bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilience of Historical Public Buildings against Blast in a Context of Monument Preservation
Authors: Mariš Ladislav , Grúňová Zuzana , Figuli Lucia , Jangl Štefan
Published: September 2017

Last terrorist attacks have shown, that among so called soft targets of attackers are included places with the concentrated mass of innocent people. Among such a places belong theatres, concert halls etc., having a seat in historical buildings. Historical heritage is important part of every nation self-conscience, pride and memory. Many historical buildings, preserved as cultural monuments create genius loci of urban environment and at the same time they serve as a public buildings in compliance to the most of the safety measures demanded in Slovak legislation. Some exceptions could be legally made and should be made to retain their authentic historical values, protected by international documents on monument preservation. A case study of historical Slovak National Theatre building is analyzed in the paper.
Designing on the New Elevation Database of the Czech Republic
Authors: Sobotka Jan
Published: September 2017

The article presents new possibilities of earthworks designing on new elevation data of the Czech Republic. These new elevation data are the result of the airborne laser scanning of the Czech Republic, which replace the old one. The new digital elevation database is another source of elevation data, which can be used during earthworks designing. Furthermore, the paper presents two projects, where new elevation data were used in practice.
Charge Size Assessment According to the Caused Damages
Authors: Jangl Štefan , Ivančo Matúš , Kontrová Lýdia , Figuli Lucia , Kavický Vladimir
Published: September 2017

The aim of the paper is to provide an expert opinion on the issue of charge size estimation of used explosion weight according to the caused damages on the sourronings buildings. The research is focused on the analytical approach of setting the weight of explosives used in explosive improvised devices, using a current state-of-art of blast pressure setting. The vice versa methodology is to estimate the weight of used explosive from maximal pressure of blast wave.
Therapeutic Effects of Monoclonal Antibody against Dengue Virus NS1 in a STAT1 Knockout Mouse Model of Dengue Infection
Authors: Wan Shu-Wen , Chen Pei-Wei , Chen Chin-Yu , Lai Yen-Chung , Chu Ya-Ting , Hung Chia-Yi , Lee Han , Wu Hsuan Franziska , Chuang Yung-Chun , Lin Jessica , Chang Chih-Peng , Wang Shuying , Liu Ching-Chuan , Ho Tzong-Shiann , Lin Chiou-Feng , Lee Chien-Kuo , Wu-Hsieh Betty A. , Anderson Robert , Yeh Trai-Ming , Lin Yee-Shin
Published: September 2017

Dengue virus (DENV) is the causative agent of dengue fever, dengue hemorrhagic fever, and dengue shock syndrome and is endemic to tropical and subtropical regions of the world. Our previous studies showed the existence of epitopes in the C-terminal region of DENV nonstructural protein 1 (NS1) which are cross-reactive with host Ags and trigger anti–DENV NS1 Ab–mediated endothelial cell damage and platelet dysfunction. To circumvent these potentially harmful events, we replaced the C-terminal region of DENV NS1 with the corresponding region from Japanese encephalitis virus NS1 to create chimeric DJ NS1 protein. Passive immunization of DENV-infected mice with polyclonal anti–DJ NS1 Abs reduced viral Ag expression at skin inoculation sites and shortened DENV-induced prolonged bleeding time. We also investigated the therapeutic effects of anti-NS1 mAb. One mAb designated 2E8 does not recognize the C-terminal region of DENV NS1 in which host–cross-reactive epitopes reside. Moreover, mAb 2E8 recognizes NS1 of all four DENV serotypes. We also found that mAb 2E8 caused complement-mediated lysis in DENV-infected cells. In mouse model studies, treatment with mAb 2E8 shortened DENV-induced prolonged bleeding time and reduced viral Ag expression in the skin. Importantly, mAb 2E8 provided therapeutic effects against all four serotypes of DENV. We further found that mAb administration to mice as late as 1 d prior to severe bleeding still reduced prolonged bleeding time and hemorrhage. Therefore, administration with a single dose of mAb 2E8 can protect mice against DENV infection and pathological effects, suggesting that NS1-specific mAb may be a therapeutic option against dengue disease.
Unveiling the Peptide Motifs of HLA-C and HLA-G from Naturally Presented Peptides and Generation of Binding Prediction Matrices
Authors: Di Marco Moreno , Schuster Heiko , Backert Linus , Ghosh Michael , Rammensee Hans-Georg , Stevanović Stefan
Published: September 2017

