Narratives of life with long-term low back pain: A follow up interview study.

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Narratives of life with long-term low back pain: A follow up interview study.

Scand J Pain. 2017 Oct 17;:

Authors: Angel S, Jensen LD, Maribo T, Gonge BK, Buus N

Abstract
BACKGROUND: Long-term low back pain is associated with multiple challenges to a person's identity and social position. Despite efforts to understand the challenges of low back pain, recovery remains a major problem both personally and socially. This indicate a need for a different approach. Although personal stories have been used to extend knowledge of issues that relate to low back pain, they also make it possible to learn about how people understand themselves and their lives. As such, analysis of narratives may provide further insights into people's coping processes and novel insights about how best to support them.
OBJECTIVE: The aim of the study was to analyse personal recovery narratives to gain an insight into how people understand themselves and cope with long-term low back pain 2-4 years after a bio-psycho-social counselling intervention.
STUDY DESIGN: Using a Ricoeurian phenomenological-hermeneutic perspective, qualitative in-depth interviews were undertaken and interpreted to explore people's narratives of long-term recovery after an intervention.
METHODS: We interviewed 25 informants 2-4 years after participating in a counselling intervention for low back pain where they were advised to exercise regularly; they were part of the intervention group in a randomised clinical trial. The sample included both informants who had benefited from the intervention and some who had not. Analysis was informed by Ricoeur's interpretation theory.
FINDINGS: The informants' stories revealed two main narratives regarding themselves and their lives: (1) getting on with life without pain, (2) life with continual pain and variations of the emplotment. The first included Recovering from low back pain and returning to prior lifestyle if possible, Keeping low back pain in check by strict regimes, or Developing strategies when low back pain recurs. The second related to Finding a way to a functioning everyday life with continual pain while narratives of being stuck with low back pain and finding no way out highlight the significance of being able to configure a narrative that can support an understanding of the pain and how to deal with it to have a functioning life. Furthermore, the health professional has a significant role to play in the configuration of narratives.
CONCLUSIONS: The challenge for people with low back pain was to find ways of getting on with life, and this included their ability to configure an understandable narrative that opened up for a future, implying new understandings of the self and how life could be lived. When healthcare professionals offered personal and realistic suggestions to the informants' configuration of narratives of life with low back pain, they supported a positive change in the informants' ways of coping with their situation.
IMPLICATIONS: Health professionals can play an important role in low back pain sufferers' configuration of meaningful narratives that help in coping with pain and learning about the relationship between pain and everyday life.

PMID: 29054790 [PubMed - as supplied by publisher]

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Project Octo-Pills - A practice model engaging community pharmacists in the care of patients from a tertiary hospital.

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Project Octo-Pills - A practice model engaging community pharmacists in the care of patients from a tertiary hospital.

Res Social Adm Pharm. 2017 Oct 13;:

Authors: Ong KY, Chung WL, Mamun K, Chen LL

Abstract
Even while pharmacy practice evolves to a more patient-centric mode of practice, local hospitals, due to high patient load as well as space and resource constraints, find it challenging to conduct thorough medication review and physical medication reconciliation for all patients. In light of this, optimizing the local current healthcare system to involve community pharmacists in the care of patients from public hospitals could potentially better cater to the healthcare needs of the older population. Due to easy accessibility, community pharmacies are often the first point of contact in the healthcare system. Project Octo-Pills aims to engage community pharmacists in the collaborative care of patients from a tertiary hospital, providing patients with quality medication reconciliation and review services from a more convenient location within their neighborhood. This paper describes the model for this pilot initiative.

PMID: 29054693 [PubMed - as supplied by publisher]

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Baseline asthma burden, comorbidities, and biomarkers in omalizumab-treated patients in PROSPERO.

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Baseline asthma burden, comorbidities, and biomarkers in omalizumab-treated patients in PROSPERO.

Ann Allergy Asthma Immunol. 2017 Oct 17;:

Authors: Chipps BE, Zeiger RS, Luskin AT, Busse WW, Trzaskoma BL, Antonova EN, Pazwash H, Limb SL, Solari PG, Griffin NM, Casale TB

Abstract
BACKGROUND: Patients included in clinical trials do not necessarily reflect the real-world population.
OBJECTIVE: To understand the characteristics, including disease and comorbidity burden, of patients with asthma receiving omalizumab in a real-world setting.
METHODS: The Prospective Observational Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab (PROSPERO) was a US-based, multicenter, single-arm, and prospective study. Patients (≥12 years of age) with allergic asthma initiating omalizumab treatment based on physician-assessed need were included and followed for 12 months. Exacerbations, health care use, adverse events, and Asthma Control Test (ACT) scores were assessed monthly. Biomarkers (blood eosinophils, fractional exhaled nitric oxide, and periostin) were evaluated and patient-reported outcomes (Asthma Quality of Life Questionnaire for 12 Years and Older [AQLQ+12] and Work Productivity and Activity Impairment: Asthma questionnaire [WPAI:Asthma]) were completed at baseline and months 6 and 12. The Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) was completed at baseline and 12 months.
RESULTS: Most of the 806 enrollees (91.4%) were adults (mean age 47.3 years, SD 17.4), white (70.3%), and female (63.5%). Allergic comorbidity was frequently reported (84.2%), as were hypertension (35.5%) and depression (22.1%). In the 12 months before study entry, 22.1% of patients reported at least 1 asthma-related hospitalization, 60.7% reported at least 2 exacerbations, and 83.3% reported ACT scores no higher than 19 (uncontrolled asthma). Most patients had low biomarker levels based on prespecified cut-points. Baseline mean patient-reported outcome scores were 4.0 (SD 1.4) for AQLQ+12, 2.7 (SD 1.4) for MiniRQLQ, and 47.7 (SD 28.9) for WPAI:Asthma percentage of activity impairment and 33.5 (SD 28.7) for percentage of overall work impairment.
CONCLUSION: The population initiating omalizumab in PROSPERO reported poorly controlled asthma and a substantial disease burden.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01922037.

PMID: 29054589 [PubMed - as supplied by publisher]

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Combating Malignant Astrocytes: Strategies Mitigating Tumor Invasion.

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Combating Malignant Astrocytes: Strategies Mitigating Tumor Invasion.

Neurosci Res. 2017 Oct 17;:

Authors: Umans RA, Sontheimer H

Abstract
Malignant gliomas are glial-derived, primary brain tumors that carry poor prognosis. Existing therapeutics are largely ineffective and dramatically affect quality of life. The standard of care details a taxing combination of surgical resection, radiation of the resection cavity, and temozolomide (TMZ) chemotherapy, with treatment extending life by only an average of months (Maher et al., 2001; Stupp et al., 2005). Despite scientific and technological advancement, surgery remains the most important treatment modality. Therapeutic obstacles include xenobiotic protection conveyed by the blood-brain barrier (Zhang et al., 2015), invasiveness and therapeutic resistance of tumor cell populations (Bao et al., 2006), and distinctive attributes of secondary glioma occurrence (Ohgaki and Kleihues, 2013). While these brain malignancies can be classified by grade or grouped by molecular subclass, each tumor presents itself as its own complication. Based on all of these obstacles, new therapeutic approaches are urgently needed. These will likely emerge from numerous exciting studies of glioma biology that are ongoing and reviewed here. These show unexpected roles for ion channels, amino-acid transporters, and connexin gap junctions in supporting the invasive growth of gliomas. These studies have identified a number of proteins that may be targeted for therapy in the future.

PMID: 29054465 [PubMed - as supplied by publisher]

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Optimizing Surgical Quality Datasets to Care for Older Adults: Lessons from the American College of Surgeons NSQIP Geriatric Surgery Pilot.

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Optimizing Surgical Quality Datasets to Care for Older Adults: Lessons from the American College of Surgeons NSQIP Geriatric Surgery Pilot.

J Am Coll Surg. 2017 Sep 28;:

Authors: Berian JR, Zhou L, Hornor MA, Russell MM, Cohen ME, Finlayson E, Ko CY, Robinson TN, Rosenthal RA

Abstract
BACKGROUND: Surgical quality datasets can be better tailored toward older adults. The American College of Surgeons (ACS) NSQIP Geriatric Surgery Pilot collected risk factors and outcomes in 4 geriatric-specific domains: cognition, decision-making, function, and mobility. This study evaluated the contributions of geriatric-specific factors to risk adjustment in modeling 30-day outcomes and geriatric-specific outcomes (postoperative delirium, new mobility aid use, functional decline, and pressure ulcers).
STUDY DESIGN: Using ACS NSQIP Geriatric Surgery Pilot data (January 2014 to December 2016), 7 geriatric-specific risk factors were evaluated for selection in 14 logistic models (morbidities/mortality) in general-vascular and orthopaedic surgery subgroups. Hierarchical models evaluated 4 geriatric-specific outcomes, adjusting for hospitals-level effects and including Bayesian-type shrinkage, to estimate hospital performance.
RESULTS: There were 36,399 older adults who underwent operations at 31 hospitals in the ACS NSQIP Geriatric Surgery Pilot. Geriatric-specific risk factors were selected in 10 of 14 models in both general-vascular and orthopaedic surgery subgroups. After risk adjustment, surrogate consent (odds ratio [OR] 1.5; 95% CI 1.3 to 1.8) and use of a mobility aid (OR 1.3; 95% CI 1.1 to 1.4) increased the risk for serious morbidity or mortality in the general-vascular cohort. Geriatric-specific factors were selected in all 4 geriatric-specific outcomes models. Rates of geriatric-specific outcomes were: postoperative delirium in 12.1% (n = 3,650), functional decline in 42.9% (n = 13,000), new mobility aid in 29.7% (n = 9,257), and new or worsened pressure ulcers in 1.7% (n = 527).
CONCLUSIONS: Geriatric-specific risk factors are important for patient-centered care and contribute to risk adjustment in modeling traditional and geriatric-specific outcomes. To provide optimal patient care for older adults, surgical datasets should collect measures that address cognition, decision-making, mobility, and function.

PMID: 29054389 [PubMed - as supplied by publisher]

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Bedside Chest Radiographs in the Intensive care Setting: Wireless Direct Radiography Compared to Computed Radiography.

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Bedside Chest Radiographs in the Intensive care Setting: Wireless Direct Radiography Compared to Computed Radiography.

