Algorithmic approach by endobronchial ultrasound-guided transbronchial needle aspiration for isolated intrathoracic lymphadenopathy: a study in a tuberculosis-endemic country.

Abstract:
BACKGROUND/PURPOSE
Isolated intrathoracic lymphadenopathy (IT-LAP) is clinically challenging because of the difficult anatomic location and wide range of associated diseases, including tuberculosis (TB). Although sampling via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histopathology is a major development, there is still room for improvement. This study aimed to investigate an algorithmic approach driven by EBUS-TBNA and conventional bronchoscopy to streamline the management of IT-LAP.

METHODS
Eighty-three prospectively enrolled patients with IT-LAP were subjected to an EBUS-TBNA diagnostic panel test (histopathology, cytology, and microbiology) and underwent conventional bronchoscopy for bronchoalveolar lavage. The results were structured into an algorithmic approach to direct patient treatment, workup, or follow-up.

RESULTS
The diagnostic yields of EBUS-TBNA based on histopathology were similar for each disease entity: 77.8% for malignancy, 70.0% for TB, 75.0% for sarcoidosis, 80.0% for anthracosis, and 70.0% for lymphoid hyperplasia (p = 0.96). The incidence of malignancy was 10.8% for total IT-LAP patients, and 12.0% and 33.7% for patients with TB and sarcoidosis, respectively. Thirty-five (42.2%) patients were symptomatic. The leading diagnosis was sarcoidosis (60%), followed by TB (20%), malignancy (11.4%), lymphoid hyperplasia (5.7%), and anthracosis (2.9%). By logistic regression analysis, granulomatous disease (odds ratio: 13.45; 95% confidence interval: 4.45-40.67, p < 0.001) was an independent predictor of symptoms. Seven (8.4%) and three (3.6%) IT-LAP patients diagnosed active TB and suggestive of TB with household contact history, respectively, were all placed on anti-TB treatment.

CONCLUSION
The algorithmic approach streamlines patient management. It enables early detection of malignancy, correctly places nonmalignant patients on an appropriate treatment regimen, and particularly identifies candidates at high risk of TB reactivation for anti-TB chemoprophylaxis.

Kuo|Chih-Hsi|CH| Lin|Shu-Min|SM| Lee|Kang-Yun|KY| Chung|Fu-Tsai|FT| Feng|Po-Hao|PH| Hsiung|Te-Chih|TC| Lo|Yu-Lun|YL| Liu|Chien-Ying|CY| Kuo|Han-Pin|HP|

D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration

intrathoracic lymphadenopathy
tuberculosis
EBUS-TBNA
malignancy


Birth outcomes affecting infants of mothers with intellectual and developmental disabilities.

Abstract:
BACKGROUND
Women with intellectual and developmental disabilities (IDD) face increased risk of adverse maternal pregnancy outcomes, yet less is known about infant outcomes.

OBJECTIVES
To examine birth outcomes of infants born to mothers with IDD and assess associations with demographics and IDD-type.

METHODS
We used data from the Big Data for Little Kids project, which links Wisconsin birth records to Medicaid claims for live births covered by Medicaid from 2007 to 2016. We identified IDD using maternal prepregnancy Medicaid claims and ran Poisson regression (with a log link function) with robust variance clustered by mother to compare prevalence of outcomes between singleton births with and without mothers with IDD. We adjusted the associations for demographic factors and estimated prevalence ratios (PR) as the effect measure. We assessed outcomes by IDD-type (intellectual disability, genetic conditions, cerebral palsy, and autism spectrum disorder) to explore differences by categories of IDD.

RESULTS
Of 267,395 infants, 1696 (0.6%) had mothers with IDD. A greater percentage of infants with mothers with IDD were born preterm (12.8% vs 7.8%; PR 1.64, 95% confidence interval [CI] 1.42, 1.89), small for gestational age (8.5% vs 5.4%; PR 1.42, 95% CI 1.25, 1.61), and died within 12 months of birth (3.2% vs 0.7%; PR 4.93, 95% CI 3.73, 6.43) compared to infants of mothers without IDD. Prevalence ratios were robust to adjustment for demographics factors. Estimates did not meaningfully differ when comparing different IDD-types.

CONCLUSIONS
A greater porportion of infants born to mothers with IDD who were covered by Medicaid had poor outcomes compared to other infants. Prevalence of poor infant outcomes was greater for mothers with IDD even after accounting for demographic differences. It is imperative to understand why infants of mothers with IDD are at greater risk so interventions and management can be developed.


Obstructive sleep apnoea is more prevalent in men with schizophrenia compared to general population controls: results of a matched cohort study.

Abstract:
OBJECTIVES:
Obstructive sleep apnoea (OSA) may be more common in people with schizophrenia compared to the general population, but the relative prevalence is unknown. Here, we determine the relative prevalence of severe OSA in a cohort of men with schizophrenia compared to representative general population controls, and investigate the contribution of age and body mass index (BMI) to differences in prevalence.

METHODS:
Rates of severe OSA (apnoea-hypopnoea index > 30) were compared between male patients with schizophrenia and controls from a representative general population study of OSA.

RESULTS:
The prevalence of severe OSA was 25% in the schizophrenia group and 12.3% in the general population group. In subgroups matched by age, the relative risk of severe OSA was 2.9 ( p = 0.05) in the schizophrenia subjects, but when adjusted for age and BMI, the relative risk dropped to 1.7 and became non-significant ( p = 0.17).

CONCLUSIONS:
OSA is prevalent in men with schizophrenia. Obesity may be an important contributing factor to the increased rate of OSA.

Myles|Hannah|H| Vincent|Andrew|A| Myles|Nicholas|N| Adams|Robert|R| Chandratilleke|Madhu|M| Liu|Dennis|D| Mercer|Jeremy|J| Vakulin|Andrew|A| Wittert|Gary|G| Galletly|Cherrie|C|

obstructive sleep apnoea
schizophrenia
BMI
obesity
apnoea–hypopnoea index
psychosis


Who is Advocating for Children and Adolescents With HIV Infection?

Abstract: Despite significant gains in the past 10 years in the treatment and care of children and adolescents with HIV infection, there is still need for advocacy for this group. The author discusses how far we have come and the need for on-going efforts, not only for appropriate child-friendly drug formulations, but also for cooperation between quantitative and qualitative scientists to further the existing knowledge base of how best to help these children with a chronic disease.


SAFER, an Analysis Method of Quantitative Proteomic Data, Reveals New Interactors of the C. elegans Autophagic Protein LGG-1.

Abstract: Affinity purifications followed by mass spectrometric analysis are used to identify protein-protein interactions. Because quantitative proteomic data are noisy, it is necessary to develop statistical methods to eliminate false-positives and identify true partners. We present here a novel approach for filtering false interactors, named "SAFER" for mass Spectrometry data Analysis by Filtering of Experimental Replicates, which is based on the reproducibility of the replicates and the fold-change of the protein intensities between bait and control. To identify regulators or targets of autophagy, we characterized the interactors of LGG1, a ubiquitin-like protein involved in autophagosome formation in C. elegans. LGG-1 partners were purified by affinity, analyzed by nanoLC-MS/MS mass spectrometry, and quantified by a label-free proteomic approach based on the mass spectrometric signal intensity of peptide precursor ions. Because the selection of confident interactions depends on the method used for statistical analysis, we compared SAFER with several statistical tests and different scoring algorithms on this set of data. We show that SAFER recovers high-confidence interactors that have been ignored by the other methods and identified new candidates involved in the autophagy process. We further validated our method on a public data set and conclude that SAFER notably improves the identification of protein interactors.

Yi|Zhou|Z| Manil-Ségalen|Marion|M| Sago|Laila|L| Glatigny|Annie|A| Redeker|Virginie|V| Legouis|Renaud|R| Mucchielli-Giorgi|Marie-Hélène|MH|

proteomics
C. elegans
autophagy
atg-8/LC3
label free mass spectrometry
statistical methodology


Effects of klotho deletion from bone during chronic kidney disease.

Abstract: Klotho is a type I transmembrane protein that acts as a permissive co-receptor for FGF23 and helps to maintain proper mineral metabolism. Mice carrying a loss-of-function mutation in either the Klotho or Fgf23 gene develop many similar phenotypes including osteoporosis. Based on these observations it was hypothesized that the bone phenotypes in Klotho- and Fgf23-null mice may be mediated through a common signaling pathway. Recent improvements in antibody specificity have shown that osteoblasts and osteocytes, which produce FGF23, also express low amount of membrane Klotho. But, the role of Klotho in bone is still largely unclear. In this review we summarize the literature and show that Klotho has an FGF23 dependent and independent effect in bone.

Klotho
Bone
Chronic kidney disease
FGF23
Bone histomorphometry


Executive functions and depressive symptoms interplay in binge eating disorder: A structural equation model analysis.

Abstract:
OBJECTIVE
Executive functions (EF) have been so far investigated as potential endophenotypes for binge eating disorder (BED). However, major critical limitations in previous research, such as the influence of obesity and comorbid depression, prevented any consensus to be reached. The present study investigated the association between depressive symptoms, a broad range of EF and binge eating severity in individuals with obesity and with/without BED, and whether this association may be explained by a mediation or independency model.

METHOD
One hundred and seven participants completed clinical and psychometric examination. Associations between EF, depressive symptoms and binge eating severity were assessed through bivariate correlation analysis, and the magnitude, as well as the direction of associations between variables, was estimated with structural equation model.

RESULTS
Two reliable models were tested; results showed that depressive symptoms exhibited significant direct and indirect effects on the severity of binge eating; conversely, EF did not show either significant direct or indirect effect on binge eating severity.

CONCLUSION
Depression contributes more than EF to psychopathology of BED. Thus, clinicians should routinely assess and, eventually, tailor depressive symptoms in treatment to improve the outcomes of patients with BED.

executive functions
depression
binge eating disorder
BED
path analysis


Molecular ecology of Listeria spp., Salmonella, Escherichia coli O157:H7 and non-O157 Shiga toxin-producing E. coli in pristine natural environments in Northern Colorado.

Abstract:
AIMS
Molecular subtyping is commonly used in foodborne disease surveillance and microbial source tracking. There is a knowledge gap regarding the molecular ecology of foodborne pathogens in non-food-associated environments. The objective of this study was to isolate and subtype foodborne pathogens from pristine natural environments with minimal anthropogenic inputs.

MATERIALS AND RESULTS
Five locations (wilderness areas) in Northern Colorado were sampled during the spring, summer and fall over a 2-year period. Soil, water, sediment, surface soil and wildlife faecal samples were microbiologically analysed to detect Listeria, Salmonella and Shiga toxin-producing Escherichia coli (STEC), and resultant isolates were subtyped. Three samples tested positive for Listeria monocytogenes and 19 samples contained other Listeria spp. Salmonella was isolated from two samples, five samples contained non-O157 STEC, and E. coli O157:H7 was not detected. Two L. monocytogenes isolates from faecal samples collected from the same wilderness area over a year apart shared the same PFGE pattern, while all other isolates had a unique type.

