Severity, change over time and risk factors of anxiety in children with cancer depends on anxiety instrument used.

Severity, change over time and risk factors of anxiety in children with cancer depends on anxiety instrument used.

Psychooncology. 2019 Jan 22;:

Authors: Lazor T, Pole JD, De Souza C, Schechter T, Grant R, Davis H, Duong N, Stein E, Cook S, Tigelaar L, Sung L

Abstract
OBJECTIVE: The primary objective was to describe severity of anxiety among children and adolescents receiving chemotherapy for cancer or undergoing hematopoietic stem cell transplantation (HSCT). Secondary objectives were to describe how anxiety changes over time and determine factors associated with anxiety.
METHODS: Participants were aged 8-18 and either receiving chemotherapy for cancer or undergoing HSCT for any indication. Respondents self-reported three anxiety measurement instruments at chemotherapy cycle or HSCT conditioning start and three weeks later.
RESULTS: The proportion of participants with severe anxiety ranged from 10/77 (13.0%) to 22/77 (28.6%) depending on instrument used. Change over time also varied across instruments, with significant improvement observed with PedsQL (procedural) (P=0.037) and PROMIS (P=0.013). Factors associated with anxiety similarly varied by instrument. Older age was associated with more anxiety on the PedsQL (worry) (P=0.036) and higher household income was associated with less anxiety on the MASC-10 (P=0.028).
CONCLUSIONS: While we found that a small proportion of patients met or exceeded thresholds for severe anxiety, we also noted that severity, change over time and predictors of anxiety varied depending on instrument used. Future research should ensure selected instruments measure the construct of interest and describe how anxiety is conceptualized in the study.

PMID: 30669186 [PubMed - as supplied by publisher]

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Accelerated progression of IDH mutant glioma after first recurrence.

Accelerated progression of IDH mutant glioma after first recurrence.

Neuro Oncol. 2019 Jan 22;:

Authors: Miller JJ, Loebel F, Juratli TA, Tummala SS, Williams EA, Batchelor TT, Arrillaga-Romany I, Cahill DP

Abstract
Background: Isocitrate dehydrogenase (IDH) mutant gliomas are a distinct subtype, reflected in WHO 2016 revised diagnostic criteria. To inform IDH-targeting trial design, we sought to characterize outcomes exclusively within IDH mutant gliomas.
Methods: We retrospectively analyzed 275 IDH mutant glioma patients treated at our institution. Progression was determined using low-grade glioma RANO criteria. We calculated survival statistics with the Kaplan-Meier method and survival proportions were correlated with molecular, histologic and clinical factors.
Results: During a median follow-up of 6.4 years, 44 deaths (7.6%) and 149 first progression (PFS1) events (54.1%) were observed. Median PFS1 was 5.7 years (95% CI 4.7-6.4) and OS was 18.7 years (95% CI 12.2 years - not reached). Consistent with prior studies, we observed an association of grade, molecular diagnosis and treatment with PFS1. Following the first progressive episode, 79 second progression events occurred during a median follow-up period of 4.1 years. Median PFS following an initial progressive event (PFS2) was accelerated at 3.1 years (95% CI 2.1-4.1). PFS2 was a surrogate prognostic marker, identifying patients with poorer overall survival.
Conclusion: We report outcomes in a large cohort of IDH mutant glioma, providing a well-characterized historical control population for future clinical trial design. Notably, the interval between first to second recurrence (PFS2 - 3.0 years) is shorter than time from diagnosis to first recurrence (PFS1 - 5.7 years), evidence that these tumors clinically degenerate from an indolent course to an accelerated malignant phase. Thus, PFS2 represents a relevant outcome for trials investigating drug efficacy at recurrence.

PMID: 30668823 [PubMed - as supplied by publisher]

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Liquid biopsy in Central Nervous System metastases: a RANO review and proposals for clinical applications.

Liquid biopsy in Central Nervous System metastases: a RANO review and proposals for clinical applications.

Neuro Oncol. 2019 Jan 22;:

Authors: Boire A, Brandsma D, Brastianos PK, Le Rhun E, Ahluwalia M, Junk L, Glantz M, Groves MD, Lee EQ, Lin N, Raizer J, Rudà R, Weller M, van den Bent MJ, Vogelbaum MA, Chang S, Wen PY, Soffietti R

Abstract
Liquid biopsies collect and analyze tumor components in body fluids, and there is an increasing interest in the investigation of liquid biopsies as a surrogate for tumor tissue in the management of both primary and secondary brain tumors. Herein we critically review available literature on spinal fluid and plasma circulating tumor cells (CTCs) and cell-free tumor (ctDNA) for diagnosis and monitoring of leptomeningeal and parenchymal brain metastases. We discuss technical issues and propose several potential applications of liquid biopsies in different clinical settings, i.e. for initial diagnosis, for assessment during treatment and for guidance of treatment decisions. Last, ongoing clinical studies on CNS metastases, that include liquid biopsies, are summarized and recommendations for future clinical studies are provided.

PMID: 30668804 [PubMed - as supplied by publisher]

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Controversies in relation to neck management in N0 early oral tongue cancer.

Controversies in relation to neck management in N0 early oral tongue cancer.

Jpn J Clin Oncol. 2019 Jan 22;:

Authors: Hanai N, Asakage T, Kiyota N, Homma A, Hayashi R

Abstract
The standard local treatment for early-stage tongue cancer with no clinical lymph node metastases is partial glossectomy. The frequency of occult lymph node metastasis is ~20-30%. Thus, whether prophylactic neck dissection with glossectomy or glossectomy alone should be performed has been a controversial issue since the 1980s. Both treatments have advantages and disadvantages; however, especially in cases involving prophylactic neck dissection, surgical invasion and complications including the cosmetic disadvantage caused by neck skin incision, accessory nerve paralysis or facial nerve (mandibular marginal branch) paralysis, stiffness of the shoulder or neck and a feeling of neck tightness have been considered issues that could be solved by providing less-invasive treatment to the 70-80% of patients without occult lymph node metastasis.A more accurate preoperative diagnosis and strict follow-up are required to provide minimally invasive treatment while ensuring the therapeutic effect. It is also necessary to narrow down the target based on the risk-benefit balance. The depth of invasion should be considered in cases involving oral cavity malignancies. This was also taken into account in recent revisions of eighth edition of the TNM Classification of Malignant Tumors and it is an important factor for N0 neck management. This review article summarizes previous and recent reports on neck management, focusing on the risk-benefit and future perspectives of the diagnosis and treatment of early-stage oral tongue cancer. This effort is an attempt to establish treatment from the patient's point of view, with the patient's quality of life taken into account.

PMID: 30668761 [PubMed - as supplied by publisher]

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TNM classification of gynaecological malignant tumours, eighth edition: changes between the seventh and eighth editions.

TNM classification of gynaecological malignant tumours, eighth edition: changes between the seventh and eighth editions.

Jpn J Clin Oncol. 2019 Jan 22;:

Authors: Tokunaga H, Shimada M, Ishikawa M, Yaegashi N

Abstract
The staging classification of gynaecological malignancies has been revised by the International Federation of Gynecology and Obstetrics (FIGO) and has been subsequently reviewed by the FIGO Committee on Gynecologic Oncology, the International Union for Cancer Control TNM Committee and the American Joint Committee on Cancer. The major change in the eighth edition of TNM classification of gynaecological malignant tumours is integrated staging for ovarian, fallopian tube and primary peritoneal carcinoma, whereas the seventh edition distinguished 'ovary and primary peritoneal carcinoma' and 'Fallopian tube carcinoma'. Furthermore, the new edition describes a prognostic factor grid for vulvar, cervical, endometrial and ovarian, fallopian tube and primary peritoneal carcinoma. If these factors contribute strongly to the prognosis, they may be incorporated into future staging classifications. This paper reviews the staging system for gynaecological malignancies, how it was developed, and current problems to be resolved.

PMID: 30668753 [PubMed - as supplied by publisher]

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Subgroups of parotid gland infiltrating ductal carcinoma benefit from postoperative radiotherapy: a population-based study.

Subgroups of parotid gland infiltrating ductal carcinoma benefit from postoperative radiotherapy: a population-based study.

Future Oncol. 2019 Jan 22;:

Authors: Lv T, Wang Y, Wang X

Abstract
AIM: To analyze the prognostic factors and the impact of postoperative radiotherapy (PORT) in parotid gland infiltrating ductal carcinoma (IDC).
MATERIALS & METHODS: 252 patients diagnosed with parotid gland IDC were identified from the SEER database. Kaplan-Meier and Cox regression analysis was performed to evaluate the prognostic factors. Propensity score matching was applied then.
RESULTS: Multivariate analysis showed old age and chemotherapy were independent risk factors in parotid gland IDC. Subgroup analysis demonstrated that overall survival (OS) rate of the PORT group was significantly superior to that of the no radiotherapy group in the T3-4 subgroup (p = 0.049), N1 subgroup (p = 0.019) and Tumor, Node, Metastasis (TNM) III subgroup (p = 0.025).
CONCLUSION: PORT improved survival of parotid gland IDC patients within T3-4, N1 and TNM III subgroups.

PMID: 30667284 [PubMed - as supplied by publisher]

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Cancer Prevention Europe.

Cancer Prevention Europe.

Mol Oncol. 2019 Jan 22;:

Authors: Wild CP, Espina C, Bauld L, Bonanni B, Brenner H, Brown K, Dillner J, Forman D, Kampman E, Nilbert M, Steindorf K, Storm H, Vineis P, Baumann M, Schüz J

Abstract
The case for cancer prevention in Europe is the same as for all other parts of the world. The number of cancers is increasing, driven by demographic change and evolution in the exposure to risk factors, while the cost of treating patients is likewise spiralling. Estimations suggest that around 40% of cancers in Europe could be prevented if current understanding of risk and protective factors was translated into effective primary prevention, with further reductions in cancer incidence and mortality by screening, other approaches to early detection, and potentially medical prevention. However, the infrastructure for cancer prevention tends to be fragmented between and within different countries in Europe. This lack of a coordinated approach recently led to the foundation of Cancer Prevention Europe (Forman et al. 2018), a collaborative network with the main aims of strengthening cancer prevention in Europe by increasing awareness of the needs, the associated required resources, and reducing inequalities in access to cancer prevention across Europe. This article showcases the need for strengthening cancer prevention and introduces the objectives of Cancer Prevention Europe and its foreseen future role in reducing the European cancer burden.

