Results on exposure during pregnancy from a pregnancy registry for AS04-HPV-16/18 vaccine.

Abstract:
OBJECTIVE
To assess pregnancy outcomes after exposure to AS04-HPV-16/18 vaccine (Cervarix, GSK, Belgium) prior to, or during pregnancy, as reported to a pregnancy registry.

METHODS
A pregnancy exposure registry was established to collect data in the United Kingdom and the United States. Exposure was defined as vaccination with AS04-HPV-16/18 within 60days before the estimated conception date and delivery. Reporting was voluntary.

RESULTS
Between September 2007 and November 2015, 306 pregnancy exposure reports were received of which 181 were prospective, evaluable reports. From these 181 reports, 154 (85.1%) pregnancies resulted in a live birth, 14 (7.7%) in spontaneous abortion, one (0.5%) in stillbirth, and 12 (6.6%) were electively terminated. There was no clustering of outcomes with respect to the timing of exposure. There were 18 infants born with a congenital anomaly of which nine were minor structural defects, seven were major structural defects, one was a hereditary disorder and one was likely the result of a congenital infection. In three cases of structural defect (two minor and one major), there was a temporal association to vaccination during the critical developmental period of gestation. There was no cluster or constellation of congenital anomalies suggestive of possible teratogenesis.

CONCLUSION
The pharmacovigilance plan to investigate the effects of inadvertent exposure to AS04-HPV-16/18 vaccine during pregnancy included assessment of pregnancy outcomes among women enrolled in clinical trials, evaluation of pregnancy exposure reports from all countries as part of routine passive safety surveillance, a large, well conducted post-authorization observational study, and the pregnancy registry. These registry data complement other data from clinical trials and post-marketing surveillance showing no evidence that vaccination with AS04-HPV-16/18 during the defined exposure period (within 60days before conception until delivery) increases the risk of teratogenicity.

López-Fauqued|Marta|M| Zima|Julia|J| Angelo|Maria-Genalin|MG| Stegmann|Jens-Ulrich|JU|

Pregnancy
Registry
AS04-HPV-16/18 vaccine
Spontaneous abortion
Congenital anomaly
Safety


The Effect of Implementing a Multimodal Approach on the Rates of Periprosthetic Joint Infection After Total Joint Arthroplasty.

Abstract:
INTRODUCTION
We examined the efficacy of implementing a multimodal program aimed at reducing the incidence of periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) in a mid-size community hospital.

METHODS
An infection reduction committee (IRC) was formed at our hospital in November 2010. The IRC consisted of two orthopaedic surgeons, an infectious disease specialist, an internist with extensive experience in perioperative medical management of TJA patients, an anesthesiologist, the hospital infection control nurse, and two additional nurses. Their goals were to 1) evaluate the current incidence of PJI at our institution, compare it with the reported national data, and consider measures already in place directed at preventing PJI; 2) review and routinely evaluate recently published studies or information obtained from continuing medical education events related to PJI to determine if practice changes were warranted (based on intervention efficacy, cost, and safety) and then develop a plan to implement appropriate alterations in perioperative protocols using a multimodal strategy; and 3) evaluate the effect and safety of newly-introduced infection reduction strategies on the incidence of PJI.

RESULTS
In 2008, the incidence of PJI at our hospital was 1.0%. By 2013, this rate had reduced to 0.4%. In absolute numbers, in 2009, 20 of 1,150 TJAs developed a PJI in the 12-month period following partial, primary, or revision TJA. In 2013, PJI occurred in only 4 of 1,053 TJA patients.

CONCLUSION
We found that formation of an IRC focused on evaluating and implementing strategies to reduce PJI following TJA can be effective.

Matsen Ko|Laura J|LJ|
Yoo|Joanne Y|JY|
Maltenfort|Mitchell|M|
Hughes|Amy|A|
Smith|Eric B|EB|
Sharkey|Peter F|PF|

multimodal approach
periprosthetic joint infection
total joint arthroplasty
infection reduction
complications


Early-Onset Parkinsonism: Case Report and Review of the Literature.

Abstract:
BACKGROUND
Early-onset parkinsonism can be caused by PTEN-induced putative kinase 1 (PINK1) gene defects and is usually characterized by an age of onset in the fourth decade of life, slow disease progression, resting tremor, rigidity, bradykinesia, postural instability, and levodopa-induced dyskinesia.

METHODS
We evaluated a child with early-onset symptoms and performed a literature review for previously reported examples of children aged 18 years or less with PINK1 gene defects.

RESULTS
We describe a five-year-old boy with autosomal recessive early-onset parkinsonism caused by a homozygous missense mutation in the PINK1 gene. This is the youngest individual yet reported with early-onset parkinsonism.

CONCLUSION
PINK1-type of early-onset parkinsonism can occur in very young patients, and phenotypic expression of PINK1 mutations may depend on age of onset and ethnicity.

early-onset parkinsonism
parkinsonism
pink1
Parkinson disease
dystonia
movement disorders


Epilepsy in patients with autism: links, risks and treatment challenges.

Abstract: Autism is more common in people with epilepsy, approximately 20%, and epilepsy is more common in people with autism with reported rates of approximately 20%. However, these figures are likely to be affected by the current broader criteria for autism spectrum disorder (ASD), which have contributed to an increased prevalence of autism, with the result that the rate for ASD in epilepsy is likely to be higher and the figure for epilepsy in ASD is likely to be lower. Some evidence suggests that there are two peaks of epilepsy onset in autism, in infancy and adolescence. The rate of autism in epilepsy is much higher in those with intellectual disability. In conditions such as the Landau-Kleffner syndrome and nonconvulsive status epilepticus, the epilepsy itself may present with autistic features. There is no plausible mechanism for autism causing epilepsy, however. The co-occurrence of autism and epilepsy is almost certainly the result of underlying factors predisposing to both conditions, including both genetic and environmental factors. Conditions such as attention deficit hyperactivity disorder, anxiety and sleep disorders are common in both epilepsy and autism. Epilepsy is generally not a contraindication to treating these conditions with suitable medication, but it is important to take account of relevant drug interactions. One of the greatest challenges in autism is to determine why early childhood regression occurs in perhaps 25%. Further research should focus on finding the cause for such regression. Whether epilepsy plays a role in the regression of a subgroup of children with autism who lose skills remains to be determined.

epilepsy autism Landau-Kleffner genetics regression CSWS environment


Evaluation of genetic variability among "Early Mature" Juglans regia using microsatellite markers and morphological traits.

Abstract: Limiting the juvenile phase and reducing tree size are the two main challenges for breeders to improve most fruit crops. Early maturation and dwarf cultivars have been reported for many fruit species. "Early mature" and low vigor walnut genotypes were found among seedlings of Persian walnut. Nine microsatellite markers were used to evaluate genetic diversity among "Early Mature" Persian walnut accessions and provide a comparison with "normal growth" accessions. Six maturation related characteristics were also measured in "Early Mature" samples. Phenotypic traits and diversity indices showed relatively high levels of genetic diversity in "Early Mature" seedlings and indicated high differentiation between individuals. Seedling height, the most diverse phenotypic trait, has an important role in the clustering of "Early Mature" accessions. The "Early Mature" type had higher number of alleles, number of effective allele, and Shannon index compared to the "Normal Growth" group. The two types of studied walnuts had different alleles, with more than half of produced alleles specific to a specific group. "Early Mature" and "Normal Growth" walnuts had 27 and 17 private alleles, respectively. Grouping with different methods separated "Early Mature" and "Normal Growth" samples entirely. The presence of moderate to high genetic diversity in "Early Mature" walnuts and high genetic differentiation with "Normal Growth" walnuts, indicated that "Early Mature" walnuts were more diverse and distinct from "Normal Growth" samples. Moreover, our results showed SSR markers were useful for differentiating between "Early Mature" and "Normal Growth" walnuts. A number of identified loci have potential in breeding programs for identification of "Early Mature" walnuts at the germination phase.

Ebrahimi|Aziz|A|
Zarei|Abdolkarim|A|
Zamani Fardadonbeh|Mojtaba|M|
Lawson|Shaneka|S|

Persian walnut
Genetic diversity
SSR markers
Cluster analysis
“Early Mature”


Nutritional adequacy and content of food bank parcels in Oxfordshire, UK: a comparative analysis of independent and organisational provision.

Abstract:
BACKGROUND
Food bank use has increased significantly in the UK. With the rise in demand, it is imperative that users are receiving food parcels that meet their requirements. The present study aimed to explore whether typical food parcels, supplied by The Trussell Trust and independent food banks, were meeting the daily nutrient and energy requirements of an adult user.

METHODS
The Trussell Trust (n = 2) and independent food banks (n = 9) were surveyed in Oxfordshire, UK. Data were collected on food bank use, resources, donations and parcel content. The energy and nutrient contents of a representative parcel were compared with the average dietary reference values (DRVs) for an adult. Additional comparisons were made between The Trussell Trust and independent provision.

RESULTS
Parcels provided energy, carbohydrate, sugar, protein and fibre contents that significantly exceeded the DRVs. In total, 62.2% of energy was provided as carbohydrate and 569% of the DRV was provided by sugars. The vitamin D and retinol content of the parcels was significantly lower than the DRVs, meeting 25% and 27% of users' needs respectively; provision of all other micronutrients exceeded the DRVs. The Trussell Trust's parcels provided significantly less vitamin D and copper than independent parcels.

CONCLUSIONS
Food bank parcels distributed in Oxfordshire, UK, exceeded energy requirements and provided disproportionately high sugar and carbohydrate and inadequate vitamin A and vitamin D compared to the UK guidelines. Improved links with distributors and access to cold food storage facilities would help to address these issues, via increased fresh food provision.

nutritional adequacy
food banks
dietary analysis
food insecurity


Synthesis and Evaluation of Chroman-4-One Linked to N-Benzyl Pyridinium Derivatives as New Acetylcholinesterase Inhibitors.

Abstract: A novel series of chroman-4-one derivatives containing the N-benzyl pyridinium moiety were designed, synthesized, and evaluated for their acetylcholinesterase (AChE) inhibitory activities. Among the various synthesized compounds, (E)-1-(2,3-dibromobenzyl)-4-((7-ethoxy-4-oxochroman-3-ylidene)methyl)pyridinium bromide (8l) depicted the most potent anti-AChE activity (IC50 = 0.048 μM). In addition, the molecular modeling study allowed us to detect possible binding modes that are in full compliance with the observed results through in vitro experiments.

Arab|Saman|S| Sadat-Ebrahimi|Seyed-Esmail|SE| Mohammadi-Khanaposhtani|Maryam|M| Moradi|Alireza|A| Nadri|Hamid|H| Mahdavi|Mohammad|M| Moghimi|Setareh|S| Asadi|Mehdi|M| Firoozpour|Loghman|L| Pirali-Hamedani|Morteza|M| Shafiee|Abbas|A| Foroumadi|Alireza|A|

D000110:Acetylcholinesterase
D001593:Benzyl Compounds
D002800:Cholinesterase Inhibitors
D015195:Drug Design
D062105:Molecular Docking Simulation
D011487:Protein Conformation
D011726:Pyridinium Compounds
D013329:Structure-Activity Relationship

Chroman-4-one
N-Benzyl pyridinium
Acetylcholinesterase
Alzheimer's disease
Docking study


Integrating influenza antigenic dynamics with molecular evolution.