CONCLUSIONS
Our data indicate that (i) there was a rare presence of human foodborne pathogens in pristine natural environments in Northern Colorado, (ii) there was genetic diversity between organisms isolated within a given wilderness area, and (iii) the Northern Colorado climate and topography may contribute to the low occurrence of these organisms.

SIGNIFICANCE AND IMPACT OF THE STUDY
Relatively little is known about the molecular ecology of foodborne pathogens in pristine natural environments. While foodborne pathogens were rarely detected in wildlife faecal and environmental samples from the wilderness areas in this study, some isolates shared DNA fingerprint types with human clinical isolates from same region during the same time frame, highlighting the need for environmental isolate subtype data. The availability of molecular subtyping data for non-food-associated foodborne pathogen isolates can facilitate epidemiological and microbial source tracking investigations.

Ahlstrom|C A|CA|
Manuel|C S|CS|
Den Bakker|H C|HC|
Wiedmann|M|M|
Nightingale|K K|KK|

molecular ecology
Salmonella
wildlife
Shiga toxin-producing Escherichia coli
Listeria monocytogenes
pristine environments


Fosaprepitant versus ondansetron for the prevention of postoperative nausea and vomiting in patients who undergo gynecologic abdominal surgery with patient-controlled epidural analgesia: a prospective, randomized, double-blind study.

Abstract:
PURPOSE
Postoperative nausea and vomiting (PONV) is the most common postoperative complication. The postoperative use of opioids is known to increase the incidence. We compared fosaprepitant, a neurokinin-1 (NK1) receptor antagonist, and ondansetron for their preventive effects on PONV in patients who underwent gynecologic abdominal surgery with patient-controlled epidural analgesia.

METHODS
This prospective, double-blind, randomized study comprised 44 patients who underwent gynecologic abdominal surgery. They were randomly allocated to receive 150 mg intravenous fosaprepitant (n = 24; NKI group) or 4 mg ondansetron (n = 20; ONS group) before anesthesia, which was maintained with volatile anesthetics, remifentanil, fentanyl, and rocuronium. All patients received postoperative fentanyl by patient-controlled epidural anesthesia. The incidence of nausea and vomiting, complete response rate (i.e., no vomiting and no rescue antiemetic use), rescue antiemetic use, nausea score (0-3), and visual analog scale score (VAS 0-10) for pain were recorded at 2, 24, 48, and 72 h after surgery.

RESULTS
No (0 %) patient in the NKI group experienced vomiting after surgery; however, 4-6 (20-30 %) of 20 patients in the ONS group experienced vomiting. This difference was significant at 0-24, 0-48, and 0-72 h. During the study period, no significant differences existed between the NK1 and ONS groups in the incidence of PONV, complete response rate, rescue antiemetic use, nausea score, and VAS score for pain.

CONCLUSION
Compared to ondansetron, fosaprepitant more effectively decreased the incidence of vomiting in patients who underwent gynecologic abdominal surgery with patient-controlled epidural analgesia.

Soga|Tomohiro|T|
Kume|Katsuyoshi|K|
Kakuta|Nami|N|
Hamaguchi|Eisuke|E|
Tsutsumi|Rie|R|
Kawanishi|Ryosuke|R|
Fukuta|Kohei|K|
Tanaka|Katsuya|K|
Tsutsumi|Yasuo M|YM|

D020250:Postoperative Nausea and Vomiting

Fosaprepitant
Ondansetron
Postoperative nausea and vomiting
Gynecologic abdominal surgery
Patient-controlled epidural analgesia


Loss of MyD88 leads to more aggressive TRAMP prostate cancer and influences tumor infiltrating lymphocytes.

Abstract:
BACKGROUND
The influence of pattern recognition receptor (PRR) signaling in the prostate tumor microenvironment remains unclear. Although there may be a role for PRR agonists as adjuvants to therapy, prior evidence suggests tumor promoting as well as tumor inhibiting mechanisms. The purpose of this study is to examine the role of the key Toll-like receptor (TLR) signaling adaptor protein myeloid differentiation primary response gene 88 (MyD88) in prostate cancer development.

METHODS
MyD88(-/-) mice in a C57Bl6 background were crossed with transgenic adenocarcinomas of the mouse prostate (TRAMP) mice to create MyD88(-/-) TRAMP(Tg+/-) animals, which were compared to MyD88(+/+) TRAMP(Tg+/-) animals and their non-transgenic counterparts at 30 weeks. Prostates were examined histologically, by immunohistochemistry and immunofluorescence staining, and by qPCR, to characterize tumor-infiltrating immune populations as well as activation of the downstream NF-κB pathway and androgen receptor (AR) expression. Splenocytes were examined for development of distinct immune cell populations.

RESULTS
Absence of MyD88 led to increased prostatic intraepithelial neoplasm (PIN) and areas of well-differentiated adenocarcinoma in TRAMP transgenic mice. Analysis of infiltrating immune populations revealed an increase in CD11b(+) Gr1(+) myeloid-derived suppressor cells (MDSCs), as evidenced by increased expression of prostatic arginase-1 and iNOS as well as the cytokine IL-10, and a deficiency in NK cells in prostates from MyD88(-/-) TRAMP(Tg+/-) compared to MyD88(+/+) TRAMP(Tg+/-) mice, whereas a decrease in splenocytic NK cell differentiation was observed in MyD88(-/-) mice. Prostate tumors revealed no significant differences in NF-κB or AR expression in MyD88(+/+) TRAMP(Tg+/-) compared to MyD88(-/-) TRAMP(Tg+/-) mice.

CONCLUSIONS
During prostate cancer development in the TRAMP model, MyD88 may play a role in limiting prostate tumorigenesis by altering tumor-infiltrating immune populations. This suggests that in the context of specific cancers, distinct PRRs and signaling pathways of innate immune signaling may influence the tumor microenvironment and represent a novel therapeutic strategy.

Peek|Elizabeth M|EM|
Song|Wang|W|
Zhang|Hanwei|H|
Huang|Jiaoti|J|
Chin|Arnold I|AI|

D053594:Myeloid Differentiation Factor 88

D060888:Real-Time Polymerase Chain Reaction

MyD88
TRAMP
prostate cancer
Toll-like receptors
NF-κB
tumor-infiltrating lymphocytes


Matching in Vitro Bioaccessibility of Polyphenols and Antioxidant Capacity of Soluble Coffee by Boosted Regression Trees.

Abstract: The aim of this study was to evaluate changes in polyphenol profile and antioxidant capacity of five soluble coffees throughout a simulated gastro-intestinal digestion, including absorption through a dialysis membrane. Our results demonstrate that both polyphenol content and antioxidant capacity were characteristic for each type of studied coffee, showing a drop after dialysis. Twenty-seven compounds were identified in coffee by HPLC-MS, while only 14 of them were found after dialysis. Green+roasted coffee blend and chicory+coffee blend showed the highest and lowest content of polyphenols and antioxidant capacity before in vitro digestion and after dialysis, respectively. Canonical correlation analysis showed significant correlation between the antioxidant capacity and the polyphenol profile before digestion and after dialysis. Furthermore, boosted regression trees analysis (BRT) showed that only four polyphenol compounds (5-p-coumaroylquinic acid, quinic acid, coumaroyl tryptophan conjugated, and 5-O-caffeoylquinic acid) appear to be the most relevant to explain the antioxidant capacity after dialysis, these compounds being the most bioaccessible after dialysis. To our knowledge, this is the first report matching the antioxidant capacity of foods with the polyphenol profile by BRT, which opens an interesting method of analysis for future reports on the antioxidant capacity of foods.

Podio|Natalia S|NS|
López-Froilán|Rebeca|R|
Ramirez-Moreno|Esther|E|
Bertrand|Lidwina|L|
Baroni|María V|MV|
Pérez-Rodríguez|María L|ML|
Sánchez-Mata|María-Cortes|MC|
Wunderlin|Daniel A|DA|

bioaccessibility
boosted regression trees
polyphenol profile
chemometrics
in vitro gastrointestinal digestion


Effects of Transcranial Direct Current Stimulation (tDCS) for Auditory Hallucinations: A Systematic Review.

Abstract:
BACKGROUND
Transcranial direct current stimulation (tDCS) is a non-invasion brain stimulation, which has been suggested as a safe and promising treatment for auditory hallucinations, however, no systematic review has been conducted to evaluate the effects of tDCS on auditory hallucinations (AH).

OBJECTIVE
To investigate the efficacy and safety of tDCS for auditory hallucinations among patients with schizophrenia.

METHODS
We searched relevant randomized controlled trials (RCTs) from PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, Chinese Biological Medical Literature Database, and Taiwan Electronic Periodical Services (TEPS) before February 13, 2016. Studies were selected based on pre-defined inclusion and exclusion criteria. The quality of each included study was assessed by the risk of bias table. The levels of evidence of primary outcomes were evaluated using GRADE criteria. Data synthesis was conducted using RevMan 5.3.

RESULTS
304 papers were screened. Finally, three studies with a combined sample size of 87 patients were included in the meta-analysis. Two studies were classified as having 'low risk of bias', one study was classified as having 'unclear'. Inconsistent results and the overall level of evidence of primary outcome was graded as 'low'.

CONCLUSIONS
The sample sizes of the published studies were small and the results were inconsistent. We could not draw any strong conclusions from these trials. Further high quality RCTs with large sample sizes are needed to assess the efficacy of tDCS for auditory hallucinations in patients with schizophrenia.

Li|Haibin|H| Wang|Yiran|Y| Jiang|Jiangling|J| Li|Wei|W| Li|Chunbo|C|

transcranial direct current stimulation
auditory hallucination
schizophrenia


Characterization of growth phenotypes and gastrointestinal tract microbiota in sheep fed with caragana.

Abstract:
AIMS
Using high-protein caragana as an unconventional feed supplement has promising application potential in livestock feeding programmes, and verifying its function is of great importance to guide efficient dietary management of livestock.

METHODS AND RESULTS
This study investigated the resulting changes in the growth, slaughter performance, serum physiological index, physical and chemical characteristics of meat, ruminal and intestine morphology and gastrointestinal tract microbiota in sheep fed with caragana (CAR), corn straw (COR) and alfalfa (ALF) diets. The CAR group showed an increased abundance of Christensenellaceae R-7 group, Marvinbryantia, Ruminococcaceae NK4A214, Lachnospiraceae UCG-002 and Desulfuromonas in the rumen compared with ALF, and CAR group mainly enhanced starch and sucrose metabolism, fructose and mannose metabolism, photosynthesis and d-alanine metabolism in the rumen compared with ALF.

CONCLUSIONS
CAR diet positively changed the fatty acid profile of longissimus dorsi muscle and significantly altered the composition and function of the microbiota in the rumen, ileum and cecum.