PMID: 30667152 [PubMed - as supplied by publisher]

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The Crohn's disease polymorphism, ATG16L1 T300A, alters the gut microbiota and enhances the local Th1/Th17 response.

The Crohn's disease polymorphism, ATG16L1 T300A, alters the gut microbiota and enhances the local Th1/Th17 response.

Elife. 2019 Jan 22;8:

Authors: Lavoie S, Conway KL, Lassen KG, Jijon HB, Pan H, Chun E, Michaud M, Lang JK, Gallini Comeau CA, Dreyfuss JM, Glickman JN, Vlamakis H, Ananthakrishnan A, Kostic A, Garrett WS, Xavier RJ

Abstract
Inflammatory bowel disease (IBD) is driven by dysfunction between host genetics, the microbiota, and immune system. Knowledge gaps remain regarding how IBD genetic risk loci drive gut microbiota changes. The Crohn's disease risk allele ATG16L1 T300A results in abnormal Paneth cells due to decreased selective autophagy, increased cytokine release, and decreased intracellular bacterial clearance. To unravel the effects of ATG16L1 T300A on the microbiota and immune system, we employed a gnotobiotic model using human fecal transfers into ATG16L1 T300A knock-in mice. We observed increases in Bacteroides ovatus and Th1 and Th17 cells in ATG16L1 T300A mice. Association of altered Schaedler flora mice with B. ovatus specifically increased Th17 cells selectively in ATG16L1 T300A knock-in mice. Changes occur before disease onset, suggesting that ATG16L1 T300A contributes to dysbiosis and immune infiltration prior to disease symptoms. Our work provides insight for future studies on IBD subtypes, IBD patient treatment and diagnostics.

PMID: 30666959 [PubMed - in process]

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Approaches to understanding and interpreting the risks of red blood cell transfusion in neonates.

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Approaches to understanding and interpreting the risks of red blood cell transfusion in neonates.

Transfus Med. 2019 Jan 21;:

Authors: Keir AK, New H, Robitaille N, Crighton GL, Wood EM, Stanworth SJ

Abstract
In this review, we explore how to assess potential harm related to neonatal transfusion practice. We consider different sources of information, including passive or active surveillance systems such as registries, observational studies, randomised trials and systematic reviews. Future research directions are discussed.

PMID: 30666733 [PubMed - as supplied by publisher]

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Oncology Training in Rwanda: Challenges and Opportunities for Undergraduate Medical Students (The EDUCAN Project).

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Oncology Training in Rwanda: Challenges and Opportunities for Undergraduate Medical Students (The EDUCAN Project).

J Cancer Educ. 2019 Jan 21;:

Authors: Manirakiza A, Rubagumya F, Fehr AE, Triedman AS, Greenberg L, Mbabazi G, Ntacyabukura B, Nyagabona S, Maniragaba T, Longombe AN, Ndoli DA, Makori K, Kiugha M, Rulisa S, Hammad N

Abstract
A critical shortage of trained cancer specialists is one of the major challenges in addressing the increasing cancer burden in low- and middle-income countries. Inadequate undergraduate cancer education in oncology remains a major obstacle for both task shifting to general practitioners and for training of specialists. We provide the first report of cancer education in Rwanda's undergraduate program to survey how new graduates are prepared to provide care for cancer patients. Anonymous online survey was sent January to June 2017 to medical students in their senior clinical years (years 5 and 6). Questions related to the demographics, medical curriculum, and general oncology exposure were included in the survey. Of 192 eligible students, 42% (n = 80) completed the survey and were analyzed. The majority were 25 to 29 years of age and 41% were female. Internal medicine was cited to provide the most exposure to cancer patients (50%) and cancer bedside teaching (55%). Close to a half (46%) have been taught oncology formally in addition to bedside teaching. A tenth (11%) of the participants felt comfortable in attending a cancer patient, and a fifth (21%) of the students felt comfortable while addressing multimodality treatment approach. The majority (99%) of the participants preferred having a formal oncology rotation. Of particular interest, 61% of the students are interested in pursuing an oncology career path. There is a need to modify the current oncology undergraduate curriculum to prepare future physicians for delivering cancer care in Rwanda. Raising the profile of oncology in undergraduate medical education will complement the on-going efforts to increase the country's capacity in task shifting and in training of cancer specialists.

PMID: 30666585 [PubMed - as supplied by publisher]

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Treatment engagement mediates the links between symptoms of anxiety, depression, and alcohol use disorder with abstinence among smokers registered on an Internet cessation program.

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Treatment engagement mediates the links between symptoms of anxiety, depression, and alcohol use disorder with abstinence among smokers registered on an Internet cessation program.

J Subst Abuse Treat. 2019 Mar;98:59-65

Authors: Cohn AM, Zhou Y, Cha S, Perreras L, Graham AL

Abstract
Mental health problems like anxiety, depression, and substance use problems commonly co-occur with cigarette smoking and are linked to poor cessation outcomes. Although millions of smokers seek online quitting assistance each year, few studies have examined links between website utilization and cessation outcomes among smokers with mental health problems. This study recruited 600 smokers with anxiety, depression, and alcohol use disorders (AUDs) who were new users of a publicly available Internet cessation treatment. Among participants with 3-month outcome data (n = 247, 42%), structural equation models (SEM) examined the association of symptoms of anxiety/depression (combined) and AUD diagnosis on website engagement and 3-month quit rates, controlling for covariates. The 3-month 30-day abstinence rate among those who completed follow-up was 28%, but only 14% among smokers with an AUD and 24.7% among smokers with symptoms of anxiety/depression. SEM results showed that treatment engagement significantly mediated the effect of mental health problems on 3-month abstinence: those with symptoms of anxiety/depression or an AUD had lower quit rates overall, however engagement with the website had a buffering effect on 3-month cessation outcomes. Engagement with an evidence-based Internet cessation program may be particularly useful for smokers with mental health comorbidities in increasing the chances of cessation. Future work should examine what level of treatment engagement meaningfully impacts behavior change for smokers with mental health problems who access Internet cessation programs.

PMID: 30665605 [PubMed - in process]

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The Photographs of Meaning Program for Pediatric Palliative Caregivers: Feasibility of a Novel Meaning-Making Intervention.

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The Photographs of Meaning Program for Pediatric Palliative Caregivers: Feasibility of a Novel Meaning-Making Intervention.

Am J Hosp Palliat Care. 2019 Jan 21;:1049909118824560

Authors: Levy K, Grant PC, Depner RM, Tenzek KE, Pailler ME, Beaupin LK, Breier JM, Byrwa DJ

Abstract
BACKGROUND:: Research indicates that informal caregiving can have intense physical and mental impact on the individual. Relative to caregivers of adults, pediatric palliative caregivers appear less in literature despite experiencing greater mental, physical, financial, and social strain. There is limited research on the creation and evaluation of interventions specifically for this population despite clear need.
OBJECTIVE:: This study aims to evaluate the feasibility and engagement of the Photographs of Meaning Program, a modified meaning-making intervention for pediatric palliative caregivers.
DESIGN:: Participants completed a pre-post intervention meaning-in-life measure. Over a 9-week period, participants followed a meaning-making curriculum whereby they created and shared photo narratives via social media. As part of the intervention, a community photo exhibition was held featuring these photo narratives. Exit interviews were also conducted at study close.
SETTING/PARTICIPANTS:: Nine individuals providing informal care to children in a pediatric palliative care program participated in the intervention. All participants were female and are older than 18 years. Settings for research include participant homes and at The Center for Hospice and Palliative Care in Cheektowaga, New York.
RESULTS:: Participants posted 95 photographs and 96 narratives during the intervention, posting on average once each week. Statistical analysis within the small sample indicated an increased presence of meaning in the lives of participants ( P = .022). Exit interviews conveyed satisfaction with the intervention.
CONCLUSIONS:: Findings suggest that the Photographs of Meaning Program is a practical intervention with life-enhancing potential for pediatric palliative. Future research should aim to collect additional evidence of the intervention's effectiveness.

PMID: 30665322 [PubMed - as supplied by publisher]

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Histone deacetylase 11 as a key regulator of metabolism and obesity.

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Histone deacetylase 11 as a key regulator of metabolism and obesity.

EBioMedicine. 2018 Sep;35:27-28

Authors: Bhaskara S

Abstract
In this thought commentary, I highlight the discoveries made by Seto and colleagues related to HDAC11 and obesity. I discuss how their reported work fills a gap in the HDAC field and comment on the clinical implications of their findings. Overall, selective inhibition of HDAC11 could be a novel potential therapeutic avenue for both obesity and diabesity, the diabetes caused by obesity. Future studies to further dissect this mechanistic link between HDAC11 and metabolic programs will pave the way for designing mechanism-based combination therapeutic strategies for these two life style diseases.

PMID: 30126820 [PubMed - indexed for MEDLINE]

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Predictors of participation in risk-based prostate cancer screening.

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Predictors of participation in risk-based prostate cancer screening.

PLoS One. 2018;13(7):e0200409

Authors: Koitsalu M, Eklund M, Adolfsson J, Sprangers MAG, Grönberg H, Brandberg Y

Abstract
BACKGROUND: Implementation of risk-based prostate cancer screening has been proposed as a means to reduce the harms of PSA screening. Little is known, however, about the factors influencing men's decision to attend a prostate cancer screening based on a risk assessment.
METHOD: We sent postal invitations with a login to a survey to 10.000 men, three months before invitation to a risk-based prostate cancer screening. Prostate cancer specific worry, prostate cancer-related knowledge, health behaviour, and health related quality of life were used as predictors of subsequent participation. Participation to risk-based prostate cancer screening was defined as providing a blood sample for the STHLM3 trial, a study evaluating a risk-based model that predicts the risk for aggressive prostate cancer.
RESULTS: With a response rate of 20%, 1.347 men (70%) participated in ensuing risk-based prostate cancer screening three months later whereas 568 men (30%) declined participation in the STHLM3-study. These decliners reported less worry and feeling less vulnerable to prostate cancer and responded "Do not know" more often than participants when asked questions about prostate cancer knowledge. Participants reported greater benefits of prostate testing (p = 0.0005), less barriers to prostate testing (p<0.0001), and higher intention to attend prostate cancer testing (p<0.0001) than decliners. Finally, participants reported better overall health than decliners (p<0.0001).
CONCLUSION: Prostate cancer worry, PC knowledge, health behaviour and quality of life were identified as predictors of participation in risk-based prostate cancer screening. Targeting these predictors may improve the participation rates. These results can inform policymaking for future population-based prostate cancer screening programs that should address potential worry in men and lack of knowledge about prostate cancer.

