Usutu virus, Austria and Hungary, 2010–2016
Emerging Microbes & Infections 6, e85 (October 2017). doi:10.1038/emi.2017.72
Authors: Tamás Bakonyi, Károly Erdélyi, René Brunthaler, Ádám Dán, Herbert Weissenböck & Norbert Nowotny
UK experts are urging the government to take steps to restrict advertising of junk food after a new analysis was published showing that food companies spend much more on such advertising than the...
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A Gram-stain-negative, non-motile, non-spore-forming, rod-shaped, aerobic bacterium, designated 15J8-9T, was isolated from a sandy beach in Jeju Island, South Korea. The isolate was able to grow between 10 and 30 °C, pH 5–8, and in presence of 0–1% (w/v) NaCl. Based on 16S rRNA gene phylogenetic analysis, the novel strain was closely related to members of the genus Spirosoma (96.1–90.9% similarities) and showed highest sequence similarity to Spirosoma panaciterrae DSM 21099T (96.1%). The G + C content of the genomic DNA of strain 15J8-9T was 45.1 mol%. The isolate contained menaquinone MK-7 as the predominant respiratory quinone, phosphatidylethanolamine as the major polar lipid, and summed feature 3 (C16:1ω6c/C16:1ω7c; 28.0%), C16:1ω5c (23.4%), iso-C15:0 (13.5%), and C16:0 (11.5%) as the major fatty acids that supported the affiliation of strain 15J8-9T to the genus Spirosoma. The isolate could be differentiated clearly from recognized Spirosoma species on the basis of several phenotypic, genotypic and chemotaxonomic features. Therefore, strain 15J8-9T is considered to represent a novel species of the genus the genus Spirosoma, for which the name Spirosoma harenae sp. nov. is proposed. The type strain is 15J8-9T (= KCTC 52030T = JCM 31993T).
IJERPH, Vol. 14, Pages 1212: Landscapes and Human Health
International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14101212
Authors: William Sullivan Chun-Yen Chang
As urbanization increases around the world and fewer and fewer people have easy access to completely natural places, there is a growing need to understand how the landscapes we design and inhabit impact our health and wellbeing.[...]
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Fertility Preservation in Breast Cancer.
South Med J. 2017 Oct;110(10):621-626
Authors: O'Donoghue C, Quinn GP, Lee MC
Abstract
As more young women survive breast cancer, fertility preservation (FP) is an important component of care. This review highlights the importance of early pretreatment referral, reviews the risks of infertility associated with breast cancer treatment, and defines existing and emerging techniques for FP. The techniques reviewed include ovarian suppression, embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation and transplantation. The barriers women face, such as not being appropriately referred and the costs of treatment, also are addressed. Multidisciplinary, patient-centered care is essential to discussing FP with patients with breast cancer and ensuring appropriate care that includes quality of life in survivorship.
PMID: 28973701 [PubMed - indexed for MEDLINE]
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Depression screening with patient-targeted feedback in cardiology: The cost-effectiveness of DEPSCREEN-INFO.
PLoS One. 2017;12(8):e0181021
Authors: Brettschneider C, Kohlmann S, Gierk B, Löwe B, König HH
Abstract
BACKGROUND: Although depression is common in patients with heart disease, screening for depression is much debated. DEPSCREEN-INFO showed that a patient-targeted feedback in addition to screening results in lower depression level six months after screening. The purpose of this analysis was to perform a cost-effectiveness analysis of DEPSCREEN-INFO.
METHODS: Patients with coronary heart disease or arterial hypertension were included. Participants in both groups were screened for depression. Participants in the intervention group additionally received a patient-targeted feedback of their result and recommended treatment options. A cost-utility analysis using quality-adjusted life years (QALY) based on the EQ-5D was performed. The time horizon was 6 months. Resource utilization was assessed by a telephone interview. Multiple imputation using chained equations was used. Net-benefit regressions controlled for prognostic variables at baseline were performed to construct cost-effectiveness acceptability curves. Different sensitivity analyses were performed.
RESULTS: 375 participants (intervention group: 155; control group: 220) were included at baseline. After 6 months, in the intervention group adjusted total costs were lower (-€2,098; SE: €1,717) and more QALY were gained (0.0067; SD: 0.0133); yet differences were not statistically significant. The probability of cost-effectiveness was around 80% independent of the willingness-to-pay (range: €0/QALY-€130,000/QALY). The results were robust.
CONCLUSIONS: A patient-targeted feedback in addition to depression screening in cardiology is cost-effective with a high probability. This underpins the use of the patient-targeted feedbacks and the PHQ-9 that are both freely available and easy to implement in routine care.
PMID: 28806775 [PubMed - indexed for MEDLINE]
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Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta-analysis of clinical studies.
PLoS One. 2017;12(8):e0182942
Authors: Varjú P, Farkas N, Hegyi P, Garami A, Szabó I, Illés A, Solymár M, Vincze Á, Balaskó M, Pár G, Bajor J, Szűcs Á, Huszár O, Pécsi D, Czimmer J
Abstract
BACKGROUND: Irritable bowel syndrome (IBS) and functional digestive tract disorders, e.g. functional bloating, carbohydrate maldigestion and intolerances, are very common disorders frequently causing significant symptoms that challenge health care systems. A low Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) diet is one of the possible therapeutic approaches for decreasing abdominal symptoms and improving quality of life.
OBJECTIVES: We aimed to meta-analyze data on the therapeutic effect of a low-FODMAP diet on symptoms of IBS and quality of life and compare its effectiveness to a regular, standard IBS diet with high FODMAP content, using a common scoring system, the IBS Symptom Severity Score (IBS-SSS).
METHODS: A systematic literature search was conducted in PubMed, EMBASE and the Cochrane Library as well as in the references in a recent meta-analysis. Adult patients diagnosed with IBS according to the Rome II, Rome III, Rome IV or NICE criteria were included in the analysis.
STATISTICAL METHODS: Mean differences with 95% confidence intervals were calculated from studies that contained means, standard deviation (SD) or mean differences and SD of differences and p-values. A random effect model was used because of the heterogeneity (Q test (χ2) and I2 indicator). A p-value of less than 0.05 was chosen to indicate a significant difference.
RESULTS: The literature search yielded 902 publications, but only 10 were eligible for our meta-analysis. Both regular and low-FODMAP diets proved to be effective in IBS, but post-diet IBS-SSS values were significantly lower (p = 0.002) in the low-FODMAP group. The low-FODMAP diet showed a correlation with the improvement of general symptoms (by IBS-SSS) in patients with IBS.
CONCLUSIONS: This meta-analysis provides high-grade evidence of an improved general symptom score among patients with irritable bowel syndrome who have maintained a low-FODMAP diet compared to those on a traditional IBS diet, therefore showing its superiority to regular IBS dietary therapy. These data suggest that a low-FODMAP diet with dietitian control can be a candidate for first-line therapeutic modality in IBS. Because of a lack of data, well-planned randomized controlled studies are needed to ascertain the correlation between improvement of separate key IBS symptoms and the effect of a low-FODMAP diet.
