Skin thickness score as a surrogate marker of organ involvements in systemic sclerosis: a retrospective observational study.

Abstract:
BACKGROUND
Previous studies have shown the relationship between higher skin thickness score and the existence of organ involvements in systemic sclerosis (SSc). Here, we firstly investigated the correlation between skin thickness score and quantitative measurements of each organ involvement in Japanese patients with SSc.

METHODS
All Japanese SSc patients hospitalized to our clinic for initial evaluation of SSc were selected. Skin thickness was evaluated by modified Rodnan total skin thickness score (mRSS). Relationship between mRSS and prevalence or incidence of organ involvements was examined by logistic analyses. Correlation between mRSS and quantitative measurements of organ involvements was examined by correlation analyses and regression analyses.

RESULTS
We recruited 198 patients into our study. The mean disease duration was 7.3 years with the mean follow-up duration of 3.2 years. Multivariate logistic regression analyses revealed that higher mRSS is related to higher prevalence of interstitial lung disease (P < 0.05), restrictive impairment (P < 0.01), and diffusion impairment (P < 0.05) of the lung. Correlation analyses revealed mRSS negatively correlates with forced vital capacity (P < 0.001) and diffusing capacity (P < 0.001) of the lung. Correlation between longitudinal change of mRSS and that of forced vital capacity (P < 0.05) or diffusing capacity (P < 0.001) of the lung was also demonstrated.

CONCLUSIONS
Skin thickness score significantly correlates with quantitative measurements of lung involvement in Japanese patients with SSc.

Matsuda|Kazuki M|KM|
Yoshizaki|Ayumi|A|
Kuzumi|Ai|A|
Fukasawa|Takemichi|T|
Ebata|Satoshi|S|
Miura|Shunsuke|S|
Toyama|Tetsuo|T|
Yoshizaki|Asako|A|
Sumida|Hayakazu|H|
Asano|Yoshihide|Y|
Oba|Koji|K|
Sato|Shinichi|S|

Modified Rodnan total skin thickness score


Agaricus blazei-Based Mushroom Extract Supplementation to Birch Allergic Blood Donors: A Randomized Clinical Trial.

Abstract: Since Agaricus blazei Murill (AbM) extract reduced specific IgE and ameliorated a skewed Th1/Th2 balance in a mouse allergy model, it was tested in blood donors with self-reported, IgE-positive, birch pollen allergy and/or asthma. Sixty recruited donors were randomized in a placebo-controlled, double-blinded study with pre-seasonal, 7-week, oral supplementation with the AbM-based extract AndosanTM. Before and after the pollen season, questionnaires were answered for allergic rhino-conjunctivitis, asthma, and medication; serum IgE was measured, and Bet v 1-induced basophil activation was determined by CD63 expression. The reported general allergy and asthma symptoms and medication were significantly reduced in the AbM compared to the placebo group during pollen season. During the season, there was significant reduction in specific IgE anti-Bet v 1 and anti-t3 (birch pollen extract) levels in the AbM compared with the placebo group. While the maximal allergen concentrations needed for eliciting basophil activation before the season, changed significantly in the placebo group to lower concentrations (i.e., enhanced sensitization) after the season, these concentrations remained similar in the AndosanTM AbM extract group. Hence, the prophylactic effect of oral supplementation before the season with the AbM-based AndosanTM extract on aeroallergen-induced allergy was associated with reduced specific IgE levels during the season and basophils becoming less sensitive to allergen activation.

Mahmood|Faiza|F|
Hetland|Geir|G|0000-0003-1272-3436
Nentwich|Ivo|I|
Mirlashari|Mohammad Reza|MR|
Ghiasvand|Reza|R|
Nissen-Meyer|Lise Sofie Haug|LSH|

clinical trial
birch pollen allergy
asthma
AndosanTM
basophil activation
Agaricus blazei mushroom


Effects of hypercapnia in acute respiratory distress syndrome.

Abstract: In patients with acute respiratory distress syndrome (ARDS) hypercapnia is a marker of poor prognosis, however there is controversial information regarding the effect of hypercapnia on outcomes. Recently two studies in a large population of mechanical ventilation patients showed higher mortality associated independently to hypercapnia. Key roles responsible for the poor clinical outcomes observed in critically ill patients exposed to hypercapnia are not well known, two possible mechanisms involved are the effect of CO2 on the muscle and the alveolar epithelium. Hypercapnia frequently coexists with muscle atrophy and dysfunction, moreover patients surviving ARDS present reduced muscle strength and decreased physical quality of life. One of the possible mechanisms responsible for these abnormalities could be the effects of hypercapnia during the course of ARDS. More over controversy persists about the hypercapnia role in the alveolar space, in the last years there is abundant experimental information on its deleterious effects on essential functions of the alveolar epithelium.


Diagnostic Performance of Magnetic Resonance Imaging for Detecting Meniscal Ramp Lesions in Patients With Anterior Cruciate Ligament Tears: A Systematic Review and Meta-analysis.

Abstract:
BACKGROUND
The clinical importance of meniscal ramp lesions in patients with anterior cruciate ligament (ACL) tear has emerged as a major issue. However, the diagnostic accuracy of magnetic resonance imaging (MRI) for detecting ramp lesions has a wide range.

PURPOSE
To perform a systematic review and meta-analysis of the diagnostic performance of MRI for diagnosing ramp lesion in patients with ACL tear.

STUDY DESIGN
Systematic review and meta-analysis.

METHODS
A literature search of PubMed, EMBASE, and the Cochrane Library was performed based on the revised guidelines for the PRISMA DTA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Accuracy Studies) statement. Diagnostic performance studies using MRI as the index test and arthroscopy as the reference standard for ramp lesion were included. Bivariate and hierarchical summary receiver operating characteristic modeling was used to evaluate the diagnostic performance. Meta-regression analyses were performed to identify potential sources of heterogeneity.

RESULTS
The review and meta-analysis included 9 studies from 8 articles (883 patients with ACL tear and reconstruction). The summary sensitivity, summary specificity, and area under the hierarchical summary receiver operating characteristic for ramp lesion were 0.71 (95% CI, 0.59-0.81), 0.94 (95% CI, 0.88-0.97), and 0.90 (95% CI, 0.87-0.92), respectively. Among the potential covariates, magnet strength (P < .01), patient knee position (P = .04), and MRI interpreter (P = .04) were associated with heterogeneity in terms of sensitivity, whereas magnet strength (P = .03) was associated with heterogeneity in terms of specificity.

CONCLUSION
MRI demonstrated moderate sensitivity and excellent specificity for diagnosing ramp lesion. Routine arthroscopic assessment is recommended for the presence of ramp lesion, regardless of whether it is suspected on MRI. Further clinicoradiological studies of diagnostic algorithms are needed for identifying ramp lesion, including high-resolution MRI with appropriate knee position.

Koo|Boyeon|B|
Lee|Sun Hwa|SH|
Yun|Seong Jong|SJ|
Song|Jae Gwang|JG|

D000070598:Anterior Cruciate Ligament Injuries

magnetic resonance imaging
ramp lesions
anterior cruciate ligament
meta-analysis
meniscocapsular junction


Temporal changes in the pattern of invasive angiography use and its outcome in suspected coronary artery disease: implications for patient management and healthcare resources utilization.

Abstract:
Introduction
Invasive coronary angiography (CAG), the 'gold standard' in coronary artery disease (CAD) diagnosis, requires hospitalization, is not risk-free, and engages considerable healthcare resources.

Aim
To assess recent (throught out 10 years) evolution of 'significant' (≥ 50% stenosis(es)) CAD prevalence in subjects undergoing CAG for CAD diagnosis in a high-volume tertiary referral center.

Material and methods
Anonymized medical records were compared for the last vs. the first 2-years of the decade (June 2007 to May 2018). Referrals for suspected CAD were 2067 of 4522 hospitalizations (45.7%) and 1755 of 5196 (33.8%) respectively (p < 0.001).

Results
The median patient age (64 vs. 68 years) and the prevalence of heart failure (24.1% vs. 42.2%) increased significantly (p < 0.001). The CAG atherosclerotic lesions, for all stenosis categories (< 50%; ≥ 50%; ≥ 70%; occlusion(s)), were significantly more prevalent in men. The proportion of subjects with any atherosclerosis on CAG increased (80.7% vs. 77.6%, p = 0.015). However, in the absence of any gross change in, for instance, the fraction of women (40.4% vs. 41.8%), the proportion of CAGs with significant CAD (lesion(s) ≥ 50%) decreased from 55.2% in 2007/2008 to below 1 in every 2 angiograms (48.9%) in 2017/2018 (p < 0.001). This unexpected finding occurred consistently across nearly all CAG referral categories.

Conclusions
Despite more advanced age and a higher proportion of subjects with 'any' coronary atherosclerosis on CAG, the likelihood of a 'negative' angiogram (lesion(s) < 50%; no further evaluation/intervention) has increased significantly over the last decade. The exact nature of this phenomenon requires further investigation, particularly as a reverse trend would be expected with the growing role (and current high penetration) of contemporary non-invasive diagnostic tools to rule out significant CAD.

Chmiel|Jakub|J|
Książek|Miłosz K|MK|
Stryszak|Weronika|W|
Iwaszczuk|Paweł|P|
Hołda|Mateusz K|MK|
Świtacz|Grażyna|G|
Kozanecki|Artur|A|
Wilkołek|Piotr|P|
Rubiś|Paweł|P|
Kopeć|Grzegorz|G|
Odrowąż-Pieniążek|Piotr|P|
Przewłocki|Tadeusz|T|
Tracz|Wiesława|W|
Podolec|Piotr|P|
Musiałek|Piotr|P|

angiography
coronary artery disease
coronary angiography
diagnosis
coronary angiogram
invasive evaluation


Long-term stability of bioelectricity generation coupled with tetrathionate disproportionation.

Abstract: To prevent uncontrolled acidification of the environment, reduced inorganic sulfur compounds (RISCs) can be bioelectrochemically removed from water streams. The long-term stability of bioelectricity production from tetrathionate (S4O6(2-)) was studied in highly acidic conditions (pH<2.5) in two-chamber fed-batch microbial fuel cells (MFCs). The maximum current density was improved from previously reported 80mAm(-2) to 225mAm(-2) by optimizing the external resistance. The observed reaction products of tetrathionate disproportionation were sulfate and elemental sulfur. In long-term run, stable electricity production was obtained for over 700days with the average current density of 150mAm(-2). The internal resistance of the MFC decreased over time and no biofouling was observed. This study shows that tetrathionate is an efficient substrate also for long-term bioelectricity production.

Sulonen|Mira L K|ML|
Lakaniemi|Aino-Maija|AM|
Kokko|Marika E|ME|
Puhakka|Jaakko A|JA|

Long-term stability
Tetrathionate
Disproportionation
Microbial fuel cell
Acidophile


Identification of Suppressors of top-2 Embryonic Lethality in Caenorhabditis elegans.

