bluuebunny/crossref_metadata_2025 huggingface dataset:
Antidiabetic Activity of Acidic Polysaccharide From Schisandra chinensis in STZ-Induced Diabetic Mice
Authors: Tao Xue , Liang Shuang , Che Jin-Ying , Li He , Sun Hong-Xia , Chen Jian-Guang , Du Xing-Xu , Wang Chun-Mei
Published: June 2019

Polysaccharide, one of the main components in Schisandra chinensis, has been discovered to have an antidiabetic effect. In this study, we further observed the effect of the secondary component of Schisandra polysaccharide, acidic polysaccharide, on diabetes induced by streptozotocin (STZ) in mice and H2O2-induced MIN6 cell injury model and investigated the underlying mechanisms at the same time. The results showed that S. chinensis acidic polysaccharide (SCAP) could increase the content of fasting blood insulin and the activity of superoxide dismutase, lower the level of fasting blood glucose and malondialdehyde, and improve the pathological changes in the pancreatic islet in STZ-induced diabetic mice. SCAP decreased the percent of apoptotic cells and increased Cleaved Caspase-3 activity in H2O2-incubated cells. Furthermore, SCAP treatment inhibited the upregulation of phospho C-Jun N-terminal kinase (JNK), BAX, and Cleaved Caspase-3 protein expressions, and increased the expression of Bcl-2. These results indicate that SCAP has a therapeutic effect on STZ-induced diabetic mouse, and this protective effect may be mediated through preventing the apoptosis of β-cells via inhibiting the expression of JNK and related apoptotic proteins.
Fatty Acids, Sterols, and Triterpenes of the Fruits of 8 Heracleum Taxa
Authors: Ušjak Ljuboš , Sofrenić Ivana , Tešević Vele , Drobac Milica , Niketić Marjan , Petrović Silvana
Published: June 2019

Fatty acids (FAs), sterols, and triterpenes of dichloromethane extracts of the fruits of 8 Heracleum L. taxa (Apiaceae) from southeastern Europe were investigated by gas chromatography with flame ionization detector and gas chromatography with mass spectrometry. In order to analyze the FAs, their volatile methyl esters were obtained by saponification and subsequent esterification of oily supernatants of the fruit extracts. Dominant was petroselinic acid (42.8%-56.5%), followed by linoleic (20.3%-33.3%) and oleic acids (12.3%-13.7%). Sterols and triterpenes were analyzed as volatile derivatives obtained by the silanization of residual unsaponifiable fractions. Among them, the most abundant was β-sitosterol (44.9%-56.9%), followed by stigmasterol (15.7%-25.0%), Δ7-stigmastenol (6.6%-12.5%), and campesterol (5.2%-8.1%). The quantity of petroselinic acid was also determined by the external standard method (298.8-433.4 mg/g of oily supernatant). The obtained results show that the investigated plants are potential valuable sources of the compounds utilized in different industries.
Chemical Composition and Antimicrobial Activity of the Essential Oil From the Bark of Xylopia hypolampra
Authors: Pedrali Alice , Robustelli della Cuna Francesco S. , Grisoli Pietro , Corti Marco , Brusotti Gloria
Published: June 2019

Hydrodistillation of Xylopia hypolampra Mildbr. stem bark afforded 39 mg (dry weight basis) of a pale yellow fragrant essential oil; gas chromatography-flame ionization detector and gas chromatography-mass spectrometry analyses allowed the identification of 28 compounds (90.5%, of the total oil composition). The major constituent was found to be verbenone (20.2%) followed by borneol (7.8%), eucalyptol (5.9%), nopinone (5.5%), trans-pinocarveol (4.9%), α-terpineol (4.4%), para-cymen-8-ol (3.5%), terpinen-4-ol (3.1%), cyperotundone (2.7%), and myrtenal co-eluted with myrtenol (6.8%). The antimicrobial activity was evaluated against Streptococcus pyogenes, Staphylococcus aureus, and Escherichia coli based on the minimum inhibitory concentration by the micro- and macrodilution methods.
Layout Planning in Healthcare Facilities: A Systematic Review
Authors: Benitez Guilherme B. , Da Silveira Giovani J. C. , Fogliatto Flavio S.
Published: June 2019

This study presents a systematic review of the literature on layout planning in healthcare facilities. The review includes 81 articles from journals, conferences, books, and other documents. Articles were classified in two groups according to their main contents including (i) concepts and guidelines and (ii) techniques and tools to assist in layout planning in healthcare facilities. Results indicate that a great variety of concepts and tools have been used to solve layout problems in healthcare. However, healthcare environments such as hospitals can be complex, limiting the ability to obtain optimal layout solutions. Influential factors may include the flows of patients, staff, materials, and information; layout planning and implementation costs; staff and patients safety and well-being; and environmental contamination, among others. The articles reviewed discussed and often proposed solutions covering one or more factors. Results helped us to propose future research directions on the subject.
Validation of the Diagnostic and Prognostic Values of ADAMTS5 and FSTL1 in Osteoarthritis Rat Model
Authors: Elsadek Bakheet E. M. , Abdelghany Ahmed A. , Abd EL-Aziz Mohamed A. , Madkor Hafez R. , Abd Elrady Ahmed Ahmed , Abd-Elghaffar Sary Kh. , Elsadek Amer Alkot Mostafa
Published: June 2019

Objective

Osteoarthritis (OA) is a global public health problem and a leading cause of morbidity and disability. Due to lack of sensitive and specific tools for early OA diagnosis and predicting prognosis, the availability of new reliable and sensitive biomarkers is a widely appreciated need to identify patients at risk for incident disease or disease progression. Accordingly, our study was conducted to validate the usefulness of disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5) and follistatin-like protein 1 (FSTL1) to achieve this goal.