PMID: 28806407 [PubMed - indexed for MEDLINE]
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Sixty Years of Placebo-Controlled Antipsychotic Drug Trials in Acute Schizophrenia: Systematic Review, Bayesian Meta-Analysis, and Meta-Regression of Efficacy Predictors.
Am J Psychiatry. 2017 Oct 01;174(10):927-942
Authors: Leucht S, Leucht C, Huhn M, Chaimani A, Mavridis D, Helfer B, Samara M, Rabaioli M, Bächer S, Cipriani A, Geddes JR, Salanti G, Davis JM
Abstract
OBJECTIVE: Antipsychotic drug efficacy may have decreased over recent decades. The authors present a meta-analysis of all placebo-controlled trials in patients with acute exacerbations of schizophrenia, and they investigate which trial characteristics have changed over the years and which are moderators of drug-placebo efficacy differences.
METHOD: The search included multiple electronic databases. The outcomes were overall efficacy (primary outcome); responder and dropout rates; positive, negative, and depressive symptoms; quality of life; functioning; and major side effects. Potential moderators of efficacy were analyzed by meta-regression.
RESULTS: The analysis included 167 double-blind randomized controlled trials with 28,102 mainly chronic participants. The standardized mean difference (SMD) for overall efficacy was 0.47 (95% credible interval 0.42, 0.51), but accounting for small-trial effects and publication bias reduced the SMD to 0.38. At least a "minimal" response occurred in 51% of the antipsychotic group versus 30% in the placebo group, and 23% versus 14% had a "good" response. Positive symptoms (SMD 0.45) improved more than negative symptoms (SMD 0.35) and depression (SMD 0.27). Quality of life (SMD 0.35) and functioning (SMD 0.34) improved even in the short term. Antipsychotics differed substantially in side effects. Of the response predictors analyzed, 16 trial characteristics changed over the decades. However, in a multivariable meta-regression, only industry sponsorship and increasing placebo response were significant moderators of effect sizes. Drug response remained stable over time.
CONCLUSIONS: Approximately twice as many patients improved with antipsychotics as with placebo, but only a minority experienced a good response. Effect sizes were reduced by industry sponsorship and increasing placebo response, not decreasing drug response. Drug development may benefit from smaller samples but better-selected patients.
PMID: 28541090 [PubMed - indexed for MEDLINE]
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Economic evaluation of an intervention program with the aim to improve at-work productivity for workers with rheumatoid arthritis.
J Occup Health. 2017 May 25;59(3):267-279
Authors: Noben C, Vilsteren MV, Boot C, Steenbeek R, Schaardenburg DV, Anema JR, Evers S, Nijhuis F, Rijk A
Abstract
OBJECTIVES: Evaluating the cost effectiveness and cost utility of an integrated care intervention and participatory workplace intervention for workers with rheumatoid arthritis (RA) to improve their work productivity.
METHODS: Twelve month follow-up economic evaluation alongside a randomized controlled trial (RCT) within specialized rheumatology treatment centers. Adults diagnosed with RA between 18-64 years, in a paid job for at least eight hours per week, experiencing minor difficulties in work functioning were randomized to the intervention (n = 75) or the care-as-usual (CAU) group (n = 75). Effect outcomes were productivity and quality of life (QALYs). Costs associated with healthcare, patient and family, productivity, and intervention were calculated from a societal perspective. Cost effectiveness and cost utility were assessed to indicate the incremental costs and benefits per additional unit of effect. Subgroup and sensitivity analyses evaluated the robustness of the findings.
RESULTS: At-work productivity loss was about 4.6 hours in the intervention group and 3.5 hours in the care as usual (CAU) group per two weeks. Differences in QALY were negligible; 0.77 for the CAU group and 0.74 for the intervention group. In total, average costs after twelve months follow-up were highest in the intervention group (€7,437.76) compared to the CAU group (€5,758.23). The cost-effectiveness and cost-utility analyses show that the intervention was less effective and (often) more expensive when compared to CAU. Sensitivity analyses supported these findings.
DISCUSSION: The integrated care intervention and participatory workplace intervention for workers with RA provides gains neither in productivity at the workplace nor in quality of life. These results do not justify the additional costs.
PMID: 28381814 [PubMed - indexed for MEDLINE]
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Evaluation of Skeletal Muscle Function in Lung Transplant Candidates.
Transplantation. 2017 Sep;101(9):2183-2191
Authors: Rozenberg D, Singer LG, Herridge M, Goldstein R, Wickerson L, Chowdhury NA, Mathur S
Abstract
BACKGROUND: Lung transplantation (LTx) is offered to older and more complex patients who may be at higher risk of skeletal muscle dysfunction, but the clinical implications of this remain uncertain. The study aims were to characterize deficits in skeletal muscle mass, strength and physical performance, and examine the associations of these deficits with clinical outcomes.
METHODS: Fifty LTx candidates (58% men; age, 59 ± 9 years) were prospectively evaluated for skeletal muscle deficits: muscle mass using bioelectrical impedance, quadriceps, respiratory muscle and handgrip strength, and physical performance with the Short Physical Performance Battery. Comparisons between number of muscle deficits (low muscle mass, quadriceps strength and physical performance) and 6-minute walk distance (6MWD), London Chest Activity of Daily Living Questionnaire, and quality of life were assessed using one-way analysis of variance. Associations with pretransplant and posttransplant delisting/mortality, hospital duration, and 3-month posttransplant 6MWD were evaluated using Fisher exact test and Spearman correlation.
RESULTS: Deficits in quadriceps strength (n = 27) and physical performance (n = 24) were more common than muscle mass (n = 8). LTx candidates with 2 or 3 muscle deficits (42%) compared with those without any deficits (26%) had worse 6MWD = -109 m (95% confidence interval [CI], -175 to -43), London Chest Activity of Daily Living Questionnaire = 18 (95% CI, 7-30), and St. George's Activity Domain = 12 (95% CI, 2-21). Number of muscle deficits was associated with posttransplant hospital stay (r = 0.34, P = 0.04), but not with delisting/mortality or posttransplant 6MWD.
CONCLUSIONS: Deficits in quadriceps muscle strength and physical performance are common in LTx candidates and further research is needed to assess whether modifying muscle function pretransplant can lead to improved clinical outcomes.
PMID: 28376036 [PubMed - indexed for MEDLINE]
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Patient-reported outcomes as predictors of remission in early rheumatoid arthritis patients treated with tight control treat-to-target approach.