The classical HLA-C and the nonclassical HLA-E and HLA-G molecules play important roles both in the innate and adaptive immune system. Starting already during embryogenesis and continuing throughout our lives, these three Ags exert major functions in immune tolerance, defense against infections, and anticancer immune responses. Despite these important roles, identification and characterization of the peptides presented by these molecules has been lacking behind the more abundant HLA-A and HLA-B gene products. In this study, we elucidated the peptide specificities of these HLA molecules using a comprehensive analysis of naturally presented peptides. To that end, the 15 most frequently expressed HLA-C alleles as well as HLA-E*01:01 and HLA-G*01:01 were transfected into lymphoblastoid C1R cells expressing low endogenous HLA. Identification of naturally presented peptides was performed by immunoprecipitation of HLA and subsequent analysis of HLA-bound peptides by liquid chromatographic tandem mass spectrometry. Peptide motifs of HLA-C unveil anchors in position 2 or 3 with high variances between allotypes, and a less variable anchor at the C-terminal end. The previously reported small ligand repertoire of HLA-E was confirmed within our analysis, and we could show that HLA-G combines a large ligand repertoire with distinct features anchoring peptides at positions 3 and 9, supported by an auxiliary anchor in position 1 and preferred residues in positions 2 and 7. The wealth of HLA ligands resulted in prediction matrices for octa-, nona-, and decamers. Matrices were validated in terms of their binding prediction and compared with the latest NetMHC prediction algorithm NetMHCpan-3.0, which demonstrated their predictive power.
Comparison of the Changes in Hyoid Bone Position in Subjects with Normodivergent and Hyperdivergent Growth Patterns: A Cephalometric Study
Authors: Kumar Shashi , Arshad Faisal , Nahin Javeriya , Lokesh NK , Riyaz Khadeer
Published: September 2017

Objective

The aim of this study is to test the hypothesis that there is no difference in hyoid bone position among individuals with different growth patterns before and after treatment.

Materials and Methods

Pre- and post-treatment lateral cephalogram of forty Class I adults in the age group of 20–27 years were grouped. All the cases were treated with the first premolar extraction in all quadrants. Based on the growth pattern of the face, individuals were divided into: (1) Group 1 (n = 20): Normodivergent, i.e., FH/MP angle smaller than 30.5° (20 patients). (2) Group 2 (n = 20): Hyperdivergent, i.e., FH/MP angle larger than 30.5° (20 patients). Lateral cephalograms were traced and analyzed manually for evaluation of hyoid bone position. Patients in both groups were treated with preadjusted appliances. Pre- and post-treatment lateral cephalograms were traced, and variables were compared using paired t-test, and the relationship between dentofacial variables, growth pattern, and the hyoid bone position was analyzed using Karl Pearson’s correlation coefficient method. The changes of hyoid position after treatment were compared using t-test.

Results

The data were analyzed by Kolmogorov–Smirnov and paired t-test. Karl Pearson’s correlation coefficient test was performed to determine whether there was an association between the changes of hyoid and growth pattern. Following retraction of incisors, statistically significant correlation was observed in the pre- and post-treatment values of dentofacial structures and hyoid bone, but no significant correlation was found in position of the hyoid bone in the normodivergent and hyperdivergent groups. In both the groups, hyoid bone moved in an inferior and posterior direction after orthodontic treatment.

Conclusion

No change was seen in position of the hyoid bone in normodivergent and hyperdivergent groups.
Anticancer Conjugates and Cocktails Based on Methotrexate and Nucleoside Synergism
Authors: Vortherms Anthony R. , Dang Hester N. , Doyle Robert P.
Published: September 2017

Conjugates of methotrexate (MTX) and the nucleoside analogs 3-azidodeoxythymidine (AZT), iododeoxyuridine (IUdR) and dideoxycytidine (ddC) linked using poly(ethyleneglycol) are presented. In vitro cytotoxicity assays of the conjugates against drug resistant ovarian cell line A2780/AD are preformed and comparisons made to such assays performed for unconjugated (cocktail) systems. All systems tested were inactive, or had low activity, at 24 h. After 72 hr incubation however, the cocktails of MTX and AZT, IUdR or ddC showed high cytotoxicity in the low nanomolar range. The conjugates were only very moderately active with IC50 values in the [0.1 to 1.0 mM] range. Conjugation of the antifolate to the nucleoside analogs has it seems reduced the activity significantly when compared to a cocktail of the components, indicating a conjugate approach is unlikely to translate into success in vivo. The positive note comes from the observation that by combining two of the new conjugates, namely those based on MTX with IUdR or AZT, an IC50 at 24 hours of~ [180 μM] was produced.
Hospital Costs of Colorectal Cancer Care
Authors: Macafee D.A.L. , West J. , Scholefield J.H. , Whynes D.K.
Published: September 2017

Objective

In a hospital based setting, identify factors which influence the cost of colorectal cancer care?

Design

Retrospective case note review

Setting

Nottingham, United Kingdom

Participants

227 patients treated for colorectal cancer

Methods

Retrospective review of the hospital records provided the primary data for the costing study and included all CRC related resource consumption over the study period.

Results

Of 700 people identified, 227 (32%) sets of hospital notes were reviewed. The median age of the study group was 70.3 (IQR 11.3) years and there were 128 (56%) males. At two years, there was a significant difference in costs between Dukes D cancers (£3641) and the other stages (£3776 Dukes A; £4921 Dukes B). Using univariate and multivariate regression, the year of diagnosis, Dukes stage of disease, intensive nursing care, stoma requirements and recurrent disease all significantly affected the total cost of care.

