Single-Bone Forearm as a Salvage Procedure in Recalcitrant Pediatric Forearm Pathologies.

Abstract:
PURPOSE
To report on the outcome of single-bone forearm reconstruction (SBFR) as a salvage procedure in pediatric forearm pathologies.

METHODS
Twenty-eight forearms in 27 patients (median age, 9.6 years; range, 3.4-29.7 years) treated with SBFR at a pediatric referral center were included in the study. Records and radiographs were retrospectively analyzed. Median follow-up was 84 months (range, 24-261 months). The most common underlying condition was multiple hereditary exostoses (MHEs) (17 of 28), followed by brachial plexus birth injury (5 of 28), Ollier disease (2 of 28), congenital radial head dislocation (2 of 28), and others (2 of 28).

RESULTS
By 4 months (range, 2-10 months) after surgery, 21 of 28 forearms had united. Median resting postoperative forearm rotation was 10° pronation (range, neutral to 25° pronation). Before surgery, pain was present in 23 of 28 forearms. At the latest follow-up, pain was present in 5 of 28 forearms. In three of the 5 forearms with residual pain, this was attributed to ulnohumeral degenerative changes that existed prior to SBFR. Following SBFR, elbow flexion-extension range was maintained. In the subgroup with MHEs, radial articular angle was maintained (median, 37°-30°) and carpal slip percentage improved significantly (median, 40%-12%). Complications occurred in 8 forearms: 3 cases of nonunion in older patients (age, 30, 20, and 14 years), 2 cases of traumatic juxtaimplant fractures following successful union, 1 case of infection, 1 case of compartment syndrome, and 1 case of persistent radiocapitellar impingement. All complications were successfully treated. When stratified by age, none of the patients in the younger group (16 forearms, age < 12 years) had nonunions or pain at latest follow-up.

CONCLUSIONS
The SBFR is an old, but generally reliable, option as a single-stage salvage procedure for a number of recalcitrant pediatric forearm pathologies. Success rate may be higher in younger patients.

TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.

Wang|Kemble K|KK|
Vuillermin|Carley B|CB|
Waters|Peter M|PM|

single-bone forearm
salvage
radial head dislocation
Forearm instability
osteochondromatosis


Utilisation of skilled birth attendance in Northern Nigeria: a cross-sectional survey.

Abstract:
OBJECTIVE
to determine the level and determinants for utilisation of Skilled Birth Attendance (SBA).

METHODS
a population-based survey using a structured questionnaire was conducted in Goya and Tundunya political wards of Katsina state from May to June 2012. Four hundred women aged 15-49 years who had delivered a baby within two years prior to the study were asked about birth attendance during antenatal care (ANC), childbirth and postnatal period of their most recent birth. Logistic regression analysis was performed to obtain independent predictors of skilled birth attendance (SBA).

FINDINGS
of the 400 women recruited for the study, 145 (36.3%) received antenatal care, 52 (13%) had their births assisted by skilled personnel and 88 (22%) received postnatal care from skilled birth attendants. Of the 52 women who had their births attended by skilled birth attendants only 29 (56%) had their births in a health facility. Maternal education, husband's occupation, presence of complication and previous place of childbirth were found to be statistically significant predictors for SBA utilisation. Barriers to SBA utilisation identified included lack of health care provider, lack of equipment and supplies and poverty. Enablers mentioned included availability of staff, husband's approval and affordable service.

CONCLUSION
women are more likely to utilise SBA with the availability of skilled personnel, strengthening of the health system and intervention to remove user fees for maternal health services. Joint effort should be made by government and community leaders to promote girl's education and to encourage men's involvement in maternal health services.

Adewemimo|Adeyinka W|AW|
Msuya|Sia E|SE|
Olaniyan|Christine T|CT|
Adegoke|Adetoro A|AA|

Skilled birth attendance
Skilled birth attendance
Barriers
Enablers
Skilled birth attendants


Current knowledge of Chagas-related heart disease among pediatric cardiologists in the United States.

Abstract:
BACKGROUND
Chagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S.

METHODS
We prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience.

RESULTS
Of 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture.

CONCLUSIONS
Pediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.

Malhotra|Sanchi|S|0000-0002-2485-3927
Masood|Imran|I|
Giglio|Noberto|N|
Pruetz|Jay D|JD|
Pannaraj|Pia S|PS|

D007722:Health Knowledge, Attitudes, Practice

Pediatrics
Cardiomyopathy
Conduction
Chagas heart failure
Epidemiology


Technical Note: Deep Learning approach for automatic detection and identification of patient positioning devices for radiation therapy.

Abstract:
PURPOSE
Automatic detection and identification of setup devices, using a deep convolutional neural network (CNN) for real-time multiclass object detection, has the potential to reduce errors in the treatment delivery process by avoiding documentation errors.

METHODS
A database of the setup device photos from the most recent 1200 patients treated at our institution was downloaded from the record and verify (R&V) system along with the corresponding setup notes. Images were manually labeled with bounding boxes of each device. A real-time object detection CNN using the "you only look once" (YOLOv2) architecture was trained using transfer learning of a pretrained CNN (ResNet50). The CNN was trained to detect and identify 11 of the most common treatment accessories used at our institution.

RESULTS
Using transfer learning of a CNN for multiclass object detection, we are able to automatically detect and identify setup devices in photographs with an accuracy of 96%.

CONCLUSIONS
Automation in radiation oncology has the potential to reduce risk. Automatic detection of setup devices is possible using a CNN and transfer learning. This work shows both the value of incident learning systems (ILS) in practice knowledge dissemination, and shows how automation of clinical processes and less reliance on manual documentation has the potential for risk reduction in radiation oncology treatments.

Thomas|David H|DH|
Schubert|Leah K|LK|
Vinogradskiy|Yevgeniy|Y|
Nath|Sameer|S|
Kavanagh|Brian|B|
Miften|Moyed|M|
Jones|Bernard|B|

setup devices
incident learning
computer vision
machine learning


Baicalin protects against gastroduodenal ulcers via the modulation of Nrf2 expression: Experimental, biochemical, and histological analyses.

Abstract:
BACKGROUND
The present study aimed to determine the mechanisms underlying the gastroprotective effects of baicalin using several animal models of chemically induced gastric ulcers.

METHODS
The gastroprotective effects of baicalin against ulcers induced by water immersion stress, alcohol-induced ligation, and indomethacin-induced pylorus ligation were assessed in the present study. Additionally, macroscopic evaluations were performed at the completion of the study and Western blot analyses of Nrf2 were conducted to determine the possible mechanisms of action underlying the effects of baicalin.

RESULTS
Compared to the effects of ranitidine in a confirmed model of indomethacin-induced ligation, treatment with various doses of baicalin resulted in significant (p <0.001) increases in protection against ulcers in a dose-dependent manner. Baicalin was 72% effective versus the reference drug and 80% effective against ethanol-induced ulcers. Additionally, in rat stomachs with pylorus ligatures, Western blot analyses revealed that baicalin was 82% protective and that cimetidine was 85% protective. Taken together, the present findings indicate that baicalin is an alternative medicine with the potential to be an effective gastroprotective agent.

CONCLUSION
The present findings suggest that the protective effects of baicalin may be regulated via Nrf2-mediated anti-secretory actions.

Baicalin Nrf2 Gastroprotective Anti-secretory


Understanding the molecular mechanism(s) of hepatitis C virus (HCV) induced interferon resistance.

Abstract: Hepatitis C virus (HCV) is one of the foremost causes of chronic liver disease affecting over 300 million globally. HCV contains a positive-stranded RNA of ~9600 nt and is surrounded by the 5' and 3'untranslated regions (UTR). The only successful treatment regimen includes interferon (IFN) and ribavirin. Like many other viruses, HCV has also evolved various mechanisms to circumvent the IFN response by blocking (1) downstream signaling actions via STAT1, STAT2, IRF9 and JAK-STAT pathways and (2) repertoire of IFN Stimulatory Genes (ISGs). Several studies have identified complex host demographic and genetic factors as well as viral genetic heterogeneity associated with outcomes of IFN therapy. The genetic predispositions of over 2000 ISGS may render the patients to become resistant, thus identification of such parameters within a subset of population are necessary for management corollary. The ability of various HCV genotypes to diminish IFN antiviral responses plays critical role in the establishment of chronic infection at the acute stage of infection, thus highlighting importance of the resistance in HCV treated groups. The recently defined role of viral protein such as C, E2, NS3/NS4 and NS5A proteins in inducing the IFN resistance are discussed in this article. How the viral and host genetic composition and epistatic connectivity among polymorphic genomic sites synchronizes the evolutionary IFN resistance trend remains under investigation. However, these signals may have the potential to be employed for accurate prediction of therapeutic outcomes. In this review article, we accentuate the significance of host and viral components in IFN resistance with the aim to determine the successful outcome in patients.

Qashqari|Hanadi|H|
Al-Mars|Amany|A|
Chaudhary|Adeel|A|
Abuzenadah|Adel|A|
Damanhouri|Ghazi|G|
Alqahtani|Mohammed|M|
Mahmoud|Maged|M|
El Sayed Zaki|Maysaa|M|
Fatima|Kaneez|K|
Qadri|Ishtiaq|I|

interferon and ribavirin resistance determining region

interferon sensitivity determining region

nuclear factor kappa-light-chain-enhancer of activated B cells

repressor element-1 silencing transcription factor

signal transducer and activator of transcription

P P P P P P P P P U U U U U U M U U U U U U U U U R U U U U M U U U U U U M M U U U U U U M M U U M M M R M M R U M M U U M U M M M M M U M M M


Particulate Matter (PM10) Promotes Cell Invasion through Epithelial-Mesenchymal Transition (EMT) by TGF-β Activation in A549 Lung Cells.

Abstract: Air pollution presents a major environmental problem, inducing harmful effects on human health. Particulate matter of 10 μm or less in diameter (PM10) is considered an important risk factor in lung carcinogenesis. Epithelial-mesenchymal transition (EMT) is a regulatory program capable of inducing invasion and metastasis in cancer. In this study, we demonstrated that PM10 treatment induced phosphorylation of SMAD2/3 and upregulation of SMAD4. We also reported that PM10 increased the expression and protein levels of TGFB1 (TGF-β), as well as EMT markers SNAI1 (Snail), SNAI2 (Slug), ZEB1 (ZEB1), CDH2 (N-cadherin), ACTA2 (α-SMA), and VIM (vimentin) in the lung A549 cell line. Cell exposed to PM10 also showed a decrease in the expression of CDH1 (E-cadherin). We also demonstrated that expression levels of these EMT markers were reduced when cells are transfected with small interfering RNAs (siRNAs) against TGFB1. Interestingly, phosphorylation of SMAD2/3 and upregulation of SMAD induced by PM10 were not affected by transfection of TGFB1 siRNAs. Finally, cells treated with PM10 exhibited an increase in the capacity of invasiveness because of EMT induction. Our results provide new evidence regarding the effect of PM10 in EMT and the acquisition of an invasive phenotype, a hallmark necessary for lung cancer progression.