Curr Probl Diagn Radiol. 2017 Sep 21;:

Authors: Audin CR, Aran S, Muse VV, Abbott GF, Ackman JB, Sharma A, Wu CC, Kalra MK, McLoud TC, Shepard JO, Fintelmann FJ, Gilman MD

Abstract
OBJECTIVES: To compare image quality, visibility of anatomic landmarks, tubes and lines, and other clinically significant findings on portable (bedside) chest radiographs acquired with wireless direct radiography (DRw) and computed radiography (CR).
METHODS: In a prospective IRB-approved and HIPAA-compliant study, portable DRw (DRX-1C mobile retrofit portable wireless direct radiography, CareStream Inc., Rochester, NY) and portable CR (AGFA CR (DXG) version; NIM2103, AGFA Healthcare, Ridgefield Park, NJ) images of the chest were acquired within 24-hours in 80 patients in the intensive care unit (ICU). Image pairs of 75 patients (37% female) with a mean age of 60.7±16 years were independently compared side-by-side by 7 experienced thoracic radiologists using a five-point scale. When tubes and lines were present, the radiologist also compared an edge-enhanced copy of the DRw image to the CR image.
RESULTS: Most radiologists found significantly fewer artifacts on DRw images compared to CR images and all readers agreed that when present, these artifacts did not significantly preclude the ability to evaluate anatomic landmarks, tubes and lines, or clinically significant findings. None of the radiologists (0/7) reported superior visibility of anatomic structures on CR images compared to DRw images and some radiologists (3/7) found DRw images significantly better for visibility of anatomic landmarks such as the carina (p=0.01-0.001). Most radiologists (6/7) found DRw images to be better or clearly better than CR images for position of tubes and lines, and edge-enhanced DRw images to be especially helpful for evaluation of central venous catheters and esophageal tubes (p=0.027-0.001). None of the radiologists deemed CR images superior for visibility of clinically significant findings.
CONCLUSIONS: Critical care chest radiography with a portable DRw system can provide similar or superior information compared to a CR system regarding clinically significant findings and position of tubes and lines.

PMID: 29054314 [PubMed - as supplied by publisher]

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Under-utilization of pacemaker therapy for sinus node dysfunction - Real world data from South Asia.

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Under-utilization of pacemaker therapy for sinus node dysfunction - Real world data from South Asia.

Indian Heart J. 2017 Sep - Oct;69(5):607-612

Authors: Narasimhan C, Sanyal J, Sethi R, Kothari Y, Malik FTN, Pandurangi U, Khan N, Sahu S, Lande J, Sachanandani H, Naik A

Abstract
OBJECTIVE: Chronic symptomatic sinus node dysfunction (SND), the most common bradyarrhythmia, can be effectively managed by permanent cardiac pacing. Yet the care pathway and barriers to adoption of pacing therapy are not well understood - particularly in low volume implanting countries. The IMPROVE Brady study is a quality improvement initiative being conducted at centers in South Asia, Latin America, and Russia. We assessed the rates of SND diagnosis and pacemaker treatment for SND in the South Asia cohort.
METHODS: The prospective study enrolled patients with heart rate of  ≤50 beats per minute presenting with symptoms including syncope, dizziness, and/or dyspnea from ten centers in India and Bangladesh. Patients were followed to identify the proportion diagnosed with SND and subsequently treated with pacemaker therapy.
RESULTS: A total of 508 patients meeting criteria were enrolled and followed on average for 8.3±8.0months. Patients were on average 58 years of age, 77% were male, and 91% had completed at least primary education. An SND diagnosis was made in 368 (72%) of patients, with the majority (80%) of diagnoses occurring within 1 month of enrollment. Of the patients with an SND diagnosis, 63 (17%) were treated with a pacemaker. Reasons for not receiving treatment were: subject refusal or deferred decision (45%), unaffordability (34%), physician determined - not-indicated (20%), and other (1%). Older age, female gender, history of hypertension, lower resting heart rate, and syncopal or pre-syncopal symptoms were associated with a higher probability of implant.
CONCLUSIONS: In a care pathway assessment for the diagnosis and treatment of symptomatic SND in South Asia only 1 in 6 patients received pacemaker indicated therapy, largely due to patient refusal and physician decision. Phase II of the study will be aimed to improve this treatment rate.

PMID: 29054184 [PubMed - in process]

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The NoSAS score: A new and simple screening tool for obstructive sleep apnea syndrome in depressive disorder.

The NoSAS score: A new and simple screening tool for obstructive sleep apnea syndrome in depressive disorder.

J Affect Disord. 2017 Oct 05;227:136-140

Authors: Guichard K, Marti-Soler H, Micoulaud-Franchi JA, Philip P, Marques-Vidal P, Vollenweider P, Waeber G, Preisig M, Haba-Rubio J, Heinzer R

Abstract
BACKGROUND: Since the clinical presentation of obstructive sleep apnea syndrome (OSAS) shares common features with major depressive (MDE), the screening of OSAS is challenging in this population. The aim of this study was to assess the effectiveness of the NoSAS score in predicting the presence of OSAS among participants with current MDE and to compare it with the performance of existing screening tools.
METHODS: A random sample of the population-based cohort CoLaus (Lausanne, Switzerland) underwent a psychiatric evaluation (PsyCoLaus) and a complete polysomnography at home (HypnoLaus). The effectiveness of the NoSAS score in detecting the risk of significant OSAS among current MDE participants was assessed and compared with STOP-BANG and Berlin scores.
RESULTS: Among the 1761 subjects (58,75 ± 11y.o.; 47,8%men) who underwent polysomnography, significant OSAS was present in 24.0% with and 26.1% without current MDE. Using a threshold of ≥ 8 points, the NoSAS score identified OSAS in MDE participants with a sensitivity of 0.79, a specificity of 0.66, a negative predictive value of 0.91, and a positive predictive value of 0.41. The area under the ROC curve was 0.72 for NoSAS, 0.66 for STOP-BANG and 0.69 for the Berlin score (NS).
LIMITATIONS: Only 44% of the PsyCoLaus participants had a polysomnography. The studied population was mainly of Caucasian ancestry and above 40 years of age.
CONCLUSIONS: This is the first study assessing the performance of screening tools for OSAS in MDE. The NoSAS score is a simple and efficient screening tool for OSAS in this population, and may be a helpful instrument for clinicians.

PMID: 29055261 [PubMed - as supplied by publisher]

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Cognition, quality-of-life and symptom clusters in breast cancer: using Bayesian networks to elucidate complex relationships.

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Cognition, quality-of-life and symptom clusters in breast cancer: using Bayesian networks to elucidate complex relationships.

Psychooncology. 2017 Oct 20;:

Authors: Xu S, Thompson W, Ancoli-Israel S, Liu L, Palmer B, Natarajan L

Abstract
OBJECTIVE: Breast cancer patients frequently complain of cognitive dysfunction during chemotherapy. Patients also report experiencing a cluster of sleep problems, fatigue and depressive symptoms during chemotherapy. We aimed to understand the complex dynamic interrelationships of depression, fatigue, and sleep to ultimately elucidate their role in cognitive performance and quality of life among breast cancer survivors undergoing chemotherapy treatment.
METHODS: Our study sample comprised 74 newly diagnosed stage I-III breast cancer patients scheduled to receive chemotherapy, and followed them for one year. An objective neuropsychological test battery and self-reported fatigue, mood, sleep quality, and quality of life were collected at three time points: before the start of chemotherapy (baseline: BL), at the end of cycle 4 chemotherapy (C4) and one year after the start of chemotherapy (Y1). We applied novel Bayesian network methods to investigate the role of sleep/fatigue/mood on cognition and quality of life prior to, during, and after chemotherapy.
RESULTS: The fitted network exhibited strong direct and indirect links between symptoms, cognitive performance and quality of life. The only symptom directly linked to cognitive performance was C4 sleep quality; at C4, fatigue was directly linked to sleep, and thus indirectly influenced cognitive performance. Mood strongly influenced concurrent quality of life at C4 and Y1. Regression estimates indicated that worse sleep quality, fatigue and mood were negatively associated with cognitive performance or quality of life.
CONCLUSIONS: The Bayesian network identified local structure (e.g., fatigue-mood-QoL or sleep-cognition), and possible intervention targets (e.g., a sleep intervention to reduce cognitive complaints during chemotherapy).

PMID: 29055062 [PubMed - as supplied by publisher]

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Suppression of adaptive responses to targeted cancer therapy by transcriptional repression.

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Suppression of adaptive responses to targeted cancer therapy by transcriptional repression.

Cancer Discov. 2017 Oct 20;:

Authors: Rusan M, Li K, Li Y, Christensen CL, Abraham BJ, Kwiatkowski N, Buczkowski KA, Bockorny B, Chen T, Li S, Rhee K, Zhang H, Chen W, Terai H, Tavares T, Leggett AL, Li T, Wang Y, Zhang T, Kim TJ, Hong SH, Poudel-Neupane N, Silkes M, Mudianto T, Tan L, Shimamura T, Meyerson M, Bass AJ, Watanabe H, Gray NS, Young RA, Wong KK, Hammerman PS

Abstract
Acquired drug resistance is a major factor limiting the effectiveness of targeted cancer therapies. Targeting tumors with kinase inhibitors induces complex adaptive programs that promote the persistence of a fraction of the original cell population, facilitating the eventual outgrowth of inhibitor-resistant tumor clones. We show that the addition of a newly identified CDK7/12 inhibitor, THZ1, to targeted therapy enhances cell killing and impedes the emergence of drug-resistant cell populations in diverse cellular and in vivo cancer models. We propose that targeted therapy induces a state of transcriptional dependency in a subpopulation of cells poised to become drug tolerant, which THZ1 can exploit by blocking dynamic transcriptional responses, remodeling of enhancers and key signalling outputs required for tumor cell survival in the setting of targeted therapy. These findings suggest that the addition of THZ1 to targeted therapies is a promising broad-based strategy to hinder the emergence of drug-resistant cancer cell populations.

PMID: 29054992 [PubMed - as supplied by publisher]

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Prevalence of sleep apnoea and capnographic detection of nocturnal hypoventilation in amyotrophic lateral sclerosis.

