Diagnosis and management of food allergies: new and emerging options: a systematic review.

Abstract: It is reported that 6% of children and 3% of adults have food allergies, with studies suggesting increased prevalence worldwide over the last few decades. Despite this, our diagnostic capabilities and techniques for managing patients with food allergies remain limited. We have conducted a systematic review of literature published within the last 5 years on the diagnosis and management of food allergies. While the gold standard for diagnosis remains the double-blind, placebo-controlled food challenge, this assessment is resource intensive and impractical in most clinical situations. In an effort to reduce the need for the double-blind, placebo-controlled food challenge, several risk-stratifying tests are employed, namely skin prick testing, measurement of serum-specific immunoglobulin E levels, component testing, and open food challenges. Management of food allergies typically involves allergen avoidance and carrying an epinephrine autoinjector. Clinical research trials of oral immunotherapy for some foods, including peanut, milk, egg, and peach, are under way. While oral immunotherapy is promising, its readiness for clinical application is controversial. In this review, we assess the latest studies published on the above diagnostic and management modalities, as well as novel strategies in the diagnosis and management of food allergy.

O'Keefe|Andrew W|AW|
De Schryver|Sarah|S|
Mill|Jennifer|J|
Mill|Christopher|C|
Dery|Alizee|A|
Ben-Shoshan|Moshe|M|

skin prick testing
component testing
epinephrine autoinjector
oral immunotherapy
oral challenge
specific IgE


Skin regeneration: the complexities of translation into clinical practise.

Abstract: The integration of engineering into biological science has resulted in the capacity to provide tissue engineered solutions for tissue damage. Skin regeneration remains the goal of skin repair to reduce the long term consequences of scarring to the individual. A scar is abnormal in its architecture, chemistry and cell phenotype, tissue engineering of scaffolds and cells opens up the potential of tissue regeneration into the future. Tissue engineering solutions have been applied to skin many decades despite technical success the clinical application has been modest. To realise the potential of the developing technologies needs alignment of not only the science and engineering but also the commercial upscaling of production in a safe and regulated framework for clinical use. In addition the education and training for the introduction of new technology within the health system is essential, bringing together the technology and systems for utilisation to optimise the patient outcome. This article is part of a Directed Issue entitled: Regenerative Medicine: The challenge of translation.

Skin
Tissue engineering
Tissue regeneration
Burn wound


The renin-angiotensin-aldosterone system: a crossroad from arterial hypertension to heart failure.

Abstract: The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in the regulation of blood pressure and volume homeostasis, promoting critical structural changes in every component of the cardiovascular system, including the heart and blood vessels. Consequently, the RAAS is a crucial therapeutic target for several chronic diseases of the cardiovascular system, spanning from arterial hypertension (AH) to heart failure (HF). AH represents a leading risk factor for the development of symptomatic HF, particularly with left ventricle (LV) preserved ejection fraction (HFpEF). LV diastolic dysfunction and cardiac remodelling are the first discernible manifestations of heart disease in patients with AH. Typically, AH develops many years before the diagnosis of overt HF, providing a therapeutic target for preventive strategies. Treatment of AH is based on different classes of antihypertensive drugs, which show differences in their capacity to prevent the evolution towards HF. The blockers of the RAAS are effective drugs to treat AH and prevent HF with reduced ejection fraction (HFrEF), but the evidence of the potential benefits in patients with HFpEF remains limited. In this review, the authors summarise data from several clinical trials of HFpEF and HFrEF, focusing on the mechanisms leading the transition from AH to HF and late complications.

D016032:Randomized Controlled Trials as Topic

Renin-angiotensin-aldosterone system
Arterial hypertension
Heart failure
Preserved ejection fraction


Carotenoids and their role in cancer prevention.

Abstract: Approximately two of every five people will develop cancer in their lifetime. Dietary modifications are one of the most promising lifestyle changes that can adjust the risk of developing cancer by nearly 40%. Carotenoids are a diverse group of natural pigments and are present in many fruits and vegetables. The data surrounding carotenoids and their potential roles in carcinogenesis have been rapidly growing over the past two decades. This review summarizes the literature surrounding the associations between the most six common carotenoids in the diet and ten of the most commonly diagnosed cancers. In this study, preclinical, epidemiological, and toxicology data were reviewed. Data from these studies suggest that several carotenoids might provide a beneficial impact on reducing carcinogenesis. Further studies are needed to determine the causal relationships between individual carotenoids and cancer incidence and progression. This article is part of a Special Issue entitled Carotenoids recent advances in cell and molecular biology edited by Johannes von Lintig and Loredana Quadro.

Carotenoids Cancer Prevention Epidemiology Beta-carotene Lycopene


Detection and Predictive Value of Fractional Anisotropy Changes of the Corticospinal Tract in the Acute Phase of a Stroke.

Abstract:
BACKGROUND AND PURPOSE
A decrease in fractional anisotropy (FA) of the ipsilesional corticospinal tract (CST) distal to stroke lesions in the subacute (eg, 30 days) and chronic phase has been correlated with poor motor outcomes, but it is unclear whether FA values obtained within the acute stroke phase (here defined as 80 hours after onset) can predict later outcome.

METHODS
Fifty-eight patients underwent an assessment of motor impairment in the acute phase and at 3 months using the upper extremity Fugl-Meyer assessment. FA values, obtained within 80 hours after stroke onset, were determined in 2 regions of interest: cerebral peduncle and a stretch of the CST caudal to each stroke lesion (nearest-5-slices).

RESULTS
The FA laterality index for the cerebral peduncle-regions of interest was a poor predictor of 3-month outcome (R(2)=0.044; P=0.137), whereas the slope over the FA laterality index of the nearest-5-slices showed a relatively weak but significant prediction (R(2)=0.11; P=0.022) with the affected side having lower FA values. Initial upper extremity Fugl-Meyer (R(2)=0.69; P<0.001) and the weighted CST lesion load (R(2)=0.71; P<0.001) were strong predictors of 3-month outcome. In multivariate analyses, controlling for initial upper extremity Fugl-Meyer, weighted CST lesion load, and days-of-therapy, neither the FA laterality index of the cerebral peduncle nor the slope over the FA laterality index of the nearest-5-slices significantly contributed to the prediction of 86% of the variance in the upper extremity Fugl-Meyer at 3 months.

CONCLUSIONS
FA reductions of the CST can be detected near the ischemic lesion in the acute stroke phase, but offer minimal predictive value to motor outcomes at 3 months.

Doughty|Christopher|C| Wang|Jasmine|J| Feng|Wuwei|W| Hackney|David|D| Pani|Ethan|E| Schlaug|Gottfried|G|

corticospinal tract
stroke
lesion load
diffusion tensor imaging
lesion mapping
magnetic resonance imaging
outcomes assessment


Checkpoint immunotherapy for cancer: superior survival, unaccustomed toxicities.

Abstract: Novel cancer immunotherapy antibodies are moving from clinical trials into routine practice, delivering sustained benefits and prolonged survival to patients with melanoma, lung, kidney and other cancers. These immunostimulatory antibodies non-specifically activate the patient's own immune system by inhibiting immune system checkpoint proteins. This mechanism of action is entirely different to traditional cancer treatments, such as chemotherapy. While there are virtually no immediate toxicities, serious life-threatening autoimmune side-effects such as colitis, dermatitis, hypophysitis, pneumonitis and hepatitis can occur, sometimes starting long after the treatment has been given. Recognition, referral and prompt treatment with immunosuppressive drugs like corticosteroids can control these immune-related side-effects without compromising efficacy. This exciting new class of drugs is defining a new paradigm in cancer therapy.

Gedye|C|C|
van der Westhuizen|A|A|
John|T|T|

immunotherapy
cancer
melanoma
checkpoint protein
immune-related side-effect
lung cancer


Data Integrity-Based Methodology and Checklist for Identifying Implementation Risks of Physiological Sensing in Mobile Health Projects: Quantitative and Qualitative Analysis.

Abstract:
BACKGROUND
Mobile health (mHealth) technologies have the potential to bring health care closer to people with otherwise limited access to adequate health care. However, physiological monitoring using mobile medical sensors is not yet widely used as adding biomedical sensors to mHealth projects inherently introduces new challenges. Thus far, no methodology exists to systematically evaluate these implementation challenges and identify the related risks.

OBJECTIVE
This study aimed to facilitate the implementation of mHealth initiatives with mobile physiological sensing in constrained health systems by developing a methodology to systematically evaluate potential challenges and implementation risks.

METHODS
We performed a quantitative analysis of physiological data obtained from a randomized household intervention trial that implemented sensor-based mHealth tools (pulse oximetry combined with a respiratory rate assessment app) to monitor health outcomes of 317 children (aged 6-36 months) that were visited weekly by 1 of 9 field workers in a rural Peruvian setting. The analysis focused on data integrity such as data completeness and signal quality. In addition, we performed a qualitative analysis of pretrial usability and semistructured posttrial interviews with a subset of app users (7 field workers and 7 health care center staff members) focusing on data integrity and reasons for loss thereof. Common themes were identified using a content analysis approach. Risk factors of each theme were detailed and then generalized and expanded into a checklist by reviewing 8 mHealth projects from the literature. An expert panel evaluated the checklist during 2 iterations until agreement between the 5 experts was achieved.

RESULTS
Pulse oximetry signals were recorded in 78.36% (12,098/15,439) of subject visits where tablets were used. Signal quality decreased for 1 and increased for 7 field workers over time (1 excluded). Usability issues were addressed and the workflow was improved. Users considered the app easy and logical to use. In the qualitative analysis, we constructed a thematic map with the causes of low data integrity. We sorted them into 5 main challenge categories: environment, technology, user skills, user motivation, and subject engagement. The obtained categories were translated into detailed risk factors and presented in the form of an actionable checklist to evaluate possible implementation risks. By visually inspecting the checklist, open issues and sources for potential risks can be easily identified.

CONCLUSIONS
We developed a data integrity-based methodology to assess the potential challenges and risks of sensor-based mHealth projects. Aiming at improving data integrity, implementers can focus on the evaluation of environment, technology, user skills, user motivation, and subject engagement challenges. We provide a checklist to assist mHealth implementers with a structured evaluation protocol when planning and preparing projects.

mHealth
physiological monitoring
medical sensors
data completeness
signal quality
content analysis
data quality
digital health
implementation research


Cytoskeletal Alteration Is an Early Cellular Response in Pulmonary Epithelium Infected with Aspergillus fumigatus Rather than Scedosporium apiospermum.