SIGNIFICANCE AND IMPACT OF THE STUDY
This study systematically demonstrated the feasibility of CAR as an alternative to ALF for animal fattening in a complete formula granulated feed and provided a fundamental basis for further research and development of CAR as an unconventional feed source for ruminants.

sheep
caragana
fermentation parameters
gastrointestinal microbiota
nutrient digestibility


Using a single noninferiority margin or preserved fraction for an entire pharmacological class was found to be inappropriate.

Abstract:
OBJECTIVE
To assess the impact on noninferiority decisions when using a single margin or single preserved fraction (PF) for all noninferiority trials within a pharmacological class.

STUDY DESIGN AND SETTING
A search in PubMed, EMBASE, and CENTRAL resulted in seven active-controlled statin trials (nine noninferiority comparisons) for treating hyperlipidemia. The impact of using a single margin was assessed by calculating whether this margin corresponds to different PFs among comparator statins which will demonstrate that the threshold of demonstrating noninferiority (in terms of the PF) varies among comparator statins. The use of a single PF was assessed by reanalyzing noninferiority in the included trials with new margins (based on the single PF) for each comparator statin.

RESULTS
The use of a single margin resulted in PFs that range between 81% and 89% for the different comparators (i.e., different thresholds). The use of a single PF resulted in four of nine (44%) different noninferiority conclusions compared with the original analyses.

CONCLUSION
The threshold of demonstrating noninferiority with a single margin or single PF of the effect per pharmacological class may not be consistent with using a margin/PF for each comparator separately and may impact the conclusions of noninferiority.

Althunian|Turki A|TA|
de Boer|Anthonius|A|
Groenwold|Rolf H H|RHH|
Klungel|Olaf H|OH|

D003625:Data Collection
D003657:Decision Making
D004056:Differential Threshold
D004358:Drug Therapy
D000074099:Equivalence Trials as Topic
D006801:Humans
D012107:Research Design

Noninferiority
Biostatistics
Clinical trials
Drug regulation
Methodology
Randomized controlled trials


Refractive errors in Cameroonians diagnosed with complete oculocutaneous albinism.

Abstract:
BACKGROUND
Albinism causes significant eye morbidity and amblyopia in children. The aim of this study was to determine the refractive state in patients with complete oculocutaneous albinism who were treated at the Gynaeco-Obstetric and Paediatric Hospital, Yaoundé, Cameroon and evaluate its effect on vision.

METHODS
We carried out this retrospective study at the ophthalmology unit of our hospital. All oculocutaneous albino patients who were treated between March 1, 2003 and December 31, 2011 were included.

RESULTS
Thirty-five patients (70 eyes) diagnosed with complete oculocutaneous albinism were enrolled. Myopic astigmatism was the most common refractive error (40%). Compared with myopic patients, those with myopic astigmatism and hypermetropic astigmatism were four and ten times less likely, respectively, to demonstrate significant improvement in distance visual acuity following optical correction.

CONCLUSION
Managing refractive errors is an important way to reduce eye morbidity-associated low vision in oculocutaneous albino patients.

Eballé|André Omgbwa|AO|
Mvogo|Côme Ebana|CE|
Noche|Christelle|C|
Zoua|Marie Evodie Akono|ME|
Dohvoma|Andin Viola|AV|

refraction
albinism
Cameroon
visual acuity


Acute care revisits after adenotonsillectomy in a pediatric Medicaid population in Ohio.

Abstract:
INTRODUCTION
Guidelines for inpatient admission after pediatric tonsillectomy have been proposed to improve the safety of this procedure. This study examined the association between performing adenotonsillectomy in an inpatient setting and acute care revisits within 30 days among children enrolled in a Medicaid Accountable Care Organization in Ohio.

METHODS
The Accountable Care Organization's claims database was queried for adenotonsillectomies performed in children ages 0-18 years in 2008-2014. Procedures associated with an inpatient facility stay were classified as inpatient adenotonsillectomies. The primary outcome was emergency department visit or inpatient re-admission within 30 days. Secondary outcomes were revisits within 7 days and >7 days post-discharge. Logistic regression was used to test for association between inpatient procedure and need for revisits.

RESULTS
Adenotonsillectomies in 8835 girls and 7773 boys (age 6.8 ± 3.8 years) were analyzed, of which 842 (5%) were inpatient procedures. Revisits were required in 2511 (15%) cases and were primarily visits to the emergency department. In multivariable analysis, inpatient and outpatient procedures had comparable need for 30-day revisits (OR = 0.85; 95% CI: 0.69, 1.05; p = 0.124). In sub-analyses, inpatient adenotonsillectomy was associated with lower odds of early (≤7 days post-discharge; OR = 0.76; 95% CI: 0.58, 0.99; p = 0.045) but not later (≥8 days) revisits.

CONCLUSIONS
In a pediatric Medicaid population, inpatient adenotonsillectomy was not associated with greater odds of acute care revisits, compared to outpatient procedures. Appropriate risk stratification of children undergoing adenotonsillectomy can reduce the need for early acute care revisits by scheduling high-risk patients for prolonged observation.

Tumin|Dmitry|D|
Walia|Hina|H|
Raman|Vidya T|VT|
Tobias|Joseph D|JD|

Inpatient Tonsillectomy Readmission Surgery


Comparison of the strength of two multi-strand tendon repair configurations in a chicken model.

Abstract: We sought to investigate the strength of two multi-strand tendon repair configurations in a chicken model. Fifty-six chicken flexor tendons were repaired with one to two different four-strand configurations: 1) a four-strand repair consisting of a two-strand core modified Kessler suture with a circle loop repair and 2) a four-strand core Kessler suture repair with three separate peripheral suture points. The strength of the repaired tendons were measured 2, 3 and 4 weeks after the surgical repair and were analyzed statistically. The strength of the two repair methods was not statistically different 2 weeks after surgery. The tendons repaired with the four-strand core Kessler suture repair and three separate peripheral suture points were significantly stronger than those repaired with a two-strand core modified Kessler suture and a circle loop repair at 3 weeks (P = 0.033) and 4 weeks (P = 0.039). The four-strand repair with three separate peripheral suture points had greater strength than a two-strand repair with one circle loop suture based on an in vivo chicken flexor tendon model.

D000818:Animals
D002645:Chickens
D023421:Models, Animal
D013536:Suture Techniques
D013708:Tendon Injuries
D013718:Tensile Strength

Flexor tendon
Configuration multibrin
Early healing period
Forces de cicatrisation
Multi-strand configurations
Période de cicatrisation précoce
Repair strength
Tendon fléchisseur


Aortic valve repair in patients with ventricular septal defect.

Abstract:
BACKGROUND
The aim of the study is to evaluate early and late clinical outcomes of patients undergoing the aortic valve repair in patients associated with ventricular septal defect and to analyze whether age is a risk factor predicting repair failure.

METHODS
All patients who were underwent aortic valve repair with concomitant ventricular septal defect closure from 2006 to 2018 were included and divided into two groups: less than 10 years (Group 1) and more than or equal to 10 years (Group 2).

RESULTS
About 159 patients were included (Group 1 = 92; Group 2 = 67). Overall median age was 8 years, 70% were males. The most common ventricular septal defect was perimembranous in both groups. Two patients in Group 2 had to undergo aortic valve replacement subsequently which resulted in early mortality. Univariable analysis showed prolonged ventilation (p < .001), postoperative intensive care unit stay (p = .019) as significant factors for early mortality. Estimated survival was 97.6% ± 2.4 at the end of 5 years and 10 years in Group 1 and 93.6% ± 3.6 in Group 2. Freedom from residual aortic regurgitation more than or equal to moderate at 5 years and 10 years was 85.6% ± 4.9 and 55% ± 13.8 in Group 1 and 76.9% ± 6.7 and 47.4% ± 12.2 in Group 2, however, it was not significant (p = . .084).

CONCLUSION
The aortic valve repair in patients with ventricular septal defect provides satisfactory early and late results in terms of mortality and need for reintervention in all age groups.

D006345:Heart Septal Defects, Ventricular


Benefit by design: Determining the 'value' of donor human milk and medical products derived from human milk in NICU.

Abstract: The use of donor human milk to provide therapeutic benefit to infants should only proceed where there is positive 'value'. This can be determined through an assessment of the benefit and the known risks. The emergence of new products derived from human milk requires new value assessments. The known hazards in human milk are modified by differences in the donor selection, processing methods and intended use and result in a unique risk assessment where any of these factors vary. The human source of the raw product requires high ethical standards in the design of these services with care taken to protect donors and recipients from harm. Any supplement to maternal milk should be provided cautiously to avoid displacement of maternal lactation.

D046148:Donor Selection
D006801:Humans
D007223:Infant
D007231:Infant, Newborn
D007363:Intensive Care Units, Neonatal
D008487:Medical History Taking
D017784:Milk Banks
D008895:Milk, Human
D011309:Preservation, Biological
D018570:Risk Assessment
D013242:Sterilization

Best practice
Bioethics
Donor Human Milk Banking


Evaluating Effectiveness of Axiostat Hemostatic Material in achieving Hemostasis and Healing of Extraction Wounds in Patients on Oral Antiplatelet Drugs.

Abstract:
AIM
The aim of this study was to evaluate the efficacy of Axiostat Hemostatic Dental dressing in achieving hemostasis postextraction and determining its effect on pain and healing of the extraction wound, compared with control, i.e., conventional method of extraction in patients on oral antiplatelet therapy.

MATERIALS AND METHODS
Totally, 40 patients on oral antiplatelet drugs were included in the study and overall 80 extractions were done applying split mouth study design, without altering patient's drug regime. Extraction sites were divided into two groups: Group I received Axiostat Hemostatic Dental Dressing (study site), and group II received conventional method; pressure pack with sterile gauze under biting pressure followed by suturing if required (control site) was used to attain hemostasis.

RESULTS
Extraction sites treated with Axiostat Hemostatic Dressing achieved hemostasis earlier (mean 1 minute 13 seconds) compared with control sites (mean = 14 minutes 1 second), which was also statistically significant (p < 0.001). Postoperative pain was considerably lower and significantly better healing was seen in the study group (p < 0.001) compared with the control.

CONCLUSION
Axiostat demonstrated to be an effective hemo-static agent that considerably lessens the bleeding time in patients on oral antiplatelet drugs postextraction. In addition, it even offered minimal postoperative pain and improved healing of the extraction wound. On comparing the results of this study with our study on HemCon Dental Dressing, Axiostat Dental Dressing (ADD) is found to be as effective and at par in achieving hemostasis in patients on oral antiplatelet therapy.

CLINICAL SIGNIFICANCE
The past few decades have seen an upsurge in use of low-dose aspirin either alone or in combination with other drugs. When these patients require dental/maxillofacial treatment, earlier concept of stopping these medications is associated with increased risk of thromboembolic event. The present study highlights an alternative approach using ADD which aids in quick hemostasis, accentuates healing, and reduce postoperative pain.

Sharma|Saurabh|S|
Kale|Tejraj P|TP|
Balihallimath|Lingaraj J|LJ|
Motimath|Abhishek|A|

D048271:Chitosan
D006490:Hemostatics
D006801:Humans
D010149:Pain, Postoperative
D010975:Platelet Aggregation Inhibitors
D000072836:Surgical Wound
D014081:Tooth Extraction
D016896:Treatment Outcome
D014945:Wound Healing

Axiostat
Extraction
Antiplatelet
Chitosan
Hemorrhage Wound healing.