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Prevalence of sleep apnoea and capnographic detection of nocturnal hypoventilation in amyotrophic lateral sclerosis.

J Neurol Neurosurg Psychiatry. 2017 Oct 20;:

Authors: Boentert M, Glatz C, Helmle C, Okegwo A, Young P

Abstract
OBJECTIVE: This retrospective study aimed to investigate whether overnight oxymetry and early morning blood gas analysis predict nocturnal hypoventilation (NH) as reflected by night-time hypercapnia in patients with amyotrophic lateral sclerosis (ALS). In addition, prevalence and clinical determinants of sleep apnoea in ALS were evaluated.
METHODS: In 250 patients with non-ventilated ALS, transcutaneous capnometry was performed along with polysomnography or polygraphy and early morning blood gases.
RESULTS: 123 patients were female, and 84 patients had bulbar-onset ALS. 40.0% showed NH, and an apnoea-hypopnoea index (AHI) >5/hour was found in 45.6%. In 22.3%, sleep apnoea and NH coincided. The obstructive apnoea index was significantly higher than the central apnoea index (p<0.0001). Both NH and sleep apnoea were significantly more common in male than in female patients. Sleep apnoea and AHI were associated with better bulbar function . Desaturation time (t<90%) and transcutaneous CO2 were negatively correlated with upright vital capacity. Early morning base excess (EMBE), bicarbonate and t<90% were independent predictors of NH. However, among 100 patients with NH, 31 were missed by t<90% >5 min and 17 were not identified when EMBE >3 mmol/L and t<90% >5 min were combined.
CONCLUSION: In ALS, sleep apnoea is common and often accompanies NH. It is mainly obstructive, and central apnoea appears to be clinically irrelevant. Polygraphy or oxymetry alone are not sufficient to uncover NH. Combination of EMBE and t<90% may increase sensitivity, but transcutaneous capnography is strongly recommended for reliable detection of NH in patients with ALS.

PMID: 29054915 [PubMed - as supplied by publisher]

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Assessing the extent of non-aggressive cancer in clinically detected stage I non-small cell lung cancer.

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Assessing the extent of non-aggressive cancer in clinically detected stage I non-small cell lung cancer.

Thorax. 2017 Oct 20;:

Authors: Kale MS, Sigel K, Mhango G, Wisnivesky JP

Abstract
BACKGROUND: Overdiagnosis among clinically detected lung cancers likely consists of cases that are non-aggressive and slowly progressive and will never disseminate, cause symptoms or be a threat to a subject's survival, even if untreated. In this study, we estimate the prevalence of non-aggressive lung cancers from a large, population-based cancer registry.
METHODS: We identified individuals ≥65 years with histologically confirmed, untreated stage I non-small cell lung cancers (NSCLCs) from the Surveillance, Epidemiology, and End Results-Medicare registry. We estimated the rate of non-aggressive lung cancers by determining the point at which the cumulative lung cancer-specific survival curve no longer changed (ie, the slope approaches zero). At this point, there are no additional deaths due to progressive lung cancer observed among untreated patients after adjusting for deaths from competing risks (these long-term survivors can be considered 'non-aggressive cases).
RESULTS: The overall rate of non-aggressive cancers among 2197 clinically detected cases of untreated stage I NSCLC was 2.4%, 95% CI: 1.0% to 3.8%. The rate of non-aggressive cancer was 1.9% (95% CI: 0.0% to 4.9%) for women and 2.4% (95% CI: 0.7% to 4.1%) for men (p=0.84). When stratifying by tumour size, non-aggressive cancer rates were 10.2% (95% CI: 0.0% to 29.3%), 2.1% (95% CI: 0.0% to 9.2%), 4.9% (95% CI: 0.0% to 10.3%), 1.8% (95% CI: 0.0% to 5.2%) and 0.0% (95% CI: 0.0% to 1.0%) for tumour sizes <15 mm, 15-24 mm, 25-34 mm, 35-44 mm and ≥45 mm, respectively. In comparison with the smallest tumour sizes (<15 mm), the rates of non-aggressive cancers were not statistically significantly different for tumour sizes 15-24 mm (p=0.36), 25-34 mm (p=0.57), 35-44 mm (p=0.38) and tumour sizes >45 mm (p=0.30).
DISCUSSION: We found relatively low rates of non-aggressive cancers among clinically detected, stage I NSCLC regardless of sex or size. Our findings suggest that most clinically diagnosed early stage cancers should be treated with curative intent.

PMID: 29054884 [PubMed - as supplied by publisher]

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Ontogeny of circadian rhythms and synchrony in the suprachiasmatic nucleus.

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Ontogeny of circadian rhythms and synchrony in the suprachiasmatic nucleus.

J Neurosci. 2017 Oct 20;:

Authors: Carmona-Alcocer V, Abel JH, Sun TC, Petzold LR, Doyle FJ, Simms CL, Herzog ED

Abstract
In mammals, the suprachiasmatic nucleus (SCN) of the hypothalamus coordinates daily rhythms including sleep-wake, hormone release and gene expression. The cells of the SCN must synchronize to each other to drive these circadian rhythms in the rest of the body. The ontogeny of circadian cycling and intercellular coupling in the SCN remains poorly understood. Recent in vitro studies have recorded circadian rhythms from the whole embryonic SCN. Here, we tracked the onset and precision of rhythms in PERIOD2 (PER2), a clock protein, within the SCN isolated from embryonic and postnatal mice of undetermined sex. We found that a few SCN cells developed circadian periodicity in PER2 by 14.5 days after mating (E14.5) with no evidence for daily cycling on E13.5. On E15.5, the fraction of competent oscillators increased dramatically corresponding with stabilization of their circadian periods. The cells of the SCN harvested at E15.5 expressed sustained, synchronous daily rhythms. By postnatal day 2 (P2), SCN oscillators displayed the daily, dorsal-ventral phase wave in clock gene expression typical of the adult SCN. Strikingly, vasoactive intestinal polypeptide (VIP), a neuropeptide critical for synchrony in the adult SCN, and its receptor, VPAC2R, reached detectable levels after birth and after the onset of circadian synchrony. Antagonists of GABA or VIP signaling or action potentials did not disrupt circadian synchrony in the E15.5 SCN. We conclude that endogenous daily rhythms in the fetal SCN begin with few noisy oscillators on E14.5, followed by widespread oscillations that rapidly synchronize on E15.5 by an unknown mechanism.SIGNIFICANCE STATEMENTWe recorded the onset of PER2 circadian oscillations during embryonic development in the mouse SCN. When isolated at E13.5, the anlagen of the SCN expresses high, arrhythmic PER2. In contrast, a few cells show noisy circadian rhythms in the isolated E14.5 SCN and most show reliable, self-sustained, synchronized rhythms in the E15.5 SCN. Strikingly, this synchrony at E15.5 appears prior to expression of VIP or its receptor and persists in the presence of blockers of VIP, GABA or neuronal firing. Finally, the dorsal-ventral phase wave of PER2 typical of the adult SCN appears around P2, indicating that multiple signals may mediate circadian synchrony during the ontogeny of the SCN.

PMID: 29054877 [PubMed - as supplied by publisher]

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Obesity-Related CKD: When Kidneys Get the Munchies.

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Obesity-Related CKD: When Kidneys Get the Munchies.

J Am Soc Nephrol. 2017 Oct 20;:

Authors: Mount PF, Juncos LA

PMID: 29054854 [PubMed - as supplied by publisher]

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Visual and Quantitative Electroencephalographic Analysis in Healthy Term Neonates Within the First Six Hours and the Third Day of Life.

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Visual and Quantitative Electroencephalographic Analysis in Healthy Term Neonates Within the First Six Hours and the Third Day of Life.

Pediatr Neurol. 2017 May 04;:

Authors: Castro Conde JR, González Barrios D, González Campo C, González González NL, Reyes Millán B, Sosa AJ

Abstract
BACKGROUND: What constitutes a "normal" background electroencephalography (EEG) rhythm immediately after birth is not well understood. We performed video-electroencephalography recordings in the first six hours (first measure) and the third day of life (second measure) for evidence of transient changes in brain function.
METHODS: We performed a cohort study of an incidental sample of healthy term neonates in a single-center nursery. Main outcome measures were as follows: (1) EEG visual analysis, which included sleep-wake cycles, proportions of discontinuity and bursts with delta brushes, and number per hour of alpha/theta rolandic activity, encoches frontales, and transients; and (2) the electroencephalographic spectral analysis, which included power spectrum in the following frequency bands: delta, 0.5 to 4 Hz; theta, 4 to 8 Hz; alpha, 8 to 13 Hz; and beta, 13 to 30 Hz. Theta/delta and alpha/delta ratios were also calculated.
RESULTS: Twenty-two babies were enrolled. Significant findings (P < 0.05) in the first six hours with respect to 48 to 72 hours of life were (1) increased discontinuity, indeterminate sleep, and bursts with delta brushes; (2) higher number of transients, and lower number of alpha/theta rolandic activity and encoches frontales. Minimal changes were found in power spectrum data. However, using receiver operating characteristic curve analysis, theta/delta ratio ≤0.484 was the best cutoff to discriminate between the two measures (positive predictive value, 100.0; 95% confidence interval 71.0 to 100).
CONCLUSIONS: In healthy term neonates, immature electroencephalographic patterns, lack of clearly defined sleep-wake cycles, and frequent transients can be considered normal electroencephalographic findings in the first six hours of life. Normative power spectrum data are provided. These findings suggest that neonatal adaptation immediately after birth leads to transient changes in brain function.

PMID: 29054698 [PubMed - as supplied by publisher]

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The resilient brain and the guardians of sleep: New perspectives on old assumptions.

Related Articles

The resilient brain and the guardians of sleep: New perspectives on old assumptions.