Abstract: Invasive aspergillosis and scedosporiosis are life-threatening fungal infections with similar clinical manifestations in immunocompromised patients. Contrarily, Scedosporium apiospermum is susceptible to some azole derivative but often resistant to amphotericin B. Histopathological examination alone cannot diagnose these two fungal species. Pathogenesis studies could contribute to explore candidate protein markers for new diagnosis and treatment methods leading to a decrease in mortality. In the present study, proteomics was conducted to identify significantly altered proteins in A549 cells infected with or without Aspergillus fumigatus and S. apiospermum as measured at initial invasion. Protein validation was performed with immunogold labelling alongside immunohistochemical techniques in infected A549 cells and lungs from murine models. Further, cytokine production was measured, using the Bio-Plex-Multiplex immunoassay. The cytoskeletal proteins HSPA9, PA2G4, VAT1, PSMA2, PEX1, PTGES3, KRT1, KRT9, CLIP1 and CLEC20A were mainly changed during A. fumigatus infection, while the immunologically activated proteins WNT7A, GAPDH and ANXA2 were principally altered during S. apiospermum infection. These proteins are involved in fungal internalisation and structural destruction leading to pulmonary disorders. Interleukin (IL)-21, IL-1α, IL-22, IL-2, IL-8, IL-12, IL-17A, interferon-γ and tumour necrosis factor-α were upregulated in both aspergillosis and scedosporiosis, although more predominately in the latter, in accordance with chitin synthase-1 and matrix metalloproteinase levels. Our results demonstrated that during invasion, A. fumigatus primarily altered host cellular integrity, whereas S. apiospermum chiefly induced and extensively modulated host immune responses.

Aspergillus fumigatus
Scedosporium apiospermum
Histopathology
Proteomics
Bio-Plex-Multiplex immunoassay
Cytoskeleton


High Accumulation and Subcellular Distribution of Thallium in Green Cabbage (Brassica Oleracea L. Var. Capitata L.).

Abstract: The accumulation of thallium (Tl) in brassicaceous crops is widely known, but both the uptake extents of Tl by the individual cultivars of green cabbage and the distribution of Tl in the tissues of green cabbage are not well understood. Five commonly available cultivars of green cabbage grown in the Tl-spiked pot-culture trials were studied for the uptake extent and subcellular distribution of Tl. The results showed that all the trial cultivars mainly concentrated Tl in the leaves (101∼192 mg/kg, DW) rather than in the roots or stems, with no significant differences among cultivars (p = 0.455). Tl accumulation in the leaves revealed obvious subcellular fractionation: cell cytosol and vacuole >> cell wall > cell organelles. The majority (∼ 88%) of leaf-Tl was found to be in the fraction of cytosol and vacuole, which also served as the major storage site for other major elements such as Ca and Mg. This specific subcellular fractionation of Tl appeared to enable green cabbage to avoid Tl damage to its vital organelles and to help green cabbage tolerate and detoxify Tl. This study demonstrated that all the five green cabbage cultivars show a good application potential in the phytoremediation of Tl-contaminated soils.

Ning|Zengping|Z| He|Libin|L| Xiao|Tangfu|T| Márton|László|L|

subcellular distribution
Thallium
green cabbage
uptake
translocation


lncRNA profile of Apis mellifera and its possible role in behavioural transition from nurses to foragers.

Abstract:
BACKGROUND
The behavioural transition from nurses to foragers in honey bees is known to be affected by intrinsic and extrinsic factors, including colony demography, hormone levels, brain chemistry and structure, and gene expression in the brain. However, the molecular mechanism underlying this behavioural transition of honey bees is still obscure.

RESULTS
Through RNA sequencing, we performed a comprehensive analysis of lncRNAs and mRNAs in honey bee nurses and foragers. Nurses and foragers from both typical colonies and single-cohort colonies were used to prepare six libraries to generate 49 to 100 million clear reads per sample. We obtained 6863 novel lncRNAs, 1480 differentially expressed lncRNAs between nurses and foragers, and 9308 mRNAs. Consistent with previous studies, lncRNAs showed features distinct from mRNAs, such as shorter lengths, lower exon numbers, and lower expression levels compared to mRNAs. Bioinformatic analysis showed that differentially expressed genes were mostly involved in the regulation of sensory-related events, such as olfactory receptor activity and odorant binding, and enriched Wnt and FoxO signaling pathways. Moreover, we found that lncRNAs TCONS_00356023, TCONS_00357367, TCONS_00159909 and mRNAs dop1, Kr-h1 and HR38 may play important roles in behavioural transition in honey bees.

CONCLUSION
This study characterized the expression profile of lncRNAs in nurses and foragers and provided a framework for further study of the role of lncRNAs in honey bee behavioural transition.

Liu|Fang|F|
Shi|Tengfei|T|
Qi|Lei|L|
Su|Xin|X|
Wang|Deqian|D|
Dong|Jie|J|
Huang|Zachary Y|ZY|

D000818:Animals
D001516:Bees
D001522:Behavior, Animal
D020869:Gene Expression Profiling
D062085:RNA, Long Noncoding
D012333:RNA, Messenger
D017423:Sequence Analysis, RNA

lncRNA
Behavioural transition
Nurses
Foragers
mRNA


Comparative Study of Microbiological Profile and Management Outcomes of Acute Endophthalmitis after Microincision Vitrectomy Surgery versus Intravitreal Injections.

Abstract: Purpose: The aim of this study was to evaluate and compare incidence and outcomes of management of acute endophthalmitis after microincision vitrectomy surgery (MIVS) and intravitreal injections (IVIs).Methods: Medical records were retrospectively reviewed from January 2012 to December 2017, and the incidence, clinical and microbiological profiles of acute endophthalmitis were documented.Results: Of 26,332 MIVS and 24,143 IVI performed, incidence of acute endophthalmitis in MIVS group was 0.027% (1 in 3761 cases) against 0.054% (1 in 1857 cases) in IVI. Gram-positive organisms were causative in post IVI group as against gram-negative organisms in MIVS group.Conclusion: Incidence of endophthalmitis after IVI is almost twice that after MIVS. A trend toward poorer outcomes in MIVS eyes was observed. Both MIVS and IVI being pars plana procedures warrant similar kind of aseptic precautions.

Endophthalmitis
intravitreal injection
MIVS
IVI
pars plana vitrectomy


Control of hmu Heme Uptake Genes in Yersinia pseudotuberculosis in Response to Iron Sources.

Abstract: Despite the mammalian host actively sequestering iron to limit pathogenicity, heme (or hemin when oxidized) and hemoproteins serve as important sources of iron for many bloodborne pathogens. The HmuRSTUV hemin uptake system allows Yersinia species to uptake and utilize hemin and hemoproteins as iron sources. HmuR is a TonB-dependent outer membrane receptor for hemin and hemoproteins. HmuTUV comprise a inner membrane ABC transporter that transports hemin and hemoproteins from the periplasmic space into the bacterial cytoplasm, where it is degraded by HmuS. Here we show that hmuSTUV but not hmuR are expressed under iron replete conditions, whereas hmuR as well as hmuSTUV are expressed under iron limiting conditions, suggesting complex transcriptional control. Indeed, expression of hmuSTUV in the presence of inorganic iron, but not in the presence of hemin, requires the global regulator IscR acting from a promoter in the intergenic region between hmuR and hmuS. This effect of IscR appears to be direct by binding a site mapped by DNaseI footprinting. In contrast, expression of hmuR under iron limiting conditions requires derepression of the ferric uptake regulator Fur acting from the hmuR promoter, as Fur binding upstream of hmuR was demonstrated biochemically. Differential expression by both Fur and IscR would facilitate maximal hemin uptake and utilization when iron and heme availability is low while maintaining the capacity for periplasmic removal and cytosolic detoxification of heme under a wider variety of conditions. We also demonstrate that a Y. pseudotuberculosis ΔiscR mutant has a survival defect when incubated in whole blood, in which iron is sequestered by heme-containing proteins. Surprisingly, this phenotype was independent of the Hmu system, the type III secretion system, complement, and the ability of Yersinia to replicate intracellularly. These results suggest that IscR regulates multiple virulence factors important for Yersinia survival and growth in mammalian tissues and reveal a surprising complexity of heme uptake expression and function under differing conditions of iron.

Schwiesow|Leah|L|
Mettert|Erin|E|
Wei|Yahan|Y|
Miller|Halie K|HK|
Herrera|Natalia G|NG|
Balderas|David|D|
Kiley|Patricia J|PJ|
Auerbuch|Victoria|V|

D015964:Gene Expression Regulation, Bacterial


Surveillance of COVID-19 in the General Population Using an Online Questionnaire: Report From 18,161 Respondents in China.

Abstract:
BACKGROUND
The recent outbreak of the coronavirus disease (COVID-19) has become an international pandemic. So far, little is known about the role of an internet approach in COVID-19 participatory surveillance.

OBJECTIVE
The aim of this study is to investigate whether an online survey can provide population-level information for observing prevalence trends during the early phase of an outbreak and identifying potential risk factors of COVID-19 infection.

METHODS
A 10-item online questionnaire was developed according to medical guidelines and relevant publications. It was distributed between January 24 and February 17, 2020. The characteristics of respondents and temporal changes of various questionnaire-derived indicators were analyzed.

RESULTS
A total of 18,161 questionnaires were returned, including 6.45% (n=1171) from Wuhan City. Geographical distributions of the respondents were consistent with the population per province (R2=0.61, P<.001). History of contact significantly decreased with time, both outside Wuhan City (R2=0.35, P=.002) and outside Hubei Province (R2=0.42, P<.001). The percentage of respondents reporting a fever peaked around February 8 (R2=0.57, P<.001) and increased with a history of contact in the areas outside Wuhan City (risk ratio 1.31, 95% CI 1.13-1.52, P<.001). Male sex, advanced age, and lung diseases were associated with a higher risk of fever in the general population with a history of contact.

CONCLUSIONS
This study shows the usefulness of an online questionnaire for the surveillance of outbreaks like COVID-19 by providing information about trends of the disease and aiding the identification of potential risk factors.

D007722:Health Knowledge, Attitudes, Practice

surveillance
COVID-19
online questionnaire
coronavirus
participatory surveillance
Wuhan
syndromic surveillance


Emissions and Health Implications of Pennsylvania's Entry into the Regional Greenhouse Gas Initiative.

Abstract: The Regional Greenhouse Gas Initiative (RGGI) is a cap-and-trade system targeting CO2 emissions from the electricity sector in the northeastern United States. As a major power producer and carbon emitter, Pennsylvania plans to join RGGI in 2022, which will affect both the carbon market (i.e., RGGI) and the regional electricity market (i.e., PJM). Combining a PJM power system model with a reduced-form model of CO2 emissions abatement from RGGI states that are not in PJM, we find the annual average emissions from power plants in Pennsylvania can be reduced by 40%, 79%, 68%, and 76% for CO2, SO2, NOx, and PM2.5, respectively, during 2022-2030. Then, based on a range of source-specific marginal damage estimates, we find the cumulative monetized health cobenefits to be 17.7 to 40.8 billion USD. However, the reduced emissions and health damages in Pennsylvania are slightly offset by increases in the other states in PJM that do not participate in RGGI. Our study hence highlights the potential cross-state leakage issue that warrants careful consideration in the policy design and implementation process.

