Post-traumatic stress and related symptoms among juvenile detention residents: Results from intake screening.

Abstract:
BACKGROUND
Juvenile justice-involved youth have high rates of trauma exposure, physical and sexual abuse and PTSD. Several factors have been found to be related to PTSD symptoms in youth including number and chronicity of traumatic events.

OBJECTIVE
To simultaneously examine the relationships between allostatic load (defined here as number of traumatic experiences), poly-victimization (exposure to two or more forms of victimization based on 5 of the 6 categories in Ford et al.'s 2010 study), physical/sexual abuse and PTSD in justice-involved youth.

PARTICIPANTS AND SETTING
The sample consisted of 1984 youth in juvenile detention in a Northeastern city. The sample was 73.4% male and the majority of youth were either African American or Hispanic.

METHODS
Clinicians collected demographic and psychosocial information, and measured symptoms of PTSD, depression, and problematic substance use.

RESULTS
Results showed that youth with more traumas, those who experienced poly-victimization and those who experienced physical/sexual assault/abuse were not only more likely to have PTSD, but also more likely to have depression, thoughts of suicide/self-harm, and problematic substance use (as indicated by the presence of 2 or more of 6 possible indicators). Poly-victimization was a stronger correlate of PTSD than number of traumas or physical/sexual assault/abuse. However, among youth with PTSD, number of traumas was associated with co-occurring problems while poly-victimization and physical/sexual assault/abuse were not.

CONCLUSIONS
Findings can be used to help direct resources to juvenile justice-involved youth who are most in need of treatment.

McNair|Felicia Debbra|FD|
Havens|Jennifer|J|
Surko|Michael|M|
Weinberger|Emily|E|
Baetz|Carly|C|
Moaveni|Mahtab|M|
Bart|Amanda|A|
Marr|Mollie|M|
Quinlan|Carol|C|
Horwitz|Sarah McCue|SM|

Poly-victimization
Depression
Adolescents
Comorbidity
Delinquency
Juvenile justice
Posttraumatic Stress Disorder (PTSD)
Substance abuse
Suicidal ideation


Transcatheter aortic valve replacement in patients with severe aortic stenosis and active cancer: a systematic review and meta-analysis.

Abstract:
Background
Patients with severe aortic stenosis and concomitant active cancer (AC) are considered high-risk patients and usually are not allowed to undergo surgical valve replacement. Transcatheter aortic valve replacement (TAVR) may be an attractive option for them; however, little is known about the outcomes of TAVR in this subset of complex patients.

Methods and results
In this meta-analysis, Medline, Cochrane Library and Scopus databases were searched (anytime up to April 2019) for studies evaluating the outcomes of TAVR in patients with or without AC. We assessed pooled estimates (with their 95% CIs) of the risk ratio (RR) for the all-cause mortality at the 30-day and 1-year follow-ups, a 4-point safety outcome (any bleeding, stroke, need for a pacemaker and acute kidney injury) and a 2-point efficacy outcome (device success and residual mean gradient (mean difference)). Three studies (5162 patients) were included. Of those patients, a total of 368 (7.1%) had AC. Apart from a significantly higher need for a postprocedural pacemaker (RR 1.29, 95% CI 1.06 to 1.58, p=0.01), TAVR in patients with AC resulted in similar outcomes for safety and efficacy at the 30-day follow-up compared with those without AC. Patients with AC experienced similar rates of the all-cause mortality at the 30-day follow-up compared with those without (RR 0.92, 95% CI 0.53 to 1.59, p=0.76); however, the all-cause mortality was significantly higher in patients with AC at the 1-year follow-up (RR 1.71, 95% CI 1.26 to 2.33, p=0.0006). This mortality difference was independent of cancer stage (advanced or limited) at the 30-day follow-up but not at the 1-year follow-up; only patients with limited cancer stages showed similar all-cause mortality rates compared with those without cancer at the 1-year follow-up (RR 1.22, 95% CI 0.79 to 1.91, p=0.37).

Conclusion
TAVR in patients with AC is associated with similar 30-day and potentially worse 1-year outcomes compared with those in patients without AC. The 1-year all-cause mortality appears to be dependent on the cancer stage. Involving a specialised oncologist who usually considers cancer stage in the decision-making process and applying additional preoperative scores such as frailty indices might refine the risk assessment process among these patients.

PROSPERO registration number
CRD42019120416.

Bendary|Ahmed|A|0000-0002-0161-3779 Ramzy|Ahmed|A| Bendary|Mohamed|M| Salem|Mohamed|M|

D065467:Transcatheter Aortic Valve Replacement

aortic valve disease
malignancy
percutaneous valve therapy
quality of care and outcomes


Seizure description accuracy and seizure classification results from patient histories.

Abstract:
OBJECTIVES
To study the influence of inaccurate histories on the seizure classification results and explore the characteristics of the inaccurate descriptions from the relatives of people with epilepsy (PWE).

METHODS
Fifty-four individuals from our multi-disciplinary meeting (MDM) were included. Their histories were collected. The relatives of the individuals answered a questionnaire regarding habitual seizures. Experienced epileptologists reviewed ictal videos, classified habitual seizures based on histories and videos separately with short term EEGs and brain MRIs, and answered the same questionnaire. With the answers from the epileptologists as references, the overall mistake rate for each relative was calculated. Mistake rate, kappa value, and other indicators were also calculated for each item of the questionnaire. Furthermore, seizure-related and socioeconomic factors were included in a multivariable logistic regression model to determine their roles in the overall mistake rates.

RESULTS
The inconsistency of classifications from the histories is 25.93 %, with 18.52 % missing focal onset descriptions. The average overall mistake rate of the questionnaire was 28.92 %. Answers to most items were in moderate agreement with the epileptologists. Relatives were not good at reporting eye, face and head movements; asymmetrical postures; and time estimations. Movements of the limbs were likely to be detected. Younger individuals as well as relatives with higher educational levels were related to higher overall mistake rates (P = 0.012 and P = 0.031, respectively).

CONCLUSIONS
The potential inaccuracy in histories didn't lead to a large deviation on seizure classifications. There is a certain space for improvement, the importance of detecting focal signs, subtle movements, and asymmetrical postures during seizures should be stressed.

Gao|Hui|H| Du|Xudong|X| Li|Wei|W| Liu|Wenyu|W| Zhou|Dong|D|


Interleukin-37 is increased in adult-onset Still's disease and associated with disease activity.

Abstract:
BACKGROUND
Interleukin (IL)-37 has been known to play an immunosuppressive role in various inflammatory disorders, but whether it participates in the regulation of pathogenesis of adult-onset Still's disease (AOSD) has not been investigated. In this study, we examined serum IL-37 levels and their clinical association with AOSD, and we explored the anti-inflammatory effects of IL-37 on peripheral blood mononuclear cells (PBMCs) from patients with AOSD.

METHODS
Blood samples were collected from 62 patients with AOSD and 50 healthy control subjects (HC). The serum IL-37 levels were determined using an enzyme-linked immunosorbent assay (ELISA). The correlations of serum IL-37 levels with disease activity, laboratory values, and inflammatory cytokines in AOSD were analyzed by Spearman's correlation test. The correlations between serum IL-37 levels and clinical manifestations were analyzed by Mann-Whitney U test. PBMCs from ten patients with AOSD were stimulated with recombinant human IL-37 protein, and expression levels of tumor necrosis factor (TNF)-α, IL-6, IL-10, IL-1β, and IL-18 were determined by qRT-PCR and ELISA.

RESULTS
A significantly higher IL-37 protein level was observed in patients with AOSD than in HC. Serum IL-37 levels correlated with systemic score, laboratory values, IL-1β, IL-18, and IL-10 in patients with AOSD. The expression levels of IL-37 were closely related to the patients with AOSD who also had fever, skin rash, lymphadenopathy, splenomegaly, myalgia, and arthralgia. Moreover, the production of proinflammatory cytokines such as IL-6, IL-1β, TNF-α, and IL-18 in PBMCs from patients with AOSD was obviously attenuated after recombinant human IL-37 stimulation.

CONCLUSIONS
Increased expression of IL-37 and its positive correlation with disease activity suggest its involvement in AOSD pathogenesis. More importantly, IL-37 inhibits the expression of proinflammatory cytokines in PBMCs from patients with AOSD, indicating the potential anti-inflammatory role of IL-37 in AOSD. Thus, IL-37 may be a novel disease activity biomarker and research target in AOSD.

Chi|Huihui|H| Liu|Dongzhou|D| Sun|Yue|Y| Hu|Qiongyi|Q| Liu|Honglei|H| Cheng|Xiaobing|X| Ye|Junna|J| Shi|Hui|H| Yin|Yufeng|Y| Liu|Mengru|M| Wu|Xinyao|X| Zhou|Zhuochao|Z| Teng|Jialin|J| Yang|Chengde|C| Su|Yutong|Y|

IL-37
Peripheral blood mononuclear cells
Cytokines
Adult-onset Still’s disease


Spontaneous Aerosol Ejection: Origin of Inorganic Particles in Biomass Pyrolysis.

Abstract: At high thermal flux and temperatures of approximately 500 °C, lignocellulosic biomass transforms to a reactive liquid intermediate before evaporating to condensable bio-oil for downstream upgrading to renewable fuels and chemicals. However, the existence of a fraction of nonvolatile compounds in condensed bio-oil diminishes the product quality and, in the case of inorganic materials, catalyzes undesirable aging reactions within bio-oil. In this study, ablative pyrolysis of crystalline cellulose was evaluated, with and without doped calcium, for the generation of inorganic-transporting aerosols by reactive boiling ejection from liquid intermediate cellulose. Aerosols were characterized by laser diffraction light scattering, inductively coupled plasma spectroscopy, and high-speed photography. Pyrolysis product fractionation revealed that approximately 3 % of the initial feed (both organic and inorganic) was transported to the gas phase as aerosols. Large bubble-to-aerosol size ratios and visualization of significant late-time ejections in the pyrolyzing cellulose suggest the formation of film bubbles in addition to the previously discovered jet formation mechanism.

Teixeira|Andrew R|AR|
Gantt|Rachel|R|
Joseph|Kristeen E|KE|
Maduskar|Saurabh|S|
Paulsen|Alex D|AD|
Krumm|Christoph|C|
Zhu|Cheng|C|
Dauenhauer|Paul J|PJ|

aerosols biomass pyrolysis cellulose calcium


Diet derived polycyclic aromatic hydrocarbons and its pathogenic roles in colorectal carcinogenesis.

Abstract: Polycyclic aromatic hydrocarbon (PAHs) are molecules that contaminate meat products during the high-temperature cooking of meat. This study reviewed the pathogenic roles of meat derived polycyclic aromatic hydrocarbons in the carcinogenesis of colorectal cancer (CRC). Ingested PAHs undergo xenobiotic metabolism resulting in the activation of genotoxic metabolites that can induce DNA damage in the colorectum. Genetic polymorphisms in PAH xenobiotic enzymes are linked to the risk of CRC and suggest a role for PAH-meat ingestion in carcinogenesis of colorectal malignancies. Furthermore, PAH specific DNA adducts have been identified in colorectal cancer tissue and linked to high meat intake. DNA adduct resolution is mediated by the nucleotide excision repair, and polymorphisms within genes of this repair pathway and high meat intake are associated with increased CRC risk. In the literature, there is evidence from metabolic enzyme gene variants, DNA repair genes, PAH metabolites, and epidemiological studies suggesting PAH involvement in CRC.