Abstract: Influenza viruses undergo continual antigenic evolution allowing mutant viruses to evade host immunity acquired to previous virus strains. Antigenic phenotype is often assessed through pairwise measurement of cross-reactivity between influenza strains using the hemagglutination inhibition (HI) assay. Here, we extend previous approaches to antigenic cartography, and simultaneously characterize antigenic and genetic evolution by modeling the diffusion of antigenic phenotype over a shared virus phylogeny. Using HI data from influenza lineages A/H3N2, A/H1N1, B/Victoria and B/Yamagata, we determine patterns of antigenic drift across viral lineages, showing that A/H3N2 evolves faster and in a more punctuated fashion than other influenza lineages. We also show that year-to-year antigenic drift appears to drive incidence patterns within each influenza lineage. This work makes possible substantial future advances in investigating the dynamics of influenza and other antigenically-variable pathogens by providing a model that intimately combines molecular and antigenic evolution. DOI: http://dx.doi.org/10.7554/eLife.01914.001.

Bedford|Trevor|T|
Suchard|Marc A|MA|
Lemey|Philippe|P|
Dudas|Gytis|G|
Gregory|Victoria|V|
Hay|Alan J|AJ|
McCauley|John W|JW|
Russell|Colin A|CA|
Smith|Derek J|DJ|
Rambaut|Andrew|A|

influenza
evolution
antigenic cartography
Bayesian inference
multidimensional scaling
phylogenetics


Integrative genomic analyses identify WDR12 as a novel oncogene involved in glioblastoma.

Abstract: Glioblastoma (GBM) is the most malignant primary brain tumor in adults. Due to its invasive nature, it cannot be thoroughly eliminated. WD repeat domain 12 (WDR12) processes the 32S precursor rRNA but cannot affect the synthesis of the 45S/47S primary transcript. In this study, we found that WDR12 is highly expressed in GBM according to the analysis results of mRNA expression by The Cancer Genome Atlas database. The high expression level of WDR12 is dramatically related to shorter overall survival and reduced disease-free survival. Next, we knocked down WDR12 and found that knockdown of WDR12 promoted the apoptosis and inhibited the proliferation by cell biology experiments. Differential expression genes in gene-chip revealed that WDR12 knockdown mainly inhibited cell cycle. Finally, we also found that WDR12 is associated with PLK1 and EZH2 in cell proliferation of GBM. Resumptively, this report showed a possible evidence that WDR12 drove malignant behavior of GBM, whose expression may present a neoteric independent prognostic biomarker in GBM.

Li|Jun-Liang|JL| Chen|Cheng|C| Chen|Wei|W| Zhao|Ling-Feng|LF| Xu|Xin-Ke|XK| Li|Yang|Y| Yuan|Hong-Yao|HY| Lin|Jin-Rong|JR| Pan|Jun-Ping|JP| Jin|Bi-Lian|BL| Li|Fang-Cheng|FC|0000-0003-0082-0095

D015972:Gene Expression Regulation, Neoplastic

genomic analyses
WDR12
oncogene
glioblastoma


Computed tomography classification of endoscopic retrograde cholangiopancreatography-related perforation.

Abstract: Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation leads to high morbidity and mortality. The Stapfer classification divides patients with different perforation locations and suggests management accordingly. The classification may be unknown if perforation is not detected during endoscopy. We classified patients with ERCP-related perforation (ERP) through computed tomography (CT) and observed the clinical outcomes with varyingly invasive management. Fifty-two cases of ERP between July 2009 and December 2017 were retrospectively reviewed. Of them, 41 who underwent CT for ERCP were included. According to their CT findings, we divided patients into air-alone (n = 16), air-fluid (n = 18), and fluid-alone (n = 7) groups. Perforation severity was graded using the Clavien-Dindo classification for surgical complications. Demographic data and clinical outcomes among different groups were analyzed. Fifteen patients (37%) had an unknown Stapfer classification. More than half of the patients in the air-fluid group had a Clavien-Dindo complication grade of >3. Four patients underwent surgical repair; all of them were from the air-fluid group. All patients in the air- and fluid-alone groups underwent medical treatment without need for subsequent salvage surgery. The air-fluid group had the longest mean hospital stay (25.1 ± 21.9 days) and the exclusive two mortality cases in this study. Patients with ERCP can be divided into groups with different outcomes according to the presence of air or fluid on CT images. Because patients with both air and fluid have the worst clinical outcome, they may require more aggressive treatment than patients with either air or fluid alone.


Water spectral pattern as holistic marker for water quality monitoring.

Abstract: Online water quality monitoring technologies have been improving continuously. At the moment, water quality is defined by the respective range of few chosen parameters. However, this strategy requires sampling and it cannot provide evaluation of the entire water molecular system including various solutes. As it is nearly impossible to monitor every single molecule dissolved in water, the objective of our research is to introduce a complimentary approach, a new concept for water screening by observing the water molecular system changes using aquaphotomics and Quality Control Chart method. This approach can continuously provide quick information about any qualitative change of water molecular arrangement without taking into account the reason of the alteration of quality. Different species and concentrations of solutes in aqueous systems structure the water solvent differently. Aquaphotomics investigates not the characteristic absorption bands of the solute in question, but the solution absorption at vibrational bands of water's covalent and hydrogen bonds that have been altered by the solute. The applicability of the proposed concept is evaluated by monitoring the water structural changes in different aqueous solutions such as acid, sugar, and salt solutions at millimolar concentration level and in ground water. The results show the potential of the proposed approach to use water spectral pattern monitoring as bio marker of water quality. Our successful results open a new venue in water quality monitoring by offering a quick and cost effective method for continuous screening of water molecular arrangement. Instead of the regular analysis of individual physical or chemical parameters, with our method - as a complementary tool - the structural changes of water molecular system used as a mirror reflecting even small disturbances in water can indicate the necessity of further detailed analysis by conventional methods.

Kovacs|Zoltan|Z| Bázár|György|G| Oshima|Mitsue|M| Shigeoka|Shogo|S| Tanaka|Mariko|M| Furukawa|Akane|A| Nagai|Airi|A| Osawa|Manami|M| Itakura|Yukari|Y| Tsenkova|Roumiana|R|

Water molecular system
Aquaphotomics
Quality control chart
Spectral monitoring


Brain network profiling defines functionally specialized cortical networks.

Abstract: Neuroimaging research made rapid advances in the study of the functional architecture of the brain during the past decade. Many proposals endorsed the relevance of large-scale brain networks, defined as ensembles of brain regions that exhibit highly correlated signal fluctuations. However, analysis methods need further elaboration to define the functional and anatomical extent of specialized subsystems within classical networks with a high reliability. We present a novel approach to characterize and examine the functional proprieties of brain networks. This approach, labeled as brain network profiling (BNP), considers similarities in task-evoked activity and resting-state functional connectivity across biologically relevant brain subregions. To combine task-driven activity and functional connectivity features, principal components were extracted separately for task-related beta values and resting-state functional connectivity z-values (data available from the Human Connectome Project), from 360 brain parcels. Multiple clustering procedures were employed to assess if different clustering methods (Gaussian mixtures; k-means) and/or data structures (task and rest data; only rest data) led to improvements in the replication of the brain architecture. The results indicated that combining information from resting-state functional connectivity and task-evoked activity and using Gaussian mixtures models for clustering produces more reliable results (99% replication across data sets). Moreover, the findings revealed a high-resolution partition of the cerebral cortex in 16 networks with unique functional connectivity and/or task-evoked activity profiles. BNP potentially offers new approaches to advance the investigation of the brain functional architecture.

Di Plinio|Simone|S|0000-0002-2551-0985
Ebisch|Sjoerd J H|SJH|

clustering
Gaussian mixture model
brain functional architecture
parallel analysis
principal component analysis
resting-state fMRI
task fMRI


The efficacy of thymosin α1 as immunomodulatory treatment for sepsis: a systematic review of randomized controlled trials.

Abstract:
BACKGROUND
Thymosin α1 (Tα1) as immunomodulatory treatment is supposed to be beneficial for the sepsis patients by regulating T cell subsets and inflammatory mediators. However, limited by the small sample size and the poor study design, the persuasive power of the single clinical studies is weak. This meta-analysis aimed to investigate the impact of Tα1 on the sepsis patients.

METHODS
We searched for the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CBM, VIP, CNKI, WANFANG, Igaku Chuo Zasshi (ICHUSHI) and Korean literature databases reporting the effects of Tα1 on outcomes in sepsis patients.

RESULTS
Among 444 related articles, 19 randomized controlled trials (RCTs) met our inclusion criteria. Mortality events were reported in 10 RCTs included 530 patients, and the meta-analysis showed significant decrease in Tα1 group compared with control group (RR 0.59, 95 % CI 0.45 to 0.77, p = 0.0001). The subgroup analysis showed no difference between the two dosages (RR 0.59, 95 % CI 0.43 to 0.81; RR 0.59, 95 % CI 0.35 to 0.98, respectively). In 9 RCTs, with a total of 489 patients, Tα1 administered once per day decrease APACHE II score significantly (SMD -0.80, 95 % CI -1.14 to -0.47, p < 0.0001) while Tα1 twice per day showed no effect (SMD 0.30, 95 % CI-0.10 to 0.70, p = 0.14). However, the length of ICU stay, the incidence of multiple organ failure (MOF) and duration of mechanical ventilation were not significantly affected by Tα1 treatment (SMD -0.52, 95 % CI -1.06 to 0.11, p = 0.06; SMD -0.49, 95 % CI -1.09 to 0.11, p = 0.11; SMD -0.37, 95 % CI -0.90 to 0.17, p = 0.17, respectively). As to the immunological indicators, the level of HLA-DR were increased by Tα1 (SMD 1.23, 95 % CI 0.28 to 2.18, p = 0.01) according to the pooled analysis of 8 studies involving 721 patients. Lymphocyte subsets CD3, CD4 and cytokines IL-6, IL-10 and TNF-α were also beneficially affected by Tα1 treatment.

CONCLUSIONS
Tα1 may be beneficial to sepsis patients in reducing mortality and modulating inflammation reactions. However, the quality of evidence supporting the effectiveness is low considering the small sample sizes and inadequate adherence to standardized reporting guidelines for RCTs among the included studies.

Liu|Fang|F| Wang|Hong-Mei|HM| Wang|Tiansheng|T| Zhang|Ya-Mei|YM| Zhu|Xi|X|

D016032:Randomized Controlled Trials as Topic

Thymosin α1
Immunomodulatory
Sepsis
Systematic review


The stingless bee honey protects against hydrogen peroxide-induced oxidative damage and lipopolysaccharide-induced inflammation in vitro.

Abstract: Oxidative stress, DNA damage, and unresolved inflammation are the predisposing factors of many chronic and degenerative diseases, including cancer. Stingless bee honey (SBH) is recognized to have high medicinal value by traditional medicine practitioners and has been used to treat various illnesses traditionally. This study aimed to determine the antioxidant, anti-inflammatory, and genoprotective effects of SBH by using in vitro cell culture models. The sugar content, total phenolic content, radical scavenging activity, and ferric reducing antioxidant power (FRAP) of SBH were determined in this study. Then, the protective effect of SBH against hydrogen peroxide (H2O2)-induced cell death and DNA damage was studied by using WIL2-NS human lymphoblastoid cell line, while the lipopolysaccharide (LPS)-induced RAW 264.7 murine macrophages cell line was used to study the anti-inflammatory effects of SBH. Results from this present study showed that the major sugar contents of SBH were fructose (19.39 + 0.01%) and glucose (14.03 ± 0.03%). Besides, the total phenolic content, the radical scavenging activity, and the FRAP value of SBH were 15.38 ± 0.02 mg GAE/100 g of honey, 34.04 ± 0.21%, and 206.77 + 1.76 μM AAE/100 g honey respectively. Pretreatment with SBH protected WIL2-NS cells from H2O2-induced cell death and DNA damage (p < 0.001). Moreover, SBH was also able to attenuate the production of nitric oxide by inhibiting the expression of inducible nitric oxide synthase in LPS-induced RAW 264.7 cells (p < 0.001). In conclusion, SBH is rich in total phenolic content and possesses strong antioxidant, anti-inflammatory, and genoprotective properties. Our current findings suggest that SBH might be useful in the prevention and treatment of many diseases caused by oxidative stress and inflammation assuming the observed effects are also achievable in vivo.

