Is liver transplantation 'out-of-hours' non-inferior to 'in-hours' transplantation? A retrospective analysis of the UK Transplant Registry.

Abstract:
OBJECTIVES
Increased morbidity and mortality have been associated with weekend and night-time clinical activity. We sought to compare the outcomes of liver transplantation (LT) between weekdays and weekends or night-time and day-time to determine if 'out-of-hours' LT has acceptable results compared with 'in-hours'.

DESIGN, SETTING AND PARTICIPANTS
We conducted a retrospective analysis of patient outcomes for all 8816 adult, liver-only transplants (2000-2014) from the UK Transplant Registry.

OUTCOME MEASURES
Outcome measures were graft failure (loss of the graft with or without death) and transplant failure (either graft failure or death with a functioning graft) at 30 days, 1 year and 3 years post-transplantation. The association of these outcomes with weekend versus weekday and day versus night transplantation were explored, following the construction of a risk-adjusted Cox regression model.

RESULTS
Similar patient and donor characteristics were observed between weekend and weekday transplantation. Unadjusted graft failure estimates were 5.7% at 30 days, 10.4% at 1 year and 14.6% at 3 years; transplant failure estimates were 7.9%, 15.3% and 21.3% respectively.A risk-adjusted Cox regression model demonstrated a significantly lower adjusted HR (95% CI) of transplant failure for weekend transplant of 0.77 (0.66 to 0.91) within 30 days, 0.86 (0.77 to 0.97) within 1 year, 0.89 (0.81 to 0.99) within 3 years and for graft failure of 0.81 (0.67 to 0.97) within 30 days. For patients without transplant failure within 30 days, there was no weekend effect on transplant failure. Neither night-time procurement nor transplantation were associated with an increased hazard of transplant or graft failure.

CONCLUSIONS
Weekend and night-time LT outcomes were non-inferior to weekday or day-time transplantation, and we observed a possible small beneficial effect of weekend transplantation. The structure of LT services in the UK delivers acceptable outcomes 'out-of-hours' and may offer wider lessons for weekend working structures.

Halliday|Neil|N|0000-0001-8220-9139 Martin|Kate|K| Collett|David|D| Allen|Elisa|E| Thorburn|Douglas|D|

hepatology
quality in health care
transplant medicine
transplant surgery


Preoperative Interventions and Charges Before Total Knee Arthroplasty.

Abstract:
BACKGROUND
The cost effectiveness of total knee arthroplasty (TKA) has been well established, but little data exist regarding preoperative interventions and their costs. The purpose of this study was to examine preoperative interventions and their associated charges within the 2-year period before TKA.

METHODS
A retrospective cohort analysis of patients undergoing TKA between 2007 and 2011 was conducted using the PearlDiver Patient Record Database. Patients' inpatient and outpatient billing records were tracked over the 2-year period before receiving a TKA.

RESULTS
A total of 35,596 patients from Medicare and 47,064 from United Healthcare underwent TKA from 2009 to 2011. In the 2-year period before TKA, the per patient average charge was $3545.82 for Medicare and $3281.57 for United Healthcare. In the 2-year period before TKA, 21.4% (Medicare) and 23.3% (United Healthcare) of all patients received a magnetic resonance imaging, with between 31.9% (Medicare) and 45.6% (United Healthcare) of these occurring within 3 months of surgery (P < .05). During this same period, 49.4% (Medicare) and 63.2% (United Healthcare) of all patients received an intra-articular injection, with between 29.4% (Medicare) and 44.8% (United Healthcare) of these occurring within 3 months of surgery (P < .05).

CONCLUSION
Interventions and costs before TKA occur largely within 6 months preoperatively, with a substantial portion occurring within 3 months. These interventions may not be clinically or cost effective for certain patients, such as those with moderate-to-severe osteoarthritis. Foregoing these interventions and opting to perform TKA earlier may reduce costs and prevent unnecessary tests and procedures.

Cohen|Jeremiah R|JR|
Bradley|Alexander T|AT|
Lieberman|Jay R|JR|

preoperative interventions
total knee arthroplasty
PearlDiver
Medicare
United Healthcare


Anti-inflammatory iron chelator, DIBI, reduces leukocyte-endothelial adhesion and clinical symptoms of LPS-induced interstitial cystitis in mice.