Acquired diaphragmatic hernia after hepatectomy and liver transplantation in adults and children: A case series and literature review.

Abstract:
Backgrounds/Aims
Acquired diaphragmatic hernia is a rare complication following liver surgery in adult and pediatric patients. This study aims to describe main features occurring in adult and pediatric patients after liver surgery and report an up-date review of the literature.

Methods
All adult and pediatric patients who were diagnosed with postoperative acquired diaphragmatic hernia in Lyon and Marseille University Hospitals were included in this study. Diagnosis, clinical, radiologic, and therapeutic data were analysed retrospectively from medical papers and/or electronic records.

Results
Thirteen adults with a median age of 50 years (range, 30-67 years) and 5 children aged 2.4 years (range, 0.9-4 years) were diagnosed with acquired diaphragmatic hernia after a median time of 65.1 (range, 1.8-244.7) and 2 (range, 0.33-10.9) months, respectively, following surgeries (5 live-donor right hepatectomies, 5 right and 1 left hepatectomies for tumors and cysts, and 2 whole liver transplantations in adults; and 5 liver transplantations with left lateral section in children). Eleven patients presented digestive and/or thoracic symptoms whereas seven were asymptomatic and diagnosed by routine imaging follow-up. All patients were re-operated with a median delay of 2.4 months (range, 0-25.3 months) for adults and 1 day (range, 0-2 days) for children. Two recurrences resulted in a secondary surgical repair.

Conclusions
Acquired diaphragmatic hernia is a rare and potentially serious event after liver surgery. Recognition and surgical repair of this particular complication should be considered in the setting of unexplained abdominal and/or thoracic symptoms. Preventive measures should be taken intraoperatively.

Hepatectomy
Liver transplantation
Adults and children
Surgery
Hernia, diaphragmatic


Intravitreal enzyme replacement preserves retinal structure and function in canine CLN2 neuronal ceroid lipofuscinosis.

Abstract: CLN2 neuronal ceroid lipofuscinosis is a hereditary neurodegenerative disorder characterized by progressive vision loss, neurological decline, and seizures. CLN2 disease results from mutations in TPP1 that encodes the lysosomal enzyme tripeptidyl peptidase-1 (TPP1). Children with CLN2 neuronal ceroid lipofuscinosis experience ocular disease, characterized by progressive retinal degeneration associated with impaired retinal function and gradual vision loss culminating in total blindness. A similar progressive loss of retinal function is also observed in a dog CLN2 model with a TPP1 null mutation. A study was conducted to evaluate the efficacy of periodic intravitreal injections of recombinant human (rh) TPP1 in inhibiting retinal degeneration and preserving retinal function in the canine model. TPP1 null dogs received periodic intravitreal injections of rhTPP1 in one eye and vehicle in the other eye beginning at approximately 12 weeks of age. Ophthalmic exams, in vivo ocular imaging, and electroretinography (ERG) were repeated regularly to monitor retinal structure and function. Retinal histology was evaluated in eyes collected from these dogs when they were euthanized at end-stage neurological disease (43-46 weeks of age). Intravitreal rhTPP1 dosing prevented disease-related declines in ERG amplitudes in the TPP1-treated eyes. At end-stage neurologic disease, TPP1-treated eyes retained normal morphology while the contralateral vehicle-treated eyes exhibited loss of inner retinal neurons and photoreceptor disorganization typical of CLN2 disease. The treatment also prevented the development of disease-related focal retinal detachments observed in the control eyes. Uveitis occurred secondary to the administration of the rhTPP1 but did not hinder the therapeutic benefits. These findings demonstrate that periodic intravitreal injection of rhTPP1 preserves retinal structure and function in canine CLN2 disease.

Whiting|Rebecca E H|REH|
Pearce|Jacqueline W|JW|
Vansteenkiste|Daniella P|DP|
Bibi|Katherine|K|
Lim|Stefanie|S|
Robinson Kick|Grace|G|
Castaner|Leilani J|LJ|
Sinclair|John|J|
Chandra|Sundeep|S|
Nguyen|Annalisa|A|
O'Neill|Charles A|CA|
Katz|Martin L|ML|

Retinal degeneration
Uveitis
Electroretinogram
Genetic diseases
Intravitreal drug delivery
Retina


Significance of pretransplant abstinence on harmful alcohol relapse after liver transplantation for alcoholic cirrhosis in Japan.

Abstract:
AIM
Alcoholic liver cirrhosis (ALC) is an established indication for liver transplantation (LT). Although the importance of preoperative abstinence is accepted, the optimal period of pretransplant abstinence is unclear. Our previous report in a Japanese cohort revealed a significant negative impact of recidivism on patient survival but failed to show significance of the length of pretransplant abstinence. The aim of this study was to evaluate the optimal period of pretransplant abstinence.

METHODS
Subjects underwent LT for ALC (n = 195: 187 living donor liver transplantations, five deceased donor liver transplantations and three domino LT) in Japan from November 1997 to December 2011. Risk factors and the impact on outcome of alcohol relapse were analyzed in 140 patients, after excluding 26 patients with in-hospital mortality and 29 patients without information about alcohol relapse.

RESULTS
The incidence of alcohol consumption after LT was 22.9% (32/140). The relapse time was within 18 months after LT in 24 patients, after 18 months in two patients and unknown in six patients. Alcohol-related damage occurred in 18 of the 24 patients with recidivism within 18 months. The patient survival rate of patients with harmful relapse was significantly lower than that of abstinent patients and patients with non-harmful relapse (P = 0.019). Preoperative abstinence shorter than 18 months was a significant indicator of the risk of harmful relapse (P = 0.009). High-risk alcohol relapse scores had no impact on the incidence.

CONCLUSION
Preoperative abstinence was an important predictor of post-transplant harmful relapse leading to inferior outcomes.

Egawa|Hiroto|H| Ueda|Yoshihide|Y| Kawagishi|Naoki|N| Yagi|Takahito|T| Kimura|Hiroyuki|H| Ichida|Takafumi|T|

pretransplant abstinence
recidivism
living donor liver transplantation
harmful relapse
high-risk alcohol relapse score


16S rRNA Gene Sequencing Reveals a Shift in the Microbiota of Diaphorina citri During the Psyllid Life Cycle.

Abstract: The Asian citrus psyllid (Diaphorina citri) is a major pest of citrus trees as it transmits Candidatus Liberibacter asiaticus (CLas). The composition of a host's microbiota can affect the evolution and ecological distribution of the host. This study monitored the compositional shifts in the citrus psyllid microbiota through all the life stages (egg, nymph 1-5 stages, and adult) by next-generation sequencing (NGS) and quantitative real-time PCR. There were clear differences in both α- and β-diversity of microbiota through the psyllid life stages. Microbiota diversity was markedly higher in the nymph 2-5 stages than in the adult, egg, and nymph 1 stages. Proteobacteria were dominant in all the life stages of D. citri, representing >97.5% of the total bacterial community, and Candidatus Profftella armature was the dominant genus in all the life stages. Data from the qPCR analysis showed an exponential increase in the populations of three D. citri endosymbionts: Candidatus Profftella armature, Candidatus Carsonella ruddii, and Wolbachia. The gut bacterium Pantoea was present in all the life stages, but it was markedly higher in the nymph 2-5 stages. The microbiota composition substantially differed among the egg-nymph 1, nymphs 2-5, and adult stages. Therefore, we successfully characterized the microbiota dynamics and thus identified a microbiota shift during the life cycle of D. citri by 16S rRNA gene sequencing and quantitative PCR. Moreover, 16S rRNA gene sequencing suggested that D. citri acquired the ability to bear CLas in the nymph 1 stage. This study enhances our understanding of microbial establishment in the developing D. citri and provides a reference resource for the identification of potential biocontrol approaches against this pest.

Meng|Lixue|L| Li|Xiaoyang|X| Cheng|Xiaoqin|X| Zhang|Hongyu|H|

Diaphorina citri
quantitative real-time PCR
bacterial community
Illumina MiSeq sequencing
developmental stages


Effects of diet on gut microbiota of soil collembolans.

Abstract: The importance of diet in regulating the gut microbiome of globally distributed and functionally important soil generalist invertebrates such as collembolans remain poorly understood. Here, we studied a model collembolan (Folsomia candida) and found that diet (bacteria, plant litters, yeast, mixed food) is a critical factor in regulating the microbial diversity and community composition of this important soil organism. Collembolans fed with litter exhibited the lowest bacterial diversity and were dominated by Ochrobactrum. Conversely, collembolans fed with mixed diets resulted in the highest bacterial diversity. Our findings further suggest that microbial communities associated with different diets are linked to different levels of collembolan fitness. For example, the relative abundance of the genera of unclassified Thermogemmatisporaceae, Brevibacillus, and Novosphingobium were positively correlated with growth of the collembolans. Together, our work provides evidence that diet is a major force controlling the gut microbiome of collembolans, and is a good environmental predictor for collembolan growth, with implications for ecosystem functioning in terrestrial environments.

Xiang|Qian|Q| Zhu|Dong|D| Chen|Qing-Lin|QL| Delgado-Baquerizo|Manuel|M| Su|Jian-Qiang|JQ| Qiao|Min|M| Yang|Xiao-Ru|XR| Zhu|Yong-Guan|YG|

Diets
Collembolans
Bacterial community
Soil invertebrates


Species-rich ecosystems are vulnerable to cascading extinctions in an increasingly variable world.

Abstract: Global warming leads to increased intensity and frequency of weather extremes. Such increased environmental variability might in turn result in increased variation in the demographic rates of interacting species with potentially important consequences for the dynamics of food webs. Using a theoretical approach, we here explore the response of food webs to a highly variable environment. We investigate how species richness and correlation in the responses of species to environmental fluctuations affect the risk of extinction cascades. We find that the risk of extinction cascades increases with increasing species richness, especially when correlation among species is low. Initial extinctions of primary producer species unleash bottom-up extinction cascades, especially in webs with specialist consumers. In this sense, species-rich ecosystems are less robust to increasing levels of environmental variability than species-poor ones. Our study thus suggests that highly species-rich ecosystems such as coral reefs and tropical rainforests might be particularly vulnerable to increased climate variability.

Kaneryd|Linda|L| Borrvall|Charlotte|C| Berg|Sofia|S| Curtsdotter|Alva|A| Eklöf|Anna|A| Hauzy|Céline|C| Jonsson|Tomas|T| Münger|Peter|P| Setzer|Malin|M| Säterberg|Torbjörn|T| Ebenman|Bo|B|

weather extremes
environmental variability
food web
extinction cascades
Biodiversity
climate change
ecological networks
species interactions
stability
stochastic models


Transport of Amino Acids across the Vacuolar Membrane of Yeast: Its Mechanism and Physiological Role.