Design

Fifty-four male Wistar rats were randomized into 3 groups; 24 rats were subjected to medial meniscal tear (MMT) surgery on the right knee joint (OA group), 24 rats were subjected to sham surgery (sham group), and 6 healthy rats (negative control group). Six animals from each group were sacrificed every 2 weeks. At each time point, the right knee joint of each animal was visualized radiologically, a blood sample was collected, and cartilage tissues were isolated for histopathological and western blot analysis.

Results

We found that the expression levels of ADAMTS5 and FSTL1 significantly increased with OA progression, especially at weeks 4, 6, and 8 after surgery. Notably, the serum levels of ADAMTS5 and FSTL1 showed significant positive correlations with each other and with the studied inflammatory markers.

Conclusions

Our findings suggest that ADAMTS5 and FSTL1 can serve as important and informative serological markers of disease activity in OA. However, further research is needed to validate their use for improving the diagnosis and prognosis of OA in humans.
The impact of medication review with version 2 STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria in a French nursing home: a 3-month follow-up study
Authors: Gaubert-Dahan Marie-Line , Sebouai Abdellatif , Tourid Wafaa , Fauvelle Francis , Aikpa Raoul , Bonnet-Zamponi Dominique
Published: June 2019

Background:

Improving medication appropriateness is a priority of French national campaigns in nursing homes. A pilot study was conducted to evaluate the impact of a medication review in a French nursing home with a 3-month follow up.

Method:

A medication review was conducted in 2015 using version 2 STOPP and START criteria. The number and type of drugs meeting a STOPP that were reintroduced and the number and type of drug meeting a START that were stopped during follow up were measured. An expert committee adjudicated whether 3-month hospitalizations and deaths were related to medication review. The impact of medication review on the cost related to drug consumption was calculated for 3 months.

Results:

The 52 residents (age 84 ± 9 years, 83% female) fulfilled, on average, 2 ± 1.4 of the STOPP criteria and 0.7 ± 0.6 of the START criteria. A total of 101 drugs were stopped and 34 drugs were started. Five deaths occurred during follow up and were judged as not related to medication review. Five drugs stopped were reintroduced in five residents for a rebound effect or a symptom occurrence and one resident had stopped a START medication (aspirin) for a minor adverse drug reaction. At 3 months, a gain of 20.21 ± 31.34 euros per resident was observed.

Conclusion:

The medication review using version 2 STOPP and START criteria and involving the physician in charge seems useful for detecting and correcting inappropriate prescribing in a nursing home.
Long-term functional outcomes after cardiac rehabilitation in older patients. Data from the Cardiac Rehabilitation in Advanced aGE: EXercise TRaining and Active follow-up (CR-AGE EXTRA) randomised study
Authors: Pratesi Alessandra , Baldasseroni Samuele , Burgisser Costanza , Orso Francesco , Barucci Riccardo , Silverii Maria Vittoria , Venturini Simone , Ungar Andrea , Marchionni Niccolò , Fattirolli Francesco
Published: June 2019

Aim

Cardiac rehabilitation promotes functional recovery after cardiac events. Our study aimed at evaluating whether, compared to usual care, a home-based exercise programme with monthly reinforcement sessions adds long-term functional benefits to those obtained with cardiac rehabilitation in the elderly.

Methods

After a 4-week outpatient cardiac rehabilitation, 160 of 197 patients aged 75 years and older screened for eligibility with different indications for cardiac rehabilitation, were randomly assigned to a control (C) or an active treatment (T) group. During a 12-month follow-up, C patients received usual care, while T patients were prescribed a standardised set of home-based exercises with centre-based monthly reinforcements for the first 6 months. The main (peak oxygen consumption) and three secondary outcome measures (distance walked in 6 minutes, inferior limbs peak 90° Torque strength, health-related quality of life) were assessed at baseline, at random assignment and at 6 and 12-month follow-ups with the cardiopulmonary exercise test, 6-minute walking test, isokinetic dynamometer and the Short Form-36 questionnaire, respectively.

Results

Both C and T groups obtained a significant and similar improvement from baseline to the end of the 4-week cardiac rehabilitation programme in the three functional outcome measures. However, at univariable and age and gender-adjusted analysis of variance for repeated measures, changes from random assignment to 6 or 12-month follow-up in any outcome measure were similar in the C and T groups.

Conclusion

Results from this randomised study suggest that a home-based exercise programme with monthly reinforcements does not add any long-term functional benefit beyond those offered by a conventional, 4-week outpatient cardiac rehabilitation programme.

