bluuebunny/crossref_metadata_2025 huggingface dataset:
Agency, embodiment and enactment in psychosomatic theory and practice
Authors: Kirmayer Laurence J , Gómez-Carrillo Ana
Published: June 2019

In this paper, we examine some of the conceptual, pragmatic and moral dilemmas intrinsic to psychosomatic explanation in medicine, psychiatry and psychology. Psychosomatic explanation invokes a social grey zone in which ambiguities and conflicts about agency, causality and moral responsibility abound. This conflict reflects the deep-seated dualism in Western ontology and concepts of personhood that plays out in psychosomatic research, theory and practice. Illnesses that are seen as psychologically mediated tend also to be viewed as less real or legitimate. New forms of this dualism are evident in philosophical attacks on Engel’s biopsychosocial approach, which was a mainstay of earlier psychosomatic theory, and in the recent Research Domain Criteria research programme of the US National institute of Mental Health which opts for exclusively biological modes of explanation of illness. We use the example of resignation syndrome among refugee children in Sweden to show how efforts to account for such medically unexplained symptoms raise problems of the ascription of agency. We argue for an integrative multilevel approach that builds on recent work in embodied and enactive cognitive science. On this view, agency can have many fine gradations that emerge through looping effects that link neurophenomenology, narrative practices and cultural affordances in particular social contexts. This multilevel ecosocial view points the way towards a renewed biopsychosocial approach in training and clinical practice that can advance person-centred medicine and psychiatry.
Population-level diagnosis and care cascade for chlamydia in Australia
Authors: Gray Richard T , Callander Denton , Hocking Jane S , McGregor Skye , McManus Hamish , Dyda Amalie , Moreira Clarissa , Braat Sabine , Hengel Belinda , Ward James , Wilson David P , Donovan Basil , Kaldor John M , Guy Rebecca J
Published: June 2019

Objectives

Key strategies to control chlamydia include testing, treatment, partner management and re-testing. We developed a diagnosis and care cascade for chlamydia to highlight gaps in control strategies nationally and to inform efforts to optimise control programmes.

Methods

The Australian Chlamydia Cascade was organised into four steps: (1) annual number of new chlamydia infections (including re-infections); (2) annual number of chlamydia diagnoses; (3) annual number of diagnoses treated; (4) annual number of diagnoses followed by a re-test for chlamydia within 42–180 days of diagnosis. For 2016, we estimated the number of infections among young men and women aged 15–29 years in each of these steps using a combination of mathematical modelling, national notification data, sentinel surveillance data and previous research studies.

Results

Among young people in Australia, there were an estimated 248 580 (range, 240 690–256 470) new chlamydia infections in 2016 (96 470 in women; 152 100 in men) of which 70 164 were diagnosed (28.2% overall: women 43.4%, men 18.6%). Of the chlamydia infections diagnosed, 65 490 (range, 59 640–70 160) were treated (93.3% across all populations), but only 11 330 (range, 7660–16 285) diagnoses were followed by a re-test within 42–180 days (17.3% overall: women 20.6%, men 12.5%) of diagnosis.

Conclusions

The greatest gaps in the Australian Chlamydia Cascade for young people were in the diagnosis and re-testing steps, with 72% of infections undiagnosed and 83% of those diagnosed not re-tested: both were especially low among men. Treatment rates were also lower than recommended by guidelines. Our cascade highlights the need for enhanced strategies to improve treatment and re-testing coverage such as short message service reminders, point-of-care and postal test kits.
US young adults’ perceived effectiveness of draft pictorial e-cigarette warning labels
Authors: Sontag Jennah , Manderski Michelle T Bover , Hammond David , Wackowski Olivia A
Published: June 2019

Significance

Research shows that pictorial warning labels for cigarettes are more effective than text-only warnings, and preliminary work suggests that pictorial warnings could also be considered for electronic cigarettes (e-cigarettes). Pictorial warnings may be important for maximising their effectiveness among young people and enhancing the salience of the single nicotine addiction warning required for e-cigarettes to date in the USA. This study collected pilot data about the perceived effectiveness of draft e-cigarette pictorial warnings.

Methods

Participants were 876 young adults (ages 18–29) recruited through Amazon Mechanical Turk who completed an online e-cigarette survey in 2018. Participants viewed and ranked five versions of the same e-cigarette nicotine addiction warning message—four pictorial and one text-only–on their perceived noticeability, likelihood of capturing young people’s attention, memorability, relevance to the addiction warning text and overall effectiveness in warning people about e-cigarette risks. For each outcome, presentation of the five warning versions was randomised. Pictorials included symbolic images of risk and addiction, and of priority audiences for the warning (ie, young people).

Results

For all outcomes, pictorial warnings were ranked higher than the text-only warning, and the warning using a yellow triangle caution icon was ranked highest for all outcomes. The text-only warning was ranked as the least likely to be effective for all four outcomes in which it was assessed. Trends were similar for current e-cigarette users and non-users.