Rheumatol Int. 2017 May;37(5):825-830
Authors: Kuusalo L, Puolakka K, Kautiainen H, Karjalainen A, Malmi T, Yli-Kerttula T, Leirisalo-Repo M, Rantalaiho V, NEO-RACo Study Group
Abstract
Identifying prognostic factors for remission in early rheumatoid arthritis (ERA) patients is of key clinical importance. We studied patient-reported outcomes (PROs) as predictors of remission in a clinical trial. We randomized 99 untreated ERA patients to receive remission-targeted treatment with three disease-modifying antirheumatic drugs and prednisolone for 24 months, and infliximab or placebo for the initial 6 months. At baseline, we measured following PROs: eight Short Form 36 questionnaire (SF-36) dimensions, patient's global assessment [PGA, visual analogue scale (VAS)], Health Assessment Questionnaire (HAQ), and pain VAS. We used multivariable-adjusted regression models to identify PROs that independently predicted modified American College of Rheumatology remission at 2 years. Follow-up data at 2 years were available for 93 patients (92%), and 58 patients (62%) were in remission. At baseline, patients who achieved remission had higher radiological score (p = 0.04), lower tender joint count (p = 0.001), lower PGA (p = 0.005) and physician's global assessment (p = 0.019), lower HAQ (p = 0.016), less morning stiffness (p = 0.009), and significantly higher scores in seven out of eight SF-36 dimensions compared with patients who did not. In multivariable models that included all PROs, remission was associated with SF-36 dimensions higher vitality (odds ratio 2.01; 95% confidence interval 1.19-3.39) and better emotional role functioning (odds ratio 1.64; 95% confidence interval 1.01-2.68). PGA, pain VAS, HAQ, and other SF-36 dimensions were not associated with remission. We conclude that self-reported vitality and better emotional role functioning are among the most important PROs for the prediction of remission in ERA.
PMID: 28289873 [PubMed - indexed for MEDLINE]
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Physical Functioning, Physical Activity, Exercise Self-Efficacy, and Quality of Life Among Individuals With Chronic Heart Failure in Korea: A Cross-Sectional Descriptive Study.
J Nurs Res. 2017 Apr;25(2):131-139
Authors: Lee H, Boo S, Yu J, Suh SR, Chun KJ, Kim JH
Abstract
BACKGROUND: Both the beneficial relationship between exercise and quality of life and the important role played by exercise self-efficacy in maintaining an exercise regimen among individuals with chronic heart failure are well known. However, most nursing interventions for Korean patients with chronic heart failure focus only on providing education related to risk factors and symptoms. Little information is available regarding the influence of physical functions, physical activity, and exercise self-efficacy on quality of life.
PURPOSE: This study was conducted to examine the impact of physical functioning, physical activity, and exercise self-efficacy on quality of life among individuals with chronic heart failure.
METHODS: This study used a cross-sectional descriptive design. Data were collected from 116 outpatients with chronic heart failure in Korea. Left ventricular ejection fraction and New York Heart Association classifications were chart reviewed. Information pertaining to levels of physical activity, exercise self-efficacy, and quality of life were collected using self-administered questionnaires. Data were analyzed using descriptive statistics, t tests, analyses of variance, correlations, and hierarchical multiple regressions.
RESULTS: About 60% of participants were physically inactive, and most showed relatively low exercise self-efficacy. The mean quality-of-life score was 80.09. The significant correlates for quality of life were poverty, functional status, physical inactivity, and exercise self-efficacy. Collectively, these four variables accounted for 50% of the observed total variance in quality of life.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Approaches that focus on enhancing exercise self-efficacy may improve patient-centered outcomes in those with chronic heart failure. In light of the low level of exercise self-efficacy reported and the demonstrated ability of this factor to predict quality of life, the development of effective strategies to enhance exercise self-efficacy offers a novel and effective approach to improving the quality of life of patients with chronic heart failure. Nurses should be proactive in advising patients with chronic heart failure to be more physically active and to enhance their self-confidence in diverse ways.
PMID: 28277393 [PubMed - indexed for MEDLINE]
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Modifying homes for persons with physical disabilities in Thailand.
Bull World Health Organ. 2017 Feb 01;95(2):140-145
Authors: Tongsiri S, Ploylearmsang C, Hawsutisima K, Riewpaiboon W, Tangcharoensathien V
Abstract
PROBLEM: Thailand passed the Persons with Disabilities Empowerment Act in 2007. The Act, which is in compliance with the United Nations Convention on the Rights of Persons with Disabilities, ensures that registered persons with disabilities are entitled to home environment modifications' benefits up to a maximum of 20 000 baht (670 United States dollars); however, the Act's enforcement is still weak in Thailand.
APPROACH: In 2013, researchers developed a home modification programme, consisting of a multidisciplinary team of medical and nonmedical practitioners and volunteers, to modify homes for persons with disabilities. The programme recruited participants with physical disabilities and assessed their functioning difficulties. Participants' homes were modified to address identified functioning difficulties.
LOCAL SETTING: The project was implemented in four provinces in collaboration with staff from 27 district hospitals located in north-eastern Thailand.
RELEVANT CHANGES: After the home modifications, all 43 recruited participants reported reduced difficulties in all areas, except for participants with severe degrees of difficulties, such as those reporting being unable to walk and unable to get up from the floor. The participants' quality of life had also improved. The average EQ-5D-5L score, measuring quality of life, increased by 0.203 - from 0.346 at baseline to 0.549 after the modifications.
LESSONS LEARNT: Home modifications in low-resourced settings are technically and financially feasible and can lead to reducing functioning difficulties and improving the quality of life of persons with disabilities. Implementation requires government subsidies to finance home modifications and the availability of technical guidelines and training on home modifications for implementing agents.
PMID: 28250515 [PubMed - indexed for MEDLINE]
Within a project exploring the difference which high-precision chronologies make for narratives of the European Neolithic, this paper examines the place of material culture in the flow of social existence. In contrast to approaches based on imprecise chronologies and stressing gradual change, we examine increasingly high-resolution dendrochronological data in the Neolithic of the northern Alpine foreland, where sharp boundaries between material styles were not in evidence. While 60-year filters allow a more differentiated analysis of the relative distribution of Cortaillod and Pfyn pottery, higher-resolution dendrochronology enables a very detailed narrative of the rapid introduction of Corded Ware in the Lake Zürich area, highlighting significant differences between eastern and western Switzerland. At the scale of individual sites, Concise shows continuity of the local potting tradition, despite repeated episodes of outside influence. At the short-lived site Arbon Bleiche 3, pottery changes much less than diet. This reveals a complex pattern of exactly contemporary diversity, seen even more sharply at the very briefly occupied settlement of Bad Buchau Torwiesen II. To get at agency within the flow of social life, we need as much temporal and spatial detail as possible, close attention to the material and approaches that allow for nuanced narratives.
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Many heuristics for cost-optimal planning are based on linear programming. We cover several interesting heuristics of this type by a common framework that fixes the objective function of the linear program. Within the framework, constraints from different heuristics can be combined in one heuristic estimate which dominates the maximum of the component heuristics. Different heuristics of the framework can be compared on the basis of their constraints. We present theoretical results on the relation between existing heuristics and experimental results that demonstrate the potential of the proposed framework.