PMID: 29990335 [PubMed - indexed for MEDLINE]

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A computational approach for predicting off-target toxicity of antiviral ribonucleoside analogues to mitochondrial RNA polymerase.

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A computational approach for predicting off-target toxicity of antiviral ribonucleoside analogues to mitochondrial RNA polymerase.

J Biol Chem. 2018 06 22;293(25):9696-9705

Authors: Freedman H, Winter P, Tuszynski J, Tyrrell DL, Houghton M

Abstract
In the development of antiviral drugs that target viral RNA-dependent RNA polymerases, off-target toxicity caused by the inhibition of the human mitochondrial RNA polymerase (POLRMT) is a major liability. Therefore, it is essential that all new ribonucleoside analogue drugs be accurately screened for POLRMT inhibition. A computational tool that can accurately predict NTP binding to POLRMT could assist in evaluating any potential toxicity and in designing possible salvaging strategies. Using the available crystal structure of POLRMT bound to an RNA transcript, here we created a model of POLRMT with an NTP molecule bound in the active site. Furthermore, we implemented a computational screening procedure that determines the relative binding free energy of an NTP analogue to POLRMT by free energy perturbation (FEP), i.e. a simulation in which the natural NTP molecule is slowly transformed into the analogue and back. In each direction, the transformation was performed over 40 ns of simulation on our IBM Blue Gene Q supercomputer. This procedure was validated across a panel of drugs for which experimental dissociation constants were available, showing that NTP relative binding free energies could be predicted to within 0.97 kcal/mol of the experimental values on average. These results demonstrate for the first time that free-energy simulation can be a useful tool for predicting binding affinities of NTP analogues to a polymerase. We expect that our model, together with similar models of viral polymerases, will be very useful in the screening and future design of NTP inhibitors of viral polymerases that have no mitochondrial toxicity.

PMID: 29739852 [PubMed - indexed for MEDLINE]

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Systematic Review of Temporal Bone-Resurfacing Techniques for Pulsatile Tinnitus Associated with Vascular Wall Anomalies.

Systematic Review of Temporal Bone-Resurfacing Techniques for Pulsatile Tinnitus Associated with Vascular Wall Anomalies.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818823205

Authors: Liu GS, Boursiquot BC, Blevins NH, Vaisbuch Y

Abstract
OBJECTIVE: To systematically review literature evidence on temporal bone-resurfacing techniques for pulsatile tinnitus (PT) associated with vascular wall anomalies.
DATA SOURCES: We searched PubMed, Embase, and the Cochrane Database. The period covered was from 1962 to 2018.
REVIEW METHODS: We included studies in all languages that reported resurfacing outcomes for patients with PT and radiographic evidence or direct visualization of sigmoid sinus wall anomaly, jugular bulb wall anomaly, or dehiscent or aberrant internal carotid artery.
RESULTS: Of 954 citations retrieved in database searches and 5 citations retrieved from reference lists, 20 studies with a total of 141 resurfacing cases involving 138 patients were included. Resurfacing outcomes for arterial sources of PT showed 3 of 5 cases (60%) with complete resolution and 2 (40%) with partial resolution. Jugular bulb sources of PT showed 11 of 14 cases (79%) with complete resolution and 1 (7%) with partial resolution. Sigmoid sinus sources of PT showed 91 of 121 cases (75%) with complete resolution and 12 (10%) with partial resolution. Symptoms occurred more in females and on the right side. Most cases (94%) used hard-density materials for resurfacing. Material density did not appear to be associated with resurfacing outcomes. Use of autologous materials was associated with improved outcomes for arterial sources resurfacing. Major complications involving sigmoid sinus thrombosis or compression were reported in 4% of cases without long-term morbidity or mortality.
CONCLUSIONS: Resurfacing surgery is likely effective and well tolerated for select patients with PT associated with various vascular wall anomalies.

PMID: 30667295 [PubMed - as supplied by publisher]

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Effect of Adenotonsillectomy on Ambulatory Blood Pressure in Pediatric Obstructive Sleep Apnea: 6-Month Follow-up Study.

Effect of Adenotonsillectomy on Ambulatory Blood Pressure in Pediatric Obstructive Sleep Apnea: 6-Month Follow-up Study.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825462

Authors: Kang KT, Chiu SN, Lin CY, Weng WC, Lee PL, Hsu WC

Abstract
OBJECTIVE: To investigate 24-hour ambulatory blood pressure changes 6 months after surgery among children with obstructive sleep apnea.
STUDY DESIGN: Prospective interventional study.
SETTING: Tertiary medical hospital.
SUBJECTS AND METHODS: Children aged 4 to 16 years with symptoms of obstructive sleep apnea (apnea-hypopnea index >1) were recruited. All children underwent adenotonsillectomy and postoperative polysomnography overnight. The 24-hour ambulatory blood pressure was measured before and 6 months after surgery.
RESULTS: The study cohort enrolled 124 children: mean (SD) age, 7.3 (3.1) years; 73% boys. After surgery, the apnea-hypopnea index significantly decreased from 13.3 (18.1) to 3.3 (7.2) events per hour ( P < .001). Overall systolic blood pressure and diastolic blood pressure were not significantly different following surgery, while daytime systolic blood pressure was slightly increased (114.3 to 117.3 mm Hg, P < .01) postoperatively. The hypertensive group (n = 43) exhibited significantly decreased levels of overall diastolic, nighttime systolic, and nighttime diastolic blood pressure ( P < .05), and 54% of hypertensive children became nonhypertensive after surgery. The nonhypertensive group (n = 81) showed slightly increased levels of nocturnal overall systolic, daytime systolic, and nighttime systolic blood pressure. A generalized linear mixed model revealed that children with hypertension had a greater decrease in systolic and diastolic ambulatory blood pressure during the daytime and nighttime (all P < .05) than those without hypertension.
CONCLUSIONS: Ambulatory blood pressure changes after adenotonsillectomy among children with obstructive sleep apnea are minimal. The decrease in ambulatory blood pressure after surgery is more prominent for hypertensive children than nonhypertensive children.

PMID: 30668275 [PubMed - as supplied by publisher]

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When Have We Done Enough? Provider-Patient Discord in Terminal Head and Neck Cancer.

When Have We Done Enough? Provider-Patient Discord in Terminal Head and Neck Cancer.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825457

Authors: Talmadge J, Judge P, Sayed Z

PMID: 30668269 [PubMed - as supplied by publisher]

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Relationship of Vitamin D Deficiency and Intraoperative Parathyroid Hormone Elevation in Completion and Total Thyroidectomy.

Relationship of Vitamin D Deficiency and Intraoperative Parathyroid Hormone Elevation in Completion and Total Thyroidectomy.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825467

Authors: Lawson BR, Hinson AM, Lucas JC, Bodenner DL, Stack BC

Abstract
OBJECTIVE: To quantify how frequently intraoperative parathyroid hormone levels increase during thyroid surgery and to explore a possible relationship between secondary hyperparathyroidism due to vitamin D deficiency and elevation in intraoperative parathyroid hormone.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary academic center.
SUBJECTS AND METHODS: A total of 428 consecutive patients undergoing completion and total thyroidectomy by the senior author over a 7-year period were included for analysis. All patients had baseline and postexcision intraoperative parathyroid hormone levels as well as vitamin D levels from the same laboratory. Institute of Medicine criteria were employed for vitamin D stratification (>30, normal; 20-29.9, insufficient; <20, deficient) . Other data analyzed include sex, age, neck dissection status, and parathyroid autotransplantation.
RESULTS: A total of 118 patients (27.6%) had an intraoperative parathyroid hormone elevation above baseline. Patients with vitamin D deficiency were significantly more likely to experience hormone elevation ( P = .04). When parathyroid hormone rose, it did so by a mean 32.1 pg/mL. Patients with vitamin D deficiency demonstrated significantly larger hormone increases ( P = .03).
CONCLUSION: Elevation in intraoperative parathyroid hormone levels above baseline after completion and total thyroidectomy occurs in over one-fourth of cases and is significantly associated with vitamin D deficiency. This study is the first to report this observation. We hypothesize that vitamin D deficiency in these patients may create a subclinical secondary hyperparathyroidism that leads to intraoperative parathyroid hormone elevation when the glands are manipulated. Additional studies will be needed to explore this physiologic mechanism and its clinical significance.

PMID: 30668264 [PubMed - as supplied by publisher]

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Children with Cleft Palate: Predictors of Otologic Issues in the First 10 Years.

Children with Cleft Palate: Predictors of Otologic Issues in the First 10 Years.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825461

Authors: Funamura JL, Lee JW, McKinney S, Bayoumi AG, Senders CW, Tollefson TT

Abstract
OBJECTIVE: To evaluate the characteristics of children with cleft palate associated with persistent otologic issues in the first 10 years of life.
STUDY DESIGN: Case series with chart review.
SETTING: Single academic center.
SUBJECTS AND METHODS: Children born with cleft palate from 2003 to 2007 and treated by the UC Davis Cleft and Craniofacial Team between January 2003 and December 2017 were included in the study. Data from 143 patients were analyzed via Wilcoxon rank sum and Fisher exact tests for univariate analysis and logistic regression to determine adjusted odds ratios.
RESULTS: The median length of follow-up was 9.9 years, and the age at last ear examination was 10.7 years. At the last evaluation, unresolved otologic issues were common, with at least 1 ear having a tympanic membrane (TM) perforation (16.1%), a tympanostomy tube (36.2%), or conductive hearing loss (23.1%). After adjusting for demographic and clinical characteristics, history of palate revision or speech surgery was associated with having a TM perforation ( P = .02). The only clinical variables associated with conductive hearing loss was the presence of a TM perforation ( P < .01) or a genetic abnormality ( P = .02). Severity of palatal clefting was not associated with specific otologic or audiologic outcomes after adjusting for other characteristics.
CONCLUSION: A large proportion of children with cleft palate have persistent otologic issues at age 10 years and would benefit from continued close monitoring well after the age when most children have normalized eustachian tube function. Prolonged otologic issues were not found to be associated with cleft type.