Conclusions

Future research should assess perceptions and the appropriateness of pictorial imagery for e-cigarette warnings and test their efficacy against text-only warnings experimentally.
Comparison of geophysical and botanical results in simulated clandestine graves in rural and tropical environments in Colombia, South America
Authors: Molina Carlos Martin , Pringle Jamie K.
Published: June 2019

In most Latin American countries there are significant numbers of both missing people and forced disappearances,
c.
84 000 alone in Colombia. Successful detection of buried human remains by forensic search teams can be difficult in varying terrain and climates. This paper reports on the geophysical and botanical monitoring of simulated clandestine graves in two different environments over 24 months to establish optimal detection methods and equipment configurations. Twelve clandestine burials were simulated at three different burial depths (0.5, 0.8 and 1.2 m) commonly encountered in Latin America. The simulated targets were three pig carcasses, three human skeletons, three graves with burnt human beheaded skeletons and finally three empty graves to act as control. Geophysical detection methods included ground-penetrating radar, magnetic susceptibility, bulk ground conductivity and electrical resistivity. Geophysical results showed that apparent electrical resistivity was optimal to detect targets (85% success) in semi-rural areas and ground-penetrating radar was optimal to detect targets (92%) in tropical rainforest areas, followed by magnetic susceptibility and bulk ground conductivity. Botanical results evidenced variations in both study sites, which should be noted by forensic search investigators, with rapid growth of
Raphanus
in the tropical rainforest graves and
Malvaceae
and
Petiveria
in the rural study site. This paper shows the importance of conducting long-term controlled studies to assist forensic search teams with expected results and optimum equipment configuration(s).
Intracranial Pressure and Intracranial Elastance Monitoring in Neurocritical Care
Authors: Heldt Thomas , Zoerle Tommaso , Teichmann Daniel , Stocchetti Nino
Published: June 2019

Patients with acute brain injuries tend to be physiologically unstable and at risk of rapid and potentially life-threatening decompensation due to shifts in intracranial compartment volumes and consequent intracranial hypertension. Invasive intracranial pressure (ICP) monitoring therefore remains a cornerstone of modern neurocritical care, despite the attendant risks of infection and damage to brain tissue arising from the surgical placement of a catheter or pressure transducer into the cerebrospinal fluid or brain tissue compartments. In addition to ICP monitoring, tracking of the intracranial capacity to buffer shifts in compartment volumes would help in the assessment of patient state, inform clinical decision making, and guide therapeutic interventions. We review the anatomy, physiology, and current technology relevant to clinical management of patients with acute brain injury and outline unmet clinical needs to advance patient monitoring in neurocritical care.
Challenges and Opportunities in the Design of Liver-on-Chip Microdevices
Authors: Ehrlich Avner , Duche Daniel , Ouedraogo Gladys , Nahmias Yaakov
Published: June 2019

The liver is the central hub of xenobiotic metabolism and consequently the organ most prone to cosmetic- and drug-induced toxicity. Failure to detect liver toxicity or to assess compound clearance during product development is a major cause of postmarketing product withdrawal, with disastrous clinical and financial consequences. While small animals are still the preferred model in drug development, the recent ban on animal use in the European Union created a pressing need to develop precise and efficient tools to detect human liver toxicity during cosmetic development. This article includes a brief review of liver development, organization, and function and focuses on the state of the art of long-term cell culture, including hepatocyte cell sources, heterotypic cell–cell interactions, oxygen demands, and culture medium formulation. Finally, the article reviews emerging liver-on-chip devices and discusses the advantages and pitfalls of individual designs. The goal of this review is to provide a framework to design liver-on-chip devices and criteria with which to evaluate this emerging technology.
New Sensor and Wearable Technologies to Aid in the Diagnosis and Treatment Monitoring of Parkinson's Disease
Authors: Monje Mariana H.G. , Foffani Guglielmo , Obeso José , Sánchez-Ferro Álvaro
Published: June 2019

Parkinson's disease (PD) is a degenerative disorder of the brain characterized by the impairment of the nigrostriatal system. This impairment leads to specific motor manifestations (i.e., bradykinesia, tremor, and rigidity) that are assessed through clinical examination, scales, and patient-reported outcomes. New sensor-based and wearable technologies are progressively revolutionizing PD care by objectively measuring these manifestations and improving PD diagnosis and treatment monitoring. However, their use is still limited in clinical practice, perhaps because of the absence of external validation and standards for their continuous use at home. In the near future, these systems will progressively complement traditional tools and revolutionize the way we diagnose and monitor patients with PD.
Randall_ECS_235_PEMFC_Modeling_05292019
Authors: Randall Corey Ryan , DeCaluwe Steven C.
Published: June 2019

Use of pseudo-2d simulations to understand microstructure-performance relationships in PEMFC cathode catalyst layers.Prepared and presented by Corey Randall at 235th Electrochemical Society Meeting, Dallas, TX, May 29, 2019. Funding provided by the US Department of Energy, Basic Energy Sciences Early Career Award.By estimating Nafion structure-property relationships from previously published data, we are able to capture changes to the limiting current with varying Pt loading. However, there remains a kinetic limitation, which scales linearly with Pt loading, which the model does not currently capture. Results also predict non-monotonic variation of PEMFC performance with variations in the Nafion catalyst coating thickness within the catalyst layer.
Development and assessment of an academic performance enrichment program for low-performing, first-year pharmacy students
Authors: Dirks-Naylor Amie J. , Cook Corbin , Nhean Pov
Published: June 2019

