bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Broilers Supplemented With Peppermint (Mentha piperita L.) Powder
Authors: Asadi Nematollah , Husseini Seyed Davood , Tohidian Mohammad-Taghi , Abdali Nargess , Mimandipoure Amir , Rafieian-Kopaei Mahmoud , Bahmani Mahmoud
Published: April 2017

This study was conducted to determine the effects of dietary supplementation of peppermint ( Mentha piperita L.) on the performance of broiler chicks. 500 Ross broiler chicks were divided into 5 treatment groups of 4 replications in a completely randomized design format. The diets were ISO-caloric and ISO-nitrogenous ones and contained 1.5, 3, 4.5, and 6 g/kg of peppermint powder. At start, growing, and end periods, the effects of peppermint powder on average daily weight gain, feed conversation ratio, and mortality rate were studied. The results of the present study showed that over a production period of 42 days peppermint had a significant effect on average daily weight gain and feed conversation ratio when compared with the control group ( P < .05). The level of 4.5 g/kg had the highest average daily weight gain (52.78 g), and control treatment with 46.98 g had the least average daily weight gain among different levels of peppermint. The level of 4.5 g/kg and 6 g/kg of peppermint had the least mortality compared to control treatment during training period ( P < .05). From this experiment, we can conclude that treatment with 4.5 g/kg peppermint powder has better performance and carcass characteristics in broilers.
Risk Factors for Medical and Surgical Complications Following Single-Level ALIF
Authors: Choy Winward , Barrington Nikki , Garcia Roxanna M. , Kim Robert B. , Rodriguez Heron , Lam Sandi , Dahdaleh Nader , Smith Zachary A.
Published: April 2017

Study Design:

Retrospective cohort study.

Objective:

The objective of the study was to determine rates of medical and surgical postoperative complications following anterior lumbar interbody fusion (ALIF) along with their associated predictors.

Methods:

Using the American College of Surgeons National Surgical Quality Improvement database, patients who underwent single-level ALIF surgery from 2006 to 2013 were identified. The 30-day rate of postoperative medical and surgical complications along with associated risk factors were evaluated by multivariable logistic regression.

Results:

In total, 1474 patients were included in the analysis. The overall rate of complications was 14.5%. The medical complication rate was 12.7%, while the surgical complication rate was 2.8%. Predictors of surgical complications were diabetes (odds ratio [OR] = 2.79, 95% CI = 1.20-6.01, P = .009), corticosteroid dependence (OR = 4.94, 95% CI = 1.73-14.08, P = .003), and preoperative transfusion of >4 units (OR = 7.12, 95% CI = 1.43-35.37, P = .016). Predictors of medical complications were longer operative times (OR = 4.25, 95% CI = 2.90-6.24, P < .001), preoperative anemia (OR = 2.29, 95% CI = 1.50-3.50, P < .001), >10% weight loss prior to surgery (OR = 6.79, 95% CI = 1.01-45.93, P = .049), and more severe American Society of Anesthesiologists classification (OR = 2.18, 95% CI = 1.54-3.11, P < .001).

Conclusions:

The present study determines postoperative medical and surgical complications among patients undergoing ALIF. The risk factors elucidated in this study indicate that clinical practices to curtail complications should be targeted toward patients with preoperative anemia, weight loss, corticosteroid dependence, and toward those at risk for perioperative transfusions.
Effect of Cervical Sagittal Balance on Laminoplasty in Patients With Cervical Myelopathy
Authors: Kato Minori , Namikawa Takashi , Matsumura Akira , Konishi Sadahiko , Nakamura Hiroaki
Published: April 2017

Study Design:

Retrospective clinical study.

Objective:

We evaluated the relationship between cervical sagittal alignment parameters and clinical status in patients with cervical myelopathy and analyzed the effect of cervical sagittal balance on cervical laminoplasty.

Methods:

Patients with cervical myelopathy (n = 110) who underwent laminoplasty were included in this study. The relationship between cervical sagittal alignment parameters and clinical status was evaluated. The changes in radiographic cervical sagittal parameters and clinical status 2 years after surgery were compared between patients with preoperative C2-7 SVA ≥35 mm (group A) and those with preoperative C2-7 SVA <35 mm (group B).

Results:

Preoperatively, C2-7 SVA had no correlation with defined health-related quality of life evaluation scores. At 2-year follow-up, the improvement in SF-36 physical component summary was significantly lower in group A than in group B. The postoperative change of C2-7 SVA did not significantly differ in 2 groups. Patients in group A maintained cervical regional balance after laminoplasty but experienced extensive postoperative neck pain.

Conclusions:

Our patients with a C2-7 SVA of ≥35 mm maintained cervical regional balance after laminoplasty and their improvement in myelopathy was equivalent to that in patients with a C2-7 SVA of <35 mm. However, the patents with a C2-7 SVA of ≥35 mm experienced severe postoperative neck pain. C2-7 SVA is a parameter worth considering because it can lead to poor QOL and axial neck pain after laminoplasty.
Anti-apoptotic effect of dexamethasone in an ototoxicity model
Authors: Lee Jin Ho , Oh Se Heang , Kim Tae Ho , Go Yoon Young , Song Jae-Jun
Published: April 2017

Background

Dexamethasone (DEX) is used for the treatment of various inner ear diseases. However, the molecular mechanism of DEX on gentamicin induced hair cell damage is not known. Therefore, this study investigated the protective effect of DEX on gentamicin (GM)-induced ototoxicity and the effect of GM on the expression of apoptosis related genes.

