bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular aspects of diabetes mellitus: Resistin, microRNA, and exosome
Authors: Saeedi Borujeni Mohammad Javad , Esfandiary Ebrahim , Taheripak Gholamreza , Codoñer‐Franch Pilar , Alonso‐Iglesias Eulalia , Mirzaei Hamed
Published: July 2017

Diabetes mellitus (DM) is known as one of important common endocrine disorders which could due to deregulation of a variety of cellular and molecular pathways. A large numbers studies indicated that various pathogenesis events including mutation, serin phosphorylation, and increasing/decreasing expression of many genes could contribute to initiation and progression of DM. Insulin resistance is one of important factors which could play critical roles in DM pathogenesis. It has been showed that insulin resistance via targeting a sequence of cellular and molecular pathways (eg, PI3 kinases, PPARγ co‐activator‐1, microRNAs, serine/threonine kinase Akt, and serin phosphorylation) could induce DM. Among of various factors involved in DM pathogenesis, microRNAs, and exosomes have been emerged as effective factors in initiation and progression of DM. A variety of studies indicated that deregulation of these molecules could change behavior of various types of cells and contribute to progression of DM. Resistin is other main factor which is known as signal molecule involved in insulin resistance. Multiple lines evidence indicated that resistin exerts its effects via affecting on glucose metabolism, inhibition of fatty acid uptake and metabolism with affecting on a variety of targets such as CD36, fatty acid transport protein 1, Acetyl‐CoA carboxylase, and AMP‐activated protein kinase. Here, we summarized various molecular aspects are associated with DM particularly the molecular pathways involved in insulin resistance and resistin in DM. Moreover, we highlighted exosomes and microRNAs as effective players in initiation and progression of DM.
Retracted: Knockdown of lncRNA HULC inhibits proliferation, migration, invasion, and promotes apoptosis by sponging miR‐122 in osteosarcoma
Authors: Kong Daliang , Wang Yang
Published: July 2017

Osteosarcoma is a rare malignant bone tumor with high degree of malignancy. HULC (highly upregulated in liver cancer), a long noncoding RNA (lncRNA) was involved in hepatocellular carcinoma development and progression, but its underlying mechanism in osteosarcoma is unknown. The aim of this study was to explore the functional role of HULC in osteosarcoma. The study was conducted in human osteosarcoma cell lines and the expression of HULC in the cell lines was detected by qRT‐PCR. Furthermore, the effects of HULC on tumorigenicity of osteosarcoma cells were evaluated by in vitro assays. Results revealed that HULC was highly expressed in osteosarcoma MG63 and OS‐732 cells compared to osteoblast hFOB1.19 cells. Suppression of HULC in osteosarcoma cells inhibited cell viability, migration, invasion, and promoted apoptosis. HULC functioned as an endogenous sponge for miR‐122, and its silence functioned through upregulating miR‐122. HNF4G was a target of miR‐122, and the effect of HNF4G on OS‐732 cells was the same as HULC. Furthermore, overexpression of miR‐122 inactivated PI3K/AKT, JAK/STAT, and Notch pathways by downregulation of HNF4G. These findings suggest that knockdown of HULC inhibited proliferation, migration, and invasion by sponging miR‐122 in osteosarcoma cells. HULC may act as a novel therapeutic target for management of osteosarcoma.
Physiology of biodeterioration on canvas paintings
Authors: Poyatos Fernando , Morales Fátima , Nicholson Allen W. , Giordano Antonio
Published: July 2017

The study of the physiological action of microorganisms in artistic materials is one of the most interesting topics in biodeterioration nowadays. Pathologies and illnesses of organic and inorganic materials provoked by microorganisms can be treated by experts by a variety of preventive interventions. Artistic medicine encompasses the monitoring of the exhibition and storage of art, as well as proper environmental conditions and the regular cleaning of museums. Biodeterioration control is essential in order to prevent fungal and bacterial contamination in artwork. Biodeterioration of canvas paintings is a complex phenomenon, not well‐known at the moment. Canvas paintings are created by several artistic techniques on textile supports that are not always kept in the best conditions, and the best parameters of preventive conservation are often not applied. Therefore, we need to research the agents and the main causes that provoke canvas painting biodeterioration. By applying new methodologies, we can identify the alterations and the treatments needed in order to manage the diverse materials employed in artwork correctly. Herein, we review the causes of biodeterioration that affect artwork, especially art created on textile supports. We also study the alterations of the natural filmogenic materials employed in traditional pictorial techniques, such as agglutinants and protection layers, and the biodeterioration agents that impact them. Additionally, we review current scientific methods employed for the identification of microbial species, and the types of alterations of the materials where the organisms grow. Finally, we summarize the different biocides and preventive conservation treatments that are currently employed.
Yes‐associated protein 1 promotes the differentiation and mineralization of cementoblast
Authors: Yang Beining , Sun Hualing , Song Fangfang , Wu Yanru , Wang Jiawei
Published: July 2017