Anxiety and Mood Disorders Impacting Physician Opioid Prescribing in the Pediatric Hospital Setting.

Abstract: This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain-the pain-opioid relation was stronger for patients without an anxiety disorder than for patients with an anxiety diagnosis. Instead, physicians were more likely to place non-opioid analgesic orders to manage the pain of patients with anxiety disorders. Findings imply that pain management decisions might be influenced by patient's mental health.

Donaldson|Candice D|CD|
Kain|Zeev N|ZN|
Ehwerhemuepha|Louis|L|
Fortier|Michelle A|MA|
Phan|Michael T|MT|
Tomaszewski|Daniel M|DM|
Yang|Sun|S|
Feaster|William|W|
Jenkins|Brooke N|BN|

Mood disorders
Opioids
Anxiety disorders
Pain management
Pediatric pain


Weaning from mechanical ventilation in people with neuromuscular disease: protocol for a systematic review.

Abstract:
INTRODUCTION
Neuromuscular diseases (NMD) are characterised by progressive muscular impairment. The muscle weakness is directly related to respiratory muscles weakness, causing reduction in vital capacity, especially when associated with mechanical ventilation (MV). Conventional MV weaning in NMD is generally difficult. Weaning process can be conducted in protocols such as: 'T' piece or Pressure Support Ventilaton. Weaning failure is frequent because of muscle weakness. Protocol aim is to assess the effects of different weaning protocols in NMD patients receiving invasive MV in weaning success rate, duration of weaning, intensive care unit (ICU) stay, hospital stay and ICU mortality.

METHODS AND ANALYSIS
A search will be carried in the Cochrane Neuromuscular Specialised Register, MEDLINE, EMBASE, Web of Science, Scopus, United States National Institutes of Health Clinical Trials Registry, ClinicalTrials.gov and WHO International Clinical Trial Registry Protal, of randomised controlled trials (RCTs) and quasi-RCTs. Inclusion criteria of individuals are adults (above 16 years old) and children (from 5 to 16 years old), with clinical diagnosis of NMD (muscular dystrophy, amyotrophic lateral sclerosis, congenital myasthenia, myasthenia gravis, congenital myopathy, spinal muscular atrophy, Guillian Barré Syndrome, severe inherited neuropathies, metabolic myopathies, inflammatory myopathies, mitochondrial diseases) of any gender. All patients ventilated for at least 48 hours due to respiratory failure and clinically considered ready for weaning. Other respiratory or cardiovascular diagnosis associated will not be included. Intervention assessed will be weaning from MV using a protocol with 30 min to 2 hours of spontaneous breathing trial at the end point. All comparisons of different protocols will be considered.

ETHICS AND DISSEMINATION
Formal ethical approval is not required as primary data will not be collected, since it will be a systematic review. All studies included should have ethical committee approval. The results will be disseminated through a peer-reviewed publication and in conferences and congresses or symposia.

PROSPERO REGISTRATION NUMBER
CRD42019117393.

Bernardes Neto|Saint Clair Gomes|SCG|0000-0001-5089-0564

respiratory medicine (see thoracic medicine)


A New Scientific Paradigm may be Needed to Finally Develop an HIV Vaccine.

Abstract: The bulk of current HIV vaccine research is conducted within the infectious disease paradigm that has been very successful in developing vaccines against many other viral diseases. Different HIV vaccine concepts, based on the induction of neutralizing antibodies and/or cell mediated immunity, have been developed and clinically tested over the last 30 years, resulting in a few small successes and many disappointments. As new scientific knowledge is obtained, HIV vaccine concepts are constantly modified with the hope that the newly introduced tweaks (or paradigm drifts) will provide the solution to one of the most difficult challenges that modern biomedical research is confronting. Efficacy trials have been critical in guiding HIV vaccine development. However, from the five phase III efficacy trials conducted to date, only one (RV144) resulted in modest efficacy. The results from RV144 were surprising in many ways, including the identified putative correlates of protection (or risk), which did not include neutralizing antibodies or cytotoxic T-cells. The solution to the HIV vaccine challenge may very well come from approaches based on the current paradigm. However, at the same time, out-of-the-paradigm ideas should be systematically explored to complement the current efforts. New mechanisms are needed to identify and support the innovative research that will hopefully accelerate the development of an urgently needed HIV vaccine.

innovation
HIV-1 vaccines
non-neutralizing antibodies
paradigm shift
vaccine efficacy trials


EP4 Antagonist-Elicited Extracellular Vesicles from Mesenchymal Stem Cells Rescue Cognition/Learning Deficiencies by Restoring Brain Cellular Functions.

Abstract: Adult brains have limited regenerative capacity. Consequently, both brain damage and neurodegenerative diseases often cause functional impairment for patients. Mesenchymal stem cells (MSCs), one type of adult stem cells, can be isolated from various adult tissues. MSCs have been used in clinical trials to treat human diseases and the therapeutic potentials of the MSC-derived secretome and extracellular vesicles (EVs) have been under investigation. We found that blocking the prostaglandin E2 /prostaglandin E2 receptor 4 (PGE2 /EP4 ) signaling pathway in MSCs with EP4 antagonists increased EV release and promoted the sorting of specific proteins, including anti-inflammatory cytokines and factors that modify astrocyte function, blood-brain barrier integrity, and microglial migration into the damaged hippocampus, into the EVs. Systemic administration of EP4 antagonist-elicited MSC EVs repaired deficiencies of cognition, learning and memory, inhibited reactive astrogliosis, attenuated extensive inflammation, reduced microglial infiltration into the damaged hippocampus, and increased blood-brain barrier integrity when administered to mice following hippocampal damage. Stem Cells Translational Medicine 2019.

Chen|Shih-Yin|SY| Lin|Meng-Chieh|MC| Tsai|Jia-Shiuan|JS| He|Pei-Lin|PL| Luo|Wen-Ting|WT| Herschman|Harvey|H| Li|Hua-Jung|HJ|0000-0002-6041-3873

D058309:Receptors, Prostaglandin E, EP4 Subtype

Extracellular vesicle
Mesenchymal stem cell
Astrocyte
Inflammation
Cognition and memory
Exosome
PGE2/EP4 signaling


Comparison of the removal torque and a histomorphometric evaluation of the RBM treated implants with the RBM followed by laser treated implants: an experimental study in rabbits.

Abstract:
Background
In the osseointegration of dental implants, the implant surface properties have been reported to be some of the most important critical factors. The effect of implant's surfaces created by resorbable blast media (RBM) followed by laser ablation on bone tissue reactions was examined using the removal torque test and histomorphometric analysis.

Methods
Two types of dental implants, RBM-laser implants (experimental group) and RBM implants (control group) (CSM implant system, Daegu, Korea; L=6 mm, diameter=3.75 mm) were placed into the right and left distal femoral metaphysis of 17 adult rabbits. Six weeks after placement, removal torque was measured and histomorphometric analysis was performed.

Results
The mean removal torque was 24.0±10.2 Ncm and 46.6±16.4 Ncm for the control and test specimens, respectively. The experimental RBM-laser implants had significantly higher removal torque values than the control RBM implants (p=0.013). The mean values of total and cortical bone to implant contact (BIC) were respectively 46.3±10.8% and 65.3±12.5% for the experimental group, and 41.9±18.5% and 57.6±10.6% for the control group. The experimental RBM-laser implants showed a higher degree of total and cortical BIC compared with RBM implants, but there was no statistical significance (p=0.482, 0.225).

Conclusion
The removal torque and BIC of the test group were higher than those of the control group. In this study, the surface treatment created by RBM treatment followed by laser ablation appears to have a potential in improving bone tissue reactions of dental implants.

Osseointegration
Dental implants
Laser ablation
Resorbable surface media


Affinity chromatography revealed insights into unique functionality of two 14-3-3 protein species in developing maize kernels.

Abstract:
UNLABELLED
The 14-3-3 proteins are a group of regulatory proteins of divergent functions in plants. However, little is known about their roles in maize kernel development. Using publically available gene expression profiling data, we found that two 14-3-3 species genes, zmgf14-4 and zmgf14-6, exhibited prominent expression profiles over other 14-3-3 protein genes during maize kernel development. More than 5000 transcripts of these two genes were identified accounting for about 1/10 of the total transcripts of genes correlating to maize kernel development. We constructed a proteomics pipeline based on the affinity chromatography, in combination with 2-DE and LC-MS/MS technologies to identify the specific client proteins of the two proteins for their functional characterization. Consequently, we identified 77 specific client proteins from the developing kernels of the inbred maize B73. More than 60% of the client proteins were commonly affinity-identified by the two 14-3-3 species and are predicted to be implicated in the fundamental functions of metabolism, protein destination and storage. In addition, we found ZmGF14-4 specifically bound to the disease- or defense-relating proteins, whilst ZmGF14-6 tended to interact with the proteins involving metabolism and cell structure. Our findings provide primary insights into the functional roles of 14-3-3 proteins in maize kernel development.

BIOLOGICAL SIGNIFICANCE
Maize kernel development is a complicated physiological process for its importance in both genetics and cereal breeding. 14-3-3 proteins form a multi-gene family participating in regulations of developmental processes in plants. However, the correlation between this protein family and maize kernel development has hardly been studied. We have for the first time found 12 14-3-3 protein genes from maize genome and studied in silico the gene transcription profiling of these genes. Comparative studies revealed that maize kernel development aroused a great number of gene expression, among which 14-3-3 protein genes took a significant proportion. We applied affinity chromatographic approach, in combination with 2-DE and LC-MS/MS, to explore the specific client proteins of two crucial 14-3-3 protein species that exhibit prominent gene expression over other members in the family during the kernel development. Assessments of the identified client proteins resulted in important information toward understanding the functional mechanism of 14-3-3 protein family in maize kernel development.

Dou|Yao|Y| Liu|Xiangguo|X| Yin|Yuejia|Y| Han|Siping|S| Lu|Yang|Y| Liu|Yang|Y| Hao|Dongyun|D|

D018507:Gene Expression Regulation, Developmental

D018506:Gene Expression Regulation, Plant

Affinity chromatography
14-3-3 protein species
Kernel development
Functional characterization
Zea mays


Microglia knockdown reduces inflammation and preserves cognition in diabetic animals after experimental stroke.

Abstract:
INTRODUCTION
Unfortunately, over 40% of stroke victims have pre-existing diabetes which not only increases their risk of stroke up to 2-6 fold, but also worsens both functional recovery and the severity of cognitive impairment. Our lab has recently linked the chronic inflammation in diabetes to poor functional outcomes and exacerbated cognitive impairment, also known as post-stroke cognitive impairment (PSCI). Although we have shown that the development of PSCI in diabetes is associated with the upregulation and the activation of pro-inflammatory microglia, we have not established direct causation between the two. To this end, we evaluated the role of microglia in the development of PSCI.