Methods

The protective effects of DEX were measured by phalloidin staining of explant cultures of organ of Corti from postnatal day 2–3 mice with GM-induced hair cell loss. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining was used to detect apoptosis and immunofluorescence was done to analyze the effect of DEX on the expression of apoptosis related genes.

Results

Cochlear explant cultures of postnatal day-4-old mice were exposed to 0, 1, 5, 10, 30, 50, and 100 μg/ml DEX and GM during culture. DEX protected from GM-induced hair cell loss in the inner ear of postnatal day 4 mice. To understand the molecular mechanisms by which DEX pre-treatment decreased hair cell loss, the testes of cochlear explant cultures of postnatal day 4 mice were examined for changes in expression of cochlear apoptosis mediators. The pro-apoptotic protein Bax was significantly down-regulated and numbers of apoptotic hair cells were decreased.

Conclusions

DEX has a protective effect on GM-induced hair cell loss in neonatal cochlea cultures and the protective mechanism may involve inhibition of the mitochondrial apoptosis pathway. The combination with scaffold technique can improve delivery of DEX into the inner ear to protect GM-induced ototoxicity.
Clinical Significance of Androgen Receptor Splice Variant-7 mRNA Detection in Circulating Tumor Cells of Men With Metastatic Castration-Resistant Prostate Cancer Treated With First- and Second-Line Abiraterone and Enzalutamide
Authors: Antonarakis Emmanuel S. , Lu Changxue , Luber Brandon , Wang Hao , Chen Yan , Zhu Yezi , Silberstein John L. , Taylor Maritza N. , Maughan Benjamin L. , Denmeade Samuel R. , Pienta Kenneth J. , Paller Channing J. , Carducci Michael A. , Eisenberger Mario A. , Luo Jun
Published: April 2017

Purpose

We reported previously that the detection of androgen receptor splice variant-7 (AR-V7) mRNA in circulating tumor cells (CTCs) correlated with poor outcomes from the use of abiraterone and enzalutamide in patients with castration-resistant prostate cancer (CRPC). Here, we expanded our cohort size to better characterize the prognostic significance of AR-V7 in this setting.

Methods

We prospectively enrolled 202 patients with CRPC starting abiraterone or enzalutamide and investigated the prognostic value of CTC detection (+ v –) and AR-V7 detection (+ v –) using a CTC-based AR-V7 mRNA assay. We examined ≥ 50% prostate-specific antigen (PSA) responses, PSA progression-free survival, clinical and radiologic progression-free survival, and overall survival. We constructed multivariable models adjusting for PSA, Gleason sum, number of prior hormone therapies, prior abiraterone or enzalutamide use, prior taxane use, presence of visceral metastases, and Eastern Cooperative Oncology Group score. We also separately examined the first-line and second-line novel hormonal therapy (NHT) settings.

Results

Median follow-up times were 15.0, 21.7, and 14.6 months for CTC–, CTC+/AR-V7– and CTC+/AR-V7+ patients, respectively. CTC+/AR-V7+ patients were more likely to have Gleason scores ≥ 8 ( P = .05), metastatic disease at diagnosis ( P = .01), higher PSA ( P < .01), prior abiraterone or enzalutamide use ( P = .03), prior taxane use ( P = .02), and Eastern Cooperative Oncology Group ≥ 1 ( P = .01). Outcomes for the overall cohort (and separately for the first-line and second-line NHT cohorts) were best for CTC– patients, intermediate for CTC+/AR-V7– patients, and worse for CTC+/AR-V7+ patients. These correlations remained significant in multivariable models.

Conclusion

This expanded analysis further characterizes the importance of CTC-based AR-V7 mRNA detection in predicting outcomes in patients with CRPC receiving first- and second-line NHT and, to the best of our knowledge, is the first to suggest that this assay be interpreted using three separate prognostic categories: CTC–, CTC+/AR-V7–, and CTC+/AR-V7+.
Pain With Different Ablation Techniques in Healthy Cervical Tissue
Authors: Alfaro Karla , Ore Ana Sofia , Zevallos Albert , Salinas Manuel , Garai Jillian , Cremer Miriam
Published: April 2017

Abstract 21

Background:

Traditional cryotherapy and thermoablation are safe and effective treatments for precancerous cervical lesions. Women can present with short-term pain during and after the procedures. Comparing conventional treatments with CryoPen (CryoPen, Corpus Christi, TX) will stablish efficacy and adverse effects with the goal of developing low-cost, effective treatments for developing countries. We undertook this work to determine pain after treatment with conventional cryotherapy with CO2, the CryoPen adapted for low-resource settings, and the thermocoagulator.

Methods:

One hundred twenty-five women age 25 to 65 years who were scheduled for hysterectomy for indications other than cervical pathology were randomly assigned to one of five treatment arms: single- and double-freeze arms for conventional cryotherapy and the adapted CryoPen, and a single application of thermoablation at 100° C for 40 seconds. Treatment was administered 12 to 24 hours before hysterectomy. By using the verbal numerical pain scale, treating physicians asked participants to rate their pain intensity from 0 to 10.

