The occurrence of neuropathic pain following surgery of brainstem cavernous malformations.

Abstract:
BACKGROUND AND PURPOSE
This study aimed to assess the occurrence and significance of postoperative neuropathic pain (NP) in patients with surgically treated brainstem cavernous malformations (BSCMs).

METHODS
Seventy-four BSCM patients surgically treated between 2003 and 2019 were reviewed for the occurrence of postoperative NP and related treatment. The relevance of BSCM location, preoperative characteristics, influence on functional outcome, postoperative health-related quality of life (HRQOL) and life satisfaction was evaluated.

RESULTS
Six out of 74 patients (8%) suffered from NP. The Leeds Assessment of Neuropathic Symptoms and Signs scores ranged from 12 to 16 (mean 14.28 ± 1.6). Visual analog scale pain was 5.2 ± 2.0. NP had no effect on preoperative characteristics or functional outcome. Bodily pain (HRQOL) and vocational time (life satisfaction) were significantly decreased in NP compared to non-NP patients. Specific BSCM location (regarding brainstem nuclei involved in pain processing) and other preoperative patient- and BSCM-related parameters were not associated with the occurrence of postoperative NP. Three out of six patients were currently under NP-specific treatment. The proportion of patients suffering from postoperative NP (8%) was substantially higher compared to previously published studies. The pain affected the HRQOL of patients, most of whom were insufficiently treated and not satisfied with treatment results.

CONCLUSION
Our findings may help to raise awareness for postoperative NP in BSCM, which is essential to improve diagnosis and initiation of proper treatment, as well as preoperative informed consent of patients.

neuropathic pain
brainstem cavernous malformation
health-related quality of life


Optimization of Compound Plate Preparation to Address Precipitation Issue in Mammalian A549 Cytotoxicity Assay.

Abstract: This study illustrates the optimization of low-volume dispensing on a liquid handling system (LHS) to overcome the precipitation of compounds in the mammalian cytotoxicity assay with low dimethyl sulfoxide (DMSO) tolerance. All compounds at AstraZeneca Bangalore are tested in the mammalian cytotoxicity assay. In order to maintain the DMSO levels, serially diluted plates were prepared in DMSO/water. It was observed that some of the compounds precipitated. The IC50 data for such compounds were therefore erratic. To circumvent the problem of compound precipitation, the LHS was optimized to dispense low volumes (<1 µL). The plates were serially diluted using neat DMSO. Since the dilution was done using neat DMSO, there were no issues with precipitation. The serially diluted sample (0.5 µL) from the plate was stamped onto the assay plate to give the desired DMSO concentration. No significant differences in IC50 data were observed for 1 µL dispenses made from DMSO/water and 0.5 µL dispenses from neat DMSO for the samples with no precipitation issues. These data therefore gave us the confidence to switch over to 0.5 µL dispenses for the cytotoxicity assay to address the precipitation issue. However, precipitation of samples in the assay buffer is beyond the scope of this discussion.

D002460:Cell Line
D011232:Chemical Precipitation
D003584:Cytological Techniques
D004847:Epithelial Cells
D015386:Hazardous Substances
D006801:Humans
D020128:Inhibitory Concentration 50
D012995:Solubility
D014116:Toxicology

mammalian A549 cytotoxicity assay
low-volume dispense
Biomek FX liquid handler
compound management


RNA Sequencing Reveals the Wound Repair Mechanism of Cuyuxunxi Prescription in Surgical Patients with Anal Fistulas.

Abstract:
BACKGROUND
Anal fistula is one of the most common colorectal and perirectal diseases in the world. Cuyuxunxi (CYXX) prescription is an efficient herbal fumigant used to promote the surgical wound healing of anal fistulas.

OBJECTIVE
This study aimed to explore the underlying molecular mechanism of CYXX prescription on surgical wound healing of anal fistulas.

METHODS
Ten patients with anal fistula were randomized into a control group or treatment group. The wound surface of patients in the control group was rinsed by normal saline, while that in the treatment group was rinsed by CYXX prescription. The wound tissues of patients with anal fistulas seven days after the surgery were collected for hematoxylin-eosin (HE) staining and RNA sequencing. The expressions of differentially expressed genes (DEGs) were validated by real-time quantitative PCR (RT-qPCR).

RESULTS
HE staining showed that CYXX treatment reduced the infiltration of inflammatory cells. A total of 472 DEGs, including 141 up-regulated genes and 331 down-regulated genes, were identified. These genes were significantly related to skin development, xenobiotic stimulus, and inflammation. In addition, the consistency rate of RT-qPCR and sequencing results was 83.33%, which showed a high relative reliability of the sequencing results.

CONCLUSION
CYXX prescription could improve epidermis repair and reduce inflammatory responses.

Qu|Yin|Y| Zhang|Zhijun|Z| Lu|Yafeng|Y| Zheng|De|| Yang|Wei|W|

RNA sequencing
wound repair
Cuyuxunxi prescription
anal fistula


Laparoscopic reduction and repair of a left paraduodenal hernia.

Abstract: Left paraduodenal hernias are the most common type of congenital internal hernia, but they are difficult to diagnose without appropriate imaging. A 79-year-old man with a history of recurrent abdominal pain had another similar episode of abdominal pain, which prompted him to seek evaluation. The pain resolved spontaneously on arrival to the hospital. Enhanced CT scan showed the characteristic findings of a left paraduodenal hernia and laparoscopic repair was undertaken. The small intestine was reduced successfully, and the hernia orifice was approximated with a continuous closure. He was discharged uneventfully 4 days after admission. The characteristic clinical and imaging findings of paraduodenal hernias are reviewed. Laparoscopic repair is reasonable in patients who have a paraduodenal hernia without intestinal ischemia.

gastrointestinal surgery
general surgery


First Report of the Morphology and rDNA Sequences of Two Pseudopolydora Species (Annelida: Spionidae) from Japan.

Abstract: The morphology of two Pseudopolydora species, P. cf. reticulata Radashevsky and Hsieh, 2000 and P. achaeta Radashevsky and Hsieh, 2000 are reported from Japan for the first time. Pseudopolydora cf. reticulata was collected from Japanese tidal flats, and individuals possess the characteristic netlike pigmentation on the dorsum of anterior chaetigers and the longitudinal black band along midline of caruncle. Pseudopolydora achaeta was collected from subtidal bottom mud of Onagawa Bay, and individuals have distinctive characteristics, such as intensive black pigmentation on dorsal and ventral sides of the anterior body and nearly straight vertical rows of major spines on the fifth chaetiger. The morphology of P. cf. reticulata is very similar to that of P. cf. kempi, with which it had been confused in Japan. We analyzed the 18S and 28S rRNA gene sequences of all five Pseudopolydora species recorded from Japan and found strong evidence that they are genetically distinct. Our analysis also suggests that boring polydorids have evolved among non-boring ones; the genus Pseudopolydora, which mostly shows the non-boring form, appears to have remained in a more ancestral condition.

Pseudopolydora
Spionidae
polydorids
boring activity
molecular phylogeny


Contribution of 5-HT2 Receptors to the Control of the Spinal Locomotor System in Intact Rats.

Abstract: Applying serotonergic (5-HT) agonists or grafting of fetal serotonergic cells into the spinal cord improves locomotion after spinal cord injury. Little is known about the role of 5-HT receptors in the control of voluntary locomotion, so we administered inverse agonists of 5-HT2 (Cyproheptadine; Cypr), 5-HT2A neutral antagonist (Volinanserin; Volin), 5-HT2C neutral antagonist (SB 242084), and 5-HT2B/2C inverse agonist (SB 206553) receptors intrathecally in intact rats and monitored their effects on unrestrained locomotion. An intrathecal cannula was introduced at the low thoracic level and pushed caudally until the tip reached the L2/L3 or L5/L6 spinal segments. Locomotor performance was evaluated using EMG activity of hindlimb muscles during locomotion on a 2 m long runway. Motoneuron excitability was estimated using EMG recordings during dorsi- and plantar flexion at the ankle. Locomotion was dramatically impaired after the blockage of 5-HT2A receptors. The effect of Cypr was more pronounced than that of Volin since in the L5/L6 rats Cypr (but not Volin) induced significant alteration of the strength of interlimb coordination followed by total paralysis. These agents significantly decreased locomotor EMG amplitude and abolished or substantially decreased stretch reflexes. Blocking 5-HT2B/2C receptors had no effect either on locomotion or reflexes. We suggest that in intact rats serotonin controls timing and amplitude of muscle activity by acting on 5-HT2A receptors on both CPG interneurons and motoneurons, while 5-HT2B/2C receptors are not involved in control of the locomotor pattern in lumbar spinal cord.

Majczyński|Henryk|H|
Cabaj|Anna M|AM|
Jordan|Larry M|LM|
Sławińska|Urszula|U|

D058830:Serotonin 5-HT2 Receptor Antagonists

spinal cord
inverse agonist
antagonist
serotonin
intrathecal application


The impact of BDNF Val66Met on cognitive skills in veterans with posttraumatic stress disorder.

Abstract: Posttraumatic stress disorder (PTSD) is a trauma-induced disorder characterized with impaired cognitive function. BDNF modulates cognition and is involved in neuroprotection and neurocognitive processing. The BDNF Val66Met polymorphism was found to influence cognitive functions. In PTSD, carriers of the BDNF GG genotype had better spatial processing of navigation performance, and lower hyperarousal and startle reaction than A allele carriers. The hypothesis was that veterans with PTSD, carriers of the BDNF Val66Met A allele, will show reduced cognitive skills. The study included 315 male Caucasian combat veterans, with (N = 199) or without (N = 116) current and chronic PTSD. Cognition was assessed using the Rey-Osterrieth Complex Figure (ROCF) test that determines visual-spatial perception and short and long-term visual memory function. The results revealed that cognitive decline measured with ROCF test was associated with PTSD. Presence of the BDNF Val66Met GG genotype in veterans with PTSD, but not in veterans without PTSD, showed protective association with visual short-term memory and visual object manipulation after few seconds (executive function), assessed with the ROCF immediate recall test, compared to the A carriers with PTSD. In conclusion, this was the first study to confirm the association between BDNF Val66Met and memory and attention performed with ROCF in male veterans with PTSD. The results corroborated that the BDNF Val66Met A allele, compared to GG genotype, is associated with poorer short-term visual memory and attention linked with executive functions, in veterans with PTSD.

Havelka Mestrovic|Ana|A|
Tudor|Lucija|L|
Nedic Erjavec|Gordana|G|
Nikolac Perkovic|Matea|M|
Svob Strac|Dubravka|D|
Kovacic Petrovic|Zrnka|Z|
Pivac|Nela|N|

Cognition
PTSD
BDNF Val66Met polymorphism
Male veterans
Rey–Osterrieth complex figure test


Combination of electrospray deposition technology of TiO2 nanoparticles and MALDI FTICR MSI for identification of fingerprint morphology and latent components.