Yes‐associated protein 1 (YAP1) transcriptional coactivator is a mediator of mechanosensitive signaling. Cementum, which covers the tooth root surface, continuously senses external mechanical stimulation. Cementoblasts are responsible for the mineralization and maturation of the cementum. However, the effect of YAP1 on cementoblast differentiation remains largely unknown. In this study, we initially demonstrated that YAP1 overexpression enhanced the mineralization ability of cementoblasts. YAP1 upregulated the mRNA and protein expression of several cementogenesis markers, such as alkaline phosphatase (ALP), runt‐related transcription factor 2 (Runx2), osteocalcin (OCN), and dentin matrix acidic phosphoprotein 1 (DMP1). The YAP1 overexpression group showed higher intensities of ALP and Alizarin red stain than the YAP1‐knockdown group. Unexpectedly, a sharp increase in the expression of dentin sialophosphoprotein (DSPP) was induced by the overexpression of YAP1. Knockdown of YAP1 suppressed DSPP transcriptional activity. YAP1 overexpression activated Smad‐dependent BMP signaling and slightly inhibited Erk1/2 signaling pathway activity. Treatment with specific BMP antagonist (LDN193189) prevented the upregulation of the mRNA levels of ALP, RUNX2, and OCN, as well as intensity of ALP‐stained and mineralized nodules in cementoblasts. The Erk1/2 signaling pathway inhibitor (PD 98,059) upregulated these cementogenesis markers. Thus, our study suggested that YAP1 enhanced cementoblast mineralization in vitro. YAP1 exerted its effect on the cementoblast partly by regulating the Smad‐dependent BMP and Erk1/2 signaling pathways.
Improvement of glycemic state among responders to Sofosbuvir‐based treatment regimens: Single center experience
Authors: Abdel Alem Shereen , Elsharkawy Aisha , Fouad Rabab , Adel Eman , Abdellatif Zeinab , Musa Sherief , Nagy Ahmed , Hussein Muhammad S. , Yosry Ayman , Esmat Gamal
Published: July 2017

Chronic HCV infection has emerged as a complex multifaceted disease with manifestations extending beyond the liver. HCV plays a direct role in glucose metabolism leading to both insulin resistance and type 2 diabetes. To evaluate the changes in the glycemic state following Sofosbuvir‐based treatment regimens in diabetic HCV patients. Four hundred chronic hepatitis C patients who underwent Sofosbuvir‐based treatment regimens were retrospectively screened. Sixty‐five diabetic HCV patients only enrolled in our analysis. Baseline demographic and laboratory data were recorded. Pretreatment Transient elastography was performed. At 24‐week post EOT (SVR24), Fasting Plasma glucose, and Hemoglobin A1c were re‐evaluated and compared with baseline. All enrolled diabetic patients were responders. They showed statistically significant decline in Fasting Plasma glucose and Hemoglobin A1c values at SVR24. Whatever the degree of hepatic fibrosis, the level of Fasting Plasma glucose and Hemoglobin A1c decreased at SVR24 in comparison to baseline level. Fifty‐one patients showed improvement in their Hemoglobin A1c values at SVR24 and this improvement was more likely to occur among patients with low Body mass index. The reduction in Fasting Plasma glucose >20 mg/dL (>1.1 mmol/L) and Hemoglobin A1c ≥0.5% was not associated with age, gender or hepatic fibrosis stage. Sofosbuvir‐based regimens are a highly efficient antiviral therapy for diabetic chronic HCV patients resulted in improvement in Fasting Plasma glucose and Hemoglobin A1c.
Triheptanoin for the treatment of brain energy deficit: A 14‐year experience
Authors: Mochel Fanny
Published: July 2017

Triheptanoin is an odd‐chain triglyceride with anaplerotic properties—that is, replenishing the pool of metabolic intermediates in the Krebs cycle. Unlike even‐chain fatty acids metabolized to acetyl‐CoA only, triheptanoin can indeed provide both acetyl‐CoA and propionyl‐CoA, two key carbon sources for the Krebs cycle. Triheptanoin was initially used in patients with long‐chain fatty acid oxidation disorders. The first demonstration of the possible benefit of triheptanoin for brain energy deficit came from a patient with pyruvate carboxylase deficiency, a severe metabolic disease that affects anaplerosis in the brain. In an open‐label study, triheptanoin was then shown to decrease nonepileptic paroxysmal manifestations by 90% in patients with glucose transporter 1 deficiency syndrome, a disease that affects glucose transport into the brain. 31P magnetic resonance spectroscopy studies also indicated that triheptanoin was able to correct bioenergetics in the brain of patients with Huntington disease, a neurodegenerative disease associated with brain energy deficit. Altogether, these studies indicate that triheptanoin can be a treatment for brain energy deficit related to altered anaplerosis and/or glucose metabolism. © 2017 Wiley Periodicals, Inc.
Alcohol Use and Drinking Motives Among Sanctioned and Nonsanctioned Students
Authors: Doumas Diana M.
Published: July 2017

This study examined differences in the relationship of drinking motives to drinking behavior among sanctioned and nonsanctioned 1st‐year students (N = 298). Results of hierarchical regression analyses indicated that for both sanctioned and nonsanctioned students, alcohol use was predicted by social and enhancement motives, and alcohol‐related consequences were predicted by social, enhancement, and coping motives. High levels of conformity motives predicted alcohol use and alcohol‐related consequences for sanctioned students only. Counseling implications are discussed.
Communication Conflict Styles, Perception of Ethical Environment, and Job Satisfaction Among College and University Counselors
Authors: Jodoin Elizabeth C. , Ayers David F.
Published: July 2017

This quantitative study examined the perceptions of college and university counselors (N = 669) regarding their ethical environment, job satisfaction, and ways of dealing with organizational conflict. Findings indicated that counselors manifested an average, but not positive, perception of their ethical environment. Job satisfaction was highest among counselors employed at small institutions. While variable, communication conflict styles indicated possible power struggles occurring within counseling centers. Implications for campus‐based counseling centers are discussed.
A Culturally Sensitive Approach to Substance Use Counseling on Campus
Authors: Greene Catie A.
Published: July 2017