Results:

To date, 118 pain scores have been collected—23 single-freeze and 25 double-freeze conventional cryotherapy; 23 single-freeze and 25 double-freeze CryoPen; and 22 thermoablation. Pain ranged from 0 to 3 for single-freeze cryotherapy, 0 to 4 for double-freeze cryotherapy, 0 to 6 for single-freeze CryoPen, 1 to 8 for double-freeze CryoPen, and 2 to 8 for thermoablation. In descending order of median pain scores, thermoablation (3) was followed by double-freeze CryoPen (2.5), single-freeze CryoPen and double-freeze conventional cryotherapy (both 2), and single-freeze conventional cryotherapy ( Fig 1 ).

Conclusion:

Both conventional cryotherapy and CryoPen are less painful ablation techniques compared with thermoablation. Lower pain ratings for single-freeze compared with double-freeze strategies with both conventional cryotherapy and CryoPen support further research into the rationale for the traditional double-freeze regimen. [Figure: see text]

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Karla Alfaro No relationship to disclose Ana Sofia Ore No relationship to disclose Albert Zevallos No relationship to disclose Manuel Salinas No relationship to disclose Jillian Garai No relationship to disclose Miriam Cremer Honoraria: Merck Speakers' Bureau: Merck
Depth of Necrosis Using Different Ablation Techniques in Healthy Cervical Tissue
Authors: Cremer Miriam , Alfaro Karla , Maza Mauricio , Castle Philip E. , Zevallos Albert , Diaz de Uriarte Ana Cecilia , Alvarez Manuel , Salinas Manuel , Ore Ana Sofia , Taxa Luis , Felix Juan
Published: April 2017

Abstract 22

Background:

Screening followed by treatment has been a key contributor to the reduction of cervical cancer in industrialized countries and is critical to reduce its burden in low-resource countries. Screening technologies that are appropriate for low-resource settings have advanced considerably; however, treatment technologies have lagged. Treatment methods that are used in developing countries must be low cost, effective, and adaptable for areas with limited infrastructure and health care providers. This study was performed to determine the depth of necrosis in cervical tissue achieved with three treatment devices: conventional cryotherapy with CO2, the CryoPen (CryoPen, Corpus Christi, TX) adapted for low-resource settings, and the thermocoagulator.

Methods:

One hundred twenty-five women who were scheduled for hysterectomy for indications other than cervical pathology were randomly assigned to one of five treatment arms: single-freeze arms and double-freeze arms for both conventional cryotherapy and the adapted CryoPen, and a single application of thermoablation at 100° C for 40 seconds. Treatment was administered 12 to 24 hours before hysterectomy. Depth of necrosis in cervical specimens was measured by pathologists who were blinded to the treatment modality.

Results:

A total of 119 women have been enrolled to date, and 114 specimens have been reviewed. Mean depth of necrosis is 5.1 mm (0.9 to 8.5 mm) for single-freeze cryotherapy, 5.6 mm (3.8 to 10.5 mm) for double-freeze cryotherapy, 4.9 mm (3.5 to 8.5 mm) for single-freeze adapted CryoPen; 4.5 mm (3.0 to 7.3 mm) for double-freeze adapted CryoPen, and 3.7 mm (1.9 to 5.5 mm) for the thermoablation ( Table 1 ).

Conclusion:

The depths of necrosis achieved with the three different ablation modalities are competitive and surpass the targeted depth of 3.5 mm established a priori. Results thus far have demonstrated that devices that are optimized for use in low-resource settings can be as effective as conventional cryotherapy in treating cervical intraepithelial neoplasia. [Table: see text]

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Miriam Cremer Honoraria: Merck Speakers' Bureau: Merck Travel, Accommodations, Expenses: Merck Other Relationship: Basic Health International Karla Alfaro No relationship to disclose Mauricio Maza No relationship to disclose Philip E. Castle No relationship to disclose Albert Zevallos No relationship to disclose Ana Cecilia Diaz de Uriarte No relationship to disclose Manuel Alvarez No relationship to disclose Manuel Salinas No relationship to disclose Ana Sofia Ore No relationship to disclose Luis Taxa No relationship to disclose Juan Felix Expert Testimony: Johnson & Johnson, Philip Morris
High Urinary Polycyclic Aromatic Hydrocarbon Concentrations in Bomet County, Kenya, a Region With a High Incidence of Esophageal Squamous Cell Carcinoma
Authors: Pritchett Natalie R. , Murphy Gwen , Etemadi Arash , Burgert Stephen L. , Abnet Christian C. , Dawsey Sanford M. , Mwachiro Michael M.
Published: April 2017

Abstract 43

Background:

Polycyclic aromatic hydrocarbons (PAHs) are a group of more than 100 compounds that are formed during incomplete combustion of organic materials, many of which have been classified as known carcinogens. Exposure to PAHs has been suggested as an important risk factor for developing esophageal squamous cell carcinoma (ESCC) in several high-incidence areas, such as China and Iran, but corresponding PAH assessments have not been conducted in East Africa, another ESCC hot spot. To assess the internal uptake of PAH as a result of external exposures, body fluids and tissues can be monitored for PAHs or their metabolites. The primary aim of this study was to quantify the concentration of seven PAH urine metabolites in a cross-section of participants from Bomet, Kenya, an endemic area for ESCC. An additional aim was to assess demographic and lifestyle factors that may be associated with PAH metabolites.

Methods:

A community-based sample of 294 asymptomatic adults were recruited. Participants collected spot urine specimens and completed a questionnaire. Urine specimens were analyzed at the National Center for Environmental Health at the Centers for Disease Control—the same lab has performed similar analyses on urine samples from the US National Health and Nutrition Examination Survey (NHANES). The seven PAH analytes were hydroxylated metabolites of naphthalene, fluorene, phenanthrene, and pyrene. Median creatinine-adjusted PAH metabolite concentrations (nanogram per gram of creatinine) were compared by all relevant questionnaire items.