Abstract: In fingerprint recognition, besides the physical shape information afforded by fingerprint enhancement techniques (FET), in recent years, more and more efforts are focused on researching the chemical composition of a fingerprint residue. In this work, electrospray deposition method was elaborately used to softly and homogenously deposit the physical enhancers of FET, TiO2 nanoparticles (TiO2 NPs), onto fingerprints. The results showed that this type of deposition was nondestructive to the fingerprint morphology and provided the physical shape information containing all level features. Concurrently, the TiO2 NPs demonstrated as a better matrix of matrix-assisted laser desorption ionization mass spectrometry imaging (MALDI MSI) for analysis and imaging of latent components in fingerprint, including endogenous substances like triacylglycerols (TAGs), diacylglycerols (DAGs) and cholesterol esters (CEs), and exogenous substances such as certain ingredients in hand lotion. The chemical compositions in fingerprint are closely related to individual metabolites and individual lifestyles, and identification of these compositions by Fourier transform ion cyclotron resonance (FTICR) MS is extremely beneficial for forensic analysis. The combinations of electrospray deposition technology of TiO2 NPs and MALDI FTICR MSI for identification of fingerprint morphology and latent components provide dual-modes fingerprint recognition for forensic science.

Yang|Hui|H| Li|Shilei|S| Zhang|Qian|Q| Wang|Zhenpeng|Z| Li|Na|N| Han|Chao|C| Huo|Qing|Q| Zhao|Zhenwen|Z|

Electrospray deposition
MALDI FTICR MSI
Fingerprint recognition
Physical enhancement
TiO(2) nanoparticles


Risk factors associated with malignancy and with triage to surgery in thyroid nodules classified as Bethesda category III (AUS/FLUS).

Abstract:
BACKGROUND
Selection of nodules for surgery diagnosed as Bethesda category III [atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) category] is very important. We aimed at to define the predictive factors for malignancy and factors associated with triage to surgery.

METHODS
The records of all patients with nodules who underwent fine needle aspiration biopsy (FNAB) and classified by Bethesda reporting system as AUS/FLUS between 2011 and 2015 at our institution were reviewed. Univariate and multivariate analysis were performed to select independent factors associated with thyroid cancer and with triage to surgery. Using independent risk factors for malignancy predictive index categories were created.

RESULTS
Of the 485 patients who were classified as AUS/FLUS on initial FNAB, 153 underwent surgery with the associated malignancy rate of 22.8%. The malignancy rates for AUS/FLUS patients with and without repeat FNAB were 37.5% and 16.2%, respectively. Multivariate logistic regression analysis revealed that solid structure, microcalcification, hypoechogenicity, increased vascularization, and irregular margin were found to be significant and independent risk factors associated for malignancy, and solid structure, microcalcifications, increased nodule size (≥2 cm) and younger patient age (<65 years) were associated with triage to surgery.

CONCLUSIONS
Our findings showed that using predictive factors for malignancy in AUS/FLUS category as risk indices, an important proportion of patients (35%) who had nodules without any risk factors could be spared unnecessary surgery. We suggest that predictive indices should be considered for selection of the patients to triage to surgery.

Kuru|B|B|
Atmaca|A|A|
Tarim|I A|IA|
Kefeli|M|M|
Topgul|K|K|
Yoruker|S|S|
Elmali|M|M|
Danaci|M|M|

D018263:Adenocarcinoma, Follicular
D000328:Adult
D000368:Aged
D044963:Biopsy, Fine-Needle
D002471:Cell Transformation, Neoplastic
D015331:Cohort Studies
D016001:Confidence Intervals
D005260:Female
D005500:Follow-Up Studies
D006801:Humans
D008297:Male
D008875:Middle Aged
D009361:Neoplasm Invasiveness
D009367:Neoplasm Staging
D016017:Odds Ratio
D011237:Predictive Value of Tests
D012189:Retrospective Studies
D018570:Risk Assessment
D013964:Thyroid Neoplasms
D016606:Thyroid Nodule
D013965:Thyroidectomy
D016896:Treatment Outcome
D014218:Triage
D057832:Watchful Waiting

Predictive factors for thyroid malignancy

Selection of nodules for thyroid surgery


The future of cancer research: prevention, screening, vaccines, and tumor-specific drug combos.

Abstract: New cancer research strategies have developed very rapidly over the past five years, including extensive DNA sequencing of tumor and normal cells; use of highly sensitive cancer cell detection methods; vaccine development and tumor-specific (designer) drugs. These developments have raised questions about where to concentrate efforts in the near future when establishing clinical trials, particularly important in an age of diminishing resources and during a period when competing strategies for cancer control are likely to overwhelm the opportunities for establishing large, effective clinical trials. In particular, it behooves the research community to be mindful of the inevitable, challenging obligation to responsibly choose between clinical trials that offer the credible hope of incremental advances vs. trials that are less traditional but may have revolutionary outcomes.

tumor-specific drugs
cancer and diet
cancer and inflammation
cancer prevention
cancer screening
cancer vaccines
carcinogens
designer drugs
tumor promoters


Methamphetamine use and technology-mediated psychosocial interventions: A mini-review.

Abstract: Engagement with face-to-face psychosocial interventions is often compromised in people using methamphetamine (MA), in the context of high rates of polysubstance use, mental health disorders, cognitive impairment and geographic isolation. Technology-mediated interventions offer flexible ways of engaging with treatment and are readily accessible. This mini-review evaluates evidence from eight studies for the effectiveness of telephone, mHealth (text-messaging and apps) and computer-based interventions for MA use. Two papers from one telephone counselling study showed a small improvement in MA-related outcomes, particularly for individuals in active use. However, a directive counselling style was associated with a higher likelihood of MA use during recovery for those higher in resistance to authority. Text-messaging interventions generally showed small but significant reductions in MA use in non-treatment seekers. When compared, there was no significant difference in level of MA use reduction between interactive, automated and self-monitoring text messages. Studies in other modalities (smartphone app, one trial; computer-based interventions, two trials) did not confer statistically significant reductions in MA use, though were likely impacted by app design and participant characteristics. Preliminary findings hint at the potential effectiveness of telephone counselling in aftercare and the capacity for text-messaging to reach those who are not in treatment. Given the small amount of existing literature, this review discusses the potential value of emerging interventions, the importance of adapting interventions to the characteristics of people who use MA and suggests specific directions for research in each technology modality.

Rubenis|Adam J|AJ|
Baker|Amanda L|AL|
Arunogiri|Shalini|S|

Methamphetamine
Amphetamine-related disorders
Psychotherapy
Telemedicine


Venous thromboembolism following initiation of atypical antipsychotics in two geriatric patients.

Abstract:
Background
Although not formally highlighted as a risk factor in current practice guidelines, several observational studies have reported a possible association between antipsychotic use and development of venous thromboembolism (VTE). However, it is unclear to what extent the risk is elevated.

Case Report
Described are 2 cases of VTE following recent initiation of second-generation antipsychotics in elderly patients. Ms A was a 65-year-old woman with newly diagnosed bipolar I disorder who was hospitalized for acute mania and psychosis. She was treated with risperidone along with traditional mood stabilizers and developed a pulmonary embolism shortly after treatment initiation. Ms B was a 77-year-old woman with newly diagnosed bipolar I disorder who was hospitalized for depression and psychosis. She was treated with quetiapine and electroconvulsive therapy and developed a pulmonary embolism and deep vein thrombosis within 2 months of starting treatment. Risk assessment tools were not able to definitively predict the VTEs that developed in our patients.

Conclusion
The association between antipsychotic medication and VTE has shown the highest risk with atypical antipsychotics, high dosages, and initiation within the past 3 months. Risk assessment tools may assist in assessing the risk of VTE in patients on antipsychotic therapy, although patients who are deemed by these tools to have minimal risk can still develop a VTE. Discussing VTE risk with patients when considering antipsychotic usage may help clinicians and patients safely determine the most appropriate treatment for their psychiatric illnesses while mitigating potential adverse effects.

venous thromboembolism
antipsychotic
antipsychotic
geriatric
risk
VTE
antipsychotics


Study of ecological compensation in complex river networks based on a mathematical model.

Abstract: Transboundary water pollution has resulted in increasing conflicts between upstream and downstream administrative districts. Ecological compensation is an efficient means of restricting pollutant discharge and achieving sustainable utilization of water resources. The tri-provincial region of Taihu Basin is a typical river networks area. Pollutant flux across provincial boundaries in the Taihu Basin is hard to determine due to complex hydrologic and hydrodynamic conditions. In this study, ecological compensation estimation for the tri-provincial area based on a mathematical model is investigated for better environmental management. River discharge and water quality are predicted with the one-dimensional mathematical model and validated with field measurements. Different ecological compensation criteria are identified considering the notable regional discrepancy in sewage treatment costs. Finally, the total compensation payment is estimated. Our study indicates that Shanghai should be the receiver of payment from both Jiangsu and Zhenjiang in 2013, with 305 million and 300 million CNY, respectively. Zhejiang also contributes more pollutants to Jiangsu, and the compensation to Jiangsu is estimated as 9.3 million CNY. The proposed ecological compensation method provides an efficient way for solving the transboundary conflicts in a complex river networks area and is instructive for future policy-making.

D000074067:Conservation of Water Resources

Ecological compensation
River networks
Water pollution
Taihu Basin


Investigation of the confinement effect on the evaporation behavior of a droplet pinned on a micropillar structure.

Abstract: Evaporation of sessile droplet suffers from reduced evaporation rate due to the confinement of vapor diffusion imposed by the bottom substrate. However, it is possible to change the evaporation behavior of a droplet by suspending it from the bottom substrate, in particular, supporting the droplet on a micropillar. This is expected to enable diffusion transport in the downward direction that will subsequently enhance evaporative transport. In this study, we investigate the diffusion confinement effect imposed by the bottom substrate and the side wall of the micropillar through numerical simulations and experimental investigation. The approximate solutions for total evaporation rate and local evaporative flux were subsequently derived from the total evaporation rate predicted by the simulation results. The simulation results, agreeing within 5% with the experimental measurements, show that increasing the micropillar height enhances the total evaporation rate from the suspended hemispherical droplet. This enhancement is due to a dramatic improvement of the local evaporation rate near the contact line region as micropillar heights increase. The micropillar heights examined for maximum evaporation rates were observed under substrate temperatures from 60-98 °C. The increasing pillar height leads to smaller vapor diffusion resistance but greater conduction resistance.

Li|Junhui|J| Shan|Li|L| Ma|Binjian|B| Jiang|Xinyu|X| Solomon|Abel|A| Iyengar|Madhusudan|M| Padilla|Jorge|J| Agonafer|Damena|D|

Confinement effect
Vapor diffusion
Droplet evaporation
Interfacial mass transport
Phase change heat transfer


Effect of 12-week pulmonary rehabilitation on cognitive function in patients with stable chronic obstructive pulmonary disease: study protocol for a single-center randomised controlled trial.

Abstract:
INTRODUCTION
Cognitive impairment, an important complication in patients with chronic obstructive pulmonary disease (COPD), seriously affects self-management of the disease and quality of life (QoL). As an exercise-based intervention programme, pulmonary rehabilitation (PR)-especially aerobic exercise (mainly mind-body exercise) and resistance exercise (RE)-has been proposed for its potential effectiveness in improving cognitive function. However, there is still a lack of strong evidence for PR's effectiveness. In this study, we expect to clarify the effects of pulmonary-based Qigong exercise and elastic band-based RE on cognitive function in patients with COPD and to fill in the relevant evidence blanks.