Ooi|Theng Choon|TC|
Yaacob|Malisanurhidayu|M|
Rajab|Nor Fadilah|NF|
Shahar|Suzana|S|
Sharif|Razinah|R|

Stingless bee honey
DNA damage
Antioxidant
Hydrogen peroxide
Lipopolysaccharide
Anti-inflammation


Extravasation of Urine Associated with Bilateral Complete Ureteral Duplication, Vesicoureteral Reflux and Benign Prostatic Hyperplasia.

Abstract: We report a rare case of extravasation of urine, which may be associated with bilateral complete ureteral duplication, vesicoureteral reflux (VUR), and benign prostatic hyperplasia (BPH). A 71-year-old male presented with a complaint of right abdominal pain. An extravasation of urine was noted, and was improved by indwelling urethral catheterization. Transurethral resection of the prostate and the endoscopic subureteral injection of dextanomer/hyaluronic acid were performed for the treatment of BPH and VUR, respectively. The post-surgery recovery was successful.

Suzuki|Issei|I| Kaga|Kanya|K| Takei|Kohei|K| Tokura|Yuumi|Y| Sakamoto|Kazumasa|K| Nishihara|Daisaku|D| Mizuno|Tomoya|T| Yuki|Hideo|H| Betsunoh|Hironori|H| Abe|Hideyuki|H| Yashi|Masahiro|M| Fukabori|Yoshitatsu|Y| Yamanishi|Tomonori|T| Kamai|Takao|T|

Ureteral duplication
Vesicoureteral reflux
Benign prostatic hyperplasia
Urine extravasation


Endoscopic thyroidectomy using the EZ-VANS method.

Abstract:
PURPOSE
Several video-assisted and robotic surgery techniques have been reported for resection of the thyroid and parathyroid glands. Our institute has started performing endoscopic thyroidectomy using the Lap-protector and E·Z-access system, referred to as E·Z-access using video-assisted neck surgery (EZ-VANS). In this report, we evaluate the safety and efficacy of this technique.

METHODS
From January 2007 to September 2014, 110 patients underwent resection of a primary thyroid tumor, 73 who underwent a cervical collar incision (the Open group) and 37 underwent EZ-VANS (the EZ-VANS group).

RESULTS
The average operating time was 159 and 172 min in the Open group and EZ-VANS group, respectively; the amount of blood loss was 46.5 and 54.7 ml, respectively; and the length of hospital stay after surgery was 4.3 and 5.2 days, respectively, with no significant differences observed between the two groups. The learning curve for the EZ-VANS technique was shorter than for open surgery.

CONCLUSIONS
We confirmed that the EZ-VANS technique is a safe and useful method for resection of benign and early malignant thyroid tumors.

Nagata|Takuya|T| Shimada|Yutaka|Y| Miwa|Takeshi|T| Hashimoto|Isaya|I| Kojima|Hirofumi|H| Okumura|Tomoyuki|T| Tsukada|Kazuhiro|K|

Endoscopic thyroidectomy
EZ-VANS
Lap-protector
E·Z-access


Long Noncoding RNA KCNMB2-AS1 Increases ROCK1 Expression by Sponging microRNA-374a-3p to Facilitate the Progression of Non-Small-Cell Lung Cancer.

Abstract:
Purpose
The expression and roles of most long noncoding RNAs (lncRNAs) in non-small-cell lung cancer (NSCLC) remain poorly understood. Thus, this study investigated KCNMB2 antisense RNA 1 (KCNMB2-AS1) expression in NSCLC and determined the roles and mechanisms of KCNMB2-AS1 in regulating NSCLC progression.

Methods
KCNMB2-AS1 expression in NSCLC tissues and cells was detected using reverse transcription-quantitative polymerase chain reaction. Cell proliferation, apoptosis, migration, and invasion were evaluated using Cell Counting Kit-8, flow cytometry, Transwell migration, and Transwell invasion assays, respectively. In vivo tumor xenograft models were constructed to assess tumorigenicity. Bioinformatics predictions were performed to identify microRNAs targeting KCNMB2-AS1. Interactions between KCNMB2-AS1 and miR-374a-3p were analyzed using RNA immunoprecipitation, luciferase reporter, and rescue experiments.

Results
KCNMB2-AS1 levels were increased in NSCLC tissues and cells. KCNMB2-AS1 silencing hindered NSCLC cell proliferation, migration, and invasion and promoted apoptosis in vitro. Additionally, KCNMB2-AS1 knockdown decreased tumor growth in vivo. Mechanistically, KCNMB2-AS1 functioned as an endogenous miR-374a-3p sponge and increased ρ-associated coiled-coil-containing protein kinase 1 (ROCK1) expression. Furthermore, increased miR-374a-3p/ROCK1 output attenuated KCNMB2-AS1 silencing-induced inhibition of NSCLC progression.

Conclusion
The KCNMB2-AS1/miR-374a-3p/ROCK1 pathway drives NSCLC progression, suggesting that this pathway can be targeted to reduce NSCLC progression.

long noncoding RNA
KCNMB2 antisense RNA 1
ceRNA theory


Disentangling natural vs. anthropogenic induced environmental variability during the Holocene: Marambaia Cove, SW sector of the Sepetiba Bay (SE Brazil).

Abstract: Multiproxy approach based on textural, mineralogical, geochemical, and microfaunal analyses on a 176-cm-long core (SP8) has been applied to reconstruct the Holocene paleoenvironmental changes and disentangling natural vs. anthropogenic variability in Marambaia Cove of the Sepetiba Bay (SE Brazil). Sepetiba Bay became a lagoonal system due to the evolution and development of the Marambaia barrier island during the Holocene and the presence of an extensive river basin. Elemental concentrations from pre-anthropogenic layers from the nearby SP7 core have been used to estimate the baseline elemental concentrations for this region and to determine metals enrichment factors (EF), pollution load index (PLI), and sediment pollution index (SPI). Record of the core SP8 provides compelling evidence of the lagoon evolution differentiating the effects of potentially toxic elements (PTEs) under natural vs. anthropic forcing in the last ~ 9.5 ka BP. The study area was probably part of coastal sand ridges between ≈ 9.5 and 7.8 ka BP (radiocarbon date). Events of wash over deposited allochthonous material and organic matter between ≈ 8.6 and 7.8 ka. Climatic event 8.2 ka BP, in which the South American Summer Monsoon was intensified in Brazil causing higher rainfall and moisture was scored by an anoxic event. Accumulation of organic matter resulted in oxygen depletion and even anoxia in the sediment activating biogeochemical processes that resulted in the retention of potentially toxic elements (PTEs). After ≈ 7.8 ka BP at the onset of the Holocene sea-level rise, a marine incursion flooded the Marambaia Cove area (previously exposed to subaerial conditions). Environmental conditions became favorable for the colonization of benthic foraminifera. The Foram Stress Index (FSI) and Exp(H'bc) indicate that the environmental conditions turned from bad to more favorable since ≈ 7.8 ka BP, with maximum health reached at ≈ 5 ka BP, during the mid-Holocene relative sea-level highstand. Since then, the sedimentological and ecological proxies suggest that the system evolved to an increasing degree of confinement. Since ≈ 1975 AD, a sharp increase of silting, Cd, Zn, and organic matter also induced by anthropic activities caused major changes in foraminiferal assemblages with a significant increase of Ammonia/Elphidium Index (AEI), EF, and SPI values and decreasing of FSI and Exp(H'bc) (ecological indicators) demonstrating an evolution from "moderately polluted" to "heavily polluted" environment (bad ecological conditions), under variable suboxic conditions. Thus, core SP8 illustrates the most remarkable event of anthropogenic forcing on the geochemistry of the sediments and associated pollution loads and its negative effect on benthic organisms.

Multiproxies
Metals
Foraminifera
Foram Stress Index
Ammonia/Elphidium Index
Ecological Quality Status


Why rapid achievement of goal blood pressure is important in the treatment of arterial hypertension.

Abstract: Currently, there is a change in the algorithm of hypertension treatment, introducing its simplification. While in the past a careful stepwise titration of antihypertensive drugs was used, the current European Society of Hypertension Guidelines prefer a more aggressive and rapid approach to combination treatment as the initial step with the aim to achieve the goal blood pressure within three months. This review summarizes changes in recommendations and evidence supporting a more aggressive treatment of hypertension.

goal blood pressure
arterial hypertension
hypolipidemic drugs


Chlorinated Guaiane-Type Sesquiterpene Lactones as Cytotoxic Agents against Human Tumor Cells.

Abstract: Guaiane-type sesquiterpene lactones are naturally occurring compounds which have attracted attention due to their array of biological activities. In this study, chlorinated guaianolides 1-8, isolated from plants of the genus Centaurea, were evaluated against the human leukemia cell lines HL-60, U-937, a specific U-937 cell line that overexpresses the anti-apoptotic Bcl-2 protein and the human melanoma cell line SK-MEL-1. This established the relevant structure-growth inhibition relationships. Chlorohyssopifolins A (1), C (3) and D (4) and linichlorin A (6) were the most potent compounds in terms of inducing growth inhibition in the four cell lines. IC50 values were below 10 μM in all cases. Chlorohyssopifolins A (1) and D (4) and linichlorin A (6) were potent apoptotic inducers in human U-937 leukemia cells, as determined by fluorescent microscopy and flow cytometry, and their mechanism of action was associated with cytochrome c release, caspase activation and poly(ADP-ribose)polymerase cleavage. Overall this study shows that guaianolides induce cytotoxicity against human tumor cells and provides important insights into the cell death pathways that are involved.

sesquiterpene lactone
cytotoxicity
guaianolide
caspase
apoptosis
poly(ADP-ribose) polymerase


The role of mononuclear cell tissue factor and inflammatory cytokines in patients with chronic thromboembolic pulmonary hypertension.

Abstract: Thrombosis and inflammation are two major factors underlying chronic thromboembolic pulmonary hypertension (CTEPH). Tissue factor (TF), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein 1 (MCP-1) may play critical roles in the process of CTEPH thrombosis and pulmonary vascular remodeling. Ten patients with a confirmed diagnosis of CTEPH, 20 patients with acute pulmonary thromboembolism and 15 patients with other types of pulmonary hypertension were enrolled in this study, along with 20 healthy subjects as the control group. The immunoturbidimetric method was used to determine the plasma content of CRP. The plasma levels of TNF-α, MCP-1, and TF antigen were measured by an enzyme-linked immunosorbent assay, and TF activity was measured by the chromogenic substrate method. Percoll density gradient centrifugation was used to separate peripheral blood mononuclear cells from plasma. The level of monocyte TF mRNA was examined by reverse transcriptase-polymerase chain reaction. The correlations between all indices described above were analyzed. In CTEPH patients, the expression of CRP, TNF-α, and MCP-1 was significantly higher than that in controls (P < 0.05). The levels of TF activity, TF antigen, and TF mRNA in monocyte cells were increased in CTEPH patients when compared with control subjects, but only the TF antigen and TF mRNA levels were significantly different (P < 0.05). In CTEPH patients, levels of CRP, MCP-1, and TNF-α significantly correlated with the level of TF antigen in plasma. TF gene expression was increased in patients with CTEPH, suggesting that blood-borne TF mainly comes from mononuclear cells. TF expression significantly correlated with levels of CRP, TNF-α and MCP-1. These factors may play an important role in the development of CTEPH via the inflammation-coagulation-thrombosis cycle.