Abstract: In yeast cells growing under nutrient-rich condition approximately 50% of total amino acids are accumulated in the vacuoles; however, the composition of amino acids in the cytosol and in the vacuoles is quite different. The vacuoles, like lysosomes, degrade proteins transported into their lumen and produce amino acids. These amino acids should be quickly excreted to the cytosol under nutrient starvation condition and recycled for de novo protein synthesis. These suggest that specific machineries that transport amino acids into and out of the vacuoles operate at the vacuolar membrane. Several families of transporter involved in the vacuolar compartmentalization of amino acids have been identified and characterized using budding yeast Saccharomyces cerevisiae. In this review, we describe the vacuolar amino acid transporters identified so far and introduce recent findings on their activity and physiological function.

yeast
starvation
vacuolar amino acid transporter
autophagy


Long-term changes in cerebrovascular reactivity following EC-IC bypass for intracranial steno-occlusive disease.

Abstract: The purpose of this retrospective observational study is to investigate the long-term changes in cerebrovascular reactivity (CVR) as a measure of cerebral hemodynamics in patients with intracranial steno-occlusive disease (IC-SOD) after they have undergone an Extracranial-intracranial (EC-IC) bypass. Twenty-six patients suffering from IC-SOD were selected from our CVR database. Nineteen patients underwent unilateral and 7 underwent bilateral revascularization. CVR measurements were done using BOLD-MRI and precisely controlled CO2 and expressed as ΔBOLD (%)/Δ PETCO2 (mmHg). Trends in CVR over time were compared in both vascularized and non-vascularized hemispheres. Repeated measures analysis of variance with Greenhouse-Geisser correction was used to determine CVR changes within the grey matter MCA for longitudinal assessments. Overall, re-vascularized hemisphere showed a significant increase in CVR at the first follow-up, followed by a slight decrease at the second follow-up that significantly increased compared to the pre-bypass. However, the changes in the postoperative CVR were quite variable across the patients. Similar variability was seen in subsequent follow-ups, with a slight overall decline in the long term CVR as compared with first post-operative CVR. Our study demonstrates that EC-IC bypass has a beneficial long-term effect on cerebral hemodynamics and this effect varies between patients probably due to the variability in the underlying vascular pattern receiving the bypass. Hence, in the postoperative follow-up of patients routine functional imaging to monitor cerebral hemodynamics may be useful as the risk of stroke and cognitive decline remain present with impaired CVR.

Rosen|Casey|C|
McKetton|Larissa|L|
Russell|Jeremy|J|
Sam|Kevin|K|
Poublanc|Julien|J|
Crawley|Adrian|A|
Han|Jay S|JS|
Sobczyk|Olivia|O|
Duffin|James|J|
Mandell|Danny M|DM|
Tymianski|Michael|M|
Fisher|Joseph A|JA|
Mikulis|David J|DJ|
Venkatraghavan|Lashmi|L|

Blood-oxygen-level dependent magnetic resonance imaging


Polychlorinated biphenyls (PCBs) in air and soil from a high-altitude pasture in the Italian Alps: evidence of CB-209 contamination.

Abstract: This study analyses the seasonal trend of polychlorinated biphenyls (PCB) concentrations in air and soil from a high-altitude mountain pasture in the Italian Alps. PCB concentrations in soil were generally comparable to background levels and were lower than those previously measured in the same area. Only CB-209 unexpectedly showed high concentrations with respect to the other congeners. GC-MS-MS identification was very clear, rising a new problem of increasing PCB contamination concerning only CB-209, which is not present in commercial mixtures used in the past in Italy and Europe. Considering all of the congeners, seasonal PCB trends were observed both in air and in soil that were related to the temperature and precipitation measured specifically in the study area. Highly significant relationships were found between the temperature-normalised concentrations in soil and the precipitation amounts. A north/south enrichment factor was present only in soil with rapid early summer re-volatilisation kinetics from soil to air and autumn re-deposition events from air to soil. Fugacity ratio calculations confirmed these trends. Surface soils respond rapidly to meteorological variables, while subsurface soils respond much more slowly. Seasonal trends were different for the northern and southern sides of the mountain. A detailed picture of the interactions among temperature, precipitation, mountain aspects and soil features was obtained.

Tremolada|Paolo|P| Guazzoni|Niccolò|N| Comolli|Roberto|R| Parolini|Marco|M| Lazzaro|Serena|S| Binelli|Andrea|A|

PCBs
CB-209
Seasonal trends
Air contamination
Air-soil exchange
Soil contamination


A Member of the 14-3-3 Gene Family in Brachypodium distachyon, BdGF14d, Confers Salt Tolerance in Transgenic Tobacco Plants.

Abstract: Plant 14-3-3 proteins are involved in diverse biological processes, but for the model monocotyledonous species, Brachypodium distachyon, their roles in abiotic stress tolerance are not well understood. In this study, a total of eight Bd14-3-3 genes were identified from B. distachyon and these were designated respectively as BdGF14a-BdGF14g. The qRT-PCR analyses of 3-month-old plants of B. distachyon showed that these genes were all expressed in the stems, leaves, and spikelets. By contrast, most of the plants had relatively lower transcriptional levels in their roots, except for the BdGF14g gene. The different expression profiles of the Bd14-3-3s under various stress treatments, and the diverse interaction patterns between Bd14-3-3s and BdAREB/ABFs, suggested that these gene products probably had a range of functions in the stress responses. The NaCl-induced Bd14-3-3 gene, BdGF14d, was selected for overexpression in tobacco. BdGF14d was found to be localized throughout the cell and it conferred enhanced tolerance to salt in the transgenic plants. Lowered contents of malondialdehyde, H2O2, and Na+, and lower relative electronic conductance (Rec%), yet greater activities of catalase and peroxidase, were observed in the overexpressing plants. Higher photosynthetic rate, transpiration rate, stomatal conductance, and water use efficiency were measured in the transgenic lines. Following abscisic acid (ABA) or NaCl treatment, stomatal aperture in leaves of the BdGF14d-overexpression plants was significantly lower than in leaves of the wild type (WT) controls. The stress-related marker genes involved in the ABA signaling pathway, the reactive oxygen species (ROS)-scavenging system, and the ion transporters were all up-regulated in the BdGF14d-overexpressing plants as compared with WT. Taken together, these results demonstrate that the Bd14-3-3 genes play important roles in abiotic stress tolerance. The ABA signaling pathway, the ROS-scavenging system, and ion transporters were all involved in enhancing the tolerance to salt stress in the BdGF14d-overexpression plants.

He|Yuan|Y| Zhang|Yang|Y| Chen|Lihong|L| Wu|Chunlai|C| Luo|Qingchen|Q| Zhang|Fan|F| Wei|Qiuhui|Q| Li|Kexiu|K| Chang|Junli|J| Yang|Guangxiao|G| He|Guangyuan|G|

BdGF14d
salt tolerance
B. distachyon
Bd14-3-3s
ABA signaling
ROS-scavenging system


An injectable microparticle formulation for the sustained release of the specific MEK inhibitor PD98059: in vitro evaluation and pharmacokinetics.

Abstract: PD98059 is a reversible MEK inhibitor that we are investigating as a potential treatment for neurochemical changes in the brain that drive neurohumoral excitation in heart failure. In a rat model that closely resembles human heart failure, we found that central administration of PD98059 inhibits phosphorylation of ERK1/2 in the paraventricular nucleus of the hypothalamus, ultimately reducing sympathetic excitation which is a major contributor to clinical deterioration. Studies revealed that the pharmacokinetics and biodistribution of PD98059 match a two-compartment model, with drug found in brain as well as other body tissues, but with a short elimination half-life in plasma (approximately 73 min) that would severely limit its potential clinical usefulness in heart failure. To increase its availability to tissues, we prepared a sustained release PD98059-loaded PLGA microparticle formulation, using an emulsion solvent evaporation technique. The average particle size, yield percent, and encapsulation percent were found to be 16.73 μm, 76.6%, and 43%, respectively. In vitro drug release occurred over 4 weeks, with no noticeable burst release. Following subcutaneous injection of the microparticles in rats, steady plasma levels of PD98059 were detected by HPLC for up to 2 weeks. Furthermore, plasma and brain levels of PD98059 in rats with heart failure were detectable by LC/MS, despite expected erratic absorption. These findings suggest that PD98059-loaded microparticles hold promise as a novel therapeutic intervention countering sympathetic excitation in heart failure, and perhaps in other disease processes, including cancers, in which activated MAPK signaling is a significant contributing factor. Graphical abstract.

D020929:Mitogen-Activated Protein Kinase Kinases

Microparticles
Sustained release
PD98059
Heart failure
LC/MS
MEK1/2 inhibitor


National survey found that managing childhood nephrotic syndrome in Nigeria varied widely and did not comply with the best evidence.

Abstract:
AIM
This study explored any variations in managing childhood nephrotic syndrome between specialist centres in Nigeria and how closely the care reflected the best available evidence.

METHODS
In 2016, the heads of Nigerian paediatric nephrology units were asked to complete a study questionnaire that focused on managing nephrotic syndrome.

RESULTS
Of the 31 clinicians we approached, 81% returned the completed questionnaire. The majority (64%) had received paediatric nephrology training and 40% had practised for at least 10 years. We found that 60% prescribed an initial daily prednisolone for four weeks before reducing the dose and 32% prescribed it for six weeks. However, more marked variations were observed with the total steroid duration for new-onset nephrotic syndrome, with 16%, 44% and 40% prescribing prednisolone for 8, 12 and at least 16 weeks, respectively. Similarly, 56% prescribed prednisolone for less than eight weeks before diagnosing steroid-resistant nephrotic syndrome (SRNS) and 12% rarely requested a kidney biopsy for SRNS. In addition, 32% of the respondents preferred cyclophosphamide to calcineurin inhibitors for SRNS.

CONCLUSION
There were significant variations in the management of childhood nephrotic syndrome in Nigeria and the diagnosis and treatment of SRNS differed substantially from the best available evidence.

Kidney Disease: Improving Global Outcomes


Polyamines in protozoan pathogens.

Abstract: Polyamines are polycationic organic amines that are required for all eukaryotic life, exemplified by the polyamine spermidine, which plays an essential role in translation. They also play more specialized roles that differ across species, and their chemical versatility has been fully exploited during the evolution of protozoan pathogens. These eukaryotic pathogens, which cause some of the most globally widespread infectious diseases, have acquired species-specific polyamine-derived metabolites with essential cellular functions and have evolved unique mechanisms that regulate their core polyamine biosynthetic pathways. Many of these parasitic species have lost enzymes and or transporters from the polyamine metabolic pathway that are found in the human host. These pathway differences have prompted drug discovery efforts to target the parasite polyamine pathways, and indeed, the only clinically approved drug targeting the polyamine biosynthetic pathway is used to manage human African trypanosomiasis. This Minireview will primarily focus on polyamine metabolism and function in Trypanosoma, Leishmania, and Plasmodium species, which are the causative agents of human African trypanosomiasis (HAT) and Chagas disease, Leishmaniasis, and malaria, respectively. Aspects of polyamine metabolism across a diverse group of protozoan pathogens will also be explored.

polyamine
protozoan
spermidine
plasmodium
eukaryotic initiation factor 5A (eIF5A)
pseudoenzyme
trypanosome


DNAJC6 Mutations Disrupt Dopamine Homeostasis in Juvenile Parkinsonism-Dystonia.