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131 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
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Recently, a genetic-based random key generator (GRKG) for the one-time pad (OTP) cryptosystem has been proposed in the literature which has certain limitations. In this paper, two main characteristics (speed and randomness) of the GRKG method are significantly improved by presenting the IGRKG method (improved genetic-based random key generator method). The proposed IGRKG method generates an initial pad by using linear congruential generator (LCG) and improves the randomness of the initial pad using genetic algorithm. There are three reasons behind the use of LCG: it is easy to implement, it can run efficiently on computer hardware, and it has good statistical properties. The experimental results show the superiority of the IGRKG over GRKG in terms of speed and randomness. Hereby we would like to mention that no prior experimental work has been presented in the literature which is directly related to the OTP key generation using evolutionary algorithms. Therefore, this work can be considered as a guideline for future research.
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Ontologies are important components of health information management systems. As such, the quality of their content is of paramount importance. It has been proven to be practical to develop quality assurance (QA) methodologies based on automated identification of sets of concepts expected to have higher likelihood of errors. Four kinds of such sets (called QA-sets) organized around the themes of complex and uncommonly modeled concepts are introduced. A survey of different methodologies based on these QA-sets and the results of applying them to various ontologies are presented. Overall, following these approaches leads to higher QA yields and better utilization of QA personnel. The formulation of additional QA-set methodologies will further enhance the suite of available ontology QA tools.
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Analysing the economic burden of the seasonal influenza is highly essential due to the large number of outbreaks in recent years. Mathematical and actuarial models can be considered as management tools to understand the dynamical behavior, predict the risk, and compute it. This study is an attempt to develop conceptual model to investigate the economic burden due to seasonal influenza. The compartment SIS (susceptible-infected-susceptible) model is used to capture the dynamical behavior of influenza. Considering the current investment and future medical care expenditure as premium payment and benefit (claim), respectively, the insurance and actuarial based conceptual model is proposed to model the present economic burden due to the spread of influenza. Simulation is carried out to demonstrate the variation of the present economic burden with respect to model parameters. The sensitivity of the present economic burden is studied with respect to the risk of disease spread. The basic reproduction is used to identify the risk of disease spread. Impact of the seasonality is studied by introducing the seasonally varying infection rate. The proposed model provides theoretical background to investigate the economic burden of seasonal influenza.
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Insulin pumps are associated with a lower risk of serious complications among young patients with type 1 diabetes than insulin injections, research published in JAMA has found.1The population based...
The UK does not have enough radiologists to meet imaging and diagnostic demands in the NHS, the Royal College of Radiologists has warned.Nearly all radiology departments in the UK (97%) said that...
The current study determined, for the first time, the levels of titanium (Ti), strontium (Sr), barium (Ba), vanadium (V), gallium (Ga), tin (Sn), thallium (Tl), and antinomy (Sb), in deposited dust, and human hair collected from general population of different geographical areas of Pakistan. All the samples were prepared by microwave digestion and measured by ICP-MS. The results showed that on deposited dust samples, the detected elements followed the descending trend as: Ti > Sr > Ba > V > Ga > Sn > Tl > Sb similar to the upper continental crust. The deposited dust samples from low elevation areas exhibited highest levels of all studied elements (except antimony which was higher in soil samples from mountainous areas), followed by rive plains, mountainous areas, and highland valleys. In contrast, on human hair samples, the elements followed the descending trend as: Sr > Ba > Ti > Ga > V > Sn > Sb > Tl respectively. Ba, Ga, and V concentrations were higher in soil samples from lower elevation Indus plain, and Sr, Tl, Sb, and Ti were higher in samples from mountainous areas. The bioaccumulation trend of all studied elements was in descending order as follows: Sb, Ga, Sn, Ba, Sr, Ti, V, Tl, respectively. Principal component analysis (PCA) and correlation matrix evidenced both geological influences and anthropogenic activities as potential sources of these studied elements. On the other hand, the risk estimation (HI > 1) concluded that population were at higher health risk (non-carcinogenic) for Ga and Ti. All other studied rare elements were within safe limit for humans from all zones.
Under the auspices of the IAEA tissue banking programme on "Radiation Sterilisation of Tissue Graft" conducted from 1985 to 2004, many scientists and surgeons were involved in various regional research and development (R&D) projects mainly in dealing with radiation dose selection, radiation effects on human tissues and quality system in radiation sterilisation. New findings on radiation effects, tissue processing and preservation were shared during the regional and interregional meetings and workshops. Many tissue banks started to use radiation (25 kGy) to sterilize tissue grafts for tissue safety and efficacy and still continue to use it. The IAEA Code of Practice for Radiation Sterilization of Tissues Allografts developed in 2007 offered simpler methods to conduct radiation dose setting and dose validation experiments for tissue grafts. Advances in dose selection and dose mapping are continued under the quality management system when banks need to be certified to continue their operation. The combination of good tissue processing and preservation as well as good radiation practice will ensure the tissue products are properly sterilised thus safe and of high quality. Experience in meeting challenges in using radiation sterilisation and achievements reported by the tissue bankers are shared here.
In Schwann cells of the vertebrate peripheral nervous system, induction of myelination and myelin maintenance both depend on the HMG-domain-containing transcription factor Sox10. In oligodendrocytes of the central nervous system, Sox10 is also essential for the induction of myelination. Its role in late phases of myelination and myelin maintenance has not been studied so far. Here, we show that these processes are largely unaffected in mice that lack Sox10 in mature oligodendrocytes. As Sox10 is co-expressed with the related Sox8, we also analyzed oligodendrocytes and myelination in Sox8-deficient mice. Again, we could not detect any major abnormalities. Expression of many myelin genes was only modestly reduced in both mouse mutants. Dramatic reductions in expression levels and phenotypic disturbances became only apparent once Sox8 and Sox10 were both absent. This argues that Sox8 and Sox10 are jointly required for myelin maintenance and impact myelin gene expression. One direct target gene of both Sox proteins is the late myelin gene Mog. Our results point to at least partial functional redundancy between both related Sox proteins in mature oligodendrocytes and are the first report of a substantial function of Sox8 in the oligodendroglial lineage.
Background. The aim of our study was to investigate the impact of abdominal wall reconstruction surgery on tissue anatomy and to explore how flap surgery influences the patient's immune status. Methods. Experimental abdominal wall defects were created in 8 Sus scrofa (swine) animal models. The animals were divided into two groups: 4 swine were euthanized one month after surgery for the biopsies retrieval purpose and the other 4 swine were kept alive and the collection of blood samples has been done 6 months after surgery. In order to evaluate the relative gene expression in operated-on animal cohorts we compared them with samples from 4 healthy swine used as controls. Results. The inflammatory process was present in all types of repairs. Collagen I deposition was higher in the flap repairs. The expression level for the genes related to immune response after 6 months from surgery was relatively similar to the control group except minor alteration registered in the case of two swine models. Conclusion. Our findings indicate a less pronounced proinflammatory response to surgical trauma in animal models after flap surgery. The postoperative levels of the inflammatory cytokines did not show significant differences after abdominal wall reconstruction using flap surgery.