METHODS AND ANALYSIS
This study is a single-centre randomised controlled trial with assessor and data analyst blinding. We will recruit 108 participants with stable COPD starting on 23 December 2019, and randomly allocate them into the pulmonary-based Qigong exercise group, elastic band-based RE group, pulmonary-based Qigong exercise and elastic band-based RE combined group, or control group at a 1:1:1:1 ratio. Participants in intervention groups will perform 30 min of exercise two times per day, 5 days a week, for 12 weeks. The primary outcome will be the global cognitive function as assessed by the Montreal Cognitive Assessment and auditory event-related potential P300. Secondary outcomes will include the specific cognitive domains-attention, memory, executive function, verbal fluency and mental-processing speed; psychological functions and QoL. Exploratory outcomes will include grey matter volume and levels of inflammatory mediators. Outcomes will be measured before and after the interventions.

ETHICS AND DISSEMINATION
Ethics approval has been granted by the Ethics Committee of Yue-Yang Integrative Medicine Hospital, an affiliate of Shanghai University of Traditional Chinese Medicine, Shanghai, China (Grant No. 2019-141). Written informed consent will be obtained from each participant before any procedures are performed. The findings will be published in peer-reviewed journals and presented at academic conferences.

TRIAL REGISTRATION NUMBER
ChiCTR1900026869; pre-results.

Duan|Hongxia|H|0000-0001-7925-8925 Li|Peijun|P| Wang|Zhenwei|Z| Chen|Haixia|H| Wang|Ting|T| Wu|Weibing|W| Liu|Xiaodan|X|0000-0002-8379-0292

D029424:Pulmonary Disease, Chronic Obstructive

D016032:Randomized Controlled Trials as Topic

chronic airways disease
delirium & cognitive disorders
rehabilitation medicine
sports medicine


The role of VTIQ as a new tissue strain analytics measurement technique in testicular lesions.

Abstract:
PURPOSE
Virtual touch tissue imaging quantification (VTIQ) is a newly developed technique for the sonographic quantification of tissue elasticity. It has been used in the assessment of breast lesions. The purpose of this study was to determine the diagnostic performance of VTIQ in indeterminate testicular lesions.

METHODS
Twenty patients with known testicular pathology underwent conventional B-mode sonography with additional VTIQ of the testicular lesions using a Siemens Acuson S2000™ and S3000™ (Siemens Medical Solutions, Mountain View, CA, USA) system. Tissue mechanical properties were analysed in the VTIQ examination. The pathologic diagnosis was established after surgery or in the follow-up examination for suspected benign lesions.

RESULTS
Over 36 months, 22 focal testicular lesions (median lesion size, 18 mm; range, 4-36 mm in 20 patients (median age, 43 years; range, 22-81 years) were examined. Lesions were hyperechoic (n = 1), hypoechoic (n = 14), isoechoic (n = 1), of mixed echogenicity (n = 3) or anechoic (n = 3). Histological examination showed one benign lesion (6.25%) with a mean size of 7 mm and 15 malignant lesions (93.75%) with a mean size of 20 mm. Mean shear wave velocity for normal testicular tissue was 1.17 m/s. No shear wave velocity could be measured in cystic lesions. The rest of the benign lesions showed a mean shear wave velocity of 2.37 m/s. The value of the shear wave velocity in germ cell tumours showed a mean shear wave velocity of 1.94 m/s and for seminoma it showed a mean shear wave velocity of 2.42 m/s.

CONCLUSIONS
VTIQ is a reliable new method for measuring qualitative and quantitative stiffness of testicular lesions and tissue. The qualitative shear-wave elastography features were highly reproducible and showed good diagnostic performance in unclear testicular lesions. The VTIQ technique is also useful in assessing small testicular nodules and pseudolesions.

Trottmann|M|M|
Marcon|J|J|
D'Anastasi|M|M|
Karl|A|A|
Stief|C G|CG|
Reiser|M|M|
Clevert|D A|DA|

germ cell tumour
seminoma
Elastography
shear wave imaging
testis


The skin aging exposome.

Abstract: The term "exposome" describes the totality of exposures to which an individual is subjected from conception to death. It includes both external and internal factors as well as the human body's response to these factors. Current exposome research aims to understand the effects all factors have on specific organs, yet today, the exposome of human skin has not received major attention and a corresponding definition is lacking. This review was compiled with the collaboration of European scientists, specialized in either environmental medicine or skin biology. A comprehensive review of the existing literature was performed using PubMed. The search was restricted to exposome factors and skin aging. Key review papers and all relevant, epidemiological, in vitro, ex vivo and clinical studies were analyzed to determine the key elements of the exposome influencing skin aging. Here we propose a definition of the skin aging exposome. It is based on a summary of the existing scientific evidence for the role of exposome factors in skin aging. We also identify future research needs which concern knowledge about the interaction of distinct exposomal factors with each other and the resulting net effects on skin aging and suggest some protective measures.

Krutmann|Jean|J|
Bouloc|Anne|A|
Sore|Gabrielle|G|
Bernard|Bruno A|BA|
Passeron|Thierry|T|

Air pollution
Cosmetic strategies
Infrared radiation
Nutrition
Ultraviolet radiation
Visible light


Hidden Communities of Practice in Social Media Groups: Mixed Methods Study.

Abstract:
BACKGROUND
Although most US mothers initiate breastfeeding, suboptimal breastfeeding rates still exist. Although breastfeeding is a complex process, social support has been linked with increases in positive breastfeeding outcomes. Recent technological advances, including the development of social networking sites, provide mothers with convenient access to a unique array of audiences from which to seek advice about parenting, including breastfeeding. However, little is known about how the use of the sites-specifically groups centered around breastfeeding-influences breastfeeding knowledge, attitudes, or behaviors.

OBJECTIVE
This mixed methods study aimed to explore utilization of an existing probreastfeeding Facebook group and how utilization influences breastfeeding-related knowledge, attitudes, and behaviors.

METHODS
Participants were recruited online through Facebook wall posts from within the existing group. Mothers aged between 18 and 50 years who were pregnant and intended to breastfeed, were currently breastfeeding, or had recently weaned their infant in the past 3 years were eligible to participate. Participants engaged in online focus group discussions (n=21) and individual interviews (n=12). Inductive content analysis of qualitative data led to the conceptualization and contextualization of a breastfeeding community of practice (COP). Using qualitative results, a quantitative survey was then developed to assess the prevalence of qualities of a COP as well as how COP usage influenced breastfeeding-related attitudes and knowledge. A total of 314 mothers completed the online survey.

RESULTS
Qualitative findings showed an overall sense of community, with subthemes of group trust, interaction, and the promotion of breastfeeding. A majority (287/314, 91.5%) of mothers initiated breastfeeding, with 69.0% (216/314) of mothers reporting exclusive breastfeeding their infant at 6 months. Approximately 98.5% (309/314) of mothers reported that the Facebook group captured and stored knowledge; therefore, information could be easily accessed and applied. In addition, 96.2% (302/317) of mothers reported that the Facebook group motivated them to share breastfeeding-related knowledge.

CONCLUSIONS
The results suggest that this existing probreastfeeding Facebook group exhibits characteristics of an online COP, which was organically formed. Utilization of the Facebook group, in the context of an online COP, could be beneficial in impacting breastfeeding-related knowledge, attitudes, and behaviors. However, further examination and exploration of breastfeeding COPs, including using this type of model as a method of lactation support or as a telemedicine framework, is a clear need.

social media
breastfeeding
online social support
social support system


The small GTPase KlRho5 responds to oxidative stress and affects cytokinesis.

Abstract: Rho5 is the yeast homolog of the human small GTPase Rac1. We characterized the genes encoding Rho5 and the subunits of its dimeric activating guanine-nucleotide-exchange factor (GEF), Dck1 and Lmo1, in the yeast Kluyveromyces lactis. Rapid translocation of the three GFP-tagged components to mitochondria upon oxidative stress and carbon starvation indicate a similar function of KlRho5 in energy metabolism and mitochondrial dynamics as described for its Saccharomyces cerevisiae homolog. Accordingly, Klrho5 deletion mutants are hyper-resistant towards hydrogen peroxide. Moreover, synthetic lethalities of rho5 deletions with key components in nutrient sensing, such as sch9 and gpr1, are not conserved in K. lactis. Instead, Klrho5 deletion mutants display morphological defects with strengthened lateral cell walls and protruding bud scars. The latter result from aberrant cytokinesis, as observed by following the budding process in vivo and by transmission electron microscopy of the bud neck region. This phenotype can be suppressed by KlCDC42G12V, which encodes a hyper-active variant. Data from live-cell fluorescence microscopy support the notion that KlRho5 interferes with the actin moiety of the contractile actomyosin ring, with consequences different from those previously reported for mutants lacking myosin.

Yeast
Cell wall
Mitochondrion
Nutrient stress
Rho-type GTPase


Reliability and validity of a new instrument to measure tolerance of everyday risk for children.

Abstract:
BACKGROUND
A modicum of everyday risk provides opportunities for children to extend the limits of their competence. However, increasingly negative perceptions of risk have led to risk-averse behaviours in adults, including severely restricting children's play. The degree to which risk in play is tolerated by adults impacts on the lives and experiences of children. However, no measure of adult tolerance to everyday risk exists. The purpose of this study was to develop a valid and reliable instrument examining adults' tolerances of risk during children's play.

METHODS
A 31-item survey of risk tolerance was developed based on a Norwegian model of risky play; 100 parents and teachers of children aged 3 to 13 years completed the instrument. Data were subjected to Rasch analysis. Psychometric properties of the data were examined.

RESULTS
Iterative analyses produced an instrument with goodness of fit statistics in the acceptable range, a logical item hierarchy, person separation index >2 and reliability index of 0.87. There was a strong positive relationship between participants' self-perceived risk tolerance and scores on the instrument, and between the age of the child and scores on the instrument.

CONCLUSIONS
The Tolerance of Risk in Play Scale (TRiPS) yields valid and reliable data for measuring the success of interventions to change adults' everyday risk beliefs, and for exploring the impact of adults' risk tolerance on children's play and development.

risk tolerance
risky play
child development


Reconciling livestock production and wild herbivore conservation: challenges and opportunities.

Abstract: Increasing food security and preventing further loss of biodiversity are two of humanity's most pressing challenges. Yet, efforts to address these challenges often lead to situations of conflict between the interests of agricultural production and those of biodiversity conservation. Here, we focus on conflicts between livestock production and the conservation of wild herbivores, which have received little attention in the scientific literature. We identify four key socio-ecological challenges underlying such conflicts, which we illustrate using a range of case studies. We argue that addressing these challenges will require the implementation of co-management approaches that promote the participation of relevant stakeholders in processes of ecological monitoring, impact assessment, decision-making, and active knowledge sharing.

Pozo|R A|RA|
Cusack|J J|JJ|
Acebes|P|P|
Malo|J E|JE|
Traba|J|J|
Iranzo|E C|EC|
Morris-Trainor|Z|Z|
Minderman|J|J|
Bunnefeld|N|N|
Radic-Schilling|S|S|
Moraga|C A|CA|
Arriagada|R|R|
Corti|P|P|

D003247:Conservation of Natural Resources

food security
conflict
co-management
coexistence
livestock husbandry


Assessing the Efficacy of Lopinavir/Ritonavir-Based Preferred and Alternative Second-Line Regimens in HIV-Infected Patients: A Meta-Analysis of Key Evidence to Support WHO Recommendations.