Abstract:
BACKGROUND
Interstitial cystitis (IC) is a prevalent and debilitating chronic inflammatory disease of the urinary bladder. Currently there are no fully effective therapeutic agents available, in part due to the still obscure pathogenesis of IC. Lipopolysaccharide (LPS) also known as endotoxin from Gram negative bacteria elicits IC in mice and has formed the basis of model systems for investigation. Excess free iron plays an important role in inflammation through generation of reactive oxygen species (ROS). The novel iron chelator DIBI has been shown to sequester excess free iron and dampen excess inflammatory responses to systemic LPS administration and also to Gram negative bacterial infections.

OBJECTIVE
The overall objective of this study was to evaluate the effects of DIBI on LPS induced IC in mice. Leukocyte activation, endothelial adhesion and functional capillary density were assessed by intravital microscopy of the bladder microcirculation following a single intravesical LPS administration with or without intravesical DIBI treatment. Clinical IC symptoms were also assessed through behavioral and pain threshold force measurements.

METHODS
Four groups of female BALB/c mice (n = 5-6/group) were randomized in this study: control group, IC group without therapy, IC group with DIBI therapy and control group with DIBI therapy. The groups were examined using intravital microscopy (IVM) of the bladder for leukocyte-endothelial interactions (adherent leukocytes, temporarily interacting leukocytes) and functional capillary density (FCD). A modified behavioral score by Boucher et al. and Von-Frey-Aesthesiometry were used to evaluate key behavioral indices related to pain and visceral pain perception.

RESULTS
LPS introduced intravesically induced an early (≤2h) inflammation of the bladder evidenced by leukocyte activation and adhesion to bladder capillary walls. Intravesical DIBI therapy of mice 30min following LPS administration and assessed after 1.5h treatment showed a significant decrease in the number of adherent leukocytes compared to IC animals without DIBI treatment. DIBI treated mice showed a significantly lowered increase in behavioral distress scores compared to IC mice without therapy. Untreated IC mice exhibited a significantly decreased threshold force value for evoked pain response and DIBI treatment improved the threshold pain response. A significant inverse correlation was found for the two pain and suffering evaluation methods results.

CONCLUSION
DIBI reduced inflammatory endothelial leukocyte adhesion and key indices related to pain and suffering over those observed in untreated IC mice. Our findings suggest a potential therapeutic role for DIBI for IC treatment.

Hagn|Georg|G| Holbein|Bruce|B| Zhou|Juan|J| Lehmann|Christian|C|

iron chelator
DIBI
Interstitial cystitis
LPS
endotoxin
inflammation
microcirculation


Nonlinear adaptive control of tuberculosis with consideration of the risk of endogenous reactivation and exogenous reinfection.

Abstract: Tuberculosis is one of deadly diseases in many countries that attacks to the human body and causes damage to the lung, causing bloody coughing and if left untreated, it will kill half of the affected people. Tuberculosis bacteria can stay latent and reactivate after passing appropriate conditions. For this reason, control of this disease and treatment of infected people has a significant importance, and observing health issues can prevent the spread of it. In this paper, a nonlinear adaptive control method is proposed for the first time in order to control and treat tuberculosis outbreak subjected to the modeling uncertainty. To design a control system being robust against uncertainties, an adaptation law is defined to update values of estimated parameters and ensures the whole system stability. The treatment achievement and stability of the closed-loop system is proved by the Lyapunov theorem and confirmed by some simulations. The proposed strategy has the capability to control the tuberculosis outbreak by reducing the numbers of active infectious and persistent latent individuals based on their desired values in the society.

Nematollahi|Mohammad Hassan|MH|
Vatankhah|Ramin|R|
Sharifi|Mojtaba|M|

Adaptive control
Tuberculosis
Exogenous reinfection
Epidemic disease
Lyapunov stability
Nonlinear control


Ultrasound-guided fascial plane blocks of the chest wall: a state-of-the-art review.