Trial registration

ClinicalTrial.gov Identifier: NCT00641134.
Restoring pulsatility and peakVO2 in the era of continuous flow, fixed pump speed, left ventricular assist devices: ‘A hypothesis of pump's or patient's speed?’
Authors: Laoutaris Ioannis D
Published: June 2019

Despite significant improvement in survival and functional capacity after continuous flow left ventricular assist device implantation, the patient's quality of life may remain limited by complications such as aortic valve insufficiency, thromboembolic episodes and gastrointestinal bleeding attributed to high shear stress continuous flow with attenuated or absence of pulsatile flow and by a reduced peak oxygen consumption (peakVO2) primarily associated with a fixed pump speed operation. Revision of current evidence suggests that high technology pump speed algorithms, a ‘hypothesis of decreasing pump's speed’ to promote pulsatile flow and a ‘hypothesis of increasing pump's speed’ to increase peakVO2, may only partially reverse these barriers. A ‘hypothesis of increasing patient's speed’ is introduced, suggesting that exercise training may further contribute to the patient's recovery, enhancing peakVO2 and pulsatile flow by improving skeletal muscle oxidative capacity and strength, peripheral vasodilatory and ventilatory responses, favour changes in preload/afterload and facilitate native flow, formulating the rationale for further studies in the field.
Pituitary apoplexy following endoscopic nasal surgery: A case report
Authors: Harju Teemu , Alanko Juha , Numminen Jura
Published: June 2019

Pituitary apoplexy develops as a consequence of acute haemorrhage and/or infarction in a pre-existing pituitary adenoma. Typical symptoms include sudden onset headache, visual acuity/field defects, and ocular palsies. We report a male patient with a known pituitary macroadenoma who underwent a right-sided endoscopic nasal surgery. Preoperatively, thickening of sphenoid mucosa was seen in computed tomography and magnetic resonance imaging. The patient developed pituitary apoplexy postoperatively. The presented report indicates that in patients with a pituitary adenoma, nasal surgery – like any other kind of surgery – is a possible precipitating factor for pituitary apoplexy. Isolated thickening of sphenoid mucosa is associated with pituitary apoplexy. It may also precede an apoplectic event.
Sigmoido-rectal intussusception
Authors: Filiberto Amanda C , Loftus Tyler J , Tan Sanda A , Read Thomas E , Iqbal Atif
Published: June 2019

Rectal prolapse is usually of benign etiology. Rarely, sigmoido-rectal intussusception results from a malignant lead-point. We report the case of a patient with a partially obstructing sigmoid cancer causing a full thickness rectal prolapse requiring surgical intervention. An 82-year-old woman presented with 1 week of rectal bleeding, fecal incontinence, and weight loss. Computed tomography identified sigmoido-rectal intussusception. Colonoscopic biopsy revealed high-grade dysplasia. Magnetic resonance imaging demonstrated a 6-cm mass forming the lead point of the intussusceptum with epiploic appendages seen within the rectal lumen. She underwent laparoscopic low anterior resection with final pathology consistent with T2N0 adenocarcinoma, and recovered well. Among adult patients with rectal prolapse, suspicion for underlying malignancy should prompt a thorough investigation to inform the decision for resection, which may be safely performed by minimally invasive techniques.
Efficacy and safety of dimethyl fumarate in treatment-naïve Japanese patients with multiple sclerosis: Interim analysis of the randomized placebo-controlled study
Authors: Mori Masahiro , Ohashi Takashi , Onizuka Yasuhiro , Hiramatsu Katsutoshi , Hase Masakazu , Yun Jang , Matta André , Torii Shinichi
Published: June 2019

Background

The use of dimethyl fumarate has not been reported in treatment-naïve Japanese patients with relapsing–remitting multiple sclerosis.

Objectives

The purpose of this study was to evaluate the efficacy and safety of dimethyl fumarate in treatment-naïve Japanese patients with relapsing–remitting multiple sclerosis.

Methods

APEX was a phase 3, multinational trial, which consisted of a 24-week, randomized (1:1), double-blind study where patients received dimethyl fumarate 240 mg or placebo twice daily, followed by an open-label extension where all patients received dimethyl fumarate 240 mg. The primary endpoints were the total number of new gadolinium-enhancing (Gd+) lesions in Weeks 12–24 (Part I) and long-term safety (Part II). This post-hoc subgroup analysis evaluated the efficacy and safety of dimethyl fumarate in treatment-naïve Japanese patients with relapsing–remitting multiple sclerosis ( n=52) up to Week 72 (24 weeks Part I and 48 weeks Part II).

Results

Dimethyl fumarate reduced the mean total number of new gadolinium-enhancing lesions at Weeks 12–24 by 94% versus placebo; the number of patients who had a relapse over 24 weeks was reduced by 72%. Adverse events leading to discontinuation of the study drug were reported in 9% of patients receiving placebo/dimethyl fumarate and 4% of patients in dimethyl fumarate/dimethyl fumarate.

Conclusions

Dimethyl fumarate demonstrated sustained efficacy and acceptable tolerability in treatment-naïve Japanese patients with relapsing–remitting multiple sclerosis for 72 weeks.
Cell proliferation in kidney carcinoma is inhibited by lncRNA GASL1
Authors: Dong Jianping , Zheng Shiping , Yang Xiaoyan , Song Xiuyan
Published: June 2019

Long noncoding RNA (lncRNA) GASL1 was identified as a novel lncRNA, which plays an important role in the proliferation and apoptosis of cells. This study aimed to compare the expression of GASL1 mRNA in kidney cancer cells and normal cells and detect the biological role of GASL1 in kidney cancer cell line A498. Polymerase chain reaction (PCR) was performed to examine the expression of GASL1 mRNA in kidney cancer tissues, normal tissues, and the cell lines. GASL1 overexpression was achieved in kidney cancer cell lines A498 through transfection. MTT was used to detect the effects of GASL1 overexpression in A498 cells. GASL1 mRNA was significantly overexpressed in adjacent normal tissues compared with renal cell carcinoma. The expression of GASL1 is lower in kidney cancer cell lines than in normal kidney epithelium cell line HREpiC. Overexpression of GASL1 inhibits the proliferation of renal carcinoma cell lines. GASL1 mRNA was down-regulated in kidney cancer tissues and may play a role in kidney cancer cell proliferation.
Reverse Total Shoulder Arthroplasty for Geriatric Proximal Humerus Fracture Dislocation With Concomitant Nerve Injury
Authors: Gasbarro Gregory , Crasto Jared A. , Rocha Jorge , Henry Sarah , Kano Daiji , Tarkin Ivan S.
Published: June 2019