Abstract: Topoisomerase II is an enzyme with important roles in chromosome biology. This enzyme relieves supercoiling and DNA and RNA entanglements generated during mitosis. Recent studies have demonstrated that Topoisomerase II is also involved in the segregation of homologous chromosomes during the first meiotic division. However, the function and regulation of Topoisomerase II in meiosis has not been fully elucidated. Here, we conducted a genetic suppressor screen in Caenorhabditis elegans to identify putative genes that interact with topoisomerase II during meiosis. Using a temperature-sensitive allele of topoisomerase II, top-2 ( it7ts ), we identified eleven suppressors of top-2-induced embryonic lethality. We used whole-genome sequencing and a combination of RNAi and CRISPR/Cas9 genome editing to identify and validate the responsible suppressor mutations. We found both recessive and dominant suppressing mutations that include one intragenic and 10 extragenic loci. The extragenic suppressors consist of a known Topoisomerase II-interacting protein and two novel interactors. We anticipate that further analysis of these suppressing mutations will provide new insights into the function of Topoisomerase II during meiosis.

top-2
topoisomerase II
meiosis
C. elegans


Alzheimer's disease - the 'microbial hypothesis' from a clinical and neuroimaging perspective.

Abstract: The etiology of Alzheimer's disease (AD) is under debate since its first description in 1906. Extracellular senile plaques composed of beta-amyloid peptide (Aβ) and intracellular neurofibrillary tangles composed of tau protein characterize the histopathology of the disease. The 'amyloid cascade hypothesis' summarizes the molecular mechanisms leading to deposition of these proteins. However, treatments derived from this hypothesis have been unsuccessful. An infectious etiology for AD has been repeatedly proposed. Neurotropic viruses, gut and lung bacteriae, and Bovine Meat and Milk Factors have been implicated in neurodegenerative disorders including AD. These pathogens may act directly or as a trigger or co-factor for inducing neurodegeneration in AD. The antimicrobial properties of beta-amyloid have shifted the discussion of the etiological origin of AD towards an interaction hypothesis. Neuroimaging studies have added to the understanding of mechanisms involved in neurodegeneration. Antiviral agents and a bacterial protease inhibitor targeting Porphyromonas gingivalis toxins are currently tested in clinical trials. Further clinical studies are needed to test if strategies directly derived from the 'microbial hypothesis' or combination strategies including antimicrobial agents may be beneficial for patients with Alzheimer's disease.

Alzheimer's disease
Microbial hypothesis
Bovine meat and milk factors
Porphyromonas gingivalis
Borrelia burgdorferi
Chlamydophila pneumoniae
Helicobacter pylori
Herpes simplex virus type-1


Effects of Bariatric Surgery on Depression: Role of Body Image.

Abstract:
BACKGROUND
It has been suggested that psychosocial functioning improves after bariatric surgery, but the mechanism of this effect remains unclear. We propose that body image mediates the association between %EWL and improvement in depressive symptoms.

MATERIALS AND METHODS
To investigate this hypothesis, we conducted a mediation analysis in longitudinal data from 52 patients after LSG.

RESULTS
%EWL had no direct effect on depressive symptoms as assessed through the patient health questionnaire (PHQ-9), but a small indirect effect that was mediated through negative evaluation of the body (BIQ-20).

CONCLUSIONS
We interpret this observation in the context of complex individual etiologies of obesity and argue for a stronger focus on psychological interventions in aftercare regimes. This may be specifically relevant for patients with eating disorders or a desire for body contouring surgery.

Behrens|Simone C|SC|0000-0002-0430-5245
Lenhard|Konrad|K|
Junne|Florian|F|
Ziser|Katrin|K|
Lange|Jessica|J|
Zipfel|Stephan|S|
Giel|Katrin E|KE|
Teufel|Martin|M|
Mack|Isabelle|I|

D050110:Bariatric Surgery
D000073880:Body Contouring
D001828:Body Image
D003863:Depression
D006801:Humans
D009767:Obesity, Morbid

Bariatric surgery
Depression
Body image
Obesity


Coinfection with dengue and hepatitis A complicated with infective endocarditis in a Yemeni patient: a case report.

Abstract:
INTRODUCTION
Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping. These infections are self-limiting but can become complicated by subsequent infective endocarditis. We report a case of infective endocarditis following a coinfection with dengue and hepatitis A.

CASE PRESENTATION
A 17-year-old Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever. Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M. At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along with elevated C-reactive protein. Five days later, the patient was readmitted to the emergency department, complaining of high-grade fever, fatigue, myalgia, nausea, and vomiting. A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture. Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was treated with antibiotics for 4 weeks. The patient recovered completely from dengue, hepatitis A, and infective endocarditis.

CONCLUSION
In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other. Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease. An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.

Dengue
Hepatitis A
Infective endocarditis
Coagulase-negative staphylococci
Yemen


Verification of Proficiency in Basic Skills for PGY-1 Surgical Residents: 10-Year Update.

Abstract:
OBJECTIVE
The American College of Surgeons and the Association of Program Directors in Surgery developed a curriculum in 2001 that involved instructional modules for 11 basic surgical skills and a standardized Verification of Proficiency (VOP) evaluation instrument. Our institution continues to employ a modified version of this curriculum and the purpose of this study was to provide a 10-year update on our VOP evaluation instrument used to assess postgraduate year 1 (PGY-1) residents on surgical skills.

DESIGN
All PGY-1 surgical residents over the past 10 years at our institution have completed the American College of Surgeons/the Association of Program Directors in Surgery-adapted basic surgical skills curriculum and VOP assessment. Retrospective analysis of VOP data for all residents was subjected to statistical analysis for internal validity and level of correlation.

SETTING
Department of Surgery at Southern Illinois University School of Medicine located in Springfield, Illinois.

PARTICIPANTS
All PGY-1 surgical residents (per year: 4 general surgery, 3 orthopedic surgery, 2 plastic surgery, 2 urology, 2 ENT, 1 vascular surgery, and 1 neurosurgery) over the past 10 years.

RESULTS
One hundred and thirty five residents underwent VOP evaluation over 10 years; 92 (68%) failed at least 1 module and 40 (30%) failed at least 2 modules. Residents who failed to demonstrate proficiency were mandated to complete remediation and retested until their scores were considered proficient. Performance on checklist items showed moderate internal consistency (⍺ ≥ 0.50) on 9 of 11 modules. Poor internal consistency (⍺ < 0.30) was noted for overall proficiency across all modules. Combined performance on checklist items and economy of time and motion demonstrated significant positive correlation (p < 0.05) with overall proficiency in every module.

CONCLUSIONS
The VOP instrument offers an internally valid means of assessing distinct basic skills of PGY-1 residents at basic surgical skills. The instrument provides critical formative and summative feedback on surgical skill performance to trainees.

Beason|Austin M|AM|
Hitt|Collin E|CE|
Ketchum|Janet|J|
Rogers|Heather|H|
Sanfey|Hilary|H|

Surgical skills curriculum
Assessment and performance
Medical Knowledge
Postgraduate education
Practice-Based Learning and Improvement
Technical skills


Alternative detection of SARS-CoV-2 RNA by a new assay based on mass spectrometry.

Abstract:
OBJECTIVES
Accurate detection of SARS-CoV-2 RNA is essential to stopping the spread of SARS-CoV-2. The aim of this study was to evaluate the performance of the recently introduced MassARRAY® SARS-CoV-2 Panel and to compare it to the cobas® SARS-CoV-2 Test.

METHODS
The MassARRAY® SARS-CoV-2 Panel consists of five assays targeting different sequences of the SARS-CoV-2 genome. Accuracy was determined using national and international proficiency panels including 27 samples. For clinical evaluation, 101 residual clinical samples were analyzed and results compared. Samples had been tested for SARS-CoV-2 RNA with the cobas® SARS-CoV-2 Test.

RESULTS
When accuracy was tested with the MassARRAY® SARS-CoV-2 Panel, 25 of 27 (92.6%) samples revealed correct results. When clinical samples were analyzed with the MassARRAY® SARS-CoV-2 Panel and compared to the cobas® SARS-CoV-2 Test, 100 samples showed concordant results. One sample was found to be inconclusive with the MassARRAY® SARS-CoV-2 Panel. When time-to-results were compared, the new assay showed longer total and hands-on times.

CONCLUSIONS
The MassARRAY® SARS-CoV-2 Panel showed a good performance and proved to be suitable for use in the routine diagnostic laboratory. Especially during phases of shortage of reagents and/or disposables, the new test system appears as beneficial alternative to standard assays used for detection of SARS-CoV-2 RNA.

Stelzl|Evelyn|E|
Kessler|Harald H|HH|
Mustafa|Hans G|HG|
Mustafa|Maria E|ME|
Santner|Brigitte I|BI|
Seier|Josef|J|
La Torre|Marco|M|
Haushofer|Alexander C|AC|

D060888:Real-Time Polymerase Chain Reaction

SARS-CoV-2 RNA
mass spectrometry
MassARRAY®SARS-CoV-2 panel
PCR


Quality of life in older and frail patients after surgery for colorectal cancer-A follow-up study.

Abstract:
OBJECTIVE
The incidence of colorectal cancer is increasing, mainly due to the aging of the population. Frailty, describing a state of increased vulnerability, is common in older patients, but frailty and high age are not necessarily contraindications to surgical treatment. However, limited data describing long-term outcomes after surgery in this patient group exist. In this clinical follow-up study, we aimed to examine long-term health-related quality of life in older surgical patients with colorectal cancer.

MATERIALS AND METHODS
Patients were recruited from a prospective multicenter study investigating frailty as a predictor of postoperative complications after surgery for colorectal cancer. A preoperative geriatric assessment was performed, and patients were classified as frail or non-frail. Patients responded to version 3.0 of The European Organisation of Research and Treatment of Cancer Quality of Life Questionnaire-C30 before surgery, 3months postoperatively and at a long-term follow-up 16-28months (median 22months) after surgery. One-way repeated-measures analyses of variance were performed to examine changes in scores over time.

RESULTS
180 patients with a mean age of 80years were included at baseline, 138 at 3months postoperatively, and 84 patients (69% of survivors) at long-term follow-up. A significant improvement in quality of life-scores was present 3months after surgery, also in the subgroup of frail patients. At long-term follow-up, scores decreased, but to values above baseline.

CONCLUSION
Health-related quality of life may be improved in older patients after surgery for colorectal cancer, even in patients who are classified as frail preoperatively.

Rønning|Benedicte|B|
Wyller|Torgeir Bruun|TB|
Nesbakken|Arild|A|
Skovlund|Eva|E|
Jordhøy|Marit Slaaen|MS|
Bakka|Arne|A|
Rostoft|Siri|S|

D013505:Digestive System Surgical Procedures

Quality of life
Colorectal neoplasia
Colorectal surgery
Frail elderly


Improved anti-tumor activity of oxaliplatin by encapsulating in anti-DR5 targeted gold nanoparticles.