Sleep Med Rev. 2017 Oct 17;:

Authors: Parrino L, Vaudano AE

Abstract
Resilience is the capacity of a system, enterprise or a person to maintain its core purpose and integrity in the face of dramatically changed circumstances. In human physiology, resilience is the capacity of adaptively overcoming stress and adversity while maintaining normal psychological and physical functioning. In this review, we investigate the resilient strategies of sleep. First, we discuss the concept of brain resilience, highlighting the modular structure of small-world networking, neuronal plasticity and critical brain behavior. Second, we explore the contribution of sleep to brain resilience listing the putative factors that impair sleep quality and predict susceptibility to sleep disorders. The third part details the manifold mechanisms acting as guardians of sleep, i.e., homeostatic, circadian and ultradian processes, sleep microstructure (K-complexes, delta bursts, arousals, cyclic alternating pattern, spindles), gravity, muscle tone and dreams. Mapping and pooling together the guardians of sleep in a dynamic integrated framework might lead towards an objective measure of sleep resilience and identify effective personalized strategies (biological, pharmacological, behavioral) to restore or protect the core properties of healthy sleep.

PMID: 29054694 [PubMed - as supplied by publisher]

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IJMS, Vol. 18, Pages 2214: A Mini-Review of Reactive Oxygen Species in Urological Cancer: Correlation with NADPH Oxidases, Angiogenesis, and Apoptosis

IJMS, Vol. 18, Pages 2214: A Mini-Review of Reactive Oxygen Species in Urological Cancer: Correlation with NADPH Oxidases, Angiogenesis, and Apoptosis

International Journal of Molecular Sciences doi: 10.3390/ijms18102214

Authors: Yasuyoshi Miyata Tomohiro Matsuo Yuji Sagara Kojiro Ohba Kaname Ohyama Hideki Sakai

Oxidative stress refers to elevated reactive oxygen species (ROS) levels, and NADPH oxidases (NOXs), which are one of the most important sources of ROS. Oxidative stress plays important roles in the etiologies, pathological mechanisms, and treatment strategies of vascular diseases. Additionally, oxidative stress affects mechanisms of carcinogenesis, tumor growth, and prognosis in malignancies. Nearly all solid tumors show stimulation of neo-vascularity, termed angiogenesis, which is closely associated with malignant aggressiveness. Thus, cancers can be seen as a type of vascular disease. Oxidative stress-induced functions are regulated by complex endogenous mechanisms and exogenous factors, such as medication and diet. Although understanding these regulatory mechanisms is important for improving the prognosis of urothelial cancer, it is not sufficient, because there are controversial and conflicting opinions. Therefore, we believe that this knowledge is essential to discuss observations and treatment strategies in urothelial cancer. In this review, we describe the relationships between members of the NOX family and tumorigenesis, tumor growth, and pathological mechanisms in urological cancers including prostate cancer, renal cell carcinoma, and urothelial cancer. In addition, we introduce natural compounds and chemical agents that are associated with ROS-induced angiogenesis or apoptosis.

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IJMS, Vol. 18, Pages 2212: Aptamers for DNA Damage and Repair

IJMS, Vol. 18, Pages 2212: Aptamers for DNA Damage and Repair

International Journal of Molecular Sciences doi: 10.3390/ijms18102212

Authors: Maureen McKeague

DNA is damaged on a daily basis, which can lead to heritable mutations and the activation of proto-oncogenes. Therefore, DNA damage and repair are critical risk factors in cancer, aging and disease, and are the underlying bases of most frontline cancer therapies. Much of our current understanding of the mechanisms that maintain DNA integrity has been obtained using antibody-based assays. The oligonucleotide equivalents of antibodies, known as aptamers, have emerged as potential molecular recognition rivals. Aptamers possess several ideal properties including chemical stability, in vitro selection and lack of batch-to-batch variability. These properties have motivated the incorporation of aptamers into a wide variety of analytical, diagnostic, research and therapeutic applications. However, their use in DNA repair studies and DNA damage therapies is surprisingly un-tapped. This review presents an overview of the progress in selecting and applying aptamers for DNA damage and repair research.

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IJMS, Vol. 18, Pages 2213: Kinases of eIF2a Switch Translation of mRNA Subset during Neuronal Plasticity

IJMS, Vol. 18, Pages 2213: Kinases of eIF2a Switch Translation of mRNA Subset during Neuronal Plasticity

International Journal of Molecular Sciences doi: 10.3390/ijms18102213

Authors: Ekaterina Chesnokova Natalia Bal Peter Kolosov

Compared to other types of cells, neurons express the largest number of diverse mRNAs, including neuron-specific ones. This mRNA diversity is required for neuronal function, memory storage, maintenance and retrieval. Regulation of translation in neurons is very complicated and involves various proteins. Some proteins, implementing translational control in other cell types, are used by neurons for synaptic plasticity. In this review, we discuss the neuron-specific activity of four kinases: protein kinase R (PKR), PKR-like endoplasmic reticulum kinase (PERK), general control nonderepressible 2 kinase (GCN2), and heme-reguated eIF2α kinase (HRI), the substrate for which is α-subunit of eukaryotic initiation factor 2 (eIF2α). Phosphorylation of eIF2α is necessary for the cell during stress conditions, such as lack of amino acids, energy stress or viral infection. We propose that, during memory formation, neurons use some mechanisms similar to those involved in the cellular stress. The four eIF2α kinases regulate translation of certain mRNAs containing upstream open reading frames (uORFs). These mRNAs encode proteins involved in the processes of long-term potentiation (LTP) or long-term depression (LTD). The review examines some neuronal proteins for which translation regulation by eIF2 was suggested and checked experimentally. Of such proteins, we pay close attention to protein kinase Mζ, which is involved in memory storage and regulated at the translational level.

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Enhanced Optical and Electrical Properties of ITO/Ag/AZO Transparent Conductors for Photoelectric Applications

The enhancement of the optical and electrical properties of TCO films was investigated by depositing different layers of AZO (100 nm), Ag (5 nm)/AZO (95 nm), and ITO (45 nm)/Ag (5 nm)/AZO (50 nm) upon n-Si substrate at room temperature by magnetron sputtering method. The ITO/Ag/AZO device efficiently improved the electrical and optical properties with the low sheet resistance of 2.847 Ω/sq. and an increase in the rectification ratio of 455.60% when compared with AZO and Ag/AZO devices. The combination of ITO/Ag/AZO provided the optimum results in all the electrical and optical properties. These results showed that within the optimized thickness range of 100 nm, compared to AZO and Ag/AZO, ITO/Ag/AZO device showed the improvement for both optical and electrical properties at room temperature.

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HRR Profiling on Integrated Radar-Communication Systems Using OFDM-PCSF Signals

In order to improve both the transmission data rate and the range resolution simultaneously in integrated radar-communication (RadCom) systems, orthogonal frequency-division multiplexing with phase-coded and stepped-frequency (OFDM-PCSF) waveform is proposed. A corresponding high resolution range (HRR) profile generation method is also presented. We first perform OFDM-PCSF waveform design by combining the intrapulse phase coding with the interpulse stepped-frequency modulation. We then give the ambiguity function (AF) based on the presented waveforms. Then, the synthetic range profile (SRP) processing to achieve HRR performance is analyzed. Theoretical analysis and simulation results show that the proposed methods can achieve HRR profiles of the targets and high data rate transmissions, while a relative low computational complexity can be achieved.

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Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass

Supernumerary testis, also known as polyorchidism, is a condition characterized by the presence of more than two testes. Another condition of the testes is seminoma, a common cause of testicular germ cell tumor. A 35-year-old male was transferred to our hospital with a diagnosis of abdominal mass causing abdominal pain. On physical exam, he had a palpable undescended left testicle in the left inguinal canal, which was determined to be seminoma. The mass was surgically removed, and the patient underwent chemotherapy. The report discusses his workup, treatment, and outcome. This case illustrates an unusual presentation of supernumerary testis with the extra testis harboring a seminoma. When presented with a case of testicular cancer with no tumor noted in the palpable testes, malignancy in an extranumerary testicle should be considered in the differential.

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Quantum Speed Limit for Relativistic Spin-0 and Spin-1 Bosons on Commutative and Noncommutative Planes

Quantum speed limits of relativistic charged spin-0 and spin-1 bosons in the background of a homogeneous magnetic field are studied on both commutative and noncommutative planes. We show that, on the commutative plane, the average speeds of wave packets along the radial direction during the interval in which a quantum state is evolving from an initial state to the orthogonal final one can not exceed the speed of light, regardless of the intensities of the magnetic field. However, due to the noncommutativity, the average speeds of the wave packets on noncommutative plane will exceed the speed of light in vacuum provided the intensity of the magnetic field is strong enough. It is a clear signature of violating Lorentz invariance in the relativistic quantum mechanics region.

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Quantitative Serum Proteomic Analysis of Essential Hypertension Using iTRAQ Technique

Essential hypertension (EH) is a risk factor for some severe diseases. This study aimed to screen out serum special proteins and seek interaction between them, which would provide new therapeutic targets and elucidate the comprehensive pathophysiological mechanism for EH. Patients with EH (Group A, ) and healthy controls (HC) (Group B, ) were recruited in this study. Serums from the two groups were analyzed with isobaric tags for relative and absolute quantitation coupled two-dimensional liquid chromatography followed by electrospray ionization-tandem mass spectrometry technique, while the candidate special proteins were verified with ELISA and western blot. A total of 404 proteins were identified, of which 30 proteins were upregulated (>1.2-fold, ) and 81 proteins were downregulated (

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Osteogenic Differentiation of hDPSCs on Biogenic Bone Apatite Thin Films

A previous study reported the structural characterization of biogenic apatite (BAp) thin films realized by a pulsed electron deposition system by ablation of deproteinized bovine bone. Thin films annealed at 400°C exhibited composition and crystallinity degree very close to those of biogenic apatite; this affinity is crucial for obtaining faster osseointegration compared to conventional, thick hydroxyapatite (HA) coatings, for both orthopedics and dentistry. Here, we investigated the adhesion, proliferation, and osteogenic differentiation of human dental pulp stem cells (hDPCS) on as-deposited and heat-treated BAp and stoichiometric HA. First, we showed that heat-treated BAp films can significantly promote hDPSC adhesion and proliferation. Moreover, hDPSCs, while initially maintaining the typical fibroblast-like morphology and stemness surface markers, later started expressing osteogenic markers such as Runx-2 and OSX. Noteworthy, when cultured in an osteogenic medium on annealed BAp films, hDPSCs were also able to reach a more mature and terminal commitment, with respect to HA and as-deposited films. Our findings suggest that annealed BAp films not only preserve the typical biological properties of stemness of, hDPSCs but also improve their ability of osteogenic commitment.