Pharmacy school applications have steadily declined over the past several years. Thus pharmacy schools are not only searching for effective means to increase enrollment of qualified candidates, but are also focusing on the development of programs to improve academic performance and retention of enrolled students. To address the needs of struggling first-year pharmacy students enrolled in an Integrated Biological Sciences (BSI) course, an academic performance enrichment program (APEP) was developed. The program was designed to improve academic success by engaging low-performing students with the aims of improving their time management skills, study skills, metacognition, and understanding of BSI course material. The APEP consisted of structured tutoring sessions twice per week, which were required for all students with a course grade ≤73.5% at any point during the semester. To assess program effectiveness, performance improvement on BSI exams by the APEP students were compared with that of non-APEP students in the same class and to those in the previous 3 yr. Student perceptions of the program were also evaluated via an online survey. The APEP was deemed effective in that a greater percentage of students were able to improve their exam scores and to a greater extent by attending the APEP sessions compared with non-APEP students in the same class and with low-performing students in previous years when the APEP did not exist. Furthermore, APEP students believed the program was effective in meeting its aims. In conclusion, the APEP was effective in improving academic performance of low-performing students in BSI.
MicroRNA-7 directly targets Reg1 in pancreatic cells
Authors: Downing Shawna , Zhang Fan , Chen Zijing , Tzanakakis Emmanuel S.
Published: June 2019

Regenerating islet-derived (Reg) proteins, which were first discovered in the pancreas, are associated with increased proliferation, prevention of apoptosis, and enhanced differentiation in normal and disease states, but very little is known about the regulation of their expression. We hypothesized that Reg expression is influenced by microRNAs. Bioinformatic analysis predicted Reg1 to be a target of microRNA-7 (miR-7), which influences pancreatic β-cell function. To this end, we investigated the effects of miR-7 on Reg1 expression in pancreatic acinar and islet β-cells. High levels of Reg1 were noted by immunostaining and Western blotting in acinar cells in contrast to islet cells. A reciprocal expression pattern was observed for miR-7. Overexpression of miR-7 resulted in Reg1 mRNA suppression and reduction of secreted Reg1 protein. Conversely, miR-7 knockdown led to increases in Reg1. Targeting of Reg1 by miR-7 was confirmed via luciferase activity assays. In contrast, miR-7 did not directly repress the human ortholog of Reg1 REG1A as well as REG1B indicating species differences in the regulation of Reg expression. This is the first account of microRNA modulation of any Reg member warranting studies to fill gaps in our knowledge of Reg protein biology, particularly in disease contexts.
Pressure-dependent modulation of inward-rectifying K+ channels: implications for cation homeostasis and K+ dynamics in glaucoma
Authors: Fischer Rachel A. , Roux Abigail L. , Wareham Lauren K. , Sappington Rebecca M.
Published: June 2019

Glaucoma is the leading cause of blindness worldwide, resulting from degeneration of retinal ganglion cells (RGCs), which form the optic nerve. Prior to structural degeneration, RGCs exhibit physiological deficits. Müller glia provide homeostatic regulation of ions that supports RGC physiology through a process called K+ siphoning. Recent studies suggest that several retinal conditions, including glaucoma, involve changes in the expression of K+ channels in Müller glia. To clarify whether glaucoma-related stressors directly alter expression and function of K+ channels in Müller glia, we examined changes in the expression of inwardly rectifying K+ (Kir) channels and two-pore domain (K2P) channels in response to elevated intraocular pressure (IOP) in vivo and in vitro in primary cultures of Müller glia exposed to elevated hydrostatic pressure. We then measured outcomes of cell health, cation homeostasis, and cation flux in Müller glia cultures. Transcriptome analysis in a murine model of microbead-induced glaucoma revealed pressure-dependent downregulation of Kir and K2P channels in vivo. Changes in the expression and localization of Kir and K2P channels in response to elevated pressure were also found in Müller glia in vitro. Finally, we found that elevated pressure compromises the plasma membrane of Müller glia and induces cation dyshomeostasis that involves changes in ion flux through cation channels. Pressure-induced changes in cation flux precede both cation dyshomeostasis and membrane compromise. Our findings have implications for Müller glia responses to pressure-related conditions, i.e., glaucoma, and identify cation dyshomeostasis as a potential contributor to electrophysiological impairment observed in RGCs of glaucomatous retina.
Age-related changes in leg proprioception: implications for postural control
Authors: Henry Mélanie , Baudry Stéphane
Published: June 2019

In addition to being a prerequisite for many activities of daily living, the ability to maintain steady upright standing is a relevant model to study sensorimotor integrative function. Upright standing requires managing multimodal sensory inputs to produce finely tuned motor output that can be adjusted to accommodate changes in standing conditions and environment. The sensory information used for postural control mainly arises from the vestibular system of the inner ear, vision, and proprioception. Proprioception (sense of body position and movement) encompasses signals from mechanoreceptors (proprioceptors) located in muscles, tendons, and joint capsules. There is general agreement that proprioception signals from leg muscles provide the primary source of information for postural control. This is because of their exquisite sensitivity to detect body sway during unperturbed upright standing that mainly results from variations in leg muscle length induced by rotations around the ankle joint. However, aging is associated with alterations of muscle spindles and their neural pathways, which induce a decrease in the sensitivity, acuity, and integration of the proprioceptive signal. These alterations promote changes in postural control that reduce its efficiency and thereby may have deleterious consequences for the functional independence of an individual. This narrative review provides an overview of how aging alters the proprioceptive signal from the legs and presents compelling evidence that these changes modify the neural control of upright standing.
Acquisition of a simple motor skill: task-dependent adaptation and long-term changes in the human soleus stretch reflex
Authors: Mrachacz-Kersting N. , Kersting U. G. , de Brito Silva P. , Makihara Y. , Arendt-Nielsen L. , Sinkjær T. , Thompson A. K.
Published: June 2019