Abstract:
BACKGROUND
Juvenile forms of parkinsonism are rare conditions with onset of bradykinesia, tremor and rigidity before the age of 21 years. These atypical presentations commonly have a genetic aetiology, highlighting important insights into underlying pathophysiology. Genetic defects may affect key proteins of the endocytic pathway and clathrin-mediated endocytosis (CME), as in DNAJC6-related juvenile parkinsonism.

OBJECTIVE
To report on a new patient cohort with juvenile-onset DNAJC6 parkinsonism-dystonia and determine the functional consequences on auxilin and dopamine homeostasis.

METHODS
Twenty-five children with juvenile parkinsonism were identified from a research cohort of patients with undiagnosed pediatric movement disorders. Molecular genetic investigations included autozygosity mapping studies and whole-exome sequencing. Patient fibroblasts and CSF were analyzed for auxilin, cyclin G-associated kinase and synaptic proteins.

RESULTS
We identified 6 patients harboring previously unreported, homozygous nonsense DNAJC6 mutations. All presented with neurodevelopmental delay in infancy, progressive parkinsonism, and neurological regression in childhood. 123 I-FP-CIT SPECT (DaTScan) was performed in 3 patients and demonstrated reduced or absent tracer uptake in the basal ganglia. CSF neurotransmitter analysis revealed an isolated reduction of homovanillic acid. Auxilin levels were significantly reduced in both patient fibroblasts and CSF. Cyclin G-associated kinase levels in CSF were significantly increased, whereas a number of presynaptic dopaminergic proteins were reduced.

CONCLUSIONS
DNAJC6 is an emerging cause of recessive juvenile parkinsonism-dystonia. DNAJC6 encodes the cochaperone protein auxilin, involved in CME of synaptic vesicles. The observed dopamine dyshomeostasis in patients is likely to be multifactorial, secondary to auxilin deficiency and/or neurodegeneration. Increased patient CSF cyclin G-associated kinase, in tandem with reduced auxilin levels, suggests a possible compensatory role of cyclin G-associated kinase, as observed in the auxilin knockout mouse. DNAJC6 parkinsonism-dystonia should be considered as a differential diagnosis for pediatric neurotransmitter disorders associated with low homovanillic acid levels. Future research in elucidating disease pathogenesis will aid the development of better treatments for this pharmacoresistant disorder. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

DNAJC6 dopamine parkinsonism auxilin dystonia


Human papillomavirus symptomatic infection associated with increased risk of new-onset alopecia areata: A nationwide population-based cohort study.

Abstract:
BACKGROUND
We investigated the correlation between a history of human papillomavirus (HPV) infection and alopecia areata risk.

METHODS
The study cohort comprised 30,001 patients with newly diagnosed HPV infection between 2000 and 2012; and with use of computer-generated randomly numbers, patients not had HPV infection were randomly selected as the comparison cohort. HPV infection cohort were matched to comparison individuals at a 1:1 ratio by age, gender and index year. All study individuals were followed up until they developed alopecia areata, withdraw from the insurance program, lost to follow-up, or until the end of 2013. Cox proportional hazards regression analysis was used to analyze the risk of alopecia areata with hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort.

RESULTS
The adjusted hazard ratio (aHR) of alopecia areata for HPV patients relative to controls was 2.55 (95% C.I. = 1.88-3.47) after adjusting sex, age and comorbidities. Subgroup analysis indicated that patients with HPV infections had a significantly greater risk of alopecia areata for both genders, all age subgroups, and those with mental disorder diseases.

CONCLUSIONS
A history of HPV infection is associated with the development of subsequent alopecia areata in Taiwanese subjects.

Tu|Ting-Yu|TY|
Chang|Renin|R|
Lai|Jung-Nien|JN|
Tseng|Chu-Chiao|CC|
Chen|Ming-Li|ML|
Yip|Hei-Tung|HT|
Hung|Yao-Min|YM|
Cheng-Chung Wei|James|J|

National health insurance research database


Built environmental correlates of cycling for transport across Europe.

Abstract: This cross-sectional study aimed to determine which objective built environmental factors, identified using a virtual neighbourhood audit, were associated with cycling for transport in adults living in five urban regions across Europe. The moderating role of age, gender, socio-economic status and country on these associations was also investigated. Overall, results showed that people living in neighbourhoods with a preponderance of speed limits below 30km/h, many bicycle lanes, with less traffic calming devices, more trees, more litter and many parked cars forming an obstacle on the road were more likely to cycle for transport than people living in areas with lower prevalence of these factors. Evidence was only found for seven out of 56 possible moderators of these associations. These results suggest that reducing speed limits for motorized vehicles and the provision of more bicycle lanes may be effective interventions to promote cycling in Europe.

Mertens|Lieze|L|
Compernolle|Sofie|S|
Deforche|Benedicte|B|
Mackenbach|Joreintje D|JD|
Lakerveld|Jeroen|J|
Brug|Johannes|J|
Roda|Célina|C|
Feuillet|Thierry|T|
Oppert|Jean-Michel|JM|
Glonti|Ketevan|K|
Rutter|Harry|H|
Bardos|Helga|H|
De Bourdeaudhuij|Ilse|I|
Van Dyck|Delfien|D|

Cycling
Active transport
Built environment
Google street view
Virtual audit


Conjugated Coordination Porphyrin-based Nanozymes for Photo-/Sono-Augmented Biocatalytic and Homologous Tumor Treatments.

Abstract: Porphyrin-based nanozymes (Porzymes) have shown promising application potential to fight against tumors using catalytically generated reactive oxygen species from the excessively produced H2O2 in the tumor microenvironment. However, the low coordination porphyrin (CP) loading ratio, difficult controllable nanostructure, low bioavailability, and low biocatalytic activities of current established Porzymes have severely limited their antitumor applications. Here, a novel malignant melanoma cell membrane-coated Pd-based CP nanoplatform (Trojan Porzymes) has been synthesized for biocatalytic and homologous tumor therapies. The Trojan Porzymes exhibit a high CP loading ratio, uniform nanoscale size, single-atom nanostructure, homologous targeted ability, and high-efficiency photo/sono-augmented biocatalytic activities. The enzyme-like biocatalytic experiments display that the Trojan Porzymes can generate abundant •OH via chemodynamic path and 1O2 via visible light or ultrasound excitation. Then we demonstrate that the Trojan Porzymes show homologous targeting ability to tumor cells and can achieve efficient accumulation and long-term retention in cancer tissues. Our in vivo data further disclose that the photo/sono-assisted chemodynamic therapies can significantly augment the treatment efficiency of malignant melanoma. We believe that our work will afford a new biocatalytic and homologous strategy for future clinical malignant melanoma treatments, which may inspire and guide more future studies to develop individualized biomedicine in precise tumor therapies.

porphyrin-based nanozymes
reactive oxygen species
malignant melanoma
biocatalytic and homologous nanoagents
biocatalytic tumor therapies


Comprehensive review of the basic chemical behaviours, sources, processes, and endpoints of trace element contamination in paddy soil-rice systems in rice-growing countries.

Abstract: Rice is the leading staple food for more than half of the world's population, and approximately 160 million hectares of agricultural area worldwide are under rice cultivation. Therefore, it is essential to fulfil the global demand for rice while maintaining food safety. Rice acts as a sink for potentially toxic metals such as arsenic (As), selenium (Se), cadmium (Cd), lead (Pb), zinc (Zn), manganese (Mn), nickel (Ni), and chromium (Cr) in paddy soil-rice systems due to the natural and anthropogenic sources of these metals that have developed in the last few decades. This review summarizes the sources and basic chemical behaviours of these trace elements in the soil system and their contamination status, uptake, translocation, and accumulation mechanisms in paddy soil-rice systems in major rice-growing countries. Several human health threats are significantly associated with these toxic and potentially toxic metals not only due to their presence in the environment (i.e., the soil, water, and air) but also due to the uptake and translocation of these metals via different transporters. Elevated concentrations of these metals are toxic to plants, animals, and even humans that consume them regularly, and the uniform deposition of metals causes a severe risk of bioaccumulation. Furthermore, the contamination of rice in the global rice trade makes this a critical problem of worldwide concern. Therefore, the global consumption of contaminated rice causes severe human health effects that require rapid action. Finally, this review also summarizes the available management/remediation measures and future research directions for addressing this critical issue.

Ali|Waqar|W| Mao|Kang|K| Zhang|Hua|H| Junaid|Muhammad|M| Xu|Nan|N| Rasool|Atta|A| Feng|Xinbin|X| Yang|Zhugen|Z|

Accumulation
Health effects
Paddy soil system
Trace metal contaminants
Transportation mechanisms


Successful tracheal intubation using fiberoptic bronchoscope via an I-gel™ supraglottic airway in a pediatric patient with Goldenhar syndrome -A case report-.

Abstract: The I-gel™ is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gel™ supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gel™ supraglottic airway. The authors suggest that I-gel™ is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway.

Kim|Young-Lok|YL| Seo|Da-Mi|DM| Shim|Kwang-Seok|KS| Kim|Eun-Ju|EJ| Lee|Ji-Hyang|JH| Lee|Sang-Gon|SG| Ban|Jong-Seouk|JS|

Fiberoptic bronchoscope
Pediatric
Goldenhar syndrome
Airway management
Laryngeal mask airway


An overview on Leucosidea sericea Eckl. & Zeyh.: A multi-purpose tree with potential as a phytomedicine.

Abstract:
ETHNOPHARMACOLOGICAL RELEVANCE
Leucosidea sericea (the sole species in this genus) is a tree species found in southern Africa and possesses several therapeutical effects against infectious diseases in humans and livestock. This review aims to document and summarize the botany, phytochemical and biological properties of Leucosidea sericea.

MATERIALS AND METHODS
Using the term 'Leucosidea sericea', we systematically searched literature including library catalogues, academic dissertations and databases such as PubMed, SciFinder, Web of Science, Google Scholar and Wanfang. Taxonomy of the species was validated using 'The Plant List' (www.theplantlist.org).

RESULTS
Leucosidea sericea remains a widely used species among the different ethnic groups in southern Africa. The species is a rich source of approximately 50 essential oils and different classes of phytochemicals (phenolics, phloroglucinols, cholestane triterpenoids, alkaloids and saponins) which may account for their diverse biological properties. Documented biological activities which were mainly observed under in vitro systems included antimicrobial, anti-parasitic, antioxidant, acetylcholinesterase (AChE) inhibition and anti-inflammatory properties. Preliminary safety tests on Leucosidea sericea extracts suggest moderate cytotoxic effects based on a few cell lines that were investigated.

CONCLUSIONS
Leucosidea sericea possesses diverse medicinal potential with the antimicrobial, anti-parasitic, antioxidant and anti-inflammatory activities being the most prominent. The relative abundance and tendency of Leucosidea sericea to evade in nature suggest an abundant reservoir of raw materials for potential commercialization (upon validation of its pharmacological potential). However, more stringent investigations on the extracts (and isolated bioactive compounds) focusing on the mode of actions, which will inevitably unravel their pharmacokinetics, pharmacodynamics and clinical relevance remain pertinent.