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Antihypertensive Effects of Roselle-Olive Combination in L-NAME-Induced Hypertensive Rats

This study aimed to evaluate the antihypertensive efficacy of a new combination therapy of Hibiscus sabdariffa and Olea europaea extracts (2 : 1; Roselle-Olive), using N(G)-nitro-L-arginine-methyl ester- (L-NAME-) induced hypertensive model. Rats received L-NAME (50 mg/kg/day, orally) for 4 weeks. Concurrent treatment with Roselle-Olive (500, 250, and 125 mg/kg/day for 4 weeks) resulted in a dose-dependent decrease in both systolic and diastolic blood pressure, reversed the L-NAME-induced suppression in serum nitric oxide (NO), and improved liver and kidney markers, lipid profile, and oxidative status. Furthermore, Roselle-Olive significantly lowered the elevated angiotensin-converting enzyme activity (ACE) and showed a marked genoprotective effect against oxidative DNA damage in hypertensive rats. Roselle-Olive ameliorated kidney and heart lesions and reduced aortic media thickness. Real-time PCR and immunohistochemistry showed an enhanced endothelial nitric oxide synthase (eNOS) gene and protein expression in both heart and kidney of Roselle-Olive-treated rats. To conclude, our data revealed that Roselle-Olive is an effective combination in which H. sabdariffa and O. europaea synergistically act to control hypertension. These effects are likely to be mediated by antioxidant and genoprotective actions, ACE inhibition, and eNOS upregulation by Roselle-Olive constituents. These findings provide evidences that Roselle-Olive combination affords efficient antihypertensive effect with a broad end-organ protective influence.

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Recurrent Huge Left Bartholin’s Gland Abscess for One Year in a Teenager

Bartholin's gland abscess is the commonest worldwide reported abscess in gynaecological outpatient clinics; it has also been reported that Bartholin's gland abscess is three times more common in occurrences compared to Bartholin's gland cyst. It is more common in women who are at risk of acquiring sexually transmitted infections; however, other causes of infection should be investigated to exclude other causes of disease. We present the case of an 18-year-old female patient, a teenager of the reproductive age group, with the recurrent development of huge Bartholin's gland abscess in a period of one year. The marsupialization surgical technique of repair was performed successfully. She was discharged home and she was scheduled to visit STI's clinic where she was receiving regular screening for STI's and she was also given health education regarding preventive measures for STI's.

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Resveratrol Ameliorates Mitochondrial Elongation via Drp1/Parkin/PINK1 Signaling in Senescent-Like Cardiomyocytes

Resveratrol is widely known for its antiaging properties and exerts cardiovascular protective effects in different experimental models. The role of resveratrol in regulating mitochondrial functions and dynamics during the cardiac aging process remains poorly understood. In this study, the effects of resveratrol on mitochondrial morphology and mitochondrial depolarization and on expressions of Drp1, parkin, PINK1, and LC3 were investigated in H9c2 cells after D-galactose treatment that induced senescent-like cardiomyocytes. The results show that downregulation of Drp1 markedly increased mitochondrial elongation. Senescent-like cardiomyocytes were more resistant to CCCP-induced mitochondrial depolarization, which was accompanied by suppressed expression of parkin, PINK1, and LC3-II. Resveratrol treatment significantly increased Drp1 expression, ameliorated mitochondrial elongation, and increased the mitochondrial translocations of parkin and PINK1. In addition, resveratrol significantly enhanced LC3-II expression and decreased TOM20-labeled mitochondrial content. Resveratrol also suppressed the phosphorylation of parkin and PINK1, which may relate to its abilities to degrade the impaired mitochondria in senescent-like cardiomyocytes. These findings show that suppressing mitochondrial elongation in a Drp1-dependent manner is involved in the effect of resveratrol on attenuating the development of aging cardiomyocytes. Activation of parkin and PINK1 may be a potential mechanism of resveratrol for treating cardiovascular complications related to aging.

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Severe Cytomegalovirus Reactivation in Patient with Low-Grade Non-Hodgkin’s Lymphoma after Standard Chemotherapy

Clinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies after nonintensive chemotherapy. We treated a patient at our centre for stage IVB follicular lymphoma with standard chemotherapy who successively developed CMV colitis associated with a CMV viral load of >3 million copies/ml. Four lines of antiviral treatment were necessary to obtain biochemical remission with undetectable CMV levels, with an initially insufficient response to valganciclovir despite therapeutic pre- and posttreatment levels. Subsequently, our patient also developed an infection with Pneumocystis jirovecii pneumonia (PJP) as further evidence of severe immune compromise. This case report demonstrates the importance of including investigations for less common sources of infection when confronted with a patient with a low-grade haematological malignancy and a pyrexia of unknown origin.

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Vitamin D Status, Disease Activity, and Endothelial Dysfunction in Early Rheumatoid Arthritis Patients

Cardiovascular diseases represent important complications in rheumatoid arthritis (RA) patients, generated by an accelerated atherosclerosis. The aim of this study is represented by the assessment of the correlations between serum levels of vitamin D, disease activity, and endothelial dysfunction in patients with early RA. Material and Methods. The study was performed on a group of 35 patients with early RA and 35 healthy subjects matched for age and gender, as controls. In all studied subjects, the following were determined: inflammatory markers, insulin resistance, vitamin D levels, and endothelial dysfunction. Statistical analysis were performed using the Student's t-test and the Pearson's test. p values of less than 0.05 were considered statistically significant. Results. The group of patients with RA patients presented inflammation, low levels of vitamin D, elevated insulin resistance, and reduced flow-mediated vasodilation, statistically significant compared to the control group (). Significant inverse correlations between the levels of 25(OH) vitamin D and DAS28, respective insulin resistance, and significant positive correlation between 25(OH) vitamin D and endothelial function were demonstrated. Conclusion. In early RA patients with moderate and high disease activity, low serum levels of vitamin D were associated with disease activity, increased insulin resistance, and endothelial dysfunction.

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A Look into Stem Cell Therapy: Exploring the Options for Treatment of Ischemic Stroke

Neural stem cells (NSCs) offer a potential therapeutic benefit in the recovery from ischemic stroke. Understanding the role of endogenous neural stem and progenitor cells under normal physiological conditions aids in analyzing their effects after ischemic injury, including their impact on functional recovery and neurogenesis at the site of injury. Recent animal studies have utilized unique subsets of exogenous and endogenous stem cells as well as preconditioning with pharmacologic agents to better understand the best situation for stem cell proliferation, migration, and differentiation. These stem cell therapies provide a promising effect on stimulation of endogenous neurogenesis, neuroprotection, anti-inflammatory effects, and improved cell survival rates. Clinical trials performed using various stem cell types show promising results to their safety and effectiveness on reducing the effects of ischemic stroke in humans. Another important aspect of stem cell therapy discussed in this review is tracking endogenous and exogenous NSCs with magnetic resonance imaging. This review explores the pathophysiology of NSCs on ischemic stroke, stem cell therapy studies and their effects on neurogenesis, the most recent clinical trials, and techniques to track and monitor the progress of endogenous and exogenous stem cells.

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Plasma Fibulin-3 as a Potential Biomarker for Patients with Asbestos-Related Diseases in the Han Population

Fibulin-3 has been reported as a potential biomarker for mesothelioma. However, little is known about the diagnostic efficacies of fibulin-3 for asbestos-related diseases (ARDs) in China. This study was to investigate the utility of fibulin-3 for asbestos exposure and ARDs. A total of 430 subjects were recruited from Southeast China, including healthy individuals, asbestos-exposed (AE) individuals, and patients with pleural plaques (PP), asbestosis, and malignant pleural mesothelioma (MPM). Plasma fibulin-3 was measured using the enzyme-linked immunosorbent assay. Linear regression analyses were applied to explore the influencing factors of fibulin-3. Receiver operating characteristic curves were used to determine the cutoff values. The median fibulin-3 level of subjects in the mesothelioma group was higher than that in other groups. Subjects in the asbestosis group had higher median fibulin-3 level than those in the control group. A higher fibulin-3 level was found in the group with ≥10 years of asbestos exposure as compared with control groups. The AUCs of fibulin-3 for distinguishing MPM subjects from control, AE, PP, and asbestosis subjects were 0.92, 0.88, 0.90, and 0.81, respectively. Our study provided evidence that fibulin-3 could be a potential biomarker for the early screening of MPM, but not of other nonmalignant ARDs in Chinese populations.

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Correlation between Traditional Chinese Medicine Constitution and Dyslipidemia: A Systematic Review and Meta-Analysis

Objective. To study the correlation between Traditional Chinese Medicine (TCM) constitution and dyslipidemia. Methods. CNKI, VIP, Wanfang database, CBMdisc, PubMed, and Embase were searched, and meta-analysis was performed by Review Manager 5.2 software. Results. Altogether 11 studies were included with 12890 individuals. The results showed that balanced constitution was a protective factor of dyslipidemia (OR = 0.62, 95% CI 0.47~0.82) while phlegm-dampness constitution was a risk factor of it (OR = 2.50, 95% CI 2.22~2.80), and the effect of phlegm-dampness constitution in South China (OR = 3.31, 95% CI 1.71~6.43) was more obvious than that in East (OR = 2.40, 95% CI 2.06~2.80) and North China (OR = 2.24, 95% CI 1.81~2.78). Conclusion. This study provides evidence for the prevention and treatment of dyslipidemia in TCM. However, most of the studies included are of moderate quality; more high quality, multicenter, large-sample studies are expected to provide higher level evidence.

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Cardiac Nonmyocyte Cell Functions and Crosstalks in Response to Cardiotoxic Drugs

The discovery of the molecular mechanisms involved in the cardiac responses to anticancer drugs represents the current goal of cardio-oncology research. The oxidative stress has a pivotal role in cardiotoxic responses, affecting the function of all types of cardiac cells, and their functional crosstalks. Generally, cardiomyocytes are the main target of research studies on cardiotoxicity, but recently the contribution of the other nonmyocyte cardiac cells is becoming of growing interest. This review deals with the role of oxidative stress, induced by anticancer drugs, in cardiac nonmyocyte cells (fibroblasts, vascular cells, and immune cells). The alterations of functional interplays among these cardiac cells are discussed, as well. These interesting recent findings increase the knowledge about cardiotoxicity and suggest new molecular targets for both diagnosis and therapy.