Results:

All seven measured PAH metabolites in the study population were markedly elevated compared with the US population. For example, the median value for 1-hydroxypyrene in Bomet was 1,190 ng/g in males versus 106 ng/g in NHANES, and 2,840 ng/g in females versus 133 ng/g in NHANES. Age (< 50 years), sex (female), and performing indoor cooking were significantly ( P < .01) associated with higher PAH concentrations for all measured metabolites. Regular tobacco use was not reported by many participants (19%) and was not associated with PAH concentrations.

Conclusion:

PAH metabolite concentrations in Bomet were high compared with the US population. Elevated PAH concentrations were associated with age, sex, and indoor cooking. Additional studies are needed to define the association between high PAH exposure and the risk of developing ESCC as well as to determine the sources of PAH exposure in this high-risk population. Funding: The African Organization for Research and Training in Cancer’s Beginning Investigator Grant for Catalytic Research (BIG Cat) Program, in collaboration with the US National Institutes of Health’s National Cancer Institute, Office of International Affairs.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
Cervical Pap Smear Cytology at Kamuzu Central Hospital in Malawi: A Quality Assurance Study
Authors: Liauw Daniel , Dhungel Bal Mukunda , Tomoka Tamiwe , Krysiak Robert , Kampani Coxcilly , Chimzimu Fred , Fedoriw Yuri
Published: April 2017

Abstract 53

Background:

Cervical cancer remains the most common cancer in women of the developing world, largely as a result of a lack of screening. The gold standard screening test for cervical cancer, the Pap smear, has been effective in reducing cervical cancer incidence and mortality by identifying precancerous and cancerous lesions; however, little is known about quality assurance practices for gynecologic cytopathology in resource-limited settings. The goal of this study was to document baseline clinical and laboratory characteristics in the hope of improving the efficacy of cervical cancer screening and informing future quality improvement initiatives.

Methods:

A retrospective study of cervical cytology at Kamuzu Central Hospital, Malawi, from January 1, 2013, to April 30, 2016, was conducted.

Results:

Of 2,809 Pap smears processed, 2,396 (85.3%) samples were diagnostic, with 92.3% of nondiagnostic smears (381 of 413) deemed unsatisfactory because of improper collection techniques. The 18-month patient follow-up rate for unsatisfactory Pap smear was found to be 23.0% (n = 95), with repeat smears reflecting a similar satisfactory rate (n = 82; 86%). Of diagnostic Pap smears, 6.1% (n = 147) were premalignant, whereas 2.0% (n = 48) were malignant. Cytology-histology correlation was also investigated one the basis of the corresponding samples collected concurrently. Of 70 pairs, 55 pairs (78.6%) were concordant, whereas six (8.6%) and nine (12.9%) were majorly and minorly discordant, respectively. The sensitivity and specificity of the Pap smear as a screening test were 83.8% and 81.8%, respectively.

Conclusion:

The Pap smear is a sensitive and specific screening method for cervical cancer in our setting. We hope that documentation of baseline quality and services of cervical cytology will inform future quality assurance programs and assist other laboratories in the development of similar programs in resource-limited settings.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Daniel Liauw No relationship to disclose Bal Mukunda Dhungel No relationship to disclose Tamiwe Tomoka No relationship to disclose Robert Krysiak No relationship to disclose Coxcilly Kampani No relationship to disclose Fred Chimzimu No relationship to disclose Yuri Fedoriw Honoraria: Alexion Pharmaceuticals Consulting or Advisory Role: Alexion Pharmaceuticals
Feasibility Study of Molecular Profiling of Gastric Cancer Specimens From Rwanda
Authors: Chamberlin Mary D. , Rugwizangoga Belson , DeAbreu Francine B. , Rutaganda Eric , Dusabejambo Vincent , Habyarimana Oswald , Bensen Steve , Tsongalis Gregory J.
Published: April 2017

Abstract 51

Background:

Gastric cancer is associated with high mortality in Rwanda. Geographic or genetic differences may lead to variations in somatic mutations and novel therapies. Overseas collaboration to determine gastric cancer molecular profiles is paramount. We undertook this work to determine the feasibility of collaboration between researchers in Rwanda and the United States by creating a research platform for gastric and other cancers in Rwanda.

Methods:

Patients consented for biopsy. Cases that were confirmed as gastric adenocarcinoma were included. Formalin-fixed paraffin-embedded tissue blocks or eight unstained sections (4 μm) were transported to the United States. DNA extraction and library preparation was performed by using 50 ng gDNA. Samples were normalized, pooled, and sequenced by using the Pillar NGS SLIMamp Lung Hot Spot Panel (Pillar Biosciences, Natick, MA). FASTq files were uploaded to Pillar Biosciences to perform sequence alignment, annotation, and variant classification.

Results:

Fifty-seven samples were received and 35 were excluded because of low DNA yield or quality (18 and 17, respectively). Mutations were detected in nine (41%) of 22 samples. One sample contained three mutations, other cases had one to two mutations identified. In total, 12 mutations were identified: TP53 (four), SMAD4 (two), ERBB4 (two; S341L and D228N), PTEN (two; K267RfsTer9 and C136Y), FBXW7 (one), and KRAS (one).