Abstract: Oxaliplatin is one of the chemotherapeutic agents in the first line therapy for treatment of colorectal cancer. But, limitations of chemotherapy affects the clinical applicability of oxaliplatin depriving its activity at targeted site attributed to the lack of site specificity. This limitation paves the way for undesirable toxic effects to healthy cells resulting in sub-standard drug amount at the tumors obliging for increased dose. The present study emphasizes on formulating gold nanoparticles encapsulating oxaliplatin and later conjugating with anti-DR5 antibody for improved anti-cancer activity in a synergistic and site-specific manner. Oxaliplatin immuno-nanoparticles (Co-Ox-AuNPs) had shown sustained release and confirmed by fluorescence and flow cytometry studies. MTT assay exhibited 3-fold decrease in cell viability of nanoparticles comparable to oxaliplatin. Triple fluorescence method employed in HCT 116 and MCF-7 cells justified its site specificity. Annexin-propidium iodide (PI) and Acridine orange-ethidium bromide assays further supported the apoptotic activity. Moreover, caspase-dependent molecular mechanism behind oxaliplatin induced anti-cancer activity was explored by western blot analysis. Reduction in tumor size and volume in xenograft tumor models justified its in vitro activity. Oxaliplatin side effects were analyzed in mice and were confirmed for their clinical efficacy highlighting our formulation as an alternative to chemotherapy.

Tummala|Shashank|S|
Kumar|M N Satish|MN|
Pindiprolu|Sai Kiran|SK|

D000971:Antineoplastic Combined Chemotherapy Protocols

D053220:Receptors, TNF-Related Apoptosis-Inducing Ligand

D023041:Xenograft Model Antitumor Assays

oxaliplatin
Colorectal cancer
site specific
DR5
TRAIL


The human sensorimotor cortex fosters muscle synergies through cortico-synergy coherence.

Abstract: In neuromotor control, the dimensionality of complex muscular activation patterns is effectively reduced through the emergence of muscle synergies. Muscle synergies are tailored to task-specific biomechanical needs. Traditionally, they are considered as low-dimensional neural output of the spinal cord and as such their coherent cortico-muscular pathways have remained underexplored in humans. We investigated whether muscle synergies have a higher-order origin, especially, whether they are manifest in the cortical motor network. We focused on cortical muscle synergy representations involved in balance control and examined changes in cortico-synergy coherence accompanying short-term balance training. We acquired electromyography and electro-encephalography and reconstructed cortical source activity using adaptive spatial filters. The latter were based on three muscle synergies decomposed from the activity of nine unilateral leg muscles using non-negative matrix factorization. The corresponding cortico-synergy coherence displayed phase-locked activity at the Piper rhythm, i.e., cortico-spinal synchronization around 40 Hz. Our study revealed the presence of muscle synergies in the motor cortex, in particular, in the paracentral lobule, known for the representation of lower extremities. We conclude that neural oscillations synchronize between the motor cortex and spinal motor neuron pools signifying muscle synergies. The corresponding cortico-synergy coherence around the Piper rhythm decreases with training-induced balance improvement.

Zandvoort|Coen S|CS|
van Dieën|Jaap H|JH|
Dominici|Nadia|N|
Daffertshofer|Andreas|A|

Muscle synergies
Electromyography
Electro-encephalography
Cortico-muscular connectivity
Motor control
Postural stability


Is disease induced by flooding representative of nursery conditions in rhododendrons infected with Phytophthora cinnamomi or P. plurivora?

Abstract: The degree of flooding commonly used to induce disease in Phytophthora root rot studies rarely occurs in container nurseries. Instead, over-irrigation and poor drainage result in plants periodically sitting in shallow pools of water. Rhododendron plants were grown in a noninfested substrate or substrate infested with Phytophthora cinnamomi or P. plurivora to determine whether root rot induced by flooding represents disease that occurs under simulated nursery conditions when plants are in a shallow pool of water (saucers) or are allowed to freely drain and maintained at ~ 75% container capacity (75% CC). Generally, P. cinnamomi caused more disease than P. plurivora and all water treatments were conducive to root rot. In experiment 1, the amount of disease due to flooding was similar to that in the saucer treatment (75% CC not tested) while in experiment 2, flooding often caused more rapid and severe disease than the saucer or 75% CC treatment. Pathogens differed in their response to water treatments. P. cinnamomi caused more disease in treatments with >90% substrate moisture for either a short (flood) or long duration (saucer), while P. plurivora was less capable of causing disease when soil moisture was maintained >90% than when substrate moisture was maintained at a more moderate level (flood, 75% CC). Our results indicate that it is not necessary to flood plants to induce disease under experimental conditions and that disease induced by flooding can represent disease in container nurseries when containers are in pools of water or maintained at ~75% CC. In addition, our results suggest that P. cinnamomi is a more aggressive pathogen than P. plurivora in nursery conditions where drainage is poor; however, both species are capable of causing a similar amount of disease under more typical irrigation management.

Mestas|Angie|A|
Weiland|Jerry E|JE|
Scagel|Carolyn F|CF|
Grünwald|Niklaus J|NJ|
Davis|E Anne|EA|
Beck|Bryan R|BR|
Mitchell|Jesse|J|

Causal Agent
Crop Type
Epidemiology
Oomycetes
Ornamentals
Subject Areas
disease development and spread
woody ornamentals


Orchestration of autonomous trusted third-party banking.

Abstract: Background Digital transformation is changing the structure and landscape of future banking needs with much emphasis on value creation. Autonomous banking solutions must incorporate on-the-fly processing for risky transactions to create this value. In an autonomous environment, access control with role and trust delegation has been said to be highly relevant. The aim of this research is to provide an end to end working solution that will enable autonomous transaction and task processing for banking. Method We illustrate the use case for task delegation with the aid of risk graphs, risk bands and finite state machines. This paper also highlights a step by step task delegation process using a risk ordering relation methodology that can be embedded into smart contracts. Results Task delegation with risk ordering relation is illustrated with six process owners that share immutable ledgers. Task delegation properties using Multi Agent Systems (MAS) is used to eliminate barriers for autonomous transaction processing. Secondly, the application of risk graph and risk ordering relation with reference to delegation of tasks is a novel approach that is nonexistent in RBAC. Conclusion The novelty of this study is the logic for task delegation and task policies for autonomous execution on autonomous banking platforms akin to the idea of federated ID (Liberty Alliance).

Autonomous banking
task delegation
risk graph
risk band
risk ordering relation
RBAC
RkBAC
role based


Determining soil enzyme activities for the assessment of fungi and citric acid-assisted phytoextraction under cadmium and lead contamination.

Abstract: Microorganism or chelate-assisted phytoextraction is an effective remediation tool for heavy metal polluted soil, but investigations into its impact on soil microbial activity are rarely reported. Consequently, cadmium (Cd)- and lead (Pb)-resistant fungi and citric acid (CA) were introduced to enhance phytoextraction by Solanum nigrum L. under varied Cd and Pb pollution levels in a greenhouse pot experiment. We then determined accumulation of Cd and Pb in S. nigrum and the soil enzyme activities of dehydrogenase, phosphatase, urease, catalase, sucrase, and amylase. Detrended canonical correspondence analysis (DCCA) was applied to assess the interactions between remediation strategies and soil enzyme activities. Results indicated that the addition of fungi, CA, or their combination enhanced the root biomass of S. nigrum, especially at the high-pollution level. The combined treatment of CA and fungi enhanced accumulation of Cd about 22-47 % and of Pb about 13-105 % in S. nigrum compared with the phytoextraction alone. However, S. nigrum was not shown to be a hyperaccumulator for Pb. Most enzyme activities were enhanced after remediation. The DCCA ordination graph showed increasing enzyme activity improvement by remediation in the order of phosphatase, amylase, catalase, dehydrogenase, and urease. Responses of soil enzyme activities were similar for both the addition of fungi and that of CA. In summary, results suggest that fungi and CA-assisted phytoextraction is a promising approach to restoring heavy metal polluted soil.

Mao|Liang|L| Tang|Dong|D| Feng|Haiwei|H| Gao|Yang|Y| Zhou|Pei|P| Xu|Lurong|L| Wang|Lumei|L|

Soil enzymes
Fungi
Cadmium
Lead
Citric acid
Solanum nigrum L


Determination of mandibular morphology in a TURKISH population with Down syndrome using panoramic radiography.

Abstract:
BACKGROUND
Down syndrome (DS) is by far the most common known chromosomal disorder. Some characteristic features of DS are generalised growth deficiency, craniofacial abnormalities such as mandibular prognathism and underdevelopment of the midfacial region, dental abnormalities such as taurodontism and hypodontia. Individuals with DS have an increased prevalence of periodontal disease compared with age-matched control patients. The aim of the present study is to determine the morphologic features of the mandible among individuals with DS.

METHODS
Thirty-four DS patients and thirty four age- and gender-matched control subjects underwent panoramic radiography, which included measurement of the mandibular canal (MC), the mandibular foramen (MF), the mandibular ramus (MR), the distance from the MC to the mandibular lower border (C-MLB), and the distance between the MC and the alveolar crest upper limit (C-AUL). Patients were separated into two groups based on age: < 15 (n = 15) and ≥ 15 (n = 19). In order to determine whether the MF, MR, MC, C-AUL, and C-MLB scores differed according to the groups (DS and control), one-way multivariate analysis of covariance (MANCOVA) was applied in which gender and age were taken as covariates.

RESULTS
When the main effect according to the group was examined separately according to each measurement, the MF in the DS group was high with a moderate effect (F = 9207; p = 0.003). MR (F = 40,518; p < 0.001), MC (F = 23,747; p < 0.001), and C-AUL (F = 58,571; p < 0.001) in the DS group were lower with a larger effect. C-MLB did not significantly differ between the groups, and the effect size was quite low (p > 0.05).

CONCLUSIONS
Mandibular canal morphology may exhibit anatomical variations in DS. The alveolar bone level may differ from non-DS due to growth development retardation and/or periodontal diseases.

Down syndrome
Mandibular canal
Mandibular foramen


Monoolein-based nanoparticles for drug delivery to the central nervous system: A platform for lysosomal storage disorder treatment.

Abstract: Lysosomal Storage Disorders (LSDs) are characterized by an abnormal accumulation of substrates within the lysosome and comprise more than 50 genetic disorders with a frequency of 1:5000 live births. Nanotechnology may be a promising way to circumvent the drawbacks of the current therapies for lysosomal diseases. The blood circulation time and bioavailability of the enzymes or drugs could be improved by inserting them in nanocarriers, which could decrease and/or avoid the need of frequent intravenous infusions along with the minimization or elimination of associated immunogenic responses. Considering the exposed, we aimed to build monoolein-based nanoparticles stabilized by polysorbate 80 as a smart platform able to reach the central nervous system (CNS) to deliver drugs or enzymes inside lysosomes. We developed and characterized the nanoparticles by dynamic light scattering (DLS), small-angle X-ray scattering (SAXS) and cryogenic transmission electron microscopy (Cryo-TEM). The nanoparticles showed a diameter of 115 nm, which is compatible with in vivo application. The SAXS patterns of the formulations displayed a single broad correlation peak that was fitted to the Teubner-Strey model confirming that disordered bicontinuous structures were obtained. Cryo-TEM images corroborated this finding and showed nanoparticles with size values that are similar to those determined by DLS. Furthermore, the nanoparticles did not present cytotoxicity when they were incubated with human fibroblasts, and demonstrated hemolytic activity proportional to the negative control, proving to be safe for parenteral administration. Through the use of a fluorescent dye to track the nanoparticles inside the cell, we demonstrated that they reached lysosomes after 1 h of treatment. More interestingly, the fluorescent dye was detected in the CNS of mice just after 3 h of treatment. The nanoparticles show great potential to improve the treatment of LSDs with brain impairment, acting as a smart platform to targeted delivery of drugs or enzymes.