Abstract: Ultrasound-guided fascial plane blocks of the chest wall are increasingly popular alternatives to established techniques such as thoracic epidural or paravertebral blockade, as they are simple to perform and have an appealing safety profile. Many different techniques have been described, which can be broadly categorised into anteromedial, anterolateral and posterior chest wall blocks. Understanding the relevant clinical anatomy is critical not only for block performance, but also to match block techniques appropriately with surgical procedures. The sensory innervation of tissues deep to the skin (e.g. muscles, ligaments and bone) can be overlooked, but is often a significant source of pain. The primary mechanism of action for these blocks is a conduction blockade of sensory afferents travelling in the targeted fascial planes, as well as of peripheral nociceptors in the surrounding tissues. A systemic action of absorbed local anaesthetic is plausible but unlikely to be a major contributor. The current evidence for their clinical applications indicates that certain chest wall techniques provide significant benefit in breast and thoracic surgery, similar to that provided by thoracic paravertebral blockade. Their role in trauma and cardiac surgery is evolving and holds great potential. Further avenues of research into these versatile techniques include: optimal local anaesthetic dosing strategies; high-quality randomised controlled trials focusing on patient-centred outcomes beyond acute pain; and comparative studies to determine which of the myriad blocks currently on offer should be core competencies in anaesthetic practice.

D006801:Humans
D009407:Nerve Block
D035441:Thoracic Wall
D018084:Ultrasonography, Interventional

fascial plane block
thoracic surgery
cardiac surgery
breast surgery
postoperative analgesia
regional anaesthesia
thoracic trauma


The COVID-19 pandemic and reproductive genetic counseling: Changes in access and service delivery at an academic medical center in the United States.

Abstract: The COVID-19 pandemic widely disrupted the delivery of healthcare services, including genetic counseling. To ensure continuity of care, the reproductive genetic counselors at a large academic medical center in the United States rapidly transitioned their practice from 90% in-person patient consultations to a predominantly telehealth model. The present study describes this transition in regard to patient access to genetic counseling and genetic screening. A chart review of patients seen by the reproductive genetic counselors from January 2020 to August 2020 was completed. The time frame included the three months prior to the COVID-19 pandemic and the first five months during COVID-19. Patient demographics and clinical and appointment data were compared between the pre-COVID-19 and during-COVID-19 timeframes. Overall, 88.6% of patients were seen via telehealth during COVID-19 and there was no significant difference based upon patient age (p = .20), indication for appointment (p = .06), or gestational age (p = .06). However, non-English speaking patients were more often seen in-person than by telehealth (p < .001), and more patients residing farther from the clinic were seen via telehealth (p = .004). During-COVID-19 results for prenatal cell-free DNA screening and expanded carrier screening were delayed (p < .001). Additionally, after consenting to screening, patients seen during COVID-19 were more likely to not complete a sample collection for their intended screening when compared to those seen pre-COVID-19 (OR = 6.15, 95% CI = 1.43-26.70, p = .015). Overall, this study supports that access to genetic counseling services and genetic screening can be maintained during a global pandemic like COVID-19. Genetic counselors are well-equipped to pivot swiftly during challenging times; however, they must continue to work to address other barriers to accessing genetic services, especially for non-English speaking populations. Future studies are needed to pose solutions to the obstacles confronted in this service delivery model during a global pandemic.

Mann|Caitlin|C|0000-0003-2647-790X Goodhue|Brighton|B| Guillard|Arianna|A| Slamon|Jill|J| Newman|Randa|R| Zhao|Zhiguo|Z| Ding|Tan|T| Petrelli|Gianna|G| Dudek|Martha|M|

COVID-19
genetic counseling
genetic counselors
genetic services
service delivery models
prenatal genetic counseling
telemedicine


Vitamin A Levels Among Pre-School Children of Central and Western China.

Abstract: Objective: To investigate vitamin A deficiency of pre-school children in central and western China for developing strategies to prevent and control vitamin A deficiency (VAD) among children. Design: From November 2018 to September 2019, a total of 2,194 healthy children aged 2-6 years were enrolled. Serum retinol levels in the children were detected by liquid-phase tandem mass spectrometry. In addition, social demographic and dietary questionnaires were collected through interviews with children's caregivers. Setting: The participants were enrolled in 12 cities or their subordinate jurisdictions in the central and western regions of China. Participants: Two thousand one hundred and ninety four healthy children aged 2-6 years old. Results: Overall, 35.51% (779/2,194) of the children were found to be vitamin A insufficient (VAI, serum retinol < 1.05 μmol/L). Elder children had a higher risk to suffer from VAI, with proportions of 25.00% (87/348), 28.92% (142/491), 38.38% (256/667), and 42.73% (294/688) among children aged 2, 3, 4, and 5 years, respectively. Vitamin A levels were also positively correlated with per capita income (AOR = 1.18) and regional economic level (0.71), and the frequency of milk intake (0.91). Conclusions: The incidence of VAI was higher among children aged 2-6 years, and the incidence of VAI increases with age. VA levels were positively correlated with levels of economic development in the family and region. So prevention strategies for VAD need to focus on pre-school children, especially dairy intake and developing regions.