Conclusion:

Overseas collaboration for the molecular profiling of gastric cancer samples is feasible. Quality improved with larger biopsies or tissue blocks. Frequency of mutations is lower than expected. ERBB4 mutations identified are not known to be pathogenic. PTEN mutations are considered pathogenic—a potential target for therapy in larger trials. A larger fusion panel may be more effective in identifying potential targets. Funding: Pillar Biosciences provided reagents for sequencing.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Mary D. Chamberlin Research Funding: Pillar Biosciences Belson Rugwizangoga No relationship to disclose Francine B. DeAbreu No relationship to disclose Eric Rutaganda No relationship to disclose Vincent Dusabejambo No relationship to disclose Oswald Habyarimana No relationship to disclose Steve Bensen No relationship to disclose Gregory J. Tsongalis Honoraria: Roche, ChromaCode, Foundation Medicine, Physician Choice Labs Consulting or Advisory Role: Baystate Health System, Jackson Laboratory for Genomic Medicine (Inst) Research Funding: Qiagen, Illumina, QuanDx, Leica Biosystems, Abbott Molecular, Affymetrix
Grassroots Partnership to See and Treat Cervical Cancer in Rural Uganda
Authors: Cherniak William , Stern Eben , Picart Carol , Sinasac Sarah , Iwasa Carolyn , Silverman Michael , Anguyo Geoffrey
Published: April 2017

Abstract 9

Background:

In Uganda, cervical cancer is the leading cause of cancer death, affecting 45 in every 100,000 women annually and killing 25 in every 100,000 annually. To effect change, two Canadian registered charities partnered with a Ugandan nongovernmental organization, a university, and the Ministry of Health to develop a novel screening, treatment, and educational training program. The two major goals of our program were to develop a training program for health care providers in southwestern Uganda for visual inspection of the cervix with acetic acid (VIA) and a cryotherapy see and treat model; and to implement the first cervical cancer screening program of its kind in the Kabale region of southwestern Uganda.

Methods:

Our program was developed in partnership with Mbarara University of Science and Technology, a grass-roots Ugandan community development organization (Kigezi Healthcare Foundation [KIHEFO]), a Canadian charity that is focused on providing medical and dental care and educational training and infrastructure development (Bridge to Health Medical and Dental), and a Canadian charity that is focused on treatment for advanced cervical cancer (Road to Care).

Results:

Requisite supplies were obtained by Bridge to Health Medical and Dental and left behind with KIHEFO. A partnership was formed between academia, government, and civil society across Canada and Uganda. Over 5 days, 15 Ugandan health care workers were trained in VIA and cryotherapy, and 96 patients were screened for cervical cancer. Six patients were successfully treated for precancerous lesions. One biopsy was sent for pathology review and analysis.

Conclusion:

Since the pilot program, KIHEFO has conducted two additional cervical cancer screening programs using VIA and the see and treat approach. A new cervical cancer screening and treatment campaign, along with a quality control and educational training refresher, for the original 15 health care providers is planned for February 2017. Funding: Bridge to Health Medical and Dental and Kigezi Healthcare Foundation in partnership with the Ugandan Ministry of Health.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
Adequacy of Cancer Pain Management and Pain Interference With Daily Functioning Among Patients Visiting the Oncology Ward of an Ethiopian University
Authors: Tegegn Henok G. , Gebreyohannes Eyob A.
Published: April 2017

Abstract 4

Background:

Pain is the most common of symptoms among patients with cancer. Cancer pain has also been associated with interference in the daily activity, reported by nearly one half of patients with cancer. Despite the availability of several established guidelines for management of cancer pain, undertreatment is well documented. We aimed to assess the adequacy of cancer pain treatment, its subsequent interference on daily functioning, and associated factors in the oncology ward of Gondar University Hospital.

Methods:

This cross-sectional study was conducted from February 15, 2016, to May 15, 2016, in the oncology ward of Gondar University Hospital. A questionnaire-based interview using the Brief Pain Inventory-Short Form and chart review were used

Results:

Of 83 patients with cancer, 76 (91.6%) experienced pain with varying degrees of severity. Fifty-four patients (65%) had received inadequate cancer pain treatment, with a negative pain management index. Of 76 patients with cancer who experienced pain, 68 (89.2%) experienced pain interference with their daily activities. Educational level, metastasis status, and number and types of analgesics for adequacy of cancer pain management, whereas tumor stage, presence of metastasis, history of treatment modality, history of pain, and pain management adequacy for pain interference in patient daily functioning were identified as statistically significantly predicting factors.

Conclusion:

It is vital to anticipate and assess the pain of patients with cancer as a routine clinical practice to optimize analgesic therapy through identification of barriers to adequate pain management and intervening, thereby improving patient health outcome and quality of life.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from either author.
Analysis of Delays in Breast Cancer Treatment and Late-Stage Diagnosis in Kazakhstan By Using Electronic Cancer Registry Data
Authors: Chukmaitov Askar S. , Sianghpoe Umaporn , Kaidarova Dilyara R. , Talaeva Snnar T. , Sheppard Vanessa B. , Ettner Susan L.
Published: April 2017

Abstract 27

Background:

Although Kazakhstan (KZ) has made significant investments to improve population health, high cancer rates persist, with breast cancer as the most prevalent. We assessed factors that contribute to delays in treatment and late staging for patients with breast cancer.