Donida|Bruna|B|
Tauffner|Bárbara|B|
Raabe|Marco|M|
Immich|Maira F|MF|
de Farias|Marcelo A|MA|
de Sá Coutinho|Diego|D|
Machado|Andryele Zaffari|AZ|
Kessler|Rejane Gus|RG|
Portugal|Rodrigo V|RV|
Bernardi|Andressa|A|
Frozza|Rudimar|R|
Moura|Dinara J|DJ|
Poletto|Fernanda|F|
Vargas|Carmen Regla|CR|

Nanoparticles
Lysosomal storage disorders
Brain
Coumarin-6
Lysosome targeting
Monoolein


Person-centred rehabilitation: what exactly does it mean? Protocol for a scoping review with thematic analysis towards framing the concept and practice of person-centred rehabilitation.

Abstract:
INTRODUCTION
Person-centredness is a philosophy for organising and delivering healthcare based on patients' needs, preferences and experiences. Although widely endorsed, the concept suffers from a lack of detail and clarification, in turn accounting for ambiguous implementation and outcomes. While a conceptual framework based on a systematic review defines person/patient-centred care components (Scholl et al, 2014), it applies across healthcare contexts and may not be sensitive to the nuances of the rehabilitation of adults with physical impairments. Accordingly, this study aims to build a conceptual framework, based on existing literature, of what person-centredness means in the rehabilitation of adults with physical impairments in the clinical encounter and broader health service delivery.

METHODS AND ANALYSIS
We will use a scoping review methodology. Searches on relevant databases will be conducted first, combining keywords for 'rehabilitation', 'person-centered' and associated terms (including patient preferences/experiences). Next, snowball searches (citation tracking, references lists) will be performed. Papers will be included if they fall within predefined selection categories (seen as most likely informative on elements pertaining to person-centred rehabilitation) and are written in English, regardless of design (conceptual, qualitative, quantitative). Two reviewers will independently screen titles and abstracts, followed by screening of the full text to determine inclusion. Experts will then be consulted to identify relevant missing papers. This can include elements other than the peer-reviewed literature (eg, book chapters, policy/legal papers). Finally, information that helps to build the concept and practice of person-centred rehabilitation will be abstracted independently by two reviewers and analysed by inductive thematic analysis to build the conceptual framework.

DISSEMINATION
The resulting framework will aid clarification regarding person-centred rehabilitation, which in turn is expected to conceptually ground and inform its operationalisation (eg, measurement, implementation, improvement). Findings will be disseminated through local, national and international stakeholders, both at the clinical and service organisation levels.

Jesus|Tiago S|TS|0000-0003-1300-6308
Bright|Felicity|F|
Kayes|Nicola|N|
Cott|Cheryl A|CA|

D003210:Concept Formation
D003695:Delivery of Health Care
D006801:Humans
D018802:Patient-Centered Care
D012046:Rehabilitation
D000078202:Systematic Reviews as Topic

Rehabilitation
protocol
scoping review
conceptual framework
person-centered


Resistant Hypertension From Renal Artery Stenosis Leading to Heart Failure With Preserved Ejection Fraction.

Abstract: Resistant hypertension remains an important cause of heart failure. In this article, we describe a case of resistant hypertension in a 63-year-old woman leading to heart failure and marked morbidity. Her clinical course was characterized by chronic pleural effusions and recurrent hospitalizations with respiratory failure and flash pulmonary edema associated with heart failure with preserved ejection fraction. Her transthoracic echocardiogram showed severe concentric left hypertrophy and diastolic dysfunction. The clinical phenotype was secondary to resistant hypertension due to bilateral renal artery stenosis, and her blood pressure and heart failure resolved after successful renal artery angioplasty. This case demonstrates how heart failure with preserved ejection fraction due to renal artery stenosis can easily go unrecognized especially in patients with multiple comorbidities. The potentially curable nature of this condition clearly warrants consideration especially in patients with multiple risk factors for atherosclerotic vascular disease.

Alyamani|Motasem|M|
Thomas|Jissy|J|
Shanks|Miriam|M|
Oudit|Gavin Y|GY|

D002037:Bundle-Branch Block
D003251:Constriction, Pathologic
D004452:Echocardiography
D005260:Female
D006333:Heart Failure
D006801:Humans
D006973:Hypertension
D008875:Middle Aged
D011654:Pulmonary Edema
D012077:Renal Artery
D012078:Renal Artery Obstruction
D013318:Stroke Volume
D018487:Ventricular Dysfunction, Left


The Role of Arrestin Domain-Containing 3 in Regulating Endocytic Recycling and Extracellular Vesicle Sorting of Integrin β4 in Breast Cancer.

Abstract: Despite the established role of integrin β4 (ITG β4) in breast cancer progression, the importance of endocytic recycling of ITG β4 and its regulatory mechanism are poorly understood. Here, we found that a sub-population of ITG β4 is sorted into early endosomes, recycled back to the plasma membrane, and secreted in the form of extracellular vesicles (EVs) upon EGF treatment in triple negative breast cancer (TNBC) cells. A metastasis suppressor, ARRDC3 (arrestin domain-containing 3) prevents EGF-driven endocytic recycling of ITG β4 by inducing NEDD4-dependent ubiquitination of ITG β4 and targeting endosomal ITG β4 into lysosomes. Endocytic recycling of ITG β4 is linked to sorting of ITG β4 into EVs (ITG β4+ EVs). ITG β4+ EVs are mainly detectable from supernatants of TNBC cells and their production is inhibited by ARRDC3 expression. ARRDC3 reduces the metastatic potentials of breast cancer cell-derived EVs by reducing ITG β4 levels in EVs. Overall, current studies provide novel mechanistic insights on the regulatory mechanism of ITG β4 recycling, and its importance in invasive potentials of TNBC EVs, thus providing the basis for therapeutic targeting of the ARRDC3/ITG β4 pathway in TNBC.

Soung|Young Hwa|YH|
Ford|Shane|S|
Yan|Cecilia|C|
Chung|Jun|J|

endocytic recycling
extracellular vesicles
integrin β4
ARRDC3
ubiquitination
triple-negative breast cancer (TNBC)


Robot-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy.

Abstract: Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2) , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy will be more frequently carried out as a safe, effective and minimally-invasive nephron-sparing surgery procedure.

Shiroki|Ryoichi|R| Fukami|Naohiko|N| Fukaya|Kosuke|K| Kusaka|Mamoru|M| Natsume|Takahiro|T| Ichihara|Takashi|T| Toyama|Hiroshi|H|

robot-assisted partial nephrectomy
nephron-sparing surgery
warm ischemic time
kidney tumor


Anesthetic management of a parturient with uncorrected tetralogy of Fallot for Cesarean section.

Abstract: Tetralogy of Fallot is the most common cyanotic congenital heart disease. We report the anesthetic management of a patient with uncorrected Fallot's tetralogy for Cesarean section.

tetralogy of Fallot
Cesarean section
pregnancy


A comparative study of the vibro-impact capsule systems with one-sided and two-sided constraints.

Abstract: This paper studies the dynamics of the vibro-impact capsule systems with one-sided and two-sided soft constraints under variations of various system and control parameters, including mass ratio, stiffness ratio, gap of contact, and amplitude and frequency of external excitation. The aim of this study is to optimise the progression speed and energy consumption of the capsule and minimise the required cabin length for prototype design used for engineering pipeline inspection. Our studies focus on three systems: the capsule with a right constraint, the capsule with a right and a weak left constraints, and the capsule with a right and a strong left constraints. Bifurcation analyses show that the behaviour of the capsule with one-sided constraint is mainly periodic, and the dynamic responses of the other two capsules with two-sided constraints become complex when the stiffness of the left constraint increases. Based on our extensive comparisons, the following optimisation strategies are recommended. When the capsule speed is paramount, one can employ the two-sided capsule with a weak left constraint under large amplitude of excitation. When energy consumption is taken into account, the one-sided capsule is preferable. When a miniaturized prototype is needed, the two-sided capsule with a strong left constraint is the best choice.

Vibro-impact
Optimisation
Energy consumption
Non-smooth dynamical system
Stick-slip


Double-stapling technique for transhiatal distal esophageal resection: feasibility test in a cadaver model.

Abstract:
OBJECTIVES
To assess the feasibility of a new surgical technique for the resection of the distal third of the esophagus and/or cardias for neoplasm.

METHODS
This surgical technique consists of two steps: For this purpose we built a stainless steel support bar for the anvil that is thinner than the freespace of a standard linear suturing stapler (TATM). The support bar holds up a push rod that can be adapted to the hooking-unhooking of the anvil.

RESULTS
We performed our new technique on five cadavers. We did not encounter any difficulty during the procedures. We tested the anastomosis with hydropneumatic assessment without recording any leaks. The esophago-enteric anastomosis was then opened without finding any mechanical defects related to the procedure.

CONCLUSION
It can often be very difficult to fashion a safe hand-sewn pouch or a purse string around the anvil of an EEATM during the resection of the distal third of the esophagus or the cardias by a trans-hiatal approach. Moreover, there is no standardized procedure to minimize anastomotic leak. To avoid these mechanical problems we designed this innovative procedure, which is considered to be reproducible without significant training.

Gentilli|S|S| Davoli|F|F| Portigliotti|L|L| Boldorini|R|R| Casadio|C|C| Garavoglia|M|M|

Transhiatal Esophagus Stapler Anastomoses Cancer


Heparanase regulation of sFLT-1 release in trophoblasts in vitro.

Abstract:
INTRODUCTION
Preeclampsia is a common pregnancy disorder which is characterized by new onset hypertension and endothelial dysfunction. Despite efforts to determine the causal factors of this disease, little progress has been made in discerning the etiology. The hypoxic and ischemic placenta, however, is generally accepted as the source for secreted factors in the maternal circulation, such as sFLT-1, which drive the maternal syndrome.

METHODS
Using BeWo placental trophoblast cells, we measured the role of hypoxia on sFLT-1 mRNA as well as protein production. We also exposed the cells to treatment with heparin and heparanase inhibitor OGT-2115.

RESULTS
We found that under hypoxic conditions mRNA levels of sFLT-1 were unchanged compared to normoxic controls. Although the message level did not differ under hypoxic conditions, the sFLT-1 release into the media was significantly greater in hypoxia. Additionally, we found that sFLT-1 is able to bind heparan strands in the extracellular matrix with its heparin binding site. These heparan strands can be cleaved by the extracellular enzyme heparanase. We found that heparanase expression was significantly increased in hypoxia, and inhibiting the actions of heparanase attenuated the release of sFLT-1 into the media.