Abstract: Background: Nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs (NNRTIs) with boosted protease inhibitors are included in standardized first-line and second-line regimens. Recent World Health Organization (WHO) guidelines recommend a boosted protease inhibitor (PI) combined with 2 NRTIs or raltegravir as a second-line regimen. Objective: Ritonavir-boosted lopinavir (LPV/r) is known as a key second-line antiretroviral therapy (ART) in resource-limited settings. We carried out a meta-analysis to analyze virologic suppression and effectiveness of LPV/r-based second-line therapy in HIV-infected patients. Methods: In this meta-analysis, we searched randomized controlled trials and observational cohort studies to evaluate outcomes of second-line ART for patients with HIV who failed first-line therapy. A systematic search was conducted in Pubmed, Cochrane Library, and Embase from inception to January 2018. Outcomes included viral suppression, CD4 cell counts, drug resistance, adverse events, and self-reported adherence. We assessed comparative efficacy and safety in a meta-analysis. Data analysis was performed using RevMan 5.3 and Stata12.0. Results: Nine studies comprising 3,923 patients were included in the meta-analysis. The overall successful virologic suppression rate of the second-line regimen was 77% (ITT) and 87% (PP) at 48 weeks with a plasma HIV RNA load of <400 copies/mL. No statistical significance was found in CD4 cell count recoveries between LPV/r plus 2-3 NRTIs and simplified regimens (LPV/r plus raltegravir) at 48 weeks (P = 0.09), 96 weeks (P = 0.05), and 144 weeks (P = 0.73). Four studies indicated that the virus had low-level resistance to LPV/r, and the most common clinically significant PI-resistance mutations were 46I, 54V, 82A/82F, and 76V; however, no virologic failure due to LPV/r resistance was detected. In addition, no statistical significance was found between the two groups in self-reported adherence [relative risks (RR) = 1.03,95% confidence interval (CI) 1.00, 1.07, P = 0.06], grade 3 or 4 adverse events (RR = 0.84, 95% CI 0.64, 1.10, P = 0.20) or serious events (RR = 0.85, 95% CI 0.77, 1.17, P = 0.62). Conclusions: These results suggest that the LPV/r-based regimen demonstrates efficacious and low resistance as second-line antiretroviral therapy.Both LPV/r plus 2-3 NRTIs and LPV/r plus RAL regimens improved CD4 cell counts. There was no evidence of superiority of simplified regimens over LPV/r plus 2-3 NRTIs.

Huang|Yinqiu|Y| Huang|Xiaojie|X| Luo|Yadong|Y| Zhou|Yihong|Y| Tao|Xingbao|X| Chen|Hui|H| Song|Aixin|A| Chen|Yaokai|Y| Wu|Hao|H|

second-line antiretroviral therapy
efficacy and safety
ART-experienced
human immunodeficiency virus
lopinavir/ritonavir


Investigation of mass-scale drift effects in the milli-mass range: Influence on high mass resolution mode multicollector-inductively coupled plasma mass spectrometer isotope ratio measurements.

Abstract: The consequences, possible origins, and prevention of mass-scale drifts in the high mass resolution mode (HR, M/ΔM ≈ 8000) under constant conditions were investigated and simulated in case of a multicollector-inductively coupled plasma mass spectrometer (MC-ICP-MS) using silicon enriched in 28 Si as the main element in this survey. A drifting mass scale strongly impairs the precise and accurate determination of isotope ratios, depending especially on the peak/plateau width. For example, 29 Si+ in Si highly enriched in 28 Si has an extremely small mass plateau width of ΔM ≤ 4 × 10-3 u, compare ΔM(56 Fe+ ) ≈ 18 × 10-3 u, which is to our knowledge one of the smallest plateaus routinely investigated in isotope ratio measurements, thus requiring extreme stability. During warm-up of the double-focusing sector field mass spectrometer, a mass drift up to ΔM/Δt ≥ 0.006 u/hr has been observed. Long-term studies on mass scale stability and simulations concerning fluctuations of the magnetic field B, acceleration voltage Uacc and ESA voltage UESA are reported. A change of one of these quantities of 0.01% induces changes of the mass scale of 6 × 10-3 u, 3 × 10-3 u, and 1 × 10-3 u in the case of B, Uacc , and UESA , respectively. After identifying electrical charging/discharging effects in the mass spectrometer affecting the mass scale stability, the instrument was completely dismantled and carefully reinstalled. Additional stability tests using silicon, strontium, and lead finally yielded a mass drift of ΔM/Δt ≤ 0.001 u/8 h in the case of silicon. This enhanced stability guarantees measurements of isotope ratios on smallest plateaus with lowest uncertainty. The importance of a stable mass scale is pointed out and the relevant quantities of a typical magnetic sector field mass spectrometer are discussed.

isotope ratios
high-resolution MC-ICP-MS
magnetic sector field MS
mass scale drift


The Epitympanum Revisited: Endoscopic Anatomy.

Abstract: In contrast to other means of studying the epitymapnum, the endoscope allows unparallel access without disruption of anatomy. The aim of this study is to delineate the anatomy of the epitympanum through transcanal endoscopy. Systematic dissection of anatomic specimens. We performed systematic endoscopic dissection of 20 ears in 10 fresh frozen anatomical specimens. A detailed flow sheet was filled up documenting the status of the lateral attic folds, the tensor fold, the cog and the tensor folds, the supratubal recess, and the patency of the anterior and posterior isthmus. None of the ears showed indication of previous chronic otitis media. The lateral incudomallear fold was intact in all but one ear. The lateral mallear fold was intact in all specimens. The tensor fold was complete in 16 ears and partial in four. Two of these ears belonged to the same specimen. The epitympanic diaphragm was complete in 15 out of 20 ears in 10 anatomic specimens. The endoscope allows for assessment of the attic anatomy and integrity of the diaphragm without undue disruption of anatomy. The epitympanic diaphragm is present in the majority of healthy ears and can in theory serve as the anatomic basis for the isolated attic retraction.

Endoscopic ear surgery 2
Epitympanic diaphragm 6
Epitympanum 1
Lateral incudomallear fold 3
Lateral mallear fold 4
Tensor fold 5


Vitamin K antagonist use and renal function in pre-dialysis patients.

Abstract:
Purpose
A post hoc analysis of a recent trial on direct oral anticoagulants versus vitamin K antagonists showed that amongst patients with mildly decreased kidney function, use of vitamin K antagonists was associated with a greater decline in renal function than use of direct oral anticoagulants. Whether these vitamin K antagonist effects are the same in pre-dialysis patients is unknown. Therefore, the aim of this study was to investigate the association between vitamin K antagonist use and the rate of renal function decline and time until start of dialysis in incident pre-dialysis patients.

Methods
Data from 984 patients from the PREdialysis PAtient REcord study, a multicenter follow-up study of patients with chronic kidney disease who started pre-dialysis care in the Netherlands (1999-2011), were analyzed. Of these patients, 101 used a vitamin K antagonist. Linear mixed models were used to compare renal function decline between vitamin K antagonist users and non-users. Cox proportional hazards models were used to estimate the HR with 95% CI for starting dialysis.

Results
Vitamin K antagonist use was associated with an extra change in renal function of -0.09 (95% CI -1.32 to 1.13) mL/min/1.73 m2 per year after adjustment for confounding. The adjusted HR for the start of dialysis was 1.20 (95% CI 0.85 to 1.69) in vitamin K antagonist users, compared to non-users.

Conclusion
In incident pre-dialysis patients, the use of vitamin K antagonists was not associated with an accelerated kidney function decline or an earlier start of dialysis compared to non-use. The lack of knowledge on the indication for vitamin K antagonist use could lead to confounding by indication.

Voskamp|Pauline Wm|PW|
Dekker|Friedo W|FW|
Rookmaaker|Maarten B|MB|
Verhaar|Marianne C|MC|
Bos|Willem Jan W|WJW|
van Diepen|Merel|M|
Ocak|Gurbey|G|

chronic kidney disease
coumarins
epidemiology
glomerular filtration rate


Percutaneous nephrolithotomy: position, position, position!

Abstract: Percutaneous nephrolithotomy (PCNL) is the regular surgery for treating large or complex renal stones. Since its first inception, many variations have come in the approach including the modifications of patient position. The prone position is traditionally used, and subsequently, variations in prone and supine technique have been proposed and assessed over time. In an attempt to provide comprehensive information about the strategy applications of patient's position, the present review describes the position-related general basis, and provides a literature review of the pros and cons of various positions from a surgical and anaesthetic point of view. Latest evidence has shown the major advantages of supine PCNL compared with standard prone PCNL to be as follows: optimal cardiovascular and airway control; shorter operation time due to lack of the need for repositioning; opportunity for a combined retrograde approach. However, the prone position provides a broader surface area for percutaneous access; a wider space for manipulating the nephroscope and lithotripters; and opportunity for bilateral simultaneous PCNL. To overcome their respective limitations, various positioning modifications have been proposed. However, most reports are based on case series and/or have not obtained their results in a randomized controlled fashion and/or have not been analysed according to stone complexity and particular body status (e.g. obesity, etc.), thereby limiting the ability to make strong recommendations. One important caveat is that endourology training of supine PCNL would increase supine popularization, and the prone ureteroscopic technique would overcome the difficulty of endoscopic combined intrarenal surgery in the prone position. Thereby, adequate training in the different techniques for PCNL is important for optimizing the indications and treatment outcomes.

Zhao|Zhijian|Z|
Fan|Junhong|J|
Liu|Yang|Y|
de la Rosette|Jean|J|
Zeng|Guohua|G|

Percutaneous nephrolithotomy
Prone
Supine
Comparisons
Modified position


Elevated serum galectin-9 levels in patients with atopic dermatitis.

Abstract: Galectin-9 is a member of the galectin family that has a wide spectrum of biological functions. Among them, galectin-9 has been known mainly as a potent chemoattractant for eosinophils. In addition, galectin-9 alters the T-cell balance by negatively regulating T-helper (Th)1 and Th17 cells, resulting in Th2 polarization. Atopic dermatitis (AD) is a skin allergic disease characterized by peripheral eosinophilia, mast cell activation and predominance of Th2 cells. To investigate possible roles of galectin-9 in AD, we measured serum galectin-9 levels in AD patients and investigated galectin-9 expression in lesional skin by immunohistochemistry. Serum galectin-9 levels in patients with AD were significantly higher than those in healthy controls and correlated with the Eczema Area and Severity Index. Serum galectin-9 levels were decreased after treatment, accompanied by improvement of skin lesions. Immunohistochemical study revealed that galectin-9 was expressed on epidermal keratinocytes and mast cells in lesional skin of AD. Our results suggest that elevated galectin-9 expression is associated with progression of AD and that galectin-9 could be a therapeutic target in AD.

Nakajima|Rina|R| Miyagaki|Tomomitsu|T| Oka|Tomonori|T| Nakao|Momoko|M| Kawaguchi|Makiko|M| Suga|Hiraku|H| Morimura|Sohshi|S| Kai|Hiromichi|H| Asano|Yoshihide|Y| Tada|Yayoi|Y| Kadono|Takafumi|T| Sato|Shinichi|S| Sugaya|Makoto|M|

galectin-9
atopic dermatitis
mast cells
Eczema Area and Severity Index
epidermal keratinocytes


Rubrioxytricha guamensis nov. spec. (Ciliophora, Spirotricha), a Novel Hypotrich Ciliate from Guam (United States), Micronesia.