PMID: 30668229 [PubMed - as supplied by publisher]

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Association of Respiratory Mechanic Instability and Respiratory Parameters among Adults with Obstructive Sleep Apnea.

Association of Respiratory Mechanic Instability and Respiratory Parameters among Adults with Obstructive Sleep Apnea.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825468

Authors: Choi JH, Lee B, Hwang SH

Abstract
OBJECTIVES: Respiratory mechanic instability (RMI) is derived from analysis of paradoxical thoracoabdominal movements during airway obstruction. This study aimed to evaluate RMI parameters in obstructive sleep apnea (OSA) and the correlation between RMI parameters and other parameters in polysomnography.
STUDY DESIGN: Retrospective review.
SETTING: A university hospital.
METHODS: A retrospective chart review was performed, and data from 189 adult patients who underwent an in-laboratory sleep study and were seen in our clinic during the past 8 months. The RMI parameters were measured from thoracoabdominal bands during polysomnography.
RESULTS: Subjects were divided into 2 groups: control (n = 67, apnea-hypopnea index [AHI] <5) and OSA (n = 122, AHI ≥5). The OSA group was divided into 2 subgroups according to AHI: mild, 5 ≤ AHI < 15; moderate, 15 ≤ AHI < 30; severe, AHI ≥30. As AHI increased, all RMI parameters showed a significant rising pattern and difference between control and subgroups. Arousal index, lowest oxygen saturation, and oxygen desaturation index ≥3% were significantly correlated with all RMI parameters. Based on cutoff values, areas under the curves of the RMI index for predicting mild, moderate, and severe OSA were >0.85.
CONCLUSION: All RMI parameters were well related to respiratory parameters of polysomnography, such as arousal index, lowest oxygen saturation, and oxygen desaturation index ≥3%. The areas under the curves of all RMI parameters for predicting OSA and subgroups showed significant diagnostic performance. These parameters may be useful to identify OSA cases from control.

PMID: 30668216 [PubMed - as supplied by publisher]

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Relative Preservation of Superior Semicircular Canal Architecture in CHARGE Syndrome.

Relative Preservation of Superior Semicircular Canal Architecture in CHARGE Syndrome.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818824306

Authors: Tawfik KO, Leader BA, Walters ZA, Choo DI

Abstract
OBJECTIVES: (1) Describe common patterns of semicircular canal (SCC) anomalies in CHARGE syndrome (CS) and (2) recognize that in CS, the architecture of the superior SCC may be relatively preserved.
STUDY DESIGN: This is a retrospective review of temporal bone imaging studies.
SETTING: Quaternary care center.
SUBJECTS AND METHODS: A sample of 37 patients with CS. All subjects met clinical diagnostic criteria for CS. The presence/absence of anomalies of the middle ear, mastoid, temporal bone venous anatomy, inner ear, and internal auditory canal was recorded. Anomalies of each SCC were considered separately and by severity (normal, dysplasia, aplasia).
RESULTS: Thirty-seven subjects (74 temporal bones) were reviewed. Thirty-four (92.0%) patients demonstrated bilateral SCC anomalies. Three (8.0%) had normal SCCs. In patients with SCC anomalies, all canals demonstrated bilateral abnormalities. Thirty-two (86.5%) patients had bilateral horizontal SCC aplasia. These 32 patients also demonstrated posterior SCC aplasia in at least 1 ear. Of 74 temporal bones, 37 (50.0%) had superior SCC dysplasia. All dysplastic superior SCCs showed preservation of the anterior limb. Complete superior SCC aplasia was found in 28 (37.8%) temporal bones.
CONCLUSION: SCC anomalies occur with high frequency in CS. Complete absence of the horizontal and posterior canals is typical and usually bilateral. By contrast, the superior SCC often demonstrates relative preservation of the anterior limb.

PMID: 30667318 [PubMed - as supplied by publisher]

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Degree of Frontal Bone Exposure via Upper Blepharoplasty Incision: Considerations for Frontal Sinus Fracture.

Degree of Frontal Bone Exposure via Upper Blepharoplasty Incision: Considerations for Frontal Sinus Fracture.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825456

Authors: Kinzinger M, Steele TO, Chin O, Strong EB

Abstract
OBJECTIVE: The upper eyelid blepharoplasty incision affords direct access to the frontal bone for skull base surgery and trauma reconstruction with a well-hidden scar. The goal of this study is to quantify frontal bone exposure that can be achieved with an upper eyelid blepharoplasty incision.
DESIGN: Anatomic study with human cadaver heads.
SETTING: UC Davis Medical Center.
SUBJECTS/METHODS: Fourteen human cadaver heads were used to perform 26 upper blepharoplasty approaches. Exposure was measured with virtual planning software to create virtual reference points at the midline of the superior orbital rim. Surgical navigation was used with a 3-dimensionally printed drill model to measure the maximum exposure achievable relative to the virtual reference point at 5 standardized angles.
RESULTS: Mean ± SD exposures at medial 60°, medial 30°, 0°, lateral 30°, and lateral 60° were 16.1 ± 1.3 mm, 17.8 ± 1.3, 18.3 ± 1.4, 19.3 ± 1.9, and 20.9 ± 1.9, respectively. Significant differences were detected between exposures at 60° laterally and 60° medially and between exposures 60° laterally and 30° medially ( P < .05).
CONCLUSIONS: The upper eyelid blepharoplasty incision provides direct surgical access to the inferior frontal bone. Access was greatest with far lateral extension (mean, 20.9 mm) and most limited with far medial extension (mean, 16.1 mm). Treatment of injuries above this level could be achieved with additional percutaneous incisions for screw placement.

PMID: 30667301 [PubMed - as supplied by publisher]

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Airway Closure Delay: The Predominant Pathophysiology in Reflux-Associated Dysphagia.

Related Articles

Airway Closure Delay: The Predominant Pathophysiology in Reflux-Associated Dysphagia.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818824302

Authors: Kendall KA

Abstract
OBJECTIVE: Reflux disease is common in patients with oropharyngeal dysphagia, but the impact of reflux on oropharyngeal swallowing physiology is not known. This study uses objective measures of swallowing function from modified barium swallow studies to describe the pathophysiology of dysphagia in a group of patients whose only associated condition is reflux.
STUDY DESIGN: Retrospective chart review.
SETTING: Tertiary care voice and swallowing clinic.
SUBJECTS AND METHODS: The Swallowing Database at the University of Utah was queried for patients with a diagnosis of reflux without additional conditions known to affect swallowing function. Pharyngeal transit time (TPT), distance of hyoid elevation (Hmax), maximum opening size of the upper esophageal sphincter (UESmax), area of pharynx at maximum constriction (PAmax), airway closure timing relative to the arrival of the bolus at the UES, and penetration/aspiration (Pen/Asp) score were assessed.
RESULTS: Of the 122 patients who met inclusion criteria for the study, 42% had normal pharyngeal swallowing function, 57% had at least 1 abnormal swallowing measure, and 47.5% demonstrated a delay in airway closure relative to arrival of the bolus at the UES on at least 1 swallow. The incidence of prolonged TPT, diminished Hmax, poor UESmax, and enlarged PAmax were 2.5%, 8%, 4%, and 11.5%, respectively. Sixty percent with a delay in airway closure had a normal Pen/Asp score.
CONCLUSION: A delay in airway closure relative to the arrival of the bolus at the UES is the most common abnormality of swallowing function found in patients with reflux-associated dysphagia but may not be identified using the Pen/Asp score.

PMID: 30665331 [PubMed - as supplied by publisher]

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Neck and Shoulder Motor Function following Neck Dissection: A Comparison with Healthy Control Subjects.

Related Articles

Neck and Shoulder Motor Function following Neck Dissection: A Comparison with Healthy Control Subjects.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818821885

Authors: Gane EM, McPhail SM, Hatton AL, Panizza BJ, O'Leary SP

Abstract
OBJECTIVE: To compare the neck and shoulder motor function of patients following neck dissection, including comparison with a group of healthy volunteers.
STUDY DESIGN: Cross-sectional study.
SETTING: Two tertiary hospitals in Brisbane, Australia.
SUBJECTS AND METHODS: Participants included patients 0.5 to 5 years after unilateral nerve-sparing neck dissection and healthy control subjects. Demographic and clinical information was collected with cervical and shoulder motor function measures (scapular resting position, active range of motion, and isometric muscle strength). Differences between groups were examined via regression analyses that included statistical adjustment for the potential effect of age, sex, body mass index, and other disease-related variables.
RESULTS: The 57 patients (68%, men; median age, 62 years) were typically older than the 34 healthy controls (47%, men; median age, 46 years). There were no differences between types of nerve-preserving neck dissection for any of the motor function measures. When adjusted for age, sex, and body mass index, healthy volunteers (vs patients) had significantly greater cervical range (eg, extension coefficient [95% CI]: 11.04° [4.41°-17.67°]), greater affected shoulder range (eg, abduction: 16.64° [1.19°-31.36°]), and greater isometric strength of the cervical flexors (eg, men: 4.24 kgf [1.56-6.93]) and shoulder flexors (eg, men: 8.00 kgf [1.62-14.38]).
CONCLUSIONS: Strength and flexibility of the neck and shoulder are impaired following neck dissection in comparison with healthy controls. Clinicians and researchers are encouraged to consider the neck-and the neck dissection as a whole-as a source of motor impairment for these patients and not just the status of the accessory nerve.

PMID: 30665326 [PubMed - as supplied by publisher]

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Peripheral Vestibulopathy Presenting as Acute Vertigo and Spontaneous Nystagmus with Negative Video Head Impulse Test.

Related Articles

Peripheral Vestibulopathy Presenting as Acute Vertigo and Spontaneous Nystagmus with Negative Video Head Impulse Test.