Methods:

A retrospective follow-up study design was used. By using 2014 registry data, we identified 4,248 patients with breast cancer who were treated at cancer centers in the 16 KZ regions. Patients with delays in treatment as a result of medical errors and other reasons were identified. We used logistic regression to estimate associations of delays with patient demographics, occupation, and cancer center region; and associations of late-stage (III and IV) cancer diagnosis with delays in treatment while controlling for patient demographics, occupation, and cancer center region.

Results:

Approximately 9% (n = 378) of patients experienced delayed treatment. Older and Russian patients as well as those treated in regions further away from Almaty City had significantly higher adjusted risk of delayed treatment. However, risk of late-stage diagnosis was greater for patients who were treated in Almaty City and for those who were Russian, unemployed, or who had delayed treatment.

Conclusion:

The main driver of delayed treatment was cancer center region. Patients who were treated in Almaty City, where the national cancer research and treatment center is located, had fewer delays in treatment but a higher likelihood of late-stage diagnosis, likely as a result of referrals of sicker patients from neighboring regions. These findings suggest that referrals to new tertiary care centers being developed in KZ may reduce treatment delays but affect facility case mix. Future research will examine the role played by distance to cancer centers in access to specialty care and whether tertiary care is associated with improved outcomes conditional on case mix.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from the authors.
Building the Global Cancer Workforce: Assessing the Cancer Research and Control Progress of Low- and Middle-Income Country Participants in the National Cancer Institute Summer Curriculum in Cancer Prevention
Authors: Morgan Camille , Williams Makeda
Published: April 2017

Abstract 48

Background:

The National Cancer Institute (NCI) Summer Curriculum in Cancer Prevention, hosted by NCI’s Cancer Prevention Fellowship Program, has provided interdisciplinary training to physicians, scientists, nurses, and other cancer health care professionals in the principles and practice of cancer prevention, control, and molecular biology and genetics. Since 1998, the summer curriculum has enrolled an increasing number of international participants, with many nominees from All-Ireland NCI Cancer Consortium and the International Atomic Energy Agency’s Programme of Action for Cancer Therapy. NCI’s Center for Global Health selects meritorious international participants, specifically from low- and middle-income countries (LMICs), and has offered limited travel and subsistence scholarships. In spring 2016, the Center for Global Health conducted an evaluation of LMIC participants from 1999 to 2015 to assess the impact of the summer curriculum on participants’ engagement and activities in cancer research and control, including peer-reviewed publications, grants received, scientific presentations, cancer control planning, and advocacy.

Methods:

We surveyed participants about these topics by using an electronic survey system (Questionnaire Design Studio, v3.0) and analyzed responses in SPSS (SPSS, Chicago, IL) and Excel (Microsoft, Redmond, WA).

Results:

Of 427 LMIC participants from 1999 to 2015, 357 were surveyed via e-mail invitations to an online survey link, of which 156 responded (44%) during a 4-week study period with follow-up. Overall, 97% report using the knowledge and skills acquired frequently or sometimes, and 80% reported training at least one other person in course content. Nearly 50% reported publishing and 27% reported receiving research funding, of which 84% had not received a grant before participation.

Conclusion:

Participation of international attendees at the NCI Summer Curriculum builds a global cancer community, utilizing the expertise of Cancer Prevention Fellowship Program in training the cancer health care workforce.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

No COIs from either author.
Sex-Specific Life Course Changes in the Neuro-Metabolic Phenotype of Glut3 Null Heterozygous Mice: Ketogenic Diet Ameliorates Electroencephalographic Seizures and Improves Sociability
Authors: Dai Yun , Zhao Yuanzi , Tomi Masatoshi , Shin Bo-Chul , Thamotharan Shanthie , Mazarati Andrey , Sankar Raman , Wang Elizabeth A. , Cepeda Carlos , Levine Michael S. , Zhang Jingjing , Frew Andrew , Alger Jeffry R. , Clark Peter M. , Sondhi Monica , Kositamongkol Sudatip , Leibovitch Leah , Devaskar Sherin U.
Published: April 2017

We tested the hypothesis that exposure of glut3+/− mice to a ketogenic diet ameliorates autism-like features, which include aberrant behavior and electrographic seizures. We first investigated the life course sex-specific changes in basal plasma–cerebrospinal fluid (CSF)–brain metabolic profile, brain glucose transport/uptake, glucose and monocarboxylate transporter proteins, and adenosine triphosphate (ATP) in the presence or absence of systemic insulin administration. Glut3+/− male but not female mice (5 months of age) displayed reduced CSF glucose/lactate concentrations with no change in brain Glut1, Mct2, glucose uptake or ATP. Exogenous insulin-induced hypoglycemia increased brain glucose uptake in glut3+/− males alone. Higher plasma-CSF ketones (β-hydroxybutyrate) and lower brain Glut3 in females vs males proved protective in the former while enhancing vulnerability in the latter. As a consequence, increased synaptic proteins (neuroligin4 and SAPAP1) with spontaneous excitatory postsynaptic activity subsequently reduced hippocampal glucose content and increased brain amyloid β1-40 deposition in an age-dependent manner in glut3+/− males but not females (4 to 24 months of age). We then explored the protective effect of a ketogenic diet on ultrasonic vocalization, sociability, spatial learning and memory, and electroencephalogram seizures in male mice (7 days to 6 to 8 months of age) alone. A ketogenic diet partially restored sociability without affecting perturbed vocalization, spatial learning and memory, and reduced seizure events. We conclude that (1) sex-specific and age-dependent perturbations underlie the phenotype of glut3+/− mice, and (2) a ketogenic diet ameliorates seizures caused by increased cortical excitation and improves sociability, but fails to rescue vocalization and cognitive deficits in glut3+/− male mice.
Emerging Roles for MicroRNAs in Diabetic Microvascular Disease: Novel Targets for Therapy
Authors: Zhang Yu , Sun Xinghui , Icli Basak , Feinberg Mark W.
Published: April 2017