Conclusions

CRC remains costly with no significant difference in costs if diagnosed before compared to after 1992. Very early and very late stage cancers remain the least costly stage of cancers to treat. Other significant effectors of hospital costs were the site of cancer (rectal), intensive nursing care, recurrent disease and the need for a stoma.
Gastric Adenocarcinoma: Is Computed Tomography (CT) Useful in Preoperative Staging?
Authors: Cidón Ssther Uña , Cuenca Isabel Jiménez
Published: September 2017

Background and Purpose

Although multiple studies testing the accuracy of CT in the preoperative staging of gastric adenocarcinoma have been carried out, their results are controversial. Whilst some authors claim that CT is an accurate method for preoperatively staging gastric cancer, others have advocated the contrary. Because of this discrepancy we have retrospectively reviewed preoperative CT findings compared with histopathological results in patients with gastric adenocarcinoma.

Patients and Methods

Seventy-two patients diagnosed with gastric cancer who underwent potentially curative surgery and preoperative staging CT of quality were included in the study. The size, gastric wall thickening, presence of lymphadenopathy, adjacent organ invasion and location of the gastric mass was recorded. Early tumors (T1 and T2) and more advanced tumors (T3 and T4) were grouped together. CT staging was correlated with the final histopathological stage (TNM). The global results were expressed as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results

Seventy-two cases were included with fifty-five being male and a median age of 67 years (range 33–91). CT correctly identified the location of the tumor in 56 (53% antropyloric, 18% subcardial). Median time from CT scan to surgery was fourteen days (range 2–49). In T detection: T1/T2 and T3/T4 with sensitivity of 70% and 61%. Lymph node involvement: Sensitivity 49%. Overstaged in 47% Understaged in 75%. Specificity of 53%. Nine patients with colon-mesocolon (5 patients) and pancreas (4 patients) invasion. Sensitivity 44% and specificity 96%.

Conclusion

Spiral CT is not an accurate method in predicting preoperative stages in gastric cancer.
Risk Factors for Renal Cell Cancer in a Japanese Population
Authors: Washio Masakazu , Mori Mitsuru
Published: September 2017

The incidence of renal cell cancer has been increasing worldwide. Although the incidence of renal cell cancer in Japan is lower than the rates in the other industrialized countries, there is no doubt that it is increasing. In this paper, we would like to introduce the result of our studies, which evaluate the risk factors for renal cell cancer in Japan. Hypertension, diabetes mellitus, kidney diseases, fondness for fatty food and black tea showed an increased risk of renal cell carcinoma while an intake of starchy roots such as taro, sweet potato and potato reduced the risk of renal cell carcinoma. In Japan, however, drinking black tea may be a surrogate for westernized dietary habits while eating starchy roots may be a surrogate for traditional Japanese dietary habits. Further studies may be needed to evaluate risk factors for renal cell cancer because the number of renal cancer cases was small in our studies in spite of a large population-based cohort study.
Colon Cancer and Physical Activity: A Content Analysis of Reciprocal Relationship
Authors: Janecka Ivo P.
Published: September 2017

Background

Colon cancer is among the leading causes of cancer mortality and its incidence is increasing worldwide. This is true in spite of broad basic research into colon cancer while, concurrently, physical activity has been shown to offer significant preventive potential. This background led to the formulation of the following research questions: • Why is physical activity so effective in decreasing the incidence of colon cancer? • Is there a common denominator to colon cancer and physical activity, which has a reciprocal function? • Knowing the potential for public health impact of physical activity on colon cancer, has physical activity-colon cancer relationship been in the forefront of research efforts?

Methods

Content analysis of archival literature has been carried out on census of 32,822 message units, extracted from the National Library of Medicine and its PubMed database. The following search terms were used: colon cancer, physical activity, melatonin, age/genetics, diet (obesity, vitamin D, calcium), immunity/inflammation, and bioactive substances incorporating insulin-like growth factor 1, interleukins, and prostaglandins. The research timeframe for each category began with the first article published and ended with the last one printed in 2005.

Results/Conclusions

The effectiveness of physical activity in decreasing the incidence of colon cancer is likely the result of its biologic activity within not one or two but all of the major known colon cancer etiologies, demonstrating a powerful reciprocal relationship. Melatonin is identified as a plausible common denominator of colon cancer and physical activity. The greatest volume of publications deals with colon cancer and genetics. A significant societal health care impact could be achieved by adopting physical activity as a major cancer control strategy.
Late Relapse and Follow-up Protocols in Testicular Germ Cell Tumours: The Edinburgh Cancer Centre Experience and Review of the Literature
Authors: Detti Beatrice , Elliott Paul A. , Mclaren Duncan B. , Howard Grahame C.W.
Published: September 2017

Aims

To identify clinicopathological features and outcomes in patients with late relapse (LR) of testicular germ cell tumours (GCTs) in order to guide follow-up policy.

Materials and Methods

The Edinburgh Cancer Centre (ECC) database identified all patients diagnosed with testicular GCT between 1988 and 2002. Of 703 patients, six relapsed more than 24 months after their initial treatment. A retrospective casenote review was performed to extract clinical, pathological, treatment and outcome data.