Abstract: The oxytrichid ciliate Rubrioxytricha guamensis nov. spec. isolated from water samples collected from a small freshwater pond near the Hagåtña River in Hagåtña, Guam (United States territory), Micronesia, was investigated, using live observation and protargol impregnation. The morphology, ontogenesis, and molecular phylogeny inferred from the small-subunit rRNA gene sequences were studied. The new species is mainly characterized by a cell size of about 100 × 35 μm in vivo, two elongate ellipsoidal macronuclear nodules and two micronuclei, a single contractile vacuole, a colorless cytoplasm, yellowish cortical granules, arranged in short rows and in small groups, an adoral zone occupying about 34% of body length and comprising 27 membranelles on average, about 27 cirri each in the right and left marginal rows, 18 frontoventral transverse cirri, four dorsal kineties including one dorsomarginal row, and one or two caudal cirri at the posterior end of dorsal kinety 3. The ontogenesis of the new species is similar to that of Rubrioxytricha indica Naqvi et al., 2006. Phylogenetic analyses based on SSU rRNA gene sequences consistently place the new species within the family Oxytrichidae Ehrenberg, 1838, where it clustered with other Rubrioxytricha species, viz., R. tsinlingensis, R. ferruginea, and R. haematoplasma.

Kumar|Santosh|S|
Bharti|Daizy|D|
Kabir|Ahmed Salahuddin|AS|
Hong|Jun Seo|JS|
Shin|Mann Kyoon|MK|0000-0001-6592-1204

Ontogenesis
phylogeny
SSU rRNA gene
Pseudocyrtohymena
undulating membranes pattern


Biochar stability assessment by incubation and modelling: Methods, drawbacks and recommendations.

Abstract: Biochar produced from pyrolysis of biomass is a candidate with great potential for climate change mitigation by carbon sequestration and reduction of greenhouse gases (GHG) emission in soil. Its potential depends considerably on biochar properties. Biochar stability or biochar C recalcitrance is decisive to its carbon storage/sequestration potential in soil. Three groups of methods including: I) biochar C structure or composition analyses, II) biochar oxidation resistance determination, and III) biochar persistence assessment by incubation & modelling, have been developed for evaluation of biochar stability. Amongst, incubation & modelling is the most commonly used one and is the basis of the other two assessment methods. However, the strategies for incubation experiment designing and data modelling significantly influence the biochar stability results. Drastic differences were observed for stability results obtained from different studies partly because of the large flexibility of the incubation & modelling method. Biased biochar stability would be obtained if the method was used improperly. The present review aims to provide comprehensive information on method strategies used for incubation and modelling, followed by discussions on the key issues such as what kind of biochar to use, how the experiment should be designed, how to determine biochar C mineralization, how the mineralization data should be expressed, and what model should be used, for an accurate biochar stability evaluation. In general, incubating biochar at long-term duration, modelling incubation data with double-exponential model, using C isotopic technology for CO2 evolution determination with C mineralization data express as percentage of total organic carbon mineralized, applying biochar in the field are favorable to biochar stability assessment. Other strategies such as the use of standard (reference) biochar materials may be effective to improve the assessment.

Leng|Lijian|L| Xu|Xinwei|X| Wei|Liang|L| Fan|Liangliang|L| Huang|Huajun|H| Li|Jianan|J| Lu|Qian|Q| Li|Jun|J| Zhou|Wenguang|W|

Bio-char
Carbon dioxide
Charcoal
Mean residence time
Pyrogenic organic carbon
Soil organic matter


Incidence and Predictors of Upgrading and Up Staging among 10,000 Contemporary Patients with Low Risk Prostate Cancer.

Abstract:
PURPOSE
We determined the incidence of pathological upgrading and up staging for contemporary, clinically low risk patients, and identified predictors of having occult, advanced disease to inform the selection of patients for active surveillance.

MATERIALS AND METHODS
We studied 10,273 patients in the SEER database diagnosed with clinically low risk disease (cT1c/T2a, prostate specific antigen less than 10 ng/ml, Gleason 3 + 3 = 6) in 2010 to 2011 and treated with prostatectomy. The primary outcome was the incidence of upgrading to pathological Gleason score 7-10 or up staging to pathological T3-T4/N1 disease. Multivariable logistic regression of cases with complete biopsy data (5,581) identified significant predictors of upgrading or up staging, which were then used to create a risk stratification table.

RESULTS
At prostatectomy 44% of cases were upgraded and 9.7% were up staged. Multivariable analysis of 5,581 patients showed age, prostate specific antigen and percent positive cores (all p < 0.001) but not race were associated with occult, advanced disease. With these variables dichotomized at the median, age older than 60 years (AOR 1.39), prostate specific antigen greater than 5.0 ng/ml (AOR 1.28) and more than 25% positive cores (AOR 1.76) were significantly associated with upgrading (all p < 0.001). Similarly, age older than 60 years (AOR 1.42), prostate specific antigen greater than 5.0 ng/ml (AOR 1.44) and more than 25% positive cores (AOR 2.26) were associated with up staging (all p < 0.001). Overall 60% of 5,581 low risk cases with prostate specific antigen 7.5 to 9.9 ng/ml and more than 25% positive cores were upgraded. This study is limited by possible bias introduced by only using patients selected for prostatectomy.

CONCLUSIONS
Nearly half of clinically low risk patients harbor Gleason 7 or greater, or pT3 or greater disease, and should be risk stratified by prostate specific antigen and percent positive cores for consideration of further testing before deciding on active surveillance.

Dinh|Kathryn T|KT|
Mahal|Brandon A|BA|
Ziehr|David R|DR|
Muralidhar|Vinayak|V|
Chen|Yu-Wei|YW|
Viswanathan|Vidya B|VB|
Nezolosky|Michelle D|MD|
Beard|Clair J|CJ|
Choueiri|Toni K|TK|
Martin|Neil E|NE|
Orio|Peter F|PF|
Sweeney|Christopher J|CJ|
Trinh|Quoc D|QD|
Nguyen|Paul L|PL|

SEER program
neoplasm grading
neoplasm staging
prostatic neoplasms
watchful waiting


Diagnostic Yield of Microscopic Colitis in Open Access Endoscopy Center.

Abstract:
BACKGROUND
The diagnostic yield in open access endoscopy has been evaluated which generally support the effectiveness and efficiency of open access endoscopy. With a few exceptions, diagnostic yield studies have not been performed in open access endoscopy for more specific conditions. Therefore, we conducted a study to determine the efficiency of open access endoscopy in the detection of microscopic colitis as compared to traditional referral via a gastroenterologist.

METHODS
A retrospective search of the pathology database at the University of Missouri for specimens from a local open access endoscopy center was conducted via SNOMED code using the terms: "microscopic", "lymphocytic", "collagenous", "spirochetosis", "focal active colitis", "melanosis coli" and "histopathologic" in the diagnosis line for the time period between January 1, 2004 and May 25, 2006. Specimens and colonoscopy reports were reviewed by a single pathologist.

RESULTS
Of 266 consecutive patients with chronic diarrhea and normal colonoscopies, the number of patients with microscopic disease are as follows: Lymphocytic colitis (n = 12, 4.5%), collagenous colitis (n = 17, 6.4%), focal active colitis (n = 15, 5.6%), and spirochetosis (n = 2, 0.4%).

CONCLUSIONS
The diagnostic yield of microscopic colitis in this study of an open access endoscopy center does not differ significantly from that seen in major medical centers. In terms of diagnostic yield, open access endoscopy appears to be as effective in diagnosing microscopic colitis.

Ellingson|Derek|D| Miick|Ronald|R| Chang|Faye|F| Hillard|Robert|R| Choudhary|Abhishek|A| Ashraf|Imran|I| Bechtold|Matthew|M| Diaz-Arias|Alberto|A|

Diagnostic yield
Microscopic colitis
Open access endoscopy
Lymphocytic
Collagenous


Pattern of congenital heart disease among Egyptian children: a 3-year retrospective study.

Abstract:
BACKGROUND
Congenital heart disease (CHD) is a multifactorial birth defect which has variable demographic characteristics among children in different geographical areas. This study aimed to detect the distribution of demographic data, perinatal risk factors, types, age, and mode of presentation of CHD among Egyptian children.

RESULTS
The medical records of 1005 patients were included. They were 545 males (54%) and 462 females (46%) with a ratio of 1.2:1. Acyanotic CHD was encountered in 79.2%. Isolated ventricular septal defect and tetralogy of Fallot were the most common acyanotic and cyanotic lesions, respectively. The majority was diagnosed within the first year of life (86.7%) and was born to young mothers (91.3%). The accidental discovery of a murmur was the most frequent presentation (35%). Heart failure was detected in 44%, audible murmurs in 74.4%, maternal illnesses in 54%, consanguinity in 44.6%, prematurity in 19.3%, assisted reproduction in 11.7%, family history of CHD in 9.2%, abortions in 7.1%, and extracardiac anomalies in 3.6% of the studied population. Down syndrome (DS) was the most commonly occurring chromosomal anomaly, and the atrioventricular septal defect was the most characteristic cardiac lesion found among them.

CONCLUSIONS
There is no sex predilection among Egyptian children with CHD. Most of the cases are diagnosed in early infancy. Accidental discovery of a murmur is the most common mode of presentation. A variety of predisposing risk factors are abundant in the Egyptian population. DS is the most common chromosomal anomaly linked to CHD. Establishment of a national medical birth registry containing all information about all births in Egypt is needed for adequate surveillance and monitoring of perinatal health problems and congenital birth defects so that preventive measures can be early implemented. Proper and detailed data collection should be fulfilled in the medical records of every single patient.

Al-Fahham|Marwa Moustapha|MM|
Ali|Yasmin Abdelrazek|YA|

Perinatal risk factors
Maternal illnesses
Consanguinity
Congenital heart defects
Maternal age


Renal medullary carcinoma response to chemotherapy: a referral center experience in Brazil.

Abstract: Renal medullary carcinoma (RMC) is rare, accounting for less than 1% of all renal neoplasms. Case reports suggest RMC is highly aggressive, poorly responsive to chemotherapy, often metastatic at diagnosis, affects young men with sickle cell trait, and median overall survival (mOS) is less than 12 months. We report the epidemiological characteristics, treatments performed, response rate to each treatment and mOS of five patients with RMC. All patients had sickle cell trait, four were male, three had metastatic disease at diagnosis and mean age at diagnosis was 25 years. Non-metastatic patients were submitted to nephrectomy. Two patients had partial response to first line chemotherapy including cisplatin and gemcitabine. There was no response to sunitinib or second line chemo - therapy; mOS was 6 months. Due to its rarity, case series are the only evidence available to discuss the treatment for RMC. In our experience, only cisplatin and gemcitabine based regimen offered response.

Maroja Silvino|Marina Cavalcanti|MC|
Venchiarutti Moniz|Camila Motta|CM|
Munhoz Piotto|Gustavo Henrique|GH|
Siqueira|Sheila|S|
Galapo Kann|Ariel|A|
Dzik|Carlos|C|

renal medullary carcinoma
carcinoma
sickle cell trait
kidney neoplasms
renal cell


Comparative study on the treatment of raw and biologically treated textile effluents through submerged nanofiltration.