METHODS
At 13 weeks of age, diabetic animals received bilateral intracerebroventricular (ICV) injections of short hairpin RNA (shRNA) lentiviral particles targeting the colony stimulating factor 1 receptor (CSF1R). After 14 days, animals were subjected to 60 min middle cerebral artery occlusion (MCAO) or sham surgery. Adhesive removal task (ART), novel object recognition (NOR), and 2-trial Y-maze were utilized to evaluate sensorimotor and cognitive function. Tissue from freshly harvested brains was analyzed by flow cytometry and immunohistochemistry.

RESULTS
CSF1R silencing resulted in a 94% knockdown of residential microglia to relieve inflammation and improve myelination of white matter in the brain. This prevented cognitive decline in diabetic animals.

CONCLUSION
Microglial activation after stroke in diabetes may be causally related to the development of delayed neurodegeneration and PSCI.

Jackson|Ladonya|L|
Dumanli|Selin|S|
Johnson|Maribeth H|MH|
Fagan|Susan C|SC|
Ergul|Adviye|A|

Colony stimulating factor 1 receptor CSF1R


Radionuclides distribution, properties, and microbial diversity of soils in uranium mill tailings from southeastern China.

Abstract:
OBJECTIVE
To collect the radioactive contamination data for environmental rehabilitation in uranium mill tailings in southeastern China.

METHOD
The sample areas were divided into high, moderate and low concentration areas, according to the uranium concentration. For every area, 3 soil samples were collected at 0-15 cm, 15-30 cm and 30-45 cm depth respectively, with 5 repetitions for each. Total 45 (3 × 5 × 3) soil samples were collected. Physicochemical properties and enzyme activities of soils were determined as described by references. The concentrations of the radionuclides (238)U, (232)Th, (226)Ra and (40)K in soils were determined by using HPGe gamma-ray spectrometer. Soil microbial diversity was analyzed via denaturing gradient gel electrophoresis (DGGE).

RESULTS
Soil samples were all acidic. Physicochemical properties, like pH, content of total/available N, P and K, as well as enzyme activities were all increased along with decreased uranium concentration. The (232)Th concentration was increased with the decreased uranium concentration and was not influenced by the depth of sample sites. However, uranium concentration and depth of sample showed no significant influence on the concentrations of (226)Ra and (40)K. The concentration of (232)Th was significantly correlated with that of (226)Ra and (40)K, while the concentrations of (226)Ra and (40)K were significantly correlated. However, Pearson correlation coefficients between (238)U and other radionuclides were not significant. The microbial population in different concentration areas was different with four domain strains in low area, and two for both moderate and high areas. Furthermore, in each sample site, Proteobacteria was the most dominant flora, while environmental samples were the second according to GenBank database. Moreover, Serratia sp. of Proteobacteria was the dominant strain.

CONCLUSION
Radionuclides distribution in the uranium mill tailing showed a profound influence on soil properties and microbial diversity. This primarily study might provide valuable data for further research towards a better understanding of the radioactive contamination in uranium mill tailings in southeast China.

Radionuclides
Uranium mill tailings
Soil microbial diversity
Soil properties


The Object Context-place-location Paradigm for Testing Spatial Memory in Mice.

Abstract: This protocol was originally designed to examine long-term spatial memory in PKMζ knockout (i.e., PKMζ-null) mice (Tsokas et al., 2016). Our main goal was to test whether the ability of these animals to maintain previously acquired spatial information was sensitive to the type and complexity of the spatial information that needs to be remembered. Accordingly, we modified and combined into a single protocol, three novelty-preference tests, specifically the object-in-context, object-in-place and object-in-location tests, adapted from previous studies in rodents (Mumby et al., 2002; Langston and Wood, 2010; Barker and Warburton, 2011). During the training (learning) phase of the procedure, mice are repeatedly exposed to three different environments in which they learn the spatial arrangement of an environment-specific set of non-identical objects. After this learning phase is completed, each mouse receives three different memory tests configured as environment mismatches, in which the previously learned objects-in-space configurations have been modified from the original training situation. The mismatch tests differ in their cognitive demands due to the type of spatial association that is manipulated, specifically evaluating memory for object-context and object-place associations. During each memory test, the time differential spent exploring the novel (misplaced) and familiar objects is computed as an index of novelty discrimination. This index is the behavioral measure of memory recall of the previously acquired spatial associations.

Lesburguères|Edith|E|
Tsokas|Panayiotis|P|
Sacktor|Todd Charlton|TC|
Fenton|André Antonio|AA|

Context
Discrimination memory
Novelty preference
Recognition memory
Space


Differences between Motile and Nonmotile Cells of Haematococcus pluvialis in the Production of Astaxanthin at Different Light Intensities.

Abstract: Haematococcus pluvialis, as the best natural resource of astaxanthin, is widely used in nutraceuticals, aquaculture, and cosmetic industries. The purpose of this work was to compare the differences in astaxanthin accumulation between motile and nonmotile cells of H. pluvialis and to determine the relationship between the two cells and astaxanthin production. The experiment design was achieved by two different types of H. pluvialis cell and three different light intensities for an eight day induction period. The astaxanthin concentrations in nonmotile cell cultures were significantly increased compared to motile cell cultures. The increase of astaxanthin was closely associated with the enlargement of cell size, and the nonmotile cells were more conducive to the formation of large astaxanthin-rich cysts than motile cells. The cyst enlargement and astaxanthin accumulation of H. pluvialis were both affected by light intensity, and a general trend was that the higher the light intensity, the larger the cysts formed, and the larger the quantity of astaxanthin accumulated. In addition, the relatively low cell mortality rate in the nonmotile cell cultures indicated that the nonmotile cells have a stronger tolerance to photooxidative stress. We suggest that applying nonmotile cells as the major cell type of H. pluvialis to the induction period may help to enhance the content of astaxanthin and the stability of astaxanthin production.

Li|Feng|F| Cai|Minggang|M|0000-0003-2828-0529 Lin|Mingwei|M| Huang|Xianghu|X| Wang|Jun|J| Ke|Hongwei|H| Zheng|Xuehong|X| Chen|Ding|D| Wang|Chunhui|C| Wu|Shaoting|S| An|Yu|Y|

Haematococcus pluvialis
astaxanthin
light intensity
photooxidative stress


Accuracy of digital templating of uncemented total hip arthroplasty at a certified arthroplasty center: a retrospective comparative study.

Abstract:
INTRODUCTION
To investigate the accuracy of preoperative digital templating for total hip arthroplasty (THA) at a certified arthroplasty center (EndoCert EPZmax).

MATERIALS AND METHODS
In a retrospective study design, we analysed 620 uncemented primary THAs for templating accuracy by comparing the preoperatively planned THA component size and the implanted size as documented by the surgeon. Templating was determined to be a) exact if the planned and the implanted component were the same size and b) accurate if they were exact ± one size. Moreover, we investigated factors that potentially influence templating accuracy: overweight and obesity (WHO criteria), sex, implant design, surgeon experience, preoperative diagnosis. Digital templating was done with MediCAD software. The Mann-Whitney U test and the Kruskal-Wallis test were used for statistical analysis.

RESULTS
Templating was exact in 52% of stems and 51% of cups and was accurate in 90% of the stems and 85% of the cups. Regarding the factors potentially influencing templating accuracy, the type of cup implant had a significant influence (p = 0.016). Moreover, greater accuracy of stem templating was achieved in female patients (p = 0.004). No such effect was determined for the other factors investigated.

CONCLUSIONS
We conclude that preoperative 2D templating is accurate in 90% of the stems and 85% of the cups. Greater accuracy may be achieved in female patients. In addition to gender, the type of implant used may influence planning accuracy as well. Surgeon experience, BMI and preoperative diagnosis did not influence templating accuracy.

LEVEL OF EVIDENCE
Level III (retrospective comparative study with prospective cohort).

Accuracy
Digital templating
Total hip arthroplasty
EndoCert
Experience


Preparation of Silk Sericin/Lignin Blend Beads for the Removal of Hexavalent Chromium Ions.

Abstract: In the present study, novel adsorbents having high adsorption capability and reusability were prepared using agricultural by-products: silk sericin and lignin. Silk sericin and lignin blend beads were successfully prepared using simple coagulation methods for the removal of hexavalent chromium (Cr(VI)) from aqueous solution. A 1 M lithium chloride (LiCl)/dimethyl sulfoxide (DMSO) solvent system successfully dissolved both sericin and lignin and had sufficient viscosity for bead preparation. Compared to the conventional sericin bead adsorbent, sericin/lignin blend beads showed higher Cr(VI) adsorption capacity. The amount of lignin added to the adsorbent greatly affected the adsorption capacity of the beads, and a 50:50 sericin/lignin blend ratio was optimal. Adsorption behavior followed the Freundlich isotherm, which means the adsorption of Cr(VI) occurred on the heterogeneous surface. Cr(VI) adsorption capability increased with temperature because of thermodynamic-kinetic effects. In addition, over 90% of Cr(VI) ions were recovered from the Cr(VI) adsorbed sericin/lignin beads in a 1 M NaOH solution. The adsorption-desorption recycling process was stable for more than seven cycles, and the recycling efficiency was 82%. It is expected that the sericin/lignin beads could be successfully applied in wastewater remediation especially for hazardous Cr(VI) ions in industrial wastewater.

Kwak|Hyo Won|HW|
Shin|Munju|M|
Yun|Haesung|H|
Lee|Ki Hoon|KH|

silk sericin
lignin
beads
hexavalent chromium
adsorption


Characteristics of Heart Rate Tracings in Preterm Fetus.

Abstract: Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM). The aims of this narrative review were to summarize the most relevant concepts in the field of CTG interpretation in preterm fetuses, and to provide a practical approach that can be useful in clinical practice. Materials and Methods: A MEDLINE search was carried out, and the published articles thus identified were reviewed. Results: Compared to term fetuses, preterm fetuses have a slightly higher baseline FHR. Heart rate is faster in more immature fetuses, and variability is lower and increases in more mature fetuses. Transitory, low-amplitude decelerations are more frequent during the second trimester. Transitory increases in FHR are less frequent and become more frequent and increase in amplitude as gestational age increases. Conclusions: The main characteristics of FHR tracings changes as gestation proceeds, and it is of fundamental importance to be aware of these changes in order to correctly interpret CTG patterns in preterm fetuses.

preterm fetus
cardiotocography
fetal heart rate
electronic fetal monitoring
fetal heart rate patterns


Gastric antral vascular ectasia: case report and review of the literature.

Abstract: Gastric antral vascular ectasia is the source of up to 4% of nonvariceal upper gastrointestinal bleeding. It can present with occult bleeding requiring transfusions or with acute gastrointestinal bleeding. It is associated with significant morbidity and mortality and has been associated with such underlying chronic diseases as scleroderma, diabetes mellitus, and hypertension. Approximately 30% of cases are associated with cirrhosis. We report two cases of gastric antral vascular ectasia with two strikingly different endoscopic appearances. We further describe the clinical, endoscopic, histologic, and therapeutic aspects of this entity.