Yang|Hui|H|
Pham|An Thu|AT|
Landry|Joel Reid|JR|
Blumsack|Seth Adam|SA|
Peng|Wei|W|0000-0002-1980-0759

D000393:Air Pollutants
D000397:Air Pollution
D000074382:Greenhouse Gases
D010414:Pennsylvania
D011210:Power Plants

RGGI
electricity market
cobenefits
health damage
Air pollution
climate policy


Analysis of the process of representing clinical statements for decision-support applications: a comparison of openEHR archetypes and HL7 virtual medical record.

Abstract: Delivering patient-specific decision-support based on computer-interpretable guidelines (CIGs) requires mapping CIG clinical statements (data items, clinical recommendations) into patients' data. This is most effectively done via intermediate data schemas, which enable querying the data according to the semantics of a shared standard intermediate schema. This study aims to evaluate the use of HL7 virtual medical record (vMR) and openEHR archetypes as intermediate schemas for capturing clinical statements from CIGs that are mappable to electronic health records (EHRs) containing patient data and patient-specific recommendations. Using qualitative research methods, we analyzed the encoding of ten representative clinical statements taken from two CIGs used in real decision-support systems into two health information models (openEHR archetypes and HL7 vMR instances) by four experienced informaticians. Discussion among the modelers about each case study example greatly increased our understanding of the capabilities of these standards, which we share in this educational paper. Differing in content and structure, the openEHR archetypes were found to contain a greater level of representational detail and structure while the vMR representations took fewer steps to complete. The use of openEHR in the encoding of CIG clinical statements could potentially facilitate applications other than decision-support, including intelligent data analysis and integration of additional properties of data items from existing EHRs. On the other hand, due to their smaller size and fewer details, the use of vMR potentially supports quicker mapping of EHR data into clinical statements.

González-Ferrer|A|A|
Peleg|M|M|
Marcos|M|M|
Maldonado|J A|JA|

D020000:Decision Support Systems, Clinical

D016347:Medical Records Systems, Computerized

openEHR archetypes
Computer-interpretable guidelines
HL7 virtual Medical Record (vMR)
Clinical decision-support systems
Clinical guidelines
Data integration


Disposition of isoflupredone acetate in plasma, urine and synovial fluid following intra-articular administration to exercised Thoroughbred horses.

Abstract: The use of isoflupredone acetate in performance horses and the scarcity of published pharmacokinetic data necessitate further study. The objective of the current study was to describe the plasma pharmacokinetics of isoflupredone acetate as well as time-related urine and synovial fluid concentrations following intra-articular administration to horses. Twelve racing-fit adult Thoroughbred horses received a single intra-articular administration (8 mg) of isoflupredone acetate into the right antebrachiocarpal joint. Blood, urine and synovial fluid samples were collected prior to and at various times up to 28 days post drug administration. All samples were analyzed using liquid chromatography-Mass Spectrometry. Plasma data were analyzed using a population pharmacokinetic compartmental model. Maximum measured plasma isoflupredone concentrations were 1.76 ± 0.526 ng/mL at 4.0 ± 1.31 h and 1.63 ± 0.243 ng/mL at 4.75 ± 0.5 h, respectively, for horses that had synovial fluid collected and for those that did not. The plasma beta half-life was 24.2 h. Isoflupredone concentrations were below the limit of detection in all horses by 48 h and 7 days in plasma and urine, respectively. Isoflupredone was detected in the right antebrachiocarpal and middle carpal joints for 8.38 ± 5.21 and 2.38 ± 0.52 days, respectively. Results of this study provide information that can be used to regulate the use of intra-articular isoflupredone in the horse.

Knych|Heather K|HK|
Harrison|Linda M|LM|
White|Alexandria|A|
McKemie|Daniel S|DS|

isoflupredone
corticosteroid
horse, intra-articular
racehorse


The effect of aircraft, road, and railway traffic noise on stroke - results of a case-control study based on secondary data.

Abstract:
Aim
To examine the stroke risks associated with aircraft, road traffic, and railway noise exposure in a large case-control study.

Materials and Methods
All people aged ≥40 years living around the Frankfurt airport that were insured by one of three large statutory health insurance funds between 2005 and 2010 were included in the study (n = 1,026,670). Address-specific exposure to aircraft, road, and railway traffic noise was estimated for 2005. We used insurance claim data to identify 25,495 newly diagnosed cases of stroke between 2006 and 2010 and compared them with 827,601 control participants. Logistic regression analysis was used to calculate the odds ratios adjusted for age, sex, local proportion of people receiving unemployment benefits, and if available individual indicators of socioeconomic status (education, occupation).

Results
For 24-h continuous aircraft noise exposure, neither increased risk estimates nor a positive linear exposure-risk relation was found. However, stroke risk was statistically significantly increased by 7% [95% confidence intervals (95%CI): 2-13%] for people who were exposed to <40 dB of 24-h continuous aircraft noise, but ≥6 events of maximum nightly sound pressure levels ≥50 dB. For road and railway traffic noise, there was a positive linear exposure-risk relation: Per 10 dB the stroke risk increased by 1.7% (95%CI: 0.3-3.2%) for road traffic noise and by 1.8% (95%CI: 0.1-3.3%) for railway traffic noise. The maximum risk increase of 7% (95%CI: 0-14%) for road traffic noise and 18% (95%CI: 2-38%) for railway traffic noise was found in the exposure category ≥65 to <70 dB.

Conclusion
This large case-control study indicates that traffic noise exposure may lead to an increase in stroke risk. It furthermore suggests that maximum aircraft noise levels at night increase the stroke risk even when continuous noise exposure is low, and thus highlights the relevance of maximum noise levels for research and policies on noise protection.

Seidler|Anna Lene|AL|
Hegewald|Janice|J|
Schubert|Melanie|M|
Weihofen|Verena Maria|VM|
Wagner|Mandy|M|
Dröge|Patrik|P|
Swart|Enno|E|
Zeeb|Hajo|H|
Seidler|Andreas|A|


Subcutaneous implantable cardioverter defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy: Results from an Italian multicenter registry.

Abstract:
BACKGROUND
Despite expanding indication of the subcutaneous implantable cardioverter defibrillator (S-ICD) in clinical practice, limited data exists on safety and efficacy of S-ICD in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. The aim of this multicenter study was to evaluate the safety and efficacy of S-ICD in ARVC patients.

METHODS
The study population included 44 consecutive patients with definite ARVC diagnosis according to the 2010 ITF criteria (57% male, mean age 37 ± 17 years [range 10-75 years]) who received an S-ICD. Eighteen (41%) patients were implanted for secondary prevention.

RESULTS
At implant, all inducible patients (34/44) had conversion of ventricular fibrillation at 65 J. No early complications occurred. During a median follow-up of 12 months (7-19), 3 (6.8%) patients experienced complications requiring surgical revision. No local or systemic device-related infections were observed. Six patients (14%) received a total of 61 appropriate and successful shocks on ventricular arrhythmias. Six (14%) patients experienced 8 inappropriate shocks for oversensing of cardiac signal (4 cases) and non-cardiac signal (4 cases) with one patient requiring device explantation. No patients had the device explanted due to the need for antitachycardia pacing.

CONCLUSIONS
The study shows that S-ICD provides safe and effective therapy for termination of both induced and spontaneous malignant ventricular tachyarrhythmias with high energy shocks in ARVC patients, but the risk of inappropriate shocks and complications needing surgical revision should be considered.

Migliore|Federico|F|
Viani|Stefano|S|
Bongiorni|Maria Grazia|MG|
Zorzi|Alessandro|A|
Silvetti|Massimo Stefano|MS|
Francia|Pietro|P|
D'Onofrio|Antonio|A|
De Franceschi|Pietro|P|
Sala|Simone|S|
Donzelli|Stefano|S|
Ricciardi|Giuseppe|G|
Menardi|Endry|E|
Giammaria|Massimo|M|
La Greca|Carmelo|C|
Bauce|Barbara|B|
Rigato|Ilaria|I|
Iliceto|Sabino|S|
Bertaglia|Emanuele|E|
Diemberger|Igor|I|
Corrado|Domenico|D|

D019571:Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic right ventricular cardiomyopathy


Towards a definition of Ancient Rare Diseases (ARD): Presenting a complex case of probable Legg-Calvé-Perthes Disease from the North Caucasian Bronze Age (2200-1650 cal BCE).

Abstract:
OBJECTIVE
This study discusses the challenges and possibilities of establishing a definition for Ancient Rare Diseases (ARD) in a probable case of Legg-Calvé-Perthes Disease (LCPD) from the Bronze Age cemetery Kudachurt 14, situated in the Northern Caucasus.

MATERIALS
We investigated the skeletal remains of a male aged 35-45 years at death. For comparison we examined other males buried at Kudachurt 14 (n = 24) and reviewed 22 LCPD cases from the paleopathological literature.

METHODS
We use macroscopic as well as osteometric examination methods and imaging techniques.

RESULTS
The morphology of the left hip joint corresponds to skeletal characteristics for LCPD. Co-occurring osteochondrosis dissecans, femoral anteversion, and atrophy of the left femoral shaft suggest a complex disease course.

CONCLUSIONS
Modern criteria of rare diseases applied on ancient skeletal remains are either non-transferable or require completion. We conclude that rarity is dynamic, etiological uncertainty has to be accepted, and the respective socioeconomic context is crucial. Degree of disability and level of sociomedical investment are not defining criteria for ARD.

SIGNIFICANCE
Dating 2200-1650 cal BCE, this study currently presents the earliest case of probable LCPD. This is the first attempt to transform modern characteristics of rare diseases for establishing a paleopathological concept of ARD.

LIMITATIONS
As this study is limited to LCPD, our conclusions are not directly applicable to other ARD in question.

SUGGESTIONS FOR FURTHER RESEARCH
More focused paleopathological research on skeletal populations from different cultures and time periods is needed, enabling an evolutionary perspective on the comparability of ancient, modern and future rare diseases.

Fuchs|Katharina|K|
Atabiev|Biaslan Ch|BC|
Witzmann|Florian|F|
Gresky|Julia|J|

Osteochondrosis dissecans
Femoral anteversion
Avascular necrosis
Coxa magna
Fractures
Impairment


Potential Anti-Inflammatory and Anti-Cancer Properties of Farnesol.

Abstract: Farnesol, an acyclic sesquiterpene alcohol, is predominantly found in essential oils of various plants in nature. It has been reported to exhibit anti-cancer and anti-inflammatory effects, and also alleviate allergic asthma, gliosis, and edema. In numerous tumor cell lines, farnesol can modulate various tumorigenic proteins and/or modulates diverse signal transduction cascades. It can also induce apoptosis and downregulate cell proliferation, angiogenesis, and cell survival. To exert its anti-inflammatory/anti-oncogenic effects, farnesol can modulate Ras protein and nuclear factor kappa-light-chain-enhancer of activated B cells activation to downregulate the expression of various inflammatory mediators such as cyclooxygenase-2, inducible nitric oxide synthase, tumor necrosis factor alpha, and interleukin-6. In this review, we describe the potential mechanisms of action underlying the therapeutic effects of farnesol against cancers and inflammatory disorders. Furthermore, these findings support the clinical development of farnesol as a potential pharmacological agent in clinical studies.