Changing the H reflex through operant conditioning leads to CNS multisite plasticity and can affect previously learned skills. To further understand the mechanisms of this plasticity, we operantly conditioned the initial component (M1) of the soleus stretch reflex. Unlike the H reflex, the stretch reflex is affected by fusimotor control, comprises several bursts of activity resulting from temporally dispersed afferent inputs, and may activate spinal motoneurons via several different spinal and supraspinal pathways. Neurologically normal participants completed 6 baseline sessions and 24 operant conditioning sessions in which they were encouraged to increase (M1up) or decrease (M1down) M1 size. Five of eight M1up participants significantly increased M1; the final M1 size of those five participants was 143 ± 15% (mean ± SE) of the baseline value. All eight M1down participants significantly decreased M1; their final M1 size was 62 ± 6% of baseline. Similar to the previous H-reflex conditioning studies, conditioned reflex change consisted of within-session task-dependent adaptation and across-session long-term change. Task-dependent adaptation was evident in conditioning session 1 with M1up and by session 4 with M1down. Long-term change was evident by session 10 with M1up and by session 16 with M1down. Task-dependent adaptation was greater with M1up than with the previous H-reflex upconditioning. This may reflect adaptive changes in muscle spindle sensitivity, which affects the stretch reflex but not the H reflex. Because the stretch reflex is related to motor function more directly than the H reflex, M1 conditioning may provide a valuable tool for exploring the functional impact of reflex conditioning and its potential therapeutic applications.

NEW & NOTEWORTHY Since the activity of stretch reflex pathways contributes to locomotion, changing it through training may improve locomotor rehabilitation in people with CNS disorders. Here we show for the first time that people can change the size of the soleus spinal stretch reflex through operant conditioning. Conditioned stretch reflex change is the sum of task-dependent adaptation and long-term change, consistent with H-reflex conditioning yet different from it in the composition and amount of the two components.
Prospective Association of Serum and Dietary Magnesium with Colorectal Cancer Incidence
Authors: Polter Elizabeth J. , Onyeaghala Guillaume , Lutsey Pamela L. , Folsom Aaron R. , Joshu Corinne E. , Platz Elizabeth A. , Prizment Anna E.
Published: June 2019

Background:

Laboratory and epidemiologic research suggests a protective role of magnesium in colorectal cancer development. We estimated the associations of serum and dietary magnesium with colorectal cancer incidence in the Atherosclerosis Risk in Communities (ARIC) study.

Methods:

Serum magnesium concentration was measured in blood collected twice (1987–1989 and 1990–1992) and averaged. Dietary magnesium was assessed by food-frequency questionnaire administered twice (1987–1989 and 1993–1995) and averaged. For both dietary and serum magnesium, the averaged measures were categorized into quintiles for analysis. Analyses included 315 colorectal cancer cases among 13,009 participants for serum magnesium (followed for a median of 20.4 years), and 256 cases among 10,971 participants for dietary magnesium (followed for a median of 17.5 years). Cox proportional hazards regression was used to calculate multivariable-adjusted HRs and 95% confidence intervals (CI).

Results:

Multivariable-adjusted HRs (95% CI) of colorectal cancer for the highest four quintiles compared with the first quintile of serum magnesium were as follows: Q2: 0.70 (0.49–0.99); Q3: 0.68 (0.47–1.00); Q4: 0.87 (0.62–1.21); and Q5: 0.79 (0.57–1.11; Ptrend = 0.04). An inverse association was present in females (HR for Q5 vs. Q1: 0.59, 95% CI: 0.36–0.98, Ptrend = 0.01), but not males (HR for Q5 vs. Q1: 1.10, 95% CI: 0.67–1.79, Ptrend = 0.92; Pinteraction = 0.34). Dietary magnesium was not statistically significantly associated with colorectal cancer risk.

Conclusions:

Our study found a higher risk of colorectal cancer with lower serum magnesium among females, but not males.