Cheng|Tracie|T|
Lam|Alfred K|AK|
Gopalan|Vinod|V|

Diet
Polycyclic aromatic hydrocarbon
Meat
Cancer
Bowel
Carcinoma
Colon
Rectal


Controlling Healthcare Costs: Just Cost Effectiveness or "Just" Cost Effectiveness?

Abstract: Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.

D026688:Bioethical Issues
D003362:Cost-Benefit Analysis
D017048:Health Care Costs
D015276:Health Care Rationing
D006801:Humans
D019057:Quality-Adjusted Life Years
D040841:Resource Allocation
D012935:Social Justice

National Institute for Health and Clinical Effectiveness (NICE)


Medial Septal NMDA Glutamate Receptors are Involved in Modulation of Blood Natural Killer Cell Activity in Rats.

Abstract: The purpose of the present study was to determine the specific role of the medial septal (MS) NMDA glutamate receptors on peripheral blood natural killer cell cytotoxicity (NKCC) and their (large granular lymphocyte, LGL) number, as well as the plasma concentration of tumor necrosis factor α (TNF-α) and corticosterone in male Wistar rats exposed to elevated plus maze (EPM) stress or non-stress conditions. The NMDA groups were injected with NMDA glutamate receptor agonist (N-methyl-D-aspartate; 0.25 μg/rat), the D-AP7 group was injected with DL-2-amino-7-phosphoheptanoate (0.1 μg/rat), an antagonist of NMDA glutamate receptors, and the control Sal group with saline (0.5 μl/rat) via previously implanted cannulae into the MS. There was an increase in the NKCC, NK/LGL number and plasma TNF-α concentration after the NMDA injections, being much stronger within the rats under non-stress conditions rather than the rats exposed to EPM stress. These parameters were decreased in the D-AP7 rats, suggesting receptor/ion channel specificity. Moreover, a lower plasma corticosterone concentration within the NMDA rather than the Sal and D-AP7 groups was found. The obtained results suggest that activation of the NMDA glutamate receptors in the MS, accompanied by changes in the corticosterone and cytokine responses, may be involved in modulation of the blood natural anti-tumor response, under EPM stress and non-stress conditions.

Podlacha|Magdalena|M| Glac|Wojciech|W| Listowska|Magdalena|M| Grembecka|Beata|B| Majkutewicz|Irena|I| Myślińska|Dorota|D| Plucińska|Karolina|K| Jerzemowska|Grażyna|G| Grzybowska|Maria|M| Wrona|Danuta|D|

D018691:Excitatory Amino Acid Antagonists

Medial septum, elevated plus maze, anxiety, NK cells, tumor necrosis factor-α


Cycle Network Model of Prostaglandin H Synthase-1.

Abstract: The kinetic model of Prostaglandin H Synthase-1 (PGHS-1) was developed to investigate its complex network kinetics and non-steroidal anti-inflammatory drugs (NSAIDs) efficacy in different in vitro and in vivo conditions. To correctly describe the complex mechanism of PGHS-1 catalysis, we developed a microscopic approach to modelling of intricate network dynamics of 35 intraenzyme reactions among 24 intermediate states of the enzyme. The developed model quantitatively describes interconnection between cyclooxygenase and peroxidase enzyme activities; substrate (arachidonic acid, AA) and reducing cosubstrate competitive consumption; enzyme self-inactivation; autocatalytic role of AA; enzyme activation threshold; and synthesis of intermediate prostaglandin G2 (PGG2) and final prostaglandin H2 (PGH2) products under wide experimental conditions. In the paper, we provide a detailed description of the enzyme catalytic cycle, model calibration based on a series of in vitro kinetic data, and model validation using experimental data on the regulatory properties of PGHS-1. The validated model of PGHS-1 with a unified set of kinetic parameters is applicable for in silico screening and prediction of the inhibition effects of NSAIDs and their combination on the balance of pro-thrombotic (thromboxane) and anti-thrombotic (prostacyclin) prostaglandin biosynthesis in platelets and endothelial cells expressing PGHS-1.


Telomeres in lung disease.

Abstract: Telomeres are DNA-protein structures that cap the ends of chromosomes; telomerase is the enzyme that ensures their integrity. Telomere biology has recently been implicated in the pathogenesis of a variety of lung diseases, including idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease/emphysema, and lung cancer. This review highlights recent discoveries pertaining to the role of telomere biology in lung disease.

D029424:Pulmonary Disease, Chronic Obstructive

idiopathic pulmonary fibrosis
chronic obstructive pulmonary disease
COPD
IPF
TERC
TERT
telomerase RNA component
telomerase reverse transcriptase


Biosurfactants production by yeasts using soybean oil and glycerol as low cost substrate.

Abstract: Biosurfactants are bioactive agents that can be produced by many different microorganisms. Among those, special attention is given to yeasts, since they can produce many types of biosurfactants in large scale, using several kinds of substrates, justifying its use for industrial production of those products. For this production to be economically viable, the use of residual carbon sources is recommended. The present study isolated yeasts from soil contaminated with petroleum oil hydrocarbons and assessed their capacity for producing biosurfactants in low cost substrates. From a microbial consortium enriched, seven yeasts were isolated, all showing potential for producing biosurfactants in soybean oil. The isolate LBPF 3, characterized as Candida antarctica, obtained the highest levels of production - with a final production of 13.86 g/L. The isolate LBPF 9, using glycerol carbon source, obtained the highest reduction in surface tension in the growth medium: approximately 43% of reduction after 24 hours of incubation. The products obtained by the isolates presented surfactant activity, which reduced water surface tension to values that varied from 34 mN/m, obtained from the product of isolates LBPF 3 and 16 LBPF 7 (respectively characterized as Candida antarctica and Candida albicans) to 43 mN/m from the isolate LPPF 9, using glycerol as substrate. The assessed isolates all showed potential for the production of biosurfactants in conventional sources of carbon as well as in agroindustrial residue, especially in glycerol.

Accorsini|Fábio Raphael|FR|
Mutton|Márcia Justino Rossini|MJ|
Lemos|Eliana Gertrudes Macedo|EG|
Benincasa|Maria|M|

Biosurfactants
yeast
Soybean oil
Glycerol


'Hopeful adaptation' in health geographies: Seeking health and wellbeing in times of adversity.

Abstract: Living with adversity can create wide-ranging challenges for people's health and wellbeing. This adversity may arise through personal embodied difference (e.g. acquiring a brain injury or losing mobility in older age) as well as wider structural relations that shape a person's capacity to adapt. A number of dichotomies have dominated our understanding of how people engage with health and wellbeing practices in their lives, from classifying behaviours as harmful/health-enabling, to understanding the self as being defined before/after illness. This paper critically interrogates a number of these dichotomies and proposes the concept of 'hopeful adaptation' to understand the myriad, often non-linear ways that people seek and find health and wellbeing in spite of adversity. We highlight the transformative potential in these adaptive practices, rather than solely focusing on how people persist and absorb adversity. The paper outlines an agenda for a health geography of hopeful adaptation, introducing a collection of papers that examine varied forms of adaptation in people's everyday struggles to find health and wellbeing whilst living with and challenging adversity.

Power|Andrew|A|
Bell|Sarah L|SL|
Kyle|Richard G|RG|
Andrews|Gavin J|GJ|

Hope Wellbeing Health-enabling Care Community Support Welfare


Apremilast for moderate hidradenitis suppurativa: Results of a randomized controlled trial.

Abstract:
BACKGROUND
Effective anti-inflammatory treatments for hidradenitis suppurativa (HS) are limited.

OBJECTIVE
To evaluate the efficacy and short-term safety of apremilast in patients with moderate HS.

METHODS
A total of 20 patients with moderate HS were randomized in a 3:1 ratio to receive blinded treatment with apremilast, 30 mg twice daily, or placebo for 16 weeks. The primary outcome was the Hidradenitis Suppurativa Clinical Response at week 16. Linear mixed effects modeling (analysis of covariance) was used to assess secondary clinical outcomes between treatment groups.

RESULTS
The HS clinical response was met in 8 of 15 patients in the apremilast group (53.3%) and none of 5 patients in the placebo group (0%) (P = .055) at week 16. Moreover, the apremilast-treated patients showed a significantly lower abscess and nodule count (mean difference, -2.6; 95% confidence interval, -6.0 to -0.9; P = .011), NRS for pain (mean difference, -2.7; 95% -4.5 to -0.9; P = .009), and itch (mean difference, -2.8; 95% confidence interval, -5.0 to -0.6; P = .015) over 16 weeks compared with the placebo-treated patients. There was no significant difference in the Dermatology Life Quality Index over time between the 2 treatment groups (mean difference, -3.4; 95% confidence interval, -9.0 to 2.3; P = .230). The most frequently reported adverse events in the apremilast-treated patients were mild-to-moderate headache and gastrointestinal symptoms, which did not result in dropouts.

LIMITATIONS
Small number of patients, relatively short study duration.

CONCLUSION
Apremilast, at a dose of 30 mg twice daily, demonstrated clinically meaningful efficacy and was generally well tolerated in patients with moderate HS.

Vossen|Allard R J V|ARJV|
van Doorn|Martijn B A|MBA|
van der Zee|Hessel H|HH|
Prens|Errol P|EP|

randomized controlled trial
treatment
efficacy
safety
tolerability
PDE4
acne inversa
phosphodiesterase 4 inhibitor


Fluorescent Multiplex Immunohistochemistry Coupled With Other State-Of-The-Art Techniques to Systematically Characterize the Tumor Immune Microenvironment.

Abstract: Our expanding knowledge of the interactions between tumor cells and their microenvironment has helped to revolutionize cancer treatments, including the more recent development of immunotherapies. Immune cells are an important component of the tumor microenvironment that influence progression and treatment responses, particularly to the new immunotherapies. Technological advances that help to decipher the complexity and diversity of the tumor immune microenvironment (TIME) are increasingly used in translational research and biomarker studies. Current techniques that facilitate TIME evaluation include flow cytometry, multiplex bead-based immunoassays, chromogenic immunohistochemistry (IHC), fluorescent multiplex IHC, immunofluorescence, and spatial transcriptomics. This article offers an overview of our representative data, discusses the application of each approach to studies of the TIME, including their advantages and challenges, and reviews the potential clinical applications. Flow cytometry and chromogenic and fluorescent multiplex IHC were used to immune profile a HER2+ breast cancer, illustrating some points. Spatial transcriptomic analysis of a luminal B breast tumor demonstrated that important additional insight can be gained from this new technique. Finally, the development of a multiplex panel to identify proliferating B cells, Tfh, and Tfr cells on the same tissue section demonstrates their co-localization in tertiary lymphoid structures.

Boisson|Anaïs|A|
Noël|Grégory|G|
Saiselet|Manuel|M|
Rodrigues-Vitória|Joël|J|
Thomas|Noémie|N|
Fontsa|Mireille Langouo|ML|
Sofronii|Doïna|D|
Naveaux|Céline|C|
Duvillier|Hugues|H|
Craciun|Ligia|L|
Larsimont|Denis|D|
Awada|Ahmad|A|
Detours|Vincent|V|
Willard-Gallo|Karen|K|
Garaud|Soizic|S|


Corrigendum: Impact of Player Injuries on Teams' Mental States, and Subsequent Performances, at the Rugby World Cup 2015.

Abstract: [This corrects the article on p. 807 in vol. 7, PMID: 27375511.].

injury
rugby
challenges
equality
social contagion
team ethos
technology
virtual reality


A systematic review of genitourinary injuries arising from rugby and football.

Abstract:
BACKGROUND
Genitourinary injuries in athletes engaging in high-impact sports such as football and rugby may have catastrophic consequences, especially in individuals with pre-existing urologic concerns, such as a solitary kidney.