Yang|Minxia|M| Deng|Chaosheng|C| Wu|Dawen|D| Zhong|Zhanghua|Z| Lv|Xiaoting|X| Huang|Zhihua|Z| Lian|Ningfang|N| Liu|Kaixiong|K| Zhang|Qiaoxian|Q|

D002097:C-Reactive Protein
D016022:Case-Control Studies
D018932:Chemokine CCL2
D002908:Chronic Disease
D016207:Cytokines
D006801:Humans
D006976:Hypertension, Pulmonary
D009000:Monocytes
D011655:Pulmonary Embolism
D012333:RNA, Messenger
D013925:Thromboplastin
D014409:Tumor Necrosis Factor-alpha

Chronic thromboembolic pulmonary hypertension


Complete genome sequence of a KI polyomavirus isolated from an otherwise healthy child with severe lower respiratory tract infection.

Abstract: Unbiased, deep sequencing of a nasal specimen from an otherwise healthy 13-month-old boy hospitalized in intensive care revealed high gene expression and the complete genome of a novel isolate of KI polyomavirus (KIPyV). Further investigation detected minimal gene expression of additional viruses, suggesting that KIPyV was potentially the causal agent. Analysis of the complete genome of isolate NMKI001 revealed it is different from all previously reported genomes and contains two amino acid differences as compared to the closest virus isolate, Stockholm 380 (EF127908). J. Med. Virol. 89:926-930, 2017. © 2016 Wiley Periodicals, Inc.

Dehority|Walter N|WN|
Eickman|Megan M|MM|
Schwalm|Kurt C|KC|
Gross|Stephen M|SM|
Schroth|Gary P|GP|
Young|Stephen A|SA|
Dinwiddie|Darrell L|DL|

complete genome
KI polyomavirus
human polyomavirus 3
next generation sequencing
severe lower respiratory infection


Eldecalcitol is superior to alfacalcidol in maintaining bone mineral density in glucocorticoid-induced osteoporosis patients (e-GLORIA).

Abstract:
INTRODUCTION
Eldecalcitol increases bone mineral density (BMD) and reduces vertebral fracture in patients with primary osteoporosis. However, the effect of eldecalcitol on BMD and fracture in glucocorticoid-induced osteoporosis (GIO) patients is unknown. This study was undertaken to compare the effect of eldecalcitol on BMD and fracture with that of alfacalcidol in GIO patients.

MATERIALS AND METHODS
A randomized, open-label, parallel group study was conducted to identify the effectiveness and safety of monotherapy with 0.75 μg eldecalcitol compared with 1.0 μg alfacalcidol in GIO patients.

RESULTS
Lumbar spine BMD increased with eldecalcitol, but decreased with alfacalcidol at 12 and 24 months (between group difference 1.29%, p < 0.01, and 1.10%, p < 0.05, respectively). Total hip and femoral neck BMD were maintained until 24 months by eldecalcitol, but decreased by alfacalcidol (between group difference 0.97%, p < 0.05 and 1.22%, p < 0.05, respectively). Both bone formation and resorption markers were more strongly suppressed by eldecalcitol than by alfacalcidol. Eldecalcitol showed better effect on BMD than alfacalcidol in patients with no prevalent fracture and BMD > 70% of the young adult mean, and with ≤ 3 months of previous glucocorticoid treatment. No significant difference in the incidence of vertebral fracture was found, and the incidence of adverse events was similar between the two groups.

CONCLUSIONS
Eldecalcitol was more effective than alfacalcidol in maintaining BMD in GIO patients. Because eldecalcitol was effective in patients with no or short-term previous glucocorticoid treatment, as well as those without prevalent fracture or low BMD, eldecalcitol can be a good candidate for primary prevention of GIO.

CLINICAL TRIAL REGISTRATION NUMBER
UMIN000011700.

Matsumoto|Toshio|T| Yamamoto|Kazuhiko|K| Takeuchi|Tsutomu|T| Tanaka|Yoshiya|Y| Tanaka|Sakae|S| Nakano|Tetsuo|T| Ito|Masako|M| Tomomitsu|Tatsushi|T| Hirakawa|Akihiro|A| Soen|Satoshi|S|

D050071:Bone Density Conservation Agents

Alfacalcidol
Fracture
Active vitamin D
Secondary osteoporosis


Insulin resistance is higher in prepubertal girls but switches to become higher in boys at age 16: A Cohort Study (EarlyBird 57).

Abstract:
BACKGROUND
The risk of type 2 diabetes is increasing in teenage girls, and is associated with their greater insulin resistance (IR).

HYPOTHESIS
We hypothesized that the adverse metabolic profile of girls (compared with boys) would persist from childhood through adolescence.

PATIENTS AND METHODS
Community-based longitudinal cohort of 292 children (147 boys) studied annually from 9 to 16 years.

MEASURES
IR (homeostasis-model-assessment-2), high-density lipoprotein-cholesterol (HDL-C), triglycerides, % body-fat (dual-energy x-ray absorptiometry), pubertal stage (age at peak height velocity), physical activity (accelerometry). Multi-level modelling established the age-related trends in IR and lipids and the influence of covariates.

RESULTS
Each year from 9 to 15 years, girls had 21% to 63% higher IR than boys (girls mean IR 0.73-1.33, boys 0.51-0.89, P < .005). At 16 years the gender difference was not significant (girls IR 0.60, boys 0.56, P = .45). Girls had lower HDL-C from 9 to 12 years, higher triglycerides from 9 to 14 years, greater adiposity throughout, and earlier puberty, but boys were more active than girls (all P < .05). After adjustment for %-fat, puberty and activity, the gender difference in IR between girls and boys aged 9 to 15 years became non-significant (IR girls 0.66-1.01, boys 0.65-1.04, P > .07). However, after adjustment at 16 years, girls' IR was 25% lower than boys' (girls 0.44, boys 0.63, P = .001), and they had 22% higher HDL-C (P < .001) and 20% lower triglycerides (P = .003).

CONCLUSIONS
The higher IR of prepubertal and early pubertal girls diminishes during late puberty, and boys begin to exhibit greater metabolic risk. Despite being leaner and more active, boys at 16 years have higher IR than girls, suggesting future higher risk for diabetes, thus we reject our hypothesis.

Jeffery|Sarah C|SC|
Hosking|Joanne|J|
Jeffery|Alison N|AN|0000-0001-7539-5957
Murphy|Michael J|MJ|
Voss|Linda D|LD|
Wilkin|Terence J|TJ|
Pinkney|Jonathan|J|

insulin resistance
adolescent
physical activity
adiposity
child


More similarities than differences between men and women with irritable bowel syndrome.

Abstract:
BACKGROUND
Differences regarding symptoms, coping abilities, and quality of life (QOL) between men and women with irritable bowel syndrome (IBS) have been reported but data are sparse and sometimes conflicting. The aim of present study was to investigate gender differences in gastrointestinal, extra-intestinal, and psychological symptoms, and sense of coherence (SOC) and QOL in a large group of patients diagnosed with IBS.

METHODS
We analyzed questionnaire data from 557 patients (152 men) diagnosed with IBS consecutively included in studies at an outpatient clinic for functional bowel disorders between 2002 and 2010. Following questionnaires were included: IBS severity scoring system (IBS-SSS), Hospital Anxiety and Depression Scale (HAD), IBSQOL Scale, Visceral Sensitivity Index (VSI), SOC Scale, Bristol Stool Form Scale (BSFS), and Patient Health Questionnaire (PHQ-15).

KEY RESULTS
Women had harder stools (FDR-adjusted p-value: q = 0.033), more severe bloating (q = 0.020), higher symptom severity (q = 0.042), higher total somatic symptom burden (q = 0.035), lower SOC (q = 0.042), and lower QOL. Women rated more general anxiety (q = 0.017) and gastrointestinal-specific anxiety (q = 0.042), but there were no group differences in depression, pain, stool frequency, impact on daily life, dissatisfaction with bowel habit, or extra-colonic symptoms. The differences found were small (effect sizes: r < 0.3).

CONCLUSIONS & INFERENCES
In this study, we demonstrated more similarities than differences between men and women with IBS. The largest difference were seen for QOL which might reflect certain structural stressors to which women in general are more exposed than men.

Björkman|I|I|
Jakobsson Ung|E|E|
Ringström|G|G|
Törnblom|H|H|
Simrén|M|M|

irritable bowel syndrome
symptoms
coping
quality of life
gender differences


Virulent Pseudomonas aeruginosa infection converts antimicrobial amyloids into cytotoxic prions.

Abstract: Pseudomonas aeruginosa infection elicits the production of cytotoxic amyloids from lung endothelium, yet molecular mechanisms of host-pathogen interaction that underlie the amyloid production are not well understood. We examined the importance of type III secretion system (T3SS) effectors in the production of cytotoxic amyloids. P aeruginosa possessing a functional T3SS and effectors induced the production and release of cytotoxic amyloids from lung endothelium, including beta amyloid, and tau. T3SS effector intoxication was sufficient to generate cytotoxic amyloid release, yet intoxication with exoenzyme Y (ExoY) alone or together with exoenzymes S and T (ExoS/T/Y) generated the most virulent amyloids. Infection with lab and clinical strains engendered cytotoxic amyloids that were capable of being propagated in endothelial cell culture and passed to naïve cells, indicative of a prion strain. Conversely, T3SS-incompetent P aeruginosa infection produced non-cytotoxic amyloids with antimicrobial properties. These findings provide evidence that (1) endothelial intoxication with ExoY is sufficient to elicit self-propagating amyloid cytotoxins during infection, (2) pulmonary endothelium contributes to innate immunity by generating antimicrobial amyloids in response to bacterial infection, and (3) ExoY contributes to the virulence arsenal of P aeruginosa through the subversion of endothelial amyloid host-defense to promote a lung endothelial-derived cytotoxic proteinopathy.

Voth|Sarah|S|0000-0003-3796-7154
Gwin|Meredith|M|
Francis|Christopher Michael|CM|
Balczon|Ron|R|
Frank|Dara W|DW|
Pittet|Jean-Francois|JF|
Wagener|Brant M|BM|
Moser|Stephen A|SA|
Alexeyev|Mikhail|M|
Housley|Nicole|N|
Audia|Jonathon P|JP|
Piechocki|Scott|S|
Madera|Kayla|K|
Simmons|Autumn|A|
Crawford|Michaela|M|
Stevens|Troy|T|

prion
exoenzyme Y (ExoY)
amyloid beta (Aβ)
nosocomial pneumonia
tau (τ)


Pollution Response Score of Tree Species in Relation to Ambient Air Quality in an Urban Area.

Abstract: Multivariate statistical techniques were employed on twelve leaf traits in four selected common tree species (Mangifera indica L., Polyalthia longifolia Sonn., Ficus benghalensis L. and Psidium guajava L.) to evaluate their responses with respect to major air pollutants in an urban area. Discriminant analysis (DA) identified chlorophyll/carotenoid ratio, leaf dry matter content, carotenoids, net water content and ascorbic acid as the major discriminating leaf traits, which varied maximally with respect to the pollution status. Pollution response score (PRS), calculated on the basis of discriminate functional coefficient values, increased with an increase in air pollution variables for all the tested species, with the highest increase in P. longifolia and the lowest in F. benghalensis. The study highlights the usefulness of DA for evaluation of plant specific traits and PRS for selection of tolerant species.