Abstract: Raw and biologically treated textile effluents were submerged filtrated using lab-fabricated hollow fiber nanofiltration membrane with a molecular weight cut-off of about 650 g/mol. Permeate flux, chemical oxygen demand (COD) reduction, color removal, membrane fouling, and cleaning were investigated and compared by varying the trans-membrane pressure (TMP) and volume concentrating factor (VCF). It was found that both raw and biologically treated textile effluents could be efficiently treated through submerged nanofiltration. The increase of TMP resulted in a decline in water permeability, COD reduction, color removal, and flux recovery ratio, while the increase of VCF resulted in both increased COD reduction and color removal. Under the TMP of 0.4 bar and VCF of 5.0, fluxes of 1.96 and 2.59 l/m(2)h, COD reductions of 95.7 and 94.2%, color removals of 99.0, and 97.3% and flux recovery ratios of 91.1 and 92.9% could be obtained in filtration of raw and biologically treated effluents, respectively. After filtration, the COD and color contents of the raw effluent declined sharply from 1780 to 325 mg/l and 1.200 to 0.060 Abs/cm, respectively, while for the biologically treated effluent, they decreased from 780 to 180 mg/l and 0.370 to 0.045 Abs/cm, respectively.

Chen|Qing|Q| Yang|Ying|Y| Zhou|Mengsi|M| Liu|Meihong|M| Yu|Sanchuan|S| Gao|Congjie|C|

D057919:Biological Oxygen Demand Analysis

Textile effluent
Nanofiltration
Submerged filtration
Color removal
COD reduction


Release of CXCL12 From Apoptotic Skeletal Cells Contributes to Bone Growth Defects Following Dexamethasone Therapy in Rats.

Abstract: Dexamethasone (Dex) is known to cause significant bone growth impairment in childhood. Although previous studies have suggested roles of osteocyte apoptosis in the enhanced osteoclastic recruitment and local bone loss, whether it is so in the growing bone following Dex treatment requires to be established. The current study addressed the potential roles of chemokine CXCL12 in chondroclast/osteoclast recruitment and bone defects following Dex treatment. Significant apoptosis was observed in cultured mature ATDC5 chondrocytes and IDG-SW3 osteocytes after 48 hours of 10-6  M Dex treatment, and CXCL12 was identified to exhibit the most prominent induction in Dex-treated cells. Conditioned medium from the treated chondrocytes/osteocytes enhanced migration of RAW264.7 osteoclast precursor cells, which was significantly inhibited by the presence of the anti-CXCL12 neutralizing antibody. To investigate the roles of the induced CXCL12 in bone defects caused by Dex treatment, young rats were orally gavaged daily with saline or Dex at 1 mg/kg/day for 2 weeks, and received an intraperitoneal injection of anti-CXCL12 antibody or control IgG (1 mg/kg, three times per week). Aside from oxidative stress induction systemically, Dex treatment caused reductions in growth plate thickness, primary spongiosa height, and metaphysis trabecular bone volume, which are associated with induced chondrocyte/osteocyte apoptosis and enhanced chondroclast/osteoclast recruitment and osteoclastogenic differentiation potential. CXCL12 was induced in apoptotic growth plate chondrocytes and metaphyseal bone osteocytes. Anti-CXCL12 antibody supplementation considerably attenuated Dex-induced chondroclast/osteoclast recruitment and loss of growth plate cartilage and trabecular bone. CXCL12 neutralization did not affect bone marrow osteogenic potential, adiposity, and microvasculature. Thus, CXCL12 was identified as a potential molecular linker between Dex-induced skeletal cell apoptosis and chondroclastic/osteoclastic recruitment, as well as growth plate cartilage/bone loss, revealing a therapeutic potential of CXCL12 functional blockade in preventing bone growth defects during/after Dex treatment. © 2018 American Society for Bone and Mineral Research.

Tang|Qian|Q|
Su|Yu-Wen|YW|
Fan|Chia-Ming|CM|
Chung|Rosa|R|
Hassanshahi|Mohammadhossein|M|
Peymanfar|Yaser|Y|
Xian|Cory J|CJ|

OSTEOCYTES
BONE LOSS
GROWTH PLATE
MOLECULAR PATHWAYS-DEVELOPMENT
PRECLINICAL STUDIES


Swallowing dysfunction in myasthenia gravis patients examined with high-resolution manometry.

Abstract:
OBJECTIVE
To prospectively compare oropharyngeal swallowing dysfunction in myasthenia gravis (MG) patients presenting with difficulty in swallowing between the neutral and chin-down positions, based on the results of high-resolution manometry (HRM) examination.

METHODS
We prospectively compared the HRM results of swallowing studies of seven MG patients showing difficulty in swallowing (neutral and chin-down positions) at the Department of Neurology of our institution during the period February-December 2018. The HRM assessment parameters were as follows: maximum swallowing pressure (SP) at the soft palate, meso‑hypopharynx, and upper esophageal sphincter (UES), and the duration of relaxation pressure at the UES. These parameters were compared between the two positions and their correlations with the results of neurological evaluations, such as the Quantitative Myasthenia Gravis (QMG) score (total and neck muscles alone), and grip strength, were also analyzed.

RESULTS
In comparison with the neutral position, in the chin-down position the maximum SP at the meso‑hypopharynx was significantly increased (p < 0.05), the maximum SP at the UES was significantly decreased (p < 0.05), and the duration of relaxing SP at the UES was significantly increased (p < 0.05). Interestingly, there were no correlations between the SP at any location and the results of the neurological evaluations.

CONCLUSIONS
The chin-down position appears useful for improving pharyngeal clearance in MG patients, by promoting increased SP at the meso‑hypopharynx, relaxing SP at the UES, and increasing the duration of relaxation pressure at the UES.

Kumai|Yoshihiko|Y| Miyamoto|Takumi|T| Matsubara|Keigo|K| Satoh|Chisei|C| Yamashita|Satoshi|S| Orita|Yorihisa|Y|

Myasthenia gravis
High-resolution manometry
Difficulty in swallowing
Chin-down position


Overexpression of a Gene Involved in Phytic Acid Biosynthesis Substantially Increases Phytic Acid and Total Phosphorus in Rice Seeds.

Abstract: The manipulation of seed phosphorus is important for seedling growth and environmental P sustainability in agriculture. The mechanism of regulating P content in seed, however, is poorly understood. To study regulation of total P, we focused on phytic acid (inositol hexakisphosphate; InsP₆) biosynthesis-related genes, as InsP₆ is a major storage form of P in seeds. The rice (Oryza sativa L.) low phytic acid mutant lpa1-1 has been identified as a homolog of archael 2-phosphoglycerate kinase. The homolog might act as an inositol monophosphate kinase, which catalyzes a key step in InsP₆ biosynthesis. Overexpression of the homolog in transgenic rice resulted in a significant increase in total P content in seed, due to increases in InsP₆ and inorganic phosphates. On the other hand, overexpression of genes that catalyze the first and last steps of InsP₆ biosynthesis could not increase total P levels. From the experiments using developing seeds, it is suggested that the activation of InsP₆ biosynthesis in both very early and very late periods of seed development increases the influx of P from vegetative organs into seeds. This is the first report from a study attempting to elevate the P levels of seed through a transgenic approach.

Tagashira|Yusuke|Y|
Shimizu|Tomoe|T|
Miyamoto|Masanobu|M|
Nishida|Sho|S|
Yoshida|Kaoru T|KT|

phytic acid
phosphorus
seed
Oryza sativa L.
ectopic expression
mineral element
molecular breeding
translocation


Inconclusive evidence for allergic rhinitis to predict a prolonged or chronic course of acute rhinosinusitis.

Abstract:
OBJECTIVE
To systematically review the evidence on allergic rhinitis as a predictor for a prolonged or chronic course in adult patients with acute rhinosinusitis.

DATA SOURCES
Pubmed, EMBASE, and the Cochrane library.

REVIEW METHODS
A systematic literature search was performed on March 15, 2013. During screening of title and abstract, 3 authors independently selected studies on allergic rhinitis as a predictor for the course of acute rhinosinusitis in adults. The reported study design was assessed for directness of evidence and risk of bias. We aimed to extract prior and posterior probabilities for a prolonged or chronic course of acute rhinosinusitis.

RESULTS
Of 13,202 retrieved articles, 2 articles were eligible for study assessment. They provided a high directness of evidence but carried a high risk of bias. The studies showed an incidence of a prolonged and chronic course of, respectively, .19 (95% confidence interval [CI] .16-.23) and .05 (95% CI, .02-.13). In patients with allergic rhinitis, the incidence was .25 (95% CI, .18-.35) and .14 (95% CI, .04-.34), so the added value of allergic rhinitis to predict a prolonged course is 6% and to predict a chronic course 8%.

CONCLUSION AND RECOMMENDATION
While the 2 included studies suggest that allergic rhinitis adds little to the prediction of a prolonged or chronic course in patients with acute rhinosinusitis, they carry a high risk of bias. As the available evidence does not provide grounds for different management of patients with and without allergic rhinitis, namely, according to clinical practice guidelines, both can be managed with expectant observation and symptomatic treatment.

Frerichs|Kristine A|KA|
Nigten|Gea|G|
Romeijn|Kalynda|K|
Kaper|Nina M|NM|
Grolman|Wilko|W|
van der Heijden|Geert J M G|GJ|

allergic rhinitis
acute rhinosinusitis
chronic rhinosinusitis
evidence based medicine
prognosis
prolonged rhinosinusitis


Practitioner Review: Multilingualism and neurodevelopmental disorders - an overview of recent research and discussion of clinical implications.

Abstract:
BACKGROUND
Language and communication skills are essential aspects of child development, which are often disrupted in children with neurodevelopmental disorders. Cutting edge research in psycholinguistics suggests that multilingualism has potential to influence social, linguistic and cognitive development. Thus, multilingualism has implications for clinical assessment, diagnostic formulation, intervention and support offered to families. We present a systematic review and synthesis of the effects of multilingualism for children with neurodevelopmental disorders and discuss clinical implications.

METHODS
We conducted systematic searches for studies on multilingualism in neurodevelopmental disorders. Keywords for neurodevelopmental disorders were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categories as follows; Intellectual Disabilities, Communication Disorders, Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, Motor Disorders, Other Neurodevelopmental Disorders. We included only studies based on empirical research and published in peer-reviewed journals.

RESULTS
Fifty studies met inclusion criteria. Thirty-eight studies explored multilingualism in Communication Disorders, 10 in ASD and two in Intellectual Disability. No studies on multilingualism in Specific Learning Disorder or Motor Disorders were identified. Studies which found a disadvantage for multilingual children with neurodevelopmental disorders were rare, and there appears little reason to assume that multilingualism has negative effects on various aspects of functioning across a range of conditions. In fact, when considering only those studies which have compared a multilingual group with developmental disorders to a monolingual group with similar disorders, the findings consistently show no adverse effects on language development or other aspects of functioning. In the case of ASD, a positive effect on communication and social functioning has been observed.

CONCLUSIONS
There is little evidence to support the widely held view that multilingual exposure is detrimental to the linguistic or social development of individuals with neurodevelopmental disorders. However, we also note that the available pool of studies is small and the number of methodologically high quality studies is relatively low. We discuss implications of multilingualism for clinical management of neurodevelopmental disorders, and discuss possible directions for future research.

Uljarević|Mirko|M|
Katsos|Napoleon|N|
Hudry|Kristelle|K|
Gibson|Jenny L|JL|

practitioner
Multilingualism
neurodevelopmental disorders
outcomes


A comparative study of biomass integrated gasification combined cycle power systems: Performance analysis.