Otolaryngol Head Neck Surg. 2019 Jan 22;:194599818825458

Authors: Lee JY, Kim CH, Park JS, Kim MB

Abstract
OBJECTIVE: To analyze acute vertigo showing spontaneous nystagmus with negative video head impulse test (vHIT).
STUDY DESIGN: Retrospective chart analysis.
SETTING: Tertiary referral hospital.
SUBJECTS AND METHODS: Over 16 months, 155 patients were identified with acute vertigo with spontaneous nystagmus. Of these 155, 30 (19.4%) were enrolled in this study because they did not show gain loss or catch-up saccades in both sides of the horizontal vHIT. Results of vestibular function tests (videonystagmography, horizontal vHIT, caloric test, and cervical vestibular-evoked myogenic potential [cVEMP]) and pure tone audiometry were analyzed. For all cases, magnetic resonance imaging with diffusion-weighted imaging was checked.
RESULTS: Patients consisted of 17 with Ménière's disease and 7 with sudden sensorineural hearing loss with vertigo (SSNHL_V), and only 3 patients were finally diagnosed as having acute vascular stroke. Except for the loss of hearing on the lesion side, the direction of nystagmus or cVEMP asymmetry showed very different results. All 7 patients with SSNHL_V did not have canal paresis in the caloric test, but cVEMP amplitude was smaller on the lesion side for 6 patients.
CONCLUSIONS: For patients with acute vertigo presenting spontaneous nystagmus with negative horizontal vHIT, it is important not only to focus on the diagnosis of acute vascular stroke but also to evaluate hearing because of the high possibility of Ménière's disease or SSNHL_V.

PMID: 30665325 [PubMed - as supplied by publisher]

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A fiber coherence index for quality control of B-table orientation in diffusion MRI scans

Publication date: Available online 22 January 2019

Source: Magnetic Resonance Imaging

Author(s): Kurt G. Schilling, Fang-Cheng Yeh, Vishwesh Nath, Colin Hansen, Owen Williams, Susan Resnick, Adam W. Anderson, Bennett A. Landman

Abstract

Purpose

The diffusion MRI "b-vector" table describing the diffusion sensitization direction can be flipped and permuted in dimension due to different orientation conventions used in scanners and incorrect or improperly utilized file formats. This can lead to incorrect fiber orientation estimates and subsequent tractography failure. Here, we present an automated quality control procedure to detect when the b-table is flipped and/or permuted incorrectly.

Methods

We define a "fiber coherence index" to describe how well fibers are connected to each other, and use it to automatically detect the correct configuration of b-vectors. We examined the performance on 3981 research subject scans (Baltimore Longitudinal Study of Aging), 1065 normal subject scans of high image quality (Human Connectome Project), and 202 patient scans (Vanderbilt University Medical Center), as well as 9 in-vivo and 9 ex-vivo animal data.

Results

The coherence index resulted in a 99.9% (3979/3981) and 100% (1065/1065) success rate in normal subject scans, 98% (198/202) in patient scans, and 100% (18/18) in both in-vivo and ex-vivo animal data in detecting the correct gradient table in datasets without severe image artifacts. The four failing cases (4/202) in patient scans, and two failures in healthy subject scans (2/3981), all showed prominent motion or signal dropout artifacts.

Conclusions

The fiber coherence measure can be used as an automatic quality assurance check in any diffusion analysis pipeline. Additionally, the success of this fiber coherence measure suggests potential broader applications, including evaluating data quality, or even providing diagnostic value as a biomarker of white matter integrity.

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Avoid brain contamination from surgery

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CRISPR-baby scientist, German publishing deal and hunger strike

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VTE

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Bullying investigations need a code of conduct

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Patients’ online interventions can scupper clinical trials

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Call of the wild: define it or lose it

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Proprietary data formats block health research

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Abnormal fronto-striatal intrinsic connectivity reflects executive dysfunction in alcohol use disorders

Publication date: Available online 23 January 2019

Source: Cortex

Author(s): Caterina Galandra, Gianpaolo Basso, Marina Manera, Chiara Crespi, Ines Giorgi, Giovanni Vittadini, Paolo Poggi, Nicola Canessa

Abstract

The neural bases of cognitive impairment(s) in alcohol use disorders (AUDs) have been explained either with the specific involvement of frontal regions mostly affected by alcohol neurotoxic effects, or with a global brain damage underlying different neuro-cognitive alterations. Novel insights into this issue might come from the analysis of resting-state brain activity, representing a baseline level of intrinsic connectivity within and between the networks underlying cognitive performance.

We thus addressed the neural bases of cognitive impairment(s) in 22 AUD patients, compared with 18 healthy controls, by coupling resting-state fMRI with an in-depth neuropsychological assessment of the main cognitive domains. We assessed a relationship between AUD patients' cognitive impairment and two complementary facets of intrinsic brain functioning, i.e. intensity of activation and functional network connectivity, related to the strength of connectivity within and between resting-state networks, respectively.

Alcoholic patients' decreased cognitive performance involved specifically an executive domain associated with attentional and working-memory tasks. This impairment reflected an abnormal relationship, in patients vs. controls, between cognitive performance and the intensity of intrinsic activity in the dorsolateral prefrontal and striatal nodes of the executive control network. Functional connectivity between the same structures was positively correlated with executive performance in the whole sample, but significantly reduced in patients.

The present data suggest that AUD patients' executive impairment reflects dysfunctional connectivity between the cortical and subcortical nodes of the networks underlying cognitive control on goal-directed behavior. This evidence provides a baseline for future studies addressing the abnormal neural architecture underlying cognitive impairment in AUDs and the outcome of rehabilitative treatment.

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“Looks familiar, but I do not know who she is”: The role of the anterior right temporal lobe in famous face recognition

Publication date: Available online 23 January 2019

Source: Cortex

Author(s): Valentina Borghesani, Jared Narvid, Giovanni Battistella, Wendy Shwe, Christa Watson, Richard J. Binney, Virginia Sturm, Zachary Miller, Maria Luisa Mandelli, Bruce Miller, Maria Luisa Gorno-Tempini

Abstract

Processing a famous face involves a cascade of steps including detecting the presence of a face, recognizing it as familiar, accessing semantic/biographical information about the person, and finally, if required, production of the proper name. Decades of neuropsychological and neuroimaging studies have identified a network of occipital and temporal brain regions ostensibly comprising the 'core' system for face processing. Recent research has also begun to elucidate upon an 'extended' network, including anterior temporal and frontal cortex. However, there is disagreement about which brain areas are involved in each step, as many aspects of face processing occur automatically in healthy individuals and rarely dissociate in patients. Moreover, some common phenomena are not easily induced in an experimental setting, such as having a sense of familiarity without being able to recall who the person is. Patients with the semantic variant of Primary Progressive Aphasia (svPPA) often recognize a famous face as familiar, even when they cannot specifically recall the proper name or biographical details. In this study, we analyzed data from a large sample of 105 patients with neurodegenerative disorders, including 43 svPPA, to identify the neuroanatomical substrate of three different steps of famous face processing. Using voxel-based morphometry, we correlated whole-brain grey matter volumes with scores on three experimental tasks that targeted familiarity judgment, semantic/biographical information retrieval, and naming. Performance in naming and semantic association significantly correlate with grey matter volume in the left anterior temporal lobe, whereas familiarity judgment with integrity of the right anterior middle temporal gyrus. These findings shed light on the neuroanatomical substrates of key components of overt face processing, addressing issues of functional lateralization, and deepening our understanding of neural substrates of semantic knowledge.

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The role of the hippocampus in weighting expectations during inference under uncertainty

Publication date: Available online 23 January 2019

Source: Cortex

Author(s): Francesco Rigoli, Jochen Michely, Karl J. Friston, Raymond J. Dolan

Abstract

Making inference under uncertainty requires an optimal weighting of prior expectations and observations. How this weighting is realized in the brain remains elusive. To investigate this, we recorded functional neuroimaging data while participants estimated a number based on noisy observations. Crucially, the prior expectation about the variability of observations (an expected variability) was manipulated. Consistent with normative models, when novel observations were characterized by higher expected or observed variability, participants' estimates relied more on expectations than novel observations and were characterized by higher stochasticity. Activity in hippocampus increased when novel evidence was characterized by higher expected or observed variability. Response in superior parietal cortex reflected a precision-weighted prediction error signal (i.e., the distance between observations and expectations) that was modulated by hippocampal activity. Our findings implicate the hippocampus during inference under uncertainty, suggesting a role in weighting prior representations over observations and in modulating responsivity of superior parietal cortex to prediction error.

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A comparison of treatment effectiveness between clear aligner and fixed appliance therapies

Abstract

Background

Align technology has developed greatly over past few years. Patients tended to prefer clear aligners over conventional brackets because of the superior comfort and esthetics, while the effectiveness of clear aligners was still controversial. The aim of this systematic review was to verify whether the treatment effectiveness of clear aligners was similar to the conventional fixed appliances.

Methods

A comprehensive search of the Pubmed, Web of Science, Embase, Scopus, and Cochrane Central Register of Controlled Clinical Trials Register databases for studies published through to August 20, 2018 was conducted. Comparative clinical studies assessing the effectiveness of clear aligners compared with braces were included.

Results

Eight papers were included in this study. Two of the included papers were randomized controlled trials and six were cohort studies. Clear aligners might not be as effective as braces in producing adequate occlusal contacts, controlling teeth torque, increasing transverse width and retention. While no statistically significant difference was found between two groups in Objective Grading System score (WMD = 8.38, 95% CI [− 0.17, 16.93]; P = 0.05). On the other hand, patients treated with clear aligners had a statistically significant shorter treatment duration than with braces (WMD = − 6.31, 95% CI [− 8.37, − 4.24]; P < 0.001).

Conclusion

Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.

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A novel “turn-on” mitochondria-targeting near-infrared fluorescent probe for H2S detection and in living cells imaging

Publication date: 15 May 2019

Source: Talanta, Volume 197

Author(s): Xiong-jie Zhao, Yu-ting Li, Yu-ren Jiang, Bing-qing Yang, Ce Liu, Zhi-hong Liu

Abstract

Hydrogen sulfide (H₂S) has been considered to be involved in cytoprotective processes and redox signaling. It is very meaningful to track and analyze it in mitochondria. Herein, we report a novel "turn-on" mitochondria-targeting near-infrared fluorescent probe (Mito-NIR-SH) for detection of H₂S in living cells, which was designed and synthesized by introducing 2,4-dinitrophenyl as fluorescence quenching group and H₂S response moiety into Changsha near-infrared fluorophore (CS-OH). The structure of the fluorophore and the probe were characterized by ¹H NMR, ¹³C NMR and mass spectrometry. Meanwhile, Mito-NIR-SH could quantitatively detect H₂S at concentrations ranging from 0 to 30 μM with a detection limit as low as 89.3 nM, showing good chemical stability, fast "turn-on" response, selectively mitochondrial location, as well as high sensitivity and selectivity toward H₂S. Based on this, it was successfully applied to imaging exogenous and endogenous H₂S in living HeLa cells via confocal fluorescence microscopy.