OBJECTIVE
To summarize the current literature on football-related or rugby-related genitourinary organ injuries in both adult and pediatric populations in an effort to risk stratify the likelihood of these injuries.

METHODS
An independent systematic literature search for records reporting football-related or rugby-related injuries was conducted by a certified librarian and reviewer in March 2019. The search electronic databases included Medline, EMBASE, Scopus, and Web of Science. All studies reporting football-related or rugby-related genitourinary injuries were included.

RESULTS
Twenty-two records (11 research studies, 11 case reports) were identified. In the pediatric population, the reported football-related kidney injuries were 0.1-0.7% of all football-related injuries, 0.07-0.5% of all sports-related injuries, and 1.5-37.5% of all sports-related genitourinary injuries, with incidence ranging from 0.00000084 to 0.0000092 injuries per exposure (five studies). Pediatric football-related testicular injuries were reported to be 0.11% of all football injuries, 0-0.07% of all sports-related injuries, and 0-37.5% of all sports-related genitourinary injuries; injury per exposure was 0.0000092 (four studies). In adults, there was no proportion of genitourinary injuries that could be determined, and football-related kidney injury incidence was 0.000012 injuries per exposure (one study). No adult literature investigated testicular injuries. Eleven case reports were additionally identified. Review of the case reports suggests that patients with previously existing urologic abnormalities such as ureteropelvic junction obstruction may predispose an individual to kidney injuries.

CONCLUSION
There is little to suggest that those engaged in football or rugby have a significant risk of genitourinary injury; therefore, future guidelines should reflect this.

Kim|Jin K|JK|
Koyle|Martin A|MA|
Lee|Min Joon|MJ|
Nason|Gregory J|GJ|
Ren|Lily Yuxi|LY|
O'Kelly|Fardod|F|

Genitourinary Injury Rugby Football Kidney Testis


Determinants of the practice of exclusive breastfeeding in Guinea: evidence from 2018 Guinean demographic and health survey.

Abstract:
BACKGROUND
Exclusive breastfeeding is critical for infant survival and development. However, the rate of exclusive breastfeeding in the first 6 months of life is low in sub-Saharan Africa. With the current trend in breastfeeding rates in many countries including in Guinea, the World Health Assembly target of at least 50% of children aged less than 6 months being exclusively breastfeed by 2025 is likely to be compromised and lives a numerous infant that are be at risk. The objective of this study was to identify the individual and contextual determinants of the practice of Exclusive Breastfeeding (EBF) in Guinea.

METHOD
We conducted a secondary analysis of data from the 2018 Guinea Demographic and Health Survey (DHS). The study population consisted of women who gave birth between the ages of 15 and 49. Our sample consisted of women who had their last birth six (06) months prior to collection. The enumeration areas were our second level. A multilevel logistic regression was performed using Stata version 15.1 software. Three statistical models were implemented: The final model was obtained using the bottom-up step-by-step method. The intra-class correlation coefficient was calculated.

RESULTS
On the 851 women included in our study, 33% reported having exclusively breastfed during the first 6 months of life of their children. After a multivariate analysis, the variables associated with exclusive breastfeeding are: children aged 2-3 months (OR = 0.53 CI95% = [0.36-0.79]) and children aged 4-5 months (OR = 0.23 IC95% = [0.14-0.36]), women in the Faranah area (OR = 2.69 IC95% = [1.21-5.94]) and those in Mamou (OR = 2.27 IC95% = [1.00-5.94]), women who gave birth in a health facility (OR = 1.94 IC95% = [1.34-2.80]) and women living in polygamous households (OR = 0.68 IC95% = [0.48-0.98]).

CONCLUSION
The practice of exclusive breastfeeding remains low in Guinea. For the achievement of Sustainable Development Goals, particularly the improvement of exclusive breastfeeding practices, the individual and contextual determinants identified in this study should be taken into consideration in policies and programmes.

Soumah|Anne Marie|AM|
Baldé|Mamadou Diouldé|MD|
Tassembedo|Mahamadi|M|
Ouédraogo|Ousmane|O|
Garanet|Franck|F|
Ouédraogo|Adja Mariam|AM|
Yara|Aminata|A|
Koulibaly|Mamady|M|
Camara|Ibrahima|I|
Kouanda|Seni|S|

Determinants
Exclusive breastfeeding
Guinea
Demographic and health survey


Changes in dynamic mitral valve geometry during percutaneous edge-edge mitral valve repair with the MitraClip system.

Abstract:
BACKGROUND
The aim of this study was to quantify the acute dynamic changes of mitral valve (MV) geometry throughout the cardiac cycle-during percutaneous MV repair with the MitraClip system by 3-dimensional transesophageal echocardiography (3D TEE).

METHODS
The MV was imaged throughout the cardiac cycle (CC) before and after the MitraClip procedure using 3D TEE in 28 patients (mean age, 77 ± 8 years) with functional mitral regurgitation (FMR). Dynamic changes in the MV annulus geometry and anatomical MV orifice area (AMVOA) were quantified using a novel semi-automated software.

RESULTS
Percutaneous MV repair decreased anterior-posterior diameter by up to 9% (at 50% of CC; from 34.5 to 31.9 mm; p < 0.001) throughout the CC and increased the diastolic lateral-medial diameter by up to 7% (at 60% of the CC; from 39.7 to 42.3 mm; p < 0.001), whereas the annular circumference and area were not significantly affected. Annulus sphericity index was reduced up to 13% (at 50% of the CC; from 0.89 to 0.78, p < 0.001). The AMVOA also decreased during systole, the maximum decrease being from 0.6 to 0.2 mm2 (at 0% of CC; p = 0.007), and during diastole the maximum decrease being from 4.6 to 1.6 cm2 (at 50% of CC; p < 0.001).

CONCLUSIONS
Percutaneous MV repair reduces the MR by an improved coaptation of MV leaflets joint with a simultaneous indirect reduction of anterior-posterior diameter. Further, the MitraClip procedure leads to a reduction of AMVOA of more than 60% during diastole.

Noack|Thilo|T|0000-0003-0245-0147
Kiefer|Philipp|P|
Mallon|Linda|L|
Lurz|Philipp|P|
Bevilacqua|Carmine|C|
Banusch|Joergen|J|
Emrich|Fabian|F|
Holzhey|David M|DM|
Vannan|Mani|M|
Thiele|Holger|H|
Mohr|Friedrich-Wilhelm|FW|
Borger|Michael Andrew|MA|
Ender|Joerg|J|
Seeburger|Joerg|J|

Mitral valve geometry
MitraClip
Mitral regurgitation
3D echocardiography


Pes planovalgus deformity surgical correction in ambulatory children with cerebral palsy.

Abstract:
PURPOSE
Planovalgus foot deformity is common in diplegic and quadriplegic patients. Surgery is the definitive treatment to restore the alignment of the talus, calcaneus, and navicular bones. We aimed, in the current study, to compare the effectiveness of subtalar fusion and calcaneal lengthening, and to assess the recurrence in ambulatory children with cerebral palsy.

METHODS
This is a retrospective study of 78 patients (138 feet diagnosed with planovalgus deformity) who underwent surgical correction using subtalar fusion or calcaneal lengthening. Range of motion, radiographic indices, kinematic, and pedobarographic data were used to examine the deformity and the outcome of surgery. A repeated measures analysis of variance (ANOVA) was used to test the study hypothesis.

RESULTS
Most of the patients were diplegic (87.2 %) and the mean age at surgery was 11.9 ± 2.9 years (range from 4.7 to 18.3 years), with a mean follow-up of 5 ± 4.4 years (range from 1 to 15.4 years). Sixty-three feet were treated with calcaneal lengthening, while 75 were treated with subtalar fusion. The feet treated with subtalar fusion were more severe preoperatively. However, both surgery groups showed improvement postoperatively. Among 12 cases of recurrence, medial column fusion was the main surgery performed to correct the deformity.

CONCLUSIONS
Surgery is effective in the treatment of planovalgus deformity in ambulatory children with cerebral palsy. Severe and rigid planovalgus feet can be treated effectively with subtalar fusion. Feet with milder deformity show good results, with calcaneal lengthening. Surgery provides good correction in young patients, but there is a higher recurrence rate.

Kadhim|Muayad|M| Holmes|Laurens|L| Church|Chris|C| Henley|John|J| Miller|Freeman|F|

Pes planovalgus
Cerebral palsy
Subtalar fusion
Calcaneal lengthening


Measures of patient radiation exposure during endoscopic retrograde cholangiography: beyond fluoroscopy time.

Abstract:
AIM
To determine whether fluoroscope time is a good predictor of patient radiation exposure during endoscopic retrograde cholangiopancreatography.

METHODS
This is a prospective observational study of consecutive patients undergoing endoscopic retrograde cholangiopancreatography in a tertiary care setting. Data related to radiation exposure were collected. The following measures were obtained: Fluoroscopy time (FT), dose area product (DAP) and dose at reference point (DOSERP). Coefficients of determination were calculated to analyze the correlation between FT, DAP and DOSRP. Agreement between FT and DAP/DOSRP was assessed using Bland Altman plots.

RESULTS
Four hundred sixty-three data sets were obtained. Fluoroscopy time average was 7.3 min. Fluoroscopy related radiation accounted for 86% of the total DAP while acquisition films related radiation accounted for 14% of the DAP. For any given FT there are wide ranges of DAP and DOSERP and the variability in both increases as fluoroscopy time increases. The coefficient of determination (R(2)) on the non transformed data for DAP and DOSERP versus FT were respectively 0.416 and 0.554. While fluoroscopy use was the largest contributor to patient radiation exposure during endoscopic retrograde cholangiography (ERCP), there is a wide variability in DAP and DOSERP that is not accounted for by FT. DAP and DOSERP increase in variability as FT increases. This translates into poor accuracy of FT in predicting DAP and DOSERP at higher radiation doses.

CONCLUSION
DAP and DOSERP in addition to FT should be adopted as new ERCP quality measures to estimate patient radiation exposure.

Kachaamy|Toufic|T|
Harrison|Edwyn|E|
Pannala|Rahul|R|
Pavlicek|William|W|
Crowell|Michael D|MD|
Faigel|Douglas O|DO|

Radiation
Endoscopic retrograde
Fluoroscopy
Cholangiopancreatography
Endoscopy
Standards


Experiences from coordinating research after the 2011 terrorist attacks in Norway.

Abstract: This brief report presents some of the lessons learned from coordinating research in which people directly affected by terrorist attacks in Norway in 2011 are taking part. After the terrorist attacks, it was decided to establish a national coordinating function in order to protect those who were affected when they participate in research. By gathering key stakeholders, it is possible to avoid duplication of research through practical measures such as information sharing, facilitating cooperation, and working toward sharing of data. In addition, a coordinating function provides a platform for working to increase the impact of the research among practitioners and policy makers, and inform the general public. The conclusions are that coordination should be interdisciplinary, that it is important to plan for the sharing and reuse of data, and that both the research community and the research infrastructure should take steps to improve preparedness when disaster inevitably strikes again.

Disaster
data sharing
disaster research
research ethics
terrorism


Fertility Desires and Intentions Among U.S. Women by Disability Status: Findings from the 2011-2013 National Survey of Family Growth.