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Allspice essential oil was extracted with supercritical carbon dioxide (SC-CO2) in a static process at three different temperatures (308.15, 313.15, and 318.15 K) and four levels of pressure (100, 200, 300, and 360 bar). The amount of oil extracted was measured at intervals of 1, 2, 3, 4, 5, and 6 h; the most extraction yield reached was of 68.47% at 318.15 K, 360 bar, and 6 h of contact time. In this supercritical extraction process, the distribution coefficient (), the mean effective diffusion coefficient (), the energy of activation (), the thermodynamic properties (,, and ), and the apparent solubility () expressed as mass fraction (w/w) were evaluated for the first time. At the equilibrium the experimental apparent solubility data were successfully correlated with the modified Chrastil equation.
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Since the stability of engineering rock masses has important practical significance to projects like mining, tunneling, and petroleum engineering, it is necessary to study mechanical properties and stability prediction methods for rocks, cementing materials that are composed of minerals in all shapes and sizes. Rocks will generate acoustic emission during damage failure processes, which is deemed as an effective means of monitoring the stability of coal rocks. In the meantime, actual mining and roadway surrounding rocks tend to have transverse effects; namely, the transverse scale is larger than the length scale. Therefore, it is important to explore mechanical properties and acoustic emission properties of rocks under transverse size effects. Considering the transverse scale effects of rocks, this paper employs the microparticle flow software PFC2D to explore the influence of different aspect ratios on damage mechanics and acoustic emission properties of rocks. The results show that the transverse scale affects uniaxial compression strength of rocks. As the aspect ratio increases, uniaxial compression strength of rocks decreases initially and later increases, showing a V-shape structure and although it affects the maximum hit rate and the strain range of acoustic emission, it has little influence on the period of occurrence. As the transverse scale increases, both damage degree and damage rate of rocks decrease initially and later increase.
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Background. Connatal urinary ascites is rare in females without associated malformations and occurs following bladder rupture. Case Presentation. A female very preterm was delivered by caesarean section because of abnormal Doppler findings. The mother suffered from viral pneumonia requiring intensive care in the third trimester of pregnancy. Serial fetal ultrasound examinations showed a megacystis and ascites. Postnatally, pronounced isolated ascites was drained and its urinary nature was confirmed. The bladder leak was demonstrated when blue dye, instilled via a Foley catheter, appeared in the ascitic drain. After removal of the catheter spontaneous micturition was unremarkable. A micturating cystourethrogram showed spontaneous closure of the bladder leak. Conclusion. The female infant experienced fetal bladder rupture and connatal urinary ascites due to maternal pneumonia and intensive care. The use of blue dye is an effective alternative method to any contrast media radiography and should be considered, especially in very preterm infants.
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Neoadjuvant therapy has become increasingly common in human epidermal growth factor receptor-2 (HER2)-positive breast cancer. In this study, we examined the impact of different clinicopathological characteristics on pathological complete response (pCR) in patients treated with anti-HER2 agents. The PubMed and Embase databases were searched from inception through April 2017 to identify studies that met pre-specified criteria. The odds ratios (ORs) and 95% confidence intervals (CIs) were extracted directly or were calculated with other available information. Eleven randomized controlled trials (RCTs) that involved 3,269 HER2-positive women were included in this meta-analysis. Patients with hormone receptor (HR)-negative breast cancer benefited more from anti-HER2 therapy than did patients with HR-positive tumours (OR, 2.25; 95% CI, 1.93-2.62). Furthermore, this improvement in pCR was independent of anti-HER2 agents, phase, combined chemotherapy, neoadjuvant duration, year the trials started and region where the trials were conducted. Patients with small tumours achieved greater benefits than patients with large tumours (OR, 1.25; 95% CI, 1.00-1.55). Age did not predict an additional benefit from anti-HER2 neoadjuvant treatment (OR, 1.02; 95% CI, 0.73-1.45). The impact of nodal status on pCR was dependent on the anti-HER2 agents. In conclusion, for HER2-targeted neoadjuvant treatment in breast cancer, greater benefits were achieved in patients with small HR-negative tumours compared with patients with large HR-positive tumours. These results may improve drug development and treatment strategies, economic analyses, and the design and interpretation of clinical trials. This article is protected by copyright. All rights reserved.
Socioeconomic status (SES) is a well-known determinant of outcomes in cancer. The purpose of this study was to analyze the impact of the SES on the outcomes of Hodgkin lymphoma (HL) patients from the Brazilian Prospective HL Registry. SES stratification was done using an individual asset/education-based household index. A total of 624 classical HL patients with diagnosis from January/2009 to December/2014, and treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine), were analyzed. The median follow-up was 35.6 months, and 33% were classified as lower SES. The 3-year progression- free survival (PFS) in higher and lower SES were 78% and 64% (p<0.0001), respectively. The 3-year overall survival (OS) in higher and lower SES were 94% and 82% (p<0.0001), respectively. Lower SES patients were more likely to be ≥ 60 years (16% vs 8%, p=0.003), and to present higher risk International Prognostic score (IPS) (44% vs 31%, p=0.004) and advanced disease (71% vs 58%, p=0.003). After adjustments for potential confounders, lower SES remained independently associated with poorer survival (HR = 3.12 [1.86-5.22] for OS and HR = 1.66 [1.19-2.32] for PFS). The fatality ratio during treatment was 7.5% and 1.3% for lower and higher SES (p=0.0001). Infections and treatment toxicity accounted for 81% of these deaths. SES is an independent factor associated with shorter survival in HL in Brazil. Potential underlying mechanisms associated with the impact of SES are delayed diagnosis and poorer education. Educational and socio-economic support interventions must be tested in this vulnerable population. This article is protected by copyright. All rights reserved.
Women vaccinated against HPV16/18 are approaching the age for cervical screening, however an updated screening algorithm has not been agreed. We use a microsimulation model calibrated to real published data to determine the appropriate screening intensity for vaccinated women. Natural histories in the absence of vaccination were simulated for 300,000 women using 10,000 sets of transition probabilities. Vaccination with i) 100% efficacy against HPV16/18, ii) 15% cross-protection, iii) waning vaccine efficacy, and iv) 100% efficacy against HPV16/18/31/33/45/52/58 was added, as were a range of screening scenarios appropriate to the UK. To benchmark cost-benefits of screening for vaccinated women, we evaluated the proportion of cancers prevented per additional screen (incremental benefit) of current cytology and likely HPV screening scenarios in unvaccinated women. Similar proportions of cancers are prevented through (i)vaccination with no screening and (ii)realistic compliance to the current UK screening programme in the absence of vaccination. In unvaccinated women, when switching to HPV primary testing there is no loss in effectiveness when doubling the screening interval. Benchmarking supports screening scenarios with incremental benefits of ≥2.0%, and rejects scenarios with incremental benefits ≤0.9%. In HPV16/18-vaccinated women, the incremental benefit of offering a third lifetime screen was at most 3.3% (95% CR: 2.2-4.5), with an incremental benefit of 1.3% (-0.3-2.8) for a fourth screen. For HPV16/18/31/33/45/52/58-vaccinated women, two lifetime screens are supported. It is important to know women's vaccination status; in these simulations HPV16/18-vaccinated women require three lifetime screens, HPV16/18/31/33/45/52/58-vaccinated women require two lifetime screens, yet unvaccinated women require seven lifetime screens. This article is protected by copyright. All rights reserved.