Results

Six patients (0.85%) underwent late relapse. All patients presented initially with stage I disease and five were classified as good risk (International Germ Cell Consensus Classification, IGCCC). Median time to LR was 31 months. Two patients had previously relapsed less than 24 months from initial diagnosis. Markers at the time of relapse were normal in all patients. In all cases of late relapse disease was confined to axial lymphadenopathy. Three patients were treated with chemotherapy alone, two patients underwent surgical resection and one patient received combined treatment. All patients obtained a complete response and all remain disease free with a median follow-up of 52 months.

Conclusions

The incidence of late relapse in this series is low. Chemo-naive patients with LR were successfully salvaged with chemotherapy alone and patients previously exposed to cisplatin-based chemotherapy were salvaged with complete surgical excision. The optimal length of follow-up in patients with testicular germ cell tumours is not known and practice varies widely. In this cohort of 703 patients, only one patient who relapsed was picked up by additional clinic follow-up between 5 and 10 years. Thus, on the basis of this small series, the authors suggest that follow-up after five years may not be justified.
Thyroid Carcinoma with Bone Metastases: A Prognostic Factor Study
Authors: Wu Karl , Hou Shen-Mou , Huang Tien-Shang , Yang Rong-Sen
Published: September 2017

Objective

Occult clinical presentations usually hinder the early detection and management of patients with bone metastases from thyroid carcinoma. We retrospectively investigated the clinical outcomes of such patients from 1993 to 2004 and analyzed the prognostic parameters.

Design

The basic demographic data and manifestations of 44 patients who had thyroid carcinoma with bone metastases were reviewed. We studied the gender, age, locations of metastases, histological types, treatment methods, hypercalcemic episodes and results of treatments. We used Kaplan-Meier survival analysis and log-rank tests to access the statistical significance.

Main Outcome

The incidence of bone metastasis from thyroid carcinomas in this series was 5.0%. Twenty patients (45.4%) had follicular, 16 (36.3%) had papillary, 3 (6.8%) had anaplastic, 3 (6.8%) had medullary, and 2 (4.5%) had Hurthel cell carcinomas. Twelve patients had hypercalcemic episodes, ranging from 2.6 to 2.9 mmolL−1 (mean ± SD: 2.68 ± 0.15 mmolL−1). Survival time after bone metastases ranged from 2 months to 8 years (mean ± SD: 5.3 ± 1.3 years). The 5-year survival rate was 79.4% and the 10-year survival rate was 52.9%. Regarding the histological cancer type, patients with papillary and follicular cancers survived significantly longer than those with anaplastic and medullary cancers (p < 0.05). In addition, the patients presenting with hypercalcemia had the worst survival (p < 0.05).

Conclusions

Thyroid carcinoma can present with bone metastases in its early stage. We found that both tumor type and hypercalcemia were significant prognostic factors for survival time.
The Relationship between MR Demonstration of Extramural Venous Invasion and Nodal Disease in Rectal Cancer
Authors: Koh Dow-Mu , Smith Neil J. , Swift R. Ian , Brown Gina
Published: September 2017

Purpose

To investigate the relationship between extramural venous invasion (EMVI) detected at T2-weighted MRI and nodal disease rectal cancer compared with histopathology.

Materials and Methods

The MR imaging of 79 consecutive patients with rectal cancer who underwent primary rectal surgery without neoadjuvant treatment were reviewed. MR images were scored by an expert radiologist for the presence and degree of EMVI using a five point scale blinded to pathological findings. Receiver operating characteristic curve analyses were performed to determine the sensitivity and specificity of MRI scoring in predicting EMVI and nodal disease at histopathology.

Results

Compared with histology, an MR score of >2 was found to have 100% sensitivity (95% CI: 77%-100%) and 89% specificity (95% CI: 79%–96%) in identifying EMVI involving veins >3 mm in diameter. An EMVI score of >2 was had a sensitivity of 56% (95% CI: 30%–80%) and specificity of 81% (95% CI: 69%–90%) for identifying patients with stage N2 disease.

Conclusions

EMVI score of >2 on T2-weighted MR imaging has a high sensitivity and specificity for histopathologically proven extramural venous invasion involving venules ≥3 mm in diameter. However, EMVI scores have only moderate sensitivity in the predicting nodal involvement.
Oncolytic Viruses: Do They Have a Role in Anti-Cancer Therapy?
Authors: Prestwich Robin J , Errington Fiona , Harrington Kevin J. , Pandha Hardev S. , Selby Peter , Melcher Alan
Published: September 2017