Introduction:

Preoperative axillary nerve palsy is a contraindication to reverse total shoulder arthroplasty (rTSA) due to the theoretical risk of higher dislocation rates and poor functional outcomes. Treatment of fracture-dislocations of the proximal humerus with rTSA is particularly challenging, as these injuries commonly present with concomitant neurologic and soft tissue injury. The aim of the current study was to determine the efficacy of rTSA for this fracture pattern in geriatric patients presenting with occult or profound neurologic injury.

Methods:

A retrospective case series of all shoulder arthroplasty procedures for proximal humerus fractures from February 2006 to February 2018 was performed. Inclusion criteria were patients aged greater than 65 years at the time of surgery, fracture-dislocations of the proximal humerus, and treatment with rTSA. Patients with preoperative nerve injuries were compared to patients without overt neurologic dysfunction. Forward elevation, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Visual Analog Scale (VAS), and Subjective Shoulder Value (SSV) were obtained at final follow-up.

Results:

Forty-six rTSA for acute fracture were performed during the study period, 16 patients met the inclusion criteria and 5 (31%) presented with overt preoperative nerve injuries. At mean 3.1 years follow up, there were no postoperative complications including dislocations and final forward elevation was similar between study groups. Patients with overt nerve palsy had higher QuickDASH and VAS scores with lower SSV and self-rated satisfaction.

Discussion:

In the majority of patients with or without overt nerve injury, rTSA reliably restored overhead function and led to good or excellent patient-rated treatment outcomes. Overt nerve palsy did not lead to higher complication rates, including dislocation. Despite greater disability and less satisfaction, complete or partial nerve recovery can be expected in the majority of patients.

Conclusion:

Nerve injury following proximal humeral fracture dislocation may not be an absolute contraindication to rTSA.
Chronic Kidney Disease Among Workers: A Review of the Literature
Authors: Chicas Roxana , Mix Jacqueline , Mac Valerie , Flocks Joan , Dickman Nathan Eric , Hertzberg Vicki , McCauley Linda
Published: June 2019

For the past two decades, agricultural workers in regions of Central America have reported an epidemic of chronic kidney disease of undetermined etiology (CKDu) that is not associated with established risk factors of chronic kidney disease. Several hypotheses have emerged, but the etiology of CKDu remains elusive and controversial. The aim of this literature review was to describe the potential risk factors of CKDu in Mesoamerica and implications for the U.S. agricultural worker population. PubMed and CINAHL databases were searched for articles published between 2000 and 2018 that examined CKDu in Mesoamerica; 29 original studies were included in this review. CKDu is a multifactorial disease that is often asymptomatic with hallmark characteristics of elevated serum creatinine and blood urea nitrogen (BUN), low glomerular filtration rate, electrolyte abnormalities, and non-nephrotic proteinuria. Reducing the global prevalence of CKDu will require more robust studies on causal mechanisms and on interventions that can reduce morbidity and mortality in vulnerable populations.
Autologous osteochondral transplantation method of treatment for patellar osteochondral lesions
Authors: Akgün Erkan , Akpolat Ahmet Onur
Published: June 2019

Purpose:

This study evaluated the functional and clinical outcomes of the subjects with symptomatic osteochondral lesions on articular surface of patella, who were treated with autologous osteochondral transplantation (AOT) method.

Study plan:

AOT method was applied for the treatment of 14 subjects (eight men and six women; mean age 29.7 years; range 19–49 years) with symptomatic patellar osteochondral lesions between March 2008 and April 2013. After a mean follow-up period of 3.7 years (range 32–80 months), pre- and postoperative clinical and functional evaluations of the patients were performed using Visual Pain Scale (VPS), Lysholm Knee Scoring Scale, and Kujala Anterior Knee Pain Scale. Wilcoxon test was used for statistical evaluation of pre- and postoperative outcomes. Improvement of the lesions was assessed by magnetic resonance imaging (MRI) at year 1 postoperatively at the earliest.

Results:

The mean lesion size was 1.32 cm2 (range 0.8–1.8 cm2). The mean pre- and postoperative VPS values were calculated to be 75.5 ± 12.32 (range 46–92) and 17.57 ± 10.21 (range 0–40), respectively ( p < 0.01). The mean pre- and postoperative Lysholm knee scores were 44.57 ± 9.35 (range 26–65) and 80 ± 6.9 (range 70–94), respectively ( p < 0.01), and the mean pre- and postoperative Kujala anterior knee pain scores were 48.21 ± 7.78 (range 38–68) and 78.42 ± 7.06 (range 70–96), respectively ( p < 0.01). MRI taken at year 1 postoperatively showed that the autograft bone tissue was sufficiently incorporated into the recipient site in all patients; an even articular surface was formed, but the thickness of the cartilage tissue was mostly uneven between the adjacency of the recipient site and the autograft, which caused no negative effect on clinical and functional outcomes.