DISCUSSION
While the placenta remains a source of sFLT-1, the mechanism of increased circulating sFLT-1 may differ than simple upregulation of the protein. These data demonstrate the potential importance of the role heparanase may play in releasing previously made sFLT-1 into the maternal circulation.

Eddy|Adrian C|AC|
Chapman|Heather|H|
George|Eric M|EM|

D040281:Vascular Endothelial Growth Factor Receptor-1

Heparanase sFlt-1 Trophoblasts Preeclampsia


Clinical Trial on Solid Second-Generation Platelet-Concentrates in the Management of the Chronic Osteomyelitis: Advanced Bioregenerative Surgeries.

Abstract: The supposition is that the usage of fibrin rich in leukocytes and platelets advanced (A-PRF) in ulcerative osteomyelitis of the diabetic foot allows rehabilitation from this critical illness. In this investigation, the focus was to normalize the use of platelet-rich fibrin (PRF) in patients with osteomyelitis not amputated, to use this second-generation platelet concentrate as a regeneration enabler. The researchers submitted and utilized A-PRF membranes (1300 g × 8 min) in 7 patients (all diabetics) with osteomyelitis and cutaneous injury for 6 months. The membranes, in combination with the supernatant fluid produced by stress, have been integrated into the skin lesion down to the bone after surgical debridement. The advancement of the lesions after some period of time has been analyzed. All 7 subjects had a probe-to-bone positive assay; magnetic resonance imaging indicated cortico-periosteal coagulation and/or foci of cortico-spongeous osteolysis contiguous to the lesion. Gram-positive bacteria were identified in our procedures in 52% of cases. Gram + Cocci, for example, Staphylococcus aureus (15.6%), β-hemolytic Streptococci (12.1%), Streptococcus viridans (7.1%), and Gram-negative bacteria, for example, Pseudomonas (10.6%), Proteus (7.8%), Enterobacter (5.7%) were present. Candida albicans was active in 2.8% of cases. The blood count showed no relevant differences. To date, cutaneous lesions have been cured in 6 of the 7 subjects treated (1 patient for more than 6 years) without any evidence of infection or recurrence. The results obtained on our subjects indicate that PRF membranes may be a therapeutic option in this problematic disease. In fact, this clinical approach may have the potential to promote the healing of diabetic skin lesions with osteomyelitis.

chronic osteomyelitis
platelet-rich fibrin
buffy coat
concentrates of thrombocytes
growth factor content


Radiation dose estimation of patients undergoing lumbar spine radiography.

Abstract: Radiation dose to organs of 100 adult patients undergoing lumbar spine (LS) radiography at a University Hospital have been assessed. Free in air kerma measurement using an ionization chamber was used for the patient dosimetry. Organ and effective dose to the patients were estimated using PCXMC (version 1.5) software. The organs that recorded significant dose due to LS radiography were lungs, stomach, liver, adrenals, kidney, pancreas, spleen, galbladder, and the heart. It was observed that the stomach recorded the highest dose (48.2 ± 1.2 μGy) for LS anteroposterior (AP). The spleen also recorded the highest dose (41.2 ± 0.5 μGy) for LS lateral (LAT). The mean entrance surface air kerma (ESAK) of LS LAT (122.2 μGy) was approximately twice that of LS AP (76.3 μGy), but the effective dose for both examinations were approximately the same (LS LAT = 8.6 μSv and LS AP = 10.4 μSv). The overall stochastic health effect of radiation to patients due to LS radiography in the University Hospital is independent of the projection of the examination (AP or LAT).

Gyekye|Prince Kwabena|PK|
Simon|Adu|A|
Geoffrey|Emi-Reynolds|ER|
Johnson|Yeboah|Y|
Stephen|Inkoom|I|
Engmann|Cynthia Kaikor|CK|
Samuel|Wotorchi-Gordon|WG|

lumbar spine
radiography
effective dose
Conventional X-ray
organ dose


Tepidimonas sediminis sp. nov. and Tepidimonas alkaliphilus sp. nov., two novel moderately thermophilic species isolated from a hot spring.

Abstract: The taxonomic positions of two moderately thermophilic bacteria, strains YIM 72259T and YIM 72238T, isolated from a hot spring sediment sample were determined using polyphasic taxonomic approaches. Pairwise comparison of the 16S rRNA gene sequences showed that strains YIM 72259T and YIM 72238T are closely related to Tepidimonas ignava SPS-1037T (97.0 and 97.5%, respectively), Tepidimonas taiwanensis I1-1T (96.5 and 97.3%), while sharing 98.0% sequence similarity with each other. The DNA-DNA relatedness values of strains YIM 72238T with T. ignava SPS-1037T and T. taiwanensis I1-1T were determined to be 25.2 ± 1.2 and 24.6 ± 3.1%, respectively, while the two strains (YIM 72259T and YIM 72238T) had a relatedness value of 38.3 ± 4.4% between themselves. The two strains were aerobic, Gram-stain negative, motile by means of a polar flagellum and formed non-pigmented colonies. The DNA G+C contents of strains YIM 72259T and YIM 72238T were determined to be 71.6 and 68.9 mol%, respectively. The major fatty acids in both strains were identified as (> 10%) C16:0, C17:0 and summed feature 8, while the strain YIM 72238T contained a moderately high amount of summed feature 3 as well. The polar lipid profiles for strains YIM 72259T and YIM 72238T consisted of diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, an unidentified aminolipid and several unidentified phospholipids. Besides the morphological and chemotaxonomic characteristics, phylogenetic analyses of the 16S rRNA gene sequences and the biochemical characteristics indicated that the two strains represented two novel members of the genus Tepidimonas, for which the name Tepidimonas sediminis sp. nov. [type strain YIM 72259T (= NBRC 112410T = CGMCC 1.15971T) and Tepidimonas alkaliphilus sp. nov. [type strain YIM 72238T (= KCTC 52717T = CCTCC AB 2017168T)] are proposed.

Habib|Neeli|N|
Khan|Inam Ullah|IU|
Salam|Nimaichand|N|
Xiao|Min|M|
Ahmed|Iftikhar|I|
Zhi|Xiao-Yang|XY|
Li|Wen-Jun|WJ|

D015373:Bacterial Typing Techniques
D001482:Base Composition
D000073556:Burkholderiales
D004269:DNA, Bacterial
D005227:Fatty Acids
D045482:Hot Springs
D006358:Hot Temperature
D010743:Phospholipids
D010802:Phylogeny
D012336:RNA, Ribosomal, 16S

Tepidimonas sediminis sp. nov.
Tepidimonas alkaliphilus sp. nov
Moderately thermophilic
Hot spring


A comparison of the location in membranes of curcumin and curcumin-derived bivalent compounds with potential neuroprotective capacity for Alzheimer's disease.

Abstract: Curcumin and two bivalent compounds, namely 17MD and 21MO, both obtained by conjugation of curcumin with a steroid molecule that acts as a membrane anchor, were comparatively studied. When incorporated into 1,2-dipalmitoyl-sn-glycero-3-phosphocholine the compounds showed a very limited solubility in the model membranes. Curcumin and the two bivalent compounds were also incorporated in membranes of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine and quenching the fluorescence of pure curcumin or of the curcumin moiety in the bivalent compounds by acrylamide it was seen that curcumin was accessible to this water soluble quencher but the molecule was somehow located in a hydrophobic environment. This was confirmed by quenching with doxyl-phosphatidylcholines, indicating that the curcumin moieties of 17MD and 21MO were in a more polar environment than pure curcumin itself. 1H NOESY MAS-NMR analysis supports this notion by showing that the orientation of curcumin was parallel to the plane of the membrane surface close to C2 and C3 of the fatty acyl chains, while the curcumin moiety of 17MD and 21MO positioned close to the polar part of the membrane with the steroid moiety in the centre of the membrane. Molecular dynamics studies were in close agreement with the experimental results with respect to the likely proximity of the protons studied by NMR and show that 17MD and 21MO have a clear tendency to aggregate in a fluid membrane. The anchorage of the bivalent compounds to the membrane leaving the curcumin moiety near the polar part may be very important to facilitate the bioactivity of the curcumin moiety when used as anti-Alzheimer drugs.

Ausili|Alessio|A|
Gómez-Murcia|Victoria|V|
Candel|Adela M|AM|
Beltrán|Andrea|A|
Torrecillas|Alejandro|A|
He|Liu|L|
Jiang|Yuqi|Y|
Zhang|Shijun|S|
Teruel|José A|JA|
Gómez-Fernández|Juan C|JC|

D057927:Hydrophobic and Hydrophilic Interactions

Membranes
Curcumin
(1)H NOESY MAS-NMR
DSC
Fluorescence quenching


Managing Cystic Fibrosis in Polish Healthcare.

Abstract: The quality and length of life of patients with cystic fibrosis (CF) are determined by a number of factors including the quality of healthcare received by patients, as well as access to drug programs dedicated to this particular disease. The purpose of this paper is to present an overview of changes in the average life expectancy and mortality rate of the CF population in Poland between 2000 and 2018. Furthermore, we would like to evaluate access to healthcare services, including the drug program, guaranteed by public healthcare system, and funded by National Health Fund (NHF). The average life expectancy of patients with CF increased in the period in question from ca. 14.5 ± 7.6-24.5 ± 8.9 years (mean ± SD, p = 0.0001). We have observed a drop in the number of deaths in paediatric age during that period. Despite the increase in life expectancy, the use of health resources in patients with CF, especially the drug program, is dramatically low. Considering the fact that in Poland there was no active countrywide CF registry, now it is possible to estimate the frequency of use of CF healthcare services in various provinces exclusively on the basis of database maintained by the Polish NHF.

Rachel|Marta|M| Topolewicz|Stanisław|S| Śliwczyński|Andrzej|A| Galiniak|Sabina|S|0000-0002-1129-3553

cystic fibrosis
drug program
deaths
hospital treatment


Predictive factors for recurrence of high transsphincteric anal fistula after placement of seton.

Abstract:
BACKGROUND
The optimal surgical treatment for high transsphincteric fistula-in-ano (FIA) should attain complete eradication of the fistulous track and, in the same time, not compromising the anal sphincters. The present study aimed to investigate the predictive factors for recurrence of high transsphincteric FIA after placement of draining seton and to evaluate the efficacy and complications of seton treatment for high cryptoglandular anal fistula.

MATERIALS AND METHODS
This is a retrospective case-control study of patients with high transsphincteric FIA who were treated with seton placement. Variables analyzed were the characteristics of FIA, incidence of recurrence, postoperative complications including fecal incontinence (FI), and the predictive factors for recurrence.

RESULTS
A total of 251 patients (232 males) with high transsphincteric FIA were treated with loose seton placement. Patients were followed for a median period of 16 mo. Recurrence of FIA was recorded in 26 of patients (10.3%) after a mean duration of 12.2 ± 3.9 mo of seton removal. Previously recurrent fistula (odds ratio [OR] = 2.81, P = 0.02), supralevator extension (OR = 3.19, P = 0.01) and anterior fistula (OR = 3.36, P = 0.004), and horseshoe fistula (OR = 5.66, P = 0.009) were the most significant predictors of recurrence. FI was detected in eight patients (3.2%). Female gender (OR = 15.2, P = 0.0003) and horseshoe fistula (OR = 8.66, P = 0.01) were the significant risk factors for FI after the procedure.