Kar|Papia|P|
Mitra|Subhashis|S|
Resnick|Jeffrey M|JM|
Torbey|Camille F|CF|

Gastric antral vascular ectasia
Gastrointestinal bleeding
Endoscopy
GAVE


Learning From Surprise: Harnessing a Metacognitive Surprise Signal to Build and Adapt Belief Networks.

Abstract: One's level of surprise can be thought of as a metacognitive signal indicating how well one can explain new information. We discuss literature on how this signal can be used adaptively to build, and, when necessary, reorganize belief networks. We present challenges in the use of a surprise signal, such as hindsight bias and the tendency to equate difficulty with implausibility, and point to evidence suggesting that one can overcome these challenges through consideration of alternative outcomes-especially before receiving feedback on actual outcomes-and by calibrating task difficulty with one's knowledge level. As such, we propose that a major function of education-broadly construed as the work of teachers, journalists, parents, etc.-is to assist learners in using their metacognitive surprise signals to facilitate the building and adaptation of belief networks.

Learning
Surprise
Metacognition
Belief revision
Reasoning


Evaluation of treatment options for methicillin-resistant Staphylococcus aureus infections in the obese patient.

Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major cause of infection in both the hospital and community setting. Obesity is a risk factor for infection, and the prevalence of this disease has reached epidemic proportions worldwide. Treatment of infections in this special population is a challenge given the lack of data on the optimal antibiotic choice and dosing strategies, particularly for treatment of MRSA infections. Obesity is associated with various physiological changes that may lead to altered pharmacokinetic parameters. These changes include altered drug biodistribution, elimination, and absorption. This review provides clinicians with a summary of the literature pertaining to the pharmacokinetic and pharmacodynamic considerations when selecting antibiotic therapy for the treatment of MRSA infections in obese patients.

Narayanan|Navaneeth|N|
Adams|Christopher D|CD|
Kubiak|David W|DW|
Cheng|Serena|S|
Stoianovici|Robyn|R|
Kagan|Leonid|L|
Brunetti|Luigi|L|


Frequency of Effector Memory Cells Expressing Integrin α4β7 Is Associated With TGF-β1 Levels in Therapy Naïve HIV Infected Women With Low CD4+ T Cell Count.

Abstract: Integrin α4β7 expressing CD4+ T cells are preferred targets for HIV infection and are thought to be predictors of disease progression. Concurrent analysis of integrin α4β7 expressing innate and adaptive immune cells was carried out in antiretroviral (ART) therapy naïve HIV infected women in order to determine its contribution to HIV induced immune dysfunction. Our results demonstrate a HIV infection associated decrease in the frequency of integrin α4β7 expressing endocervical T cells along with an increase in the frequency of integrin α4β7 expressing peripheral monocytes and central memory CD4+ T cells, which are considered to be viral reservoirs. We report for the first time an increase in levels of soluble MAdCAM-1 (sMAdCAM-1) in HIV infected individuals as well as an increased frequency and count of integrin   CD8+ memory T cells. Correlation analysis indicates that the frequency of effector memory CD8+ T cells expressing integrin α4β7 is associated with levels of both sMAdCAM-1 and TGF-β1. The results of this study also suggest HIV induced alterations in T cell homeostasis to be on account of disparate actions of sMAdCAM-1 and TGF-β1 on integrin α4β7 expressing T cells. The immune correlates identified in this study warrant further investigation to determine their utility in monitoring disease progression.

Kasarpalkar|Nandini J|NJ|
Bhowmick|Shilpa|S|
Patel|Vainav|V|
Savardekar|Lalita|L|
Agrawal|Sachee|S|
Shastri|Jayanthi|J|
Bhor|Vikrant M|VM|

D053773:Transforming Growth Factor beta1

effector memory cells
integrin α4β7
TGF-β1
HIV
soluble MAdCAM-1


Engineering bacteriocin-mediated resistance against the plant pathogen Pseudomonas syringae.

Abstract: The plant pathogen, Pseudomonas syringae (Ps), together with related Ps species, infects and attacks a wide range of agronomically important crops, including tomato, kiwifruit, pepper, olive and soybean, causing economic losses. Currently, chemicals and introduced resistance genes are used to protect plants against these pathogens but have limited success and may have adverse environmental impacts. Consequently, there is a pressing need to develop alternative strategies to combat bacterial disease in crops. One such strategy involves using narrow-spectrum protein antibiotics (so-called bacteriocins), which diverse bacteria use to compete against closely related species. Here, we demonstrate that one bacteriocin, putidacin L1 (PL1), can be expressed in an active form at high levels in Arabidopsis and in Nicotiana benthamiana in planta to provide effective resistance against diverse pathovars of Ps. Furthermore, we find that Ps strains that mutate to acquire tolerance to PL1 lose their O-antigen, exhibit reduced motility and still cannot induce disease symptoms in PL1-transgenic Arabidopsis. Our results provide proof-of-principle that the transgene-mediated expression of a bacteriocin in planta can provide effective disease resistance to bacterial pathogens. Thus, the expression of bacteriocins in crops might offer an effective strategy for managing bacterial disease, in the same way that the genetic modification of crops to express insecticidal proteins has proven to be an extremely successful strategy for pest management. Crucially, nearly all genera of bacteria, including many plant pathogenic species, produce bacteriocins, providing an extensive source of these antimicrobial agents.

D001430:Bacteriocins
D060467:Disease Resistance
D006801:Humans
D018551:Lycopersicon esculentum
D010935:Plant Diseases
D044224:Pseudomonas syringae

disease resistance antimicrobial peptide


Impact of ABO and Rhesus blood groups on COVID-19 susceptibility and severity: A case-control study.

Abstract: Early evidence from China suggested that blood groups may be involved in susceptibility to COVID-19. Several subsequent studies reported controversial results. We conducted a retrospective matched case-control study that aims to investigate the association between blood groups and the risk and/or severity of COVID-19. We compared the blood groups distribution of 474 patients admitted to the hospital for COVID-19 between March 2020 and March 2021, to that of a positive control group of outpatients infected with COVID-19 and matched them for sex and age, as well as to the distribution in the general population. Three hundred and eighteen HC+ pairs with available blood group information were matched. The proportion of group A Rh+ in hospitalized patients (HC+) was 39.9% (CI 35.2%-44.7%), compared to 44.8% (CI 39.8%-49.9%) and 32.3% in the positive outpatient controls (C+) and the general population (C-), respectively. Both COVID-19-positive groups (HC+ and C+) had significantly higher proportions of group A Rh+ compared to the general population (p = 0.0019 and p < 0.001, respectively), indicating that group A Rh+ increases susceptibility to COVID-19. Although blood group A Rh+ was more frequent in the outpatients C+ compared to the hospitalized group HC+, the association did not reach statistical significance, indicating that blood group A Rh+ is not associated with severity. There was no significant relationship between COVID-19 and other blood groups. Our findings indicate that blood group A Rh+ increases the susceptibility for COVID-19 but is not associated with higher disease severity.

ABO
Rhesus
blood groups
COVID-19
susceptibility
severity
pandemic


Examining perceptions of existing and newly created accessibility symbols.

Abstract:
BACKGROUND
Symbols are used to convey messages in a clear, understandable manner, without the use of written language. The most widely recognized symbol used to denote access for persons with disabilities is the International Symbol of Access. This symbol has been criticized for its inadequate representation of disability diversity poorly representing universal design of space and products.

OBJECTIVE
This descriptive study explored individual comprehension and perceptions of nine existing and newly created accessibility pictograph symbols and identified one that represented universal access to fitness equipment.

METHODS
A survey was disseminated electronically and face-to-face to individuals, groups and organizations affiliated with inclusive fitness equipment, space and programming. Quantitative data was analyzed for descriptive statistics, rank order of symbols and group comparisons of rankings. Thematic analysis of open-ended question results revealed themes to enhance understanding of symbol rank order.

RESULTS
981 participants completed the survey. Symbol four, shaped as a Venn diagram containing three icons representing individuals with varying ability levels, was ranked highest with no significant differences in group comparisons between participants with and without a disability and U.S. residents versus non-U.S. residents. 85.4% of participants demonstrated accurate comprehension of this symbol. Though symbol five had the same symbol rank median value, this symbol's distribution of scores was lower.

CONCLUSIONS
Participants accurately comprehended symbol four and it was identified as the highest ranked symbol representing universal access to fitness equipment. Because of symbol unfamiliarity, adoption will require education and consistency of use and placement.

Barstow|Beth A|BA|
Vice|Jason|J|
Bowman|Sean|S|
Mehta|Tapan|T|
Kringen|Seanna|S|
Axelson|Peter|P|
Padalabalanarayanan|Sangeetha|S|

Accessibility
Symbols
Universal design
Fitness equipment


Culture and Green Advertising Preference: A Comparative and Critical Discursive Analysis.

Abstract: As environmental concerns began to emerge, companies started to target toward the growing 'green market' to launch their green products. Companies' green advertising played an important role in facilitating corporate green marketing and fuelling the desire for environmental-friendly commodities. Applying a Critical Discursive Perspective, this study focuses on corporate environmental advertising in order to illuminate their discursive strategies and the process through which corporate green advertising generates and symbolically structures the necessity of green consumption. The comparison of constructive characteristics and constructed meanings of green advertisings identified embody distinction in Western and Chinese cognitive style and process.

green advertisement
corporate environmentalism
critical discourse analysis
environmental protection
socio-cognition


Refining an algorithm-powered just-in-time adaptive weight control intervention: A randomized controlled trial evaluating model performance and behavioral outcomes.

Abstract: Suboptimal weight losses are partially attributable to lapses from a prescribed diet. We developed an app (OnTrack) that uses ecological momentary assessment to measure dietary lapses and relevant lapse triggers and provides personalized intervention using machine learning. Initially, tension between user burden and complete data was resolved by presenting a subset of lapse trigger questions per ecological momentary assessment survey. However, this produced substantial missing data, which could reduce algorithm performance. We examined the effect of more questions per ecological momentary assessment survey on algorithm performance, app utilization, and behavioral outcomes. Participants with overweight/obesity (n = 121) used a 10-week mobile weight loss program and were randomized to OnTrack-short (i.e. 8 questions/survey) or OnTrack-long (i.e. 17 questions/survey). Additional questions reduced ecological momentary assessment adherence; however, increased data completeness improved algorithm performance. There were no differences in perceived effectiveness, app utilization, or behavioral outcomes. Minimal differences in utilization and perceived effectiveness likely contributed to similar behavioral outcomes across various conditions.

weight loss
diet
machine learning
mHealth
mobile health


Antibody Cross-Reactivity between Porcine Cytomegalovirus (PCMV) and Human Herpesvirus-6 (HHV-6).