Jung|Young Yun|YY|
Hwang|Sun Tae|ST|
Sethi|Gautam|G|
Fan|Lu|L|
Arfuso|Frank|F|
Ahn|Kwang Seok|KS|0000-0002-2882-0612

D015972:Gene Expression Regulation, Neoplastic


Anti-embolic and anti-oxidative effects of a novel (E)-4-amino-N'-(1-(7-hydroxy-2-oxo-2H-chromen-3-yl) ethylidene) benzohydrazide against isoproterenol and vitamin-K induced ischemic stroke.

Abstract: This study aimed to evaluate the cerebroprotective potential of a novel synthetic coumarin, (E)-4-amino-N'-(1-(7-hydroxy-2-oxo-2H-chromen-3-yl)ethylidene) benzohydrazide noted (HC) against a pharmaceutically induced ischemic stroke in experimental male Wistar rats. Animals were randomly allocated into four groups: control, Stroke, Stroke + Ace (acenocoumarol) and Stroke + HC-treated group for 7 days. Our results showed that stroke group evidenced atrial flutter, significant cardiac hypertrophy (+23%) and increase in plasma level of troponin-T, with disturbance in plasma ionic levels and rise in fibrinogen rate and oxidative damages in heart and brain. Moreover, the histological findings revealed myocardium necrosis, cardiac cavity thrombi and brain injury as compared to normal rats. However, HC-treatment significantly prevents the embolic process, improves cerebral damages and mitigates the oxidative stress markers in stroke rats. Overall, HC is endowed with a thrombolytic potential against MI and stroke in such severe conditions through an anti-vit K (AVK) mechanism.

Mnafgui|Kais|K| Khdhiri|Emna|E| Ghazouani|Lakhdar|L| Ncir|Marwa|M| Zaafouri|Zouhaier|Z| Allouche|Noureddine|N| Elfeki|Abdelfattah|A| Ammar|Houcine|H| Abid|Souhir|S| Hajji|Raouf|R|

Stroke
coumarin
atrial flutter
fibrinogen
myocardial infarction


Serum biochemical profile and molecular detection of pathogens in semen of infertile male dromedary camels (Camelus dromedarius).

Abstract: Detection of pathogens in the semen of camels has not been completely elucidated. Therefore, the current study aimed to determine the association of some economically important pathogens with infertility in 94 male infertile camels through molecular detection and estimation of selected biochemical parameters in serum of these animals compared with a control non infected fertile animals (n=40). PCR analysis of semen samples of infertile camels indicated that, four potential pathogens namely Mycoplasma spp., Leptospira spp., Brucella melitensis, and Bovine viral diarrhea virus (BVDV) were detected in 50 semen samples of infertile camels whereas, 44 semen samples of infertile camels were free of pathogens and all tested semen samples were negative for bovine herpes virus 1, Salmonella spp. and Trypanosoma evansi. Single and mixed infection was detected in 88% and 12% of the infected semen samples, respectively. Mycoplasma spp., Leptospira spp., Brucella and Bovine viral diarrhea virus infection represented 66%, 27.2%, 4.5% and 2.3% of the single infected semen samples. Mycoplasma spp.+Leptospira spp. and Mycoplasma spp.+Brucella spp. were detected in 83.3% and 16.7% of mixed infected semen samples, respectively. Testosterone concentration decreased significantly in infertile infected camels compare to both control and infertile non infected animals that remained comparable. The current findings reported the molecular detection of mixed infection in camel semen for the first time. Mycoplasma spp. is the most widely recognized microorganism in the present study and together with Leptospira spp., Brucella spp. and Bovine viral diarrhea virus, might be associated with infertility in dromedary camels.

Al-Busadah|Khaled A|KA|
El-Bahr|Sabry M|SM|
Khalafalla|Abdelmalik I|AI|

Serum Semen Infertility Camels Microorganisms Biochemistry


Cephalometric comparison of adult anterior open bite treatment using clear aligners and fixed appliances.

Abstract:
OBJECTIVES
To compare fixed appliances and clear aligner therapy in correcting anterior open bite and in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns.

MATERIALS AND METHODS
In this retrospective study, two treatment groups of adult (≥18 years old) hyperdivergent patients (mandibular plane angles of ≥38°) with anterior open bites were included: 17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurements representing the vertical dimension were reported for each group. A two-sample t-test was used to assess differences in changes in mandibular plane angle and overbite between the two treatment groups.

RESULTS
There were no statistical differences found in the magnitude of overbite correction and the changes in any of the cephalometric measurements for vertical control. The clear aligner group showed a slightly greater amount of lower incisor extrusion ( P = .009). The main mechanism of open bite correction was similar between the two treatment groups and was accomplished through retroclination of the upper and lower incisors while maintaining the vertical position of the upper and lower molars.

CONCLUSIONS
Cephalometric comparison of anterior open bite correction and changes in the mandibular plane angle associated with use of clear aligners and fixed appliances did not demonstrate statistically significant differences in adult hyperdivergent patients.

Garnett|Bella Shen|BS|
Mahood|Kimberly|K|
Nguyen|Mai|M|
Al-Khateeb|Aliaa|A|
Liu|Siqi|S|
Boyd|Robert|R|
Oh|Heesoo|H|

Adult
Open bite
Clear Aligner
Fixed appliance
Hyperdivergent
Vertical control


The Effect of Absorption-Enhancement and the Mechanism of the PAMAM Dendrimer on Poorly Absorbable Drugs.

Abstract: The polyamidoamine (PAMAM) dendrimer is a highly efficient absorption promoter. In the present study, we studied the absorption-enhancing effects and the mechanism of PAMAM dendrimers with generation 0 to generation 3 (G0⁻G3) and concentrations (0.1⁻1.0%) on the pulmonary absorption of macromolecules. The absorption-enhancing mechanisms were elucidated by microarray, western blotting analysis, and PCR. Fluorescein isothiocyanate-labeled dextrans (FDs) with various molecular weights were used as model drugs of poorly absorbable drugs. The absorption-enhancing effects of PAMAM dendrimers on the pulmonary absorption of FDs were in a generation- and concentration-dependent manner. The G3 PAMAM dendrimer with high effectiveness was considered to the best absorption enhancer for improving the pulmonary absorption of FDs. G3 PAMAM dendrimers at three different concentrations were non-toxic to Calu-3 cells. Based on the consideration between efficacy and cost, the 0.1% G3 PAMAM dendrimer was selected for subsequent studies. The results showed that treatment with a 0.1% G3 PAMAM dendrimer could increase the secretion of organic cation transporters (OCTs), OCT1, OCT2, and OCT3, which might be related to the absorption-enhancing mechanisms of the pulmonary absorption of FDs. These findings suggested that PAMAM dendrimers might be potentially safe absorption enhancers for improving absorption of FDs by increasing the secretion of OCT1, OCT2, and OCT3.

Lu|Juan|J| Li|Nannan|N| Gao|Yaochun|Y| Li|Nan|N| Guo|Yifei|Y| Liu|Haitao|H| Chen|Xi|X| Zhu|Chunyan|C| Dong|Zhengqi|Z| Yamamoto|Akira|A|

absorption-enhancement
mechanism
PAMAM dendrimer
fluorescein isothiocyanate-dextrans


Comparison of condylar position in orthognathic surgery cases treated with virtual surgical planning vs. conventional model planning.

Abstract:
OBJECTIVES
To assess the effect of virtual surgical planning (VSP) on the accuracy of condylar seating in surgical cases involving Bilateral Sagittal Split Osteotomy (BSSO). An additional aim was to quantify differences between actual surgical outcome and planned virtual outcome.

SETTING AND SAMPLE POPULATION
A private practice in Charlotte North Carolina. Twenty-five consecutively operated subjects prepared with VSP and twenty consecutively subjects operated with conventional surgery planning were enrolled.

MATERIAL AND METHODS
Cone beam computed tomography (CBCT) scans were obtained before surgery (T1) and post-surgery after splint removal (T2). The T1 and T2 CBCTs were superimposed on the anterior cranial base using voxel-based registration. Three dimensional (3D) models were built and oriented to a 3D Frankfurt horizontal. Displacement of corresponding condylar landmarks was measured.

RESULTS
No significant difference was found between the VSP and conventional group in the magnitude of translation or rotation of the condyles following surgery. VSP surgical outcomes differed significantly from predicted positions at all landmarks. Virtual surgical planning does not prevent changes to condylar position as a result of surgery. Actual surgical results differed significantly from VSP-predicted outcomes.

CONCLUSIONS
Virtual surgical planning did not reduce the changes to condylar position and angulation that resulted from conventionally planned orthognathic surgery.

orthognathic surgery
virtual surgical planning
accuracy
3D superimposition
condyle torque


Kerala's response to COVID-19.

Abstract: The response of Kerala state to COVID-19, led by the health department, was nested in larger social mobilization. Kerala has developed a strong government health system. Learning from managing the Nipah outbreaks, Kerala took effective prevention measures early. Local governments, actively involved in public health in Kerala, played an active role in controlling the epidemic and in cushioning the impact on the poor. Transparency in information and willingness of the government to take the people into confidence has contributed to enhancing trust in the government. These strengths will stand Kerala in good stead as it prepares to manage the next wave of COVID-19 infections.


Pain neuroscience education on YouTube.

Abstract:
Objectives
The Internet in general, and YouTube in particular, is now one of the most popular sources of health-related information. Pain neuroscience education has become a primary tool for managing persistent pain, based in part on the discovery that information about pain can change pain. Our objective was to examine the availability, characteristics, and content of YouTube videos that address the neuroscience of pain.

Methods
We conducted a systematic review of videos on YouTube using the search terms "pain education", "what is pain", and "pain brain" in January 2018. Videos were included if they were in English, were under 10 minutes long, and included information on the neuroscience of pain. Videos were coded for (i) descriptive characteristics (e.g., number of views, duration on YouTube), (ii) source and style, (iii) whether or not they addressed seven pre-determined target concepts of pain neuroscience education (e.g., 'Pain is not an accurate marker of tissue state'), and (iv) how engaging they were.

Results
We found 106 unique videos that met the inclusion criteria. The videos ranged from having four views to over five million views (Mdn = 1,163 views), with the three most highly viewed videos accounting for 75% of the total views. Animated videos were much more highly viewed than non-animated videos. Only a small number of videos had been posted by a clearly-identifiable reputable source such as an academic or medical institution (10%), although a number of videos were posted by healthcare professionals and professional medical societies. For a small number of videos (7%), the source was unclear. We found 17 videos that addressed at least one target concept of pain neuroscience science education, only nine of which were considered to be at least somewhat engaging. The target concept 'Pain is a brain output' was considered to be well addressed by the most videos (N = 11), followed by 'Pain is a protector' (N = 10). We found only one video that adequately addressed all seven target concepts of pain neuroscience education.