This article presents an integrated approach for counselors providing substance use counseling to college students with sensitivity to the students' gender, culture, development, and readiness and motivation to change. Incorporating the use of relational–cultural therapy and motivational interviewing, the author organizes these complementary modalities along the Transtheoretical Model of behavior change and discusses practical implications for counselors to reduce harm in the context of the college environment. A case illustration is included.
Rapid determination of lipophilic vitamins in human serum by ultra‐high performance liquid chromatography using a fluorinated column and high‐throughput miniaturized liquid–liquid extraction
Authors: Cervinkova Barbora , Krcmova Lenka Kujovska , Klabackova Sava , Solichova Dagmar , Solich Petr
Published: July 2017

A high‐throughput miniaturized liquid–liquid extraction procedure followed by a simple ultra‐high performance liquid chromatography method coupled with fluorescence detection for bioanalytical analysis of all tocopherol isomers and retinol in human serum has been developed and validated. In the extraction procedure, a synthetic internal standard tocol was used, which does not occur in the human body. The separation of structurally related vitamins was achieved using a new generation of pentafluorophenyl propyl core–shell stationary phase with elution using methanol and an aqueous solution of ammonium acetate. The fluorescence of retinol and tocopherol isomers was detected at λex = 325, 295 nm and λem = 480, 325 nm, respectively. The rapid baseline separation of all analytes was accomplished within 4.0 min. The sensitivity of method was demonstrated with lower limits of quantification: retinol 0.01 μM, α‐tocopherol 0.38 μM, β‐tocopherol 0.18 μM, γ‐tocopherol 0.14 μM, and δ‐tocopherol 0.01 μM. Possible application of this method in clinical practice was confirmed by the analysis of human serum samples from healthy volunteers. Finally, the simultaneous determination of retinol and all tocopherol isomers in human serum can enable the clarification of their role in metabolism and in diseases such as cancer.
Ultrasound Versus Traditional Palpation to Guide Radial Artery Cannulation in Critically Ill Children: A Randomized Trial
Authors: Anantasit Nattachai , Cheeptinnakorntaworn Pimporn , Khositseth Anant , Lertbunrian Rojjanee , Chantra Marut
Published: July 2017

Objectives

To identify success rates for radial artery cannulation in a pediatric critical care unit using either palpation or ultrasound guidance to cannulate the radial artery.

Methods

A prospective randomized comparative study of critically ill children who required invasive monitoring in a tertiary referral center was conducted. All patients were randomized by a stratified block of 4 to either ultrasound‐guided or traditional palpation radial artery cannulation. The primary outcomes were the first attempt and total success rates.

Results

Eighty‐four children were enrolled, with 43 randomized to the palpation technique and 41 to the ultrasound‐guided technique. Demographic data between the groups were not significantly different. The total success and first attempt rates for the ultrasound‐guided group were significantly higher than those for the palpation group (success ratio, 2.03; 95% confidence interval, 1.13–3.64;P = .018; and success ratio, 4.18; 95% confidence interval, 1.57–11.14;P = .004, respectively). The median time to success for the ultrasound‐guided group was significantly shorter than that for the palpation group (3.3 versus 10.4 minutes;P < .001). Cannulation complications were lower in the ultrasound‐guided group than the palpation group (12.5% versus 53.3%;P < .001).

Conclusions

The ultrasound‐guided technique could improve the success rate and allow for faster cannulation of radial artery catheterization in critically ill children.
Comparison and Combination of Strain and Shear Wave Elastography of Breast Masses for Differentiation of Benign and Malignant Lesions by Quantitative Assessment: Preliminary Study
Authors: Seo Mirinae , Ahn Hye Shin , Park Sung Hee , Lee Jong Beum , Choi Byung Ihn , Sohn Yu‐Mee , Shin So Youn
Published: July 2017

Objectives

To compare the diagnostic performance of strain and shear wave elastography of breast masses for quantitative assessment in differentiating benign and malignant lesions and to evaluate the diagnostic accuracy of combined strain and shear wave elastography.

Methods

Between January and February 2016, 37 women with 45 breast masses underwent both strain and shear wave ultrasound (US) elastographic examinations. The American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) final assessment on B‐mode US imaging was assessed. We calculated strain ratios for strain elastography and the mean elasticity value and elasticity ratio of the lesion to fat for shear wave elastography. Diagnostic performances were compared by using the area under the receiver operating characteristic curve (AUC).

Results

The 37 women had a mean age of 47.4 years (range, 20–79 years). Of the 45 lesions, 20 were malignant, and 25 were benign. The AUCs for elasticity values on strain and shear wave elastography showed no significant differences (strain ratio, 0.929; mean elasticity, 0.898; and elasticity ratio, 0.868; P > .05). After selectively downgrading BI‐RADS category 4a lesions based on strain and shear wave elastographic cutoffs, the AUCs for the combined sets of B‐mode US and elastography were improved (B‐mode + strain, 0.940; B‐mode + shear wave; 0.964; and B‐mode, 0.724; P < .001). Combined strain and shear wave elastography showed significantly higher diagnostic accuracy than each individual elastographic modality (P = .031).