Impact:

If our findings are confirmed, maintaining adequate serum magnesium levels may be important for colorectal cancer prevention.
Inhibition of Pantothenate Synthetase by Analogs of β-Alanine Precursor Ineffective as an Antibacterial Strategy
Authors: Liyanage S. Imindu , Gupta Mayuri , Wu Fan , Taylor Marcy , Carter Michael D. , Weaver Donald F.
Published: June 2019

Background: Pantothenate, the fundamental precursor to coenzyme A, is required for optimal growth and virulence of microbial pathogens. It is synthesized by the enzyme-catalyzed condensation of β-alanine and pantoate, which has shown susceptibility to inhibition by analogs of its molecular constituents. Accordingly, analogs of β-alanine are gaining inquiry as potential antimicrobial chemotherapeutics. Methods: We synthesized and evaluated 35 derivatives of β-alanine, substituted at the α, β, amine, and carboxyl sites, derived from in silico, dynamic molecular modeling to be potential competitive inhibitors of pantothenate synthetase. Employing the Clinical Laboratory Standards M7-A6 broth microdilution method, we tested these for inhibition of growth in Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. Results: All compounds proved entirely ineffective in all species tested, with no inhibition of growth being observed up to 200 µM/mL. Conclusions: Upon revision of the literature, we conclude that high enzyme selectivity or external salvage mechanisms may render this strategy futile against most bacteria.
Age-Related Oxidative Changes in Primary Porcine Fibroblasts Expressing Mutated Huntingtin
Authors: Smatlikova Petra , Askeland Georgina , Vaskovicova Michaela , Klima Jiri , Motlik Jan , Eide Lars , Ellederová Zdenka
Published: June 2019

Background: Huntington’s disease (HD) is a devastating neurodegenerative disorder caused by CAG triplet expansions in the huntingtin gene. Oxidative stress is linked to HD pathology, although it is not clear whether this is an effect or a mediator of disease. The transgenic (TgHD) minipig expresses the N-terminal part of human-mutated huntingtin and represents a unique model to investigate therapeutic strategies towards HD. A more detailed characterization of this model is needed to fully utilize its potential. Methods: In this study, we focused on the molecular and cellular features of fibroblasts isolated from TgHD minipigs and the wild-type (WT) siblings at different ages, pre-symptomatic at the age of 24–36 months and with the onset of behavioural symptoms at the age of 48 months. We measured oxidative stress, the expression of oxidative stress-related genes, proliferation capacity along with the expression of cyclin B1 and D1 proteins, cellular permeability, and the integrity of the nuclear DNA (nDNA) and mitochondrial DNA in these cells. Results: TgHD fibroblasts isolated from 48-month-old animals showed increased oxidative stress, which correlated with the overexpression of SOD2 encoding mitochondrial superoxide dismutase 2, and the NEIL3 gene encoding DNA glycosylase involved in replication-associated repair of oxidized DNA. TgHD cells displayed an abnormal proliferation capacity and permeability. We further demonstrated increased nDNA damage in pre-symptomatic TgHD fibroblasts (isolated from animals aged 24–36 months). Conclusions: Our results unravel phenotypic alterations in primary fibroblasts isolated from the TgHD minipig model at the age of 48 months. Importantly, nDNA damage appears to precede these phenotypic alterations. Our results highlight the impact of fibroblasts from TgHD minipigs in studying the molecular mechanisms of HD pathophysiology that gradually occur with age.
Verrucous Carcinoma of the Nail Bed: A New Case
Authors: Chaabani Meryam , Jaber Kahena , Rabhi Faten , Abdelli Wissal , Youssef Soumaya , Msakni Issam , Dhaoui Mohamed Raouf , Doss Nejib
Published: June 2019

Verrucous carcinoma (VC) of the nail bed is a rare variant of squamous cell carcinoma that is often misdiagnosed as a benign condition. The clinical presentation of this tumor is very similar to that of warts or onychomycosis hence the delayed appropriate treatment. Its association with human papillomavirus (HPV) infection has rarely been reported. The treatment of VC of the nail unit depends on the extent of the lesion and the presence or the absence of bone. We here report an unusual case of VC of the nail bed of the left big toe in a man associated with HPV53 infection that had been mistaken for a wart for 1 year. The condition was treated by ray amputation.
Serum Adropin Levels Are Reduced in Adult Patients with Nonalcoholic Fatty Liver Disease
Authors: Kutlu Orkide  , Altun Özgür , Dikker Okan , Aktaş Şerife , Özsoy Neslihan , Arman Yücel , Özgün Çil Eylem  , Özcan Mustafa , Aydın Yoldemir Şengül , Akarsu Murat , Toprak İlkim Deniz , Kırna Kerem , Kutlu Yasin , Toprak Zeki , Eruzun Hasan , Tükek Tufan
Published: June 2019

Objectives: Adropin is a novel marker of metabolic syndrome and insulin resistance. The aim of this study was to explore the association of serum adropin levels with hepatosteatosis among adult patients. Materials and Methods: Serum biochemical parameters including liver and renal function tests, insulin levels, and serum adropin levels were compared between adult patients with nonalcoholic fatty liver disease (NAFLD) and healthy control cases. Results: A total of 51 patients with a mean age of 37.9 ± 9.96 years diagnosed with grade 2–3 hepatosteatosis and 30 healthy control cases with a mean age of 34.8 ± 9.5 years were included in the study. Serum adropin levels in the NAFLD group were statistically significantly lower than in the control cases (588.4 ± 261.0 vs. 894.2 ± 301.2, respectively; p < 0.001). The study participants were further subdivided into 2 groups as patients with (n = 35) or without (n = 46) insulin resistance using the serum homeostatic model of assessment-insulin resistance (HOMA-IR). Serum adropin levels were statistically significantly lower in patients with insulin resistance (p < 0.01). There was a negative correlation between adropin levels and serum insulin, HOMA-IR, urea, gamma-glutamyl transferase, total cholesterol, and triglyceride levels. Conclusion: We observed a decrease in serum adropin levels among adult patients with NAFLD. We also found lower levels of serum adropin in patients with insulin resistance, supporting previous data in the literature. Studies investigating the association of adropin levels with other inflammatory parameters are warranted to define its exact role in the pathogenesis of hepatosteatosis.
Phenotypic and Genotypic Characterization of ESBL-, AmpC-, and Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli Isolates
Authors: Kazemian Hossein , Heidari Hamid , Ghanavati Roya , Ghafourian Sobhan , Yazdani Fateme , Sadeghifard Nourkhoda , Valadbeigi Hasan , Maleki Abbas , Pakzad Iraj
Published: June 2019