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Viruses, Vol. 9, Pages 310: Human Metapneumovirus Attachment Protein Contributes to Neutrophil Recruitment into the Airways of Infected Mice

Viruses, Vol. 9, Pages 310: Human Metapneumovirus Attachment Protein Contributes to Neutrophil Recruitment into the Airways of Infected Mice

Viruses doi: 10.3390/v9100310

Authors: Nagarjuna Cheemarla Antonieta Guerrero-Plata

Human Metapneumovirus (HMPV) is a leading respiratory pathogen that causes lower respiratory tract infections worldwide. Acute HMPV infection induces an exacerbated inflammatory neutrophilic response leading to bronchiolitis and pneumonia. However, the mechanism by which the virus regulates neutrophil infiltration into the airways still remains unexplored. In this work, we used an experimental mouse model of HMPV infection to demonstrate that the attachment (G) protein of HMPV contributes to the recruitment of neutrophils into the airways and modulate the production of neutrophil chemoattractants and Type I IFN responses, specifically IFN-α. These findings provide the first evidence that the HMPV G protein contributes to the in vivo neutrophilic response to HMPV infection and furthers our understanding on virus induced inflammatory responses in the airways.

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Cells, Vol. 6, Pages 37: Standard Assays for the Study of Autophagy in the Ex Vivo Retina

Cells, Vol. 6, Pages 37: Standard Assays for the Study of Autophagy in the Ex Vivo Retina

Cells doi: 10.3390/cells6040037

Authors: Raquel Gómez-Sintes Beatriz Villarejo-Zori Ana Serrano-Puebla Lorena Esteban-Martínez Elena Sierra-Filardi Ignacio Ramírez-Pardo Natalia Rodríguez-Muela Patricia Boya

Autophagy is a catabolic pathway that mediates the degradation and recycling of intracellular components, and is a key player in a variety of physiological processes in cells and tissues. Recent studies of autophagy in the eye suggest that this pathway is fundamental for the preservation of retinal homeostasis. Given its accessible location outside the brain, the retina is an ideal organ in which to study the central nervous system and a wide range of neuronal processes, from development to neurodegeneration. Here we review several methods used to assess autophagy in the retina in both physiological and pathological conditions.

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Cells, Vol. 6, Pages 36: Monitoring Autophagy in the Model Green Microalga Chlamydomonas reinhardtii

Cells, Vol. 6, Pages 36: Monitoring Autophagy in the Model Green Microalga Chlamydomonas reinhardtii

Cells doi: 10.3390/cells6040036

Authors: María Pérez-Pérez Inmaculada Couso Luis Heredia-Martínez José Crespo

Autophagy is an intracellular catabolic system that delivers cytoplasmic constituents and organelles in the vacuole. This degradative process is mediated by a group of proteins coded by autophagy-related (ATG) genes that are widely conserved from yeasts to plants and mammals. Homologs of ATG genes have been also identified in algal genomes including the unicellular model green alga Chlamydomonas reinhardtii. The development of specific tools to monitor autophagy in Chlamydomonas has expanded our current knowledge about the regulation and function of this process in algae. Recent findings indicated that autophagy is regulated by redox signals and the TOR network in Chlamydomonas and revealed that this process may play in important role in the control of lipid metabolism and ribosomal protein turnover in this alga. Here, we will describe the different techniques and approaches that have been reported to study autophagy and autophagic flux in Chlamydomonas.

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IJERPH, Vol. 14, Pages 1269: Barriers and Facilitators to the Elimination of Asbestos Related Diseases—Stakeholders’ Perspectives

IJERPH, Vol. 14, Pages 1269: Barriers and Facilitators to the Elimination of Asbestos Related Diseases—Stakeholders' Perspectives

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph14101269

Authors: Joanne Vincenten Frank George Marco Martuzzi Peter Schröder-Bäck Elizabet Paunovic

Despite sound scientific knowledge and evidence that any exposure to asbestos fibers in all of its forms, are carcinogenic to humans, its presence, use and trade is still substantial, including in the World Health Organization (WHO) European Region. Banning the production and use of all forms of asbestos, as recommended by the International Labour Organization (ILO) and WHO, has been proven as the most efficient evidence-based strategy to eliminate Asbestos Related Diseases (ARDs). To effectively move elimination of ARDs forward, attaining a greater understanding of key stakeholders perspectives was identified as an important action. The WHO Regional Office for Europe, the European Centre for Environment and Health, undertook semi-structured interviews, and follow-up discussions with diverse representatives dealing professionally with asbestos. The interview questionnaire was developed based on the current ARDs WHO Report, the Evidence Implementation Model for Public Health and categories of the theory of diffusion. Data were attained on three main questions within the interview questionnaire: (1) Identifying barriers to implementation of WHO evidence-based asbestos recommendations; (2) Describing roles of key stakeholders; and, (3) Proposing possible solutions. The results demonstrated use of sound and convincing scientific evidence along with economic evidence and facilitators can be used to achieve evidence-based policy development, and comprehensive diverse actions.

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Renoprotective Effects of Total Glucosides from Paeony against Nephrotoxicity Induced by Total Alkaloids from Semen Strychni

Semen Strychni have been shown to have therapeutic effect in improving blood circulation, relieving rheumatic pain, and treating cancer. However, Semen Strychni could cause severe nephrotoxicity. The present study was designed to evaluate whether treatment with total glucosides from paeony (TGP) has renoprotective effect against nephrotoxicity induced by total alkaloids from Semen Strychni (TAS). The levels of blood urea nitrogen (BUN) and creatinine (Cr) were determined and histopathological changes were also examined to evaluate renal injury. Moreover, a HPLC-MS method was developed and validated to investigate the comparative toxicokinetics of strychnine and brucine in rats plasma after oral administration of TAS and pretreatment with TGP. Results demonstrated that the levels of BUN and Cr were significantly increased () in TAS group, together with tubule epithelium cloudy swelling, degeneration, and glomerular atrophy in rats' kidneys. The TAS-induced kidney damage was alleviated after pretreatment with TGP. Besides, of strychnine and brucine were increased and of strychnine and brucine were decreased after pretreatment with TGP. The toxicokinetics study showed that pretreatment with TGP could attenuate the absorption of strychnine and brucine, as well as accelerate their elimination. These results suggest that TGP possesses renoprotective effects.

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The NIMO Scandinavian Study: A Prospective Observational Study of Iron Isomaltoside Treatment in Patients with Iron Deficiency

Background. Intravenous iron allows for efficient and well-tolerated treatment in iron deficiency and is routinely used in diseases of the gastrointestinal tract. Objective. The aims of this study were to determine the probability of relapse of iron deficiency over time and to investigate treatment routine, effectiveness, and safety of iron isomaltoside. Methods. A total of 282 patients treated with iron isomaltoside were observed for two treatments or a minimum of one year. Results. Out of 282 patients, 82 had Crohn's disease and 67 had ulcerative colitis. Another 133 patients had chronic blood loss, malabsorption, or malignancy. Patients who received an iron isomaltoside dose above 1000 mg had a 65% lower probability of needing retreatment compared with those given 1000 mg. A clinically significant treatment response was shown, but in 71/191 (37%) of patients, anaemia was not corrected. The mean dose given was 1100 mg, lower than the calculated total iron need of 1481 mg. Adverse drug reactions were reported in 4% of patients. Conclusion. Iron isomaltoside is effective with a good safety profile, and high doses reduce the need for retreatment over time. Several patients were anaemic after treatment, indicating that doses were inadequate for full iron correction. This trial is registered with NCT01900197.

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Pulmonary Complications after Surgery for Rectal Cancer in Elderly Patients: Evaluation of Laparoscopic versus Open Approach from a Multicenter Study on 477 Consecutive Cases

Aim. To evaluate the impact of open or laparoscopic rectal surgery on pulmonary complications in elderly (>75 years old) patients. Methods. Data from consecutive patients who underwent elective laparoscopic or open rectal surgery for cancer were collected prospectively from 3 institutions. Pulmonary complications were defined according to the ACS/NSQUIP definition. Results. A total of 477 patients (laparoscopic group: 242, open group: 235) were included in the analysis. Postoperative pulmonary complications were significantly more common after open surgery (8 out of 242 patients (3.3%) versus 23 out of 235 patients (9.8%); ). In addition, PPC occurrence was associated with the increasing of postoperative pain (5.04 ± 1.62 versus 5.03 ± 1.58; ) and the increasing of operative time (270.06 ± 51.49 versus 237.37 ± 65.97; ). Conclusion. Our results are encouraging to consider laparoscopic surgery a safety and effective way to treat rectal cancer in elderly patients, highlighting that laparoscopic surgery reduces the occurrence of postoperative pulmonary complications.

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The Effect of CM082, an Oral Tyrosine Kinase Inhibitor, on Experimental Choroidal Neovascularization in Rats

The aims of this study were to evaluate the effects of CM082 on the development of choroidal neovascularization (CNV) in a laser-induced CNV rat model and to determine the drug concentration in the ocular tissues. After the laser-induced CNV model was established in rats, CM082 was orally administered. The effects of CM082 on the CNV lesions were assessed using fundus fluorescein angiography (FFA), CNV histology, and retinal pigment epithelium- (RPE-) choroid-sclera eyecup analysis. The concentrations of CM082 in the plasma and eye tissues were determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results of FFA, histology, and RPE-choroid-sclera eyecup analysis demonstrated that the CM082-treated (10 mg/kg/d or 30 mg/kg/d) rats exhibited significantly less neovascularization than did the control group. The total concentration of CM082 in the eyes (172.86 ± 57.11 ng/g) was similar to that in the plasma (196.87 ± 73.13 ng/ml). Within the eye, the concentrations of CM082 and its metabolites were highest in the retina-sclera. The orally administered CM082 thus effectively passed through the blood-retina barrier (BRB) to reach the retina in the Brown Norway rats. Therefore, at both 10 mg/kg/d and 30 mg/kg/d, CM082 was able to reduce CNV lesions in the laser-induced CNV rat model.

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Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study

Aim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. Methods. We conducted a cohort study on nondiabetic women  10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. Conclusion. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM.