Mafole|Tshepiso C|TC|
Aremu|Adeyemi O|AO|
Mthethwa|Thandekile|T|
Moyo|Mack|M|

Essential oil
Antimicrobial
Antioxidants
Anti-inflammatory
Natural product
Rosaceae
Toxicology


Estimation of daily aluminum intake in Japan based on food consumption inspection results: impact of food additives.

Abstract: Dietary aluminum (Al) intake by young children, children, youths, and adults in Japan was estimated using the market basket method. The Al content of food category (I-VII) samples for each age group was determined by inductively coupled plasma-atomic emission spectrometry (ICP-AES). The Al content in processed foods and unprocessed foods ranged from 0.40 to 21.7 mg/kg and from 0.32 to 0.54 mg/kg, respectively. For processed foods in all age groups, the Al content in food category VI samples, sugar and confections/savories, was the highest, followed by those in category II, cereals. The daily dietary Al intake from processed foods was much larger than that from unprocessed foods. The mean weekly percentages of the provisional tolerable weekly intake (PTWI, established by the joint FAO/WHO Expert Committee on Food Additives in 2011) from processed foods for all age groups are 43.1, 22.4, 17.6 and 15.1%, respectively. Only the highest consumer Al exposure value (>P 95) of the young children group exceeded the PTWI.

Sato|Kyoko|K| Suzuki|Ippei|I| Kubota|Hiroki|H| Furusho|Noriko|N| Inoue|Tomoyuki|T| Yasukouchi|Yoshikazu|Y| Akiyama|Hiroshi|H|

Aluminum
food additive
ICP-AES
provisional tolerable weekly intake
dietary intake


Cognitive Dysfunction, Affective States, and Vulnerability to Nicotine Addiction: A Multifactorial Perspective.

Abstract: Although smoking prevalence has declined in recent years, certain subpopulations continue to smoke at disproportionately high rates and show resistance to cessation treatments. Individuals showing cognitive and affective impairments, including emotional distress and deficits in attention, memory, and inhibitory control, particularly in the context of psychiatric conditions, such as attention-deficit hyperactivity disorder, schizophrenia, and mood disorders, are at higher risk for tobacco addiction. Nicotine has been shown to improve cognitive and emotional processing in some conditions, including during tobacco abstinence. Self-medication of cognitive deficits or negative affect has been proposed to underlie high rates of tobacco smoking among people with psychiatric disorders. However, pre-existing cognitive and mood disorders may also influence the development and maintenance of nicotine dependence, by biasing nicotine-induced alterations in information processing and associative learning, decision-making, and inhibitory control. Here, we discuss the potential forms of contribution of cognitive and affective deficits to nicotine addiction-related processes, by reviewing major clinical and preclinical studies investigating either the procognitive and therapeutic action of nicotine or the putative primary role of cognitive and emotional impairments in addiction-like features.

cognition
nicotine
addiction
emotion
psychiatric disorders
predisposition


Phylogenetic analysis of Uncaria species based on internal transcribed spacer (ITS) region and ITS2 secondary structure.

Abstract:
CONTEXT
The plant genus Uncaria (Rubiaceae), also known as Gouteng, is the source of an important traditional Chinese medicine. Misidentification and adulteration of Gouteng affect the safety and efficacy of the medication. Phylogenetic relationships among the species of this genus are unknown.

OBJECTIVE
The present study sought to detect the phylogenetic relationships based on internal transcribed spacer (ITS) region of all 12 species of Uncaria recorded in the Flora of China.

MATERIALS AND METHODS
Accession of seven species of Uncaria served as reference samples. ITS region was used for polymerase chain reaction (PCR) amplification of the reference samples representing 39 specimens. Distance analysis, species discrimination, and secondary structure of ITS2 were used to assess the ability of ITS sequence in authenticating. The phylogenetic relationships were detected using three methods: Bayesian inference (BI), maximum likelihood (ML), and neighbor joining (NJ).

RESULTS
Five species of traditional Chinese medicine Gouteng were well resolved in molecular phylogenetic tree. Besides, Uncaria lancifolia Hutch. was closer to U. rhynchophylloides F.C. How and U. sessilifructus Roxb. was closer to U. laevigata Wall. within the tree. Further, we also found that ITS2 secondary structure can be a candidate tool in distinguishing two closely related species U. yunnanensis K.C.Hsia and U. lanosa Wall. For accurate identification of different species of Uncaria based on species-specific nucleotide sites, a consensus sequences database with all 12 species is established.

DISCUSSIONS AND CONCLUSIONS
The results are able to discriminate Uncaria species and illustrate the phylogenetic relationships, which are essential for the investigation of adulterants and misidentifications of Uncaria.

D058893:DNA Barcoding, Taxonomic
D018744:DNA, Plant
D021903:DNA, Ribosomal Spacer
D020459:Genes, rRNA
D009690:Nucleic Acid Conformation
D010802:Phylogeny
D010946:Plants, Medicinal
D016133:Polymerase Chain Reaction
D032070:Uncaria

discrimination
DNA barcoding
Molecular phylogeny


Social disconnection and metabolic syndrome score among Cambodian Americans with depression.

Abstract:
AIMS
Migrants experience social disconnection and also have high risk for metabolic syndrome (MetS). This study explored associations of social alienation, social isolation, and social support with MetS among Cambodian Americans.

METHODS
We conducted secondary data analysis on baseline assessments from a diabetes prevention trial for Cambodian Americans with depression and high risk for diabetes. Participants were aged 35-75, Cambodian or Cambodian-American, Khmer speaking, lived in Cambodia during the Pol Pot regime, lived in the northeastern U.S. at the time of study, endorsed elevated risk factors for diabetes and met criteria for depression by medication for depression and/or elevated depressive symptoms. They completed surveys and provided anthropometric and blood pressure measurements and fasting blood samples.

RESULTS
In multiple linear regressions, greater social alienation was associated with increased risk for MetS. The social alienation-MetS association was stronger in men than women. Associations were not better accounted for by crude indicators of social isolation such as marital status, living alone, and number of people in the household. Social support was not associated with MetS and did not buffer the deleterious association between social alienation and MetS.

CONCLUSIONS
Decreasing social alienation may mitigate risk for MetS among migrant populations.

Megan Berthold|S|S|
Bermudez-Millan|Angela|A|
Buckley|Thomas|T|
Buxton|Orfeu M|OM|
Feinn|Richard|R|
Kong|Sengly|S|
Kuoch|Theanvy|T|
Scully|Mary|M|
Seng|Kagnica|K|
Wagner|Julie|J|

Metabolic syndrome
Cambodian
Depression
Social alienation
Social support
Diabetes


Studies in Australian Tettigoniidae: New Fully-winged Agraeciini From North-eastern Australia (Orthoptera: Tettigoniidae; Conocephalinae; Agraeciini).

Abstract: Four new genera including five new species are described. All are from north-eastern Queensland. Barbaragraecia comprises two new species. B. unicorn Rentz Su, gen. et sp. nov. (the type species) and B. richardsoni Rentz Su, sp. nov. Geoffagraecia is known from a single species, G. gwinganna Rentz Su, sp. nov. the type species. Greenagraecia Rentz Su, gen. et sp. nov. is known from two species, G. attenuata Rentz Su, gen. et sp. nov., the type species and G. cooloola Rentz Su, gen. et sp. nov.. The unrelated genus Nicsara Walker 1869 is discussed and species with falcate ovipositors are removed and placed in a new genus, Larifugagraecia Rentz Su gen. nov., with Nicsara spuria Redtenbacher 1891 designated as the type species. Two species are removed from Nicsara and placed in Larifugagraecia. These are N. cornuta (Redtenbacher 1891) and N. spuria. Other species remain in Nicsara until they can be further assessed. Biological and ecological notes accompany detailed descriptions of the new species along with many morphological illustrations. Illustrations also are provided for L. spuria gen. nov. A key to the described fully-winged Australian agraeciine genera is provided at the end of the paper.

Orthoptera, Agraeciini, new genera and species, Queensland Tettigoniidae


Assessing the drivers of dissolved organic matter export from two contrasting lowland catchments, U.K.

Abstract: Two lowland catchments in the U.K. were sampled throughout 2010-11 to investigate the dominant controls on dissolved organic matter quantity and composition. The catchments had marked differences in terms of nutrient status, land cover and contrasting lithologies resulting in differences in the dominant flow pathways (groundwater vs. surface water dominated). The Upper Wylye is a chalk stream with a baseflow index of 0.98, draining a catchment dominated by intensive agricultural production. Millersford Brook is a lowland peat catchment with a baseflow index of 0.43, draining a semi-natural catchment with heather moorland and coniferous forest. Samples were collected weekly between October 2010 and September 2011 from eleven sampling locations. Samples were analysed to determine dissolved organic carbon, nitrogen and phosphorus fractions with DOM composition evaluated via the DOC:DON ratio, DOC:DOP ratio, specific UV absorption at 254nm, absorbance ratio (a250:a365) and the spectral slope parameter between 350 and 400nm (S350-400). Significant differences were observed in all determinands between the catchments, over time, and spatially along nutrient enrichment and geoclimatic gradients. Seasonal variation in preferential flow pathways mobilising groundwater-derived DOM were identified as likely controls on the delivery of DOM in the permeable chalk dominated catchment. Steeper S350-400 values and elevated a250:a365 ratios in this catchment suggest material of a lower bulk aromatic C content and molecular weight delivered during the winter months when compared to the summer. DOC:DON ratios were markedly lower in the chalk catchment than the peatland catchment, reflecting the paucity of organic matter within the mineral soils of the chalk landscape, and higher fertiliser application rates. This manuscript highlights that DOM composition varies according to catchment landscape character and hydrological function.

Yates|Christopher A|CA|
Johnes|Penny J|PJ|
Spencer|Robert G M|RGM|

Dissolved organic matter
Carbon
Nitrogen
Phosphorus
CDOM


Antibacterial Activity against Staphylococcus Aureus of Titanium Surfaces Coated with Graphene Nanoplatelets to Prevent Peri-Implant Diseases. An In-Vitro Pilot Study.