Graphical abstract

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Review of the existing maximum residue levels for spiromesifen according to Article 12 of Regulation (EC) No 396/2005

Abstract

According to Article 12 of Regulation (EC) No 396/2005, EFSA has reviewed the maximum residue levels (MRLs) currently established at European level for the pesticide active substance spiromesifen. To assess the occurrence of spiromesifen residues in plants, processed commodities, rotational crops and livestock, EFSA considered the conclusions derived in the framework of Regulation (EC) No 1107/2009, the MRLs established by the Codex Alimentarius Commission, as well as the import tolerances and European authorisations reported by Member States (including the supporting residues data). Based on the assessment of the available data, MRL proposals were derived and a consumer risk assessment was carried out. Although no apparent risk to consumers was identified, some information required by the regulatory framework was missing. Hence, the consumer risk assessment is considered indicative only and some MRL proposals derived by EFSA still require further consideration by risk managers.

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Cannabidiol modulates phosphorylated rpS6 signalling in a zebrafish model of Tuberous Sclerosis Complex

Publication date: Available online 23 January 2019

Source: Behavioural Brain Research

Author(s): Ines Serra, Chloë Scheldeman, Michael Bazelot, Benjamin J. Whalley, Mark L. Dallas, Peter A.M. de Witte, Claire M. Williams

Abstract

Tuberous sclerosis complex (TSC) is a rare disease caused by mutations in the TSC1 or TSC2 genes and is characterized by widespread tumour growth, intractable epilepsy, cognitive deficits and autistic behaviour. CBD has been reported to decrease seizures and inhibit tumour cell progression, therefore we sought to determine the influence of CBD on TSC pathology in zebrafish carrying a nonsense mutation in the tsc2 gene.

CBD treatment from 6 to 7 days post-fertilization (dpf) induced significant anxiolytic actions without causing sedation. Furthermore, CBD treatment from 3 dpf had no impact on tsc2^-/- larvae motility nor their survival. CBD treatment did, however, reduce the number of phosphorylated rpS6 positive cells, and their cross-sectional cell size. This suggests a CBD mediated suppression of mechanistic target of rapamycin (mTOR) activity in the tsc2^-/- larval brain.

Taken together, these data suggest that CBD selectively modulates levels of phosphorylated rpS6 in the brain and additionally provides an anxiolytic effect. This is pertinent given the alterations in mTOR signalling in experimental models of TSC. Additional work is necessary to identify upstream signal modulation and to further justify the use of CBD as a possible therapeutic strategy to manage TSC.

Graphical abstract

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Abnormal empathy-like pro-social behaviour in the valproic acid model of autism spectrum disorder

Publication date: Available online 22 January 2019

Source: Behavioural Brain Research

Author(s): Mellanie Fontes-Dutra, Gustavo Della-Flora Nunes, Julio Santos Terra, Walquíria Souza-Nunes, Guilherme Bauer-Negrini, Mauro Mozael Hirsch, Lily Green, Rudimar Riesgo, Carmem Gottfried, Victorio Bambini-Junior

Abstract

Impairments in social behaviour are a defining feature of autism spectrum disorder (ASD). Individuals with ASD also usually present some difficulty to recognise or understand another person's feelings. Therefore, it is possible that altered empathy processing could hinder typical social interaction in ASD. Recently, robust paradigms confirmed that rodents show primordial forms of empathy-like behaviour. Therefore, in this work, we used one of these new protocols to test pro-social behaviour in the rat model of autism induced by Valproic Acid (VPA). We also evaluated possible beneficial effects of Resveratrol, since it can prevent social deficits in the VPA model. Rats were tested on their ability to open a restrainer to release a trapped conspecific. Exposure to VPA precludes the timely manifestation of this empathy-like behaviour, but does not affect its continuation after its first expression. We also found a significant correlation between average speed during the first day of test and becoming an Opener. Similarly, rats able to open the restrainer on the first day had an increased likelihood of repeating this behaviour in the later days of the testing programme. We did not find any protective effects of Resveratrol. Further investigation of empathy-like behaviour in the VPA model and in other models of autism could help to clarify the behavioural and neural processes underpinning the basic aspects of empathy alterations in autistic individuals.

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Effects of chronic cocaine exposure on the circadian rhythmic expression of the clock genes in reward-related brain areas in rats

Publication date: Available online 22 January 2019

Source: Behavioural Brain Research

Author(s): De-Quan Wang, Xin - Ling Wang, Chong - Yang Wang, Yuan Wang, Su - Xia Li, Ke - Zhi Liu

Abstract

Drug addiction is a widespread social problem, which not only brings adverse consequences to the human body, but also causes great burden to the society. However, it's still unclear how the long-term and sustained cocaine exposure will affect clock genes' expression in the reward related brain areas. We hypothesize that chronic cocaine exposure causes changes in the circadian rhythmic expression of clock genes in brain regions associated with reward, since previous studies have shown that cocaine use causes circadian disorders. Sprague-Dawley male rats were administrated with cocaine 20 mg/kg at ZT4 through intraperitoneal injection for 21 consecutive days. Twenty-four hours after the last cocaine administration brain samples were collected at 4-hour intervals for 24 hours (every 4h: ZT 0; ZT 4; ZT 8; ZT 12; ZT 16; ZT 20) to examine expression of rPer1, rPer2, rPer3, rCry, rBmal1 and rClock by quantitative real-time reverse-transcription polymerase chain reaction (RT-PCR). We found that chronic cocaine exposure to rats resulted in significantly disturbances in expression of clock genes in reward related brain areas compared to saline - treated rats. In cocaine-treated rats,rPer1 expression in the suprachiasmatic nucleus (SCN), prefrontal cortex (PFC) and ventral tegmental area (VTA); rPer2 expression in the nucleus accumbens (NAc) shell and hippocampus; rPer3 expression in the NAc core; rCry expression in the SCN and PFC; rBmal1 expression in the SCN and NAc core showed robust circadian rhythms that were essentially identical to those in control rats. However, robust circadian rhythm in rPer1 expression in the SCN and rCry expression in the PFC was nearly completely phase - reversed in cocaine-treated rats. A blunting of circadian oscillations of rPer1 expression occurred in the NAc core and shell and hippocampus; of rPer2 expression occurred in the SCN, PFC, NAc core and hippocampus; of rPer3 expression occurred in the SCN, PFC, NAc shell, hippocampus and VTA; of rCry expression occurred in the NAc core and shell, hippocampus and VTA; of rBmal1 expression occurred in the PFC, NAc shell, hippocampus and VTA in cocaine - treated rats. These rhythm changes accompanied by significant increase in rPer1, rPer2, rPer3 and rBmal1 in the PFC, rPer1, rPer2 and rBmal1 in the hippocampus; significant decrease in rPer2, rPer3 and rCry in the SCN, rPer3, rCry, rBmal1 and rClock in the NAc core compared to control rats. rClock expression in cocaine - treated rats showed no rhythmic change, identical to control rats.These results suggest that chronic cocaine exposure results in disturbances in clock genes' expression in reward related areas.

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Development of herpes zoster during infliximab treatment for pediatric generalized pustular psoriasis, a case report

Abstract

We report a 12‐year‐old Chinese child with generalized pustular psoriasis who was responded well to infliximab, but an adverse effect of herpes zoster occurred after the first infusion soon. The anti‐viral treatment was effective and no recurrence or flaring was observed after half‐year of follow‐up. This case reminds us to highlight the risk of viral infection during biologic treatment on patients with psoriasis or autoimmune disease.

This article is protected by copyright. All rights reserved.

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Human evolution’s ties to tectonics

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Technologies to watch in 2019

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Understanding the Family Impact of Autism Spectrum Disorder in a Racially and Ethnically Diverse Sample: Findings from the National Survey of Children with Special Health Care Needs

Abstract

Objectives Caregivers of children with autism spectrum disorder (ASD) experience stress at greater rates than caregivers of other children with developmental conditions. Little is known about how families from different racial and ethnic backgrounds report family impact beyond individual stressors associated with caregiving. This paper aims to examine differences in family impact variables among caregivers of ASD children from different racial/ethnic backgrounds. Methods Using data from the 2005–2006 and 2009–2010 National Survey of Children with Special Health Care Needs, this retrospective, cross-sectional study examined family impact among caregivers of children with ASD. Family impact was defined as financial impact, time spent caregiving, and work impact variables and evaluated in five racial/ethnicity groups: white, non-Hispanic; any race, English-speaking Hispanic; any race, Spanish-speaking Hispanic; black, non-Hispanic; and other race, non-Hispanic respondents (n = 5115). Multivariate logistic regression was used to analyze the association of race and ethnicity with family impact variables while controlling for child and family covariates. Results Significant differences were found between race/ethnicity groups of caregivers on financial spending of more than $500 per year on care and providing more than 11 h a week on direct child care. No significant differences were observed in job impact variables between race/ethnicity groups. Conclusions for Practice Racial/ethnic differences exist in providing and spending more on direct care, but they do not necessarily represent disparities. More research is needed to fully understand if family impact is affected by cultural differences in care provided for children with ASD.

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How the next recession could save lives

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Prostatic Acid Phosphatase (PAP) Predicts Prostate Cancer Progress in a Population-Based Study: The Renewal of PAP?