Abstract: Porcine cytomegalovirus (PCMV) infection is widely prevalent among pigs, and PCMV is one of the viruses which may be transmitted during xenotransplantation using pig cells, tissues, or organs. While human cytomegalovirus (HCMV) is a major risk factor for allotransplantation, it is still unclear whether PCMV is able to infect human cells or pose a risk for xenotransplantation. Previously, it was shown that transmission of PCMV after pig kidney to non-human primate transplantations resulted in a significantly reduced survival time of the transplanted organ. To detect PCMV, PCR-based and immunological methods were used. Screening of pigs by Western blot analyses using recombinant viral proteins revealed up to 100% of the tested animals to be infected. When the same method was applied to screen human sera for PCMV-reactive antibodies, positive Western blot results were obtained in butchers and workers in the meat industry as well as in normal blood donors. To exclude an infection of humans with PCMV, the sera were further investigated. PCMV is closely related to human herpesvirus-6 (HHV-6) and human herpesvirus-7 (HHV-7), and a sequence alignment of glycoprotein B suggests that the antibodies may cross-react with identical epitope sequences. HCMV is not related with PCMV, and no correlation between antibody reactivity against PCMV and HCMV was detected. These data indicate that antibodies against PCMV found in humans are cross-reactive antibodies against HHV-6.

Fiebig|Uwe|U| Holzer|Angela|A| Ivanusic|Daniel|D| Plotzki|Elena|E| Hengel|Hartmut|H|0000-0002-3482-816X Neipel|Frank|F| Denner|Joachim|J|0000-0003-3244-6085

D000818:Animals
D000914:Antibodies, Viral
D015153:Blotting, Western
D003429:Cross Reactions
D003587:Cytomegalovirus
D003586:Cytomegalovirus Infections
D004279:DNA, Viral
D015654:Herpesvirus 6, Human
D006801:Humans
D016133:Polymerase Chain Reaction
D011994:Recombinant Proteins
D016415:Sequence Alignment
D013552:Swine
D014759:Viral Envelope Proteins

porcine cytomegalovirus
human herpesvirus-6
xenotransplantation
human cytomegalovirus
virus transmission


Comparative Analysis of Skeletal Muscle Transcriptional Signatures Associated With Aerobic Exercise Capacity or Response to Training in Humans and Rats.

Abstract: Increasing exercise capacity promotes healthy aging and is strongly associated with lower mortality rates. In this study, we analyzed skeletal muscle transcriptomics coupled to exercise performance in humans and rats to dissect the inherent and response components of aerobic exercise capacity. Using rat models selected for intrinsic and acquired aerobic capacity, we determined that the high aerobic capacity muscle transcriptome is associated with pathways for tissue oxygenation and vascularization. Conversely, the low capacity muscle transcriptome indicated immune response and metabolic dysfunction. Low response to training was associated with an inflammatory signature and revealed a potential link to circadian rhythm. Next, we applied bioinformatics tools to predict potential secreted factors (myokines). The predicted secretome profile for exercise capacity highlighted circulatory factors involved in lipid metabolism and the exercise response secretome was associated with extracellular matrix remodelling. Lastly, we utilized human muscle mitochondrial respiration and transcriptomics data to explore molecular mediators of exercise capacity and response across species. Human transcriptome comparison highlighted epigenetic mechanisms linked to exercise capacity and the damage repair for response. Overall, our findings from this cross-species transcriptome analysis of exercise capacity and response establish a foundation for future studies on the mechanisms that link exercise and health.

Kelahmetoglu|Yildiz|Y|
Jannig|Paulo R|PR|
Cervenka|Igor|I|
Koch|Lauren G|LG|
Britton|Steven L|SL|
Zhou|Jiajia|J|
Wang|Huating|H|
Robinson|Matthew M|MM|
Nair|K Sreekumaran|KS|
Ruas|Jorge L|JL|

skeletal muscle
exercise
response to training
aerobic capacity
human studies
rat models of exercise
transcriptome (RNA-seq)


Rimonabant, gastrointestinal motility and obesity.

Abstract:
BACKGROUND
Obesity and overweight affect more than half of the US population and are associated with a number of diseases. Rimonabant, a cannabinoid receptor 1 blocker in the endocannabinoid (EC) system, was indicated in Europe for the treatment of obesity and overweight patients with associated risk factors but withdrawn on Jan, 2009 because of side effects. Many studies have reported the effects of rimonabant on gastrointestinal (GI) motility and food intake. THE AIMS OF THIS REVIEW ARE: to review the relationship of EC system with GI motility and food intake;to review the studies of rimonabant on GI motility, food intake and obesity;and to report the tolerance and side effects of rimonabant.

METHODS
THE LITERATURE (PUBMED DATABASE) WAS SEARCHED USING KEYWORDS: rimonabant, obesity and GI motility.

RESULTS
GI motility is related with appetite, food intake and nutrients absorption. The EC system inhibits GI motility, reduces emesis and increases food intake; Rimonabant accelerates gastric emptying and intestinal transition but decreases energy metabolism and food intake. There is rapid onset of tolerance to the prokinetic effect of rimonabant. The main side effects of rimonabant are depression and GI symptoms.

CONCLUSIONS
Rimonabant has significant effects on energy metabolism and food intake, probably mediated via its effects on GI motility.

Rimonabant
gastrointestinal motility
obesity
food intake.


Examining the relationship between oral health-promoting behavior and dental visits.

Abstract:
Objective
The objective of this study was to explore the relationship between a number of health-promoting behavior and dental visits.

Methods
A stratified sample from 16 primary schools in Riyadh was selected. A total of 1087 students aged 6-12 years were included in the study between October 2017 and January 2018. The World Health Organization (WHO) criteria for assessing dental caries were used to collect clinical data. Information on dental visits and health-promoting behaviors were collected through modified WHO questionnaire. An aggregate variable of eleven health-related behaviors was created. Logistic regression model was used to examine the relationship between regular dental visits and the aggregate health behavior variable accounting for age, sex, parental education, family income, and caries experience.

Results
Only 6.8% of the sample reported regular dental visits. The logistic regression showed that the aggregate variable of health-promoting behavior was significantly related to regular dental visits with odds ratio 1.23 (confidence interval 95% 1.10-1.39). Other variables significantly related to regular dental visits included sex (female), higher family income, and lower mean of caries experience.

Conclusion
Despite the availability of free dental services in Saudi Arabia, most of the dental visits are symptomatic. The observed association between health-promoting behaviors and regular dental visits implies that those at higher risk of oral diseases are less likely to visit a dentist regularly.

oral health-promoting behavior
regular dental visits
Dental services


Defending eliminative structuralism and a whole lot more (or less).

Abstract: Ontic structural realism argues that structure is all there is. In (French, 2014) I argued for an 'eliminativist' version of this view, according to which the world should be conceived, metaphysically, as structure, and objects, at both the fundamental and 'everyday' levels, should be eliminated. This paper is a response to a number of profound concerns that have been raised, such as how we might distinguish between the kind of structure invoked by this view and mathematical structure in general, how we should choose between eliminativist ontic structural realism and alternative metaphysical accounts such as dispositionalism, and how we should capture, in metaphysical terms, the relationship between structures and particles. In developing my response I shall touch on a number of broad issues, including the applicability of mathematics, the nature of representation and the relationship between metaphysics and science in general.

Structure Metaphysics Object Representation Causation Dependence Disposition


Material Environments and the Shaping of Anorexic Embodiment: Towards A Materialist Account of Eating Disorders.

Abstract: Anorexia nervosa is a paradoxical disorder, regarded across disciplines as a body project and yet also an illness of disembodied subjectivity. This overlooks the role that material environments-including objects and spaces-play in producing embodied experiences of anorexia both within and outside treatment. To address this gap, this paper draws together two ethnographic studies of anorexia to explore the shared themes unearthed by research participants' engagements with objects that move across boundaries between treatment spaces and everyday lives. Demonstrating how the anorexic body is at once both phenomenologically lived and socio-medically constituted, we argue that an attention to materiality is crucial to understanding lived experiences. A materialist account of anorexia extends the literature on treatment resistance in eating disorders and offers a reconceptualisation of 'the body in treatment', showing how  objects and spaces shape, maintain, and even 'trigger' anorexia. Therefore, against the background of the high rates of relapse in eating disorders, this analysis calls for consideration of how interventions can better take account of eating disordered embodiment as shaped by material environments.

Materiality
Embodiment
Eating disorders
Anorexia nervosa
Ethnography
Mental health


Association between penetrating eye injuries and attention deficit hyperactivity disorder in children.

Abstract:
PURPOSE
To investigate whether there is an association between penetrating eye injuries and attention deficit hyperactivity disorder (ADHD) symptoms in children.

METHODS
45 children aged 3-18 years who were treated due to penetrating ocular injuries (patient group) and 75 control subjects (control group) were enrolled in the study. The symptoms of ADHD were evaluated by the Turkish adapted and validated form of the Conner Parent Rating Scale (CPRS).

RESULTS
The mean age was 8.9±4.1 years in the patient group and 9.7±3.7 years in the control group. All subscale scores of CPRS were higher in the patient group compared with the control group (all p<0.05). Gender-specific analyses showed that the boys of the patient group had significantly higher mean scores of all subscales, including inattentiveness, hyperactivity, oppositional defiant disorder and conduct disorder, compared with the boys of the control group (all p<0.05). However, the girls of the patient group had higher mean scores of only the conduct disorder subscale (p<0.05) compared with the girls of the control group. Three of 45 patients (6.6%) and 0 of 75 control subjects (0%) had a history of previous ocular trauma (p<0.05).

CONCLUSIONS
There was an association between penetrating eye injuries and inattentiveness, hyperactivity, oppositional defiant disorder and conduct disorder in boys, and conduct disorder in girls. An appropriate evaluation of ADHD symptoms may prevent vision loss due to penetrating eye injuries in children. In addition, evaluation by a child psychiatrist of children presenting with penetrating eye injuries may prevent repetition of injuries.

Bayar|Hasan|H| Coskun|Erol|E| Öner|Veysi|V| Gokcen|Cem|C| Aksoy|Umit|U| Okumus|Seydi|S| Erbagci|Ibrahim|I|

D001289:Attention Deficit Disorder with Hyperactivity

Trauma
Child health (paediatrics)
Eye (Globe)


Novel 8-(p-substituted-phenyl/benzyl)xanthines with selectivity for the A2A adenosine receptor possess bronchospasmolytic activity.

Abstract: A new series of 8-(p-substituted-phenyl/benzyl)xanthines has been synthesized and evaluated in vitro for adenosine receptor binding affinity and in vivo for bronchospasmolytic effects. It was observed that the nature of substituent at para-position of 8-phenyl/benzyl group on the xanthine scaffold remarkably affects the binding affinity and selectivity of xanthine derivatives for various adenosine receptor subtypes and also their bronchospasmolytic effects. Newly synthesized 8-phenylxanthines displayed potent binding affinity and significant selectivity for A2A receptors and also produced potent bronchospasmolytic effects. Replacement of phenyl ring with benzyl moiety at C8 of xanthine skeleton resulted in notable reduction in adenosine receptor affinity and broncholytic effects.