Abstract: Dental implants are one of the most commonly used ways to replace missing teeth. Nevertheless, the close contact with hard and soft oral tissues expose these devices to infectious peri-implant diseases. To prevent such infection, several surface treatments have been developed in the last few years to improve the antimicrobial properties of titanium dental implants. In this in-vitro pilot study, the antimicrobial activity of titanium surfaces coated with different types of graphene nanoplatelets are investigated. Six different colloidal suspensions of graphene nanoplatelets (GNPs) were produced from graphite intercalated compounds, setting the temperature and duration of the thermal shock and varying the number of the exfoliation cycles. Titanium disks with sand-blasted and acid-etched surfaces were sprayed with 2 mL of colloidal GNPs suspensions. The size of the GNPs and the percentage of titanium disk surfaces coated by GNPs were evaluated through a field emission-scanning electron microscope. The antibacterial activity of the specimens against Staphylococcus aureus was estimated using a crystal violet assay. The dimension of GNPs decreased progressively after each sonication cycle. The two best mean percentages of titanium disk surfaces coated by GNPs were GNPs1050°/2 and GNPs1150°/2. The reduction of biofilm development was 14.4% in GNPs1150°/2, 20.1% in GNPs1150°/3, 30.3% in GNPs1050°/3, and 39.2% in GNPs1050°/2. The results of the study suggested that the surface treatment of titanium disks with GNPs represents a promising solution to improve the antibacterial activity of titanium implants.

graphene nanoplatelets antibacterial surface


Elastofibroma Dorsi: A Rare Connective Tissue Tumor.

Abstract: Elastofibroma dorsi (ED) is a benign connective tissue tumor that most commonly occurs on the inferior pole of the scapula. It can be found incidentally on radiologic imaging or due to clinical symptoms. Patients may become apprehensive due to it mimicking new malignancy or recurrence of prior malignancy. Treatment is only recommended in symptomatic cases and biopsy is usually unnecessary. We present a case of a 70-year-old female status-post lung cancer resection who was found to have a lump at the inferior pole of her right scapula. She was seen by multiple different specialties and subsequently, a biopsy confirmed her mass to be consistent with ED. Since ED is a benign soft tissue tumor, educating physicians is of utmost importance to avoid pursuing unnecessary diagnosis and to thereby decrease the cost of care to the patient. Therapeutic excision should only be performed in symptomatic patients and observing these lesions in asymptomatic patients would be sufficient.

Suliman|Mohamed S|MS|
Higginbothom|Zachary S|ZS|
Amro|Ahmed|A|
McCorkle|Colin|C|
Saunders|Elizabeth|E|

elastofibroma
benign tumor
soft tissue mass


Making matters of fraud: Sociomaterial technology in the case of Hwang and Schatten.

Abstract: This paper revisits the "Hwang case," which shook Korean society and the world of stem cell research in 2005 with the fraudulent claim of creating patient-specific embryonic stem cells. My goal is to overcome a human-centered, Korea-oriented narrative, by illustrating how materials can have an integral role in the construction and judgment of fraud. To this end, I pay attention to Woo Suk Hwang's lab at Seoul National University as a whole, including human and nonhuman agents, that functioned as what I call sociomaterial technology, and Gerald P. Schatten at the University of Pittsburgh, Hwang's collaborator, who played a crucial role in demonstrating the potency of this technology to the members of the scientific community. By recasting the whole event as the "case of Hwang and Schatten," I argue that fraud is, like all knowledge claims, a sociotechnical construct, and that matters of fraud are locally judged. Fraud leaves its mark on materials, but I show that material evidence alone never tells the whole story and instead can be used to limit the range of responsibility.

sociomaterial technology
stem cell
materiality
Woo Suk Hwang
Gerald Schatten
Scientific fraud
ethics
research integrity


Quantum Dot Emission Driven by Mie Resonances in Silicon Nanostructures.

Abstract: Resonant dielectric nanostructures represent a promising platform for light manipulation at the nanoscale. In this paper, we describe an active photonic system based on Ge(Si) quantum dots coupled to silicon nanodisks. We show that Mie resonances govern the enhancement of the photoluminescent signal from embedded quantum dots due to a good spatial overlap of the emitter position with the electric field of Mie modes. We identify the coupling mechanism, which allows for engineering the resonant Mie modes through the interaction of several nanodisks. In particular, the mode hybridization in a nanodisk trimer results in an up to 10-fold enhancement of the luminescent signal due to the excitation of resonant antisymmetric magnetic and electric dipole modes.

Mie resonances
Silicon nanodisks
oligomer nanostructures
photoluminescence enhancement
quantum emitters
self-assembled quantum dots


Cytotoxicity of chlorhexidine and neem extract on cultured human gingival fibroblasts through fluorescence-activated cell sorting analysis : An in-vitro study.

Abstract:
Objective
To assess the influence of chlorhexidine (CHX), neem vehicle control (NVC), and neem extract (NE) on cultured human gingival fibroblasts (hGFs) using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and fluorescence-activated cell sorting (FACS) analysis.

Materials and Methods
Fibroblasts were derived from healthy gingival biopsy specimens harvested aseptically. The effects of CHX, NVC, and NE were evaluated on cultured hGFs through FACS and MTT assay.

Results
MTT assay with hGFs indicated altered morphology with maximum cell death at 10% CHX, while NVC and NE showed similar results at a concentration of 75% and above. On FACS analysis, beyond 1%, CHX adversely affected the cell cycle phase distribution whereas NE exerted a detrimental effect only at 100%. Moreover, both with NVC and NE cells were well differentiated in all the three phases of the cell cycle, with distinction getting lost at 50% to finally causing cell death at 100%.

Conclusions
CHX beyond 1% concentration exhibited a toxic effect on hGFs at 1, 5, and 15 min time exposure. However, NE did not adversely affect the fibroblasts even up to 50% concentration showing a less toxic effect in comparison with CHX on these cells. The cytoprotective and oral friendly quality of NE emphaisze the superiority of NE over CHX.

Verma|Umesh Pratap|UP|
Gupta|Abhaya|A|
Yadav|Rakesh Kumar|RK|
Tiwari|Rini|R|
Sharma|Ramesh|R|
Balapure|Anil Kumar|AK|


Application of systematic evidence mapping to assess the impact of new research when updating health reference values: A case example using acrolein.

Abstract:
BACKGROUND
The environmental health community needs transparent, methodologically rigorous, and rapid approaches for updating human health risk assessments. These assessments often contain reference values for cancer and/or noncancer effects. Increasingly, the use of systematic review methods are preferred when developing these assessments. Systematic evidence maps are a type of analysis that has the potential to be very helpful in the update process, especially when combined with machine-learning software advances designed to expedite the process of conducting a review.

OBJECTIVES
To evaluate the applicability of evidence mapping to determine whether new evidence is likely to result in a change to an existing health reference value, using inhalation exposure to the air pollutant acrolein as a case example.

METHODS
New literature published since the 2008 California Environmental Protection Agency's Office of Environmental Health Hazard Assessment (OEHHA) Reference Exposure Level (REL) for acrolein was assessed. Systematic review methods were used to search the literature and screening included the use of machine-learning software. The Populations, Exposures, Comparators and Outcomes (PECO) criteria were kept broad to identify studies that characterized acute and chronic exposure and could be informative for hazard characterization. Studies that met the PECO criteria after full-text review were briefly summarized before their suitability for chronic point of departure (POD) derivation and calculation of a reference value was considered. Studies considered potentially suitable underwent a targeted evaluation to determine their suitability for use in dose-response analysis.

RESULTS
Over 15,000 studies were identified from scientific databases. Both machine-learning and manual screening processes were used to identify 60 studies considered PECO-relevant after full-text review. Most of these PECO-relevant studies were short-term exposure animal studies (acute or less than 1 month of exposure) and considered less suitable for deriving a chronic reference value when compared to the subchronic study in rats used in the 2008 OEHHA assessment. Thirteen epidemiological studies were identified but had limitations in the exposure assessment that made them less suitable for dose-response compared to the subchronic rat study. Among the 13 studies, there were four controlled trial studies that have the potential to be informative for future acute reference value derivation. Thus, the 2008 subchronic rat study used by OEHHA appears to still be the most appropriate study for chronic reference value derivation. In addition, advances in dosimetric modeling for gases, including new evidence pertinent to acrolein, could be considered when updating existing acrolein toxicity values.

CONCLUSIONS
Evidence mapping is a very useful tool to assess the need for updating an assessment based on understanding the potential impact of new studies on revising an existing health reference value. In this case example, the focus was to identify studies suitable for chronic exposure dose-response analysis, while also identifying studies that may be important to consider for acute exposure scenarios, hazard identification, or for future research. This allows the evidence map to be a useful resource for a range of decision-making contexts. Specialized systematic review software increased the efficiency of the process in terms of human resources and time to conduct the analysis.

Keshava|Channa|C|
Davis|J Allen|JA|
Stanek|John|J|
Thayer|Kristina A|KA|
Galizia|Audrey|A|
Keshava|Nagalakshmi|N|
Gift|Jeff|J|
Vulimiri|Suryanarayana V|SV|
Woodall|George|G|
Gigot|Carolyn|C|
Garcia|Kelly|K|
Greenhalgh|Andrew|A|
Schulz|Brittany|B|
Volkoff|Savannah|S|
Camargo|Krisa|K|
Persad|Amanda S|AS|

Evidence map
Risk assessment
Systematic review
Hazard characterization
Hazardous air pollutant


Training programme designs in professional team sport: An ecological dynamics exemplar.

Abstract: Ecological dynamics is a contemporary theory of skill acquisition, advocating the mutuality of the performer-environment system, with clear implications for the design of innovative training environments in elite sport. It contends that performance behaviours emerge, and are adapted, by athletes satisfying a confluence of constraints impacting on their structural and functional capacities, the physics of a performance environment and the intended task goals. This framework implicates contemporary models of coaching, training design and sport science support, to stimulate continuous interactions between an individual and performance environment, predicated on representative learning designs (RLD). While theoretical principles of RLD in ecological dynamics are tangible, their practical application in elite and high level (team) sports need verification. Here, we exemplify how data sampled from a high-performance team sport setting could underpin innovative methodologies to support practitioners in designing representative training activities. We highlight how the use of principles grounded within ecological dynamics, along with data from performance analytics, could suggest contemporary models of coaching and preparation for performance in elite sport.

Woods|Carl T|CT|
McKeown|Ian|I|
Shuttleworth|Richard J|RJ|
Davids|Keith|K|
Robertson|Sam|S|

Ecological dynamics
Skill acquisition
Representative learning design
Constraints-led approach
Interdisciplinarity
Localised interactions
Performance analysis


Coronary artery disease detection - limitations of stress testing in left ventricular dysfunction.

Abstract: Incidental diagnosis of left ventricular systolic dysfunction (LVD) is common in clinical practice. The prevalence of asymptomatic LVD (Ejection Fraction, EF < 50%) is 6.0% in men and 0.8% in women and is twice as common as symptomatic LVD. The timely and definitive exclusion of an ischemic etiology is central to optimizing care and reducing mortality in LVD. Advances in cardiovascular imaging provide many options for imaging of patients with left ventricular dysfunction. Clinician experience, patient endurance, imaging modality characteristics, cost and safety determine the choice of testing. In this review, we have compared the diagnostic utility of established tests - nuclear and echocardiographic stress testing with newer techniques like coronary computerized tomography and cardiac magnetic resonance imaging and highlight their inherent limitations in patients with underlying left ventricular dysfunction.

Coronary artery disease
Stress testing
Left ventricular dysfunction
Dobutamine stress echocardiography
Myocardial perfusion imaging


Scaphoid overstuffing: the effects of the dimensions of scaphoid reconstruction on scapholunate alignment.