Conclusions

These preliminary results showed that strain and shear wave elastography had similar diagnostic performance. The addition of strain and shear wave elastography to B‐mode US improved diagnostic performance. The combination of strain and shear wave elastography results in a higher diagnostic yield than each individual elastographic modality.
“Lying‐Down” Adrenal Sign: There Are Exceptions to the Rule Among Fetuses and Neonates
Authors: Majmudar Anand , Cohen Harris L.
Published: July 2017

A linear‐shaped or “lying‐down” adrenal gland is a sign often seen with the absence of the kidney in the renal fossa due to renal agenesis, renal ectopia, or horseshoe kidney. It is theorized that the presence of the kidney in the normal location within the renal fossa is important for the formation of the normal triangular inverted V or Y adrenal shape. There are exceptions to this rule whereby a kidney is missing from the renal fossa, yet a normal adrenal shape is present. This series looked at 18 cases of an empty renal fossa in fetal, neonatal, and pediatric patients and recorded the shape of the adrenal gland. Nine cases (50%) appropriately showed the linear or lying‐down adrenal gland; 6 (33%) showed an exception to the rule, with a normally shaped adrenal gland; and 3 (17%) showed a pseudo exception in which the adrenal gland was linear but blended with the diaphragmatic crus to simulate a triangular adrenal gland. The sonographic characteristics of the crus are different from those of the adrenal gland; thus, this pseudo exception can be avoided by careful inspection. Because the absence of the kidney is often a difficult diagnosis, the lying‐down adrenal gland sign can be a helpful secondary sign for confirming that a kidney is absent or ectopic in position and not within the renal bed.
Quality indicators of laryngeal cancer care in commercially insured patients
Authors: Britt Christopher J. , Chang Hsien‐Yen , Quon Harry , Kang Hyunseok , Kiess Ana P. , Eisele David W. , Frick Kevin D. , Gourin Christine G.
Published: July 2017

Objective

To examine associations between quality, complications, and costs in commercially insured patients treated for laryngeal cancer.

Study Design

Retrospective cross‐sectional analysis of MarketScan Commercial Claim and Encounters data (Truven Health Analytics, Ann Arbor, Michigan, U.S.A.).

Methods

We evaluated 10,969 patients diagnosed with laryngeal cancer from 2010 to 2012 using cross‐tabulations and multivariate regression. Using quality indicators derived from guidelines for recommended care, summary measures of quality were calculated for diagnosis, initial treatment, surveillance, treatment for recurrence, performance, and an overall summary measure of quality.

Results

Higher‐quality care in the initial treatment period was associated with lower odds of 30‐day mortality (odds ratio [OR] = 0.21, 95% confidence interval [CI] [0.04–0.98]), surgical complications (OR = 0.39 [0.17–0.88]), and medical complications (OR = 0.68 [0.49–0.96]). Mean incremental 1‐year costs were higher for higher‐quality diagnosis ($20,126 [$14,785–$25,466]), initial treatment ($17,918 [$10,481–$25,355]), and surveillance ($25,424 [$20,014–$30,834]) quality indicators, whereas costs were lower for higher‐quality performance measures (−$45,723 [−$56,246–−$35,199]) after controlling for all other variables. Higher‐quality care was associated with significant differences in mean incremental costs for initial treatment in surgical patients ($−37,303 [−$68,832–−$5,775]), and for the overall summary measure of quality in patients treated nonoperatively ($10,473 [$1,121–$19,825]). After controlling for the overall summary measure of quality, costs were significantly lower for patients receiving high‐volume surgical care (mean −$18,953 [−$28,381–−$9,426]).

Conclusion

Higher‐quality larynx cancer care in commercially insured patients was associated with lower 30‐day mortality and morbidity. High‐volume surgical care was associated with lower 1‐year costs, even after controlling for quality. These data have implications for discussions of value and quality in an era of healthcare reform.

Level of Evidence

2c. Laryngoscope, 127:2805–2812, 2017
Assessment of human papillomavirus awareness in association with head and neck cancer at a screening event
Authors: Berger Michael H. , Cohen Erin R. , Shamrock Alan G. , Chan Brandon , Camp Michelle , Lo Kaming , Sargi Zoukaa B.
Published: July 2017

Objectives/Hypothesis

To assess the baseline awareness of human papillomavirus (HPV) infection as a cause of head and neck cancer (HNC) to design improved targeted screening and education efforts.

Study Design

Retrospective review of collected survey at a cancer screening event.

Methods

This was a screening event at three hospitals and one community center in Miami, Florida. Participants were recruited throughout the Greater Miami area. Descriptive statistics were used to summarize the demographic characteristics of those who were aware of HPV and those who were not. Adjusted odds ratios, odds ratios, and χ2 tests were used in statistical analysis.

Results

A total of 196 women and 112 men were screened across four sites, with 187 participants at hospital‐based events and 124 participants at the community‐based event. Forty percent of respondents had heard of HPV, and 28.0% identified HPV as a risk factor for HNC. Non‐Hispanic and Hispanic respondents were 3.309 and 2.445 times, respectively, more likely than Haitian respondents to have heard of HPV. Women were 2.488 times more likely than men to be aware of HPV. College graduates were 2.268 times more likely than those with less than a college degree to be aware of HPV. Younger respondents were more likely to be aware of HPV. Of those who identified HPV as a risk factor for HNC, 95.4% also correctly identified smoking and 75.9% also correctly identified alcohol as risk factors.

Conclusions

Disparities in HPV and HNC awareness were noted between gender, age, education level, and ethnicity.

Level of Evidence

NA. Laryngoscope, 128:386–392, 2018
Revision rates and time to revision following endoscopic sinus surgery: A large database analysis
Authors: Stein Nathan R. , Jafari Aria , DeConde Adam S.
Published: July 2017

Objectives/Hypothesis

Endoscopic sinus surgery (ESS) is performed for patients with chronic rhinosinusitis (CRS) that have failed maximal medical therapy. This study seeks to determine the prevalence of revision surgery and factors predicting the need for revision after ESS using a large statewide surgery database.

Study Design

Large retrospective cohort study using the State Ambulatory Surgery Database for the state of California between 2005 and 2011.