Oncolytic viruses are replication competent, tumor selective and lyse cancer cells. Their potential for anti-cancer therapy is based upon the concept that selective intratumoral replication will produce a potent anti-tumor effect and possibly bystander or remote cell killing, whilst minimizing normal tissue toxicity. Viruses may be naturally oncolytic or be engineered for oncolytic activity, and possess a host of different mechanisms to provide tumor selectivity. Clinical use of live replicating viruses is associated with a unique set of safety issues. Clinical experience has so far provided evidence of limited efficacy and a favourable toxicity profile. The interaction with the host immune system is complex. An anti-viral immune response may limit efficacy by rapidly clearing the virus. However, virally-induced cell lysis releases tumor associated antigens in a ‘dangerous’ context, and limited evidence suggests that this can lead to the generation of a specific anti-tumor immune response. Combination therapy with chemotherapy or radiotherapy represents a promising avenue for ongoing translation of oncolytic viruses into clinical practice. Obstacles to therapy include highly effective non-specific host mechanisms to clear virus following systemic delivery, immune-mediated clearance, and intratumoral barriers limiting virus spread. A number of novel strategies are now under investigation to overcome these barriers. This review provides an overview of the potential role of oncolytic viruses, highlighting recent progress towards developing effective therapy and asks if they are a realistic therapeutic option at this stage.
Pre-operative Concomitant Radio-chemotherapy in Bulky Carcinoma of the Cervix: A Single Institution Study
Authors: De La Rochefordiere Anne , Kirova Youlia , Alran Severine , Plancher Corine , Fourchotte Virginie , Beuzeboc Philippe , De Margerie Vincent , Petrow Peter , Sastre-Garau Xavier , Servois Vincent , Scholl Suzy , Cottu Paul , Mignot Laurent , De Cremoux Patricia , Salmon Remy
Published: September 2017

Objective

To evaluate the treatment results of patients (pts) with FIGO stage IB2, IIA, IIB cervical carcinoma (CC) treated with pre-operative radio-chemotherapy, followed by extended radical hysterectomy.

Methods

Retrospective study of 148 women treated to the Institut Curie for operable FIGO Stage IB2 to IIB, biopsy proved CC. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio-cisplatinum based chemotherapy, intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test.

Results

Complete histological local-regional response was obtained in 56% of the pts (n = 39). Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%). All but one had in-situ microscopic residual CC. Lateral residual disease in the parametria was also present in 9 pts, all with residual CC. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%). Eight of 55 (11%) radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40%) radiological N1 (p = 0.03). Seventeen pts (25%) had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8–141), 38/70 patients (54.1%) are still alive and free of disease, 6 (8.6%) alive with disease, and 11 (15.8%) patients were lost for follow-up but free of disease.

In Conclusion

The treatment of locally advanced CC needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease.
Effect of Thiazolidinediones on the Erythropoeitic and Germinal Cells in the Male Wistar Rats
Authors: Rabbani Syed Imam , Devi Kshama , Khanam Salma
Published: September 2017

Hyperglycemia is the main determinant of long term diabetic complications mainly through induction of oxidative stress responsible for secondary defects including cancer, infertility etc. Thiazolidinediones (TZDs) are known to posses the antioxidant potential against the reactive oxygen species. The ability of clinically used TZDs like Rosiglitazone (RSG) and Pioglitazone (PIO) in diabetic complications is still need to be studied extensively in the literature. In this study, the role of RSG and PIO on the frequency of nuclear and germinal cell damage was studied using bone marrow micronucleus (MN) test, sperm shape abnormality and sperm count in normal animals. The drugs were tested in the three doses (1, 10 and 100 mg/kg) after acute (48 hrs and 72 hrs) and chronic (4 weeks) treatment. The results indicated that RSG has produced significant (p < 0.01) decrease in P/N (polychromatic and normochromatic erythrocytes) ratio at 10 and 100 mg/kg without affecting the frequency of micronucleated erythrocytes, sperm shape morphology and sperm count. PIO in the tested doses did not induce any change in P/N ratio and sperm count but the higher dose (100 mg/kg) showed suppression of MN in normochromatic erythrocytes and % sperm shape abnormality compared to the control group.
Potential of Neural Stem Cells for the Treatment of Brain Tumors
Authors: Taupin P.
Published: September 2017

Neural stem cells (NSCs) are self-renewing multipotent cells that generate the main phenotypes of the nervous system, neurons, astrocytes and oligodendrocytes. As such they hold the promise to treat a broad range of neurological diseases and injuries. Neural progenitor and stem cells have been isolated and characterized in vitro, from adult, fetal and post-mortem tissues, providing sources of material for cellular therapy. However, NSCs are still elusive cells and remain to be unequivocally identified and characterized, limiting their potential use for therapy. Neural progenitor and stem cells, isolated and cultured in vitro, can be genetically modified and when transplanted migrate to tumor sites in the brain. These intrinsic properties of neural progenitor and stem cells provide tremendous potential to bolster the translation of NSC research to therapy. It is proposed to combine gene therapy and cellular therapy to treat brain cancers. Hence, neural progenitor and stem cells provide new opportunities for the treatment of brain cancers.
Treated Colorectal Cancer: What is the Cost to Primary Care?
Authors: Macafee D.A.L. , West J. , Scholefield J.H. , Whynes D.K.
Published: September 2017

Background

Colorectal cancer is the second commonest cause of cancer death and the cost to primary care has not been estimated.

Aim

To determine the direct primary care costs of colorectal cancer care.

Design

Retrospective case note review.

Setting

Nottingham, United Kingdom.

Methods

We identified people with colorectal cancer between 1995 and 1998, from computerised pathology records. Colorectal cancer related resources consumed in primary care, from hospital discharge to death, were identified from retrospective notes review. Outcome measures were costs incurred by the General Practitioner (GP) and the total cost to primary care. We used multiple linear regression to identify predictors of cost.