Abstract:
PURPOSE
Osteochondral replacement of the proximal scaphoid has been reported using a vascularized flap from the medial femoral trochlea. A concern with this technique is the loss of stability of the scapholunate relationship with resection of the scaphoid proximal pole. Overexpansion of the scaphoid dimensions (overstuffing) during scaphoid reconstruction with the osteochondral flap may play a role in maintaining scapholunate alignment. Our purpose was to determine if overstuffing the scaphoid can correct rotatory carpal instability in a cadaveric model studied radiographically.

METHODS
The radiolunate angle and scapholunate interval were measured for 5 fresh cadaver wrists. We completely incised the scapholunate interosseous ligament and performed an osteotomy to excise the proximal third of the scaphoid to simulate a proximal pole deficiency nonunion and create a dorsal intercalated segmental instability deformity. Radiographic measurements were repeated. The proximal pole of the scaphoid was replaced with its original piece of bone; radiographic measurements were repeated without scapholunate ligament repair. The osteotomy site was overstuffed with a 4-mm sawbone spacer without scapholunate ligament repair, and radiographs were obtained.

RESULTS
Sectioning of scapholunate ligaments and proximal pole excision successfully created carpal instability demonstrated by abnormal radiolunate angles. Without ligament repair, proximal pole replacement did not restore normal radiolunate angles. Expansion of the scaphoid dimensions corrected radiolunate angles on lateral unloaded radiographs and improved scapholunate intervals on clenched fist radiographs. These findings were statistically significant compared with the unexpanded (replaced) scaphoid.

CONCLUSIONS
These findings suggest that scaphoid reconstruction that results in expansion of the scaphoid's normal dimensions will restore carpal alignment without scapholunate ligament reconstruction.

CLINICAL RELEVANCE
Osteochondral reconstruction of difficult proximal pole nonunions may not require any preservation or reconstruction of scapholunate integrity if the reconstruction expands the normal dimensions of the native scaphoid. Scapholunate interval and carpal alignment may be restored by scaphoid over stuffing. The effects on increased contact pressure and range of motion require further investigation.

Capito|Anthony E|AE|
Higgins|James P|JP|

dorsal intercalated segmental instability (DISI)


A critical review of state-of-the-art electrocoagulation technique applied to COD-rich industrial wastewaters.

Abstract: Electrocoagulation (EC) is one of the emerging technologies in groundwater and wastewater treatment as it combines the benefits of coagulation, sedimentation, flotation, and electrochemical oxidation processes. Extensive research efforts implementing EC technology have been executed over the last decade to treat chemical oxygen demand (COD)-rich industrial wastewaters with the aim to protect freshwater streams (e.g., rivers, lakes) from pollution. A comprehensive review of the available recent literature utilizing EC to treat wastewater with high COD levels is presented. In addition, recommendations are provided for future studies to improve the EC technology and broaden its range of application. This review paper introduces some technologies which are often adopted for industrial wastewater treatment. Then, the EC process is compared with those techniques as a treatment for COD-rich wastewater. The EC process is considered as the most privileged technology by different research groups owing to its ability to deal with abundant volumes of wastewater. After, the application of EC as a single and combined treatment for COD-rich wastewaters is thoroughly reviewed. Finally, this review attempts to highlight the potentials and limitations of EC. Related to the EC process in batch operation mode, the best operational conditions are found at 10 V and 60 min of voltage and reaction time, respectively. These last values guarantee high COD removal efficiencies of > 90%. This review also concludes that considerably large operation costs of the EC process appears to be the serious drawback and renders it as an unfeasible approach for handling of COD rich wastewaters. In the end, this review has attempted to highlights the potential and limitation of EC and suggests that vast notably research in the field of continuous flow EC system is essential to introduce this technology as a convincing wastewater technology.

Mousazadeh|Milad|M|
Niaragh|Elnaz Karamati|EK|
Usman|Muhammad|M|
Khan|Saif Ullah|SU|
Sandoval|Miguel Angel|MA|
Al-Qodah|Zakaria|Z|
Khalid|Zaied Bin|ZB|
Gilhotra|Vishakha|V|
Emamjomeh|Mohammad Mahdi|MM|

D057919:Biological Oxygen Demand Analysis

Electrocoagulation
Wastewater treatment
COD-rich wastewater
COD removal
Environmental pollution


Dietary chia (Salvia hispanica L.) improves the nutritional quality of broiler meat.

Abstract:
OBJECTIVE
The current study was conducted to evaluate the quality and profile of fatty acid in the breast and thigh, and the performance of broilers fed diets containing seed or oil of chia (Salvia hispanica L.) as a replacement for soybean, in the rearing period from 29 to 42 days of age.

METHODS
On the 29th day of age, 120 broilers were distributed in four treatments evaluated in five replicates of six birds. The grain or oil of soybean was respectively replaced on a weightto-weight basis in the formulation by the seed or oil of chia, constituting the experimental diets. The roasted whole soybean and chia seed were included in the feed at 16.4%, whereas the soybean and chia oils were included at 2.5%.

RESULTS
The dietary chia oil increased the lipid peroxidation in the thigh meat, and the dietary chia seed increased the cooking loss of the thigh. However, for the other physicochemical parameters evaluated and for the proximate composition of the breast and thigh, in general, the inclusion of chia seed or oil in the diet provided similar or better results than those observed when the diets contained soybean oil or roasted whole soybean. With regard to the fatty acid profile and associated parameters, dietary chia increased the concentrations of α-linolenic, eicosapentaenoic, and docosahexaenoic acids and reduced the Σω-6:Σω-3 ratio and the atherogenicity and thrombogenicity indices of the broiler meat. However, the dietary chia seed worsened the feed conversion ratio.

CONCLUSION
Diet containing 2.5% chia oil supplied to broilers during the period from 29 to 42 days of age improves the feed conversion ratio, increases the deposition of the ω-3 fatty acids in the breast and thigh, in addition to reducing the Σω-6:Σω-3 ratio and the atherogenicity and thrombogenicity indices, thereby resulting in meat with higher nutritional quality.

Mendonça|Nicole Batelli de Souza Nardelli|NBSN|

Chia Seed
Chia Oil
Fatty Acid Profile
ω-3
Food Enrichment
Omega-3


Intranasal fluticasone associated with delayed tympanostomy tube placement in children with eustachian tube dysfunction.

Abstract:
OBJECTIVES
Pediatric patient caregivers may prefer to avoid a surgical intervention and request a medical management option for eustachian tube dysfunction (ETD). However, there are limited published data evaluating the efficacy of intranasal fluticasone in the medical management of ETD as an alternative to tympanostomy tube placement. The objectives of this study were to: 1) determine if intranasal fluticasone (INF) prevented tympanostomy tube placement in children with ETD, and 2) describe differences in patient response to INF related to cleft lip and/or palate (CLP) and Down syndrome.

METHODS
Case series with planned chart review at a Tertiary academic hospital. We reviewed pediatric patients treated with INF for ETD. Inclusion criteria included ETD, no prior intranasal or oral steroid therapy, and no prior tympanostomy tube placement. Outcomes included time-to- tympanostomy tube placement with or without INF and therapy compliance. Kaplan-Meier survival analyses with log-rank tests and Fisher's exact tests were used to examine outcome variables.

RESULTS
676 fulfilled inclusion criteria. 393 (58.7%) were male, and 355 (52.5%) Caucasian with mean age of 27.1 months old. 92 (13.6%) had CLP and 46 (6.8%) had Down Syndrome. 266 (39.4%) received INF, and 202 (88.2%) were compliant at their next visit. 474 (70.1%) had tympanostomy tubes placed. Children treated with INF were less likely to have tympanostomy tubes placed than children not treated (52.6% vs. 81.5%; p < 0.0001). Using survival analyses, INF use was associated with significantly longer mean time-to-tympanostomy tube than no INF use (199.4 vs. 133.7 days; p < 0.0001). INF did not reduce time-to-tympanostomy tube in patients with CLP (p = 0.05) or Down Syndrome (p = 0.27).

CONCLUSION
INF significantly reduces the number of children requiring tympanostomy tube placement for ETD. The CLP and Down Syndrome anatomical variants may attenuate INF efficacy. Further in vivo characterization of INF action on eustachian tube tissues will help further substantiate these observations.

Crowson|Matthew G|MG|
Ryan|Marisa A|MA|
Ramprasad|Vaibhav H|VH|
Choi|Kevin J|KJ|
Raynor|Eileen|E|

Fluticasone
Eustachian tube dysfunction
Intranasal steroids


Capability of different non-nutritive feed additives on improving productive and physiological traits of broiler chicks fed diets with or without aflatoxin during the first 3 weeks of life.

Abstract: An experiment was conducted to determine whether some non-nutritive feed additives (NNFA) could block the adverse effects of aflatoxin (AF) on growth performance and physiological parameters of Cobb broilers throughout the period from 1 to 21 day of age. There were eight treatments consisting of two levels of AF at 0 and 200 ppb and four NNFA within each AF level. These additives included mannan oligosaccharides (MOS) at 2 g/kg diet, hydrated sodium calcium aluminosilicate (HSCAS) at 2 g/kg diet and Lactobacillus acidophilus (Lac) at 2 g/kg diet. At 21 day of age, five chickens of each treatment were slaughtered to study dressing percentage and relative weight of inner organs and glands. AF had a significant negative effect on body weight gain (BWG), and feed intake, while impairing feed conversion ratio (FCR). Aflatoxin significantly increased percentage liver, lymphocyte (%), monocyte (%), serum triglyceride level, and the aspartate aminotransferase (AST), and alanine aminotransferase (ALT), concentrations while decreasing dressing percentage, intestinal percentage, white blood cells (WBCs), red blood cells (RBCs), haemoglobin (Hgb), packed cell volume (PCV), heterophil (%), heterophil/lymphocyte ratio, total serum protein and serum albumin. Aflatoxin adversely affected the morphology of the liver, bursa and the thymus. There was a significant interaction between AF and NNFA on the relative weights of liver, heart and intestine. Lac completely blocked the negative effects of AF on the percentage liver and the heart and partially on the intestine. In conclusion, Lac was most effective in reversing the adverse effects of AF on growth and FCR and on the percentage, functions and morphology of the liver. Hydrated sodium calcium aluminosilicate also improved the economic traits of broilers but was less effective than Lac and more effective than MOS.

Attia|Y A|YA|
Allakany|H F|HF|
Abd Al-Hamid|A E|AE|
Al-Saffar|A A|AA|
Hassan|R A|RA|
Mohamed|N A|NA|

D000824:Animal Nutritional Physiological Phenomena

feed additives
broilers
aflatoxin
blood constituents
productive performance


Acellular Human Amniotic Membrane Scaffold with 15d-PGJ2 Nanoparticles in Postinfarct Rat Model.