Abstract: Objectives We compared fertility desires and intentions among women with disabilities and women without disabilities in the United States, using a new evidence-based measure of disability. Methods We analyzed data from a sample of 5601 US women 15-44 years of age in the 2011-2013 National Survey of Family Growth. The data were analyzed via cross-tabulation and logistic regression. We classified women into those with a disability and those without a disability. Results Women with disabilities were about as likely to want a baby (61%) as women without disabilities (60%). But only 43% of women with disabilities intended to have a baby in the future, compared with 50% of women without disabilities. Thus, the difference between the percent who want a baby and the percent who intend to have one was larger for disabled women. Women with disabilities were also less certain of their fertility intentions. Multivariate analysis shows that having a disability lowers the odds of intending another birth, after controlling for several other determinants of fertility intentions. Conclusions for Practice All women, regardless of disability status, desired more children than they actually planned to have, but the gap was larger for most groups of women with disabilities than for non-disabled women. Given the sample sizes available in this analysis, future research should use more detailed classifications of disability, however, we have shown that women living with disabilities constitute large populations with unexplored family planning needs.

Bloom|Tina L|TL|
Mosher|William|W|
Alhusen|Jeanne|J|
Lantos|Hannah|H|
Hughes|Rosemary B|RB|

D007722:Health Knowledge, Attitudes, Practice

Fertility
Intention
Practice
Attitudes
Disabled persons
Female
Health knowledge


Head and neck reconstruction in the elderly patient: a safe procedure?

Abstract: Demographic changes strongly affect industrialized countries. While free tissue transfer was initially believed to be beneficial only for younger patients, there is an increasing number of elderly patients requiring microvascular operations in our aging society. Medical and surgical risks for head and neck cancer patients over a certain age who undergo free tissue transfer has hardly been investigated. A retrospective mono-center cohort study was performed. All patients with the age 75 or higher undergoing microvascular operations were reviewed. Patient characteristics including the ASA-status, the ACE-27-score, flap survival and postoperative medical and surgical complications were evaluated. The Clavien-Dindo-classification system for postoperative complications was applied to assess the severity of the complications. A total of 31 patients with an average age of 78.8 years were included. 4 patients suffered from venous congestion and had to undergo revision surgery. All flaps could successfully be salvaged. Higher ASA-status and ACE-score were significantly associated with postoperative medical and surgical complications and a higher severity of the complications. However , neither age nor operating time had influence on the complication rate. Microvascular free tissue transfer can be performed with a high degree of security in selected elderly patients. However, serious medical complications remain a concern, correlating strongly with high ASA and ACE-score. Careful patient selection is mandatory to reduce complications to a minimum.

D010043:Outcome and Process Assessment, Health Care

Head and neck
Reconstruction
Elderly
Microvascular
Complications
Free flap
Radical


Effects of green tea extract on overweight and obese women with high levels of low density-lipoprotein-cholesterol (LDL-C): a randomised, double-blind, and cross-over placebo-controlled clinical trial.

Abstract:
BACKGROUND
This study aims to examine the effects of green tea extract (GTE) supplement on overweight and obese women with high levels of low density lipoprotein-cholesterol (LDL-C).

METHODS
The randomized, double-blind, crossover and placebo-controlled clinical trial was conducted from August 2012 to December 2013. Seventy-three out of 90 subjects aged between 18 and 65 years, with body mass index (BMI) ≥ 27 kg/m2 and LDL-C ≥ 130 mg/dl were included in the analysis. The subjects were randomly divided into Groups A and B. Group A received GTE supplement treatment for the first 6 weeks, while Group B received placebo daily. After 6 weeks of treatment and 14 days of washout period, Group A switched to placebo and Group B switched to GTE treatment for 6 weeks. The reduction of LDL-C level between treatments was assessed as the outcome. Additionally, anthropometric measurements, plasma lipoproteins and hormone peptides of both groups were measure at the beginning of weeks 6, 8, and 14 after treatment.

RESULTS
Subjects treated with GTE (n = 73) for 6 weeks showed significant differences, with 4.8% (p = 0.048) reduction in LDL-C and 25.7% (p = 0.046) increase in leptin. However, there was no statistical difference in the levels of total cholesterol, triglyceride and high density lipoprotein between the GTE and placebo groups after treatments.

CONCLUSIONS
This study shows that green tea extract effectively increases leptin and reduces LDL in overweight and obese women after 6 weeks of treatment even though there were no significant changes in other biochemical markers related to overweight.

TRIAL REGISTRATION
This clinical trial is registered with ClinicalTrials.gov: NCT02116517 on 17 April 2014. Retrospectively registered. The first patient enrolled in October 2012 and the study was completed December 2013.

Green tea extract
Obesity
LDL-C
Leptin
EGCG
Epigallocatechin gallant
Hyperlipidemia
Low density lipoprotein


Pharmacist participation in hospital ward teams and hospital readmission rates among people with dementia: a randomized controlled trial.

Abstract:
PURPOSE
To assess whether comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team reduce drug-related hospital readmission rates among people with dementia or cognitive impairment.

METHODS
This randomized controlled trial was carried out between January 9, 2012, and December 2, 2014. Patients aged ≥65 years with dementia or cognitive impairment admitted to three wards at two hospitals located in Northern Sweden were included.

RESULTS
Of the 473 deemed eligible for participation, 230 were randomized to intervention and 230 to control group by block randomization. The primary outcome, risk of drug-related hospital readmissions, was assessed at 180 days of follow-up by intention-to-treat analysis. During the 180 days of follow-up, 18.9% (40/212) of patients in the intervention group and 23.0% (50/217) of those in the control group were readmitted for drug-related reasons (HR = 0.80, 95% CI = 0.53-1.21, p = 0.28, univariable Cox regression). Heart failure was significantly more common in the intervention group. After adjustment for heart failure as a potential confounder and an interaction term, multiple Cox regression analysis indicated that pharmacist participation significantly reduced the risk of drug-related readmissions (HR = 0.49, 95% CI = 0.27-0.90, p = 0.02). A post-hoc analysis showed a significantly reduced risk of 30-day readmissions due to drug-related problems in the total sample (without adjustment for heart failure).

CONCLUSION
Participation of clinical pharmacists in healthcare team conducting comprehensive medication reviews did not significantly reduce the risk of drug-related readmissions in patients with dementia or cognitive impairment; however, post-hoc and subgroup analyses indicated significant effects favoring the intervention. More research is needed.

TRIAL REGISTRATION
Clinical trials NCT01504672.

Gustafsson|Maria|M| Sjölander|Maria|M| Pfister|Bettina|B| Jonsson|Jeanette|J| Schneede|Jörn|J| Lövheim|Hugo|H|

Dementia
Medication reviews
Clinical pharmacists
Drug-related readmissions
Old people


Organ size control via hydraulically gated oscillations.

Abstract: Hollow vesicular tissues of various sizes and shapes arise in biological organs such as ears, guts, hearts, brains and even entire organisms. Regulating their size and shape is crucial for their function. Although chemical signaling has been thought to play a role in the regulation of cellular processes that feed into larger scales, it is increasingly recognized that mechanical forces are involved in the modulation of size and shape at larger length scales. Motivated by a variety of examples of tissue cyst formation and size control that show simultaneous growth and size oscillations, we create a minimal theoretical framework for the growth and dynamics of a soft, fluid-permeable, spherical shell. We show that these shells can relieve internal pressure by bursting intermittently, shrinking and re-growing, providing a simple mechanism by which hydraulically gated oscillations can regulate size. To test our theory, we develop an in vitro experimental set-up to monitor the growth and oscillations of a hollow tissue spheroid growing freely or when confined. A simple generalization of our theory to account for irreversible deformations allows us to explain the time scales and the amplitudes of oscillations in terms of the geometry and mechanical properties of the tissue shells. Taken together, our theory and experimental observations show how soft hydraulics can regulate the size of growing tissue shells.

Ruiz-Herrero|Teresa|T|
Alessandri|Kévin|K|
Gurchenkov|Basile V|BV|
Nassoy|Pierre|P|
Mahadevan|L|L|0000-0002-5114-0519

Organ size control
Hydraulic gating
Morphogenesis
Synthetic cysts


Development of a Novel Staging Model for Affective Disorders Using Partial Least Squares Bootstrapping: Effects of Lipid-Associated Antioxidant Defenses and Neuro-Oxidative Stress.

Abstract: Although, staging models gained momentum to stage define affective disorders, no attempts were made to construct mathematical staging models using clinical and biomarker data in patients with major depression and bipolar disorder. The aims of this study were to use clinical and biomarker data to construct statistically derived staging models, which are associated with early lifetime traumata (ELTs), affective phenomenology, and biomarkers. In the current study, 172 subjects participated, 105 with affective disorders (both bipolar and unipolar) and 67 controls. Staging scores were computed by extracting latent vectors (LVs) from clinical data including ELTs, recurring flare ups and suicidal behaviors, outcome data such as disabilities and health-related quality of life (HR-QoL), and paraoxonase (PON)1 actvities and nitro-oxidative stress biomarkers. Recurrence of episodes and suicidal behaviors could reliably be combined into a LV with adequate composite reliability (the "recurrence LV"), which was associated with female sex, the combined effects of multiple ELTs, disabilities, HR-QoL, and impairments in cognitive tests. All those factors could be combined into a reliable "ELT-staging LV" which was significantly associated with nitro-oxidative stress biomarkers. A reliable LV could be extracted from serum PON1 activities, recurrent flare ups, disabilities, and HR-QoL. Our ELT-staging index scores the severity of a relevant affective dimension, shared by both major depression and bipolar disorder, namely the trajectory from ELTs, a relapsing course, and suicidal behaviors to progressive disabilities. Patients were classified into three stages, namely an early stage, a relapse-regression stage, and a suicidal-regression stage. Lowered lipid-associated antioxidant defenses may be a drug target to prevent the transition from the early to the later regression stages.

Staging
Affective disorders
Major depression
Bipolar disorder
Neuro-immune
Oxidative


Singlet-Contrast Magnetic Resonance Imaging: Unlocking Hyperpolarization with Metabolism*.

Abstract: Hyperpolarization-enhanced magnetic resonance imaging can be used to study biomolecular processes in the body, but typically requires nuclei such as 13 C, 15 N, or 129 Xe due to their long spin-polarization lifetimes and the absence of a proton-background signal from water and fat in the images. Here we present a novel type of 1 H imaging, in which hyperpolarized spin order is locked in a nonmagnetic long-lived correlated (singlet) state, and is only liberated for imaging by a specific biochemical reaction. In this work we produce hyperpolarized fumarate via chemical reaction of a precursor molecule with para-enriched hydrogen gas, and the proton singlet order in fumarate is released as antiphase NMR signals by enzymatic conversion to malate in D2 O. Using this model system we show two pulse sequences to rephase the NMR signals for imaging and suppress the background signals from water. The hyperpolarization-enhanced 1 H-imaging modality presented here can allow for hyperpolarized imaging without the need for low-abundance, low-sensitivity heteronuclei.

hyperpolarization
singlet order
NMR
MRI
parahydrogen


Sweet potato (Ipomoea batatas) attenuates diet-induced aortic stiffening independent of changes in body composition.