D000393:Air Pollutants
D000397:Air Pollution
D002734:Chlorophyll
D004784:Environmental Monitoring
D015999:Multivariate Analysis
D018515:Plant Leaves
D013312:Stress, Physiological
D014197:Trees

Pollution response score
Trees
Leaf traits
Nitrogen dioxide
Total suspended particles


Baetid abundances are a rapid indicator of thermal stress and riparian zone intactness.

Abstract: Riparian zone vegetation plays an integral role in freshwater ecology, notably by buffering water temperatures, and in providing habitat for the adult stages of many aquatic species. We measured the contribution that riparian vegetation makes to temperature buffering, and how this affects the freshwater fauna, specifically using changes in abundances of baetid may flies for the Luvuvhu River catchment in South Africa. Water temperatures were compared for shaded versus un-shaded sites, and thermal stress between seasons was estimated using a cumulative probability model for the most widespread mayfly species, Dabulamanzia media. It is concluded that thermal stress due to losses in riparian shading could be detected using mayfly abundances in a regular monitoring programme.

Rivers-Moore|N A|NA|
Ramulifho|P A|PA|
Foord|S H|SH|

Abundance
Thermal stress
Water temperature
Probability model
Monitoring
Ephemeroptera


Correlation of hematocrit and Apgar scores in newborns of women with hypertensive disorders in pregnancy.

Abstract:
OBJECTIVES
To compare the incidence of polycythemia in newborns of women with hypertensive disorders in pregnancy (HDP) with those of normotensive mothers, to determine the incidence of perinatal stress using Apgar scores and to correlate hematocrit with Apgar scores in these newborn.

STUDY DESIGN
This was a hospital-based comparative study conducted in the University of Port Harcourt Teaching Hospital, Nigeria.

MAIN OUTCOME MEASURES
Apgar scores of 200 newborns- 100 from mothers with HDP (case group) and 100 from normotensive mothers (control group)- were taken at 1st and 5th minute of birth and cord blood samples collected to determine hematocrit. The subjects were categorized into polycythemic and non polycythemic using a hematocrit ≥65%.

RESULTS
Eight percent of newborns of women with HDP had polycythemia while none of the controls did. Apgar scores in the case group with and without polycythemia at one-minute were 4.1±1.8 and 6.6±2.1, respectively and at 5 minutes were 6.9±1.7 and 8.5±1.4 respectively. Hematocrit correlated positively with Apgar scores (both at one and five minutes) in cases without polycythemia (r = 0.221, p = 0.034 and r = 0.255, p = 0.014). Hematocrit of polycythemic newborns did not correlate with Apgar scores (r = -0.287, p = 0.491 and r = -0.436, p = 0.281).

CONCLUSION
The incidence of polycythemia is significantly higher in newborns of women with HDP and these polycythemic neonates had a significantly higher incidence of birth asphyxia. Therefore, birth outcome as determined by Apgar score is influenced by hematocrit.

Okoye|Helen Chioma|HC|
Nwogoh|Benedict|B|
Odetunde|Odutola Israel|OI|


Team-based care: Views from community health center staff.

Abstract: Community health centers (CHC) provide quality care for vulnerable patients, and a potentially contributing factor to this quality is the integration of a patient-centered medical home (PCMH). PCMH relies on a team-based approach, a principle in which social workers are trained and research examines in primary care environments. Less is known about team-based care in CHCs. An exploratory qualitative study with 14 CHC staff was conducted to examine the current state of team-based care and secondarily, to examine the role of social workers. Content analysis revealed four themes central to team-based care. Implications for CHCs and social workers are discussed.

Law|Kristi L|KL|0000-0003-0275-1900
Rowe|Jeannine M|JM|

team-based care
community health centers
AND patient-centered medical homes


Pediatric Extraspinal Sacrococcygeal Ependymoma: Report of Two Cases and Literature Review.

Abstract: Primary central nervous system (CNS) tumors represent the most common solid tumors in childhood. Ependymomas arise from ependymal cells lining the wall of ventricles or central canal of spinal cord and their occurrence outside the CNS is extremely rare, published in the literature as case reports or small case series. We present two cases of extra-CNS myxopapillary ependymomas treated at our institution in the past three years; both cases originate in the sacrococcygeal region and were initially misdiagnosed as epidermoid cyst and germ cell tumor, respectively. The first case, which arose in a 9-year-old girl, was treated with a surgical excision in two stages, due to the non-radical manner of the first operation; no recurrence was observed after two years of follow-up. The other case was a 12-year-old boy who was treated with a complete resection and showed no evidence of recurrence at one-year follow-up. In this paper, we report our experience in treating an extremely rare disease that lacks a standardized approach to diagnosis, treatment and follow-up; in addition, we perform a literature review of the past 35 years.

myxopapillary ependymoma
extra-CNS ependymoma
pediatric ependymoma
pilonidal disease


Development of a list of reference chemicals for evaluating alternative methods to in vivo fish bioaccumulation tests.

Abstract: The aim to reduce the number of animals in experiments has highlighted the need to develop and validate nonanimal methods as alternatives to bioaccumulation studies using fish. The present study details a novel 3-tier approach to develop a list of reference compounds to aid this process. The approach was based on 1) the inclusion of relevant chemical classes supported by high-quality in vivo data for the bioconcentration factor (BCF), whole-body biotransformation rates (K(met)), and metabolism characterization for rainbow trout (Oncorhynchus mykiss) and common carp (Cyprinus carpio) (tiers I and II); and 2) the refinement to ensure a broad coverage of hydrophobicity, bioconcentration potential, molecular weight, maximum molecular diameter, whole-body biotransformation half-lives, and metabolic pathways (tier III). In silico techniques were employed to predict maximal log BCF and molecular and metabolic properties. Of the 157 compounds considered as reference compounds, 144 were supported by high-quality BCF data, 8 were supported by K(met) data, and 5 were supported by in vivo metabolism data. Additional criteria for refinement of the list of reference compounds were suggested to aid practical implementation in experimental efforts. The present list of reference compounds is anticipated to facilitate the development of alternative approaches, enhance understanding of in vivo and in vitro bioaccumulation relationships, and refine in silico BCF and metabolism predictions.

Rodriguez-Sanchez|Neus|N|
Cronin|Mark Timothy David|MT|
Lillicrap|Adam|A|
Madden|Judith Clare|JC|
Piechota|Przemyslaw|P|
Tollefsen|Knut Erik|KE|

D057927:Hydrophobic and Hydrophilic Interactions

Bioaccumulation
Bioconcentration
In vitro
Alternative testing
Reference list


Efficacy and safety of febuxostat in the treatment of hyperuricemia in stable kidney transplant recipients.

Abstract:
BACKGROUND
Post-transplant hyperuricemia (PTHU), defined as serum uric acid concentration ≥7.0 mg/dL or need for treatment with allopurinol or benzbromarone, reduces long-term allograft survival in kidney transplant recipients. Febuxostat, a new nonpurine selective xanthine oxidase inhibitor, is well tolerated in patients with moderate renal impairment. However, its efficacy and safety in kidney recipients with PTHU is unclear. We therefore assessed the efficacy and safety of febuxostat in stable kidney transplant recipients with PTHU.

METHODS
Of 93 stable adult kidney transplant recipients, 51 were diagnosed with PTHU (PTHU group) and 42 were not (NPTHU group). Of the 51 patients with PTHU, 26 were treated with febuxostat (FX group) and 25 were not (NFX group), at the discretion of each attending physician. One-year changes in serum uric acid concentrations, rates of achievement of target uric acid (<6.0 mg/dL), estimated glomerular filtration rates in allografts, and adverse events were retrospectively analyzed in the FX, NFX, and NPTHU groups.

RESULTS
The FX group showed significantly greater decreases in serum uric acid (-2.0±1.1 mg/dL versus 0.0±0.8 mg/dL per year, P<0.01) and tended to show a higher rate of achieving target uric acid levels (50% versus 24%; odds ratio 3.17 [95% confidence interval 0.96-10.5], P=0.08) than the NFX group. Although baseline allograft estimated glomerular filtration rates tended to be lower in the FX group than in the NFX group (40±14 mL/min/1.73 m(2) versus 47±19 mL/min/1.73 m(2)), changes in allograft estimated glomerular filtration rate were similar (+1.0±4.9 mL/min/1.73 m(2) versus -0.2±6.9 mL/min/1.73 m(2) per year, P=0.50). None of the patients in the FX group experienced any severe adverse effects, such as pancytopenia or attacks of gout, throughout the entire study period. Nephrologists were more likely than urologists to start febuxostat in kidney transplant recipients with PTHU (69% versus 8%).

CONCLUSION
Treatment with febuxostat sufficiently lowered uric acid levels without severe adverse effects in stable kidney transplant recipients with PTHU.

Sofue|Tadashi|T| Inui|Masashi|M| Hara|Taiga|T| Nishijima|Yoko|Y| Moriwaki|Kumiko|K| Hayashida|Yushi|Y| Ueda|Nobufumi|N| Nishiyama|Akira|A| Kakehi|Yoshiyuki|Y| Kohno|Masakazu|M|

febuxostat
post-transplant hyperuricemia
uric acid
chronic kidney disease


A suction thrombectomy technique: a rapid and effective method for intra-arterial thrombolysis.

Abstract:
OBJECTIVE
During mechanical thrombolysis, to reduce procedure-related complications and time, the authors have performed a simple suction thrombectomy technique. In this article, the authors describe the technical details and clinical outcomes of this technique.

MATERIALS AND METHODS
From January 2013 to December 2013, 14 consecutive acute ischemic stroke (AIS) patients with large cerebral arterial occlusions in the middle cerebral artery (MCA; n = 7), internal cerebral artery (ICA; n = 5), basilar artery (BA; n = 1), and a tandem lesion (ICA and MCA; n = 1) were treated using this technique. The proximal part of the occluding clot was aspirated or captured and retrieved as one piece using a large bored microcatheter by applying negative suction pressure using a 50 mL syringe.

RESULTS
Overall recanalization rate was 85.7% (12 patients). In the 8 patients in whom this technique was used alone, the recanalization rate was 87.5% (7 patients). The median procedural duration was 30 minutes (range 17-112) in these 7 patients. Distal embolism did not occur. Two patients developed post-procedural intracerebral hemorrhages and one was symptomatic. His modified Rankin Scale (mRS) score at 90 days was 4.

CONCLUSION
This technique is a feasible, fast, and safe method for treatment of AIS.

Suction Thrombectomy Thrombolysis Acute Stroke


Gentle facemask ventilation during induction of anesthesia.

Abstract:
BACKGROUND
To determine the level of inspiratory pressure minimizing the risk of gastric insufflation while providing adequate pulmonary ventilation.

METHODS
In this prospective, randomized, double-blind study, patients were allocated to one of the two groups (P10, P15) defined by the inspiratory pressure applied during controlled-pressure ventilation: 10 and 15 cm H2O. Anesthesia was induced using propofol and sufentanil; no neuromuscular-blocking agent was administered. Once loss of eyelash reflex occurred, facemask ventilation was started for a 2-min period. The cross-sectional antral area was measured using ultrasonography before and after facemask ventilation. Respiratory parameters were recorded.

RESULTS
Forty patients were analyzed. Mean tidal volume was about 7 ml/kg in group P10, and was >11 ml/kg in group P15 in the same period. As indicated by ultrasonography test, the antral area in P15 group was markedly incresed compared with P10 group.

CONCLUSION
Inspiratory pressure of 10 cm H2O allowed for reduced occurrence of gastric insufflation with proper lung ventilation during induction of anesthesia with sufentanil and propofol in nonparalyzed and nonobese patients.