CONCLUSIONS
Significant risk factors for recurrence of FIA were previous fistula surgery, anterior anal fistula, and presence of secondary tracks or branches as supralevator extension, and horseshoe fistula.

Emile|Sameh Hany|SH|
Elfeki|Hossam|H|
Thabet|Waleed|W|
Sakr|Ahmed|A|
Magdy|Alaa|A|
El-Hamed|Tito M Abd|TMA|
Omar|Waleed|W|
Khafagy|Wael|W|

Predictive
Recurrence
Transsphincteric
Anal fistula
Seton


Where and how alpha-synuclein pathology spreads in Parkinson's disease.

Abstract: In Parkinson's disease (PD), neuronal alpha-synuclein aggregates are distributed throughout the nervous system, including the brain, spinal cord, sympathetic ganglia, submandibular gland, enteric nervous system, cardiac and pelvic plexuses, adrenal medulla, and skin. Thus, PD is a progressive multiorgan disease clinically associated with various motor and nonmotor symptoms. The earliest PD-related lesions appear to develop in the olfactory bulb, dorsal vagal nucleus, and possibly also the peripheral autonomic nervous system. The brain is closely connected with the enteric nervous system via axons of the efferent fibers of the dorsal nucleus of vagal nerve. Anatomical connections also exist between the olfactory bulb and brainstem. Accumulating evidence from experimental studies indicates that transneuronal propagation of misfolded alpha-synuclein is involved in the progression of PD. However, it cannot be ruled out that alpha-synuclein pathology in PD is multicentric in origin. Based on pathological findings from studies on human materials, the present review will update the progression pattern of alpha-synuclein pathology in PD.

alpha-synuclein
enteric nervous system
Braak stage
Lewy body
Parkinson’s disease


Transition-Metal-Mediated Cleavage of Fluoro-Silanes under Mild Conditions.

Abstract: Si-F bond cleavage of fluoro-silanes was achieved by transition-metal complexes under mild and neutral conditions. The Iridium-hydride complex [Ir(H)(CO)(PPh3 )3 ] was found to readily break the Si-F bond of the diphosphine- difluorosilane {(o-Ph2 P)C6 H4 }2 Si(F)2 to afford a silyl complex [{[o-(iPh2 P)C6 H4 ]2 (F)Si}Ir(CO)(PPh3 )] and HF. Density functional theory calculations disclose a reaction mechanism in which a hypervalent silicon species with a dative Ir→Si interaction plays a crucial role. The Ir→Si interaction changes the character of the H on the Ir from hydridic to protic, and makes the F on Si more anionic, leading to the formation of H(δ+) ⋅⋅⋅F(δ-) interaction. Then the Si-F and Ir-H bonds are readily broken to afford the silyl complex and HF through σ-bond metathesis. Furthermore, the analogous rhodium complex [Rh(H)(CO)(PPh3 )3 ] was found to promote the cleavage of the Si-F bond of the triphosphine-monofluorosilane {(o-Ph2 P)C6 H4 }3 Si(F) even at ambient temperature.

Kameo|Hajime|H| Kawamoto|Tatsuya|T| Sakaki|Shigeyoshi|S| Bourissou|Didier|D| Nakazawa|Hiroshi|H|

Si−F bond
Z-type ligands
cleavage reactions
sigma-bond metathesis
transition metals


A Rare Case of Hibernoma Occasionally Identified by 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in a Patient with Lung Cancer.

Abstract: Hibernoma is a benign tumor arising from brown fat tissue. Conventional imaging techniques are not able to differentiate it from other benign lesions or malignant fatty tumors. We report the case of a 73-year-old patient who underwent a thorax computed tomography (CT) and was then referred to our department for metabolic assessment of a solitary lung nodule. An F18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) scan was performed and demonstrated, in addition, a highly metabolic fat-containing lesion mimicking a malignant fatty tumor in the left great pectoralis muscle. The lesion was excised and resulted to be a hibernoma. This case shows that hibernoma can appear as a malignant-like lesion on 18F-FDG-PET/CT scan as per other imaging techniques, and the grade of FDG uptake does not accurately reflect malignancy in this fat-containing tumor. However, 18F-FDG-PET/CT with its whole-body scanning capability may represent a useful imaging tool in identifying, in the course of an imaging study for oncological evaluation, additional incidental findings such as benign fat-containing lesions that may require a surgical approach.

Penna|Daniele|D| Quartuccio|Natale|N| Testa|Claudio|C| Arena|Vincenzo|V| Cistaro|Angelina|A| Pelosi|Ettore|E|

hibernoma
brown fat tissue
fat tissue tumor
fdg-pet
lipoma
liposarcoma
pet


The pH-dependent long-term stability of an amorphous manganese oxide in smelter-polluted soils: implication for chemical stabilization of metals and metalloids.

Abstract: An amorphous manganese oxide (AMO) and a Pb smelter-polluted agricultural soil amended with the AMO and incubated for 2 and 6 months were subjected to a pH-static leaching procedure (pH 3-8) to verify the chemical stabilization effect on metals and metalloids. The AMO stability in pure water was pH-dependent with the highest Mn release at pH 3 (47% dissolved) and the lowest at pH 8 (0.14% dissolved). Secondary rhodochrosite (MnCO3) was formed at the AMO surfaces at pH>5. The AMO dissolved significantly less after 6 months of incubation. Sequential extraction analysis indicated that "labile" fraction of As, Pb and Sb in soil significantly decreased after AMO amendment. The pH-static experiments indicated that no effect on leaching was observed for Cd and Zn after AMO treatments, whereas the leaching of As, Cu, Pb and Sb decreased down to 20%, 35%, 7% and 11% of the control, respectively. The remediation efficiency was more pronounced under acidic conditions and the time of incubation generally led to increased retention of the targeted contaminants. The AMO was found to be a promising agent for the chemical stabilization of polluted soils.

Ettler|Vojtěch|V| Tomášová|Zdeňka|Z| Komárek|Michael|M| Mihaljevič|Martin|M| Šebek|Ondřej|O| Michálková|Zuzana|Z|

D052918:Environmental Restoration and Remediation

Amorphous manganese oxide
Chemical stabilization
pH-static experiment
Polluted soil
Metal(loid)s


Preparation of Progressive Antibacterial LDPE Surface via Active Biomolecule Deposition Approach.

Abstract: The use of polymers in all aspects of daily life is increasing considerably, so there is high demand for polymers with specific properties. Polymers with antibacterial properties are highly needed in the food and medical industries. Low-density polyethylene (LDPE) is widely used in various industries, especially in food packaging, because it has suitable mechanical and safety properties. Nevertheless, the hydrophobicity of its surface makes it vulnerable to microbial attack and culturing. To enhance antimicrobial activity, a progressive surface modification of LDPE using the antimicrobial agent grafting process was applied. LDPE was first exposed to nonthermal radio-frequency (RF) plasma treatment to activate its surface. This led to the creation of reactive species on the LDPE surface, resulting in the ability to graft antibacterial agents, such as ascorbic acid (ASA), commonly known as vitamin C. ASA is a well-known antioxidant that is used as a food preservative, is essential to biological systems, and is found to be reactive against a number of microorganisms and bacteria. The antimicrobial effect of grafted LDPE with ASA was tested against two strong kinds of bacteria, namely, Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), with positive results. Surface analyses were performed thoroughly using contact angle measurements and peel tests to measure the wettability or surface free energy and adhesion properties after each modification step. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) were used to analyze the surface morphology or topography changes of LDPE caused by plasma treatment and ASA grafting. Surface chemistry was studied by measuring the functional groups and elements introduced to the surface after plasma treatment and ASA grafting, using Fourier transform infrared (FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS). These results showed wettability, adhesion, and roughness changes in the LDPE surface after plasma treatment, as well as after ASA grafting. This is a positive indicator of the ability of ASA to be grafted onto polymeric materials using plasma pretreatment, resulting in enhanced antibacterial activity.

Habib|Salma|S|0000-0002-0994-090X Lehocky|Marian|M|0000-0002-5368-5029 Vesela|Daniela|D| Humpolíček|Petr|P| Krupa|Igor|I| Popelka|Anton|A|

antibacterial
polyethylene
plasma treatment
biointerface
grafting modification


Documentation of psychotropic pro re nata medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

Abstract:
AIMS AND OBJECTIVES
To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process.

BACKGROUND
The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544-1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544-1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122-1131).

DESIGN
The project was a mixed-method, two-phase study that collected data from two sites.

METHODS
In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice.

RESULTS
Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration.

CONCLUSIONS
We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation.

RELEVANCE TO CLINICAL PRACTICE
Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases.

documentation
pro re nata
electronic health record
inpatient
mental health


Metachronous tracheal squamous cell carcinoma treated with Nd: YAG laser.

Abstract: Tracheal squamous cell carcinoma detected early in a high-risk patient has been treated twice with local neodymium-yttrium aluminium garnet laser therapy with good result so far. Ongoing bronchoscopic monitoring continues.

Bronchoscopy and interventional techniques


Evaluation of visual structural and functional factors that predict the development of multiple sclerosis in clinically isolated syndrome patients.

Abstract:
PURPOSE
To evaluate visual pathway structure and function in patients with clinical isolated syndrome (CIS) by using spectral-domain optical coherence tomography (OCT) and multifocal visual-evoked potentials (mfVEP), predicting CIS conversion to clinically definite multiple sclerosis (MS).

METHODS
This observational, longitudinal study assessed the eyes with no previous history of optic neuritis of 29 consecutive patients with CIS according to the McDonald criteria. The relationships of the mfVEP results with the clinical findings, and psychophysical (Humphrey perimetry) and structural (OCT) diagnostic test data were investigated.

RESULTS
The mfVEP amplitude responses (interocular and monocular probability analysis) showed abnormal cluster visual field defects in 48.3% of the CIS eyes, whereas mfVEP latency analysis showed significant delays in 20.7%. The OCT average retinal nerve fiber layer thickness (RNFLT) was significantly reduced compared with the control group (P = 0.02). Significant differences between CIS eyes with abnormal and normal mfVEP latencies were found for the OCT RNFLT (P < 0.001) with a longer latency being linked to more severe axonal damage. Using multivariate logistic regression analysis, OCT average RNFLT was found to be an independent predictor of clinically definitive MS diagnosis at 12 months.

CONCLUSIONS
The combined use of OCT and mfVEP is helpful to detect significant subclinical visual pathway abnormalities and axonal loss in CIS patients. Retinal axonal loss measured by OCT is an important prognostic factor of conversion to MS in patients with CIS in absence of symptomatic optic neuritis.