Chen|Qian|Q| Liu|Yongfang|Y| Chen|Li|L| Chen|Jie|J| Yang|Ting|T| Cheng|Qian|Q| Li|Tingyu|T|

vitamin A
China
Z-score
nutritional status
pre-school child


Complete mitochondrial genome of Carijoa riisei (Duchassaing & Michelotti, 1860) (Octocorallia: Alcyonacea: Stolonifera: Clavulariidae).

Abstract: We report the first complete Stoloniferamitochondrial genome.Carijoa riisei(Duchassaing&Michelotti, 1860) isolate CLP2_A03was collected by scuba at 32 m on the USTS Texas Clipper (27° 53.7827' N, 93° 36.2702' W). The complete mitogenome has the ancestral octocoral gene order for its 14 protein-coding genes, two rRNA genes, and one tRNA gene. It is 18,714 bp (30.7% A, 15.8% C, 18.8% G, and 34.7% T). Of the Alcyonacea mitogenomes published to date, it is most genetically similar (94% uncorrected) to Sinularia ceramensisVerseveldt, 1977 (NC_044122).

Cnidaria
Gulf of Mexico
artificial reef
mesophotic


Canine superficial bacterial folliculitis: current understanding of its etiology, diagnosis and treatment.

Abstract: Superficial bacterial folliculitis (SBF) is more common in the dog than other mammalian species. Until recently, a successful outcome in cases of canine SBF was possible by administering a potentiated amoxicillin, a first generation cephalosporin or a potentiated sulfonamide. Unfortunately, this predictable susceptibility has changed, because methicillin resistant Staphylococcus pseudintermedius (MRSP) and Staphylococcus aureus (MRSA) are becoming more prevalent in canine SBF cases. The increasing frequency of multidrug resistance complicates the selection of antimicrobial therapy. Antimicrobial agents that were once rarely used in cases of canine SBF, such as amikacin, rifampicin and chloramphenicol, are becoming the drugs of choice, based on bacterial culture and susceptibility testing. Furthermore, changes in antimicrobial susceptibility have helped to re-emphasize the importance of a multimodal approach to treatment of the disease, including topical therapy. Due to the increasing frequency of identification of highly resistant Staphylococcus spp., topical antimicrobial therapy, including the use of diluted sodium hypochlorite (bleach), is becoming necessary to successfully treat some cases of canine SBF. Other important antiseptics that can be used include chlorhexidine, benzoyl peroxide, ethyl lactate, triclosan and boric acid/acetic acid. This review discusses the diagnostic and therapeutic management of canine SBF, with a special emphasis on treating methicillin resistant staphylococcal infections.

Canine
Methicillin
Staphylococcus
Antimicrobial resistance
Pyoderma


Role of Natural Phenolics in Hepatoprotection: A Mechanistic Review and Analysis of Regulatory Network of Associated Genes.

Abstract: The liver is not only involved in metabolism and detoxification, but also participate in innate immune function and thus exposed to frequent target Thus, they are the frequent target of physical injury. Interestingly, liver has the unique ability to regenerate and completely recoup from most acute, non-iterative situation. However, multiple conditions, including viral hepatitis, non-alcoholic fatty liver disease, long term alcohol abuse and chronic use of medications can cause persistent injury in which regenerative capacity eventually becomes dysfunctional resulting in hepatic scaring and cirrhosis. Despite the recent therapeutic advances and significant development of modern medicine, hepatic diseases remain a health problem worldwide. Thus, the search for the new therapeutic agents to treat liver disease is still in demand. Many synthetic drugs have been demonstrated to be strong radical scavengers, but they are also carcinogenic and cause liver damage. Present day various hepatic problems are encountered with number of synthetic and plant based drugs. Nexavar (sorafenib) is a chemotherapeutic medication used to treat advanced renal cell carcinoma associated with several side effects. There are a few effective varieties of herbal preparation like Liv-52, silymarin and Stronger neomin phages (SNMC) against hepatic complications. Plants are the huge repository of bioactive secondary metabolites viz; phenol, flavonoid, alkaloid etc. In this review we will try to present exclusive study on phenolics with its mode of action mitigating liver associated complications. And also its future prospects as new drug lead.