Zhang|Qingfu|Q| Zhou|Quanhong|Q| Zhang|Junfeng|J| Zhao|Daqiang|D|

Gentle facemask ventilation
Gastric insufflation
Lung ventilation
Anesthesia induction
Surgery


Accommodative changes after SMILE for moderate to high myopia correction.

Abstract:
BACKGROUND
To investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction.

METHODS
A total of 32 eyes of 32 patients with no strabismus who underwent SMILE were enrolled in this prospective clinical study. The accommodative response was obtained viewing monocularly with spherical equivalent refractive error corrected, using an open-field autorefractor at different stimulus levels (2.00D, 2.50D, 3.00D, 4.00D and 5.00D) for the right eye before a standard SMILE surgery and at 1-month follow-up after surgery.

RESULTS
The mean age of the patients were 23.34 ± 2.90 years and the mean preoperative manifest refraction spherical equivalent was -5.74 ± 1.98 diopters. Significant differences were detected in both preoperative and postoperative accommodative responses to different stimulus levels (P < 0.001). Multiple linear regression model analysis revealed preoperative manifest refractive spherical equivalent (P = 0.006) and preoperative accommodative lag (P = 0.04) showed a significant impact on postoperative accommodative lag.

CONCLUSIONS
This is the first report of accommodative changes after SMILE. Our preliminary results showed that a decrease in postoperative accommodative lag that might be related to the relief of the visual discomfort symptom.

D000065:Accommodation, Ocular
D000328:Adult
D003319:Corneal Stroma
D048988:Corneal Surgery, Laser
D005260:Female
D006801:Humans
D054018:Lasers, Excimer
D008297:Male
D009216:Myopia
D011446:Prospective Studies
D012029:Refraction, Ocular
D054140:Refractive Surgical Procedures
D012044:Regression Analysis
D014792:Visual Acuity
D055815:Young Adult

Small incision lenticule extraction (SMILE)


A polysaccharide from Umbilicaria yunnana: Structural characterization and anti-inflammation effects.

Abstract: A polysaccharide JUYP was isolated and purified from Umbilicaria yunnana. The detailed structure of JUYP was studied using gas chromatography (GC), Fourier transform infrared spectroscopy (FTIR), methylation-GC-MS, nuclear magnetic resonance (NMR) and transmission electron microscopy (TEM). A homogeneous polysaccharide JUYP was obtained with the yield of 21.2% and average molecular weight (Mw) of 577 kDa. Monosaccharide composition analysis indicated that JUYP was composed of glucose, galactose and mannose with a molar ratio of 2.3:1:0.7. Structural analyses demonstrated that the dominate components in JUYP were 6-β-D-Glcp, and other sugar residues included 2,4-β-D-Manp and T-β-D-Galf. TEM images further revealed JUYP was a linear branched molecule with entangled chains. Based on the anti-inflammatory assays, 1 μg/mL of JUYP exhibited good inhibitory effects on TNF-α, IL-6, IL-1β and COX-2 mRNA expressions in LPS-stimulated RAW 264.7 cells, while the inhibitory effects (87.8% for mRNA, 55.89% for protein) of JUYP on IL-1β expressions were more significant than that of dexamethasone (DXMS, 61.6% for mRNA, 35.15% for protein) (p<0.01).

Luo|Dianhui|D| Wang|Zhaojing|Z| Zhou|Rong|R| Cao|Sen|S|

Umbilicaria yunnana
Structural characterization
Anti-inflammation effects


Free ammonia pretreatment enhances the removal of antibiotic resistance genes in anaerobic sludge digestion.

Abstract: Sludge has been recognized as a reservoir of antibiotic resistance genes (ARGs) in the wastewater treatment plants. Our previous study has demonstrated that free ammonia (FA, i.e., NH3-N) pretreatment is an effective method for enhancing anaerobic digestion of sludge. However, the effects of FA pretreatment on the removal of ARGs in the anaerobic sludge digestion is still unknown. In this study, several ARGs representing various antibiotic classes and integrase gene (intI1) which is crucial for horizontal transfer of ARGs were chosen. This study demonstrated that combined FA pretreatment (420 mg NH3-N/L for 24 h, under which the highest anaerobic sludge biodegradability was achieved in our previous study) and anaerobic digestion could enhance the removal of aac(6')-Ib-cr, blaTEM, sul2, tetA, tetB and tetX from sludge by 17-74% compared with anaerobic digestion without FA pretreatment, resulting in a lower ARGs abundance in the anaerobically digested sludge. This is caused by the removal of tested ARGs during FA pretreatment and the reduced abundance of potential microbial hosts of ARGs due to FA pretreatment during anaerobic digestion. The removal of IntI1 was not significantly affected by FA pretreatment and intI1 did not play a large role in the fate of the tested ARGs in this study. This study indicated that FA pretreatment for anaerobic digestion could potentially reduce the spread of ARGs from the sludge to the natural environment during sludge disposal or reuse.

Zhang|Zehao|Z| Li|Xuan|X| Liu|Huan|H| Gao|Li|L| Wang|Qilin|Q|

Free ammonia
Antibiotic resistance genes
Wastewater treatment plants
Anaerobic digestion


Enhanced Youden's index with net benefit: A feasible approach for optimal-threshold determination in shared decision making.

Abstract:
OBJECTIVES
To establish an enhanced Youden's index with net benefit, as a scientific method for optimal-threshold determination in shared decision making.

METHOD
We redefined the Youden's index by changing the target function from the maximization of accuracy to the maximization of net benefit and established the process for pursuing the patient's individual optimal-threshold. In addition, we illustrated how the enhanced Youden's index works with an example of cataract operation decision making using the data from Shanghai, China.

RESULTS
We modified the method of calculating net benefit in decision curve analysis and fused it with Youden's index to expand the purpose from finding a threshold with the best test accuracy to finding one with the best net benefit. As an example, we used the enhanced Youden's index to establish an optimal-thresholds list for cataract operation decision making. Then, we calculated three imaginary patients' respective thresholds after integrating the local recovery rate, their visual activities, and individual preferences. The results demonstrated that the thresholds of patients with the same objective examination results might vary widely due to their individual preferences. Therefore, the thresholds are more individualized according to the enhanced Youden's index.

CONCLUSION
The enhanced Youden's index can establish the optimal-thresholds from the perspective of maximization of patients' net benefit and provide a quantifiable method for shared decision making.

D002681:China
D000080536:Decision Making, Shared
D003955:Diagnostic Tests, Routine
D006801:Humans
D012107:Research Design
D012680:Sensitivity and Specificity

Youden's index
net benefit
shared decision making


ARF1 and ARF6 regulate recycling of GRASP/Tamalin and the Rac1-GEF Dock180 during HGF-induced Rac1 activation.

Abstract: Hepatocyte growth factor (HGF) is a potent signaling factor that acts on epithelial cells, causing them to dissociate and scatter. This migration is coordinated by a number of small GTPases, such as ARF6 and Rac1. Active ARF6 is required for HGF-stimulated migration and intracellular levels of ARF6-GTP and Rac1-GTP increase following HGF treatment. During migration, cross talk between ARF6 and Rac1 occurs through formation of a multi-protein complex containing the ARF-GEF cytohesin-2, the scaffolding protein GRASP/Tamalin, and the Rac1-GEF Dock180. Previously, the role of ARF6 in this process was unclear. We have now found that ARF6 and ARF1 regulate trafficking of GRASP and Dock180 to the plasma membrane following HGF treatment. Trafficking of GRASP and Dock180 is impaired by blocking ARF6-mediated recycling pathways and is required for HGF-stimulated Rac1 activation. Finally, HGF treatment stimulates association of GRASP and Dock180. Inhibition of ARF6 trafficking pathways traps GRASP and Dock180 as a complex in the cell.

D020823:ADP-Ribosylation Factor 1
D000089982:ADP-Ribosylation Factor 6
D020727:ADP-Ribosylation Factors
D000818:Animals
D002352:Carrier Proteins
D002462:Cell Membrane
D004285:Dogs
D011992:Endosomes
D004789:Enzyme Activation
D055785:Gene Knockdown Techniques
D017228:Hepatocyte Growth Factor
D006801:Humans
D061985:Madin Darby Canine Kidney Cells
D008565:Membrane Proteins
D021381:Protein Transport
D020744:rac GTP-Binding Proteins
D020830:rac1 GTP-Binding Protein


The Role of Regular Physical Therapy on Spasticity in Children With Cerebral Palsy.

Abstract:
OBJECTIVE
To investigate the effect of physical therapy (PT) intervention on spasticity in patients with cerebral palsy (CP), and to assess the degree of deterioration of spasticity when regular PT is interrupted in those patients.

METHODS
We recruited 35 children with spastic CP who visited our hospital for PT, and whose Modified Tardieu Scale (MTS) scores were serially recorded including before and after a 10-day public holiday time frame period. The outcome measures were the angle of range of motion (ROM) of dorsiflexion of the ankle joint (R1 and R2) in the knee flexion and extension positions as assessed using the MTS.

RESULTS
The range of dorsiflexion of the ankle joint (R1 and R2) after the holiday period was significantly decreased as compared with that measured ROM noted before the holiday period, regardless of the knee position, age, or gross motor function. The dynamic component of the MTS (R2-R1) showed a slight decrease in the knee flexion position.

CONCLUSION
Interruption of regular PT aggravated spasticity and decreased ankle joint ROM in children with spastic CP. Our findings suggest that regular PT in the care continuum for children with CP is crucial for the maintenance of ROM in the spastic ankle joints.

Lee|Heewon|H|
Kim|Eun Kyung|EK|
Son|Dong Baek|DB|
Hwang|Youngdeok|Y|
Kim|Joon-Sung|JS|
Lim|Seong Hoon|SH|
Sul|Bomi|B|
Hong|Bo Young|BY|

Physical therapy
Cerebral palsy
Range of motion
Ankle joint
Muscle spasticity


Alexithymia explains increased empathic personal distress in individuals with and without eating disorders.

Abstract: It is often assumed that empathy impairments are common in individuals with eating disorders (EDs), but empirical work has been limited and produced mixed results, making the clinical features and treatment needs of this population difficult to determine. Alexithymia, characterised by difficulties identifying and describing one's own emotions, frequently co-occurs with EDs and is associated with atypical recognition of, and empathy for, others' emotions. This study used an existing empathy for pain paradigm to determine whether atypical empathy in EDs stems from co-occurring alexithymia, rather than EDs per se. Empathy (specifically personal distress in response to others' pain) was assessed in individuals with EDs (N = 21) and an alexithymia-matched control group (N = 22). Participants were simultaneously members of a high alexithymia (N = 16) or low alexithymia (N = 27) group, allowing the independent contributions of alexithymia and EDs to be determined. Participants judged the laterality of hands and feet in painful and non-painful situations, and the degree of empathic interference on response times was measured. Results indicated that observation of painful stimuli affected task performance in those with high levels of alexithymia more than those with low levels, but no effect of ED diagnosis was observed. These findings suggest that co-occurring alexithymia explains increased empathic personal distress in ED populations. Atypical empathy may therefore not be a core feature of EDs, and interventions aimed at improving empathy-related social functioning may only be necessary for patients who also have alexithymia. These findings emphasise the importance of determining the influence of co-occurring alexithymia when assessing empathy in clinical populations.

Brewer|Rebecca|R| Cook|Richard|R| Cardi|Valentina|V| Treasure|Janet|J| Catmur|Caroline|C| Bird|Geoffrey|G|

D039721:Diagnostic and Statistical Manual of Mental Disorders

Alexithymia
personal distress
eating disorders
empathy


The Effectiveness of Early Mobilization Time on Balance and Functional Ability after Ischemic Stroke.