Yadav|Rakesh|R|
Bansal|Ranju|R|
Kachler|Sonja|S|
Klotz|K N|KN|

Adenosine receptors
Bronchospasmolytic activity
8-Phenylxanthines


Effect of reminiscence on cognitive impairment and depression in haemodialysis patients.

Abstract:
BACKGROUND
Cognitive impairment and depression are common problems in haemodialysis patients.

AIM
The present study was carried out to determine the impact of reminiscence on cognitive impairment and depression in haemodialysis patients.

DESIGN
This clinical trial (2016) was conducted with a pretest-posttest design on the haemodialysis patients of hospitals in Shahrud, Iran.

PARTICIPANTS AND MEASUREMENTS
Block random sampling was used to investigate the patients' cognitive status and Beck's Depression Scale were administered among 75 patients divided into intervention (given 12 sessions of Stinson's group reminiscence), control (group discussions), and sham (without any intervention) groups before, immediately and 30 days after the intervention.

RESULTS
Immediately and 30 days after the intervention, the cognitive score was significantly higher in the reminiscence group than the control (p < 0.001) and sham (p < 0.001) groups. Immediately after the intervention, the depression score was significantly lower in the reminiscence group than the control (p = 0.011) and sham (p < 0.001) groups. Also, immediately and 30 days after the intervention, the depression score was significantly lower in the reminiscence group than the control (p = 0.031) and sham (p < 0.001) groups.

CONCLUSIONS
The findings showed that reminiscence increased the cognitive health score and improved depression in haemodialysis patients. Therefore, reminiscence protocols can be utilized as an independent routine nursing care measure for improving cognitive status and depression in haemodialysis patients.

reminiscence
cognitive impairment
depression
haemodialysis


Assessment of knowledge, attitude and practices among dental practitioners on methods of infection control while carrying out dental procedures during novel coronavirus (COVID-19) pandemic.

Abstract:
Introduction
dental procedures produce bio-aerosols that can carry the highly contagious COVID-19 virus. Hence, the entire dental care team has to follow the current COVID-19 related infection control protocols. The study aims to assess the knowledge, attitude, and practices associated with infection control methods during dental procedures among dental practitioners during the COVID-19 pandemic in India.

Methods
the online questionnaire consisted of four sections namely, demographic details, eight questions on knowledge, four questions on attitude and eight questions on the practice of dentists during COVID-19 pandemic. One point was attributed for a correct response and zero point for an incorrect response. The study used descriptive statistics and binary logistic regression models in Jamovi 1.8.1 to establish relationships between knowledge, attitude, and practices among dental professionals and their demographic characteristics.

Results
among 384 dentists, 294 (76.6%) were aware of the hand hygiene methods, 372 dentists (96.9%) were aware of the Personal Protective Equipment (PPE), 343 dentists (89.3%) recorded the body temperature of the patients. One hundred and thirty eight (138) dentists (35.9%) did not use rubber dam and 158 dentists (41.1%) were not aware of the four-handed dentistry. Among the study participants, 57.8% displayed adequate knowledge, 63.8% possessed good attitude and 93.5% followed good practices on COVID-19 appropriate infection control measures during dental procedures. The mean knowledge, attitude, and practice scores were found to be 6.61, 2.04, and 3.38 respectively. Based on multivariable binary logistic regression analysis, it is observed that males (aOR: 0.55, 95% CI 0.35-0.87; p=0.011) have a lower likelihood of having a good knowledge when compared with females after adjusting for the other independent variables in the model. Also, individuals with higher qualifications (aOR: 0.57, 95% CI 0.36-0.92; p=0.022) appear to have lower likelihood of having good knowledge on COVID-19 infection control methods during dental procedure.

Conclusion
the study concludes that participants possess sound knowledge, attitude and practice on hand hygiene, PPE, patient triage and waiting area modifications at the workplace. However, poor response was noted on the use of rubber dam, remote telephonic screening and four-handed dentistry practice.

Shenoy|Neetha|N| Ballal|Vasudev|V| Rani|Usha|U| Kotian|Himani|H| Lakshmi|Vani|V|

D007722:Health Knowledge, Attitudes, Practice

knowledge
practice
Infection control
COVID-19 pandemic
dentists


Two-dimensional black phosphorus nanoflakes: A coreactant-free electrochemiluminescence luminophors for selective Pb2+ detection based on resonance energy transfer.

Abstract: As a nondegradable environmental pollutant, lead ion (Pb2+) has been proven to be deleterious for environmental and health. Conveniently, quickly and accurately on-site detection of Pb2+ is of paramount importance. Herein, an electrochemiluminescence (ECL) assay protocol using two-dimensional black phosphorus (2D BP) nanoflakes as new ECL emitter for highly sensitive and selective trace Pb2+ was designed on the basis of Pb2+ induced ECL resonance energy transfer (ECL-RET) between 2D BP nanoflakes and Ag/AgCl nanocubes. Anodic green ECL emission of BP nanoflakes without any coreactants was achieved. It is noteworthy that the possible ECL mechanism and the influence of coreactants on the ECL behaviour of BP nanoflakes were further investigated. Benefitting from the well match between the ECL emission spectrum of BP nanoflakes (∼510 nm) and the absorption spectrum of Ag/AgCl nanocubes (200-300 nm and 400-700 nm), effective energy transfer yielded. The introduction of Pb2+ would lead to the detachment of Ag/AgCl nanocubes then result in an enhanced ECL emission. Based on this, the proposed method could accurately quantify the Pb2+ in the range from 0.5 pM to 5 nM, which exhibited comparative performance to previous work. Furthermore, this study presents the example of employing 2D BP nanoflakes as ECL emitters and constructing a coreactant-free ECL sensing platform, which might open up a promising route for the potential design and implement in clinical analysis.

Wang|Yanhu|Y| Shi|Huihui|H| Zhang|Lina|L| Ge|Shenguang|S| Meiling|Xu|X| Wang|Xiao|X| Yu|Jinghua|J|

Black phosphorus
Coreactant-free
Electrochemiluminescence
Resonance energy transfer
Pb(2+) sensing


Hyrax versus transverse sagittal maxillary expander: An assessment of arch changes on dental casts. A retrospective study.

Abstract:
Objective
The aim of this study was to compare arch changes before and after maxillary expansion with Transverse Maxillary Sagittal Expander (TSME) and Hyrax Palatal Expander (HPE), in growing patients with diagnosis of maxillary hypoplasia.

Materials and methods
The sample consisted of 40 patients' records (20 males 20 females mean age 9.2 ± 2.6 years) were selected from the archive of the Orthodontic Department of the University of Milan, Italy. Patients were randomly divided in two groups: patients in group 1 were treated with HPE as they presented only transverse deficiency of the maxilla and in group 2 were treated with TSME. Plaster models have been measured with a Verniere caliper to evaluate the differences in maxillary expansion of the two devices. Measurements were performed on casts poured from impressions taken before appliance bonding (T0), immediately after appliance debonding (T1) and at 6 months follow-up (T2). The variations in the following distances have been considered: inter-molar distance, inter-canine distance, palatal depth, palatal length and arch circumference. Shapiro-Wilk test was performed to assess normality distribution. ANOVA for repeated measures with multiple paired t-test for pairwise comparisons and its non-parametric equivalent Friedman's test with multiple Wilcoxon tests for pairwise comparisons were performed to evaluate changes in time of each variable in each group. Between groups comparisons were performed for each variable at each observing time using independent t-test or Mann-Whitney test. Significance level was set at p < 0,05.

Results
Both the Friedman test and the rm-ANOVA test and their respective post-hoc show that within both groups the respective variables have a statistically significant increase between T0 and T1 (p < 0,05) and a slight decrease between T1 and T2 (p < 0,05) that is not clinically relevant remaining always T2 greater than T0 in a statistically and clinically relevant way (p < 0,05). The analysis between the differences of the measurements at different timing measured by the Mann-Whitney test shows that for all the variables there is no statistically significant difference between the 2 devices (p < 0,05), except for the perimeter of the arch and the length of the palate; in this case it appeared that the TSME is better statistically (p < 0,05).

Conclusions
The study has shown that RPE and TSME can achieve similar results in transversal palatal expansion. Differences have been found in the palatal length and in the arch perimeter where TSME seems to be more efficient.

Maspero|C|C| Cavagnetto|D|D| Fama|A|A| Giannini|L|L| Galbiati|G|G| Farronato|M|M|

Transverse sagittal maxillary expander (TSME)


The feasibility of physiologically based pharmacokinetic modeling in forensic medicine illustrated by the example of morphine.

Abstract: In forensic medicine, expert opinion is often required concerning dose and time of intake of a substance, especially in the context of fatal intoxications. In the present case, a 98-year-old man died 4 days after admission to a hospital due to a femur neck fracture following a domestic fall in his retirement home. As he had obtained high morphine doses in the context of palliative therapy and a confusion of his supplemental magnesium tablets with a diuretic by the care retirement home was suspected by the relatives, a comprehensive postmortem examination was performed. Forensic toxicological GC- and LC-MS analyses revealed, besides propofol, ketamine, and a metamizole metabolite in blood and urine, toxic blood morphine concentrations of approximately 3 mg/l in femoral and 5 mg/l in heart blood as well as 2, 7, and 10 mg/kg morphine in brain, liver, and lung, respectively. A physiologically based pharmacokinetic (PBPK) model was developed and applied to examine whether the morphine concentrations were (i) in agreement with the morphine doses documented in the clinical records or (ii) due to an excessive morphine administration. PBPK model simulations argue against an overdosing of morphine. The immediate cause of death was respiratory and cardiovascular failure due to pneumonia following a fall, femur neck fracture, and immobilization accompanied by a high and probably toxic concentration of morphine, attributable to the administration under palliative care conditions. The presented case indicates that PBPK modeling can be a useful tool in forensic medicine, especially in question of a possible drug overdosing.

Physiologically based pharmacokinetic modeling


Doctors for Tribal Areas: Issues and Solutions.

Abstract: Health parameters of tribal population had always been a concern for India's march towards Millennium development Goals (MDG's). Tribal population contributes 8.6% of total population, in spite of efforts and commitment of Government of India towards MGD, India lagged far behind from achieving and optimal health of tribal population will be a concern for achieving Sustainable development Goals SDG's also. Some of the common health problems of the tribal population face are deficiency of essential components in diet like energy malnutrition, protein calorie malnutrition and micronutrient deficiencies. Goiter, Gastrointestinal disorders, particularly dysentery and parasitic infections are very common. High prevalence of genetic disorders like sickle cell anemia and others are endemic in few tribes of India. Tribal Health is further compounded issues by social issues like excessive consumption of alcohol, poor access to contraceptive, substance abuse and gender based violence. Besides other reasons, like poor budget allocation, difficult to reach, poor access to health care facility, severe shortage of qualified health workers and workforce led to poor governance of health sector in tribal areas. Present view point reflects on the issues of inadequacy of doctors in tribal area and suggests possible solutions.

tribal health
Health system
human resource