Results

Of 416 people identified from pathology records, the median age at primary operation of the 135 (33%) people we selected was 74.2 (IQR 14.4) years, 75 (56%) were male. The median GP cost was: Dukes A £61.0 (IQR 516.2) and Dukes D £936.2 (1196.2) p < 0.01. The geometric mean ratio found Dukes D cancers to be 10 times as costly as Dukes A. The median total cost was: Dukes A £1038.3 (IQR 5090.6) and Dukes D £1815.2 (2092.5) p = 0.06. Using multivariate analysis, Dukes stage was the most important predictor of GP costs. For total costs, the presence of a permanent stoma was the most predictive variable, followed by adjuvant therapy and advanced Dukes stage (Dukes C and D).

Conclusions

Contrary to hospital based care costs, late stage disease (Dukes D) costs substantially more to general practice than any other stage. Stoma care products are the most costly prescribable item. Costs savings may be realised in primary care by screening detection of early stage colorectal cancers.
Role of Gut Microbiota in Early Infant Development
Authors: Wall R , Ross R.P , Ryan C.A , Hussey S , Murphy B , Fitzgerald G.F , Stanton C
Published: September 2017

Early colonization of the infant gastrointestinal tract is crucial for the overall health of the infant, and establishment and maintenance of non-pathogenic intestinal microbiota may reduce several neonatal inflammatory conditions. Much effort has therefore been devoted to manipulation of the composition of the microbiota through 1) the role of early infant nutrition, particularly breast milk, and supplementation of infant formula with prebiotics that positively influence the enteric microbiota by selectively promoting growth of beneficial bacteria and 2) oral administration of probiotic bacteria which when administered in adequate amounts confer a health benefit on the host. While the complex microbiota of the adult is difficult to change in the long-term, there is greater impact of the diet on infant microbiota as this is not as stable as in adults. Decreasing excessive use of antibiotics and increasing the use of pre- and probiotics have shown to be beneficial in the prevention of several important infant diseases such as necrotizing enterocolitis and atopic eczema as well as improvement of short and long-term health. This review addresses how the composition of the gut microbiota becomes established in early life, its relevance to infant health, and dietary means by which it can be manipulated.
INSIG2 is Associated with Lower Gain in Weight-for-Length between Birth and Age 6 Months
Authors: Wu Ann Chen , Gillman Matthew W. , Taveras Elsie M. , Litonjua Augusto A.
Published: September 2017

Researchers have described the association of a common DNA polymorphism, rs7566605, near INSIG2 (insulin-induced gene 2) with obesity in multiple independent populations that include subjects ages 11–60 years. 1 To our knowledge, no studies have examined the association of this polymorphism with weight status during early childhood. We explored the association of the rs7566605 polymorphism with weight-for-length among 319 children at 6 months and 3 years participating in Project Viva, a pre-birth cohort study. In contrast to studies of older individuals, CC homozygosity was associated with lower gain in weight-for-length z-score between birth and age 6 months than GG homozygosity or GC heterozygosity. At age 3, we did not find an association. The association of INSIG2 gene with obesity may change direction with age.
Body Fat Percentages by Dual-energy X-ray Absorptiometry Corresponding to Body Mass Index Cutoffs for Overweight and Obesity in Indian Children
Authors: Pandit Deepa , Chiplonkar Shashi , Khadilkar Anuradha , Khadilkar Vaman , Ekbote Veena
Published: September 2017

Background

Indians are suspected to have higher body fat percent at a given body mass index (BMI) than their western counterparts.

Objective

To estimate percent body fat in apparently healthy Indian children and adolescents by dual-energy X-ray absorptiometry (DXA) and explore linkages of BMI with body fat percent for better health risk assessment.

Methods

Age, weight, height of 316 boys and 250 girls (6–17 years) were recorded. Body composition was measured by dual-energy X-ray absorptiometry (DXA). High adiposity was defined as body fat percent (BF%) > McCarthy's 85th percentile of body fat reference data. Receiver operating characteristic analysis (ROC) was carried out for CDC BMI Z score for it's ability to judge excess fatness.

Results

High BF% was seen in 38.5% boys and 54.0% girls (p < 0.05). Percentage of obese children as defined by the BMI cutoffs of International Obesity Task Force (IOTF) (2.1% for boys and 6.9% for girls) was lower than that using Indian (13.7% for boys and 20.9% for girls) and CDC (14.1% for boys and 20.9% for girls) cutoffs. The point closest to one on the ROC curves of CDC BMI Z-scores indicated high adiposity at BMI cutoff of 22 at the age of 17 yr in both the genders.

Conclusions

Higher body fat percentage is associated with lower BMI values in Indian children.
Misdiagnosis of Child Abuse Related to Delay in Diagnosing a Paediatric Brain Tumour©
Authors: Wrennall Lynne
Published: September 2017

Conflicting opinion regarding the relative weight that should be allocated to the investigation of organic causes of child illness, compared to the pursuit of suspicions of child abuse, has generated considerable public debate. The discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness is at the centre of contention. In particular, concern has arisen that children's medical needs are being neglected when their conditions are misdiagnosed as child abuse.