Methods

We identified over 61,000 patients with CRS who underwent ESS, determined by Current Procedural Terminology code. We identified which patients underwent a repeat surgery, and performed multivariable modeling to determine which factors (nasal polyps, age, gender, insurance, hospital setting, ethnicity) predicted the need for revision. Adjusted odds ratios (AOR) and 95% confidence intervals are presented.

Results

Of 61,339 patients who underwent ESS, 4,078 (6.65%) returned for revision ESS during the time period investigated. In a multivariable logistic regression model, positive predictors of revision were a diagnosis of nasal polyps (AOR: 1.20, 95% CI: 1.11–1.29, P < .001) and female gender (AOR: 1.20, 95% CI: 1.11–1.29, P < .001); public insurance was marginally predictive of increased reoperation (AOR: 1.10, 95% CI: 1.00–1.21, P = .048). Patients of Hispanic ethnicity were less likely to have revision surgery (AOR: 0.86, 95% CI: 0.77–0.97, P = .011). Age, income, and hospital setting were not significant predictors.

Conclusions

A minority of patients with CRS who undergo ESS will have a revision surgery. This likelihood is increased in female patients and those with nasal polyps, and decreased in patients of Hispanic ethnicity, even when controlling for income, insurance, and hospital setting.

Level of Evidence

4. Laryngoscope, 128:31–36, 2018
Reducing sedation time for thyroplasty with arytenoid adduction with sequential anesthetic technique
Authors: Saadeh Charles K. , Rosero Eric B. , Joshi Girish P. , Ozayar Esra , Mau Ted
Published: July 2017

Objective

To determine the extent to which a sequential anesthetic technique 1) shortens time under sedation for thyroplasty with arytenoid adduction (TP‐AA), 2) affects the total operative time, and 3) changes the voice outcome compared to TP‐AA performed entirely under sedation/analgesia.

Study Design

Case‐control study.

Methods

A new sequential anesthetic technique of performing most of the TP‐AA surgery under general anesthesia (GA), followed by transition to sedation/analgesia (SA) for voice assessment, was developed to achieve smooth emergence from GA. Twenty‐five TP‐AA cases performed with the sequential GA‐SA technique were compared with 25 TP‐AA controls performed completely under sedation/analgesia. The primary outcome measure was the time under sedation. Voice improvement, as assessed by Consensus Auditory‐Perceptual Evaluation of Voice, and total operative time were secondary outcome measures.

Results

With the conventional all‐SA anesthetic, the duration of SA was 209 ± 26.3 minutes. With the sequential GA‐SA technique, the duration of SA was 79.0 ± 18.9 minutes, a 62.3% reduction (P < 0.0001). There was no significant difference in the total operative time (209.5 vs. 200.9 minutes; P = 0.42) or in voice outcome. This sequential anesthetic technique has been easily adopted by multiple anesthesiologists and nurse anesthetists at our institution.

Conclusion

TP‐AA is effectively performed under sequential GA‐SA technique with a significant reduction in the duration of time under sedation. This allows the surgeon to perform the technically more challenging part of the surgery under GA, without having to contend with variability in patient tolerance for laryngeal manipulation under sedation.

Level of Evidence

3b. Laryngoscope, 127:2813–2817, 2017
National assessment of early hospitalization after liver transplantation: Risk factors and association with patient survival
Authors: Sharma Pratima , Goodrich Nathan P. , Schaubel Douglas E. , Smith Abigail R. , Merion Robert M.
Published: July 2017

Hospitalization is known to occur frequently in the first 6 months following liver transplantation (LT). Using a novel data linkage between the Scientific Registry of Transplant Recipients and Centers for Medicare and Medicaid Services, our study has 2 objectives: (1) to determine risk factors for “early” hospitalization (ie, within 6 months of LT); and (2) to quantify the importance of hospitalization history in the first 6 months with respect to subsequent patient survival (ie, survival, conditional on surviving 6 months post‐LT). The study population consisted of patients aged ≥18 years who underwent deceased donor LT between January 1, 2003 and December 31, 2010, with Medicare as primary or secondary insurance and were discharged alive from the index LT hospitalization (n = 7220). The early hospitalization rate was 2.76 per patient‐year and was significantly associated with many recipient factors (eg, recipient age, hepatitis C, diabetes, poor renal function including dialysis, and recipient of transjugular intrahepatic portosystemic shunt procedure before LT), as well as donor race and donation after cardiac death. Conditional on surviving 6 months after LT, the covariate‐adjusted death rate increased by 22% for each additional hospitalization occurring in the first 6 months (hazard ratio, 1.22; P < 0.001). In conclusion, several LT recipient factors are significantly associated with early hospitalization. Moreover, a patient's hospitalization profile during follow‐up months 0‐6 is a very strong predictor of survival thereafter. Efforts and resources should be devoted toward identifying LT recipients at risk for early hospitalization and modifying the actionable risk factors such as hepatitis C, diabetes, and body mass index to improve resource utilization and overall outcomes. Liver Transplantation 23 1143–1152 2017 AASLD.
Serial two‐year follow‐up after lymphaticovenular anastomosis for the treatment of lymphedema
Authors: Lee Kyeong‐Tae , Park Jin‐Woo , Mun Goo‐Hyun
Published: July 2017

Purpose

Despite extensive previous investigations regarding the efficacy of lymphaticovenular anastomosis (LVA) for the treatment of lymphedema, few studies have reported the long‐term clinical course of individual patients undergoing LVA. The present study presented our experience of LVA and to report serial postoperative courses.