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Algorithm for Correcting the Keratometric Error in the Estimation of the Corneal Power in Keratoconus Eyes after Accelerated Corneal Collagen Crosslinking

Purpose. To analyze the errors associated to corneal power calculation using the keratometric approach in keratoconus eyes after accelerated corneal collagen crosslinking (CXL) surgery and to obtain a model for the estimation of an adjusted corneal refractive index minimizing such errors. Methods. Potential differences () among keratometric () and Gaussian corneal power () were simulated. Three algorithms based on the use of for the estimation of an adjusted keratometric corneal power () were developed. The agreement between (keratometric power using the keratometric index of 1.3375), , and was evaluated. The validity of the algorithm developed was investigated in 21 keratoconus eyes undergoing accelerated CXL. Results. overestimated corneal power between 0.3 and 3.2 D in theoretical simulations and between 0.8 and 2.9 D in the clinical study (). Three linear equations were defined for to be used for different ranges of r1c. In the clinical study, differences between and did not exceed ±0.8 D . No statistically significant differences were found between and () and and (). Conclusions. The use of the keratometric approach in keratoconus eyes after accelerated CXL can lead to significant clinical errors. These errors can be minimized with an adjusted keratometric approach.

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Design and Test Research on Cutting Blade of Corn Harvester Based on Bionic Principle

Existing corn harvester cutting blades have problems associated with large cutting resistance, high energy consumption, and poor cut quality. Using bionics principles, a bionic blade was designed by extracting the cutting tooth profile curve of the B. horsfieldi palate. Using a double-blade cutting device testing system, a single stalk cutting performance contrast test for corn stalks obtained at harvest time was carried out. Results show that bionic blades have superior performance, demonstrated by strong cutting ability and good cut quality. Using statistical analysis of two groups of cutting test data, the average cutting force and cutting energy of bionic blades and ordinary blades were obtained as 480.24 N and 551.31 N and 3.91 J and 4.38 J, respectively. Average maximum cutting force and cutting energy consumption for the bionic blade were reduced by 12.89% and 10.73%, respectively. Variance analysis showed that both blade types had a significant effect on maximum cutting energy and cutting energy required to cut a corn stalk. This demonstrates that bionic blades have better cutting force and energy consumption reduction performance than ordinary blades.

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Psychometric Properties of Diabetes Management Self-Efficacy in Thai Type 2 Diabetes Mellitus Patients: A Multicenter Study

Objective. The aims of this study were to translate and psychometrically evaluate the Thai version of diabetes management self-efficacy scale (T-DMSES) and to examine its association with HbA1c control in diabetic individuals. Methods. This study recruited patients from outpatient diabetes clinics of both community and university hospitals. The first phases of this study involved translation of the existing DMSES into Thai, and in the second phase, we evaluated its psychometric properties. The construct validity was evaluated using confirmatory factor analysis. Criterion validity of DMSES was subsequently evaluated by examining DMSES's association with HbA1c control. Results. The T-DMSES contains 20 items across four factors. Confirmatory factor analysis demonstrated the construct validity of T-DMSES (, df = 164, , CFI = 0.98, RMSEA = 0.065, TLI = 0.977, and AGFI = 0.981). The T-DMSES was also shown to be criterion valid with most subscales highly associated with HbA1c control. Conclusion. The T-DMSES was shown to have good psychometric properties. It is likely to provide valuable insights into the epidemiology of diabetes management self-efficacy and may also prove useful in evaluating interventions for raising diabetes management self-efficacy, which in turn, improve both patient self-management and blood sugar control.

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Two Reliable Methods for Solving the (3 + 1)-Dimensional Space-Time Fractional Jimbo-Miwa Equation

We investigate methods for obtaining exact solutions of the (3 + 1)-dimensional nonlinear space-time fractional Jimbo-Miwa equation in the sense of the modified Riemann-Liouville derivative. The methods employed to analytically solve the equation are the -expansion method and the novel -expansion method. To the best of our knowledge, there are no researchers who have applied these methods to obtain exact solutions of the equation. The application of the methods is simple, elegant, efficient, and trustworthy. In particular, applying the novel -expansion method to the equation, we obtain more exact solutions than using other existing methods such as the -expansion method and the -expansion method. The exact solutions of the equation, obtained using the two methods, can be categorized in terms of hyperbolic, trigonometric, and rational functions. Some of the results obtained by the two methods are new and reported here for the first time. In addition, the obtained exact explicit solutions of the equation characterize many physical meanings such as soliton solitary wave solutions, periodic wave solutions, and singular multiple-soliton solutions.

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Research on Spatial Channel Model for Vehicle-to-Vehicle Communication Channel in Roadside Scattering Environment

In this paper, an extension of spatial channel model (SCM) for vehicle-to-vehicle (V2V) communication channel in roadside scattering environment is investigated for the first time theoretically and by simulations. Subsequently, to efficiently describe the roadside scattering environment and reflect the nonstationary properties of V2V channels, the proposed SCM V2V model divides the scattering objects into three categories of clusters according to the location of effective scatterers by introducing critical distance. We derive general expressions for the most important statistical properties of V2V channels, such as channel impulse response, power spectral density, angular power density, autocorrelation function, and Doppler spread of the proposed model. The impact of vehicle speed, traffic density, and angle of departure, angle of arrival, and other statistical performances on the V2V channel model is thoroughly discussed. Numerical simulation results are presented to validate the accuracy and effectiveness of the proposed model.

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Visual Localization by Place Recognition Based on Multifeature (D-λLBP++HOG)

Visual localization is widely used in the autonomous navigation system and Advanced Driver Assistance Systems (ADAS). This paper presents a visual localization method based on multifeature fusion and disparity information using stereo images. We integrate disparity information into complete center-symmetric local binary patterns (CSLBP) to obtain a robust global image description (D-CSLBP). In order to represent the scene in depth, multifeature fusion of D-CSLBP and HOG features provides valuable information and permits decreasing the effect of some typical problems in place recognition such as perceptual aliasing. It improves visual recognition performance by taking advantage of depth, texture, and shape information. In addition, for real-time visual localization, local sensitive hashing method (LSH) was used to compress the high-dimensional multifeature into binary vectors. It can thus speed up the process of image matching. To show its effectiveness, the proposed method is tested and evaluated using real datasets acquired in outdoor environments. Given the obtained results, our approach allows more effective visual localization compared with the state-of-the-art method FAB-MAP.

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Proportions of Proinflammatory Monocytes Are Important Predictors of Mortality Risk in Hemodialysis Patients

Despite the continuous progression in dialysis medicine, mortality and the burden of cardiovascular disease (CVD) among hemodialysis patients are still substantial. Substantial evidence suggests that proinflammatory (CD16+) monocytes contribute to the development of atherosclerosis. A cohort of 136 stable hemodialysis patients (follow-up: 6.25 year) was assessed to investigate the association between the proportion of CD16+ monocytes for all-cause and CVD mortalities. The CD16+ monocytes were associated with both mortalities after adjusting for a preexisting CVD history. Compared to the reference group (CD16+ monocytes within [15.6–18.6], the first and second quartile), patients with CD16+ monocytes above the highest quartile level (>21.5) had an adjusted hazard ratio (HR) of 30.85 (95% confidence interval [CI]: 7.12–133.8) for CVD mortality and 5.28 (2.07–13.49) for all-cause mortality, and those with CD16+ monocytes below the lowest quartile ≤15.6), had significantly elevated death risks after 3.5-year follow-up (HR [95% CI]: 10.9 [2.42–48.96] and 4.38 [1.45–13.24] for CV and all-cause mortalities, respectively). The hemodialysis patients with CD16+ monocyte level in a low but mostly covering normal range also portended a poor prognosis. The findings shed some light for nephrologists on future prospects of early recognizing immune dysfunction and improving early intervention outcomes.

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Controlled Assembly of Nanorod TiO2 Crystals via a Sintering Process: Photoanode Properties in Dye-Sensitized Solar Cells

We present for the first time a synthetic method of obtaining 1D TiO2 nanorods with sintering methods using bundle-shaped 3D rutile TiO2 particles (3D BR-TiO2) with the dimensions of around 100 nm. The purpose of this research is (i) to control crystallization of the mixture of two kinds of TiO2 semiconductor nanocrystals, that is, 3D BR-TiO2 and spherical anatase TiO2 (SA-TiO2) on FTO substrate via sintering process and (ii) to establish a new method to create photoanodes in dye-sensitized solar cells (DSSCs). In addition, we focus on the preparation of low-cost and environmentally friendly titania electrode by adopting the "water-based" nanofluids. Our results provide useful guidance on how to improve the photovoltaic performance by reshaping the numerous 3D TiO2 particles to 1D TiO2-based electrodes with sintering technique.

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Broken faces of the Great War

Men who became guinea pigs for cosmetic surgery are to be recognised with a memorial in the UK

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Broken faces of the Great War

Men who became guinea pigs for cosmetic surgery are to be recognised with a memorial in the UK

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A New Hybrid UPFC Controller for Power Flow Control and Voltage Regulation Based on RBF Neurosliding Mode Technique

This paper presents a new technique to design a Unified Power Flow Controller (UPFC) for power flow control and DC voltage regulation of an electric power transmission system which is based on a hybrid technique which combines a Radial Basis Function (RBF) neural network (online training) with the sliding mode technique to take advantage of their common features. The proposed controller does not need the knowledge of the perturbation bounds nor the full state of the nonlinear system. Hence, it is robust and produces an optimal response in the presence of system parameter uncertainty and disturbances. The performance of the proposed controller is evaluated through numerical simulations on a Kundur power system and compared with a classical PI controller. Simulation results confirm the effectiveness, robustness, and superiority of the proposed controller.