Discussion
YouTube contains a variety of videos that practitioners, patients, and families may view to access pain neuroscience education information. A small portion of these videos addressed one or more target concepts of pain neuroscience education in an engaging manner. It is yet to be determined to what extent patients are able to learn information from these videos, to what extent the videos promote behavior change, and thus to what extent the videos may be useful for clinical practice.

Heathcote|Lauren C|LC|
Pate|Joshua W|JW|
Park|Anna L|AL|
Leake|Hayley B|HB|
Moseley|G Lorimer|GL|
Kronman|Corey A|CA|
Fischer|Molly|M|
Timmers|Inge|I|
Simons|Laura E|LE|

Pain
Pain Neuroscience Education
YouTube
Internet
Persistent pain
Systematic review
Pain education
Chronic pain
E-health
Psycho-education


Effect of Lignocaine Concentration on Human Fibroblasts Growth in Eyes Undergoing Trabeculectomy: An in vitro Study.

Abstract:
Purpose
To evaluate the effect of lignocaine on growth and apoptosis indication of primary human Tenon's capsule fibroblast (HTFs) in an in vitro model.

Patients and Methods
Tenon's capsule tissue obtained from patients undergoing trabeculectomy were grown in cell culture medium. The effect of different concentrations of lignocaine (0.5, 1.0, 1.5, and 2%) on the morphology and growth of the fibroblasts was studied using microscopy, cell viability, and proliferation assay, and apoptosis was detected using the FITC Annexin V Apoptosis Kit.

Results
Morphological changes similar to those of apoptotic cells, including cytoplasmic vacuolation, shrinkage, and rounding were visualized in the cells treated with concentrations greater than 1.0% (i.e., 1.5, 2.0%). Though proliferation inhibition was found with all four concentrations (0.5-2.0%), the viability of cells decreased from 1.0% lignocaine.

Conclusion
0.5% lignocaine prevents proliferation of fibroblasts without causing apoptosis in vitro.

Janani|Madhuravasal Krishnan|MK|
Jaichandran|Venkatakrishnan|V|
Madhavan|Hajib Narahari Rao|HNR|
Vijaya|Lingam|L|
George|Ronnie Jacob|RJ|
Ambastha|Priyam Shrikant|PS|
Manu|Abhijeet|A|
Malathi|Jambulingam|J|

Lignocaine
Trabeculectomy
Tenon's fibroblast


Sella turcica-Its importance in orthodontics and craniofacial morphology.

Abstract: The sella turcica is a structure which can be readily seen on lateral cephalometric radiographs and sella point is routinely traced for various cephalometric analyses. The search was carried out using the following key words (sella turcica, bridging of sella, size, shape of sella turcica) and with the following search engine (Pubmed, Cochrane, Google scholar). The morphology is very important for the cephalometric position of the reference point sella, not only for evaluating craniofacial morphology, but also when growth changes and orthodontic treatment results are to be evaluated. This makes it a good source of additional diagnostic information related to pathology of the pituitary gland, or to various syndromes that affect the craniofacial region. Clinicians should be familiar with the normal radiographic anatomy and morphologic variability of this area, in order to recognize and investigate deviations that may reflect pathological situations, even before these become clinically apparent. During embryological development, the sella turcica area is the key point for the migration of the neural crest cells to the frontonasal and maxillary developmental fields. The neural crest cells are involved in the formation and development of sella turcica and teeth. The size of sella turcica ranges from 4 to 12 mm for the vertical and 5 to 16 mm for the anteroposterior dimension. There are many classification systems regarding the shape of sella turcica. Majority of the studies show that about 67% of the subjects had normal appearance and about 33% showed variations. The prevalence of sella turcica bridging is high in class III malocclusions and dental anomalies.

Sathyanarayana|Haritha Pottipalli|HP|
Kailasam|Vignesh|V|
Chitharanjan|Arun B|AB|

Morphology
sella turcica
sella point
size


Home range and use of diurnal shelters by the Etendeka round-eared sengi, a newly discovered Namibian endemic desert mammal.

Abstract: To understand habitat use by the newly described Etendeka round-eared sengi (Macroscelides micus) in northwestern Namibia, we radio-tracked five individuals for nearly a month. Home ranges (100% convex polygons) in the rocky desert habitat were remarkably large (mean 14.9 ha) when compared to sengi species in more mesic habitats (<1.5 ha). The activity pattern of M. micus was strictly nocturnal, which contrasts to the normal diurnal or crepuscular activity of other sengis. The day shelters of M. micus were under single rocks and they likely were occupied by single sengis. One tagged sengi used 22 different day shelters during the study. On average, only 7% of the day shelters were used more than once by the five tagged sengis. The shelters were also unusual for a small mammal in that they were unmodified in terms of excavation or nesting material. Shelter entrances were significantly oriented to face south by south west (average 193°), away from the angle of the prevailing midday sun. This suggests that solar radiation is probably an important aspect of M. micus thermal ecology, similar to other sengis. Compared to published data on other sengis, M. micus generally conforms to the unique sengi adaptive syndrome, but with modifications related to its hyper-arid habitat.

Rathbun|Galen B|GB|
Dumbacher|John P|JP|

Home range
Shelter
Sengi
Namibia
Elephant-shrew
Namib Desert


A Multiethnic Asian Perspective of Presumed Consent for Organ Donation: A Population-Based Perception Study.

Abstract: Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remains a paucity of literature on public attitude and barriers regarding the opt-out system, with existing studies limited to Western nations. Therefore, this study aimed to understand public sentiment and different barriers toward organ donation from the perspective of Singapore, a highly diverse and multiethnic Asian society. Methods: A cross-sectional community semi-structured interview was conducted in a public housing estate in Singapore. Pilot test was undertaken before participants were interviewed face-to-face by trained personnel. All statistical evaluations were conducted using Stata. The χ2-test compared subgroups based on patient characteristics while multivariable logistic regression identified predictors of willingness to donate/ assent. Effect estimates were quantified using odds ratio (OR). Findings: Out of 799 individuals, 85% were agreeable to organ donation after death and 81% were willing to assent to donations of family members' organs, which declined by 16% (p < 0.001) after a clinical scenario was presented. Demographic factors including ethnicity, education, marital, and employment status affected willingness to donate and assent. Knowledge correlated significantly with willingness to donate and assent. In particular, knowledge regarding brain death irreversibility had the strongest correlation (AOR 2.15; 95% CI 1.60-2.89). Conclusions: Organ donation rates remain low albeit presumed consent legislation, due to patient-level barriers, including but not limited to knowledge gaps, cultural values, religious backgrounds, and emotional impact at relatives' death. To effectively boost donor rates, it is crucial for policy makers to invest in public education and improve transplant provisions and family protocols.

Muthiah|Mark D|MD|
Chua|Melissa Sin Hui|MSH|
Griva|Konstadina|K|
Low|Ivan|I|
Lim|Wen Hui|WH|
Ng|Cheng Han|CH|
Hwang|Jeff Y F|JYF|
Yap|Jason C H|JCH|
Iyer|Shridhar G|SG|
Bonney|Glenn K|GK|
Anantharaman|Vathsala|V|
Huang|Daniel Q|DQ|
Tan|Eunice Xiang-Xuan|EX|
Lee|Guan-Huei|GH|
Kow|Alfred W C|AWC|
Tai|Bee Choo|BC|

D003430:Cross-Sectional Studies
D006801:Humans
D010465:Perception
D019724:Presumed Consent
D014019:Tissue Donors
D009927:Tissue and Organ Procurement

presumed consent
attitude
knowledge
policy
organ transplantation


Diazepam Prodrug Stabilizes Human Aminopeptidase B during Lyophilization.

Abstract: Human aminopeptidase B (APB) is a labile enzyme that is being investigated as a biocatalyst for intranasal delivery of prodrug/enzyme combinations. Therefore, the stability of APB is a major concern to ensure a viable drug product. Lyophilization is one technique commonly used to extend shelf life of enzymes. However, the lyophilization process itself can cause conformational changes and aggregation, leading to inactivation of enzymes. In this study, we demonstrate the use of the substrate avizafone (AVF), a prodrug for diazepam, as a stabilizer to minimize inactivation of APB during lyophilization. Permutations of APB samples combined with AVF, trehalose, and/or mannitol were snap-frozen and lyophilized, and subsequently reconstituted to measure the activity of APB. Of the formulation permutations, an APB + AVF + trehalose combination resulted in minimum degradation with 71% retention of activity. This was followed by APB + AVF and APB + trehalose with 60 and 56% retention of activity, respectively. In comparison, APB + mannitol and APB alone retained only 16 and 6.4% activity, respectively. Lyophilizates of the APB + AVF + trehalose formulation were subjected to a 6 month accelerated stability study, at the end of which negligible reduction in activity was observed. These results suggest that colyophilization of an enzyme with its substrate can impart stability on par with the commonly used lyoprotectant, trehalose, but the combination of substrate and trehalose provides a greater stabilizing effect than either additive alone.

prodrug
stability
aminopeptidase B
lyophilization
avizafone
enzyme stabilization
freeze-drying
temperature dependence


CKS2 (CDC28 protein kinase regulatory subunit 2) is a prognostic biomarker in lower grade glioma: a study based on bioinformatic analysis and immunohistochemistry.

Abstract: Gliomas account for the highest cases of primary brain malignancies. Whereas previous studies have demonstrated the roles of CDC28 Protein Kinase Regulatory Subunit 2 (CKS2) in various cancer types, its functions in lower grade gliomas (LGGs) remain elusive. This study aimed to profile the expression and functions of CKS2 in LGG. Multiple online databases such as The Cancer Genome Atlas (TCGA), the Chinese Glioma Genome Atlas (CGGA), Gene Expression Profiling Interactive Analysis 2nd edition (GEPIA2), Tumor Immune Estimation Resource 2nd edition (TIMER2.0) as well as Gene Expression Omnibus (GEO) were used in this study. Immunohistochemistry (IHC) was performed to evaluate CKS2 protein expression. Our data demonstrated upregulation of CKS2 in LGG tissues at both mRNA and protein level, especially in grade III gliomas. Similarly, there was increased expression of CKS2 in isocitrate dehydrogenase 1 (IDH1) wildtype gliomas. In addition, increased DNA copy number and DNA hypomethylation might be associated with the upregulation of the CKS2 in LGG. Using the Kaplan-Meier survival analysis and the Cox regression analysis, CKS2 was shown to be independently associated with poor prognosis of LGG patients. Receiver operating characteristic (ROC) analysis revealed that CKS2 could effectively predict the 1-, 3- and 5-year survival rates of LGG patients. Enrichment analyses revealed that CKS2 was mainly involved in the regulation of the cell cycle in LGG. Taken together, our study demonstrated that CKS2 might be a candidate prognostic biomarker for LGG and could predict the survival rates of LGG patients.Abbreviations: LGG: lower grade glioma; CKS2: CDC28 protein kinase regulatory subunit 2; TCGA: The Cancer Genome Atlas; CGGA: the Chinese Glioma Genome Atlas; GEO: Gene Expression Omnibus; GEPIA: Gene Expression Profiling Interactive Analysis; TIMER: Tumor Immune Estimation Resource; IHC: immunohistochemistry; qRT-PCR: quantitative real-time polymerase chain reaction; PBS: phosphate buffered saline; DAB: diaminobenzidine tetrachloride; OS: overall survival; CAN: copy number alteration; IDH: Isocitrate dehydrogenase; GSEA: Gene Set Enrichment Analysis; DEG: differentially expressed gene; KEGG: Kyoto encyclopedia of genes and genomes; GO: Gene ontology; BP: biological process; CC: cellular component; MF: molecular function; NES: normalized enrichment score; NOM: nominal; FDR: false discovery rate.