Objectives: Drug resistance among gram-negative bacteria is a worldwide challenge. Due to the importance of drug-resistant Klebsiella pneumoniae and Escherichia coli strains in hospital-acquired infections, we aimed to determine the phenotypic and genotypic characteristics of ESBL-, AmpC-, and carbapenemase-producing isolates obtained from hospitalized patients in Tehran and Ilam (Iran). Materials and Methods: In total, 90 K. pneumoniae isolates and 65 E. coli isolates were collected from various infections. Phenotypic identification of bacterial isolates was performed using standard methods. Phenotypic screening of ESBL, AmpC, and carbapenemase enzymes was carried out. Detection of ESBL, AmpC, and carbapenemase genes was also performed by the PCR method. Results: Phenotypic detection tests showed that 36 (40%) K. pneumoniae and 23 (35.4%) E. coli isolates were ESBL producers. Moreover, 18 (20%) and 6 (9.2%) K. pneumoniae and E. coli isolates were AmpC producers, respectively. Modified Hodge test results indicated that 39 (43.3%) K. pneumoniae and 18 (27.7%) E. coli isolates produced carbapenemase. Molecular tests showed that 40% of K. pneumoniae and 36.9% of E. coli isolates were ESBL positive. AmpC was detected in 24.4 and 13.8% of K. pneumoniae and E. coli isolates. Carbapenemase was detected in 34 (37.8%) K. pneumoniae and 13 (20%) E. coli isolates. ­Conclusion: In this study, 3 K. pneumoniae isolates simultaneously carried ESBL, AmpC, and carbapenemase genes. Up-to-date strategies such as combination therapy or utilization of new antimicrobial agents might help to combat such drug-resistant organisms.
Prevalence of Premature Thelarche at 18 Months of Age: A Population- and Hospital-Based Study of Prevalence and Incidence in Girls Born at Northern Älvsborg County Hospital in Sweden
Authors: Österbrand Martin , Fors Hans , Norjavaara Ensio
Published: June 2019

Objective: The aim of this work was to investigate the prevalence of premature thelarche (PT) in 18-month-old girls, and the incidence of clinically evaluated PT for girls aged 18–36 months. Methods: In the prevalence substudy, a prospective population-based cohort of 3,140 girls born at Northern Älvsborg county hospital (NÄL) in Trollhättan, Sweden, was followed for 2 years. Girls with breast development at the 18-month health check were referred to one pediatric center in NÄL for evaluation. All girls with PT were included and followed for clinical outcome and 17β-estradiol. The prospective incidence substudy covered 8 years in a 10-year period and included all girls aged 18–36 months born at NÄL who were clinically evaluated for PT. Results: The prevalence of PT at 18 months in our cohort was 1.6/1,000. The 5 girls with PT no longer showed symptoms at the follow-up 3–6 months later. The incidence was 1.1/1,000 for girls aged 18–36 months and 1.0/1,000 for girls aged 18–30 months who were clinically evaluated for their PT. Conclusion: This is the first prospective population-based study of PT and it shows a prevalence of PT at age 18 months of 1.6/1,000. The incidence of clinically evaluated PT was 1.1/1,000. Our result is in line with other studies reporting the incidence of PT from medical records (0.4–40/1,000). The outcome of PT in our study, as in the other studies, is that the great majority of girls show only benign symptoms.
Laparoscopic Sleeve Gastrectomy Significantly Increases Serum Lipoprotein Lipase Level in Obese Patients
Authors: Ohira Masahiro , Yamaguchi Takashi , Saiki Atsuhito , Nakamura Shoko , Tanaka Shou , Oka Rena , Watanabe Yasuhiro , Sato Yuta , Oshiro Takashi , Murano Takeyoshi , Tatsuno Ichiro
Published: June 2019

Objectives: Obesity is one of the causes of metabolic disorders. Laparoscopic sleeve gastrectomy (LSG) confers beneficial effects not only on body weight (BW) but also on metabolic disorders. The lipoprotein lipase (LPL) level in preheparin serum is associated with visceral adipose tissue and reflects insulin resistance. However, the change in serum preheparin LPL levels after LSG remains unclear. This study aimed to examine the effect of LSG on preheparin LPL level in obese patients compared with nonsurgical treatment. Methods: We retrospectively reviewed a total of 100 obese patients who were treated for obesity and had preheparin LPL levels measured before and 12 months after LSG or after 12 months of nonsurgical treatment. Fifty-six patients received LSG (LSG group), and 44 patients had no surgical treatment (nonsurgical group). We compared clinical parameters such as body mass index (BMI), hemoglobin A1c (HbA1c), and preheparin LPL level before and 12 months after treatment. Results: BMI and HbA1c decreased significantly in both groups, but decreases in both parameters were greater in the LSG group than in the nonsurgical group. Estimated glomerular filtration was significantly improved only in the LSG group. Preheparin LPL level increased significantly only in the LSG group (from 45.8 ± 21.6 to 75.0 ± 34.9 ng/mL, p < 0.001). Multiple regression identified LSG and decreased BMI as independent predictors of preheparin LPL level increase. Conclusions: These results suggest that LSG independently increases pre­heparin LPL level beyond BW reduction in obese patients.
The Double Bubble Sign: Duodenal Atresia and Associated Genetic Etiologies
Authors: Bishop Juliet C. , McCormick Bridgette , Johnson Clark T. , Miller Jena , Jelin Eric , Blakemore Karin , Jelin Angie C.
Published: June 2019