This paper documents a case study in which the use of Child Protection procedures was linked to the belief that the child's illness had “no organic cause.” The case study is contextualised in a review of literature relevant to the diagnostic process.

The deployment of the Child Protection perspective resulted in significant delay in the diagnosis of the child's brain tumour. The child was ultimately found to be suffering from an optic chasm mass lesion involving the hypothalamus and the medial temporal regions, resulting in Diencephalic Syndrome. The evidence in this case is that erring on the side of suspecting Munchausen Syndrome by Proxy/Fabricated and Induced Illness, was not “erring on the side of the child.”

Several lessons need to be learned from the case. The importance of ensuring that the Child Protection perspective does not displace adequate assessment of alternative explanations for the child's condition is emphasised, as is the need for good communication in medical relationships. Strategies involving empathy, mediation, negotiation and conflict resolution may provide a more appropriate and therapeutic alternative to the use of Child Protection procedures in cases where the diagnosis is contentious. The need to re-write relevant policy, protocols and guidance is imperative.
Perinatal Factors Associated with Infant Maltreatment
Authors: Fujiwara Takeo , Okuyama Makiko , Tsui Haley , Koenen Karestan C.
Published: September 2017

Background

The association between birth outcomes and child maltreatment remains controversial. The purpose of this study is to test whether infants without congenital or chronic disease who are low birth weight (LBW), preterm, or small for gestational age (SGA) are at an increased risk of being maltreated.

Methods

A hospital-based case-control study of infants without congenital or chronic diseases who visited the National Center for Child Health and Development, Tokyo, between April 1, 2002 and March 31, 2005 was conducted. Cases (N = 35) and controls (N = 29) were compared on mean birth weight, gestational age, and z-score of birth weight.

Results

SGA was significantly associated with infant maltreatment after adjusting for other risk factors (adjusted odds ratio: 4.45, 95% CI: 1.29–15.3). LBW and preterm births were not associated with infant maltreatment.

Conclusion

Infants born as SGA are 4.5 times more at risk of maltreatment, even if they do not have a congenital or chronic disease. This may be because SGA infants tend to have poorer neurological development which leads them to be hard-to-soothe and places them at risk for maltreatment.

Abbreviations

SCAN, Suspected Child Abuse and Neglect; LBW, low birth weight; ZBW, z-score of birth weight adjusted for gestational age, sex, and parity; SGA, small for gestational age; SD, standard deviation; OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval; IPV, intimate partner violence.
Grading Gradients: Evaluating Evidence for Time-dependent Memory Reorganization in Experimental Animals
Authors: Akers Katherine G. , Frankland Paul W.
Published: September 2017

In humans, hippocampal damage typically produces temporally graded retrograde amnesia, with relative sparing of remote memories compared to recent memories. This observation led to the idea that as memories age, they are reorganized in a time-dependent manner. Here, we evaluate evidence for time-dependent memory reorganization in animal models. We conclude that, although hippocampal lesions may not always produce temporal gradients under all conditions, studies using alternate experimental approaches consistently support the idea that memories reorganize over time—becoming less dependent on the hippocampus and more dependent on a cortical network. We further speculate on the processes that drive memory reorganization such as sleep, memory reactivation, synaptic plasticity, and neurogenesis.
Synaptic Mechanisms of Activity-Dependent Remodeling in Visual Cortex during Monocular Deprivation
Authors: Rittenhouse Cynthia D. , Majewska Ania K
Published: September 2017

It has long been appreciated that in the visual cortex, particularly within a postnatal critical period for experience-dependent plasticity, the closure of one eye results in a shift in the responsiveness of cortical cells toward the experienced eye. While the functional aspects of this ocular dominance shift have been studied for many decades, their cortical substrates and synaptic mechanisms remain elusive. Nonetheless, it is becoming increasingly clear that ocular dominance plasticity is a complex phenomenon that appears to have an early and a late component. Early during monocular deprivation, deprived eye cortical synapses depress, while later during the deprivation open eye synapses potentiate. Here we review current literature on the cortical mechanisms of activity-dependent plasticity in the visual system during the critical period. These studies shed light on the role of activity in shaping neuronal structure and function in general and can lead to insights regarding how learning is acquired and maintained at the neuronal level during normal and pathological brain development.
Stratification of Antigen-presenting Cells within the Normal Cornea
Authors: Knickelbein Jared E. , Watkins Simon C. , Mcmenamin Paul G. , Hendricks Robert L.
Published: September 2017

The composition and location of professional antigen presenting cells (APC) varies in different mucosal surfaces. The cornea, long considered an immune-privileged tissue devoid of APCs, is now known to host a heterogeneous network of bone marrow-derived cells. Here, we utilized transgenic mice that express enhanced green fluorescent protein (EGFP) from the CD 11c promoter (pCD11c) in conjunction with immunohistochemical staining to demonstrate an interesting stratification of APCs within non-inflamed murine corneas. pCD11c+ dendritic cells (DCs) reside in the basal epithelium, seemingly embedded in the basement membrane. Most DCs express MHC class II on at least some dendrites, which extend up to 50 μm in length and traverse up 20 μm tangentially towards the apical surface of the epithelium. The DC density diminishes from peripheral to central cornea. Beneath the DCs and adjacent to the stromal side of the basement membrane reside pCD11c–CD11b+ putative macrophages that express low levels of MHC class II. Finally, MHC class II–pCD11c–CD11b+ cells form a network throughout the remainder of the stroma. This highly reproducible stratification of bone marrow-derived cells is suggestive of a progression from an APC function at the exposed corneal surface to an innate immune barrier function deeper in the stroma.
Interplay of community dynamics, temperature, and productivity on the hydrogen isotope signatures of lipid biomarkers
Authors: Ladd S. Nemiah , Dubois Nathalie , Schubert Carsten J.
Published: September 2017