Abstract:
BACKGROUND
Early mobilisation (EM) after-ischemic stroke is a motor learning intervention aimed to restore nerve cells and to improve balance and functional ability. Unfortunately, the study of when this intervention began has not been widely studied.

AIM
On this study was compared the effect of EM started at 24 hours and 48 hours after an ischemic stroke on balance and functional ability.

MATERIAL AND METHODS
Randomized controlled trial involving 40 patients on 2 groups meeting predefined inclusion criteria. The levels of balance were measured using the Berg Balance Scale, and the functional ability was measured using the Barthel Index, at 5th and 7th day.

RESULTS
A significant difference was observed in both balance (p = 0.038) and functional ability (p = 0.021) obtained on the 7th day of assessment between both groups. A significant difference on the 5th day was observed only in the functional ability (p = 0.002) and not in the balance (p = 0.147), between the groups.

CONCLUSION
EM started at 24 hours after the ischemic stroke has been found to have a better impact on balance and functional ability compared to that at 48 hours.

Rahayu|Umi Budi|UB|
Wibowo|Samekto|S|
Setyopranoto|Ismail|I|

Balance
Functional ability
Early mobilisation
Ischemic post-stroke


Proteinase 3-antineutrophil cytoplasmic antibody-positive necrotizing crescentic glomerulonephritis complicated by infectious endocarditis: a case report.

Abstract:
BACKGROUND
Proteinase 3-antineutrophil cytoplasmic antibody has been reported to be positive in 5-10% of cases of renal injury complicated by infective endocarditis; however, histological findings have rarely been reported for these cases.

CASE PRESENTATION
A 71-year-old Japanese man with a history of aortic valve replacement developed rapidly progressive renal dysfunction with gross hematuria and proteinuria. Blood analysis showed a high proteinase 3-antineutrophil cytoplasmic antibody (163 IU/ml) titer. Streptococcus species was detected from two separate blood culture bottles. Transesophageal echocardiography detected mitral valve vegetation. Histological evaluation of renal biopsy specimens showed necrosis and cellular crescents in glomeruli without immune complex deposition. The patient met the modified Duke criteria for definitive infective endocarditis. On the basis of these findings, the patient was diagnosed with proteinase 3-antineutrophil cytoplasmic antibody-positive necrotizing crescentic glomerulonephritis complicated by Streptococcus infective endocarditis. His renal disease improved, and his proteinase 3-antineutrophil cytoplasmic antibody titer normalized with antibiotic monotherapy.

CONCLUSION
Few case reports have described histological findings of proteinase 3-antineutrophil cytoplasmic antibody-positive renal injury complicated with infective endocarditis. We believe that an accumulation of histological findings and treatments is mandatory for establishment of optimal management for proteinase 3-antineutrophil cytoplasmic antibody-positive renal injury complicated with infective endocarditis.

Yanai|Katsunori|K| Kaku|Yoshio|Y| Hirai|Keiji|K| Kaneko|Shohei|S| Minato|Saori|S| Mutsuyoshi|Yuko|Y| Ishii|Hiroki|H| Kitano|Taisuke|T| Shindo|Mitsutoshi|M| Miyazawa|Haruhisa|H| Ito|Kiyonori|K| Ueda|Yuichiro|Y| Hiruta|Masahiro|M| Ookawara|Susumu|S| Ueda|Yoshihiko|Y| Morishita|Yoshiyuki|Y|


Design and synthesis of triazolyl-donor/acceptor unnatural nucleosides and oligonucleotide probes containing triazolyl-phenanthrene nucleoside.

Abstract: In the context of abasic DNA or DNA duplex stabilization, several unnatural nucleosidic/non-nucleosidic base surrogates have been reported. Toward this end, we have designed and synthesized triazolyl-aromatic donor chomophores as unnatural nucleoside analogs. These modifications display markedly higher thermal stabilization of abasic DNA duplex in comparison to the stabilization offered by other nucleoside/non-nucleoside base surrogates reported in the literature. The same oligonucleotide probe containing triazolylphenanthrene nucleotide also offers very good stability of the self-pair duplex via π-π stacking interaction and hetero-pair duplex via charge transfer interaction when paired against triazolyl acceptor aromatic nucleoside. Moreover, the probe in the reverse sequence containing triazolylphenanthrene nucleotide has shown FRET efficiency in a chimeric DNA duplex. The triazolyl nucleotides would expectedly show stability toward exonuclease activity. This unit describes protocols for chemical synthesis of unnatural triazolyl nucleosides and one oligonucleotide probe. The unit also provides a summary of various thermal and photophysical applications of triazolylphenantherene-containing oligonucleotides.

Bag|Subhendu Sekhar|SS|
Talukdar|Sangita|S|
Das|Suman Kalyan|SK|

D031541:Fluorescence Resonance Energy Transfer

FRET donor nucleotide
abasic DNA stabilization
click chemistry
unnatural oligonucleotide
unnatural triazolylnucleosides


Quantification of Smoking Characteristics Using Smartwatch Technology: Pilot Feasibility Study of New Technology.

Abstract:
BACKGROUND
While there have been many technological advances in studying the neurobiological and clinical basis of tobacco use disorder and nicotine addiction, there have been relatively minor advances in technologies for monitoring, characterizing, and intervening to prevent smoking in real time. Better understanding of real-time smoking behavior can be helpful in numerous applications without the burden and recall bias associated with self-report.

OBJECTIVE
The goal of this study was to test the validity of using a smartwatch to advance the study of temporal patterns and characteristics of smoking in a controlled laboratory setting prior to its implementation in situ. Specifically, the aim was to compare smoking characteristics recorded by Automated Smoking PerceptIon and REcording (ASPIRE) on a smartwatch with the pocket Clinical Research Support System (CReSS) topography device, using video observation as the gold standard.

METHODS
Adult smokers (N=27) engaged in a video-recorded laboratory smoking task using the pocket CReSS while also wearing a Polar M600 smartwatch. In-house software, ASPIRE, was used to record accelerometer data to identify the duration of puffs and interpuff intervals (IPIs). The recorded sessions from CReSS and ASPIRE were manually annotated to assess smoking topography. Agreement between CReSS-recorded and ASPIRE-recorded smoking behavior was compared.

RESULTS
ASPIRE produced more consistent number of puffs and IPI durations relative to CReSS, when comparing both methods to visual puff count. In addition, CReSS recordings reported many implausible measurements in the order of milliseconds. After filtering implausible data recorded from CReSS, ASPIRE and CReSS produced consistent results for puff duration (R2=.79) and IPIs (R2=.73).

CONCLUSIONS
Agreement between ASPIRE and other indicators of smoking characteristics was high, suggesting that the use of ASPIRE is a viable method of passively characterizing smoking behavior. Moreover, ASPIRE was more accurate than CReSS for measuring puffs and IPIs. Results from this study provide the foundation for future utilization of ASPIRE to passively and accurately monitor and quantify smoking behavior in situ.

smoking
smartwatch
automated
ASPIRE
CReSS
smoking topography
wearable computing
wearable technology


Development of a Novel X-ray Compatible 3D-Printed Bone Model to Characterize Different K-Wire Fixation Methods in Support of the Treatment of Pediatric Radius Fractures.

Abstract: Additive manufacturing technologies are essential in biomedical modeling and prototyping. Polymer-based bone models are widely used in simulating surgical interventions and procedures. Distal forearm fractures are the most common pediatric fractures, in which the Kirschner wire fixation is the most widely used operative method. However, there is still lingering controversy throughout the published literature regarding the number of wires and sites of insertion. This study aims to critically compare the biomechanical stability of different K-wire fixation techniques. Different osteosyntheses were reconstructed on 189 novel standardized bone models, which were created using 3D printing and molding techniques, using PLA and polyurethane materials, and it has been characterized in terms of mechanical behavior and structure. X-ray imaging has also been performed. The validation of the model was successful: the relative standard deviations (RSD = 100 × SD × mean-1, where RSD is relative standard deviation, SD is the standard deviation) of the mechanical parameters varied between 1.1% (10° torsion; 6.52 Nm ± 0.07 Nm) and 5.3% (5° torsion; 4.33 Nm ± 0.23 Nm). The simulated fractures were fixed using two K-wires inserted from radial and dorsal directions (crossed wire fixation) or both from the radial direction, in parallel (parallel wire fixation). Single-wire fixations with shifted exit points were also included. Additionally, three-point bending tests with dorsal and radial load and torsion tests were performed. We measured the maximum force required for a 5 mm displacement of the probe under dorsal and radial loads (means for crossed wire fixation: 249.5 N and 355.9 N; parallel wire fixation: 246.4 N and 308.3 N; single wire fixation: 115.9 N and 166.5 N). We also measured the torque required for 5° and 10° torsion (which varied between 0.15 Nm for 5° and 0.36 Nm for 10° torsion). The crossed wire fixation provided the most stability during the three-point bending tests. Against torsion, both the crossed and parallel wire fixation were superior to the single-wire fixations. The 3D printed model is found to be a reliable, cost-effective tool that can be used to characterize the different fixation methods, and it can be used in further pre-clinical investigations.

K-wire
pediatrics
radius fracture
distal forearm fractures
biomechanics
3D printing
PLA
polyurethane
mechanical characterization


Apulo-Calabrese and Crossbreed Pigs Show Different Physiological Response and Meat Quality Traits after Short Distance Transport.

Abstract: Despite the increasing interest in the welfare of animals during transport, very little is known on the response of local pig breeds to the transport procedures. This study aims to compare the effect of short journey on behaviour, blood parameters, and meat quality traits in 51 Apulo-Calabrese and 52 crossbreed [Duroc × (Landrace × Large White)] pigs. All the animals were blood sampled five days before delivery (basal condition) and at exsanguination for the analysis of creatine kinase, cortisol, glucose, lactate, albumin, albumin/globulin, total protein, urea, creatinine, aspartate aminotransferase (AST), alanine aminotransferase, alkaline phosphate, sodium, and potassium. Post mortem pH, color, drip loss, cooking loss, and Warner-Bratzler shear force were measured at different times in longissimus thoracis samples. Univariate and multivariate analyses showed that glucose, albumin/globulin, urea, and AST at exsanguination were influenced by the genetic type. Apulo-Calabrese showed the highest increase in blood values of lactate, creatinine, sodium and potassium after the short distance transport. Behavioural occurrences were similar in both genetic types during unloading and lairage. Small differences were observed for meat quality although significantly higher a* and lower L* were found in Apulo-Calabrese pigs, showing meat with a deeper red colour than crossbreeds.

Apulo-Calabrese
pigs
meat quality
short distance
transport
blood parameters
local breed


Home-based diagnosis of obstructive sleep apnea in an urban population.

Abstract:
STUDY OBJECTIVES
Home-based diagnosis of obstructive sleep apnea (OSA) with portable monitoring (PM) is increasingly utilized, but remains understudied in underserved and minority populations. We tested the feasibility of home PM in an urban population at risk for OSA compared to in-laboratory polysomnography (PSG) and examined patient preference with respect to home PM versus PSG.

METHODS
Randomized crossover study of home PM (WatchPAT200) and in-laboratory simultaneous PSG and PM in 75 urban African Americans with high pre-test probability of OSA, identified with the Berlin questionnaire.

RESULTS
Fifty-seven of 75 participants were women, average age 45 ± 11 years (mean ± SD), 35% with ≤ high school education, and 76% with annual household income < $50,000. Technical failure rates were 5.3% for home vs. 3.1% for in-laboratory PM. There was good agreement between apnea hypopnea index on PSG; AHIPSG and AHI on home PM (mean ± 2 SD of the differences = 0.64 ± 46.5 and intraclass correlation coefficient; ICC = 0.73). The areas under the curve for the receiver-operator characteristic curves for home PM were 0.90 for AHIPSG ≥ 5, 0.95 for AHIPSG ≥ 10, and 0.92 for AHIPSG ≥ 15. 62/75 (82%) participants preferred home over in-laboratory testing.