Pérez-Rico|Consuelo|C| Ayuso-Peralta|Lucia|L| Rubio-Pérez|Lluisa|L| Roldán-Díaz|Isabel|I| Arévalo-Serrano|Juan|J| Jiménez-Jurado|Dolores|D| Blanco|Román|R|

D000328:Adult
D003711:Demyelinating Diseases
D005074:Evoked Potentials, Visual
D005260:Female
D005500:Follow-Up Studies
D006801:Humans
D008297:Male
D009103:Multiple Sclerosis
D012164:Retinal Diseases
D012165:Retinal Ganglion Cells
D012607:Scotoma
D041623:Tomography, Optical Coherence
D014792:Visual Acuity
D058609:Visual Field Tests
D014795:Visual Pathways


Abstract: The activity of α-L-fucosidase in oviductal fluid increases around the time of ovulation. α-L-fucosidase is also associated with the spermatozoal plasma membrane and its substrate, fucose, has been identified in the zona pellucida (ZP) and on the spermatozoal surface, suggesting a role in fertilisation. The aim of the present study was to investigate the role of exogenous α-L-fucosidase during fertilisation. Porcine oocytes were incubated with fucosidase and later subjected to in vitro fertilisation (IVF). No effect on the percentage of oocytes fertilised was observed, although there was a slight decrease in spermatozoa-ZP binding. Fucosidase was then added to IVF medium, and spermatozoa and oocytes were co-incubated for 15 min. A significant increase in spermatozoa-ZP binding and penetration was observed, suggesting a role of the enzyme in the fertilisation ability of spermatozoa. In addition, fluorescence intensity and the patterns of spermatozoa membrane-associated α-L-fucosidase distribution, as assessed by indirect immunofluorescence, were not affected by the presence or absence of exogenous enzyme, suggesting an independent role for the exogenous and spermatozoa-associated enzymes. Addition of exogenous α-L-fucosidase increased the spermatozoal intracellular ionised calcium concentration and tyrosine phosphorylation, suggesting a role in promoting capacitation and, at the same time, protecting spermatozoa from a premature acrosome reaction. Thus, α-L-fucosidase enhances capacitation-associated events in porcine spermatozoa.

α-L-fucosidase
Porcine
Spermatozoa
Oviduct
Fertilisation
Gamete biology


The Impacts of Sexual Media Exposure on Adolescent and Emerging Adults' Dating and Sexual Violence Attitudes and Behaviors: A Critical Review of the Literature.

Abstract: Dating violence (DV) and sexual violence (SV) are widespread problems among adolescents and emerging adults. A growing body of literature demonstrates that exposure to sexually explicit media (SEM) and sexually violent media (SVM) may be risk factors for DV and SV. The purpose of this article is to provide a systematic and comprehensive literature review on the impact of exposure to SEM and SVM on DV and SV attitudes and behaviors. A total of 43 studies utilizing adolescent and emerging adult samples were reviewed, and collectively the findings suggest that (1) exposure to SEM and SVM is positively related to DV and SV myths and more accepting attitudes toward DV and SV; (2) exposure to SEM and SVM is positively related to actual and anticipated DV and SV victimization, perpetration, and bystander nonintervention; (3) SEM and SVM more strongly impact men's DV and SV attitudes and behaviors than women's DV and SV attitudes and behaviors; and (4) preexisting attitudes related to DV and SV and media preferences moderate the relationship between SEM and SVM exposure and DV and SV attitudes and behaviors. Future studies should strive to employ longitudinal and experimental designs, more closely examine the mediators and moderators of SEM and SVM exposure on DV and SV outcomes, focus on the impacts of SEM and SVM that extend beyond men's use of violence against women, and examine the extent to which media literacy programs could be used independently or in conjunction with existing DV and SV prevention programs to enhance effectiveness of these programming efforts.

Rodenhizer|Kara Anne E|KAE|
Edwards|Katie M|KM|

media exposure
sexual violence
dating violence
sexually explicit media
sexually violent media
intimate partner violence
mass media
media effects
sexual assault


A survey of commercially available electronic hand hygiene monitoring systems and their impact on reducing healthcare-associated infections.

Abstract:
BACKGROUND
Although the benefits of electronic hand hygiene monitoring systems (EHHMSs) are well described, uptake has been poor since they were first introduced over 10 years ago. There is considerable published evidence on the association between the introduction of EHHMSs and improved hand hygiene (HH) compliance rates. However, their impact on healthcare-associated infection (HCAI) reduction is much less clear-cut.

METHODS
Commercial EHHMS identification was undertaken using a Google internet search and all relevant websites and marketing materials were reviewed. A structured literature search was undertaken to identify evidence of HCAI reduction through EHHMS implementation. Structured interviews were undertaken with a number of Directors of Infection Prevention and Control (DIPCs) from acute NHS Trusts in the North West of England to seek opinions on HH improvement strategies and the use of EHHMSs.

RESULTS
Twenty-nine commercial EHHMSs were identified, 20 of which are currently market active. Six EHHMSs had supporting evidence, across nine published studies, demonstrating their ability to reduce HCAIs. However, most evaluation designs were quasi-experimental with only one study using a high-quality stepped-wedge cluster randomized controlled trial design. In this study the EHHMS was part of a wider HH multi-modal improvement strategy. Structured interviews were undertaken with five DIPCs who consistently expressed a reluctance to support financial investment into this type of technology until EHHMS cost-effectiveness was better established.

CONCLUSIONS
The evidence base for the ability of EHHMSs to reduce HCAIs needs to improve before NHS trusts will consider procuring them.

Hand hygiene
Healthcare-associated infection
Electronic monitoring systems


Updating the Canadian Hemophilia Outcomes-Kids' Life Assessment Tool (CHO-KLAT) in the era of extended half-life clotting factor concentrates.

Abstract:
Introduction
The purpose of this study was to review and update the content of the Canadian Hemophilia Outcomes-Kids' Life Assessment Tool version 2.0 (CHO-KLAT), in the context of extended half-life (EHL) factor concentrates (FCs) and to establish the validity and reliability of the updated CHO-KLAT.

Methods
Focus groups were conducted with boys with hemophilia, their parents, and health care providers across Canada to review the CHO-KLAT v2.0 and determine if any modifications were required. The validity of the revised CHO-KLAT (version 3.0) was then determined in a sample of boys with hemophilia and their parents by calculating its correlation with the Pediatric Quality of Life Core Module (PedsQL-Core). Test-retest reliability was assessed using an intraclass correlation coefficient (ICC).

Results
Thirteen focus groups at 5 pediatric hemophilia treatment centers (HTCs) (n = 71) resulted in 19 changes to the CHO-KLAT v2.0, generating a revised 40-item CHO-KLAT, the CHO-KLAT v3.0. Thirty-five boys with hemophilia (median age, 14; range, 7-17 years) and 47 parents participated in the validation of the CHO-KLAT v3.0. There was a moderate correlation between the CHO-KLAT v3.0 child self-report and PedsQL-Core (r = 0.56, P = .01), and a strong correlation between the CHO-KLAT v3.0 parent-proxy and PedsQL-Core (r = .79, P = .0007). The test-retest reliability ICC was 0.90 for the child self-report CHO-KLAT v3.0 and 0.68 for the parent-proxy CHO-KLAT v3.0.

Conclusion
The CHO-KLAT v3.0 is a reliable and valid child-centric tool that effectively measures health-related quality of life in boys with hemophilia who are receiving standard half-life or EHL FCs.

hemophilia
Pediatrics
quality of life
patient reported outcome measure
questionnaire


Investigation on the relationship between the fine particle emission and crystallization characteristics of gypsum during wet flue gas desulfurization process.

Abstract: The relationship between the fine particles emitted after desulfurization and gypsum crystals in the desulfurization slurry was investigated, and the crystallization characteristics varying with the operation parameters and compositions of the desulfurization slurry were discussed. The results showed that the fine particles generated during the desulfurization process were closely related to the crystal characteristics in the desulfurization slurry by comparison of their morphology and elements. With the higher proportion of fine crystals in the desulfurization slurry, the number concentration of fine particles after desulfurization was increased and their particle sizes were smaller, indicating that the optimization of gypsum crystallization was beneficial for the reduction of the fine particle emission. The lower pH value and an optimal temperature of the desulfurization slurry were beneficial to restrain the generation of fine crystals in the desulfurization slurry. In addition, the higher concentrations of the Fe3+ ions and the F- ions in the desulfurization slurry both promoted the generation of fine crystals with corresponding change of the morphology and the effect of the Fe3+ ions was more obvious. With the application of the desulfurization synergist additive, it was beneficial for the inhibition of fine crystals while the thinner crystals were generated.

D000393:Air Pollutants
D002133:Calcium Sulfate
D003460:Crystallization
D008956:Models, Chemical
D010316:Particle Size
D052638:Particulate Matter
D011210:Power Plants

Fine particle
Emission
Wet flue gas desulfurization
Gypsum crystallization


Leishmania genome analysis and high-throughput immunological screening identifies tuzin as a novel vaccine candidate against visceral leishmaniasis.

Abstract: Leishmaniasis is a neglected tropical disease caused by Leishmania species. It is a major health concern affecting 88 countries and threatening 350 million people globally. Unfortunately, there are no vaccines and there are limitations associated with the current therapeutic regimens for leishmaniasis. The emerging cases of drug-resistance further aggravate the situation, demanding rapid drug and vaccine development. The genome sequence of Leishmania, provides access to novel genes that hold potential as chemotherapeutic targets or vaccine candidates. In this study, we selected 19 antigenic genes from about 8000 common Leishmania genes based on the Leishmania major and Leishmania infantum genome information available in the pathogen databases. Potential vaccine candidates thus identified were screened using an in vitro high throughput immunological platform developed in the laboratory. Four candidate genes coding for tuzin, flagellar glycoprotein-like protein (FGP), phospholipase A1-like protein (PLA1) and potassium voltage-gated channel protein (K VOLT) showed a predominant protective Th1 response over disease exacerbating Th2. We report the immunogenic properties and protective efficacy of one of the four antigens, tuzin, as a DNA vaccine against Leishmania donovani challenge. Our results show that administration of tuzin DNA protected BALB/c mice against L. donovani challenge and that protective immunity was associated with higher levels of IFN-γ and IL-12 production in comparison to IL-4 and IL-10. Our study presents a simple approach to rapidly identify potential vaccine candidates using the exhaustive information stored in the genome and an in vitro high-throughput immunological platform.

Lakshmi|Bhavana Sethu|BS|
Wang|Ruobing|R|
Madhubala|Rentala|R|

Genome
Tuzin
DNA vaccine
Immune response
In vitro screening
Leishmania vaccine


On the possible role of ticks in the eco-epidemiology of Coxiella burnetii in a Mediterranean ecosystem.