Abstract: The difficulty in the regeneration of cardiomyocytes after myocardial infarction is a major cause of heart failure. Together, the amniotic membrane and 15-deoxy-Δ12,14-prostaglandin J2 (15d-PGJ2) can help in the recovery of cardiomyocyte, as they present many growth factors and anti-inflammatory effect, respectively. The objective of this study is to compare the efficacy of Human Decellularized Amniotic Membrane Scaffold (AHAS) loaded with 15d-PGJ2 in improving ventricular function in a rat model of postinfarct ventricular dysfunction. Myocardial infarction was induced in 24 rats by left coronary occlusion. After a week, the animals were subjected to echocardiography for evaluation of left ventricle ejection fraction (LVEF), left ventricle end diastolic volume (LVEDV), and left ventricle end systolic volume (LVESV). Animals with ejection fraction <40% were included in the study and were randomized into three groups: control (n = 8), AHAS (n = 8) and AHAS +15d-PGJ2 (n = 8). In the AHAS group only the membrane was implanted, whereas in the AHAS +15d-PGJ2 the membrane +15d-PGJ2 was implanted on myocardial infarction. Echocardiographic evaluation was performed after 1 month. For histological analysis, heart tissue was stained with Gomori trichome, Sirius Red, the antibody against CD31 and connexin 43 (Cx43). There were no significant differences in the baseline LVEF, LVEDV, and LVESV in all groups. After 1 month, ejection fraction decreased in the control group but increased in the AHAS group and in the AHAS +15d-PGJ2 group in comparison with the control group. The LVEDV and LVESV in the AHAS and AHAS +15d-PGJ2 groups decreased compared with the control group, featuring a ventricular antiremodeling effect. Histopathology of the infarcted area identified the reduction of infarct size and collagen type 1 in the AHAS and AHAS +15d-PGJ2 groups. New blood vessels and cardiomyocytes have been identified in an infarcted area by CD31 and Cx43. AHAS +15d-PGJ2 provided an increase in the ejection fraction and prevented ventricular dilation in this postinfarction ventricular dysfunction model. Impact Statement Our study demonstrated reduction of myocardial fibrosis, proliferation of cardiomyocytes and increase in ejection fraction in rats after experimental acellular amniotic membrane scaffold (AHAS) carrying nanoparticles of 15d-PGJ2 scaffold engraftment in infarcted myocardium. AHAS grafts facilitated colonization of fibrotic myocardium regions with new contractile cells, in addition to preventing reduction of left ventricle wall thickness. This contribution is theoretically and practically relevant as current literature describes experimental studies performed on cardiac ischemic models which present conflicting results concerning cell types used in a research model.

15d-PGJ2
myocardial infarction
heart
anti-inflammatory
PPAR-γ


Stronger left-hemisphere lateralization in older versus younger adults while processing conventional metaphors.

Abstract: Thirty younger (age 20-30) and 30 older (age 69-85) right-handed Hebrew speakers performed a semantic judgement task while processing literal word pairs and conventional metaphors, presented in the divided visual field paradigm. Older adults responded more accurately to conventional metaphors in the right visual field/left hemisphere versus the left visual field/right hemisphere, whereas younger adults showed no lateralization. Vocabulary scores cancelled group differences in lateralization. An additional lexical decision task replicated the main finding of left-hemisphere lateralization in older but not in younger participants. We suggest that accumulated knowledge increases left-hemisphere lateralization on tasks of language comprehension in older relative to younger adults.

Ageing
Divided visual field
Language
Hemispheric asymmetry


Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study.

Abstract: Complex multimorbidity (CMM) has been proposed as a more nuanced concept of multimorbidity (MM). We sought to quantify the association of CMM and MM on the incidence of long-term care (LTC) needs in a cohort of older Japanese people. Our follow-up was based on a nationwide longitudinal cohort study of people aged over 65 years who were functionally dependent at baseline. Our outcome was incident LTC needs, based on certification under the Japanese LTC insurance scheme. We used both propensity score matching and inverse probability of treatment weights (IPTW) to compare individuals with and without MM versus CMM. A total of 38,889 older adults were included: 20,233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In propensity-matched analyses, both MM (n = 15,666 pairs) and CMM (n = 7524 pairs) were statistically significantly associated with the six-year LTC insurance certification rate (MM, hazard ratio (HR) 1.07, 95% confidence interval (95%CI) 1.02-1.12; CMM, HR 1.10, 95%CI 1.04-1.16). Both MM and CMM were associated with a modest but statistically significantly higher rate of LTC insurance certification. These findings support the inclusion of multimorbidity in the assessment of LTC insurance needs, although the Japanese government currently has not adopted this.

Kato|Daisuke|D|0000-0002-2449-0548 Kawachi|Ichiro|I| Saito|Junko|J| Kondo|Naoki|N|

complex multimorbidity
multimorbidity
long-term care needs


The role of surface implant treatments on the biological behavior of SaOS-2 osteoblast-like cells. An in vitro comparative study.

Abstract:
OBJECTIVES
The aim of this study was an in vitro comparison of osteoblast adhesion, proliferation and differentiation related to six dental implants with different surface characteristics, and to determine if the interaction between cells and implant is influenced by surface structure and chemical composition.

MATERIAL AND METHODS
Six types of implants were tested, presenting four different surface treatments: turned, sandblasted, acid-etched, anodized. The implant macro- and microstructure were analyzed using SEM, and the surface chemical composition was investigated using energy-dispersive X-ray analysis. SaOS-2 osteoblasts were used for the evaluation of cell adhesion and proliferation by SEM, and cell viability in contact with the various surfaces was determined using cytotoxicity MTT assays. Alkaline phosphatase (ALP) enzymatic activity in contact with the six surfaces was evaluated. Data relative to MTT assay and ALP activity were statistically analyzed using Kruskal-Wallis not parametric test and Nemenyi-Damico-Wolfe-Dunn post hoc test.

RESULTS
All the implants tested supported cell adhesion, proliferation and differentiation, revealing neither organic contaminants nor cytotoxicity effects. The industrial treatments investigated changed the implant surface microscopic aspect and SaOS-2 cell morphology appeared to be influenced by the type of surface treatment at 6, 24, and 72 h of growth. SaOS-2 cells spread more rapidly on sandblasted surfaces. Turned surfaces showed the lowest cell proliferation at SEM observation. Sandblasted surfaces showed the greatest ALP activity values per cell, followed by turned surfaces (P < 0.05).

CONCLUSIONS
On the base of this in vitro investigation, differently surfaced implants affected osteoblast morphology, adhesion, proliferation, and differentiation. Sandblasted surfaces promoted the most suitable osteoblast behavior.

Conserva|Enrico|E| Menini|Maria|M| Ravera|Giambattista|G| Pera|Paolo|P|

D000134:Acid Etching, Dental
D000469:Alkaline Phosphatase
D000537:Aluminum Oxide
D002448:Cell Adhesion
D002454:Cell Differentiation
D045744:Cell Line, Tumor
D002465:Cell Movement
D049109:Cell Proliferation
D048430:Cell Shape
D002470:Cell Survival
D004396:Coloring Agents
D045662:Dental Etching
D015921:Dental Implants
D003764:Dental Materials
D017267:Dental Prosthesis Design
D055664:Electrochemical Techniques
D004577:Electron Probe Microanalysis
D006801:Humans
D008855:Microscopy, Electron, Scanning
D010006:Osteoblasts
D010100:Oxygen
D013499:Surface Properties
D013778:Tetrazolium Salts
D013844:Thiazoles
D014025:Titanium

osteoblasts
proliferation
differentiation
dental implants
implant surface


The Effects of Multimedia-Based Puberty Health Education on Male Students' Self-Esteem in the Middle School.

Abstract:
Background
Adolescents, as a large group of the world population, face many physical and psychological changes in their puberty period. They struggle with adjusting to the intensive changes that can lead to the development of low self-esteem. This study was conducted to determine the effect of multimedia-based puberty health education on male students' self-esteem in the middle school.

Methods
It is a quasi-experimental study by using multi-stage sampling method which was done on 118 boys from two middle schools in Ilam (an Iranian city) from November 2017 to April 2018. Students were divided into two intervention (N=58) and control (N=60) groups. Then, the intervention group students were trained using a multimedia application. Data were gathered using a demographic questionnaire and Rosenberg's Self-Esteem Scale completed by students in three phases including before, immediately after, and three months after the end of the educational program. The collected data were analyzed using independent t-test, Chi-square, Fisher's exact test, post hoc test, and repeated measures ANOVA. Statistical analysis was performed using SPSS 16, and P<0.05 was considered significant.

Results
Mean and standard deviation of the self-esteem scores in the intervention and control groups were 28.37±3.58 and 27.89±3.82 before the education, 32.17±3.12 and 27.50±3.56 immediately after the education, and 33.83±3.32 as well as 27.32±4.37 three months later, respectively. Mean self-esteem scores were significantly different post-intervention (P<0.001) and three months later (P<0.001) between the two groups.

Conclusion
Education on puberty health assisted by multimedia application can increase self-esteem in adolescent boys.

Alimohammadi|Mahsa|M|
Neisani Samani|Leila|L|
Khanjari|Sedighe|S|
Haghani|Hamid|H|

Puberty
Health education
Self-esteem
Adolescent
Multimedia


Familial link of otitis media requiring tympanostomy tubes.

Abstract:
OBJECTIVES/HYPOTHESIS
Placement of tympanostomy tubes for recurrent or chronic otitis media is the most commonly performed ambulatory procedure in the United States. Etiologies have been speculated to be environmentally based, and studies have suggested a genetic component to the disease. However, no large-scale studies have attempted to define a familial component. The objective of this study was to determine the familial risk of otitis media requiring tympanostomy tubes (OMwTT) in a statewide population.

STUDY DESIGN
Retrospective observational cohort study with population-based matched controls.

METHODS
Using an extensive genealogical database linked to medical records, the familial risk of OMwTT was calculated for relatives of probands (46,249 patients diagnosed with OMwTT from 1996-2013) compared to random population controls matched 5:1 on sex and birth year from logistic regression models.

RESULTS
The median age at time of tympanostomy tube placement was 1 year (interquartile range, 0-2 years). First-degree relatives of patients with OMwTT, primarily siblings, had a 5-fold increased risk of OMwTT (P < 10-16 ). Second-degree relatives were at a 1.5-fold increased risk (P < 10-15 ). More extended relatives (third, fourth and fifth degree) showed a 1.4-fold increased risk (P < 10-15 ).

CONCLUSIONS
In the largest population-based study to date, a significant familial risk is confirmed in OMwTT, suggesting otitis media may have a significant genetic component given the increased risk found in close as well as distant relatives. This could be influenced by shared environments given a five-times risk observed in siblings. Further understanding the genetic basis of OMwTT and its interplay with environmental factors may clarify the etiology and lead to better detection of disease and treatments.

LEVEL OF EVIDENCE
3b. Laryngoscope, 127:962-966, 2017.

Padia|Reema|R|
Alt|Jeremiah A|JA|
Curtin|Karen|K|
Muntz|Harlan R|HR|
Orlandi|Richard R|RR|
Berger|Justin|J|
Meier|Jeremy D|JD|

D020022:Genetic Predisposition to Disease

Otitis media
tympanostomy tubes
genetics
pedigree