Chronic, low-grade systemic inflammation and impaired microvascular function are critical hallmarks in the development of insulin resistance. Accordingly, insulin resistance is a major risk factor for type 2 diabetes and cardiovascular disease. Accumulating studies demonstrate that restoration of impaired function of the diabetic macro- and microvasculature may ameliorate a range of cardiovascular disease states and diabetes-associated complications. In this review, we focus on the emerging role of microRNAs (miRNAs), noncoding RNAs that fine-tune target gene expression and signaling pathways, in insulin-responsive tissues and cell types important for maintaining optimal vascular homeostasis and preventing the sequelae of diabetes-induced end organ injury. We highlight current pathophysiological paradigms of miRNAs and their targets involved in regulating the diabetic microvasculature in a range of diabetes-associated complications such as retinopathy, nephropathy, wound healing, and myocardial injury. We provide an update of the potential use of circulating miRNAs diagnostically in type I or type II diabetes. Finally, we discuss emerging delivery platforms for manipulating miRNA expression or function as the next frontier in therapeutic intervention to improve diabetes-associated microvascular dysfunction and its attendant clinical consequences.
Acute Hypercortisolemia Exerts Depot-Specific Effects on Abdominal and Femoral Adipose Tissue Function
Authors: Manolopoulos Konstantinos N. , O’Reilly Michael W. , Bujalska Iwona J. , Tomlinson Jeremy W. , Arlt Wiebke
Published: April 2017

Context:

Glucocorticoids have pleiotropic metabolic functions, and acute glucocorticoid excess affects fatty acid metabolism, increasing systemic lipolysis. Whether glucocorticoids exert adipose tissue depot-specific effects remains unclear.

Objective:

To provide an in vivo assessment of femoral and abdominal adipose tissue responses to acute glucocorticoid administration.

Design and Outcome Measures:

Nine healthy male volunteers were studied on two occasions, after a hydrocortisone infusion (0.2 mg/kg/min for 14 hours) and a saline infusion, respectively, given in randomized double-blind order. The subjects were studied in the fasting state and after a 75-g glucose drink with an in vivo assessment of femoral adipose tissue blood flow (ATBF) using radioactive xenon washout and of lipolysis and glucose uptake using the arteriovenous difference technique. In a separate study (same infusion design), eight additional healthy male subjects underwent assessment of fasting abdominal ATBF and lipolysis only. Lipolysis was assessed as the net release of nonesterified fatty acids (NEFAs) from femoral and abdominal subcutaneous adipose tissue.

Results:

Acute hypercortisolemia significantly increased basal and postprandial ATBF in femoral adipose tissue, but the femoral net NEFA release did not change. In abdominal adipose tissue, hypercortisolemia induced substantial increases in basal ATBF and NEFA release.

Conclusions:

Acute hypercortisolemia induces differential lipolysis and ATBF responses in abdominal and femoral adipose tissue, suggesting depot-specific glucocorticoid effects. Abdominal, but not femoral, adipose tissue contributes to the hypercortisolemia-induced systemic NEFA increase, with likely contributions from other adipose tissue sources and intravascular triglyceride hydrolysis.
How to Measure Adipose Tissue Insulin Sensitivity
Authors: Søndergaard Esben , Espinosa De Ycaza Ana Elena , Morgan-Bathke Maria , Jensen Michael D.
Published: April 2017

Context and Objective:

Adipose tissue insulin resistance may cause hepatic and skeletal muscle insulin resistance by releasing excess free fatty acids (FFAs). Because no consensus exists on how to quantify adipose tissue insulin sensitivity we compared three methods for measuring adipose tissue insulin sensitivity: the single step insulin clamp, the multistep pancreatic clamp, and the adipose tissue insulin resistance index (Adipo-IR).

Design and Participants:

We studied insulin sensitivity in 25 adults by measuring the insulin concentration resulting in 50% suppression of palmitate flux (IC50) using both a multistep pancreatic clamp and a one-step hyperinsulinemic-euglycemic clamp. Palmitate kinetics were measured using a continuous infusion of [U-13C]palmitate. Adipo-IR was calculated from fasting insulin and fasting FFA concentrations.

Results:

Adipo-IR was reproducible (sample coefficient of variability, 10.0%) and correlated with the IC50 measured by the multistep pancreatic clamp technique (r, 0.86; P < 0.001). Age and physical fitness were significant predictors of the residual variation between Adipo-IR and IC50, with a positive relationship with age (r, 0.47; P = 0.02) and a negative association with VO2 peak (r, −0.46; P = 0.02). Likewise, IC50 measured by the multistep pancreatic clamp technique correlated with IC50 measured using the one-step hyperinsulinemic-euglycemic clamp technique (r, 0.73; P < 0.001).