Genetic factors play a large role in cancer and thus there is a great desire to understand the effects of different genes in cancer and to also develop gene therapy for better treatments. Therefore, the development of alternative diagnosis and therapy modalities are of utmost importance. The aim of our study is to illuminate the role of ESM1 (endothelial cell specific molecule-1, also known as Endocan) in proliferation and migration of head and neck cancer, thus helping to pave the way for new treatment modalities and predictive biomarkers.
ESM1 expression was shown with immunofluorescence assay by using confocal laser scanning microscope in primary and metastatic head and neck cancer cells. ESM1 expression was knocked down by RNA interference in head and neck cancer cells. Knockdown efficiency was evaluated by quantitative real time RT-PCR and western blot. Cell proliferation and migration assays were performed by xCELLigence real time cell analysis system.
Immunofluorescence assay showed nuclear localization and high expression of ESM1 in primary and metastatic head and neck cancer cells. ESM1 mRNA and protein levels were significantly decreased in ESM1-knockdown cells compared to control. ESM1-knockdown cells showed reduced proliferation and migration activity when compared to control cells.
These findings suggest that ESM1 has roles on proliferation and migration of head and neck cancer cells.
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The aim of the present study was to identify the presence and frequency of human papillomavirus (HPV) nucleic acid in p16 positive oral squamous cell carcinomas (OSCC), to assess if the virus were transcriptionally active, and to assess the utility of p16 overexpression as a surrogate marker for HPV in OSCC.
Forty-six OSCC patients treated between 2007 and 2011 with available formalin-fixed paraffin embedded (FFPE) specimens were included. Twenty-three patients were positive for p16 by immunohistochemistry (IHC) and these were matched with 23 patients with p16 negative tumours. Laser capture micro-dissection of the FFPE OSCC tissues was undertaken to isolate invasive tumour tissue. DNA was extracted and tested for high-risk HPV types using a PCR-ELISA method based on the L1 SPF10 consensus primers, and a real-time PCR method targeting HPV-16 and HPV-18 E6 region. Genotyping of HPV positive cases was performed using a reverse line blot hybridization assay (Inno-LiPA). RNAScope® (a chromogenic RNA in situ hybridization assay), was utilized to detect E6/E7 mRNA of known high-risk HPV types for detection of transcriptionally active virus.
HPV DNA was found in 3 OSCC cases, all of which were p16 IHC positive. Two cases were genotyped as HPV-16 and one as HPV-33. Only one of the HPV-16 cases was confirmed to harbour transcriptionally active virus via HPV RNA ISH.
We have shown that the presence of transcriptionally active HPV rarely occurs in OSCC and that p16 is not an appropriate surrogate marker for HPV in OSCC cases. We propose that non-viral mechanisms are responsible for the majority of IHC p16 overexpression in OSCC.
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A software package is developed for numerical simulation of wind turbine rotors autorotation by using the modified LS-STAG level-set/cut-cell immersed boundary method. The level-set function is used for immersed boundaries description. Algorithm of level-set function construction for complex-shaped airfoils, based on Bézier curves usage, is proposed. Also, algorithm for the level-set function recalculation at any time without reconstructing the Bézier curve for each new rotor position is described. The designed second-order Butterworth low-pass filter for aerodynamic torque filtration for simulations using coarse grids is presented. To verify the modified LS-STAG method, the flow past autorotating Savonius rotor with two blades was simulated at .
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Shape variation induced by mismachining tolerance, humidity and temperature of the working environment, material wear and aging, and unknown external load disturbances have a relatively large influence on the dynamic shape of a mechanical structure. When integrating piezoelectric elements into the main mechanical structure, active control of the structural shape is realized by utilizing the inverse piezoelectric effect. This paper presents a mathematical model regarding piezoelectric intelligent structure shape control. We also applied a genetic algorithm, and given a piezoelectric intelligent cantilever plate with both ends affected by a certain load, optimal shape control results of piezoelectric materials were analyzed from different perspectives (precision reference or cost reference). The mathematical model and results indicate that, by optimizing a certain number of piezoelectric actuators, high-precision active shape control can be realized.
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Background. HIV infection and long-term HAART use are associated with metabolic and morphological changes. We assessed prevalence, types, and risk factors associated with lipodystrophy among HIV-infected adults attending CTC in Dar es Salaam, Tanzania. Methods. Analysis included 466 HIV-infected patients. Study protocol involved administration of structured questionnaire to collect sociodemographic and clinical information. Diagnosis of lipodystrophy was based on physician clinical assessment. Results. Lipodystrophy was present in 95 (20.4%) of the study participants, with lipoatrophy being the most common (49.5%) followed by mixed lipodystrophy (37.9%), and lipohypertrophy was the least prevalent (12.6%). Male gender, older age, long duration on HAART, and use of Stavudine containing regimen were associated with lipodystrophy (all ). The risk for lipodystrophy was 1.6 times (AOR = 1.66, 95% CI = 1.01–2.72) for male participants and 13.3 times (AOR = 13.3, 95% CI = 6.4–27.7) for those on HAART. Long duration on HAART and use of Stavudine containing regimen were also associated with increased risk for lipodystrophy. Lipodystrophy was associated with poor perception about own body image and decreased social interactions. Conclusions. Lipodystrophy is common among HIV-infected patients in Tanzania, especially among male patients and those on HAART. Regular screening, monitoring, and patient awareness are needed for early identification and appropriate management.
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In search-and-rescue missions, multi-degrees-of-freedom (DOF) tracked robots that are equipped with subtracks are commonly used. These types of robots have superior locomotion performance on rough terrain. However, in teleoperated missions, the performance of tracked robots depends largely on the operators' ability to control every subtrack appropriately. Therefore, an autonomous traversal function can significantly help in the teleoperation of such robots. In this paper, we propose a planning and control method for 4-DOF tracked robots climbing up/down known stairs automatically based on internal sensors. Experimental results obtained using mockup stairs verify the effectiveness of the proposed method.
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The purpose of this review is to describe up-to-date diagnosis and management of vascular malformations.
Traditional treatment modalities include surgery, sclerotherapy, and laser therapy. Landmark research suggests that lymphatic malformations and other vascular malformations are caused by somatic mutations such as PIK3CA, and may be treated successfully medically.
Therapy targeting the phosphatidylinositide-3-kinase/protein kinase B/mechanistic target of rapamycin signaling pathway (mTOR) may be helpful in treating some vascular anomalies. Multimodal therapy such as intralesional injection of n-butyl cyanoacrylate followed by surgical resection may be successful in treating other lesions. In carefully selected cases in which fetal imaging detects vascular anomalies, an ex utero intrapartum treatment (EXIT) may be beneficial. Multidisciplinary collaboration is key to the successful management of patients with vascular malformations.