Hu|Menglong|M| Li|Zongkuo|Z| Qiu|Jinhuan|J| Zhang|Ruizhen|R| Feng|Junkai|J| Hu|Guiming|G| Ren|Jingli|J|0000-0001-9891-0579

CKS2 biomarker gliomas bioinformatics prognosis


Genital Tract Pathology in Female Pet Guinea Pigs (Cavia porcellus): a Retrospective Study of 655 Post-mortem and 64 Biopsy Cases.

Abstract: Disorders of the female genital tract are among the most common disorders in pet guinea pigs (Cavia porcellus); however, knowledge of many aspects of these disorders is sparse, especially regarding their incidence and age distribution. Ovarian cysts, as the most common genital tract disorder in guinea pigs, have been investigated in detail; however, information on the nature of these cysts is inconsistent. The present study reviewed genital tract disorders occurring within 655 full post-mortem examinations of intact female pet guinea pigs and 64 female genital tract biopsies examined over a 22.5 year period. Age distribution was determined from 550 post-mortem examinations of animals of known age. Genital tract disorders were found in 295 post-mortem examinations (45.0%) in animals with a median age of 52 months. Additionally, disorders were found in all genital tract biopsy samples from guinea pigs with a median age of 48 months. The incidence of genital tract diseases increased from 1.5% in guinea pigs ≤6 months of age to up to 77.8% in animals >6 years of age. Ovarian cysts were the most common genital tract disorder, found in 245 of the 655 post-mortem cases (37.4%) and 38 of 43 ovarian biopsy samples (88.4%). The incidence of ovarian cysts increased with advancing age, reaching 75.6% in animals >6 years. In 119 cases, histopathology and immunohistochemistry confirmed cystic rete ovarii as the only cyst type. A Fallopian tube adenoma was found in a single case, so disorders of the Fallopian tube should be considered rare. Uterine disorders were diagnosed in 17.4% of the post-mortem examinations and 98.1% of uterine biopsy samples. Uterine neoplasia, hyperplasia and inflammation were common, but occurred at different ages. The incidence of uterine neoplasia and hyperplasia was higher in older animals (>15% in guinea pigs >6 years), while the incidence of uterine inflammation was the highest (17.9%) in animals aged 7-12 months. An association between ovarian cysts and uterine neoplasia or hyperplasia was not evident. Vaginal disorders were rare and included leiomyoma, polyps and vaginitis.

Bertram|C A|CA|
Müller|K|K|
Klopfleisch|R|R|

guinea pig
uterine disorder
vaginal disorder
ovarian disorder


Distinct alterations in resting-state electroencephalogram during eyes closed and eyes open and between morning and evening are present in first-episode psychosis patients.

Abstract: Abnormalities in resting-state electroencephalogram (rs-EEG) activity have been previously reported in schizophrenia. While most rs-EEG recordings were performed in patients with chronic schizophrenia during eyes closed (EC), only a handful of studies have investigated rs-EEG activity during both EC and eyes open (EO) conditions. It is also unknown whether EC and EO rs-EEG alterations are present at illness onset, and whether they change during the day. Here, we performed EC and EO rs-EEG recordings in the morning (AM) and evening (PM) in twenty-six first-episode psychosis (FEP) patients and seventeen matched healthy controls (HC). In AM/EC rs-EEG, a widespread reduction was found in low alpha power in FEP relative to HC. In PM/EC, the FEP group demonstrated a trend toward decreased theta power in parietal regions, while decreased high alpha power in frontal and left parietal regions was present during PM/EO. Moreover, reduced low alpha power during AM/EC was associated with worse positive symptoms. Altogether, those findings indicate that rs-EEG alterations are present in FEP patients at illness onset, that they are linked to the severity of their psychosis, and that distinct RS abnormalities can be detected in different conditions of visual alertness and time of the day. Future work should therefore account for those factors, which will help reduce variability of rs-EEG findings across studies and may serve as monitoring biomarkers of illness severity in schizophrenia and related psychotic disorders.

Zhang|Yingyi|Y| Geyfman|Alexandra|A| Coffman|Brian|B| Gill|Kathryn|K| Ferrarelli|Fabio|F|

Resting-state
First-episode psychosis
Schizophrenia
EEG


Generation of a single-tube quality control material for hemoglobin and DNA analyses of hemoglobinopathies.

Abstract:
INTRODUCTION
Hemoglobinopathies are major public health problems worldwide. Accurate laboratory diagnosis of the carrier is essential, which includes initial screening, Hb analysis, and DNA analysis. For the first time, we have developed a single-tube quality control (QC) sample for these laboratory tests.

METHODS
The QC sample was made from a lyophilized mixture of the stabilized hemolysate with carbon monoxide saturation and the white blood cells of known thalassemia mutations. Homogeneity and stability were examined by Hb and DNA analyses on day 0 and every month for 12 months, at room temperature, 4°C, and -20°C. A preliminary proficiency testing (PT) program for hemoglobinopathies using this single QC material was developed.

RESULTS
Hemoglobin (Hb) and DNA analyses of a single-tube QC sample demonstrated satisfactory results of Hb analysis for at least five months and DNA analysis for at least one year of storage at -20°C. The results obtained from a preliminary PT program on five expert laboratories confirmed that a single tube QC sample prepared could be used as a PT item with various Hb and DNA analyses methods.

CONCLUSION
A single lyophilized control sample has been generated for use in hemoglobinopathies' internal and external quality control program. Unlike other available control materials, which are used for individual testing, a single-tube QC sample generated can be used to control the pre-analytical and analytical processes of both Hb and DNA analyses and is suitable for use in the PT program of hemoglobinopathies.

Pansuwan|Anupong|A| Changtrakul|Duangrudee|D| Chaibunruang|Attawut|A| Yamsri|Supawadee|S| Sanchaisuriya|Kanokwan|K| Fucharoen|Goonnapa|G| Fucharoen|Supan|S|

quality control materials
hemoglobinopathies
thalassemia
proficiency testing program


A High-Density SNP Genetic Linkage Map and QTL Analysis of Growth-Related Traits in a Hybrid Family of Oysters (Crassostrea gigas × Crassostrea angulata) Using Genotyping-by-Sequencing.

Abstract: Oysters are among the most important species in global aquaculture. Crassostrea gigas, and its subspecies C. angulata, are the major cultured species. To determine the genetic basis of growth-related traits in oysters, we constructed a second-generation linkage map from 3367 single-nucleotide polymorphisms (SNPs) based on genotyping-by-sequencing, genotyped from a C. gigas × C. angulata hybrid family. These 3367 SNPs were distributed on 1695 markers, which were assigned to 10 linkage groups. The genetic linkage map had a total length of 1084.3 cM, with an average of 0.8 cM between markers; it thus represents the densest genetic map constructed for oysters to date. Twenty-seven quantitative trait loci (QTL) for five growth-related traits were detected. These QTL could explain 4.2-7.7% (mean = 5.4%) of the phenotypic variation. In total, 50.8% of phenotypic variance for shell width, 7.7% for mass weight, and 34.1% for soft tissue weight were explained. The detected QTL were distributed among eight linkage groups, and more than half (16) were concentrated within narrow regions in their respective linkage groups. Thirty-eight annotated genes were identified within the QTL regions, two of which are key genes for carbohydrate metabolism. Other genes were found to participate in assembly and regulation of the actin cytoskeleton, signal transduction, and regulation of cell differentiation and development. The newly developed high-density genetic map, and the QTL and candidate genes identified provide a valuable genetic resource and a basis for marker-assisted selection for C. gigas and C. angulata.

distortion of segregation ratios
growth-related traits candidate genes
missing data imputation
reduced-representation sequencing
single nucleotide polymorphisms


Structure of Urocanate Hydratase from the protozoan Trypanosoma cruzi.

Abstract: The enzyme Urocanate Hydratase (UH) participates in the catabolic pathway of L-histidine. Trypanosoma cruzi Urocanate Hydratase (TcUH) is identified as a therapeutic molecular target in the WHO/TDR Targets Database. We report the 3D structure determination and number of features of TcUH, and compared it to other few available bacterial UH structures. Each monomer presents two domains and one NAD+ molecule. Superpositions revealed differences in the relative orientation of domains within monomers, such that TcUH monomer A resembles Urocanate Hydratase from Geobacillus kaustophilus (GkUH) (open conformation), while monomer C resembles Urocanate Hydratase from Pseudomonas putida (PpUH) and Urocanate Hydratase from Bacillus subtilis (BsUH) (closed conformations). We use the structure of TcUH to make considerations about 3 non-deleterious and 2 deleterious mutations found in human UHs: non-deleterious mutations could be accommodated without large displacements or interaction interruptions, whereas deleterious mutations in one case might disrupt an α-helix (as previously suggested) and in the other case, besides disrupting the enzyme interaction with the substrate, might interfere with interdomain movement.

Boreiko|Sheila|S|
Silva|Marcio|M|
de F P Melo|Raíssa|R|
Silber|Ariel M|AM|
Iulek|Jorge|J|

Human Urocanate Hydratase deleterious mutations


Concerns of Parents With Children Receiving Home-Based Pediatric Palliative Care.

Abstract:
CONTEXT
Caring for a child who will die from a life-limiting illness is one of the most difficult experiences a parent may face. Pediatric palliative care (PPC) has grown as a specialty service to address the unique needs of children and families with serious illness. However, gaps remain between the needs of families in PPC and the support received.

OBJECTIVES
The objective of this study was to explore the concerns of parents who have a child in home-based PPC.

METHODS
Semistructured interviews were conducted with 25 mothers and 10 fathers from 25 families shortly after their child's referral to home-based PPC. Children (57% male, Mage = 10.5 years, SD = 3.95, range = 4-18 years) had a range of diagnoses. Data were analyzed using inductive content analysis.

RESULTS
Parents' concerns clustered into four main themes: 1) ensuring that their child's remaining days were spent living well physically, emotionally, and socially; 2) uncertainty regarding their child's diagnosis, prognosis, and treatments; 3) their child's death (e.g., the process of dying and when it will occur); and 4) the family, including the impact of the child's illness and death on siblings and wanting to cherish as much time together with family as possible.

CONCLUSION
Parents of children receiving home-based PPC expressed concerns across a range of domains, both about their seriously ill child and the broader family. These results highlight salient worries among parents of children in PPC and point to critical areas for intervention for seriously ill children and the broader family.