Abstract: We hypothesized a sweet potato intervention would prevent high-fat (HF) diet-induced aortic stiffness, which would be associated with decreased arterial oxidative stress and increased mitochondrial uncoupling. Young (8-week old) C57BL/6J mice were randomly divided into 4 groups: low fat (LF; 10% fat), HF (60% fat), low-fat sweet potato (LFSP; 10% fat containing 260.3 μg/kcal sweet potato), or high-fat sweet potato diet (HFSP; 60% fat containing 260.3 μg/kcal sweet potato) for 16 weeks. Compared with LF and LFSP, HF- and HFSP-fed mice had increased body mass and percent fat mass with lower percent lean mass (all, P < 0.05). Sweet potato intervention did not influence body composition (all, P > 0.05). Arterial stiffness, assessed by aortic pulse wave velocity and ex vivo mechanical testing of the elastin region elastic modulus (EEM) was greater in HF compared with LF and HFSP animals (all, P < 0.05). Advanced glycation end products and nitrotyrosine abundance were greater in aortic segments from HF mice compared with LF and HFSP animals (all, P < 0.05). Aortic elastin and uncoupling protein 2 expressions, however, were reduced in HF compared with LF and HFSP mice (all, P < 0.05). Aortic segments cultured with 2,4-dinitrophenol (DNP), a mitochondrial uncoupler, for 72 h reduced the EEM of HF arteries compared with nontreated HF segments (P < 0.05). DNP had no effect on the EEM of aortic segments from HFSP mice. In conclusion, sweet potato attenuates diet-induced aortic stiffness independent of body mass and composition, which is associated with a normalization of arterial oxidative stress possibly due to mitochondrial uncoupling.

Garner|Tyler|T|
Ouyang|An|A|
Berrones|Adam J|AJ|
Campbell|Marilyn S|MS|
Du|Bing|B|
Fleenor|Bradley S|BS|

D000818:Animals
D001011:Aorta
D001794:Blood Pressure
D001823:Body Composition
D015992:Body Mass Index
D059305:Diet, High-Fat
D027723:Ipomoea batatas
D008297:Male
D051379:Mice
D008810:Mice, Inbred C57BL
D008954:Models, Biological
D018384:Oxidative Stress
D063177:Pulse Wave Analysis
D059289:Vascular Stiffness

mitochondrie
uncoupling proteins
2,4-dinitrophenol
2,4-dinitrophénol
mitochondria
obesity
obésité
protéines de découplage


Pain in the hand caused by a previously undescribed mechanism with possible relevance for understanding regional pain.

Abstract: Background and aims A previously undescribed mechanism of pain in the ulnar side of the hand was observed in a series of four patients. All were found to have a sensitive point in the first interspace of the hand and possible entrapment of a terminal branch of ulnar nerve piercing the fascia in the first interphalangeal webspace was suggested. Methods Pressure on the sensitive point reproduced the ulnar sided hand pain. Diagnostic and therapeutic injection of the mixture of local anesthetic and corticosteroid were performed. The degree and duration of relief of pain was noted. Results In individuals with recent onset hand pain of this type the injections abolished pain for 2 or more years. In individuals with long-standing pain (longer than 3-6 months) the pain was abolished for periods of time lasting several hours to several weeks. The correspondence of the point, where injections were done with acupuncture point LI4 was noted. Conclusions The location of possible nerve entrapment corresponds with an acupuncture point LI4 and may additionally represent a previously undescribed myofascial trigger point. Implications The suggested mechanism of ulnar sided hand pain represents a miniature chronic constriction injury similar to the animal model of neuropathic pain and may have relevance for regional pain elsewhere in the body.

regional pain
trigger point
neuropathic pain
LI4 acupoint
neuroanatomy


Immediately transcripted genes in various hepatic ischemia models.

Abstract:
PURPOSE
To elucidate the characteristic gene transcription profiles among various hepatic ischemia conditions, immediately transcribed genes and the degree of ischemic injury were compared among total ischemia (TI), intermittent clamping (IC), and ischemic preconditioning (IPC).

METHODS
Sprague-Dawley rats were equally divided into control (C, sham-operated), TI (ischemia for 90 minutes), IC (ischemia for 15 minutes and reperfusion for 5 minutes, repeated six times), and IPC (ischemia for 15 minutes, reperfusion for 5 minutes, and ischemia again for 90 minutes) groups. A cDNA microarray analysis was performed using hepatic tissues obtained by partial hepatectomy after occluding hepatic inflow.

RESULTS
THE CDNA MICROARRAY REVEALED THE FOLLOWING: interleukin (IL)-1β expression was 2-fold greater in the TI group than in the C group. In the IC group, IL-1α/β expression increased by 2.5-fold, and Na+/K+ ATPase β1 expression decreased by 2.4-fold. In the IPC group, interferon regulatory factor-1, osteoprotegerin, and retinoblastoma-1 expression increased by approximately 2-fold compared to that in the C group, but the expression of Na+/K+ ATPase β1 decreased 3-fold.

CONCLUSION
The current findings revealed characteristic gene expression profiles under various ischemic conditions. However, additional studies are needed to clarify the mechanism of protection against IPC.

Choi|Kang Kook|KK|
Cho|Jin A|JA|
Kim|Se Hoon|SH|
Lee|Sang Woo|SW|
Min|Seon Ok|SO|
Kim|Kyung Sik|KS|

Ischemic preconditioning
Microarray analysis
Apoptosis
Necrosis
Reperfusion injury


A review of Sulfur Mustard-induced pulmonary immunopathology: An Alveolar Macrophage Approach.

Abstract: Despite many studies investigating the mechanism of Sulfur Mustard (SM) induced lung injury, the underlying mechanism is still unclear. Inflammatory and subsequent fibroproliferative stages of SM-toxicity are based upon several highly-related series of events controlled by the immune system. The inhalation of SM gas variably affects different cell populations within the lungs. Various studies have shown the critical role of macrophages in triggering a pulmonary inflammatory response as well as its maintenance, resolution, and repair. Importantly, macrophages can serve as either pro-inflammatory or anti-inflammatory populations depending on the present conditions at any pathological stage. Different characteristics of macrophages, including their differentiation, phenotypic, and functional properties, as well as interactions with other cell populations determine the outcomes of lung diseases and the extent of long- or short-term pulmonary damage induced by SM. In this paper, we summarize the current state of knowledge regarding the role of alveolar macrophages and their mediators in the pathogenesis of SM in pulmonary injury. Investigating the specific cells and mechanisms involved in SM-lung injury may be useful in finding new target opportunities for treatment of this injury.

Sadeghi|Somaye|S| Tapak|Mahtab|M| Ghazanfari|Tooba|T| Mosaffa|Nariman|N|

D056704:Adaptive Immunity
D000818:Animals
D002619:Chemical Warfare Agents
D006801:Humans
D007113:Immunity, Innate
D018928:Immunity, Mucosal
D008168:Lung
D016676:Macrophages, Alveolar
D009151:Mustard Gas

Alveolar macrophage
Sulfur mustard
Inflammation
Oxidative stress


Influence of polyvinylpyrrolidone quantity on the solubility, crystallinity and oral bioavailability of fenofibrate in solvent-evaporated microspheres.

Abstract: The objective of this study is to explore the influence of polyvinylpyrrolidone (PVP) quantity on the solubility, crystallinity and oral bioavailability of poorly water-soluble fenofibrate in solvent-evaporated microspheres. Numerous microspheres were prepared with fenofibrate, sodium lauryl sulphate (SLS) and PVP using the spray-drying technique. Their aqueous solubility, dissolution, physicochemical properties and pharmacokinetics in rats were assessed. The drug in the solvent-evaporated microspheres composed of fenofibrate, PVP and SLS at the weight ratio of 1:0.5:0.25 was not entirely changed to the amorphous form and partially in the microcrystalline state. However, the microspheres at the weight ratio of 1:4:0.25 provided the entire conversion to the amorphous form. The latter microspheres, with an improvement of about 115 000-fold in aqueous solubility and 5.6-fold improvement in oral bioavailability compared with the drug powder, gave higher aqueous solubility and oral bioavailability compared with the former. Thus, PVP quantity played an important role in these properties of fenofibrate in the solvent-evaporated microspheres.

Yousaf|Abid Mehmood|AM|
Kim|Dong Wuk|DW|
Kim|Dong Shik|DS|
Kim|Jong Oh|JO|
Youn|Yu Seok|YS|
Cho|Kwan Hyung|KH|
Yong|Chul Soon|CS|
Choi|Han-Gon|HG|

polyvinylpyrrolidone
crystallinity
oral bioavailability
Fenofibrate
solvent-evaporated microsphere
aqueous solubility


Lower genetic variability of HIV-1 and antiretroviral drug resistance in pregnant women from the state of Pará, Brazil.

Abstract:
BACKGROUND
The present study aimed to describe the genetic diversity of HIV-1, as well as the resistance profile of the viruses identified in HIV-1 infected pregnant women under antiretroviral therapy in the state of Pará, Northern Brazil.

METHODS
Blood samples were collected from 45 HIV-1 infected pregnant to determine the virus subtypes according to the HIV-1 protease (PR) gene and part of the HIV-1 reverse transcriptase (RT) gene by sequencing the nucleotides of these regions. Drug resistance mutations and susceptibility to antiretroviral drugs were analyzed by the Stanford HIV Drug Resistance Database.

RESULTS
Out of 45 samples, only 34 could be amplified for PR and 30 for RT. Regarding the PR gene, subtypes B (97.1%) and C (2.9%) were identified; for the RT gene, subtypes B (90.0%), F (6.7%), and C (3.3%) were detected. Resistance to protease inhibitors (PI) was identified in 5.8% of the pregnant, and mutations conferring resistance to nucleoside reverse transcriptase inhibitors were found in 3.3%, while mutations conferring resistance to non-nucleoside reverse transcriptase inhibitors were found in 3.3%.

CONCLUSIONS
These results showed a low frequency of strains resistant to antiretroviral drugs, the prevalence of subtypes B and F, and the persistent low transmission of subtype C in pregnant of the state of Pará, Brazil.

Machado|Luiz Fernando Almeida|LF|
Costa|Iran Barros|IB|
Folha|Maria Nazaré|MN|
da Luz|Anderson Levy Bessa|AL|
Vallinoto|Antonio Carlos Rosário|AC|
Ishak|Ricardo|R|
Ishak|Marluisa Oliveira Guimarães|MO|


Why Females Do Better: The X Chromosomal TLR7 Gene-Dose Effect in COVID-19.

Abstract: A male sex bias has emerged in the COVID-19 pandemic, fitting to the sex-biased pattern in other viral infections. Males are 2.84 times more often admitted to the ICU and mortality is 1.39 times higher as a result of COVID-19. Various factors play a role in this, and novel studies suggest that the gene-dose of Toll-Like Receptor (TLR) 7 could contribute to the sex-skewed severity. TLR7 is one of the crucial pattern recognition receptors for SARS-CoV-2 ssRNA and the gene-dose effect is caused by X chromosome inactivation (XCI) escape. Female immune cells with TLR7 XCI escape have biallelic TLR7 expression and produce more type 1 interferon (IFN) upon TLR7 stimulation. In COVID-19, TLR7 in plasmacytoid dendritic cells is one of the pattern recognition receptors responsible for IFN production and a delayed IFN response has been associated with immunopathogenesis and mortality. Here, we provide a hypothesis that females may be protected to some extend against severe COVID-19, due to the biallelic TLR7 expression, allowing them to mount a stronger and more protective IFN response early after infection. Studies exploring COVID-19 treatment via the TLR7-mediated IFN pathway should consider this sex difference. Various factors such as age, sex hormones and escape modulation remain to be investigated concerning the TLR7 gene-dose effect.

TLR7
gene-dose effect
COVID-19
interferon
sex differences
X chromosome inactivation escape


Predictors of Loss of Remission and Disease Flares in Patients with Axial Spondyloarthritis Receiving Antitumor Necrosis Factor Treatment: A Retrospective Study.

Abstract:
OBJECTIVE
The aim of this study was to evaluate rate and predictive factors of loss of remission and disease flare in patients with axial spondyloarthritis (axSpA) receiving antitumor necrosis factor (anti-TNF) treatment.