Conclusion:

Adipo-IR and the one-step hyperinsulinemic-euglycemic clamp technique using a palmitate tracer are good predictors of a gold standard measure of adipose tissue insulin sensitivity. However, age and physical fitness systematically affect the predictive values. Although Adipo-IR is suitable for larger population studies, the multistep pancreatic clamp technique is probably needed for mechanistic studies of adipose tissue insulin action.
The Authoritarian Personality Revisited: Reading Adorno in the Age of Trump
Authors: Gordon Peter E.
Published: April 2017

The landmark 1950 study in social psychology The Authoritarian Personality represents a significant attempt to correlate right-wing political orientation with psychological or characterological dispositions. As a collaborator and coauthor of the study, Theodor W. Adorno brought to the research project a unique set of philosophical and social-theoretical concerns that were not always consonant with the stated aims or underlying assumptions of the group. In his “Remarks on The Authoritarian Personality” (a text that was not included in the published 1950 work), Adorno laid out a series of objections that call into question the notion of an underlying personality structure; they suggest that under the modern conditions of the late-capitalist culture industry, the individual as a psychic unity is beginning to dissolve. This dissenting perspective deserves notice, especially in an age that has seen the reemergence of authoritarian politics in the United States.
Postdigital Global Literary History: On the Fourth Edition ofThe Princeton Encyclopedia of Poetry and Poetics
Authors: Reed Brian
Published: April 2017

This review essay takes the occasion of the publication of the Fourth Edition of The Princeton Encyclopedia of Poetry and Poetics to ask what it might mean, in the digital present, to use print as a medium for trying to speak comprehensively and authoritatively about the history of poetry around the world from beginning to present. It argues that this particular reference work is a “postdigital” creation that makes use of the format of the print codex to suggest that its plethora of authors and entries, whatever their disagreements and failings, have been assembled into a global community of scholars collectively capable of recounting the whole of poetry's history as an art form. Particular attention is paid to The Princeton Encyclopedia's coverage of poetry by North American indigenous writers.
Leo Strauss, Τα τρία κύματα της νεωτερικότητας
Authors: Βερτζάγια (Despina Vertzagia) Δέσποινα
Published: April 2017

Greek translation of Leo Strauss, The three waves of modernity
Canine pancreatitis — a challenging disease. Part 1
Authors: Dröes Floris , Tappin Simon
Published: April 2017

Canine pancreatitis poses a challenge for patients, their owners and veterinary surgeons. Although pathways leading to pancreatitis and its clinical signs have been extensively researched, its exact cause mostly remains unclear and is thought to be the result of multiple factors. Dogs of any age, breed or sex can develop the disease, although some breeds are over represented. Clinical signs of pancreatitis can vary from mild lethargy, anorexia, and transient vomiting to marked abdominal pain, cardiovascular shock, multi-organ failure and in severe cases death. The diagnosis of pancreatitis is supported by elevations in amylase, lipase, cPLI, SNAP cPL and Spec cPL and often followed by diagnostic imaging to confirm the diagnosis and exclude concurrent disease. Histopathology still remains the gold standard in diagnosing pancreatitis, however collection of these samples poses a challenge due to invasiveness, cost and risk of complications. Over the past years, advancements have been made with new markers, and alternative methods of available markers, to aid the diagnosis of pancreatitis. Diagnosis of pancreatitis still remains a diagnostic challenge, relying on clinical judgement as well as supportive biochemical and imaging findings.
Explore tubular imaginations
Authors: Harries Judith
Published: April 2017

The second in a series that will explore practical activities for introducing mathematical learning and language using everyday resources and junk materials – this month, we use cardboard tubes.
A new species of the weevil genus Mogulones Reitter, 1916 (Coleoptera: Curculionidae: Ceutorhynchinae) from Northeastern Turkey
Authors: Korotyaev Boris A. , Gültekin Levent , Colonnelli Enzo
Published: April 2017

A new species Mogulones neslihanae Korotyaev, Gültekin & Colonnelli sp. nov. is described from Northeastern Turkey where it lives on Nonea caspica. The new species is very closely related to M. tristis (Korotyaev, 1981) from the Hakkari and Şırnak provinces of Southeastern Turkey; M. neslihanae sp. nov. differs primarily in the smaller body size and a well-developed pattern of the pronotum and elytra, instead of being uniformly covered with very dark brown pubescence as in M. tristis. These two Turkish species are also compared with M. austriacus (C. Brisout, 1869) from Eastern Europe and Western Asia, another species associated mostly with Nonea pulla complex with purple flowers.
Risk factors for post-operative periprosthetic fractures following primary total hip arthroplasty with a proximally coated double-tapered cementless femoral component
Authors: Gromov K. , Bersang A. , Nielsen C. S. , Kallemose T. , Husted H. , Troelsen A.
Published: April 2017

Aims

The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana).

Patients and Methods

A total of 1598 consecutive hips, in 1441 patients receiving primary THA between January 2010 and June 2015, were retrospectively identified. Level of pre-operative osteoarthritis, femoral Dorr type and cortical index were recorded. Varus/valgus placement of the stem and canal fill ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture.

Results

The mean follow-up was 713 days (1 to 2058). A total of 48 periprosthetic fractures (3.0%) were identified during the follow-up and median time until fracture was 16 days, (interquartile range 10 to 31.5). Patients with femoral Dorr type C had a 5.2 times increased risk of post-operative periprosthetic fracture compared with type B, while female patients had a near significant two times increased risk over time for post-operative fracture.

Conclusion

Dorr type C is an independent risk factor for early periprosthetic fracture, following THA using a double tapered cementless stem such as the Bi-Metric. Surgeons should take bone morphology into consideration when planning for primary THA and consider using cemented femoral components in female patients with poor bone quality. Cite this article: Bone Joint J 2017;99-B:451–7.