Objective. To characterize the disease progression and median survival of patients with prostate cancer (PCa) according to the prostatic-specific acid phosphatase (PAP) analysis in a population-based study from the Surveillance, Epidemiology, and End Results (SEER) database. Materials and Methods. Prostate cancer patients with completed PAP results were identified using the SEER database of the National Cancer Institute. The Mann-Whitney Sum test was utilized to compare the statistical significance for measurement data and ranked data. Data were stratified by ages, races, TNM Classification of Malignant Tumors (TNM), pathological grades, number of tumors, PAP, and survival duration. Multivariable logistic analysis was performed to identify predictors of the presence of invasion and metastases. Cox regression was analyzed for the factors associated with all-cause mortality and prostate cancer-specific mortality. Moreover, survival curve was used to detect the survival months. The unknown data were excluded from these tests. Results. In total, there are 5184 PAP+ patients and 3161 PAP- patients involved. The Mann-Whitney Sum test showed that slightly greater tumor size (), elevated lymphatic () and distant () metastasis rate, higher pathological grade (), localized tumor number (), and shortened survival months () were observed in the PAP+ group compared with the PAP- group. In the multivariable logistic regression, invasion and metastasis Hazard Ratio (HR) were elevated significantly () in the PAP+ individuals. In the survival analysis, PAP- patients experienced the prolonged median survival. In the postsurgical patients, the survival months were still longer in PAP+ patients compared with the negative ones (), though surgery prolonged the survival months of both groups. Survival months stratified by localized, invasion, and metastasis situations were analyzed. In the three stratified subgroups, the survival duration is significantly decreased in the PAP+ individuals in the localized PCa group () and the metastasis group ().Conclusions. The findings of this study provide population-based estimates of the PCa progress and prognosis for patients with different PAP results, which may suggest a renewed period for the PAP.

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The Dynamic Use of EGFR Mutation Analysis in Cell-Free DNA as a Follow-Up Biomarker during Different Treatment Lines in Non-Small-Cell Lung Cancer Patients

Epidermal growth factor receptor (EGFR) mutational testing in advanced non-small-cell lung cancer (NSCLC) is usually performed in tumor tissue, although cfDNA (cell-free DNA) could be an alternative. We evaluated EGFR mutations in cfDNA as a complementary tool in patients, who had already known EGFR mutations in tumor tissue and were treated with either EGFR-tyrosine kinase inhibitors (TKIs) or chemotherapy. We obtained plasma samples from 21 advanced NSCLC patients with known EGFR tumor mutations, before and during therapy with EGFR-TKIs and/or chemotherapy. cfDNA was isolated and EGFR mutations were analyzed with the multiple targeted cobas EGFR Mutation Test v2. EGFR mutations were detected at baseline in cfDNA from 57% of patients. The semiquantitative index (SQI) significantly decreased from the baseline (,-13) to the best response (,-0, ), followed by a significant increase at progression (,-15, ) in patients treated with either EGFR-TKIs or chemotherapy. The SQI obtained with the cobas EGFR Mutation Test v2 did not correlate with the concentration in copies/mL determined by droplet digital PCR. Resistance mutation p.T790M was observed at progression in patients with either type of treatment. In conclusion, cfDNA multiple targeted EGFR mutation analysis is useful for treatment monitoring in tissue of EGFR-positive NSCLC patients independently of the drug received.

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HDAC inhibitors promote intestinal epithelial regeneration via autocrine TGFβ1 signalling in inflammation

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Understanding the stress responses of Kluyveromyces marxianus after an arrest during high-temperature ethanol fermentation based on integration of RNA-Seq and metabolite data

Abstract

The thermotolerant Kluyveromyces marxianus is a potential candidate for high-temperature ethanol fermentation. Although K. marxianus exhibited high ethanol productivity at 45 °C during the early fermentation stage, we observed a fermentation arrest due to the accumulated inhibitors. The stress responses of K. marxianus during high-temperature fermentation were revealed based on integration of RNA sequencing (RNA-Seq) and metabolite data. High temperature stimulated mitochondrial respiration but repressed the tricarboxylic acid (TCA) cycle, leading to increased generation of reactive oxygen species (ROS) and a lowered ratio of reduced nicotinamide adenine dinucleotide (NADH)/oxidized nicotinamide adenine dinucleotide (NAD⁺). Glycerol production was enhanced during the early fermentation stage, which might contribute to NADH reoxidation and ROS generation. Excess ROS could be neutralized by reduced nicotinamide adenine dinucleotide phosphate (NADPH) that might be reserved in the following ways: (1) decreased biosynthesis of branched-chain amino acids (BCAAs) reduced NADPH consumption; (2) enhanced acetic acid production increased NADPH regeneration. The degree of fatty acid unsaturation was also reduced to adapt to high temperature. In addition, stress responses were also observed after the fermentation arrest at 45 °C. Genes related to peroxidase activity, iron-sulfur cluster assembly, and flavin mononucleotide (FMN) binding were downregulated, while genes associated with DNA repair and lipid composition of the plasma were upregulated. The yeast also produced more ergosterol to deal with ethanol stress. This study gains comprehensive insights into the K. marxianus transcriptome under various stresses during high-temperature ethanol fermentation, providing rich information for further metabolic engineering towards improved stress tolerance and ethanol production.

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Agree to disagree on plans for the next European supercollider

Agree to disagree on plans for the next European supercollider

Agree to disagree on plans for the next European supercollider, Published online: 23 January 2019; doi:10.1038/d41586-019-00234-6

Physics community faces a controversial decision over whether to build the world's most powerful particle smasher.

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Chiral Heterobimetallic Bismuth‐Rhodium Paddlewheel Catalysts: A Conceptually New Approach to Asymmetric Cyclopropanation

Cyclopropanation reactions of styrene derivatives with donor/acceptor carbenes formed in situ are significantly more enantioselective when catalyzed by the heterobimetallic bismuth‐rhodium complex 5a endowed with N‐phthalimido tert‐leucine paddlewheel ligands rather than by its homobimetallic dirhodium analogue 1a. This virtue is likely the result of two synergizing factors: the conical shape of 5a translates into a narrower calyx‐like chiral binding site about the catalytically active Rh center; the Bi atom, although fully solvent exposed, does not decompose aryl diazoacetates and is hence incapable of promoting a racemic background reaction. Moreover, ligand variation proved that successful catalyst design mandates that the anisotropy of the conical heterobimetallic core be matched by proper directionality within the ligand sphere.

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Super‐Bulky Penta‐arylcyclopentadienyl Ligands: Elixir for the Isolation of the Full‐range of Half‐sandwich Heavy Alkaline‐earth Metal Hydrides

Hydrogenolysis of the half‐sandwich penta‐arylcyclopentadienyl supported heavy alkaline‐earth metal alkyl complexes (CpAr)Ae[CH(SiMe3)2](S) (CpAr = C5Ar5, Ar = 3,5‐iPr2‐C6H3; S = THF or DABCO) in hexane afforded the calcium, strontium and barium metal hydride complexes as the same dimers [(CpAr)Ae(μ‐H)(S)]2 (Ae = Ca, S = THF, 2‐Ca; Ae = Sr, Ba, S = DABCO, 4‐Ae), which were characterized by NMR spectroscopy and single‐crystal X‐ray analysis. 2‐Ca, 4‐Sr and 4‐Ba catalyzed alkene hydrogenation under mild conditions (30 oC, 6 atm, 5 mol% cat.), with the activity increasing with the metal size. A variety of activated alkenes including tri‐ and tetra‐substituted olefins, semi‐activated alkene (Me3SiCH=CH2), and unactivated terminal alkene (1‐hexane) were evaluated.

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From Supramolecules to Self‐Templated Porous Carbon and Metal‐Doped Carbon Catalysts

The fabrication of carbon materials usually involves the decomposition of precursors and the reorganization of as‐generated fragments. However, the cleavage of bonds and formation of new bonds at nearly identical spatio‐temporal scale prevent effective yet precise fabrication. Herein, a supramolecular precursor, cucurbit[6]uril, that integrates multiple bonds with distinct bond strengths was proposed to decouple the twin problem of simultaneous bond cleavage and formation, rendering multistage transformations to hierarchical porous carbon (SC) and metal‐doped carbon (SC‐M) materials in a single yet effective pyrolysis step without the assist of any template or additional purification. As a proof‐of‐concept, the as‐fabrication SC‐Fe electrocatalysts realized a Pt/C‐like half‐wave potential of 0.869 V vs. RHE and small Tafel slope of 51.3 mV dec−1 in oxygen reduction reaction. This work not only provides an alternative yet controllable approach to fabricate atomically dispersed electrocatalysts but also sheds a light on the understanding of pyrolysis synthesis and rational design of carbon‐based materials via precursor bond engineering.

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Controlling an SN2 reaction by electronic and vibrational excitation ‐ tip‐induced ether cleavage on Si(001)

Controlling chemical reactions beyond thermally activated reaction schemes can open alternative reaction channels thus leading to new final products. Here we show for tetrahydrofuran (THF) on Si(001), the surface analogue of an SN2 reaction, that excitation by electrons from the tip of a scanning tunneling microscope (STM) not only opens new reaction channels, but that different final products can be selectively addressed by the type of excitation: Above a threshold voltage of 2.5 V, a direct excitation by electron transfer into the antibonding C‐O orbital of the THF molecules induces ether cleavage of the datively bonded intermediate of THF on Si(001). Below the threshold, ether cleavage is induced by multiple excitation of vibrational modes. In both modes of excitation, additional final configurations were observed when compared to the thermally activated reaction. The branching ratios of the final configurations are different for the two different excitation mechanisms, which in turn can be controlled by the applied sample bias.

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NMR Crystallography: Evaluation of Hydrogen Positions in Hydromagnesite by ¹³C{¹H} REDOR Solid‐State NMR and Density Functional Theory Calculation of Chemical Shielding Tensors

Solid‐state NMR measurements coupled with density functional theory (DFT) calculations demonstrate how hydrogen positions can be refined in a crystalline system. The precision afforded by rotational‐echo double‐resonance (REDOR) NMR to interrogate ¹³C‐¹H distances is exploited along with DFT determinations of the ¹³C tensor of carbonates (CO₃²¯). Here it is shown that nearby ¹H nuclei perturb the axial symmetry of the carbonate sites in the lattice of the hydrated carbonate mineral, hydromagnesite [4MgCO₃·Mg(OH)₂·4H₂O]. A match between the calculated structure and solid‐state NMR is found by testing multiple semi‐local and dispersion‐corrected DFT functionals, applying them to optimize the multiple hydrogen and other atom positions, starting from X‐ray diffraction (XRD) determined atomic coordinates. Optimized atomic coordinates are validated by comparing calculated to experimental ¹³C{¹H} REDOR and ¹³C chemical shift anisotropy (CSA) tensor values. The results demonstrate that the combination of solid‐state NMR, XRD, and DFT can significantly improve structure refinement for hydrated materials.