Both type of CSOM, tubotympanic which is considered safe as well as atticoantral which is considered unsafe may lead to erosion of the ossicular chain. Discontinuity of the ossicular chain is typically confirmed only during an operation. Knowing before surgery whether the patient has an ossicular discontinuity is important because it allows the surgeon to know the possibility of performing an ossiculoplasty and obtaining patient consent. The aims is to (1) study the incidence of incus necrosis in safe and unsafe CSOM. (2) Determine the preoperative predictive factors for incus necrosis. (3) Use angled otoscopes to determine the incidence of residual disease peroperative after conventional microscopic surgery. This is a prospective study carried out in the department of otorhinolaryngology, Govt Doon medical college, Dehradun from July 2014 to July 2016. A total of 100 patients who presented with CSOM and have not undergone any surgical procedure for the same were included in this study. Patients group was divided into cholesteatoma and non cholesteatoma group. Both groups were subdivided into intact and eroded incus group and were analysed in 11 parameters which were compared statistically. Incudal necrosis is more common in cholesteatoma group. In non cholesteatoma ears subtotal perforation with exposure of IS joint is reliable indicators of incudal necrosis. In non cholesteatoma group extension of cholesteatoma to tympanic sinus and mastoid and presence of persistent discharge are reliable indicators of necrosed incus. Moderate to moderately severe hearing loss indicate incudal necrosis in both groups therefore we conclude that these parameters can be reliably considered as predictors for incudal necrosis preoperatively.
Both type of CSOM, tubotympanic which is considered safe as well as atticoantral which is considered unsafe may lead to erosion of the ossicular chain. Discontinuity of the ossicular chain is typically confirmed only during an operation. Knowing before surgery whether the patient has an ossicular discontinuity is important because it allows the surgeon to know the possibility of performing an ossiculoplasty and obtaining patient consent. The aims is to (1) study the incidence of incus necrosis in safe and unsafe CSOM. (2) Determine the preoperative predictive factors for incus necrosis. (3) Use angled otoscopes to determine the incidence of residual disease peroperative after conventional microscopic surgery. This is a prospective study carried out in the department of otorhinolaryngology, Govt Doon medical college, Dehradun from July 2014 to July 2016. A total of 100 patients who presented with CSOM and have not undergone any surgical procedure for the same were included in this study. Patients group was divided into cholesteatoma and non cholesteatoma group. Both groups were subdivided into intact and eroded incus group and were analysed in 11 parameters which were compared statistically. Incudal necrosis is more common in cholesteatoma group. In non cholesteatoma ears subtotal perforation with exposure of IS joint is reliable indicators of incudal necrosis. In non cholesteatoma group extension of cholesteatoma to tympanic sinus and mastoid and presence of persistent discharge are reliable indicators of necrosed incus. Moderate to moderately severe hearing loss indicate incudal necrosis in both groups therefore we conclude that these parameters can be reliably considered as predictors for incudal necrosis preoperatively.
Our objective is to study interaction between physical and chemical properties of soils and their earthworm community characteristics in different areas irrigated by wastewaters and well waters. The fields have different topography and agricultural practices conditions and are located in two regions of Batna department (Eastern Algeria). Both regions are characterized by a semiarid climate with cold winters and Calcisol soils. Nine fields were subject of this study. Three of these fields are located in Ouled Si Slimane region whose irrigation is effectuated by natural waters of Kochbi effluent. The other six fields are located at edges of Wed El Gourzi, effluent from Batna city, and partially treated through water treatment station. The best rates of water saturation and infiltration as well as abundance of earthworms were recorded at sites characterized by irrigation with wastewaters downstream of El Gourzi effluent. PCA characterizes two major groups: a group of hydrodynamic infiltration parameters and structural index stability of soil, explained by fields irrigated with wastewaters downstream of El Gourzi effluent. This group includes chemical characteristics: pH and electric conductivity. The second group is the characteristics of earthworms and includes organic matter content, active limestone levels, and Shannon Biodiversity Index.
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We prove that general merge-and-shrink representations are strictly more powerful than linear ones by showing that there exist problem families that can be represented compactly with general merge-and-shrink representations but not with linear ones. We also give a precise bound that quantifies the necessary blowup incurred by conversions from general merge-and-shrink representations to linear representations or BDDs/ADDs. Our theoretical results suggest an untapped potential for non-linear merging strategies and for the use of non-linear merge-and-shrink-like representations within symbolic search.
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The aim was to evaluate the importance of clinical factors in the prediction of postoperative complications in patients with microvascular reconstruction for head and neck squamous cell cancer (HNSCC).
A retrospective review of case notes was performed.
Patients treated at a single institute.
The present study included 259 patients with HNSCC treated with radical surgery and microvascular reconstruction between 1993 and 2014.
We allocated the patients to three groups using a preoperative comorbidity score based on risk factors: group A (≥ 3 risk factors, n=16), group B (2 risk factors, n=49), and group C (0 or 1 risk factor, n=194).
Surgical mortality in this cohort was 1.9% (5 of 259 patients). The preoperative comorbidity score was associated with surgical mortality (p<0.001). Pharyngocutaneous fistula (p=0.001) and flap compromise (p=0.023) were more frequent as preoperative comorbidity score increased. Preoperative comorbidity score (p<0.001), advanced age (p=0.007), advanced pathologic T stage (p=0.028), advanced pathologic N stage (p=0.005), preoperative (chemo)radiotherapy (p<0.001), history of cardiovascular disease (p=0.015) and pulmonary disease (p=0.007), and diabetes (p<0.001) had significant adverse effects on 5-year disease-specific survival (DSS) in a univariate analysis. The 5-DSS rates of groups A, B, and C were 30%, 37%, and 70%, respectively. Multivariate analysis showed that preoperative comorbidity score was significantly correlated with 5-year DSS (hazard ratio [HR], 3.56; 95% confidence interval [CI], 1.81—6.99; p<0.001 for group A and HR, 1.91; 95% CI, 1.15—3.18; p=0.013 for group B compared with group C).
Patients with a high preoperative comorbidity score have an increased risk of surgical mortality and morbidity after microvascular reconstruction for HNSCC.
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Human mesenchymal stem/stromal cells (hMSCs) have generated great interest in regenerative medicine mainly due to their multidifferentiation potential and immunomodulatory role. Although hMSC can be obtained from different tissues, the number of available cells is always low for clinical applications, thus requiring in vitro expansion. Most of the current protocols for hMSC expansion make use of fetal bovine serum (FBS) as a nutrient-rich supplement. However, regulatory guidelines encourage novel xeno-free alternatives to define safer and standardized protocols for hMSC expansion that preserve their intrinsic therapeutic potential. Since hMSCs are adherent cells, the attachment surface and cell-adhesive components also play a crucial role on their successful expansion. This review focuses on the advantages/disadvantages of FBS-free media and surfaces/coatings that avoid the use of animal serum, overcoming ethical issues and improving the expansion of hMSC for clinical applications in a safe and reproducible way.