Abstract: Ruminant livestock is the main reservoir of Coxiella burnetii (Cb), but little is known about the role of wildlife and ticks in its epidemiology. The Iberian ibex (Capra pyrenaica, Schinz 1838) population of "Ports de Tortosa i Beseit" (NE Spain) suffers intense tick infestations and low reproduction rates. This study aims to (1) assess the relationship between infection in ibexes (detection of serum antibodies and/or of Cb DNA in tissues) and Cb DNA presence in ticks hosted by the same ibexes; and (2) identify Cb associated risk factors. Between 2011 and 2015, serum (n = 130), spleen (n = 72), lymph node (n = 89) and tick (n = 669) samples from 134 hunter-harvested ibexes were collected. Antibody detection was performed by ELISA and Cb DNA presence was assessed by PCR. Potential risk factors were assessed with regression tree models. Although 30% of the ibexes (39/130; 95%CI, [10%-29.8%]) had antibodies, Cb DNA was detected in only 9.8% of the ibexes (11/112; 95%CI [7.6%-27.25%]). The prevalence of Cb-carrier ticks averaged 10% and exceeded 20% for the genus Haemaphysalis. However, lacking correlation between infection in ibexes and their ticks does not support tick-to-ibex transmission or vice versa. Tree modelling points to host, population and environmental factors as drivers of Cb infection in ticks and suggests connections with the domestic cycle. The percentage of Cb-carrier ticks detected is noteworthy. Along with heavy tick infestations, it suggests vector potential for these tick species, especially for the genera Rhipicephalus and Haemaphysalis. Since vector competence has not been assessed in these tick species, a classic vector role cannot be proposed nor discarded, but promoter factors of vector capacity occur. In addition, the risk of tick-borne infection through tick excreta should not be neglected. While the airborne route is the preeminent route for Cb infection, ticks' contribution to Cb epidemiology deserves further attention.

Varela-Castro|Lucía|L| Zuddas|Carla|C| Ortega|Nieves|N| Serrano|Emmanuel|E| Salinas|Jesús|J| Castellà|Joaquim|J| Castillo-Contreras|Raquel|R| Carvalho|João|J| Lavín|Santiago|S| Mentaberre|Gregorio|G|

Coxiella burnetii
Capra pyrenaica
Haemaphysalis punctata
Q fever
Tick-borne diseases


Role of adaptor proteins and clathrin in the trafficking of human kidney anion exchanger 1 (kAE1) to the cell surface.

Abstract: Kidney anion exchanger 1 (kAE1) plays an important role in acid-base homeostasis by mediating chloride/bicarbornate (Cl-/HCO3-) exchange at the basolateral membrane of α-intercalated cells in the distal nephron. Impaired intracellular trafficking of kAE1 caused by mutations of SLC4A1 encoding kAE1 results in kidney disease - distal renal tubular acidosis (dRTA). However, it is not known how the intracellular sorting and trafficking of kAE1 from trans-Golgi network (TGN) to the basolateral membrane occurs. Here, we studied the role of basolateral-related sorting proteins, including the mu1 subunit of adaptor protein (AP) complexes, clathrin and protein kinase D, on kAE1 trafficking in polarized and non-polarized kidney cells. By using RNA interference, co-immunoprecipitation, yellow fluorescent protein-based protein fragment complementation assays and immunofluorescence staining, we demonstrated that AP-1 mu1A, AP-3 mu1, AP-4 mu1 and clathrin (but not AP-1 mu1B, PKD1 or PKD2) play crucial roles in intracellular sorting and trafficking of kAE1. We also demonstrated colocalization of kAE1 and basolateral-related sorting proteins in human kidney tissues by double immunofluorescence staining. These findings indicate that AP-1 mu1A, AP-3 mu1, AP-4 mu1 and clathrin are required for kAE1 sorting and trafficking from TGN to the basolateral membrane of acid-secreting α-intercalated cells.

Junking|Mutita|M| Sawasdee|Nunghathai|N| Duangtum|Natapol|N| Cheunsuchon|Boonyarit|B| Limjindaporn|Thawornchai|T| Yenchitsomanus|Pa-thai|PT|

D033942:Adaptor Proteins, Vesicular Transport

D001457:Anion Exchange Protein 1, Erythrocyte

kidney anion exchanger 1
distal renal tubular acidosis
basolateral sorting protein
protein trafficking
protein-protein interaction


Oral administration of aflatoxin G₁ induces chronic alveolar inflammation associated with lung tumorigenesis.

Abstract: Our previous studies showed oral gavage of aflatoxin G₁ (AFG₁) induced lung adenocarcinoma in NIH mice. We recently found that a single intratracheal administration of AFG₁ caused chronic inflammatory changes in rat alveolar septum. Here, we examine whether oral gavage of AFG₁ induces chronic lung inflammation and how it contributes to carcinogenesis. We evaluated chronic lung inflammatory responses in Balb/c mice after oral gavage of AFG₁ for 1, 3 and 6 months. Inflammatory responses were heightened in the lung alveolar septum, 3 and 6 months after AFG₁ treatment, evidenced by increased macrophages and lymphocytes infiltration, up-regulation of NF-κB and p-STAT3, and cytokines production. High expression levels of superoxide dismutase (SOD-2) and hemoxygenase-1 (HO-1), two established markers of oxidative stress, were detected in alveolar epithelium of AFG₁-treated mice. Promoted alveolar type II cell (AT-II) proliferation in alveolar epithelium and angiogenesis, as well as increased COX-2 expression were also observed in lung tissues of AFG₁-treated mice. Furthermore, we prolonged survival of the mice in the above model for another 6 months to examine the contribution of AFG₁-induced chronic inflammation to lung tumorigenesis. Twelve months later, we observed that AFG₁ induced alveolar epithelial hyperplasia and adenocarcinoma in Balb/c mice. Up-regulation of NF-κB, p-STAT3, and COX-2 was also induced in lung adenocarcinoma, thus establishing a link between AFG₁-induced chronic inflammation and lung tumorigenesis. This is the first study to show that oral administration of AFG₁ could induce chronic lung inflammation, which may provide a pro-tumor microenvironment to contribute to lung tumorigenesis.

Liu|Chunping|C|
Shen|Haitao|H|
Yi|Li|L|
Shao|Peilu|P|
Soulika|Athena M|AM|
Meng|Xinxing|X|
Xing|Lingxiao|L|
Yan|Xia|X|
Zhang|Xianghong|X|

Lung tumorigenesis
Oxidative stress
Alveolar type II cell
COX-2
Chronic inflammation
Aflatoxin G(1)


Epidemiology of Respiratory Pathogens in Children with Lower Respiratory Tract Infections in Shanghai, China, from 2013 to 2015.

Abstract: This study aimed to explore the epidemiology of pathogens in children who were hospitalized with lower respiratory tract infections (LRTIs) at the Children's Hospital of Fudan University, Shanghai, China. Children aged less than 18 years who were hospitalized with LRTIs were enrolled from January 2013 to December 2015. Respiratory specimens were collected for the detection of common respiratory viruses, atypical bacteria, and other bacteria using current laboratory diagnostic tests. The epidemiological characteristics of the respiratory pathogens were analyzed. Of the 10,123 specimens obtained from the patients, 5,966 (58.7%) were positive for at least 1 pathogen. Mycoplasma pneumoniae (M.pneumoniae) was the most commonly detected pathogen (15.7%), followed by respiratory syncytial virus (RSV) (13.9%). Co-infections were found in 11.4% of patients. Of these co-infections, viral-bacterial co-infections were the most common. The detection rates for the respiratory pathogens varied considerably by age. RSV was the most common pathogen in children aged less than 24 months. Clear seasonal peaks were observed for RSV, M. pneumoniae, parainfluenza virus, human metapneumovirus, Moraxella catarrhalis, and Haemophilus influenza infections. Our findings demonstrate specific epidemiological patterns in children with LRTIs in Shanghai, China.

Liu|Pengcheng|P| Xu|Menghua|M| He|Leiyan|L| Su|Liyun|L| Wang|Aimin|A| Fu|Pan|P| Lu|Lijuan|L| Wang|Chuanqing|C| Xu|Jin|J|

D018357:Respiratory Syncytial Virus Infections

epidemiology
respiratory pathogen
children
lower respiratory tract infection
aetiology


Relationship of microRNA locus with type 2 diabetes mellitus: a case-control study.

Abstract: Type 2 diabetes mellitus (T2DM) is considered as a metabolic disease with hyperglycemia. Accumulating investigations have explored the important role of hereditary factors for T2DM occurrence. Some functional microRNA (miR) polymorphisms may affect their interactions with target mRNAs and result in an aberrant expression. Thus, miR variants might be considered as a biomarker of the susceptibility of T2DM. In this study, we recruited 502 T2DM cases and 782 healthy subjects. We selected miR-146a rs2910164 C>G, miR-196a2 rs11614913 T>C and miR-499 rs3746444 A>G loci and carried out an investigation to identify whether these miR loci could influence T2DM occurrence. In this investigation, a Bonferroni correction was harnessed. After adjustment, we found that rs2910164 SNP was a protective factor for T2DM (GG vs CC/CG: adjusted P = 0.010), especially in never drinking (GG vs CC/CG: adjusted P = 0.001) and BMI ≥24 kg/m2 (GG vs CC/CG: adjusted P = 0.002) subgroups. We also identified that rs11614913 SNP was a protective factor for T2DM in smoking subjects (CC/TC vs TT: adjusted P = 0.002). When we analyzed an interaction of SNP-SNP with the susceptibility tof T2DM, rs11614913/rs3746444, rs2910164/rs3746444 and rs11614913/rs2910164 combinations were not associated with the risk of T2DM. In summary, this study highlights that rs2910164 SNP decreases the susceptibility of T2DM, especially in BMI ≥24 kg/m2 and never drinking subgroups. In addition, we also identify that rs11614913 C allele decreases the susceptibility of T2DM significantly in smoking subgroup.

Huang|Qiuyu|Q| Chen|Hanshen|H| Xu|Fan|F| Liu|Chao|C| Wang|Yafeng|Y| Tang|Weifeng|W| Chen|Liangwan|L|

microRNA
type 2 diabetes mellitus
polymorphism
risk


Connecting healthcare professionals in Central America through management and leadership development: a social network analysis.

Abstract:
BACKGROUND
Leadership and management training has become increasingly important in the education of health care professionals. Previous research has shown the benefits that a network provides to its members, such as access to resources and information, but ideas for creating these networks vary. This study used social network analysis to explore the interactions among Central American Healthcare Initiative (CAHI) Fellowship alumni and learn more about information sharing, mentoring, and project development activities among alumni. The CAHI Fellowship provides leadership and management training for multidisciplinary healthcare professionals to reduce health inequities in the region. Access to a network was previously reported as one of the top benefits of the program.

RESULTS
Information shared from the work of 100 CAHI fellows from six countries, especially within the same country, was analyzed. Mentoring relationships clustered around professions and project types, and networks of joint projects clustered by country. Mentorship, which CAHI management promoted, and joint project networks, in which members voluntarily engaged, had similar inclusiveness ratios.

CONCLUSION
Social networks are strategic tools for health care leadership development programs to increase their impact by promoting interactions among participants. These programs can amplify intergenerational and intercountry ties by organizing events, provide opportunities for alumni to meet, assign mentors, and support collaborative action groups. Collaborative networks have great value to potentiate health professionals' leadership and management capabilities in a resource-constrained setting, such as the Global South.

Prado|Andrea M|AM|
Pearson|Andy A|AA|
Bertelsen|Nathan S|NS|
Pagán|José A|JA|

Central America
Management
Leadership
Social network analysis