Conclusions:

Despite the difference in thickness of the cartilage tissue between the recipient and the donor site, the AOT technique for the treatment of patellar osteochondral lesions resolves the symptoms of the patient and ensures an apparent functional and clinical improvement even if an articular surface could be created.
Disparities in Cost and Access by Caseload for Arthroscopic Rotator Cuff Repair: An Analysis of 18,616 Cases
Authors: Li Lambert , Bokshan Steven L. , Mehta Shayna R. , Owens Brett D.
Published: June 2019

Background:

Surgeon caseload has been shown to affect both health and economic outcomes in arthroscopic rotator cuff repair. Although previous studies have investigated disparities in access to care, little is known about disparities between low- and high-volume surgeons and facilities.

Purpose:

To identify where disparities may exist regarding access to high-volume surgeons and facilities.

Study Design:

Cross-sectional study.

Methods:

Univariate analysis was performed to analyze differences in the caseload between low- and high-volume surgeons and facilities. Cutoff values were set at 50 cases per year for high-volume surgeons and 125 cases annually for high-volume facilities. Multiple linear regression was then used to develop a cost model incorporating all variables significant under univariate analysis. We collected 18,616 cases with Current Procedural Terminology code 29827 (“arthroscopic rotator cuff repair”) from the 2014 Florida State Ambulatory Surgery and Services Databases.

Results:

A greater proportion of the caseload for low-volume surgeons and facilities was composed of patients who were of lower socioeconomic status, had government-subsidized insurance, or lived in areas with low-income ZIP codes. Low-volume surgeons and facilities also had higher total charges, higher postoperative admission rates, and lower distal clavicle excision rates ( P < .001). In our cost model, a low facility volume significantly increased costs. Subacromial decompression, postoperative admission, distal clavicle excision, male sex, and government-subsidized insurance were all significant factors for increased costs in multivariate cost analysis.

Conclusion:

There are disparities in access to high-volume surgeons and facilities for patients undergoing arthroscopic rotator cuff repair in Florida. Patients with a lower socioeconomic status, government-subsidized insurance, and low income all faced decreased access to these high-volume groups. High-volume surgeons and facilities were associated with lower total charges, higher rates of distal clavicle excision, and lower readmission rates. Low-volume facilities added a significant amount of cost, even when controlling for all other significant variables. It is important for providers to be aware of these disparities and work to address them in their own practices.
How Do We “Do Gender”? Permeation as Over-Talking and Talking Over
Authors: Cannon Bryan C. , Robinson Dawn T. , Smith-Lovin Lynn
Published: June 2019

Gendered expectations are imported from the larger culture to permeate small-group discussions, creating conversational inequalities. Conversational roles also emerge from the negotiated order of group interactions to reflect, reinforce, and occasionally challenge these cultural patterns. The authors provide a new examination of conversational overlaps and interruptions. They show how negotiated conversational roles lead a status distinction (gender) to shape conversational inequality. The authors use a mixed-effects logit model to analyze turn taking as it unfolds in task-group discussions, focusing on how previous behavior shapes current interaction. They then use these conversational roles to examine how locally produced interaction orders mediate the relationship between gender and interruptions. The authors find a more complex process than previous research has revealed. Gender influences the history of being interrupted early in an interaction, which changes the ongoing behavioral patterns to create a cumulative conversational disadvantage. The authors then discuss the implications of these group dynamics for interventions.
Glow Powder: See the Germs? An Innovative Teaching Technique in a Student Sonography Laboratory
Authors: Pessin Yosefa J. , Matthews Eric P.
Published: June 2019

The purpose of this study was to compare the disinfection rate of a laboratory environment before and after glow powder exposure and training of sonography students (n = 23) and establish if glow powder was an effective teaching technique for infection protection and control (IPC). Fourteen locations at four scanning stations were contaminated with glow powder, visible under ultraviolet light. Students were shown contaminated areas and debriefed on the importance of disinfection. This activity was repeated to ascertain effectiveness of the training. In total, 204 areas were examined for contamination. Observation 1 revealed 21 locations (30.8%), and observation 2 detected glow powder on 12 locations (17.6%). Overall decrease in contamination rate was 13%. The gel bottle was the most frequently contaminated. The curved 3.5-MHz transducer was consistently cleaned. Disinfectant spray, time gain compensation, bed, stool, screen, and handles of the machine remained contaminated. Students’ IPC increased significantly after glow powder training, and secondary spread was reduced by 16%.
Neutrophils acquire antigen-presenting cell features after phagocytosis of IgG-opsonized erythrocytes
Authors: Meinderts Sanne M. , Baker Gabriella , van Wijk Stan , Beuger Boukje M. , Geissler Judy , Jansen Machiel H. , Saris Anno , ten Brinke Anja , Kuijpers Taco W. , van den Berg Timo K. , van Bruggen Robin
Published: June 2019

Neutrophils are particularly well known for their antimicrobial function. Although historically they are regarded as strictly a phagocyte of the innate immune system, over time it has become clear that neutrophils are versatile cells with numerous functions including innate and adaptive immune regulation. We have previously described a role for human neutrophils in antibody-mediated red blood cell (RBC) clearance. Under homeostatic conditions, neutrophils do not take up RBCs. Yet, when RBCs are immunoglobulin G (IgG) opsonized, which can occur in alloimmunization or autoimmunization reactions, neutrophils can effectively phagocytose RBCs. In the present study, we show that human neutrophils acquire an antigen-presenting cell (APC) phenotype following RBC phagocytosis. Subsequent to RBC phagocytosis, neutrophils expressed major histocompatibility complex class II (MHC-II) and costimulatory molecules such as CD40 and CD80. Moreover, in classical APCs, the respiratory burst is known to regulate antigen presentation. We found that the respiratory burst in neutrophils is reduced after IgG-mediated RBC phagocytosis. Additionally, following RBC phagocytosis, neutrophils were demonstrated to elicit an antigen-specific T-cell response, using tetanus toxoid (TT) as an antigen to elicit an autologous TT-specific CD4+ T-cell response. Lastly, although the “don’t eat me” signal CD47 is known to have a powerful restrictive role in the activation of immunity against RBCs in dendritic cells, CD47 does not seem to have a significant effect on the antigen-presenting function of neutrophils in this context. Overall, these findings reveal that besides their classical antimicrobial role, neutrophils show plasticity in their phenotype.
Stevens-Johnson Syndrome complicated by obstructive uropathy, pneumothorax, and pneumomediastinum: a case report and literature review
Authors: Bruce-Hickman Damian , Jiang Xiao , Thia Joshua Jin-Ping , Kansal Amit
Published: June 2019