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Constitutive Expression of Adiponectin in Endothelial Progenitor Cells Protects a Rat Model of Cerebral Ischemia

Endothelial progenitor cells (EPCs), as precursors to endothelial cells, play a significant part in the process of endogenous blood vessel repair and maintenance of endothelial integrity. Adiponectin (APN) is an adipocyte-specific adipocytokine. In this study, we aim to test whether we transplant a combined graft of EPCs transfected with the adiponectin gene into a rat model of cerebral ischemia could improve functional recovery after middle cerebral artery occlusion (MCAO). Sprague-Dawley (SD) rats were randomly divided into a MCAO control group, a MCAO EPC treatment group, and a MCAO LV-APN-EPC treatment group. A focal cerebral ischemia and reperfusion model was induced by the intraluminal suture method. After 2 h of reperfusion, EPCs were transplanted by injection through the tail vein. A rotarod test was conducted to assess behavioral function before MCAO and on days 1, 7, and 14 after MCAO. After 14 d, TTC staining, CD31 immunofluorescence, and TUNEL staining were used to evaluate infarct volume, microvessel density, and cell apoptosis. Results revealed that behavioral function, infarct area percentage, microvessel density, and cell apoptosis rates were more favorable in the LV-APN-EPC treatment group than in the EPC treatment group. These data suggested that gene-modified cell therapy may be a useful approach for the treatment of ischemic stroke.

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Study on Galloping Oscillation of Iced Catenary System under Cross Winds

This paper mainly aims at revealing the nature of the galloping oscillation of iced catenary system under cross winds. The aerodynamic force on the iced catenary system is assumed to be quasi-steady, and then the quasi-steady aerodynamic lift and drag coefficients are completed in FLUENT. By fitting the discrete simulation data, the expression of the vertical aerodynamic force is further obtained. According to the Den Hartog vertical galloping mechanism, the stability of iced catenary is discussed and the initial icing angle corresponding to the critical stability is obtained. On this basis, the dynamic model of the simple iced catenary system under cross winds is established. The partial differential vibration equation of the system is converted into the ordinary differential equation by the Galerkin method and then numerically solved. The condition of the unstable catenary motion in simulation is in agreement with that from theoretical stability analysis. In addition, the effects of structural damping, initial icing angle, and wind velocity on the system responses are investigated.

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A Review on Human Body Communication: Signal Propagation Model, Communication Performance, and Experimental Issues

Human body communication (HBC), which uses the human body tissue as the transmission medium to transmit health informatics, serves as a promising physical layer solution for the body area network (BAN). The human centric nature of HBC offers an innovative method to transfer the healthcare data, whose transmission requires low interference and reliable data link. Therefore, the deployment of HBC system obtaining good communication performance is required. In this regard, a tutorial review on the important issues related to HBC data transmission such as signal propagation model, channel characteristics, communication performance, and experimental considerations is conducted. In this work, the development of HBC and its first attempts are firstly reviewed. Then a survey on the signal propagation models is introduced. Based on these models, the channel characteristics are summarized; the communication performance and selection of transmission parameters are also investigated. Moreover, the experimental issues, such as electrodes and grounding strategies, are also discussed. Finally, the recommended future studies are provided.

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The Utility of the Bering Sea and East Asia Rules in Long-Range Forecasting

Using the National Center for Atmospheric Research/National Centers for Environmental Prediction (NCAR/NCEP) reanalyses and the daily Pacific North American (PNA) index values from the Climate Prediction Center from 1 January 1950 to 31 December 2016, the utility of the Bering Sea Rule (BSR) and the East Asia Rule (EAR) for making forecasts in the two-to-four-week time frame for the central USA region is examined. It is demonstrated using autocorrelation and Fourier transforms that there may be a degree of predictability in this time frame using the PNA, another teleconnection index, or some variation of them. Neither the BSR nor EAR based forecasts showed skill over climatology in the traditional sense, but using signal detection techniques these indexes were skillful at predicting the onset of anomalous temperature conditions (greater than two standard deviations) in the central USA. The BSR generally produced better results that the EAR and formulae for each index are proposed. Three case studies demonstrate the efficacy of these indexes for forecasting temperatures in the central USA. Then, it is proposed that the success of these indexes is likely due to a strong, quasistationary, and persistent Rossby wave train in the Pacific teleconnection region.

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Development of an Indirect ELISA and Dot-Blot Assay for Serological Detection of Rice Tungro Disease

Rice tungro disease (RTD) is one of the most destructive diseases of rice in South and Southeast Asia. RTD is routinely detected based on visual observation of the plant. However, it is not always easy to identify the disease in the field as it is often confused with other diseases or physiological disorders. Here we report the development of two serological based assays for ease of detection of RTD. In this study we had developed and optimized an indirect ELISA and dot-blot assay for detection of RTD. The efficiency of both assays was evaluated by comparing the specificity and sensitivity of the assays to PCR assay using established primer sets. The indirect ELISA showed 97.5% and 96.6%, while the dot-blot assay showed 97.5% and 86.4% sensitivity and specificity, respectively, when compared to established PCR method. The high sensitivity and specificity of the two assays merit the use of both assays as alternative methods to diagnose RTD. Furthermore, the dot-blot assay is a simple, robust, and rapid diagnostic assay that is suitable for field test for it does not require any specialized equipment. This is a great advantage for diagnosing RTD in paddy fields, especially in the rural areas.

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Treatment and Outcome for Children with Esophageal Atresia from a Gender Perspective

Background. Besides the incidence of esophageal atresia (EA) being higher in males, no other gender-specific differences in EA have been reported. The aim of this study was to search for gender-specific differences in EA. Methods. A retrospective study was conducted at a tertiary center for pediatric surgery. The medical charts of infants born with EA were reviewed. 20 girls were identified, and 20 boys were selected as matched controls with respect to concomitant malformations. Their treatment and outcome were evaluated. Results. Polyhydramnios was more common in pregnancies with boys, 40%, versus girls, 10%, with EA (). In total, 36 (90%) children had patent ductus arteriosus, without any gender difference (18 and 18, resp., ). The distribution of days at the different levels of care was not equally distributed between boys and girls. Boys with EA had significantly more postoperative days (median 5 days) in the ward than girls (median 5 and 2 days, resp., ). No other gender-specific differences in surgical treatment, complications, or symptoms at follow-up were identified. Conclusion. Polyhydramnios appears to be more frequent in pregnancies with boys than girls with EA. In this study, boys have longer stays than girls at the pediatric surgery ward.

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After WCCO Investigation Into Burnsville Dentist, More Accusations Surface

TV is part of CBS Television Stations, a division of CBS Corp. and one of the largest network-owned station groups in the country. Click here for WCCO-TV news stories Send us your breaking news tips [] 830 WCCO Welcome to News Radio 830 WCCO on CBSMinnesota.com! WCCO is part of CBS Radio, a division of CBS Corp. and one of the largest network-owned station groups in the country.

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Scotland is Now Getting Electricity from the World's First Floating Wind Farm

Located just over 15 miles off Scotland's coast, the 30 Megawatt (MW) wind farm is expected to power around 20,000 households.

-- Read more on ScientificAmerican.com

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Using 'Active Signposting to streamline general practitioner workload in two London-based practices

General practice is at the forefront of the National Health Service, but is currently being overwhelmed by ever-increasing patient demand and financial constraints. Telephone consultations (TCs) have been used as a method to ease pressure on general practice. Many of these consultations are booked with general practioners (GPs), despite occasions when the patient could have either been signposted to self-help or offered an alternative service. This quality improvement project (QIP) aimed to evaluate the nature of TCs undertaken by GPs at our two practices; and whether the patients' needs could have adequately been met without the involvement of a GP. Consultations where this was the case were deemed 'possibly avoidable', and those where involvement with a GP was the best option have been termed 'essential'. A retrospective analysis was undertaken to establish a baseline figure for the proportion of possibly avoidable TCs in two practices. A new intervention was then introduced, with reception staff following a set of protocols when booking in patients. Patients who did not require a GP to deal with their query were actively signposted by reception staff to other allied healthcare professionals, non-medical staff or an alternative service at the time of booking their appointment. Two practices were involved in the study. After 2 Plan, Do, Study, Act (PDSA) cycles, the proportion of essential consultations taking place at both practices increased from 28.6% and 27.3% at baseline, to 82.6% and 71.4%, respectively. A lower number of possibly avoidable TCs equates to more time for essential TCs and greater value for money for the practice. Patient access to care is also improved, with patients directed to alternative and often quicker services which still meet their needs adequately. With the current system of primary care unable to cope with the demands it faces, interventions such as active signposting provide value for both GP practices and patients alike.

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Reducing radiation hazard opportunities in neonatal unit: quality improvement in radiation safety practices

Aim

Guided by the ALARA - "As Low As Reasonably Achievable" principle in radiation safety, a quality improvement project to optimise the bedside diagnostic imaging process to the best standards of care was conducted over a six month period. The goal was too reduce the radiation hazard opportunities in the neonatal intensive care unit by at least 75% from the existing level at Q2/2015, within 6 months.

Methods

The existing bedside imaging process was critically analysed and the following quality improvement initiatives were implemented namely , mandatory lead protective gear to healthcare staff, gonadal shield for neonates, guidelines for optimal collimation of X-ray beam and optimal positioning of neonates. Radiation dosimetry results, regular staff awareness sessions and strong collaboration between neonatologists, radiologists, radiographers and neonatal nurses helped to ensure compliance to the revised imaging process. Radiation hazard opportunities were measured by analysing all radiographs done during the period under baby exposure and healthcare staff exposure categories.

Summary of results

Radiation hazard opportunities were reduced by 100% to healthcare staff and 75% to neonates, and the overall reduction was 83%. The rate of discordance between radiograph request forms and images taken was measured as a surrogate marker for compliance to the project initiatives and it declined by 77%. Mandatory orientation of staff to the revised policy on the standardised diagnostic imaging process, regular radiation awareness talks and staff feedback sessions are among several measures taken to sustain the project.

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Electronic medical record alert improves HCV testing for baby boomers in primary care setting: adults born during 1945-1965

Method

This project aims to implement the HCV birth cohort screening guidelines over a 9-month period in the primary care setting at the University of Kansas Health System General Internal Medicine Division.The project team measured the number of patients in the baby boomer population who received a one-time screen for HCV. An electronic medical record (EMR) intervention was implemented to identify baby boomers who did not have an HCV screening or diagnosis. Additionally, education was provided to all primary care providers in the clinic to increase awareness of the HCV birth cohort screening.

Results

The quality improvement methods increased the percentage of baby boomers who obtained a one-time screening test for HCV from a baseline of 30% to a 55% screening rate during the nine-month project period.

Conclusion

Identifying the HCV screening needs and creating a visual reminder in the EMR can be used to facilitate sustainable awareness and improvement of screening rates. The project team recognizes that continued work is required to close the HCV screening care gaps in the primary care setting.

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