Methods

A retrospective chart review was performed for 17 patients (2 male and 15 female) with lymphedema refractory to conservative treatment who underwent LVA and were followed‐up for at least postoperative 24 months. Mean age was 39 years. There were 7 cases with primary lymphedema and 10 with secondary lymphedema. Three patients had lymphedema in upper extremity and the other 14 had lesions in lower extremity. Outcomes were evaluated via qualitative assessment and quantitative volume measurement conducted preoperatively and 6, 12, and 24 months postoperatively.

Results

LVA was performed in the distal extremities with a mean number of 2.5 (1–3). No postoperative complications developed. Average follow‐up period was 41.8 months. Of 17 patients, 10 showed improvement in excess volume consistently during the follow‐up period, whereas 3 patients exhibited temporary improvement at postoperative 6 months and subsequent aggravation at the latter follow‐ups. No improvement was observed throughout the follow‐up period in 4 patients. The requirements of complex decongestive physical therapy significantly decreased from 1.7 to 0.77 per patient per year. The frequency of cellulitis also decreased from 0.31 to 0.16 per patient per year.

Conclusion

Our results suggest that LVA may have long‐term effectiveness and provide a favorable clinical course in the long term.
trans‐Lycopene from tomato juice attenuates inflammatory biomarkers in human plasma samples: An intervention trial
Authors: Colmán‐Martínez Mariel , Martínez‐Huélamo Miriam , Valderas‐Martínez Palmira , Arranz‐Martínez Sara , Almanza‐Aguilera Enrique , Corella Dolores , Estruch Ramón , Lamuela‐Raventós Rosa M.
Published: July 2017

Scope

The effect of carotenoids from tomato juice (TJ) on inflammatory biomarkers was evaluated by performing a 4‐week dose‐response nutritional trial in a population at high cardiovascular risk.

Methods and results

An open, prospective, randomized, cross‐over, and controlled clinical trial was carried out with 28 volunteers (mean age 69.7 ± 3.1 years; mean BMI 31.5 ± 3.6 kg/m2) at high cardiovascular risk, which were assigned to consume daily for 4 weeks in random order: 200 mL (LD) or 400 mL (HD) of TJ, or water as a control (C), with a 21‐day wash‐out period between each intervention. Blood samples were collected at baseline (B) and after each intervention. Endpoints included significant changes in plasmatic carotenoids, and adhesion molecules ICAM‐1, and VCAM‐1, as well as a tendency to decrease the chemokine IL‐8. Compared to C, concentration of ICAM‐1, and VCAM‐1 were significantly lower (p ˂ 0.001), after each TJ intervention. Decreases were correlated remarkably with the trans‐lycopene, while the other carotenoids present in TJ have presented a minor association or no association with changes in these molecules.

Conclusion

trans‐Lycopene from TJ may attenuate the risk of cardiovascular disease by reducing the concentration of important inflammatory molecules related to atherosclerosis.
Human milk exosomes and their microRNAs survive digestion in vitro and are taken up by human intestinal cells
Authors: Liao Yalin , Du Xiaogu , Li Jie , Lönnerdal Bo
Published: July 2017

Scope

Human milk exosomes provide a natural means of genetic material transfer to infants; however, the effect of gastric/pancreatic digestion milk exosomes stability and their microRNA content is largely unknown.

Methods and results

We took a simulated gastric/pancreatic digestion protocol to perform in vitro digestion of milk exosomes, explore intestinal epithelial uptake, and further elucidate microRNA responses to digestion at early‐, mid‐, late lactation by massive parallel sequencing. Both undigested and digested exosomes enter human intestinal crypt‐like cells (HIEC), with evidence of nuclear localization. We identified 288 mature microRNAs from all 24 exosome samples, and an additional 610 at low abundance. A large number of synapse development‐ and immune‐related microRNAs were identified. hsa‐miR‐22‐3p was the most abundant microRNA, and the top 15 microRNAs contributed ∼11% of the sequencing reads. Upon digestion, the overall microRNA abundance in human milk exosomes was stable.

Conclusion

Our results for the first time reveal the survivability and complexity of human milk exosome microRNAs upon simulated gastric/pancreatic digestion, and the dynamics during lactation stages. The results suggest a previously underexplored area of infant response to genetic material in human milk exosomes.
Resveratrol attenuates excessive ethanol exposure induced insulin resistance in rats via improving NAD+/NADH ratio
Authors: Luo Gang , Huang Bingqing , Qiu Xiang , Xiao Lin , Wang Ning , Gao Qin , Yang Wei , Hao Liping
Published: July 2017

Scope

Resveratrol has been shown to improve insulin resistance via activating the NAD+‐dependent deacetylase SIRT1, but the effects of resveratrol on ethanol‐induced insulin resistance remain unclear. This study was designed to explore the potential mechanism by which resveratrol ameliorated ethanol‐induced insulin resistance, focusing on its regulations on the ratio of NAD+/NADH and SIRT1 expression.

Methods and results

Male Sprague–Dawley rats were fed either control or ethanol liquid diets containing 0.8, 1.6 and 2.4 g/kg·bw ethanol with or without 100 mg/kg·bw resveratrol for 22 weeks. Resveratrol improved ethanol (2.4 g/kg·bw) induced reductions in insulin sensitivity, SIRT1 expression (51%, P < 0.05), NAD+/NADH ratio (196%, P < 0.01) as well as the expression and activity of ALDH2 while decreased the augmentations in the expression and activity of ADH and CYP2E1. In primary rat hepatocytes, ethanol exposure (25 mmol/L, 24 h) similarly decreased SIRT1 expression and NAD+/NADH ratio (33%, P < 0.05; 32%, P < 0.01), and 0.1 μmol/L resveratrol treatment reversed these decreases and inhibited the expressions of ADH and CYP2E1.