Saha|Priyanka|P|
Talukdar|Anupam Das|AD|
Nath|Rajat|R|
Sarker|Satyajit D|SD|
Nahar|Lutfun|L|
Sahu|Jagajjit|J|
Choudhury|Manabendra Dutta|MD|

phenolics
hepatoprotection
liver disease
gene network
in silico analysis
mechanism
natural product


Smarter vaccine design will circumvent regulatory T cell-mediated evasion in chronic HIV and HCV infection.

Abstract: Despite years of research, vaccines against HIV and HCV are not yet available, due largely to effective viral immunoevasive mechanisms. A novel escape mechanism observed in viruses that cause chronic infection is suppression of viral-specific effector CD4(+) and CD8(+) T cells by stimulating regulatory T cells (Tregs) educated on host sequences during tolerance induction. Viral class II MHC epitopes that share a T cell receptor (TCR)-face with host epitopes may activate Tregs capable of suppressing protective responses. We designed an immunoinformatic algorithm, JanusMatrix, to identify such epitopes and discovered that among human-host viruses, chronic viruses appear more human-like than viruses that cause acute infection. Furthermore, an HCV epitope that activates Tregs in chronically infected patients, but not clearers, shares a TCR-face with numerous human sequences. To boost weak CD4(+) T cell responses associated with persistent infection, vaccines for HIV and HCV must circumvent potential Treg activation that can handicap efficacy. Epitope-driven approaches to vaccine design that involve careful consideration of the T cell subsets primed during immunization will advance HIV and HCV vaccine development.

Moise|Leonard|L|
Terry|Frances|F|
Gutierrez|Andres H|AH|
Tassone|Ryan|R|
Losikoff|Phyllis|P|
Gregory|Stephen H|SH|
Bailey-Kellogg|Chris|C|
Martin|William D|WD|
De Groot|Anne S|AS|

vaccines
HIV
HCV
regulatory T cells
immunoinformatics
MHC class II
T cell epitope
cross-reactivity


Dual-Fluorescence Labeling Pseudovirus for Real-Time Imaging of Single SARS-CoV-2 Entry in Respiratory Epithelial Cells.

Abstract: The pseudovirus strategy makes studies of highly pathogenic viruses feasible without the restriction of high-level biosafety facility, thus greatly contributing to virology and is used in the research studies of SARS-CoV-2. Here, we generated a dual-color pseudo-SARS-CoV-2 virus using a human immunodeficiency virus-1 pseudovirus production system and the SARS-CoV-2 spike (S) glycoprotein, of which the membrane was labeled with a lipophilic dye (DiO) and the genomic RNA-related viral protein R (Vpr) of the viral core was fused with mCherry. With this dual-color labeling strategy, not only the movement of the whole virus but also the fate of the labeled components can be traced. The pseudovirions were applied to track the viral entry at a single-particle level in four types of the human respiratory cells: nasal epithelial cells (HNEpC), pulmonary alveolar epithelial cells (HPAEpiC), bronchial epithelial cells (BEP-2D), and oral epithelial cells (HOEC). Pseudo-SARS-CoV-2 entered into the host cell and released the viral core into the cytoplasm, which clearly indicates that the host entry mainly occurred through endocytosis. The infection efficiency was found to be correlated with the expression of the known receptor of SARS-CoV-2, angiotensin-converting 2 (ACE2) on the host cell surface. We believe that the dual-color fluorescently labeled pseudovirus system created in this study can be applied as a useful tool for many purposes in SARS-CoV-2/COVID-19.

respiratory epithelial cells
pseudo-SARS-CoV-2 virus
dual fluorescence
endocytic entry
single-virus imaging


Evaluation of liver failure in a pediatric transplant recipient of a liver allograft with inherited chromosomally integrated HHV-6B.