Abstract: The Biomass Integrated Gasification Combined Cycle (BIGCC) power system is believed to potentially be a highly efficient way to utilize biomass to generate power. However, there is no comparative study of BIGCC systems that examines all the latest improvements for gasification agents, gas turbine combustion methods, and CO2 Capture and Storage options. This study examines the impact of recent advancements on BIGCC performance through exergy analysis using Aspen Plus. Results show that the exergy efficiency of these systems is ranged from 22.3% to 37.1%. Furthermore, exergy analysis indicates that the gas turbine with external combustion has relatively high exergy efficiency, and Selexol CO2 removal method has low exergy destruction. Moreover, the sensitivity analysis shows that the system exergy efficiency is more sensitive to the initial temperature and pressure ratio of the gas turbine, whereas has a relatively weak dependence on the initial temperature and initial pressure of the steam turbine.

Zang|Guiyan|G|
Tejasvi|Sharma|S|
Ratner|Albert|A|
Lora|Electo Silva|ES|

Biomass
Aspen Plus
Exergy efficiency
Sensitivity analysis
System simulation


Insight into the mechanism of nonenzymatic RNA primer extension from the structure of an RNA-GpppG complex.

Abstract: The nonenzymatic copying of RNA templates with imidazole-activated nucleotides is a well-studied model for the emergence of RNA self-replication during the origin of life. We have recently discovered that this reaction can proceed through the formation of an imidazolium-bridged dinucleotide intermediate that reacts rapidly with the primer. To gain insight into the relationship between the structure of this intermediate and its reactivity, we cocrystallized an RNA primer-template complex with a close analog of the intermediate, the triphosphate-bridged guanosine dinucleotide GpppG, and solved a high-resolution X-ray structure of the complex. The structure shows that GpppG binds the RNA template through two Watson-Crick base pairs, with the primer 3'-hydroxyl oriented to attack the 5'-phosphate of the adjacent G residue. Thus, the GpppG structure suggests that the bound imidazolium-bridged dinucleotide intermediate would be preorganized to react with the primer by in-line SN2 substitution. The structures of bound GppG and GppppG suggest that the length and flexibility of the 5'-5' linkage are important for optimal preorganization of the complex, whereas the position of the 5'-phosphate of bound pGpG explains the slow rate of oligonucleotide ligation reactions. Our studies provide a structural interpretation for the observed reactivity of the imidazolium-bridged dinucleotide intermediate in nonenzymatic RNA primer extension.

Zhang|Wen|W|
Tam|Chun Pong|CP|0000-0001-6381-9011
Walton|Travis|T|
Fahrenbach|Albert C|AC|
Birrane|Gabriel|G|
Szostak|Jack W|JW|

RNA self-replication
origin of life
crystal structure
diguanosine dinucleotide


Combined Effects of Resveratrol and Vitamin E From Peanut Seeds and Sprouts on Colorectal Cancer Cells.

Abstract: Resveratrol (RES) and Vitamin E (VE) are anti-cancer active ingredients with relatively high content in peanut seeds and sprouts. This study aimed to determine the synergistic inhibitory effect of RES and VE on colorectal cancer. Using 5-FU as a positive drug control, the effect of RES combined with VE on HCT-8 cells was determined, and cell viability was detected using the cell-counting kit 8 (CCK8) method. Cell morphology changes were observed using optical microscopy. Cell migration ability was evaluated by the scratch test, while cell colonies were determined by the cloning test formation ability. Apoptosis status was assessed by flow cytometry and nuclear staining by DAPI, and the expression level of apoptosis-related proteins was determined by western blotting. Compared with the single component group, the RES combined with VE group significantly inhibited the growth and proliferation of HCT-8 intestinal cancer cells in vitro. The RES combined with VE group had a greater impact on cell morphology changes and cell colony formation and significantly reduced cell migration ability and intestinal cancer cell apoptosis (p < 0.05). Additionally, combined treatment with RES and VE significantly upregulated the expression of pro-apoptotic proteins BAX, caspase-3, caspase-8, and caspase-9, and downregulated the expression of anti-apoptotic protein BCL-2, compared to the single component treatment. RES combined with VE is effective in promoting intestinal cancer cell apoptosis. This study demonstrated the significant positive synergy of RES and VE on HCT-8 cells, providing a new perspective for more effective use of RES.

Wang|Chunfeng|C| Wang|Na|N| Li|Na|N| Yu|Qiuying|Q| Wang|Fangyu|F|

HCT-8
apoptosis
BAX and BCL-2
caspase
resveatrol
vitamim E


Whole genome detection of rotavirus mixed infections in human, porcine and bovine samples co-infected with various rotavirus strains collected from sub-Saharan Africa.

Abstract: Group A rotaviruses (RVA) are among the main global causes of severe diarrhea in children under the age of 5years. Strain diversity, mixed infections and untypeable RVA strains are frequently reported in Africa. We analysed rotavirus-positive human stool samples (n=13) obtained from hospitalised children under the age of 5years who presented with acute gastroenteritis at sentinel hospital sites in six African countries, as well as bovine and porcine stool samples (n=1 each), to gain insights into rotavirus diversity and evolution. Polyacrylamide gel electrophoresis (PAGE) analysis and genotyping with G-(VP7) and P-specific (VP4) typing primers suggested that 13 of the 15 samples contained more than 11 segments and/or mixed G/P genotypes. Full-length amplicons for each segment were generated using RVA-specific primers and sequenced using the Ion Torrent and/or Illumina MiSeq next-generation sequencing platforms. Sequencing detected at least one segment in each sample for which duplicate sequences, often having distinct genotypes, existed. This supported and extended the PAGE and RT-PCR genotyping findings that suggested these samples were collected from individuals that had mixed rotavirus infections. The study reports the first porcine (MRC-DPRU1567) and bovine (MRC-DPRU3010) mixed infections. We also report a unique genome segment 9 (VP7), whose G9 genotype belongs to lineage VI and clusters with porcine reference strains. Previously, African G9 strains have all been in lineage III. Furthermore, additional RVA segments isolated from humans have a clear evolutionary relationship with porcine, bovine and ovine rotavirus sequences, indicating relatively recent interspecies transmission and reassortment. Thus, multiple RVA strains from sub-Saharan Africa are infecting mammalian hosts with unpredictable variations in their gene segment combinations. Whole-genome sequence analyses of mixed RVA strains underscore the considerable diversity of rotavirus sequences and genome segment combinations that result from a complex evolutionary history involving multiple host species.

Nyaga|Martin M|MM|
Jere|Khuzwayo C|KC|
Esona|Mathew D|MD|
Seheri|Mapaseka L|ML|
Stucker|Karla M|KM|
Halpin|Rebecca A|RA|
Akopov|Asmik|A|
Stockwell|Timothy B|TB|
Peenze|Ina|I|
Diop|Amadou|A|
Ndiaye|Kader|K|
Boula|Angeline|A|
Maphalala|Gugu|G|
Berejena|Chipo|C|
Mwenda|Jason M|JM|
Steele|A Duncan|AD|
Wentworth|David E|DE|
Mphahlele|M Jeffrey|MJ|

Whole genome
Rotavirus
Mixed infections
Africa
Reassortants


Immune profiling of pregnant Toxoplasma-infected US and Colombia patients reveals surprising impacts of infection on peripheral blood cytokines.

Abstract: In North America (NA) and Europe, the majority of toxoplasmosis cases are benign and generally asymptomatic, whereas in South America (SA) toxoplasmosis is associated with much more severe symptoms in adults and congenitally infected children. The reasons for these differences remain unknown; currently, there is little information from patients in either region on how the immune system responds to infection with Toxoplasma gondii. Here, we report the relative abundance of 51 serum cytokines from acute and chronic toxoplasmosis cohorts of pregnant women from the United States, where approximately one-half of clinical isolates are Type II, and Colombia, where clinical isolates are generally "atypical" or Type I-like strains. Surprisingly, the results showed notably lower levels of 23 cytokines in acutely infected patients from the United States, relative to uninfected US controls. In acutely infected Colombian patients, however, only 8 cytokine levels differed detectably with 4 being lower and 4 higher relative to uninfected controls. Strikingly, there were also differences in the cytokine profiles of the chronically infected patients relative to uninfected controls in the US cohort. Hence, Toxoplasma appears to specifically impact levels of circulating cytokines, and our results may partly explain region-specific differences in the clinical spectrum of toxoplasmosis.

Pernas|Lena|L|
Ramirez|Raymund|R|
Holmes|Tyson H|TH|
Montoya|José G|JG|
Boothroyd|John C|JC|

pregnant
Colombia
cytokines
toxoplasmosis
Toxoplasma gondii
acute
chronic
congenital, cytokine profile


A giant popliteal lipoblastoma in a 23-month-old girl: a case report.

Abstract:
BACKGROUND
Lipoblastomas are rare benign tumors that arise from embryonic white fat and almost always occur in babies and children. Here, we report a case of a giant popliteal lipoblastoma in a 23-month-old Japanese girl that was successfully treated via complete resection.

CASE PRESENTATION
Our patient was a 23-month-old Japanese girl. At 6 months of age, she presented at a nearby hospital with a mass on the popliteal side of her lower right leg. She had no symptoms and was diagnosed as having a benign adipose tumor via magnetic resonance imaging. The mass gradually increased in size, and she was referred to our hospital at 1 year and 11 months of age. A physical examination and radiology revealed a localized mass 13 × 10 × 7 cm in size in the aforementioned area that restricted knee movement and caused proximal tibia deformity. Magnetic resonance imaging showed a giant circumscribed subcutaneous mass with multiple partitions that was hyperintense on T1-weighted and T2-weighted images but not fat-saturated on T2-weighted images. Based on these findings, she was diagnosed as having a lipoblastoma. Because the mass surrounded her popliteal artery and vein and part of the popliteal nerve, surgical resection was considered risky, and we opted to simply observe her. However, owing to rapid growth of the mass and the worsening of symptoms, she underwent complete resection at 2 years and 6 months of age. A histological examination confirmed the diagnosis of a lipoblastoma. She was discharged from our hospital 3 days after surgery with no symptoms. She could walk without pain at the 6-month follow-up, and no local recurrence was observed.

CONCLUSIONS
We successfully treated a giant popliteal lipoblastoma without complications by performing a total resection. Our report provides evidence that lipoblastomas should be considered for surgical resection when they progress or symptoms appear.

Hashimoto|Shogo|S| Kikuta|Kazutaka|K| Sekita|Tetsuya|T| Nakayama|Robert|R| Takayama|Shinichiro|S| Sasaki|Aya|A| Kameyama|Kaori|K| Nakamura|Masaya|M| Matsumoto|Morio|M| Morioka|Hideo|H|

Lipoblastoma
Children
Resection
Magnetic resonance imaging
Operative adaptation


Synthesis and crystal structure of 2-amino-3-hydroxypyridinium dioxido(pyridine-2,6-dicarboxylato-κ³O²,N,O⁶)vanadate(V) and its conversion to nanostructured V₂O₅.