METHODS
In this retrospective multicenter study, patients with axSpA, according to the Assessment of Spondyloarthritis international Society (ASAS) criteria, treated with adalimumab, etanercept, or infliximab with a minimum followup of 12 months and satisfying the ASAS partial remission criteria and/or Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease were studied. Disease flare was defined as a Bath Ankylosing Spondylitis Disease Activity Index score > 4.5 or ASDAS score > 2.5 on at least 1 occasion.

RESULTS
One hundred seventy-four patients with axSpA were studied. After a median [interquartile range (IQR)] followup of 4 years (2-6), 37 patients (21.2%) experienced a loss of remission and 28 (16.1% of the whole study group) a disease flare. Median (IQR) duration of remission in patients who lost this status was 1 year (0.625-2). Higher median erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, continuous nonsteroidal antiinflammatory drug (NSAID) use, and an ASDAS-CRP ≥ 0.8 during the remission period were significantly associated with both loss of remission and disease flare. At the multivariate analysis, continuous NSAID intake (OR 4.05, 95% CI 1.4-11.74, p = 0.010) and ESR > 15 (OR 2.90, 95% CI 1.23-6.82, p = 0.015) were the only factors predictive of disease reactivation.

CONCLUSION
In this study, loss of remission and disease flares occurred, respectively, in about 21% and 16% of the patients with axSpA who achieved a state of remission while receiving anti-TNF therapy. Residual disease activity was associated with disease reactivation.

Lubrano|Ennio|E|
Massimo Perrotta|Fabio|F|
Manara|Maria|M|
D'Angelo|Salvatore|S|
Addimanda|Olga|O|
Ramonda|Roberta|R|
Punzi|Leonardo|L|
Olivieri|Ignazio|I|
Salvarani|Carlo|C|
Marchesoni|Antonio|A|

REMISSION
DISEASE FLARES
AXIAL SPONDYLOARTHRITIS
ANTI-TNF-α DRUGS


Application of robotic-assisted in situ 3D printing in cartilage regeneration with HAMA hydrogel: An in vivo study.

Abstract: The concept of in situ 3D bio-printing was previously reported, while its realization has still encountered with several difficulties. The present study aimed to report robotic-assisted in situ 3D bio-printing technology for cartilage regeneration, and explore its potential in clinical application. A six-degree-of-freedom (6-DOF) robot was introduced in this study, and a fast tool center point (TCP) calibration method was developed to improve printing accuracy. The bio-ink consisted of hyaluronic acid methacrylate and acrylate-terminated 4-armed polyethylene glycol was employed as well. The in vitro experiment was performed on a resin model to verify the printing accuracy. The in vivo experiment was conducted on rabbits to evaluate the cartilage treatment capability. According to our results, the accuracy of the robot could be notably improved, and the error of printed surface was less than 30 μm. The osteochondral defect could be repaired during about 60 s, and the regenerated cartilage in hydrogel implantation and in situ 3D bio-printing groups demonstrated the same biomechanical and biochemical performance. We found that the cartilage injury could be treated by using this method. The robotic-assisted in situ 3D bio-printing is highly appropriate for improving surgical procedure, as well as promoting cartilage regeneration.

Ma|Kaiwei|K| Zhao|Tianzheng|T| Yang|Longfei|L| Wang|Peng|P| Jin|Jing|J| Teng|Huajian|H| Xia|Dan|D| Zhu|Liya|L| Li|Lan|L| Jiang|Qing|Q| Wang|Xingsong|X|

Cartilage regeneration
In situ 3D bio-printing
Robot
Bio-ink crosslinking
Tissue engineering


Interlaboratory study of a supercritical fluid chromatography method for the determination of pharmaceutical impurities: Evaluation of multi-systems reproducibility.

Abstract: Modern supercritical fluid chromatography (SFC) is now a well-established technique, especially in the field of pharmaceutical analysis. We recently demonstrated the transferability and the reproducibility of a SFC-UV method for pharmaceutical impurities by means of an inter-laboratory study. However, as this study involved only one brand of SFC instrumentation (Waters®), the present study extends the purpose to multi-instrumentation evaluation. Specifically, three instrument types, namely Agilent®, Shimadzu®, and Waters®, were included through 21 laboratories (n = 7 for each instrument). First, method transfer was performed to assess the separation quality and to set up the specific instrument parameters of Agilent® and Shimadzu® instruments. Second, the inter-laboratory study was performed following a protocol defined by the sending lab. Analytical results were examined regarding consistencies within- and between-laboratories criteria. Afterwards, the method reproducibility was estimated taking into account variances in replicates, between-days and between-laboratories. Reproducibility variance was larger than that observed during the first study involving only one single type of instrumentation. Indeed, we clearly observed an 'instrument type' effect. Moreover, the reproducibility variance was larger when considering all instruments than each type separately which can be attributed to the variability induced by the instrument configuration. Nevertheless, repeatability and reproducibility variances were found to be similar than those described for LC methods; i.e. reproducibility as %RSD was around 15 %. These results highlighted the robustness and the power of modern analytical SFC technologies to deliver accurate results for pharmaceutical quality control analysis.

Dispas|Amandine|A|
Clarke|Adrian|A|
Grand-Guillaume Perrenoud|Alexandre|A|
Losacco|Luca Gioacchino|LG|
Veuthey|Jean-Luc|JL|
Gros|Quentin|Q|
Molineau|Jérémy|J|
Noireau|Angéline|A|
West|Caroline|C|
Salafia|Fabio|F|
Zoccali|Mariosimone|M|
Mondello|Luigi|L|
Guillen|Amber|A|
Wang|Jenny|J|
Zhang|Kelly|K|
Jochems|Philipp|P|
Schad|Gesa|G|
Nakajima|Kosuke|K|
Horie|Shinnosuke|S|
Joseph|Jan|J|
Parr|Maria Kristina|MK|
Billemont|Pierre|P|
Severino|Antoni|A|
Schneider|Sonja|S|
Naegele|Edgar|E|
Kutscher|Daniel|D|
Wikfors|Rick|R|
Black|Regina|R|
Ingvaldson|Lee|L|
Da Silva|Jimmy Oliveira|JO|
Bennett|Raffeal|R|
Regalado|Erik L|EL|
Hoang|Thi Phuong Thuy|TPT|
Touboul|David|D|
Nikolova|Yana|Y|
Kamenova-Nacheva|Mariana|M|
Dimitrov|Vladimir|V|
Berger|Blair K|BK|
Schug|Kevin A|KA|
Kerviel-Guillon|Solène|S|
Mauge|Fabien|F|
Takahashi|Masatomo|M|
Izumi|Yoshihiro|Y|
Bamba|Takeshi|T|
Rouvière|Florent|F|
Heinisch|Sabine|S|
Guillarme|Davy|D|
Hubert|Philippe|P|

Supercritical fluid chromatography (SFC)


Neuroprotective Effects of Herbal Extract (Rosa canina, Tanacetum vulgare and Urtica dioica) on Rat Model of Sporadic Alzheimer's Disease.

Abstract:
BACKGROUND
Sporadic Alzheimer's Disease (SAD) is caused by genetic risk factors, aging and oxidative stresses. The herbal extract of Rosa canina (R. canina), Tanacetum vulgare (T. vulgare) and Urtica dioica (U. dioica) has a beneficial role in aging, as an anti-inflammatory and anti-oxidative agent. In this study, the neuroprotective effects of this herbal extract in the rat model of SAD was investigated.

METHODS
The rats were divided into control, sham, model, herbal extract -treated and ethanol-treated groups. Drug interventions were started on the 21(st) day after modeling and each treatment group was given the drugs by intraperitoneal (I.P.) route for 21 days. The expression levels of the five important genes for pathogenesis of SAD including Syp, Psen1, Mapk3, Map2 and Tnf-α were measured by qPCR between the hippocampi of SAD model which were treated by this herbal extract and control groups. The Morris Water Maze was adapted to test spatial learning and memory ability of the rats.

RESULTS
Treatment of the rat model of SAD with herbal extract induced a significant change in expression of Syp (p=0.001) and Psen1 (p=0.029). In Morris Water Maze, significant changes in spatial learning seen in the rat model group were improved in herbal-treated group.

CONCLUSION
This herbal extract could have anti-dementia properties and improve spatial learning and memory in SAD rat model.

Daneshmand|Parvaneh|P|
Saliminejad|Kioomars|K|
Dehghan Shasaltaneh|Marzieh|M|
Kamali|Koorosh|K|
Riazi|Gholam Hossein|GH|
Nazari|Reza|R|
Azimzadeh|Pedram|P|
Khorram Khorshid|Hamid Reza|HR|

Herbal extract
Alzheimer disease
Gene expression


Evaluating the "cushion effect" among children in frontal motor vehicle crashes.

Abstract:
BACKGROUND
The "Cushion Effect," the phenomenon in which obesity protects against abdominal injury in adults in motor vehicle accidents, has not been evaluated among pediatric patients. This work evaluates the association between subcutaneous fat cross-sectional area, quantified using analytic morphomic techniques and abdominal injury.

METHODS
This retrospective study includes 119 patients aged 1 to 18years involved in frontal impact motor vehicle accidents (2003-2015) with computed tomography scans. Subcutaneous fat cross-sectional area was measured and converted to age- and gender-adjusted percentiles from population-based normative data. Multivariable analysis determined the risk of the primary outcome, Maximum Abbreviated Injury Scale (MAIS) 2+ abdominal injury, after adjusting for age, weight, seatbelt status, and impact rating.

RESULTS
MAIS 2+ abdominal injuries occurred in 20 (16.8%) of the patients. Subcutaneous fat area percentile was not significantly associated with MAIS 2+ abdominal injury on multivariable logistic regression (adjusted Odds Ratio, 0.86; 95% CI, 0.72-1.03; p=0.10).

DISCUSSION
The "cushion effect" was not apparent among pediatric frontal motor vehicle crash victims in this study. Future work is needed to investigate other analytic morphomic measures. By understanding how body composition relates to injury patterns, there is a unique opportunity to improve vehicle safety design.

LEVEL OF EVIDENCE
Prognosis Study, Level III.

Harbaugh|Calista M|CM|
Zhang|Peng|P|
Henderson|Brianna|B|
Derstine|Brian A|BA|
Holcombe|Sven A|SA|
Wang|Stewart C|SC|
Kohoyda-Inglis|Carla|C|
Ehrlich|Peter F|PF|

Abdominal injury
Analytic morphomics
Pediatric surgery
Trauma


Primary Care Providers Welcome Smartphone Apps That Assist in Pediatric Weight Management.

Abstract: Primary care providers (PCPs) have few resources to manage their overweight/obese patients. The purpose of study was to determine if technological resources, such as smartphone apps, may be useful for weight management counseling. PCPs were surveyed about their current use of resources for obesity management and whether smartphone apps would be helpful. Seventy-four PCPs completed the survey. Only 15% currently referred patients to smartphone apps at least sometimes or more often. When asked about features of apps, 66% were not aware of apps with interactive healthy eating games, yet if aware, 45% reported they would refer patients. Providers reported a greater likelihood of being more effective using an app compared with their current ability to manage overweight/obesity, 3.19 versus 2.85, P < .01. The majority of pediatric providers surveyed do not provide technological resources for their overweight/obese patients; yet, they appear interested in using smartphone apps as a resource.

weight management
technology
pediatric obesity


Efficacy of patent foramen ovale closure for treating migraine: a prospective follow-up study.