Conclusion

Resveratrol exhibits benefits against ethanol‐induced insulin resistance via improving the ratio of NAD+/NADH to regulate SIRT1, which is associated with the modulation of ethanol metabolism enzymes.
AAPM TG158: Measurement and calculation of doses outside the treated volume from external‐beam radiation therapy
Authors: Kry Stephen F. , Bednarz Bryan , Howell Rebecca M. , Dauer Larry , Followill David , Klein Eric , Paganetti Harald , Wang Brian , Wuu Cheng‐Shie , George Xu X.
Published: July 2017

The introduction of advanced techniques and technology in radiotherapy has greatly improved our ability to deliver highly conformal tumor doses while minimizing the dose to adjacent organs at risk. Despite these tremendous improvements, there remains a general concern about doses to normal tissues that are not the target of the radiation treatment; any “nontarget” radiation should be minimized as it offers no therapeutic benefit. As patients live longer after treatment, there is increased opportunity for late effects including second cancers and cardiac toxicity to manifest. Complicating the management of these issues, there are unique challenges with measuring, calculating, reducing, and reporting nontarget doses that many medical physicists may have limited experience with. Treatment planning systems become dramatically inaccurate outside the treatment field, necessitating a measurement or some other means of assessing the dose. However, measurements are challenging because outside the treatment field, the radiation energy spectrum, dose rate, and general shape of the dose distribution (particularly the percent depth dose) are very different and often require special consideration. Neutron dosimetry is also particularly challenging, and common errors in methodology can easily manifest as errors of several orders of magnitude. Task Group 158 was, therefore, formed to provide guidance for physicists in terms of assessing and managing nontarget doses. In particular, the report: (a) highlights major concerns with nontarget radiation; (b) provides a rough estimate of doses associated with different treatment approaches in clinical practice; (c) discusses the uses of dosimeters for measuring photon, electron, and neutron doses; (d) discusses the use of calculation techniques for dosimetric evaluations; (e) highlights techniques that may be considered for reducing nontarget doses; (f) discusses dose reporting; and (g) makes recommendations for both clinical and research practice.
A pair of DICER1‐positive monozygotic twins: One with pleuropulmonary blastoma, another with acute transient hepatitis
Authors: Li Sihui , Cai Siyu , Wang Xisi , Zhang Dawei , Fu Libing , Zeng Qi , Peng Xiaoxia , Ma Xiaoli
Published: July 2017

Pleuropulmonary blastoma (PPB) is the most common primary malignant neoplasm of the lung in children that is associated with a germline mutation in DICER1. In this report, we share an interesting case of a pair of monozygotic twins: one of them developed PPB when she was 4‐year old, while the other developed acute transient hepatitis when she was 5‐year old. Next‐Gen sequencing for DICER1 mutations of their family revealed that both twins and their mother had c.C3675A mutation. The mother also had a history of multinodular goiter. Identification of DICER1 mutation carriers and close surveillance of individuals at risk for DICER1 syndrome may allow early detection and hence better outcome.
Assessing the cost of implementing the 2011 Society of Obstetricians and Gynecologists of Canada and Canadian College of Medical Genetics practice guidelines on the detection of fetal aneuploidies
Authors: Lilley Margaret , Hume Stacey , Karpoff Nina , Maire Georges , Taylor Sherry , Tomaszewski Robert , Yoshimoto Maisa , Christian Susan
Published: July 2017

Background

The Society of Obstetricians and Gynecologists of Canada and the Canadian College of Medical Genetics published guidelines, in 2011, recommending replacement of karyotype with quantitative fluorescent polymerase chain reaction when prenatal testing is performed because of an increased risk of a common aneuploidy.

Study Objective

This study's objective is to perform a cost analysis following the implementation of quantitative fluorescent polymerase chain reaction as a stand‐alone test.

Results

A total of 658 samples were received between 1 April 2014 and 31 August 2015: 576 amniocentesis samples and 82 chorionic villi sampling. A chromosome abnormality was identified in 14% (93/658) of the prenatal samples tested. The implementation of the 2011 Society of Obstetricians and Gynecologists of Canada and the Canadian College of Medical Genetics guidelines in Edmonton and Northern Alberta resulted in a cost savings of $46 295.80. The replacement of karyotype with chromosomal microarray for some indications would be associated with additional costs.

Conclusion

The implementation of new test methods may provide cost savings or added costs. Cost analysis is important to consider during the implementation of new guidelines or technologies. © 2017 John Wiley & Sons, Ltd.
Influence of Human Leukocyte Antigen (HLA) Alleles and Killer Cell Immunoglobulin‐Like Receptors (KIR) Types on Heparin‐Induced Thrombocytopenia (HIT)
Authors: Karnes Jason H. , Shaffer Christian M. , Cronin Robert , Bastarache Lisa , Gaudieri Silvana , James Ian , Pavlos Rebecca , Steiner Heidi E. , Mosley Jonathan D. , Mallal Simon , Denny Joshua C. , Phillips Elizabeth J. , Roden Dan M.
Published: July 2017