Background

Stevens-Johnson Syndrome (SJS) is an acute mucocutaneous eruption with blisters of the skin and haemorrhagic erosions of mucous membranes. This report describes air-leak syndrome and obstructive uropathy occurring simultaneously in a teenage patient affected by SJS.

Case presentation

A 17-year-old Malay female with SJS suffered from bilateral pneumothoraces, pneumomediastinum, and obstructive uropathy as early complications of her disease. She required intubation, chest tube insertion, and bilateral ureteric stenting as part of her intensive care management. These extra-cutaneous complications of renal and pulmonary systems were likely secondary to widespread epithelial detachment.

Conclusion

Despite paucity of cases in adult literature, post-renal causes for acute kidney injury must be considered in SJS, especially in the setting of gross haematuria. Bedside point-of-care ultrasonography may be a useful tool for excluding obstructive uropathy. Pneumothorax is a rare but documented complication of SJS in paediatric cases and, to a lesser extent, adult patients. Extra care should be exercised when caring for mechanically ventilated patients suffering from SJS.
Prospective Multicenter Study on the Prognostic and Predictive Impact of Tumor Budding in Stage II Colon Cancer: Results From the SACURA Trial
Authors: Ueno Hideki , Ishiguro Megumi , Nakatani Eiji , Ishikawa Toshiaki , Uetake Hiroyuki , Matsuda Chu , Nakamoto Yoshihiko , Kotake Masanori , Kurachi Kiyotaka , Egawa Tomohisa , Yasumasa Keigo , Murata Kohei , Ikawa Osamu , Shinji Seiichi , Murotani Kenta , Matsui Shigeyuki , Teramukai Satoshi , Tomita Naohiro , Sugihara Kenichi ,   on behalf of the SACURA Study Group
Published: June 2019

PURPOSE

The International Union Against Cancer highlighted tumor budding as a tumor-related prognostic factor. International assessment criteria for tumor budding were recently defined by the 2016 International Tumor Budding Consensus Conference (ITBCC2016). This study aimed to clarify the prognostic and predictive values of tumor budding in a randomized controlled trial evaluating the superiority of adjuvant chemotherapy with oral tegafur-uracil over surgery alone for stage II colon cancer (SACURA trial; ClinicalTrials.gov identifier: NCT00392899 ).

PATIENTS AND METHODS

Between 2006 and 2010, we enrolled 991 patients from 123 institutions with stage II colon cancer. Tumor budding was diagnosed by central review on the basis of the criteria adopted in the ITBCC2016. We prospectively recorded all clinical and pathologic data, including the budding grade, and performed prognostic analyses after 5 years of completing the patients’ registration.

RESULTS

Of 991 tumors, 376, 331, and 284 were classified as BD1, BD2, and BD3, respectively; the 5-year relapse-free survival (RFS) rate was 90.9%, 85.1%, and 74.4%, respectively ( P < .001), and ranged widely in T4 tumors (86.6% to 53.3%). The budding grade significantly correlated with recurrence in the liver, lungs, lymph nodes, and peritoneum ( P < .001 to .01). Multivariable analysis revealed that budding and T stage exerted an independent impact on RFS, and on the basis of the Harrell concordance index, these two factors substantially contributed to the improvement of the Cox model for predicting RFS. Both the BD2 and BD3 groups demonstrated greater improvement in the 5-year recurrence rate in the adjuvant chemotherapy group than the surgery-alone group by approximately 5%, but the difference was statistically nonsignificant.

CONCLUSION

Tumor budding grade on the basis of the ITBCC2016 criteria should be routinely evaluated in pathologic practice and could improve the benefit of adjuvant chemotherapy for stage II colon cancer.
Management of Stage II Germ Cell Tumors: Be Sure, Be Patient, Be Safe
Authors: Kollmannsberger Christian K. , Nappi Lucia , Nichols Craig
Published: June 2019