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MicroRNA-31 (miR-31) functions as tumor suppressors or oncogenes that are involved in tumor behavior. However, the function of miR-31 in cervical carcinogenesis remains unclear. The aim of this study was to validate the potential role of miR-31 and BRCA1-associated protein-1 (BAP1) on regulating epithelial-mesenchymal transition (EMT) in cervical cancer. In the present study, qRT-PCR assay revealed that the expression of miR-31 was upregulated in human cervical cancer cells and clinical tissues. Results of wound healing and cell migration assay revealed that knockdown of miR-31 inhibited cell metastasis and migration. Bioinformatic and dual-luciferase reporter gene assay showed that BAP1 was the direct target of miR-31. Furthermore, the results revealed that miR-31 promoted proliferation and EMT in cervical cancer cells and accelerated the development of tumor growth in vivo xenograft experiment by inhibiting BAP1 expression. Overall, these results highlight an important role of miR-31 functioning as an oncomir which could promote EMT in cervical cancer via downregulating BAP1 expression. Thus, downregulation of miR-31 could be a novel approach for the molecular treatment of cervical cancers and other malignancies.
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Pig-to-human xenotransplantation offers a potential bridge to the growing disparity between patients with end-stage organ failure and graft availability. Early studies attempting to overcome cross-species barriers demonstrated robust humoral immune responses to discordant xenoantigens. Recent advances have led to highly efficient and targeted genomic editing, drastically altering the playing field towards rapid production of less immunogenic porcine tissues and even the discussion of human xenotransplantation trials. However, as these humoral immune barriers to cross-species transplantation are overcome with advanced transgenics, cellular immunity to these novel xenografts remains an outstanding issue. Therefore, understanding and optimizing immunomodulation will be paramount for successful clinical xenotransplantation. Costimulation blockade agents have been introduced in xenotransplantation research in 2000 with anti-CD154mAb. Most recently, prolonged survival has been achieved in solid organ (kidney xenograft survival > 400 days with anti-CD154mAb, heart xenograft survival > 900 days, and liver xenograft survival 29 days with anti-CD40mAb) and islet xenotransplantation (>600 days with anti-CD154mAb) with the use of these potent experimental agents. As the development of novel genetic modifications and costimulation blocking agents converges, we review their impact thus far on preclinical xenotransplantation and the potential for future application.
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This paper presents three different topologies of feed forward neural network (FFNN) models for generating global, direct, and diffuse hourly solar irradiance in the city of Fez (Morocco). Results from this analysis are crucial for the conception of any solar energy system. Especially, for the concentrating ones, as direct component is seldom measured. For the three models, the main input was the daily global irradiation with other radiometric and meteorological parameters. Three years of hourly data were available for this study. For each solar component's prediction, different combinations of inputs as well as different numbers of hidden neurons were considered. To evaluate these models, the regression coefficient (R2) and normalized root mean square error (nRMSE) were used. The test of these models over unseen data showed a good accuracy and proved their generalization capability (nRMSE = 13.1%, 9.5%, and 8.05% and R = 0.98, 0.98, and 0.99) for hourly global, hourly direct, and daily direct radiation, respectively. Different comparison analyses confirmed that (FFNN) models surpass other methods of estimation. As such, the proposed models showed a good ability to generate different solar components from daily global radiation which is registered in most radiometric stations.
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Clock-drawing test (CDT) is widely used but lack of a suitable scoring method.
To compare the validity of six common CDT scoring methods and to find out the best one.
The drawing CDT was administered in a Chinese nursing-home inhabitants living on the mainland including 110 dementia, 118 MCI (mild cognitive impairment), and 133 random normal. We calculated the sensitivity and specificity of six scoring methods and applied the receiver-operating characteristic (ROC) curve statistic, including determining the area under the curve (AUC).
(1) All six CDT scoring methods had a value of sensitivity higher than 80% and a specificity of 60% except Jouk and Tuokko. Freund got the highest sensitivity (92.73%) of that five for the testing of dementia and high sensitivity (82.20%) for MCI with an acceptable specificity (70.68%). (2) The AUC (area under the ROC curve) of all six CDT methods was over 0.8 for dementia, and for MCI, only Jouk and Tuokko were lower than 0.8. Mendez had the largest AUC of 0.872 for MCI, which closely followed by Freund with 0.859. (3) Freund predicted dementia best but had no significant difference (p > 0.05); it only had significant difference with Jouk and Tuokko (p < 0.001) and the method in MoCA (p < 0.05) for both MCI and cognitive impairment.
Our study suggests that Freund scoring method could be the best one among the six evaluated scoring methods within our setting.
Alzheimer's disease (AD) affects the global quality of life of persons who suffer from it and their caregivers, because of the behavioral and psychological consequences associated with the pathology and its caring. The Alzheimer Café (AC) is one example of approach aimed to help persons and caregivers deal with their disease.
This is a pilot study focusing on the efficacy of AC in relieving caregivers' and persons' burdens due to dementia.
The quality of life of both caregivers and persons who attended the AC was compared with the quality of life of those who did not. Basic and instrumental daily activities and neuropsychiatric functioning were assessed. Caregivers also answered to general well-being and caregiving burden questionnaires. The evaluation took place at the beginning of the intervention and after 1, 3, 6, 9 and 12 months.
Caregivers who joined the AC with their persons with dementia showed to have significantly benefited in the daily care of persons with dementia, in terms of total well-being, vitality, and emotional burden.
Although improvements were not observed in persons with dementia who attended the AC, significant benefits were reported by their caregivers, suggesting that the intervention may produce better management of social and economic problems and lead to better emotional support.
The AC seems to help families of AD persons to better manage the disease, and also delay the institutionalization of these persons, which is certainly an ambitious goal for an incurable disorder such as Alzheimer's disease.
We separate for the first time the roles of cognitive and motivational factors in shaping age differences in decision making under risk. Younger and older adults completed gain, loss, and mixed-domain choice problems as well as measures of cognitive functioning and affect. The older adults' decision quality was lower than the younger adults' in the loss domain, and this age difference was attributable to the older adults' lower cognitive abilities. In addition, the older adults chose the more risky option more often than the younger adults in the gain and mixed domains; this difference in risk aversion was attributable to less pronounced negative affect among the older adults. Computational modeling with a hierarchical Bayesian implementation of cumulative prospect theory revealed that the older adults had higher response noise and more optimistic decision weights for gains than did the younger adults. Moreover, the older adults showed no loss aversion, a finding that supports a positivity-focus (rather than a loss-prevention) view of motivational reorientation in older age.
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Party group leaders seemingly use a variety of disciplinary measures to achieve unified voting behavior in party groups. However, there is little systematic knowledge about the nature of such disciplinary measures and the interaction between leaders and group members remains a black box. Most studies of party voting concentrate on institutional variables such as electoral systems and take disciplinary measures as a given. This study presents a new way to measure party discipline, based on data from semi-structured interviews with 76 party group leaders and experts from five European parliaments. The discipline index provided here is the first to consider in a systematic way the means available to reprimand or reward party group members. In a second step, the study shows that disciplinary measures can compensate for a leader's lack of control over candidate selection processes, and relate to group composition or size.
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