Tutelman|Perri R|PR|
Lipak|Keagan G|KG|
Adewumi|Aminat|A|
Fults|Marci Z|MZ|
Humphrey|Lisa M|LM|
Gerhardt|Cynthia A|CA|

D064946:Hospice and Palliative Care Nursing

parents
pediatrics
Palliative Care
hospice
quality of life
symptom management


The effect of gender on the long-term course and outcome of schizophrenia in rural Ethiopia: a population-based cohort.

Abstract:
BACKGROUND
Although some studies have suggested that women with schizophrenia are more likely to achieve positive outcomes, the evidence-base is fraught with inconsistencies. In this study we compare the long-term course and outcomes for men and women living with schizophrenia in rural Ethiopia.

METHODS
The Butajira course and outcome study for severe mental disorders is a population-based cohort study. Community ascertainment of cases was undertaken between 1998 and 2001, with diagnostic confirmation by clinicians using the Schedules for Clinical Assessment in Neuropsychiatry. Findings from annual outcome assessments were combined with clinical records, patient and caregiver report, and psychiatric assessments at 10-13 years using the Longitudinal Interval Follow-up Evaluation- LIFE chart. For the sub-group of people with schizophrenia (n = 358), we compared course of illness and treatment, co-morbidity, recovery, social outcomes and mortality between men and women. Multivariable analyses were conducted for modelling associations identified in bivariate analyses according to blocks shaped by our a priori conceptual framework of the biological and social pathways through which gender might influence the course and outcome of schizophrenia.

RESULTS
Looking into over 10-13 years of follow-up data, there was no difference in the functioning or recovery in women compared to men (AOR = 1.79, 95% CI = 0.91, 3.57). Women were less likely to report overall life satisfaction (AOR = 0.22, 95% CI = 0.09, 0.53) or good quality of spousal relationships (AOR = 0.09, 95% CI = 0.01-1.04). Men were more likely to have co-morbid substance use and there was a trend towards women being more likely to be prescribed an antidepressant (AOR = 2.38, 95% CI = 0.94, 5.88). There were no gender differences in the course of illness, number of psychotic episodes or adherence to medications.

CONCLUSION
In this rural African setting, we found little evidence to support the global evidence indicating better course and outcome of schizophrenia in women. Our findings are suggestive of a gendered experience of schizophrenia which varies across contexts. Further investigation is needed due to the important implications for the development of new mental health services in low and middle-income country settings.

Mayston|Rosie|R| Kebede|Derege|D| Fekadu|Abebaw|A| Medhin|Girmay|G| Hanlon|Charlotte|C| Alem|Atalay|A| Shibre|Teshome|T|

Gender Course Outcome Schizophrenia Butajira-cohort


Protective effects of Coreopsis tinctoria flowers phenolic extract against D-galactosamine/lipopolysaccharide -induced acute liver injury by up-regulation of Nrf2, PPARα, and PPARγ.

Abstract: Coreopsis tinctoria flowers, a well-known medicinal and edible plant, have been reported to possess antioxidant and anti-inflammatory activities. However, its protective effects and underlying mechanisms on liver injury remain unclear. The aim of this study was to investigate the underlying mechanisms by which Coreopsis tinctoria flowers phenolic extract (CTP) alleviated D-galactosamine and lipopolysaccharide (D-GalN/LPS) induced acute liver injury in mice. Our results showed that pretreatment with CTP improved liver histology while decreased levels of serum aminotransferase and malondialdehyde. CTP also increased levels of glutathione in D-GalN/LPS -induced acute liver injury mice by up-regulation of nuclear factor erythroid 2-related factor 2 (Nrf2), peroxisome proliferator-activated receptor alpha (PPARα), and peroxisome proliferator-activated receptor gamma (PPARγ). In conclusion, results suggested that CTP protected against D-GalN/LPS -induced acute liver injury by up-regulation of Nrf2, PPARα, and PPARγ.

Tian|Yong|Y| Li|Yao|Y| Li|Fuhua|F| Zhi|Qi|Q| Li|Fuxiang|F| Tang|Yu|Y| Yang|Yaxuan|Y| Yin|Ran|R| Ming|Jian|J|

D056486:Chemical and Drug Induced Liver Injury

Coreopsis tinctoria flowers
Phenolic extract
Acute liver injury
Nrf2
PPARα
PPARγ


Electrophysiological correlates of interference control at retrieval predict performance on a subsequent analogical reasoning task.

Abstract: Previous research has shown that variations in the accessibility of relevant information that stem from retrieval practice may impair analogical reasoning. In the present study, we sought to examine the neural signatures of inhibitory control during selective retrieval and its effects on a subsequent analogical reasoning task by employing electrophysiological measures. At a behavioral level, we found that selective retrieval of a subset of potential solutions led to impaired performance on the analogy test. ERPs analyses during selective retrieval revealed that (1) the repeated presentation of retrieval cues was associated with decreased amplitudes for the FN400 ERP effect, possibly reflecting reduced reactivation of competitor associates and interference across retrieval attempts; (2) this effect correlated positively with the retrieval-related impairment in analogical reasoning performance. During the analogy test, the production of control solutions (non-affected by prior retrieval practice) was characterized by more positive modulations of anterior frontal and parietal ERPs than the production of unstudied solutions, whereas inhibited solutions elicited similar amplitudes to unstudied solutions. This effect was restricted to the retrieval phase of the analogy where the actual solutions had to be retrieved, but it did not affect the mapping phase where the accessibility status of the possible solutions failed to reveal significant amplitude differences. These findings suggest that control during selective retrieval may lead to the downregulation of competing memory representations and advance our understanding of the neural correlates of analogical thinking.

Valle|Tania M|TM|
Gómez-Ariza|Carlos J|CJ|
Bajo|Teresa|T|


The circle method for preoperative TAVI sizing in a Sievers type 0 stenotic bicuspid aortic valve.

Abstract: The most common congenital cardiac anomaly, affecting an estimated 0.4-2.25% of the general population, is the bicuspid aortic valve. The "pure" bicuspid aortic valve (non-raphe-type or bicuspid aortic valve type 0) is composed of 2 cusps, morphologically and functionally. The shape of the bicuspid aortic valve annulus is often elliptical, is relatively larger than the tricuspid aortic valves, and probably shows severe eccentric calcification. This situation contributes to the difficulties in selecting the correct type and size of transcatheter heart valve when treating bicuspid aortic valve stenosis. Furthermore, it is often associated with a dilated, horizontal ascending aorta and effaced sinuses. The goal of our video tutorial is to present the contemporary circle method used in preoperative sizing during TAVI procedures in patients with a bicuspid aortic valve as well as certain technical considerations and useful advice. Although annular sizing is the main focus for most patients with a bicuspid aortic valve, some patients may need the supra-annular level of sizing. For a dedicated sizing and positioning approach for the SAPIEN 3 Ultra valve, experts in the field propose the circle method.

Van Praet|Karel M|KM|
Kukucka|Marian|M|
Kofler|Markus|M|
Klein|Christoph|C|
Falk|Volkmar|V|
Unbehaun|Axel|A|
Kempfert|Jörg|J|

D000082882:Bicuspid Aortic Valve Disease

D065467:Transcatheter Aortic Valve Replacement

Circle method
TAVI
Sizing
Bicuspid aortic valve
Aortic valve repair


Risk-based maternal group B Streptococcus screening strategy is compatible with the implementation of neonatal early-onset sepsis calculator.

Abstract:
Background
The early-onset sepsis (EOS) calculator was developed and validated in a setting with routine-based group B Streptococcus (GBS) screening.

PURPOSE
The study aimed to evaluate the extent of influence exerted by risk-based GBS screening on management recommendations by the EOS calculator.

METHODS
All newborns with a gestational age greater than 35 weeks were screened for EOS risk factors in a Dutch regional teaching hospital using a risk-based GBS screening strategy. We calculated the EOS risk at birth and stratified the infants into the following 3 risk levels with corresponding management recommendations: low, <0.65; intermediate, 0.65-1.54; and high, >1.54 per 1000 live newborns. Thereafter, we recalculated the EOS risk and recommendation for the newborn infants without available maternal GBS screening results at birth.

RESULTS
In one year, 1,877 eligible births occurred; of them, 206 infants were included. Maternal GBS status was available for 28 of 206 infants (14%) at birth, while a definitive GBS status was later available for 162 of 206 infants (79%). Median EOS risk was slightly lower after definitive GBS status was determined (0.41 vs. 0.46 per 1,000 live births, P=0.004). In 199 of 206 newborn infants (97%), the EOS calculator recommendation remained unchanged after the GBS results unavailable at birth were updated to definitive GBS status. Use of GBS status at birth versus definitive GBS status did not result in the withholding of antibiotic treatment of the newborn infants included in this study.

CONCLUSION
Risk-based GBS screening is compatible with EOS calculator recommendations. Larger studies are needed to develop the best strategy for combining GBS screening and EOS calculator recommendations.

Achten|Niek B|NB|
Dorigo-Zetsma|J Wendelien|JW|
van Rossum|Annemarie M C|AMC|
Oostenbrink|Rianne|R|
Plötz|Frans B|FB|

Group B Streptococcus
Neonatal
Early-onset sepsis
Sepsis calculator
Maternal screening


Effect of yoga training on lipid metabolism in industrial workers with reference to body constitution (Prakriti).

Abstract:
INTRODUCTION
The progressive increase in dyslipidemia and physical inactivity are considered to be major risk factors for the onset of non communicable diseases. Awareness of body constitution plays a vital role to regularise optimum health. The present study was planned to evaluate the effect of yoga practices on lipid metabolism with reference to specific body constitution (Prakriti).

METHODS
A self-as-control study was conducted on 36 male healthy volunteers between age group of 30-58 years. Their prakriti analysis was done using standardized, validated questionnaire and were divided into Vata-Pitta (n = 16) and Pitta-Kapha (n = 20) groups. The assessment of lipid profile was done in fasting blood samples before and after 12 weeks of yoga training. Data were analyzed using paired t-test and independent t-test.

RESULTS
After yoga intervention, the result of within group comparison revealed that in Vata-Pitta (V-P) group, significant decrease in the levels of TC, LDL (p < 0.001) and significant increase in HDL (p < 0.01) was observed. While, Pitta-Kapha (P-K) group showed significant decrease in TC (p < 0.001), TG (p < 0.01), LDL (p < 0.001) and VLDL (p < 0.05) levels. Further, the results between groups revealed that P-K group has significantly higher baseline levels of TC, TG and VLDL as compared to V-P group (p < 0.05).

CONCLUSION
The study concludes that yoga practices can effectively regulate lipid metabolism and total body energy expenditure with reference to specific constitutional type (Prakriti) that may act as a tool to assess magnitude of metabolic functions.

Doddoli|Suchitra|S| Shete|Sanjay|S| Kulkarni|Dattatraya|D| Bhogal|Ranjit|R|

Yoga training
Prakriti
Non communicable diseases
Lipid profile
Energy metabolism


Effect of bifurcation in the hemodynamic changes and rupture risk of small intracranial aneurysm.