Abstract: This study aims to evaluate the potential of percutaneous patent foramen ovale (PFO) closure to improve the headache in patients with migraine and PFO, and discuss the difference between the randomized controlled trials (RCTs) and the single-center studies. Patients of migraine with a large shunt of PFO, who experienced ≥2 headache attacks per month and failed ≥2 categories of standardized medication, underwent PFO closure in First Affiliated Hospital of Xi'an Jiao Tong University. The clinical outcomes, including frequency and duration of headache attacks, Headache Impact Test (HIT-6) score, and Visual Analogue Scale (VAS) score, were evaluated at 3, 6, and 12 months of follow-up after the PFO closure. The different efficacies of the clinical outcomes between patients with and without aura as well as different grades of PFO were also evaluated, respectively. 134 patients with migraine (39 male and 95 female) with PFO were enrolled, whose average age was 39.21±11.37 years. After PFO closure, there was a significant reduction in frequency and duration of headache attacks, HIT-6 score, and VAS score at 3, 6, and 12 months' follow-up (p<0.001). Migraine was completely relieved in 54 (40.30%) patients during 12 months' follow-up. The frequency of migraine was reduced by >50% in 44 (32.84%) patients at 3 months' follow-up and increased to 48 (35.82%) at 12 months' follow-up. 31.03% patients remained residual shunt after 6 months of closure with varying improvements of headache. This study confirmed that PFO closure can effectively reduce frequency and duration of migraine and improve quality of life, but the definitive indications and long-term effect still need further research.

Qi|Yi|Y|0000-0003-3687-735X Zhang|Yushun|Y| Luo|Xiaohui|X| Cheng|Gesheng|G| Du|Yajuan|Y| Liu|Rui|R| Xie|Hui|H| Cheng|Yawen|Y| Guo|Yichen|Y|0000-0002-0417-9795 Luo|Guogang|G|


Formulation optimization of palm kernel oil esters nanoemulsion-loaded with chloramphenicol suitable for meningitis treatment.

Abstract: Palm kernel oil esters nanoemulsion-loaded with chloramphenicol was optimized using response surface methodology (RSM), a multivariate statistical technique. Effect of independent variables (oil amount, lecithin amount and glycerol amount) toward response variables (particle size, polydispersity index, zeta potential and osmolality) were studied using central composite design (CCD). RSM analysis showed that the experimental data could be fitted into a second-order polynomial model. Chloramphenicol-loaded nanoemulsion was formulated by using high pressure homogenizer. The optimized chloramphenicol-loaded nanoemulsion response values for particle size, PDI, zeta potential and osmolality were 95.33nm, 0.238, -36.91mV, and 200mOsm/kg, respectively. The actual values of the formulated nanoemulsion were in good agreement with the predicted values obtained from RSM. The results showed that the optimized compositions have the potential to be used as a parenteral emulsion to cross blood-brain barrier (BBB) for meningitis treatment.

Musa|Siti Hajar|SH|
Basri|Mahiran|M|
Masoumi|Hamid Reza Fard|HR|
Karjiban|Roghayeh Abedi|RA|
Malek|Emilia Abd|EA|
Basri|Hamidon|H|
Shamsuddin|Ahmad Fuad|AF|

Chloramphenicol
Meningitis
Response surface methodology (RSM)
Central composite design (CCD)
Nanoemulsion
Blood-brain barrier (BBB)


Evaluation of six anti-SARS-CoV-2 antibody test kits and practical approaches to optimize the diagnostic performance.

Abstract: In an investigation of six anti-SARS-CoV-2 antibody kits with different target antigen and methodology, each kit showed comparable performance. As false-positive reactions occurred independently with different kits, specificity increased to 100% when pairs of kits were used. With three-kit combination, both sensitivity (99.1%) and specificity (100%) increased.

Ko|Jae-Hoon|JH|
Joo|Eun-Jeong|EJ|
Baek|Jin Yang|JY|
Huh|Kyungmin|K|
Cho|Sun Young|SY|
Kang|Cheol-In|CI|
Chung|Doo Ryeon|DR|
Kim|Yae-Jean|YJ|
Kang|Eun-Suk|ES|
Peck|Kyong Ran|KR|

D060888:Real-Time Polymerase Chain Reaction


Rapid first-line discrimination of methicillin resistant Staphylococcus aureus strains using MALDI-TOF MS.

Abstract: Fast and reliable discrimination of methicillin-resistant Staphylococcus aureus (MRSA) isolates is essential in identifying an outbreak. Molecular typing methods, such as S. aureus protein A (spa) typing, multi locus sequence typing (MLST) and pulse field gel electrophoresis (PFGE) are generally used for this purpose. These methods are all relatively time-consuming and not performed routinely in all laboratories. The aim of this study is to examine whether MALDI-TOF MS can be used as a fast, simple and easily implemented method for first-line discrimination of MRSA isolates. Mass spectra from 600 clinical MRSA isolates were included in the study, representing 89 spa types, associated with 16 different known clonal complexes. All spectra were obtained directly from colony material obtained from overnight cultures without prior protein extraction. We identified 43 useful discriminatory m/z-values (peaks) and used a concept of arranging these peaks into pairs or small clusters within a small mass range, allowing for quality control of the spectra obtained. Using this concept we could reproducibly characterise and arrange the isolates into 26 MALDI-TOF groups, which strongly correlated with spa types and clonal complexes. The results of this study clearly show that MALDI-TOF MS can be used for first-line discrimination of MRSA isolates, using a simple and fast method that is easy to implement as part of routine testing.

Østergaard|Claus|C|
Hansen|Sanne G K|SG|
Møller|Jens K|JK|

D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Staphylococcus aureus
MALDI-TOF MS
MRSA
Outbreak
Typing


Frostbite injuries and our experience treatment in the Samarkand area Uzbekistan.

Abstract: Cold injury remains one of the most complex and actual problems of emergency medicine. Frosting injuries are also observed in the regions with warm climate particularly in Uzbekistan able - bodies men suffer most often, 85-90% of them are admitted in the condition of alcohol intoxication. A retrospective review was performed of patients admitted to the Burn Department of the Centre of Emergency Medical Care with frostbite injury 92 individuals of 19 to 63 years of age. The data on each patient were collected including age, sex, period of injury, injuries of extremities, bacteriological investigations, along with general warming of victims, all patients were given intravenous injection of infusion spasm and to improve microcircula determination of the injury area and different general and local treatment. Treatment of these patients is very prolonged, expensive, frequently requiring crippling operations, resulting in disability.


Omalizumab treatment in adolescents with chronic spontaneous urticaria: Efficacy and safety.

Abstract:
BACKGROUND
Omalizumab is useful as an add-on treatment in patients unresponsive to high doses of second-generation antihistamines. This study aimed to evaluate the efficacy and safety of omalizumab treatment in adolescents with refractory chronic spontaneous urticaria (CSU).

METHODS
CSU patients aged 12-18 years old with the diagnosis of symptomatic CSU and unresponsive to classical treatment were included in the study. All patients had an urticaria-activity-score (UAS7) of ≥16 or and were treated with 300mg omalizumab every four weeks. The degree of response was classified into complete, partial and non-responders due to UAS7.

RESULTS
A total of 29 patients were evaluated. The median age and symptom onset age of the patients was 15.2 (IQR, 12.8-16.5) years and 14.0 (IQR, 11.8-15.9) years, respectively. The median duration of urticaria was eight (IQR, 4-24) months at admission. Eleven (37.9%) patients had angioedema and ten (34.5%) patients had concomitant allergic diseases. The median age at the beginning of treatment with omalizumab was 15.4 (IQR, 12.9-16.9) years. The median symptom duration was 12 (IQR, 6.5-27.5) months before the omalizumab treatment. Twenty-eight (96.5%) of the patients (89.6% complete, 6.9% partial) achieved response; however, one patient was a non-responder (3.5%). The adverse effect was observed in one (3.4%) patient as angioedema after the third dose. Twenty-three patients were followed up for a median of 18 (IQR, 13-27) months. Relapse was observed in three (13%) patients.

CONCLUSIONS
Omalizumab is considered as an effective and safe treatment for CSU in adolescents. Relapses mostly occur within the first year after the cessation of treatment.

Ocak|M|M|
Soyer|O|O|
Buyuktiryaki|B|B|
Sekerel|B E|BE|
Sahiner|U M|UM|

Omalizumab
Adolescents
Efficacy
Safety
Chronic urticaria


Geochemical landscapes as drivers of trace and toxic element profiles in wild red deer (Cervus elaphus).

Abstract: Tissue concentrations of essential trace and toxic elements in red deer (Cervus elaphus) are associated with the plants, soil and water they ingest. As such, variation in tissue concentrations is associated with variation in local geochemistry and bioavailability of elements. Physiological factors such as liver fluke (Fasciola hepatica) infection, breeding status, and in-tissue element interactions may also affect tissue concentrations, though their effects in red deer are not well understood. The primary objective of this study was therefore to survey wild red deer liver element concentrations across a range of geographically distinct populations during the Scottish red deer stalking season; and, in so doing, establishes element reference ranges while also exploring geographic and temporal variation and physiological factors. Livers were sampled from carcasses intended for human consumption on nine hunting estates during two seasons (2012-13, 2013-14). Samples were digested and analysed by ICP-OES for essential trace elements (Co, Cu, Fe, Mn, Mo, Se, Zn) and for Cd. Data (n=787) were modelled against cull location, date, and F. hepatica diagnosis. Interactions between elements within liver, and differences in element profiles between estates, were explored by principal component analysis. Our results revealed marked geographic variation in Cd, Cu and Se, where up to four-fold differences in median element concentrations occurred between estates, and, in males, Mn, Mo and Zn declined as the breeding season approached. In both sexes, within-liver associations (Cd-Cu-Se and Mn-Mo-Zn) were found. In females, liver Zn was greater on average in individuals that were not infected with F. hepatica. This study is the first to quantify geographic variation in Scottish red deer liver element concentrations; the drivers of which remain to be explored (and may be management related), and, the consequence of which may affect sub-clinical health.

French|Andrew S|AS|
Shaw|David|D|
Gibb|Stuart W|SW|
Taggart|Mark A|MA|

Trace element
Principal component analysis
Scotland
Tissue contaminant
Wildlife


Impact of provider-led, technology-enabled radiology management program on imaging.

Abstract:
OBJECTIVE
The study objective was to assess the impact of a provider-led, technology-enabled radiology medical management program on high-cost imaging use.

METHODS
This study was performed in the ambulatory setting of an integrated healthcare system. After negotiating a risk contract with a major commercial payer, we created a physician-led radiology medical management program to help address potentially inappropriate high-cost imaging use. The radiology medical management program was enabled by a computerized physician order entry system with integrated clinical decision support and accountability tools, including (1) mandatory peer-to-peer consultation with radiologists before order completion when test utility was uncertain on the basis of order requisition; (2) quarterly practice pattern variation reports to providers; and (3) academic detailing for targeted outliers. The primary outcome measure was intensity of high-cost imaging, defined as the number of outpatient computed tomography (CT), magnetic resonance imaging (MRI), and nuclear cardiology studies per 1000 patient-months in the payer's panel. Chi-square test was used to assess trends.

RESULTS
In 1.8 million patient-months from January 2004 to December 2009, 50,336 eligible studies were performed (54.1% CT, 40.3% MRI, 5.6% nuclear cardiology). There was a 12.0% sustained reduction in high-cost imaging intensity over the 5-year period (P < .001). The number of CT studies performed decreased from 17.5 per 1000 patient-months to 14.5 (P < .01); nuclear cardiology examinations decreased from 2.4 to 1.4 (P < .01) per 1000 patient-months. The MRI rate remained unchanged at 11 studies per 1000 patient-months.