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A healthy 27-year-old man discovered a left testicular mass. Several months later he saw an urologist, who palpated a suspicious mass on the left testicle; an ultrasound confirmed a 2-cm solid mass. Serum tumor marker testing disclosed a slightly elevated alpha-fetoprotein (AFP) of 12.3 µg/L (upper limit of normal, 8.0 µg/L), and a normal β-human chorionic gonadotropin (HCG). Staging imaging with a contrast-enhanced computed tomography (CT) scan of the chest/abdomen/pelvis showed no evidence for retroperitoneal lymphadenopathy or distant metastases. He underwent a left radical orchiectomy, and pathology showed a 1.5-cm mixed germ cell tumor with 85% embryonal, 10% yolk sac tumor, and 5% mature teratoma histologies. Lymphovascular invasion was present. His AFP normalized after surgery. After discussion of management alternatives, he chose active surveillance, but 4 months later a scheduled surveillance CT scan identified a 1.4-cm left para-aortic lymph node just below the left renal hilum ( Fig 1 ). Serum tumor markers remained negative. He returns to discuss his results and potential management options.
Reduced Androgen Receptor Expression in Genital Skin Fibroblasts From Patients With 45,X/46,XY Mosaicism
Authors: Hornig Nadine C , Demiri Jeta , Rodens Pascal , Murga Penas Eva Maria , Caliebe Almuth , Eckstein Anne Katrin , Schweikert Hans-Udo , Audi Laura , Hiort Olaf , Werner Ralf , Kulle Alexandra E , Ammerpohl Ole , Holterhus Paul-Martin
Published: June 2019

Context

Molecular mechanisms causing the broad phenotypic diversity of external masculinization in individuals with 45,X/46,XY mosaicism are poorly understood.

Objective

Analysis of androgen receptor (AR) expression and function as a putative influencing factor for the genital phenotype in patients with 45,X/46,XY mosaicism.

Design

Measurement of AR mRNA expression levels, AR activity [DHT-mediated APOD (apolipoprotein D) induction] and cellular 45,X/46,XY ratios in genital skin fibroblasts from individuals with 45,X/46,XY mosaicism and male reference individuals, and determination of the external virilization scale from individuals with 45,X/46,XY mosaicism.

Setting

University hospital endocrine research laboratory.

Patients or Other Participants: 30 genital skin fibroblast cultures (GFs) from male reference individuals and 15 GFs from individuals with 45,X/46,XY mosaicism.

Intervention

None

Main Outcome Measures

Determination of AR mRNA expression and AR activity in male reference GFs and 45,X/46,XY GFs and correlation of the obtained data with the cellular 45,X/46,XY ratios and the patients’ external virilization scale.

Results

In 6 of 15 45,X/46,XY GFs, AR mRNA expression and AR activity were significantly lower compared with those in the 46,XY reference GFs. In this subgroup of reduced AR mRNA expression, a positive trend was seen between AR mRNA expression and the percentage of XY-positive cells. Furthermore, we found a positive correlation between AR activity and the external virilization scale in the 15 45,X/46,XY GF samples (P = 0.03).

Conclusion

Our results suggest that AR expression and AR activity might influence the phenotypic variability seen in patients with 45,X/46,XY mosaicism.
Dynamic label-free imaging of lipid droplets and their link to fatty acid and pyruvate oxidation in mouse eggs
Authors: Bradley Josephine , Pope Iestyn , Wang Yisu , Langbein Wolfgang , Borri Paola , Swann Karl
Published: June 2019

Mammalian eggs generate most of their ATP by mitochondrial oxidation of pyruvate from the surrounding medium or from fatty acids that are stored as triacylglycerols within lipid droplets. The balance between pyruvate and fatty acid oxidation in generating ATP is not established. We have combined coherent anti-Stokes Raman scattering (CARS) imaging with deuterium labelling of oleic acid to monitor turnover of fatty acids within lipid droplets of living mouse eggs. We found that loss of labelled oleic acid is promoted by pyruvate removal but minimised when β-oxidation is inhibited. Pyruvate removal also causes a significant dispersion of lipid droplets, while inhibition of β-oxidation causes droplet clustering. Live imaging of luciferase or FAD autofluorescence from mitochondria, suggest that inhibition of β-oxidation in mouse eggs only leads to a transient decrease in ATP because there is compensatory uptake of pyruvate into mitochondria. Inhibition of pyruvate uptake followed by β-oxidation caused a similar and successive decline in ATP. Our data suggest that β-oxidation and pyruvate oxidation contribute almost equally to resting ATP production in resting mouse eggs and that reorganisation of lipid droplets occurs in response to metabolic demand.
Chromogranin B regulates early-stage insulin granule trafficking from the Golgi in pancreatic islet β-cells
Authors: Bearrows Shelby C. , Bauchle Casey J. , Becker McKenzie , Haldeman Jonathan M. , Swaminathan Svetha , Stephens Samuel B.
Published: June 2019

Chromogranin B (CgB, also known as CHGB) is abundantly expressed in dense core secretory granules of multiple endocrine tissues and has been suggested to regulate granule biogenesis in some cell types, including the pancreatic islet β-cell, though the mechanisms are poorly understood. Here, we demonstrate a critical role for CgB in regulating secretory granule trafficking in the β-cell. Loss of CgB impairs glucose-stimulated insulin secretion, impedes proinsulin processing to yield increased proinsulin content, and alters the density of insulin-containing granules. Using an in situ fluorescent pulse-chase strategy to track nascent proinsulin, we show that loss of CgB impairs Golgi budding of proinsulin-containing secretory granules, resulting in a substantial delay in trafficking of nascent granules to the plasma membrane with an overall decrease in total plasma membrane-associated granules. These studies demonstrate that CgB is necessary for efficient trafficking of secretory proteins into the budding granule, which impacts the availability of insulin-containing secretory granules for exocytic release.