Background: The “double bubble” sign is an ultrasonographic finding that commonly represents duodenal atresia and is associated with trisomy 21. Objectives: We sought to evaluate the positive predictive value of a prenatally identified double bubble sign for duodenal atresia and the genetic etiologies associated with it. Methods: We examined a retrospective cohort with prenatal double bubble sign between January 1, 2008, and June 30, 2017. Postnatal diagnoses were determined by review of operative reports and additional postnatal evaluation including cytogenetic analysis, molecular analysis, and/or clinical genetic evaluation. Results: All live births at our institution with a prenatal double bubble sign had confirmed duodenal atresia. Additional anatomic anomalies and/or genetic abnormalities were identified in 62% of cases. Out of 21 cases, 6 had trisomy 21. Of the remaining 15 cases, 8 were nonisolated duodenal atresia, 3 of which had a heterotaxy syndrome. In the 7 isolated cases, 1 likely pathogenic chromosomal microdeletion was identified. Conclusions: Prenatal double bubble sign is a reliable predictor of duodenal atresia. In addition to trisomy 21, heterotaxy may be encountered. ZIC3 mutations as well as microdeletion of 4q22.3 may be underlying genetic etiologies to be considered in the diagnostic evaluation of a prenatal double bubble sign.
Environmental Factors and the Risk of Brain Tumours in Young People: A Systematic Review
Authors: Zumel-Marne Angela , Castano-Vinyals Gemma , Kundi Michael , Alguacil Juan , Cardis Elisabeth
Published: June 2019

Background: Brain tumours (BT) are one of the most frequent tumour types in young people, although little is known about their risk factors. Objective: The objective of the current work was to review and summarize the scientific literature concerning exposure to environmental factors and BT risk in young people (<25 years old). Methods: PUBMED, Embase, Cochrane Library, Scopus, IME-Biomedina (bibliographic database of Consejo Superior de Investigaciones Científicas) and Web of science databases were searched. A score to assess the quality of the methodological information was created. Results: Some possible associations between BT risk in young people were reported for cadmium, consumption of well water, presence of nitrate or nitrate-nitrogen in tap water, mother’s passive smoking, air pollution, parental handling of pesticides at home and/or professional pesticide treatment within houses, living on a farm and/or with farm animals, some parental occupations and high amount of meat consumption. Conclusions: Although many of the studies reviewed suggest associations between the environmental exposures and BT in children and young adults, at present no reliable conclusion can be drawn as most results are based on small number of cases and exposure assessment is limited. Large-scale studies with better exposure assessment are needed to shed light on these possible associations, especially on exposure to heavy metals, tab water consumption, pesticides and parental smoking.
Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes
Authors: Gregg L. Parker , Jain Nishank , Carmody Thomas , Minhajuddin Abu T. , Rush A. John , Trivedi Madhukar H. , Hedayati S. Susan
Published: June 2019

Background: Fatigue, although common and associated with outcomes in dialysis-dependent chronic kidney disease (CKD), has not been studied in nondialysis chronic kidney disease (CKD-ND) patients. Methods: In this longitudinal cohort of 266 outpatients with CKD-ND stages 2–5, we measured self-reported fatigue on 3 scales-Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR16), Beck Depression Inventory-I (BDI-I), and short form 12 health survey (SF-12) questionnaires and evaluated the prespecified composite of progression to dialysis initiation, death, or hospitalization after 12 months. Logistic and linear regression assessed characteristics associated with fatigue. Survival analysis measured associations of fatigue with outcomes. Results: Mean age was 64.4 ± 12.0 years, and mean estimated glomerular filtration rate (eGFR) was 31.6 ± 16.7 mL/min/1.73 m2. Fatigue was common, with 69.2% reporting fatigue on QIDS-SR16 and 77.7% on BDI-I. Unemployment, comorbidities, use of antidepressant medications, and lower hemoglobin correlated with fatigue. There were 126 outcome events. Participants that reported any versus no fatigue on QIDS-SR16 were more likely to reach the composite, hazard ratio (HR) 1.70 (95% CI 1.11–2.59), which persisted after adjusting for demographics, comorbidities, substance abuse, hemoglobin, albumin, eGFR, and calcium-phosphorus product, HR 1.63 (1.05–2.55). Fatigue severity by the SF-12 was also associated with outcomes independent of demographics, comorbidities, and substance abuse, HR per unit increase 1.18 (1.03–1.35). No association was observed with fatigue on the BDI-I. Conclusion: Fatigue affected about 2/3 of CKD-ND patients and associated with unemployment, comorbidities, antidepressant medication use, and anemia. Fatigue measured by the QIDS-SR16 and SF-12 independently predicted outcomes in CKD patients. Eliciting the presence of fatigue may be a clinically significant prognostic assessment in CKD patients.
Physicians’ Knowledge and Application of Immunization Strategies in Patients with Inflammatory Bowel Disease: A Survey of the Italian Group for the Study of Inflammatory Bowel Disease
Authors: Macaluso Fabio Salvatore , Mazzola Giovanni , Ventimiglia Marco , Alvisi Patrizia , Renna Sara , Adamoli Lucia , Galli Massimo , Armuzzi Alessandro , Ardizzone Sandro , Cascio Antonio , Cottone Mario , Orlando Ambrogio ,   on behalf of IG-IBD (Italian Group for the study of Inflammatory Bowel Disease)
Published: June 2019