CONCLUSION
A provider-led radiology medical management program enabled through health information technology and accountability tools may produce a significant reduction in high-cost imaging use.

Ip|Ivan K|IK|
Schneider|Louise|L|
Seltzer|Steven|S|
Smith|Allen|A|
Dudley|Jessica|J|
Menard|Andrew|A|
Khorasani|Ramin|R|

D019033:Delivery of Health Care, Integrated

Imaging use
Health information technology
Health policy


Placental weight: relation to maternal weight and growth parameters of full-term babies at birth and during childhood.

Abstract: Human growth is a continuous process. Studies defining placental effect on prenatal and postnatal human growth are few. We studied the anthropometric data of hundred mothers who gave birth at term after an uncomplicated singleton pregnancy, and their infants in relation to their placental weight using linear regression analysis. Mother weight, placental weight, and infant length (BL), weight (BW), and head circumference (HC) were obtained at birth and during childhood period (4.5 ± 2 years) of age. At birth, placental weights were correlated significantly with maternal weights (r = 0.21, P = 0.031). Placental weights were significantly correlated with growth parameters of the child at birth and during childhood. Infant BW (r = 0.71, r < 0.001), body mass index SDS (BMI SDS) (r = 0.589, P < 0.001), length SDS (LSDS) (0.567, P < 0.001) and HC (r = 0.699, P < 0.001). During childhood, placental weights were correlated with BMI SDS (r = 0.296, P = 0.002) and HtSDS = (r = 0.254, P = 0.009). LSDS at birth was correlated significantly with HtSDS during childhood (r = 0.445, P < 0.001). Placental weight represents a good marker of fetal growth (at birth) and significantly correlates with early childhood growth in full-term infants.

Soliman|Ashraf T|AT|
Eldabbagh|Mohamed|M|
Saleem|Wail|W|
Zahredin|Khaled|K|
Shatla|Emad|E|
Adel|Ashraf|A|

placental weight
mother weight
infant length
child BMI
child height SDS
infant BMI


A suite of polymerase chain reaction-based peptide tagging plasmids for epitope-targeted enzymatic functionalization of yeast proteins.

Abstract: The budding yeast and model eukaryote Saccharomyces cerevisiae has been invaluable for purification and analysis of numerous evolutionarily conserved proteins and multisubunit complexes that cannot be readily reconstituted in Escherichia coli. For many studies, it is desirable to functionalize a particular protein or subunit of a complex with a ligand, fluorophore or other small molecule. Enzyme-catalysed site-specific modification of proteins bearing short peptide tags is a powerful strategy to overcome the limitations associated with traditional nonselective labelling chemistries. Towards this end, we developed a suite of template plasmids for C-terminal tagging with short peptide sequences that can be site-specifically functionalized with high efficiency and selectivity. We have also combined these sequences with the FLAG tag as a handle for purification or immunological detection of the modified protein. We demonstrate the utility of these plasmids by site-specifically labelling the 28-subunit core particle subcomplex of the 26S proteasome with the small molecule fluorophore Cy5. The full set of plasmids has been deposited in the non-profit plasmid repository Addgene (http://www.addgene.org).

Nemec|Antonia A|AA|
Tomko|Robert J|RJ|0000-0003-2515-1078

budding yeast
proteasome
PCR
epitope tagging
fluorescence
pFA6a plasmid


Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy.

Abstract:
OBJECTIVE
This study aimed to assess the utility of onlay pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage total laryngectomy.

METHODS
A retrospective analysis was performed of 172 patients who underwent salvage laryngectomy for recurrent carcinoma of the larynx or hypopharynx between 1999 and 2014. One hundred and ten patients underwent primary closure and 62 patients had pectoralis major myofascial flap onlay.

RESULTS
The overall pharyngocutaneous fistula rate was 43 per cent, and was similar in both groups (primary closure group, 43.6 per cent; onlay flap group, 41.9 per cent; p = 0.8). Fistulae in the onlay flap group healed faster: the median and mean fistula duration were 37 and 55 days, respectively, in the primary closure group and 20 and 25 days, respectively, in the onlay flap group (p = 0.008).

CONCLUSION
Use of an onlay pectoralis major myofascial flap did not decrease the pharyngocutaneous fistula rate, although fistula duration was shortened. A well-designed randomised-controlled trial is needed to establish parameters for its routine use in clinical practice.

Sharma|S|S|
Chaukar|D A|DA|
Laskar|S G|SG|
Kapre|N|N|
Deshmukh|A|A|
Pai|P|P|
Chaturvedi|P|P|
D'Cruz|A|A|


Luminescent peptide tagging enables efficient screening for CRISPR-mediated knock-in in human induced pluripotent stem cells.

Abstract: Human pluripotent stem cells are increasingly used for CRISPR-mediated gene targeting in efforts to generate models of human diseases. This is a challenging task because of the high sensitivity of these cells to suboptimal conditions, including CRISPR-associated DNA damage and subsequent rounds of single-cell cloning. We sought to develop a sensitive method that enables rapid screening of CRISPR targeted cells, while preserving cell viability and eliminating the need for expensive sequencing of a large number of clones. A protocol was designed in which the luminescent peptide tag, HiBiT, is appended to the extracellular portion of an inert surface membrane protein (CD46), using synthetic CRISPR reagents and a widely distributed human induced pluripotent stem cell (iPSC) line. We find that this approach substantially reduces labour-intensive screening of CRISPR-targeted iPSCs and minimises the number of subcloning steps. Successfully edited iPSCs could be identified within a week of targeting, based only on extracellular luminescence detection in live cells. The total screening time in each round was less than 30 minutes and no sequencing was required. This method can be developed further to serve as a highly sensitive co-selection strategy in CRISPR knock-in experiments, particularly in the context of challenging cell lines.

tagging
screening
knock-in
human pluripotent stem cells
CRISPR
HiBiT
iPSCs


Isoform Switch of TET1 Regulates DNA Demethylation and Mouse Development.

Abstract: The methylcytosine oxidase TET proteins play important roles in DNA demethylation and development. However, it remains elusive how exactly they target substrates and execute oxidation. Interestingly, we found that, in mice, the full-length TET1 isoform (TET1e) is restricted to early embryos, embryonic stem cells (ESCs), and primordial germ cells (PGCs). By contrast, a short isoform (TET1s) is preferentially expressed in somatic cells, which lacks the N terminus including the CXXC domain, a DNA-binding module that often recognizes CpG islands (CGIs) where TET1 predominantly occupies. Unexpectedly, TET1s can still bind CGIs despite the fact that its global chromatin binding is significantly reduced. Interestingly, global chromatin binding, but not targeted binding at CGIs, is correlated with TET1-mediated demethylation. Finally, mice with exclusive expression of Tet1s failed to erase imprints in PGCs and displayed developmental defects in progeny. These data show that isoform switch of TET1 regulates epigenetic memory erasure and mouse development.

Zhang|Wenhao|W|
Xia|Weikun|W|
Wang|Qiujun|Q|
Towers|Aaron J|AJ|
Chen|Jiayu|J|
Gao|Rui|R|
Zhang|Yu|Y|
Yen|Chia-An|CA|
Lee|Ah Young|AY|
Li|Yuanyuan|Y|
Zhou|Chen|C|
Liu|Kaili|K|
Zhang|Jing|J|
Gu|Tian-Peng|TP|
Chen|Xiuqi|X|
Chang|Zai|Z|
Leung|Danny|D|
Gao|Shaorong|S|
Jiang|Yong-Hui|YH|
Xie|Wei|W|

D018507:Gene Expression Regulation, Developmental

D054730:Protein Interaction Domains and Motifs

isoform switch
Tet1
imprinting
epigenetics
DNA methylation


Motives for physical activity in the adoption and maintenance of physical activity in men with alcohol use disorders.

Abstract: Within the self-determination theory and the trans-theoretical model (stages of change) frameworks, we investigated motives for physical activity adoption and maintenance in men with alcohol use disorder (AUD). Fifty Ugandan patients completed the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3) to assess exercise motives, the Patient-centred Assessment and Counselling for Exercise (PACE) to determine stage of change and the Alcohol Use Disorders Identification Test. The relationship between motives for physical activity and stage of change was investigated using ANOVA with post-hoc Scheffe tests. Multivariate analyses found significantly higher levels of introjected, identified and integrated motivation in the action and maintenance stage versus the pre-action stage. There were no differences in intrinsic motivation between the stages of change. Our results suggest that in order to adopt and maintain an active lifestyle the most important source of motivation comes from the benefits that may be obtained rather than from the inherent pleasure or challenge associated with it. The study provides a platform for future research to investigate the importance of autonomous motivation within physical activity interventions for people with AUD.

Vancampfort|Davy|D|
Van Damme|Tine|T|
Probst|Michel|M|
Vandael|Hannelore|H|
Hallgren|Mats|M|
Mutamba|Byamah Brian|BB|
Nabanoba|Justine|J|
Basangwa|David|D|
Mugisha|James|J|

Motivation
Physical activity
Alcohol
Exercise


A highly sensitive sensor for ethyl acetate by changing fluorescent colour of lanthanide complex.

Abstract: A lanthanide complex, namely, [La2 (L-DBTA)3 (CH3 OH)2 (H2 O)2 ]∙2H2O has been synthesized using a simple reaction of L-O,O´-dibenzoyl tartaric acid with LaCl3 ∙6H2 O under ambient temperature. The luminescence spectrum in the solid state at room temperature revealed that the complex exhibited blue-light emission that originated from ligand. In addition, the lanthanide complex is developed as a fluorescent probe for sensing small molecules. Luminescence studies reveal that the lanthanide complex could detect ethyl acetate sensitively through fluorescence colour change from blue to yellow. Furthermore, the complex exhibited appealing features including high sensitivity and an ultrafast response.

ethyl acetate
lanthanide complex
colour change
luminescent sensor


Goal Navigation, Approach-Oriented Coping, and Adjustment in Young Men with Testicular Cancer.

Abstract:
BACKGROUND
Cancer can challenge important life goals for young adult survivors. Poor goal navigation skills might disrupt self-regulation and interfere with coping efforts, particularly approach-oriented attempts. Two studies are presented that investigated relationships among goal navigation processes, approach-oriented coping, and adjustment (i.e., social, emotional, and functional well-being) in separate samples of young adults with testicular cancer.

METHODS
In study 1, in-depth interviews (N = 21) were analyzed using thematic analysis to understand experiences of goal pursuit following cancer. In study 2, 171 men completed measures of goal navigation, coping, and adjustment to cancer.

RESULTS
In study 1, three prominent themes emerged: goal clarification, goal engagement and disengagement, and responses to disrupted goals. Regression analyses in study 2 revealed that goal navigation skills were positively associated with emotional (B = .35, p < .001), social (B = .24, p < .01), and functional (B = .28, p < .001) well-being, as was approach-oriented coping (B = .22, p < .01; B = .32, p < .001; B = .26, p < .001, respectively). Goal navigation moderated associations between approach-oriented coping and well-being, such that those with low goal navigation ability and low approach-oriented coping reported lower well-being.

CONCLUSIONS
Goal navigation skills and approach-oriented coping have unique and interactive relationships with adjustment to testicular cancer. They likely represent important independent targets for intervention, and goal navigation skills might also buffer the negative consequences of low use of approach-oriented coping.

Hoyt|Michael A|MA|
Gamarel|Kristi E|KE|
Saigal|Christopher S|CS|
Stanton|Annette L|AL|

Goal navigation
Coping
Adjustment
Testicular cancer
Young adults
Oncology