This article has an associated First Person interview with the first author of the paper.
Ca2+ entry via TRPC1 is essential for cellular differentiation and modulates secretion via the SNARE complex
Authors: Schaar Anne , Sun Yuyang , Sukumaran Pramod , Rosenberger Thad A. , Krout Danielle , Roemmich James N. , Brinbaumer Lutz , Claycombe-Larson Kate , Singh Brij B.
Published: June 2019

Properties of adipocytes, including differentiation and adipokine secretion, are crucial factors in obesity-associated metabolic syndrome. Here, we provide evidence that Ca2+ influx in primary adipocytes, especially upon Ca2+ store depletion, plays an important role in adipocyte differentiation, functionality and subsequently metabolic regulation. The endogenous Ca2+ entry channel in both subcutaneous and visceral adipocytes was found to be dependent on TRPC1–STIM1, and blocking Ca2+ entry with SKF96365 or using TRPC1−/− knockdown adipocytes inhibited adipocyte differentiation. Additionally, TRPC1−/− mice have decreased organ weight, but increased adipose deposition and reduced serum adiponectin and leptin concentrations, without affecting total adipokine expression. Mechanistically, TRPC1-mediated Ca2+ entry regulated SNARE complex formation, and agonist-mediated secretion of adipokine-loaded vesicles was inhibited in TRPC1−/− adipose. These results suggest an unequivocal role of TRPC1 in adipocyte differentiation and adiponectin secretion, and that loss of TRPC1 disturbs metabolic homeostasis.

This article has an associated First Person interview with the first author of the paper.
Niepożądani – Francja wobec emigracji polskiej w latach 1930-1944
Authors: Nisiobęcka Aneta
Published: June 2019

Undesirable – French Attitudes Towards Polish Immigration in the Years 1930-1944 Polish historical literature referring to migrations to France is dominated by issues of emigrants’ everyday life and activities. The issue of politics and the legal approach of the French state towards migrants has been hitherto treated marginally. This article discusses the topic of Polish migrants adapting to their new situation and living in France through the perspective of decrees and circulars of the French state regulating the status of migrants.Sources from the French archives indicate that France tightened their laws concerning immigrants in 1930s, including allowing for the establishment of internment camps for “undesirable” foreigners.
Interferencia de imagenes de apego en adultos con transtorno de personalidad borderline
Authors: Weydmann Gibson J. , Bizarro Lisiane , Barcellos Serralta Fernanda
Published: June 2019

Los problemas interpersonales de personas con Trastorno de Personalidad Borderline (TBP) pueden acentuar la desregulación emocional. El objetivo de esta investigación fue estudiar de qué forma individuos con tpb reaccionan a las imágenes de Apego Seguro (AS) y Apego Inseguro (AI). Los participantes con tpb (n=6) fueron comparados a un grupo control (n=6) emparejados en número, sexo y edad (M=29 años, DP=5.49). Ambos grupos respondieron al Instrumento de Vínculo Parental (IVP). Las imágenes de apego utilizadas fueron seleccionadas por psicólogos (n=8). Posteriormente, los participantes con TBP y el grupo control realizaron una tarea de Interferencia Emocional (IE) y evaluaron explícitamente las imágenes de apego. Los individuos con TBP presentaron un vínculo parental significativamente más perjudicado que el grupo control. El grupo con tpb evaluó los estímulos de ai como significativamente más representativos de un apego del tipo inseguro que del grupo control y los psicólogos. No hubo efecto de ie en la tarea aplicada. Los resultados de este estudio sugieren que el apego inseguro de individuos con TBP influencia la evaluación explícita de imágenes de apego.Palabras clave: trastorno de personalidad borderline, teoría del apego, interferencia emocional.
Abuso digital nos relacionamentos amorosos: uma revisão sobre prevalência, instrumentos de avaliação e fatores de risco
Authors: Cavalcanti Jaqueline Gomes , Coutinho Maria da Penha de Lima
Published: June 2019

Com o avanço da tecnologia, uma nova forma de agressão entre casais tem emergido, o abuso digital nos relacionamentos amorosos. Embora seja um fenômeno recente, tem despertado interesse de estudos devido as suas implicações negativas. Nesse sentido, o objetivo dessa revisão foi fazer um levantamento de pesquisas empíricas relacionadas ao abuso digital nos relacionamentos amorosos, conhecendo suas prevalências, instrumentos de avaliação e fatores de risco associados. Foram encontrados e analisados 39 artigos referentes aos últimos 10 anos (2008-2018). Os resultados apontaram para uma ampla variação na prevalência desse fenômeno; além de distintas formas de operacionalizá-lo. Em termos de medidas de avaliação, verifica-se um maior uso de instrumentos de autorrelato, não obstante, a maioria desses não relataram parâmetros psicométricos. Também verificou-se que esse fenômeno emerge como um fenômeno psicossocial, podendo ser ocasionado por fatores de risco de diversas ordens, tais como: sociodemográficos; relativos ao relacionamento; familiares, psicológicos, relacionados às percepções, normas e crenças. Ademais, ao longo deste artigo foram feitas diversas sugestões de pesquisas futuras.Palavras-chave: violência por parceiro íntimo, abuso digital nos relacionamentos amorosos, agressão virtual, tecnologia.
Paediatric and adolescent rheumatic diseases: measures of disease activity
Authors: Varnier Giulia C , Ciurtin Coziana
Published: June 2019

Juvenile idiopathic arthritis, juvenile systemic lupus erythematosus and juvenile dermatomyositis are rare, chronic, multi-systemic rheumatic disorders that can be associated with significant morbidity, not only during childhood, but lifelong.

Dedicated disease activity and damage assessment tools are essential to guide clinical management and perform multicentre clinical trials to ensure the best possible care and outcome for children with rheumatic diseases using an evidence-based, treat-to-target approach. This article summarizes the outcome measures most commonly used in paediatric rheumatology.