CONCLUSIONS
Home PM for diagnosis of OSA in a high risk urban population is feasible, accurate, and preferred by patients. As home PM may improve access to care, the cost-effectiveness of this diagnostic strategy for OSA should be examined in underserved urban and rural populations.

CLINICAL TRIALS REGISTRATION
ClinicalTrials.gov, identifier: NCT01997723.

Garg|Natasha|N|
Rolle|Andrew J|AJ|
Lee|Todd A|TA|
Prasad|Bharati|B|

OSA
portable monitoring
comparative effectiveness research


Osteophilic properties of bone implant surface modifications in a cassette model on a decorticated goat spinal transverse process.

Abstract:
UNLABELLED
This study comparatively evaluated the osteophilic capacity of 17 different surface modifications (i.e. fourteen different chemical modifications via ceramic coatings and three different physical modifications via surface roughness) for titanium (Ti) surfaces. All surface modifications were subjected to physico-chemical analyses and immersion in simulated body fluid (SBF) for coating stability assessment. Subsequently, a bone conduction chamber cassette model on the goat transverse process was used for comparative in vivo analysis based on bone responses to these different surface modifications after twelve weeks. Histological and histomorphometrical analyses in terms of longitudinal bone-to-implant contact percentage (BIC%), relative bone area (BA%) were investigated within each individual channel and maximum bone height (BH). Characterization of the surface modifications showed significant differences in surface chemistry and surface roughness among the surface modifications. Generally, immersion of the coatings in SBF showed net uptake of calcium by thick coatings (>50μm; plasma-sprayed and biomimetic coatings) and no fluctuations in the SBF for thin coatings (<50μm). The histomorphometrical data set demonstrated that only plasma-sprayed CaP coatings performed superiorly regarding BIC%, BA% and BH compared to un-coated surfaces, irrespective of surface roughness of the latter. In conclusion, this study demonstrated that the deposition of plasma-sprayed CaP coating with high roughness significantly improves the osteophilic capacity of titanium surfaces in a chamber cassette model.

STATEMENT OF SIGNIFICANCE
For the bone implant market, a large number of surface modifications are available on different types of (dental and orthopedic) bone implants. As the implant surface provides the interface at which the biomaterial interacts with the surrounding (bone) tissue, it is of utmost importance to know what surface modification has optimal osteophilic properties. In contrast to numerous earlier studies on bone implant surface modifications with limited number of comparison surfaces, the manuscript by van Oirschot et al. describes the data of in vivo experiments using a large animal model that allows for direct and simultaneous comparison of a large variety of surface modifications, which included both commercially available and experimental surface modifications for bone implants. These data clearly show the superiority of plasma-sprayed hydroxyapatite coatings regarding bone-to-implant contact, bone amount, and bone height.

van Oirschot|Bart A J A|BA|
Eman|Rhandy M|RM|
Habibovic|Pamela|P|
Leeuwenburgh|Sander C G|SC|
Tahmasebi|Zeinab|Z|
Weinans|Harrie|H|
Alblas|Jacqueline|J|
Meijer|Gert J|GJ|
Jansen|John A|JA|
van den Beucken|Jeroen J J P|JJ|

Surface modifications
Biomaterials
Calcium phosphate
Goat model
Titanium implant


Time-kill determination of the bactericidal activity of telavancin and vancomycin against clinical methicillin-resistant Staphylococcus aureus isolates from cancer patients.

Abstract: The bactericidal activity of vancomycin and telavancin was compared against 4 clinical methicillin-resistant Staphylococcus aureus isolates recently recovered from cancer patients, using minimum bactericidal concentration (MBC):MIC ratios and time-kill studies. All 4 isolates were susceptible to both agents based on individual MIC values. The 2 methodologies for assessing bactericidal activity produced variable results. Telavancin appeared to have somewhat better bactericidal activity than vancomycin based on narrower MBC:MIC ratios. However, based on the results of the time-kill studies, neither agent demonstrated reliable bactericidal activity (defined as a ≥3 log10 reduction of the starting inoculum at the end of 24hours) against these organisms. These findings might be of some therapeutic importance in certain clinical settings and/or specific patient populations (such as febrile neutropenic patients) in whom potent bactericidal activity is either desired or preferred.

Rolston|Kenneth Vi|KV|
Wang|Weiqun|W|
Nesher|Lior|L|
Smith|Jordan R|JR|
Rybak|Michael J|MJ|
Prince|Randall A|RA|

Time-kill
Bactericidal activity
Telavancin
Vancomycin
Cancer patients
MRSA


Clinical complete response after chemoradiotherapy for carcinoma of thoracic esophagus: Is esophagectomy always necessary? A systematic review and meta-analysis.

Abstract:
BACKGROUND
Although a clinical complete response (cCR) after chemoradiotherapy (CRT) could lead to a better prognosis, the choice of a following strategy, such as surgical or non-surgical approach, remains controversial.

METHODS
All articles relevant to a comparison of surgical and non-surgical treatment (including further definitive chemoradiotherapy or active surveillance) for esophageal carcinoma patients with a cCR after CRT were retrieved for meta-analysis. The final date for data retrieval was 30 June 2018.

RESULTS
Four retrospective studies including 648 patients met the inclusion criteria: 620 with squamous cell carcinoma and 28 with adenocarcinoma. The CRT + surgery group had an advantage over the non-surgery group in regard to two-year disease-free survival (DFS); however, the two groups showed similar results in five-year DFS. The CRT + surgery group had an advantage over the non-surgery group in two-year overall survival (OS); nevertheless, the two groups showed similar results in five-year OS.

CONCLUSIONS
Based on the available evidence, the addition of surgery to thoracic locally advanced esophageal carcinoma patients with a cCR after neoadjuvant CRT provided no advantage to long-term survival. As an exception, the two-year DFS and OS could be improved. This research conclusion might be more suitable to patients with squamous cell carcinoma.

Wang|Jun|J|0000-0002-9733-1433 Qin|Jianjun|J| Jing|Shaowu|S| Liu|Qing|Q| Cheng|Yunjie|Y| Wang|Yi|Y| Cao|Feng|F|

clinical complete response
Chemoradiotherapy
esophageal carcinoma


Randomized community trial on nosocomial infection control educational module for nurses in public hospitals in Yemen: a study protocol.

Abstract:
Background
Nosocomial infections remain a global health problem and they are considered as one of the leading causes of increased morbidity and mortality. In-service training courses related to infection control measures can help nurses to make informed and therapeutic decisions which could prevent or reduce the incidence of nosocomial infections. This study protocol is of a hospital-based trial to develop, implement and evaluate an educational module on nosocomial infection control among nurses in public hospitals in Yemen. This study is currently ongoing and at the analysis stage.

Methods
A three-arm single-blinded randomized community hospital-based trial was conducted to evaluate the effectiveness of a newly developed nosocomial infection control educational module among nurses in public hospitals in Yemen. To ensure effective delivery and acquisition of knowledge, the Situated Learning Theory was applied during the course of the intervention. A total of 540 Yemeni in-ward nurses, who had three years nursing diploma and at least a year of working experience in the selected public hospitals were recruited in this study. The hospitals were the unit of randomization whereby eight hospitals were assigned randomly to intervention and waitlist groups. Intervention group-1 (n = 180) received an educational module supported by audio-video CD and a training course for eight weeks. Intervention group-2 (n = 180) was given only the educational module with audio-video CD (without the training course). The waitlist group received no intervention during the period of data collection but they will be given the same training and learning materials after the completion of the study.

Discussion
This study contributes to the lack of a nosocomial infection control educational module for nurses in Yemen. It is hoped that the educational module will serve as an effective approach to increase the nurses' knowledge and improve their practices regarding nosocomial infection control measures and hence decrease the prevalence of nosocomial infections in the future.

Trial registration
ID: ISRCTN19992640, Date of registration: 20/6/2017. This study protocol was retrospectively registered.

Alrubaiee|Gamil|G|
Baharom|Anisah|A|0000-0003-2590-4869
Faisal|Ibrahim|I|
Hayati|Kadir Shahar|KS|
Mohd Daud|Shaffe|S|
Basaleem|Huda Omer|HO|

Nosocomial infections
Educational module
Public hospitals
Training course
Nurses in Yemen


The relationship between quality and staffing in long-term care: A systematic review of the literature 2008-2020.

Abstract:
BACKGROUND
Higher staffing levels in long-term care have been associated with better outcomes for residents in several landmark studies. However previous systematic reviews found mixed results, calling into question the effectiveness of higher levels of staff. With persistent concerns about quality, rising resident acuity, and a growing demographic of seniors requiring more services, understanding the relationship between quality and long-term care staffing is a growing concern.

OBJECTIVES
This review considered the following question: What is the influence of nursing and personal care staffing levels (registered nurse, licensed practical nurse, and nursing assistant) and / or skill mix on long-term care residents, measured by quality of care indicators?

DESIGN
Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guided the report of this systematic review.

DATA SOURCES
Published articles focused on quality and nursing and personal care staffing in long-term care in peer-reviewed databases (MEDLINE, CINAHL, and AGELINE) and several Cochrane databases to retrieve studies published between January 2008 and June 2020.

REVIEW METHODS
A systematic review was conducted. 11,096 studies were identified, of which 34 were included in this review. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used to evaluate study quality and risk of bias, and five quality measures were selected for in-depth analyses: pressure ulcers, hospitalizations, physical restraints, deficiencies and catherization.

RESULTS
This review confirms previous review findings that evidence on the relationships between quality and long-term care staffing level and skill mix, remain mixed. Higher staffing levels and skill mix generally supported better rather than worse outcomes. Significant and consistent findings were more evident when staffing levels were further analyzed by indicator and staffing category. For example, registered nurses were consistently associated with significantly fewer pressure ulcers, hospitalizations, and urinary tract infections. Few studies examined the impact of total nursing and personal care hours compared to the impact of specific categories or classes of nursing staff on outcomes.

CONCLUSIONS
Evidence on the relationship between quality and long-term care staffing remains mixed, however some categories of nursing staff may be more effective at improving the quality of certain indicators. Study quality has improved minimally over the last decade. Although research continues to standardize units of measurement, and longitudinal and instrumental variable analyses are increasingly being used, very few studies controlled for endogeneity, conducted adequate risk-adjustment, and used resident-level data. Additional strides must still be made to improve the rigor of long-term care staffing research.

Clemens|Sara|S| Wodchis|Walter|W| McGilton|Katherine|K| McGrail|Kimberlyn|K| McMahon|Meghan|M|

D010561:Personnel Staffing and Scheduling

Nurses
Nursing Administration
Nursing Home Personnel
Nursing homes
Personnel staffing and scheduling
Quality of health care


Migration of ingested sewing needle from within sigmoid colon to outside of the lumen.

Abstract: Foreign body ingestion is a frequently observed condition in children. However, migration of an ingested foreign body from the gastrointestinal tract toward any abdominal organ is extremely rare. We report herein a case of a 2-year-old female patient in whom an ingested sewing needle was palpable by rectal examination and was determined to have migrated from within the sigmoid colon to outside of the lumen. The needle was surgically removed. In cases of foreign body ingestion, both physical examination and radiological follow-up should be performed.

Cevizci|Mehmet Nuri|MN|
Demir|Muhammet|M|
Demir|Berrin|B|
Demir|Ilknur|I|
Kilic|Omer|O|

Child
Foreign body migration
Sewing needle ingestion