.5 and NO2 concentration maps.
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Optimizing Somatostatin Analog Use in Well or Moderately Differentiated Gastroenteropancreatic Neuroendocrine Tumors
Abstract
Background
Somatostatin analogues, aiming to control tumor secretion or growth, constitute the most attractive therapeutic option for patients with well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The objective of this article is to provide a comprehensive review of the current state-of-the-art knowledge gaps and potential opportunities for future development and optimization of this therapeutic modality.
Method
A contextualized systematic review with a narrative component was conducted using PubMed, The Cochrane Library, EMBASE, and Google Scholar. Titles were screened, and non-English, duplicate, or irrelevant entries were excluded. Selection criteria for articles included the following: publication in English between 1995 and 2016, patients with GEP-NETs, analysis of efficacy, safety, practical management considerations, predictive factors, and/or strategies for overcoming resistance, concerning somatostatin analogs.
Results
Ninety-seven studies out of 2771 screened publications met the inclusion criteria (16 randomized clinical trials, 27 phase II trials, 3 phase I trials, 3 subgroup analyses of clinical trials, 1 open-label extension of a randomized trial, 1 phase IV trial, 32 observational studies, and 14 basic research articles). The nature and scope of literature was diverse with most articles dedicated to drug efficacy or indications of use (n = 49), pharmacological issues (n = 8), assessment or predictors of response (n = 4), practical management (n = 11), combination therapy or other means to overcome resistance (n = 19), receptors and signaling pathways (n = 3), and subgroup analyses (n = 3).
Conclusion
In this appraisal, we have found some practical aspects that can help to the optimization of somatostatin analog (SSA) therapy in patients with well-differentiated GEP-NETs. We have also identified areas of uncertainty in an effort to guide clinical research in the coming years.
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Deutschland Dilemma Where will Germany's Jews stand in the country's upcoming elections?
How will the Jewish community channel its feelings towards the ongoing refugee crisis in Germany and Europe into a political decision? German Chancellor Angela Merkel makes an address during an anti-Semitism demo at Berlin's Brandenburg Gate September 14, 2014. . The Jewish community in Germany is not necessarily a voting bloc that needs to be catered to ahead of the German federal election on September 24. Indeed, with an estimated German-Jewish population of about 200,000 , the Jewish vote won't likely tip the scales in anyone's favor.
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Experience with curative radiotherapy for cervix cancer in the Bahamas for 2006–2016
Abstract
Background
Cervix cancer is a significant health problem. As access to quality care in Small Island Developing States improves, and cancer centers become established, providers of care can summarize local experience to benchmark system quality and look for ways to further improve value.
Methods
This is a retrospective study of all cases of cervix cancer managed 2006–2016 at The Cancer Centre Bahamas, in conjunction with Princess Margaret Hospital, Nassau, affiliated with The University of West Indies. Seventy-two women received curative radiotherapy or chemoradiotherapy. Herein are reported presenting characteristics, treatments, waiting and overall treatment times, plus outcomes of recurrence, survival, and adverse events.
Results
For 68 newly diagnosed cases, median waiting time (diagnosis to commencing treatment) was 110 days. It was 90 days for those 47 cases who had no prior surgery or neoadjuvant chemotherapy. Overall, 99% of intended external radiotherapy fractions, 74% of brachytherapy sessions, and 79% of concurrent weekly chemotherapy were administered. For all 72 cases, median overall treatment time was 63 days; and for the 47 case sub-group, it was 78 days during 2006–2010 and 65 days during 2011–2016 (p = 0.005), so improving over calendar time. Four cases experienced grade 3–4 toxicities. Twelve had urological complications from disease or treatment. Five cases experienced local failure; eight experienced distant failure. Newly diagnosed stage 2B (26/72) had a 2-year survival of 71%.
Conclusion
This report demonstrates the impact of providing curative radiation-based treatments for cervical cancer in a small state. It suggests ways to further improve operations and justifies additional research.
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Response to "Role of regulators in safe prescribing of opioids" [Letters]
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Trends in standardized mortality among individuals with schizophrenia, 1993-2012: a population-based, repeated cross-sectional study [Research]
BACKGROUND:
We examined mortality time trends and premature mortality among individuals with and without schizophrenia over a 20-year period.
METHODS:In this population-based, repeated cross-sectional study, we identified all individual deaths that occurred in Ontario between 1993 and 2012 in persons aged 15 and over. We plotted overall and cause-specific age- and sex-standardized mortality rates (ASMRs), stratified all-cause ASMR trends by sociodemographic characteristics, and analyzed premature mortality using years of potential life lost. Additionally, we calculated mortality rate ratios (MRRs) using negative binomial regression with adjustment for age, sex, income, rurality and year of death.
RESULTS:We identified 31 349 deaths among persons with schizophrenia, and 1 589 902 deaths among those without schizophrenia. Mortality rates among people with schizophrenia were 3 times higher than among those without schizophrenia (adjusted MRR 3.12, 95% confidence interval 3.06–3.17). All-cause ASMRs in both groups declined in parallel over the study period, by about 35%, and were higher for men, for those with low income and for rural dwellers. The absolute ASMR difference also declined throughout the study period (from 16.15 to 10.49 deaths per 1000 persons). Cause-specific ASMRs were greater among those with schizophrenia, with circulatory conditions accounting for most deaths between 1993 and 2012, whereas neoplasms became the leading cause of death for those without schizophrenia after 2005. Individuals with schizophrenia also died, on average, 8 years younger than those without schizophrenia, losing more potential years of life.
INTERPRETATION:Although mortality rates among people with schizophrenia have declined over the past 2 decades, specialized approaches may be required to close the persistent 3-fold relative mortality gap with the general population.
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Cabinet shuffle brings "seismic shifts" to Indigenous affairs, health [News]
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Rebound adrenal insufficiency after withdrawal of ritonavir in a 65-year-old man using inhaled budesonide [Practice]
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Treating iron deficiency [Correction]
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Take-home naloxone [Practice]
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Addressing the scandal of early death among people with schizophrenia [Commentary]
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Contact dermatitis caused by methacrylates in nail products [Practice]
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Sensible approaches to manage the current opioid crisis [Letters]
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Summary Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering com...
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Here we report on the treatment of a 38-year-old woman with primary cutaneous γδT-cell lymphoma, which is a rare subset of cutaneous T-cell ...
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182, Treatment of basilar artery stenosis w...