Heparin‐induced thrombocytopenia (HIT) is an unpredictable, life‐threatening, immune‐mediated reaction to heparin. Variation in human leukocyte antigen (HLA) genes is now used to prevent immune‐mediated adverse drug reactions. Combinations ofHLAalleles and killer cell immunoglobulin‐like receptors (KIR) are associated with multiple autoimmune diseases and infections. The objective of this study is to evaluate the association ofHLAalleles andKIRtypes, alone or in the presence of differentHLAligands, withHIT.HITcases and heparin‐exposed controls were identified in BioVU, an electronic health record coupled to aDNAbiobank.HLAsequencing andKIRtype imputation using IlluminaOMNI‐Quad data were performed. Odds ratios forHLAalleles andKIRtypes andHLA*KIRinteractions using conditional logistic regressions were determined in the overall population and by race/ethnicity. Analysis was restricted toKIRtypes andHLAalleles with a frequency greater than 0.01. The p values forHLAandKIRassociation were corrected by using a false discovery rate q<0.05 andHLA*KIRinteractions were considered significant at p<0.05. Sixty‐fiveHITcases and 350 matched controls were identified. No statistical differences in baseline characteristics were observed between cases and controls. TheHLA‐DRB3*01:01allele was significantly associated withHITin the overall population (odds ratio 2.81 [1.57–5.02], p=2.1×10−4, q=0.02) and in individuals with European ancestry, independent of other alleles. NoKIRtypes were associated withHIT, although a significant interaction was observed betweenKIR2DS5 and theHLA‐C1KIRbinding group (p=0.03). TheHLA‐DRB3*01:01allele was identified as a potential risk factor forHIT. This classII HLAgene and allele represent biologically plausible candidates for influencingHITpathogenesis. We found limited evidence of the role ofKIRtypes inHITpathogenesis. Replication and further study of theHLA‐DRB3*01:01association is necessary.
The application of a microfluidic reactor including spontaneously adsorbed trypsin for rapid protein digestion of human tear samples
Authors: Kecskemeti Adam , Nagy Cynthia , Csosz Eva , Kallo Gergo , Gaspar Attila
Published: July 2017

Purpose

The application of a newly developed microfluidic immobilized enzymatic reactor (IMER) designed to accelerate protein digestion in clinical samples is presented.

Experimental Design

The IMER contains trypsin adsorbed on the porous surface of a PDMS microfluidic chip. Human tear with its relatively low volume and high protein content is collected and used for testing the digestion efficiency of the IMER. With the use of CZE peptide mapping, the efficiency and reproducibility of the reactor are investigated.

Results

No significant difference is observed in the CZE peptide profiles of the same tear sample digested in‐solution or via microfluidic IMER. LC‐MS measurements show that the microfluidic IMER digestion enables the identification of more proteins compared to standard in‐solution digestion and those proteins that are identified with both digestion methods have higher sequence coverage when digested with the IMER.

Conclusions and Clinical Relevance

The proposed reactor is well‐suited for rapid and efficient protein digestion and even eight digestions can be carried out simultaneously. The PDMS chip is inexpensive and easy to fabricate, thus its application can be an attractive alternative for proteomic related research.
Separation and characterization of unknown impurities in cefonicid sodium by trap‐free two‐dimensional liquid chromatography combined with ion trap time‐of‐flight mass spectrometry
Authors: Wang Jian , Xu Yu , Zhang Yunfeng , Wang Hong , Zhong Weihui
Published: July 2017

Rationale

Seven unknown antibiotic impurities in cefonicid sodium were separated and characterized by a trap‐free two‐dimensional liquid chromatography coupled to high‐resolution ion‐trap time‐of‐flight mass spectrometry (2D–LC/IT‐TOF MS) using both positive and negative modes of electrospray ionization. Trap‐free 2D–LC and an online demineralization technique made it possible to characterize cefonicid sodium under the conditions of the official standard, and the TIC chromatogram obtained by LC/MS was in conformity with the LC chromatogram obtained by the official analytical method in the peak sequence of impurities.

Methods

In the first dimension, the column was a GRACE Alltima C18 (250 mm × 4.6 mm, 5 μm), and the gradient elution used 0.02 mol·L−1 ammonium dihydrogen phosphate solution and methanol as mobile phase. In the second dimension, the analytical column was a Shimadzu Shim‐pack GISS C18 (50 mm × 2.1 mm, 1.9 μm) with 10 mmol·L−1 ammonium formate solution and methanol as mobile phase. Full scan LC/MS was first executed to obtain the exact m/z values of the molecules. Then LC/MS2 and LC–MS3 experiments were performed on the compounds of interest.

Results

The structures of seven unknown degradation products in cefonicid sodium were deduced based on the high‐resolution MSn data using both positive and negative mode.

Conclusions

The problem of incompatibility between the non‐volatile salt mobile phase and mass spectrometry was solved completely by multidimensional heart‐cutting approaches and an online demineralization technique, which is worthy of widespread use and application for the advantages of stability and repeatability.
Wilson loops in unitary matrix models at finite N
Authors: Okuyama Kazumi
Published: July 2017

Abstract

It is known that the expectation value of Wilson loops in the Gross-Witten-Wadia (GWW) unitary matrix model can be computed exactly at finite N for arbitrary representations. We study the perturbative and non-perturbative corrections of Wilson loops in the 1/N expansion, either analytically or numerically using the exact result at finite N . As a by-product of the exact result of Wilson loops, we propose a large N master field of GWW model. This master field has an interesting eigenvalue distribution. We also study the Wilson loops in large representations, called Giant Wilson loops, and comment on the Hagedorn/deconfinement transition of a unitary matrix model with a double trace interaction.
Counting the number of master integrals for sunrise diagrams via the Mellin-Barnes representation
Authors: Kalmykov Mikhail Yu. , Kniehl Bernd A.
Published: July 2017

Abstract

A number of irreducible master integrals for L-loop sunrise and bubble Feynman diagrams with generic values of masses and external momenta are explicitly evaluated via the Mellin-Barnes representation.