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Reverse Arene Sandwich Structures Based upon π‐hole•••[MII] (d8M = Pt, Pd) Interactions, where Positively Charged Metal Centers Play the Role of a Nucleophile

The complexes [Pt(tpp)] (M = Pt; H2tpp = tetraphenyl‐porphyrin), [M(acac)2] (M = Pd, Pt, Hacac = acetylacetone), and [Pd(ba)2] (Hba = benzoylacetone) were co‐crystallized with highly electron‐deficient arene systems to form reverse arene sandwich structures built by π‐hole•••[MII] (d8M = Pt, Pd) interactions. The adduct [Pt(tpp)]•2C6F6 is monomeric, whereas the diketonate 1:1 adducts form columnar infinity 1D‐stack assembled by simultaneous action of both π‐hole•••[MII] and C–F interactions. The reverse sandwiches are based on noncovalent interactions and calculated ESP distributions indicate that in π‐hole•••[MII] contacts, [MII] plays the role of a nucleophile.

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Admission to the intensive care unit: the need to study complexity and solutions

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Lung recruitment: What has computed tomography taught us in the last decade?

Although chest X-ray remains a fundamental lung imaging technique, through the years, CT scan has significantly improved our knowledge of the pathophysiological process and currently is the reference lung imag...

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NUTRI-REAPED study: nutritional assessment of French critically ill children and nutrition practice survey in French-speaking pediatric intensive care units

Impaired nutritional status is adversely associated with suboptimal outcomes in critically ill children. Undernutrition at pediatric intensive care unit (PICU) admission ranges from 15 to 65%. A lack of knowle...

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Experts’ guidelines of intubation and extubation of the ICU patient of French Society of Anaesthesia and Intensive Care Medicine (SFAR) and French-speaking Intensive Care Society (SRLF)

Intubation and extubation of ventilated patients are not risk-free procedures in the intensive care unit (ICU) and can be associated with morbidity and mortality. Intubation in the ICU is frequently required i...

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Agree to disagree on plans for the next European supercollider

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Effects of cadmium exposure on antioxidant enzymes and histological changes in the mud shrimp Austinogebia edulis (Crustacea: Decapoda)

Abstract

The trace metal cadmium (Cd) is a toxic pollutant known to induce oxidative stress and other sublethal to lethal effects on aquatic organisms. We exposed the marine mud shrimp Austinogebia edulis to Cd concentrations of 0, 0.5, and 5 mg/kg for up to 4 days (24, 48, 72, 96 h). We studied the activity of antioxidant enzymes in the hepatopancreas, gill, and muscle of A. edulis. Antioxidant enzymes (SOD, CAT, and GPx) decreased with increasing Cd concentration and extended exposure time in these three organs of the mud shrimp A. edulis. Increasing Cd concentration led to an increase in ROS and resulted ultimately in membrane lipid peroxidation at higher Cd concentrations. Significant damage of the hepatopancreas of A. edulis was noticed at higher concentrations of Cd, showing damages like the disappearance of epithelial cell boundaries, detachment of cells from the basal lamina, cellular swelling, necrosis, and reduction of glycogen. In conclusion, Cd caused oxidative damage by reducing the activities of antioxidant enzymes and by damaging the tissue structure in major organs of the mud shrimp A. edulis.

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Deployment of olive-stone waste as a substitute growing medium component for Brassica seedling production in nurseries

Abstract

In the Mediterranean region, olive-stone waste (OSW) is accumulated and considered of environmental and human health constraints. In this study, OSW was used for peat (P) replacement in growing media for Brassica seedling production. Cauliflower, broccoli, and cabbage were seeded in growing media consisted of 0–20–40–60% OSW. The mixture of OSW with peat increased growing media bulk density and reduced the total pore space and available water and air at root system. A Considerable amount of minerals were provided into the growing media with the OSW, while their availability was increased with the raised pH values. Seed emergence percentage decreased with high ratio of OSW which also increased mean emergence time. The addition of OSW decreased plant height, leaf number, and fresh weight in all three examined species. The OSW decreased stomatal conductance (in cauliflower and cabbage) and chlorophylls content (including broccoli). The insertion of OSW affected the mineral accumulation in plants with decreases in nitrogen and sodium content and increases in potassium and calcium. OSW increased to some extent for cauliflower and broccoli or unchanged for cabbage polyphenolic content and antioxidant activity (ABTS, FRAP). Cellular damage was caused by the addition of OSW by increasing the lipid peroxidation and the production of hydrogen peroxide, and as a consequence, the plant antioxidative (catalase, superoxide dismutase) enzyme metabolism increased. The current study demonstrates that up to 20% of OSW can substitute peat for cauliflower, broccoli, and cabbage seedling production while cabbage was performed better under the increased OSW-caused stress.

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Fate and toxicity of silver nanoparticles in freshwater from laboratory to realistic environments: a review

Abstract

The fate and risk assessment of silver nanoparticles (Ag NPs) is an important environmental health issue. The toxic effects, mechanisms, and modes of action of Ag NPs on aquatic organisms have been extensively determined in the laboratory. However, knowledge gaps and discrepancies exist between laboratory studies and realistic environmental research; such inconsistencies hinder the development of health and safety regulations. To bridge these gaps, this review summarizes how environmental conditions and the physicochemical properties of Ag NPs affect the inconsistent findings between laboratory studies and realistic environmental research. Moreover, this paper systematically reviews different toxic effects of Ag NPs in a realistic environment and compares these effects with those in the laboratory, which is helpful for assessing the environmental fate and risk of Ag NPs. The hazardous effects of Ag NPs on the whole aquatic ecosystem with low concentrations (μg L⁻¹) and long-term periods (months to years) are detailed. Furthermore, two perspectives of future toxicity studies of Ag NPs in realistic freshwater environments are emphasized.

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Voxel-wise deviations from healthy aging for the detection of region-specific atrophy.

Related Articles

Voxel-wise deviations from healthy aging for the detection of region-specific atrophy.

Neuroimage Clin. 2018;20:851-860

Authors: Klöppel S, Yang S, Kellner E, Reisert M, Heimbach B, Urbach H, Linn J, Weidauer S, Andres T, Bröse M, Lahr J, Lützen N, Meyer PT, Peter J, Abdulkadir A, Hellwig S, Egger K, Alzheimer's Disease Neuroimaging Initiative

Abstract
The identification of pathological atrophy in MRI scans requires specialized training, which is scarce outside dedicated centers. We sought to investigate the clinical usefulness of computer-generated representations of local grey matter (GM) loss or increased volume of cerebral fluids (CSF) as normalized deviations (z-scores) from healthy aging to either aid human visual readings or directly detect pathological atrophy. Two experienced neuroradiologists rated atrophy in 30 patients with Alzheimer's disease (AD), 30 patients with frontotemporal dementia (FTD), 30 with dementia due to Lewy-body disease (LBD) and 30 healthy controls (HC) on a three-point scale in 10 anatomical regions as reference gold standard. Seven raters, varying in their experience with MRI diagnostics rated all cases on the same scale once with and once without computer-generated volume deviation maps that were overlaid on anatomical slices. In addition, we investigated the predictive value of the computer generated deviation maps on their own for the detection of atrophy as identified by the gold standard raters. Inter and intra-rater agreements of the two gold standard raters were substantial (Cohen's kappa κ > 0.62). The intra-rater agreement of the other raters ranged from fair (κ = 0.37) to substantial (κ = 0.72) and improved on average by 0.13 (0.57 < κ < 0.87) when volume deviation maps were displayed. The seven other raters showed good agreement with the gold standard in regions including the hippocampus but agreement was substantially lower in e.g. the parietal cortex and did not improve with the display of atrophy scores. Rating speed increased over the course of the study and irrespective of the presentation of voxel-wise deviations. Automatically detected large deviations of local volume were consistently associated with gold standard atrophy reading as shown by an area under the receiver operator characteristic of up to 0.95 for the hippocampus region. When applying these test characteristics to prevalences typically found in a memory clinic, we observed a positive or negative predictive value close to or above 0.9 in the hippocampus for almost all of the expected cases. The volume deviation maps derived from CSF volume increase were generally better in detecting atrophy. Our study demonstrates an agreement of visual ratings among non-experts not further increased by displaying, region-specific deviations of volume. The high predictive value of computer generated local deviations independent from human interaction and the consistent advantages of CSF-over GM-based estimations should be considered in the development of diagnostic tools and indicate clinical utility well beyond aiding visual assessments.

PMID: 30278372 [PubMed - indexed for MEDLINE]

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Lateral parietal contributions to memory impairment in posterior cortical atrophy.

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Lateral parietal contributions to memory impairment in posterior cortical atrophy.

Neuroimage Clin. 2018;20:252-259

Authors: Ahmed S, Loane C, Bartels S, Zamboni G, Mackay C, Baker I, Husain M, Thompson S, Hornberger M, Butler C

Abstract
Objective: Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterised by progressive impairment in visuospatial and perceptual function. Recent findings show that memory functioning can also be compromised early in the course of disease. In this study, we investigated the neural basis of memory impairment in PCA, and hypothesised that correlations would be observed with parietal cortex rather than classic medial temporal memory structures.
Methods: Eighteen PCA patients, 15 typical Alzheimer's disease (tAD) patients and 21 healthy controls underwent memory testing with the Rey Auditory Verbal Learning Test (RAVLT) word list and MRI. Voxel-based morphometry (VBM) was used to identify regions in the parietal and medial temporal lobes that correlated with memory performance.
Results: Compared with controls, PCA patients were impaired at learning, immediate and delayed recall and recognition of the RAVLT. Learning rate and immediate recall was significantly better in PCA compared to tAD, whereas there was no difference in delayed recall. Recognition memory also was not statistically different between patient groups, but PCA patients made significantly more false positive errors than tAD patients. VBM analysis in the PCA patients revealed a significant correlation between total learning and grey matter density in the right supramarginal gyrus, right angular gyrus and left postcentral gyrus. The left post central gyrus also significantly correlated with immediate and delayed recall and with recognition memory. No correlations were detected in the medial temporal lobe.
Conclusions: The findings provide novel evidence that early verbal memory impairment is frequently observed in PCA, and is associated with damage to lateral parietal structures. The results have implications for the diagnosis and management of PCA.

PMID: 30094173 [PubMed - indexed for MEDLINE]

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