Abstract: 2-Amino-3-hydroxypyridinium dioxido(pyridine-2,6-dicarboxylato-κ(3)O(2),N,O(6))vanadate(V), (C5H7N2O)[V(C7H3NO4)O2] or [H(amino-3-OH-py)][VO2(dipic)], (I), was prepared by the reaction of VCl3 with dipicolinic acid (dipicH2) and 2-amino-3-hydroxypyridine (amino-3-OH-py) in water. The compound was characterized by elemental analysis, IR spectroscopy and X-ray structure analysis, and consists of an anionic [VO2(dipic)](-) complex and an H(amino-3-OH-py)(+) counter-cation. The V(V) ion is five-coordinated by one O,N,O'-tridentate dipic dianionic ligand and by two oxide ligands. Thermal decomposition of (I) in the presence of polyethylene glycol led to the formation of nanoparticles of V2O5. Powder X-ray diffraction (PXRD) and scanning electron microscopy (SEM) were used to characterize the structure and morphology of the synthesized powder.

crystal structure
V2O5 nanostructure
dipicolinate ligand
vanadium(V) complex


Acarbose Monotherapy and Type 2 Diabetes Prevention in Eastern and Western Prediabetes: An Ethnicity-specific Meta-analysis.

Abstract:
PURPOSE
Acarbose is effective in delaying or preventing the progression of prediabetes to type 2 diabetes mellitus (T2DM). The aim of this study was to assess differences in the preventive effects of acarbose in Eastern and Western populations with prediabetes.

METHODS
We performed a systematic search of databases and reference lists of clinical trials conducted through August 2013. Randomized controlled trials of acarbose alone, with a minimum intervention duration of 3 years and which provided data on T2DM incidence, were included for analysis. Analyses were conducted by using Review Manager version 5.1 software.

FINDINGS
Eight randomized controlled trials with 2628 participants were included. Acarbose decreased the occurrence of T2DM (number needed to treat [NNT], 6.7). Compared with the control (placebo and/or lifestyle intervention), the incidence of T2DM was significantly lower in the Eastern group (NNT, 5.9) than in the Western group (NNT, 11.1) (P < 0.0001, I(2) = 94.7%). At the end of follow-up, reversal of prediabetes to normal glucose tolerance was more likely in the Eastern group (NNT, 4.3) than in the Western group (NNT, 25) (P = 0.004, I(2) = 92%). Among those remaining prediabetic, there was no significant difference between the subtotal estimates for the subgroups (P = 0.17, I(2) = 46.5%). There was no positive correlation between preventive effect and dose, and no difference in studies with varying follow-up durations within and across either ethnic group.

IMPLICATIONS
The preventive effect of acarbose on the development of diabetes seems superior in Eastern populations with prediabetes compared with Western populations.

Hu|Ruijie|R| Li|Yi|Y| Lv|Qingguo|Q| Wu|Taixiang|T| Tong|Nanwei|N|

acarbose
diabetes prevention
prediabetes
ethnicity


Partitioning of soil phosphorus among arbuscular and ectomycorrhizal trees in tropical and subtropical forests.

Abstract: Partitioning of soil phosphorus (P) pools has been proposed as a key mechanism maintaining plant diversity, but experimental support is lacking. Here, we provided different chemical forms of P to 15 tree species with contrasting root symbiotic relationships to investigate plant P acquisition in both tropical and subtropical forests. Both ectomycorrhizal (ECM) and arbuscular mycorrhizal (AM) trees responded positively to addition of inorganic P, but strikingly, ECM trees acquired more P from a complex organic form (phytic acid). Most ECM tree species and all AM tree species also showed some capacity to take up simple organic P (monophosphate). Mycorrhizal colonisation was negatively correlated with soil extractable P concentration, suggesting that mycorrhizal fungi may regulate organic P acquisition among tree species. Our results support the hypothesis that ECM and AM plants partition soil P sources, which may play an ecologically important role in promoting species coexistence in tropical and subtropical forests.

Liu|Xubing|X|
Burslem|David F R P|DFRP|
Taylor|Joe D|JD|
Taylor|Andy F S|AFS|
Khoo|Eyen|E|
Majalap-Lee|Noreen|N|
Helgason|Thorunn|T|
Johnson|David|D|

tropical and subtropical forests
Mycorrhizal fungi
phosphate
resource partitioning
seedling growth
soil organic phosphorus


Arriving at no: Patient pressure to prescribe antibiotics and physicians' responses.

Abstract: While the vast majority of Acute Respiratory Infections (ARIs) are viral, between a quarter and a third of adults presenting with ARIs are given an antibiotic, making antibiotic prescribing for ARIs a major contributor to the inappropriate prescribing problem. We argue that inappropriate prescribing persists because of the interplay between physicians and patients in the medical visit. Relying on a convenience sample of 68 video recordings of primary care medical visits drawn from corpora collected in 2003-2004 and 2015-2016 in the US, we show that although few patients are "demanding" or "requesting" antibiotics, many convey subtle forms of pressure through priming physicians for a bacterial diagnosis in their problem presentations; nudging towards a bacterial diagnosis during information gathering; and resisting non-antibiotic recommendations during the counseling phase. We find that patient priming, nudging, and resisting are effective strategies to influence clinical prescribing behavior. However, we also identify two ways that physicians can counter patient pressure by working to manage patient expectations through foreshadowing a non-antibiotic outcome and using persuasion when confronted with resistance. These, we show, are effective means of countering patient pressure. We argue for the dual importance of how physicians communicate and when they communicate.

Patient expectations
Persuasion
Interaction
Negotiation
Physician-patient


Established vascular effects of continuous positive airway pressure therapy in patients with obstructive sleep apnoea-an update.

Abstract: The aim of this review was to summarize the current data from randomised controlled trials (RCTs) on vascular effects of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnoea (OSA). There is good evidence from RCTs that CPAP lowers blood pressure (BP) to a clinically significant amount. The effect seems to be dependent on the hours of nightly CPAP usage. Data from RCTs have also proven a beneficial effect of CPAP on measures of vascular function such as endothelial function and arterial stiffness. However, there is still a lack of evidence from RCTs proving that CPAP reduces vascular events and mortality.


Short- and long-term outcomes after minimally invasive versus open spleen-saving distal pancreatectomies.

Abstract:
Introduction
This study aimed to compare the perioperative outcomes of patients who underwent minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) versus open surgery SPDP (O-SPDP). It also aimed to determine the long-term vascular patency after spleen-saving vessel-preserving distal pancreatectomies (SSVDPs).

Methods
A retrospective review of 74 patients who underwent successful SPDP and met the study criteria was performed. Of these, 67 (90.5%) patients underwent SSVDP, of which 38 patients (21 open, 17 MIS) had adequate long-term post-operative follow-up imaging to determine vascular patency.

Results
Fifty-one patients underwent open SPDP, whereas 23 patients underwent minimally invasive SPDP, out of which 10 (43.5%) were laparoscopic and 13 (56.5%) were robotic. Patients who underwent MI-SPDP had significantly longer operative time (307.5 vs. 162.5 min, P = 0.001) but shorter hospital stay (5 vs. 7 days, P = 0.021) and lower median blood loss (100 vs. 200 cc, P = 0.046) compared to that of O-SPDP. Minimally-invasive spleen-saving vessel-preserving distal pancreatectomy (MI-SSVDP) was associated with poorer long-term splenic vein patency rates compared to O-SSVDP (P = 0.048). This was particularly with respect to partial occlusion of the splenic vein, and there was no significant difference between the complete splenic vein occlusion rates between the MIS group and open group (29.4% vs. 28.6%, P = 0.954). The operative time was statistically significantly longer in patients who underwent robotic surgery versus laparoscopic surgery (330 vs. 173 min, P = 0.008).

Conclusion
Adoption of MI-spleen-preserving distal pancreatectomy (SPDP) is safe and feasible. MI-SPDP is associated with a shorter hospital stay, lower blood loss but longer operation time compared to O-SPDP. In the present study, MI-SSVDP was associated with poorer long-term splenic vein patency rates compared to O-SSVDP.

Chee|Madeline|M|
Lee|Chuan-Yaw|CY|
Lee|Ser-Yee|SY|
Ooi|London L P J|LLPJ|
Chung|Alexander Y F|AYF|
Chan|Chung-Yip|CY|
Goh|Brian K P|BKP|

patency
Laparoscopic pancreatectomy
robotic pancreatectomy
spleen-saving pancreatectomy
splenic vessels


Intestinal Crypt Organoid: Isolation of Intestinal Stem Cells, In Vitro Culture, and Optical Observation.

Abstract: The isolation and culture of intestinal stem cells (ISCs) was first demonstrated in the very recent decade with the identification of ISC marker Lgr5. The growth of ISCs into crypt organoids provides an in vitro model for studying the mucosal physiology, intestinal cancer tumorigenesis, and intestinal regeneration. Here, we describe two different isolation protocols and demonstrate a fixation method that aids in the confocal observation of the organoids.

Chen|Yun|Y| Li|Chuan|C| Tsai|Ya-Hui|YH| Tseng|Sheng-Hong|SH|

D018929:Cell Culture Techniques
D002469:Cell Separation
D002478:Cells, Cultured
D006801:Humans
D066298:In Vitro Techniques
D007422:Intestines
D018613:Microscopy, Confocal
D009940:Organoids
D013234:Stem Cells

Crypt organoid
Isolation
Intestinal stem cell (ISC)
Confocal observation
Three-dimensional imaging


Sex differences in postprocedural aortic regurgitation and mid-term mortality after transcatheter aortic valve implantation.

Abstract:
BACKGROUND
The impact of female sex on mortality after transcatheter aortic valve implantation (TAVI) is controversial. Post-procedural aortic regurgitation (AR) ≥ 2 has been associated with poor outcomes. Whether sex differences in post-procedural AR ≥ 2 could contribute to a mortality difference between women and men is not known.

METHODS
Six hundred fifty-six patients, women (53.1%), men (46.9%), with aortic stenosis underwent TAVI with the CoreValve system (92.8%) or the Edwards SAPIEN valve system (7.2%). AR was graded semiquantitatively as 0 = none, 1 = trivial, 2 = mild, 3 = moderate, and 4 = severe. The incidence of post-procedural AR ≥ 2 was reported.

RESULTS
Procedural success was similar in women as compared to men (97.9 vs 96.7%, P = 0.32). Post-procedural AR ≥ 2 occurred less frequently in women than in men (20.9 vs 29.6%, P = 0.01). After a median follow-up of 434 days, all-cause mortality tended to be lower in women than in men (20.7 vs 26.6%, logrank P = 0.10), and was significantly higher in patients with AR ≥ 2 than in those without (34.8 vs 19.7%, logrank P < 0.001). AR ≥ 2 [hazard ratio (HR) 1.73, 95% confidence interval (CI) 1.22-2.43, P = 0.002], but not female sex (P = 0.17) was an independent predictor of all-cause death at multivariable Cox regression. The predictive value of AR ≥ 2 was restricted to men (HR 2.96, P < 0.001 among men; HR 0.86, P = 0.60 among women; P for interaction = 0.002).

CONCLUSIONS
Women, as compared to men, present a trend toward lower mortality. A significant lower incidence of post-procedural AR ≥ 2 among women contributes to this finding. Female sex, however, was not a significant independent predictor of death.

Ferrante|Giuseppe|G|
Pagnotta|Paolo|P|
Petronio|Anna Sonia|AS|
Bedogni|Francesco|F|
Brambilla|Nedy|N|
Fiorina|Claudia|C|
Giannini|Cristina|C|
Mennuni|Marco|M|
De Marco|Federico|F|
Klugmann|Silvio|S|
Ettori|Federica|F|
Presbitero|Patrizia|P|

D019918:Heart Valve Prosthesis Implantation

sex
aortic regurgitation
transcatheter aortic valve implantation