Abstract: The role of bifurcations is prominent in the intracranial aneurysm (IA) evaluation, and there are many contradictions and complexities in the rupture risk of small IA. Therefore, in the present study, the effect of bifurcation on the manner of hemodynamic changes and the rupture risk of the small middle cerebral artery (MCA) aneurysm is investigated. 3D anatomical models of the MCAs of 21 healthy subjects, 19 patients/IA/bifurcation, and 19 patients/IA were generated, and the models were analyzed by the computational fluid dynamic (CFD) analysis. The presence of bifurcation in the pathway of the blood flow in the parent artery of healthy subjects has reduced the maximum velocity, flow rate, and wall shear stress (WSS) by 25.8%, 38.6%, and 11.1%, respectively. The bifurcation decreased the maximum velocity and flow rate in the neck and sac of the aneurysm by 1.65~2.1 times, respectively. It increased the maximum WSS, and phase lag between the WSS graph of healthy subjects and patients by 12.8%~13.9% and 10.2%~40.4%, respectively. The effect of bifurcation on the Womersley number change in the aneurysm was insignificant, and the blood flow was in the laminar flow condition in all samples. The results also showed bifurcation increased the phase lag between the flow rate and pressure gradient graphs up to approximately 1.5 times. The rupture prediction index for patients/IA/bifurcation and patients/IA was 62.1%(CV = 4.1) and 51.8%(CV = 4.4), respectively. Thus, in equal conditions, the presence of bifurcation increased the probability of the rupture of the aneurysm by 19.9%.

Bifurcation
Ruptured risk
Intracranial aneurysm
Computational fluid dynamic
Wall shear stress
Blood hemodynamics


Quantification of 2'-deoxy-2'-β-fluoro-4'-azidocytidine in rat and dog plasma using liquid chromatography-quadrupole time-of-flight and liquid chromatography-triple quadrupole mass spectrometry: Application to bioavailability and pharmacokinetic studies.

Abstract: 2'-Deoxy-2'-β-fluoro-4'-azidocytidine (FNC) is a novel pyrimidine analog that inhibits not only the replication of the hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV but also the replication of lamivudine-resistant HBV, 4'-azidocytidine or 2'-β-methylcytidine-resistant HCV, and nucleoside reverse-transcriptase inhibitor-resistant HIV variants. The present study was undertaken to evaluate the absolute oral bioavailability of FNC in rats and the pharmacokinetic properties of FNC after intragastric administration of single and multiple doses in rats and dogs. A sensitive high-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry (HPLC/Q-TOF MS) method and a reliable high-performance liquid chromatography tandem triple quadrupole mass spectrometry (HPLC/QqQ MS/MS) method were established for the determination of FNC in the rat and dog plasmas, respectively. The sample preparation involved a protein-precipitation method with methanol after the addition of lamivudine as an internal standard. FNC was analyzed by LC using a YMC-Pack Pro C18 column (150mm×4.6mm, 3μm) with methanol (containing 0.3% formic acid): 10mM ammonium acetate (containing 0.3% formic acid, pH 2.8) (35:65, v/v) as the mobile phase. Both mass spectrometers were equipped with an electrospray ionization interface in the positive-ion mode. The linear range was from 2.00 to 2000.00ngmL(-1) in rat plasma and 0.50 to 400.00ngmL(-1) in dog plasma. The intraday and interday precision were less than 10.55%, and the accuracy was in the range of -5.86 to 5.13%. The mean recoveries were greater than 82.70% and 82.97% for FNC and IS, respectively. The HPLC/Q-TOF MS and HPLC/QqQ MS/MS methods were both successfully applied in the pharmacokinetic studies of FNC in rats and dogs.

Peng|Youmei|Y| Cheng|Tiefeng|T| Dong|Lihong|L| Zhang|Yuhai|Y| Chen|Xiaojing|X| Jiang|Jinhua|J| Zhang|Jingmin|J| Guo|Xiaohe|X| Guo|Mintong|M| Chang|Junbiao|J| Wang|Qingduan|Q|

D002851:Chromatography, High Pressure Liquid

High-performance liquid chromatography-quadrupole time-of-flight mass spectrometry

High-performance liquid chromatography-triple quadrupole mass spectrometry


Engineered Interspecies Amino Acid Cross-Feeding Increases Population Evenness in a Synthetic Bacterial Consortium.

Abstract: In nature, microbes interact antagonistically, neutrally, or beneficially. To shed light on the effects of positive interactions in microbial consortia, we introduced metabolic dependencies and metabolite overproduction into four bacterial species. While antagonistic interactions govern the wild-type consortium behavior, the genetic modifications alleviated antagonistic interactions and resulted in beneficial interactions. Engineered cross-feeding increased population evenness, a component of ecological diversity, in different environments, including in a more complex gnotobiotic mouse gut environment. Our findings suggest that metabolite cross-feeding could be used as a tool for intentionally shaping microbial consortia in complex environments.IMPORTANCE Microbial communities are ubiquitous in nature. Bacterial consortia live in and on our body and in our environment, and more recently, biotechnology is applying microbial consortia for bioproduction. As part of our body, bacterial consortia influence us in health and disease. Microbial consortium function is determined by its composition, which in turn is driven by the interactions between species. Further understanding of microbial interactions will help us in deciphering how consortia function in complex environments and may enable us to modify microbial consortia for health and environmental benefits.

microbial consortia
metabolite cross-feeding
synthetic biology


Assessment of ultrasound and Doppler parameters in the third trimester of pregnancy as predictors of adverse perinatal outcome in unselected pregnancies.

Abstract:
OBJECTIVES
The aim of the study was to investigate ultrasound and Doppler parameters in the third trimester of pregnancy as possible predictors of adverse perinatal outcome in unselected pregnancies.

MATERIAL AND METHODS
We performed a retrospective cross-sectional study including unselected pregnant women be-tween 27 and 36 + 6 weeks of gestation. The following ultrasound and Doppler parameters were assessed: estimated fetal weight (EFW) [g], EFW percentile, placental maturity grade (Grannum classification), single vertical deepest pocket (SVDP) of amniotic fluid [cm], amniotic fluid index (AFI) [cm], mean uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, middle cerebral artery (MCA) PI, MCA peak systolic velocity (PSV) [cm/s], and cerebroplacental ratio (CPR). Adverse perinatal outcome was defined as Apgar score of < 7 at 1 min, birth weight of < 2500 g at delivery, and gestational age of < 37 weeks at delivery. The unpaired t test was used to compare the groups.

RESULTS
AFI (p = 0.01), mean UtA PI (p = 0.04) and mean UA PI (p = 0.03) were significantly different with regard to the Apgar score at 1 min. EFW, EFW percentile, SVDP of amniotic fluid, AFI, mean UtA PI, UA PI, and MCA PI were significantly different (p < 0.001) in terms of birth weight. Placental maturity grade (p = 0.02), SVDP of the amniotic fluid (p < 0.001), AFI (p < 0.001), mean UtA PI (p < 0.001), UA PI (p = 0.001), and MCA PI (p < 0.001) were significantly different as far as gestational age at delivery is concerned.

CONCLUSION
Ultrasound and Doppler parameters may predict adverse perinatal outcomes in unselected pregnancies in the third trimester of pregnancy.

Rodrigues da Cunha Caldas|Taciana Mara|TM|

ultrasound
Doppler
third trimester of pregnancy
perinatal outcome
unselected


Suicide Ideation and Behavior Assessment Tool (SIBAT): Evaluation of Intra- and Inter-Rater Reliability, Validity, and Mapping to Columbia Classification Algorithm of Suicide Assessment.

Abstract: The psychometric properties of the Suicide Ideation and Behavior Assessment Tool (SIBAT) were evaluated in 130 participants with varying levels of suicidality. Inter- and intra-rater reliability were assessed for clinician-rated outcomes, including the revised Clinical Global Impressions (CGI) of severity of suicidality (CGI-SS-r). Concurrent validity of patient-reported modules with Patient-reported Outcomes Measurement Information System (PROMIS) depression scale and Sheehan-Suicidality Tracking Scale Clinically Meaningful Change Measure (S-STS CMCM), and concordance between Columbia Classification Algorithm of Suicide Assessment (C-CASA) mappings for SIBAT, S-STS CMCM and Columbia-Suicide Severity Rating Scale (C-SSRS) were assessed. 52/130 participants (mean [SD] age: 38.3 [17.77] years) consented for multiple interviews (C-CASA mappings: n=52; rater-reliability: n=25/52). SIBAT demonstrated good intra-rater reliability (weighted-kappa range:0.64-0.76; CGI-SS-r, 0.75) and adequate inter-rater reliability (ICC range:0.68-0.82; CGI-SS-r, 0.81). There were strong correlations between PROMIS depression scores and SIBAT Module 5 ratings (Spearman correlations, r=0.64-0.74) and moderate correlations (r=0.29-0.72) between S-STS CMCM and SIBAT Modules 2, 3 and 5 ratings. Moderate agreement was noted between SIBAT C-CASA mappings and corresponding mappings from S-STS CMCM (weighted kappa: 0.54) and C-SSRS (weighted kappa: 0.56). Thus, the SIBAT provided valid assessment of suicidal ideation and behavior that could be reliably rated and adequately mapped to the C-CASA.

Alphs|Larry|L|
Fu|Dong-Jing|DJ|
Williamson|David|D|
Turkoz|Ibrahim|I|
Jamieson|Carol|C|
Revicki|Dennis|D|
Canuso|Carla M|CM|

suicide ideation
C-CASA
rater-reliability
suicide behavior


Survival and predictors of deaths of patients hospitalised due to COVID-19 from a retrospective and multicentre cohort study in Brazil.

Abstract: This study aimed to analyse the survival of patients admitted to Brazilian hospitals due to the COVID-19 and estimate prognostic factors. This is a retrospective, multicentre cohort study, based on data from 46 285 hospitalisations for COVID-19 in Brazil. Survival functions were calculated using the Kaplan-Meier's method. The log-rank test compared the survival functions for each variable and from that, hazard ratios (HRs) were calculated, and the proportional hazard model was used in Cox multiple regression. The smallest survival curves were the ones for patients at the age of 68 years or more, black/mixed race, illiterate, living in the countryside, dyspnoea, respiratory distress, influenza-like outbreak, O2 saturation <95%, X-ray change, length of stay in the intensive care unit (ICU), invasive ventilatory support, previous heart disease, pneumopathy, diabetes, Down's syndrome, neurological disease and kidney disease. Better survival was observed in the influenza-like outbreak and in an asthmatic patient. The multiple model for increased risk of death when they were admitted to the ICU HR 1.28, diabetes HR 1.17, neurological disease HR 1.34, kidney disease HR 1.11, heart disease HR 1.14, black or mixed race of HR 1.50, asthma HR 0.71 and pneumopathy HR 1.12. This reinforces the importance of socio-demographic and clinical factors as a prognosis for death.

hospitalisations
Coronavirus infections
SARS virus
risk factors
survival analysis