Background: No data on European countries about knowledge and application of immunization strategies in patients with inflammatory bowel disease (IBD) are available. Objectives: We designed a questionnaire aimed at exploring these issues among Italian gastroenterologists dealing with adult and paediatric IBD. Methods: An anonymous, 24-item, questionnaire was sent via e-mail to all members of the Italian Group for the study of Inflammatory Bowel Disease. Three sets of questions were formulated: (1) Characteristics of respondents; (2) General opinions on the role of vaccines in IBD patients; (3) Immunizations of IBD patients in clinical practice. Results: Of the 455 total surveys sent, there were 198 respondents (response rate: 43.5%). The great majority of respondents (82.9%) reputed as “very important” to perform the vaccinations recommended by the guidelines in patients with IBD. The indication to immunization is given at the diagnosis of the disease by 55.6% of the respondents. The most frequently recommended vaccine in IBD patients is the annual flu vaccine, while the recommendation rate for the other vaccines is variable depending on the different pathogens. Conclusions: Efforts carried out by the scientific societies are required to increase the awareness of this relevant topic among physicians.
Caracterização e prospecção de grafita do Complexo Jequitinhonha
Authors: Brito Hermando , Piumbini Bruno Salaroli , Luz José Aurélio Medeiros da , Nascimento Eduardo Morato Dias
Published: June 2019

O advento da tecnologia do grafeno vem destacando ainda mais a importância da grafita no panorama industrial moderno, tornando esse mineral estratégico. Os novos campos de sua utilização tornaram a explotação de grafita cristalina (flake) economicamente atrativa. Os gnaisses kinzigíticos do Complexo Jequitinhonha contêm mineralizações de grafita e têm sido objeto de estudos recentes. A compreensão do comportamento da mineralização por meio da caracterização permite o avanço nas técnicas para sua prospecção e exploração. Estabelecer a influência dos contaminantes do meio geológico e as características que esses conferem à mineralização é importante para a padronização dos procedimentos de prospecção e beneficiamento. Este estudo permitiu determinar o padrão resistivo/condutivo da mineralização em função de seus contaminantes, estabelecendo as características inerentes à mineralização de grafita que permitem padronizar critérios de prospecção e posterior utilização industrial do minério.
Empagliflozin Improves Kidney Outcomes in Patients With or Without Heart Failure
Authors: Butler Javed , Zannad Faiez , Fitchett David , Zinman Bernard , Koitka-Weber Audrey , von Eynatten Maximilian , Zwiener Isabella , George Jyothis , Brueckmann Martina , Cheung Alfred K. , Wanner Christoph
Published: June 2019

Background:

In EMPA-REG OUTCOME (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) empagliflozin significantly reduced the risk of cardiovascular and kidney outcomes in patients with type 2 diabetes mellitus and established cardiovascular disease. Post hoc, we evaluated empagliflozin on kidney outcomes in patients with or without heart failure (HF).

Methods and Results:

Individuals were randomized to empagliflozin 10 mg, 25 mg, or placebo. Prespecified analyses by baseline HF status included risk of incident or worsening nephropathy and estimated glomerular filtration rate slope analyses. Cox proportional hazards models assessed consistency of treatment effect across subgroups. Safety evaluations included kidney-related adverse events. At baseline, 244 (10.5%) and 462 (9.9%) patients had HF in the placebo and empagliflozin groups, respectively. Overall, the incidence of kidney outcome events was numerically higher in patients with than without HF. In the HF group, empagliflozin reduced risk of incident or worsening nephropathy or cardiovascular death by 43% (hazard ratio, 0.57 [95% CI, 0.42–0.77]) and progression to macroalbuminuria by 50% (hazard ratio, 0.50 [0.33–0.75]). After an initial transient decrease, estimated glomerular filtration rate stabilized over time with empagliflozin but gradually declined with placebo. Kidney effects in patients with HF were consistent with those in the overall study population (all
P
values for interaction >0.05). Across groups, the incidence rate of kidney-related adverse events/100 patient-years was higher in patients with than without HF; however, overall rates were comparable between groups.

Conclusions:

These findings from EMPA-REG OUTCOME support the hypothesis that empagliflozin could reduce the risk of clinically relevant kidney events and may slow progression of chronic kidney disease in individuals with type 2 diabetes mellitus regardless of HF status.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01131676.