Abstract. The hydrogen isotopic composition (δ2H) of lipid biomarkers has diverse applications in the fields of paleoclimatology, biogeochemistry, and microbial community dynamics. Large changes in hydrogen isotope fractionation have been observed among microbes with differing core metabolisms, while environmental factors including temperature and nutrient availability can affect isotope fractionation by photoautotrophs. Much effort has gone into studying these effects under laboratory conditions with single species cultures. Moving beyond controlled environments and quantifying the natural extent of these changes in freshwater lacustrine settings and identifying their causes is essential for robust application of δ2H values of common short-chain fatty acids as a proxy of net community metabolism and of phytoplankton-specific biomarkers as a paleohydrologic proxy. This work targets the effect of community dynamics, temperature, and productivity on 2H∕1H fractionation in lipid biomarkers through a comparative time series in two central Swiss lakes: eutrophic Lake Greifen and oligotrophic Lake Lucerne. Particulate organic matter was collected from surface waters at six time points throughout the spring and summer of 2015, and δ2H values of short-chain fatty acids, as well as chlorophyll-derived phytol and the diatom biomarker brassicasterol, were measured. We paired these measurements with in situ incubations conducted with NaH13CO3, which were used to calculate the production rates of individual lipids in lake surface water. As algal productivity increased from April to June, net discrimination against 2H in Lake Greifen increased by as much as 148 ‰ for individual fatty acids. During the same time period in Lake Lucerne, net discrimination against 2H increased by as much as 58 ‰ for individual fatty acids. A large portion of this signal is likely due to a greater proportion of heterotrophically derived fatty acids in the winter and early spring, which are displaced by more 2H-depleted fatty acids as phytoplankton productivity increases. Smaller increases in 2H discrimination for phytol and brassicasterol suggest that a portion of the signal is due to changes in net photoautotrophic 2H fractionation, which may be caused by increasing temperatures, a shift from maintenance to high growth, or changes in the community assemblage. The fractionation factors for brassicasterol were significantly different between the two lakes, suggesting that its hydrogen isotope composition may be more sensitive to nutrient regime than is the case for fatty acids or phytol.
Identifying (subsurface) anthropogenic heat sources that influence temperature in the drinking water distribution system
Authors: Agudelo-Vera Claudia M. , Blokker Mirjam , de Kater Henk , Lafort Rob
Published: September 2017

Abstract. The water temperature in the drinking water distribution system and at customers' taps approaches the surrounding soil temperature at a depth of 1 m. Water temperature is an important determinant of water quality. In the Netherlands drinking water is distributed without additional residual disinfectant and the temperature of drinking water at customers' taps is not allowed to exceed 25 °C. In recent decades, the urban (sub)surface has been getting more occupied by various types of infrastructures, and some of these can be heat sources. Only recently have the anthropogenic sources and their influence on the underground been studied on coarse spatial scales. Little is known about the urban shallow underground heat profile on small spatial scales, of the order of 10 m × 10 m. Routine water quality samples at the tap in urban areas have shown up locations – so-called hotspots – in the city, with relatively high soil temperatures – up to 7 °C warmer – compared to the soil temperatures in the surrounding rural areas. Yet the sources and the locations of these hotspots have not been identified. It is expected that with climate change during a warm summer the soil temperature in the hotspots can be above 25 °C. The objective of this paper is to find a method to identify heat sources and urban characteristics that locally influence the soil temperature. The proposed method combines mapping of urban anthropogenic heat sources, retrospective modelling of the soil temperature, analysis of water temperature measurements at the tap, and extensive soil temperature measurements. This approach provided insight into the typical range of the variation of the urban soil temperature, and it is a first step to identifying areas with potential underground heat stress towards thermal underground management in cities.
AIRBORNE LIDAR POINTS CLASSIFICATION BASED ON TENSOR SPARSE REPRESENTATION
Authors: Li N. , Pfeifer N. , Liu C.
Published: September 2017

Abstract. The common statistical methods for supervised classification usually require a large amount of training data to achieve reasonable results, which is time consuming and inefficient. This paper proposes a tensor sparse representation classification (SRC) method for airborne LiDAR points. The LiDAR points are represented as tensors to keep attributes in its spatial space. Then only a few of training data is used for dictionary learning, and the sparse tensor is calculated based on tensor OMP algorithm. The point label is determined by the minimal reconstruction residuals. Experiments are carried out on real LiDAR points whose result shows that objects can be distinguished by this algorithm successfully.