Abstract:
BACKGROUND
Active infections of human herpesvirus 6B (HHV-6B) are frequent in immunocompromised recipients after transplantation. Nevertheless, they need to be distinguished from latent inherited chromosomally integrated genomes (iciHHV-6) present in about 1% of the population to avoid unnecessary administration of toxic antivirals.

METHODS
A 5-year-old child presented with acute liver allograft rejection associated with HHV-6 DNA in plasma, which led to an unfavorable outcome. We investigated the possibility of HHV-6 infection derived from an iciHHV-6 present in the donor's liver using molecular and histopathology studies in various tissues, including quantification of HHV-6 DNA, genotyping, sequencing for antiviral resistance genes, relative quantification of viral transcripts, and detection of gB and gH viral proteins.

RESULTS
The presence of iciHHV-6B was evidenced in the donor with signs of reactivation in the gallbladder and transplanted liver (detection of HHV-6B mRNA and late proteins). This localized expression could have played a role in liver rejection. Low viral loads in the recipient's plasma, with identical partial U39 sequences, were in favor of viral DNA released from the transplanted liver rather than a systemic infection.

CONCLUSIONS
Determination of iciHHV-6 status before transplantation should be considered to guide clinical decisions, such as antiviral prophylaxis, viral load monitoring, and antiviral therapy.

Bonnafous|Pascale|P|0000-0001-5528-9356
Phan|Tuan L|TL|
Himes|Ryan|R|
Eldin|Karen|K|
Gautheret-Dejean|Agnès|A|
Prusty|Bhupesh K|BK|
Agut|Henri|H|
Munoz|Flor M|FM|

D064591:Allografts
D002675:Child, Preschool
D002877:Chromosomes, Human
D004279:DNA, Viral
D017809:Fatal Outcome
D006084:Graft Rejection
D015654:Herpesvirus 6, Human
D006801:Humans
D040582:Inheritance Patterns
D017093:Liver Failure
D016031:Liver Transplantation
D019349:Roseolovirus Infections
D016662:Virus Integration

iciHHV-6
horizontal transmission
liver transplantation


Uncovering nativity disparities in cancer patterns: Multiple imputation strategy to handle missing nativity data in the Surveillance, Epidemiology, and End Results data file.

Abstract:
BACKGROUND
Although birthplace data are routinely collected in the participating Surveillance, Epidemiology, and End Results (SEER) registries, such data are missing in a nonrandom manner for a large percentage of cases. This hinders analysis of nativity-related cancer disparities. In the current study, the authors evaluated multiple imputation of nativity status among Hispanic patients diagnosed with cervical, prostate, and colorectal cancer and demonstrated the effect of multiple imputation on apparent nativity disparities in survival.

METHODS
Multiple imputation by logistic regression was used to generate nativity values (US-born vs foreign-born) using a priori-defined variables. The accuracy of the method was evaluated among a subset of cases. Kaplan-Meier curves were used to illustrate the effect of imputation by comparing survival among US-born and foreign-born Hispanics, with and without imputation of nativity.

RESULTS
Birthplace was missing for 31%, 49%, and 39%, respectively, of cases of cervical, prostate, and colorectal cancer. The sensitivity of the imputation strategy for detecting foreign-born status was ≥90% and the specificity was ≥86%. The agreement between the true and imputed values was ≥0.80 and the misclassification error was ≤10%. Kaplan-Meier survival curves indicated different associations between nativity and survival when nativity was imputed versus when cases with missing birthplace were omitted from the analysis.

CONCLUSIONS
Multiple imputation using variables available in the SEER data file can be used to accurately detect foreign-born status. This simple strategy may help researchers to disaggregate analyses by nativity and uncover important nativity disparities in regard to cancer diagnosis, treatment, and survival.

Montealegre|Jane R|JR|
Zhou|Renke|R|
Amirian|E Susan|ES|
Scheurer|Michael E|ME|

Surveillance, Epidemiology, and End Results (SEER) program


Severe hypothyroidism following a single topical exposure to iodine in a premature neonate.

Abstract: A neonate, born at 24 weeks, underwent a patent ductus arteriosus ligation, with previous normal thyroid stimulating hormone (TSH) levels, developed severe hypothyroidism from topical exposure to iodine following a single surgical procedure at 28 days of life. A low free T4 level of 0.05 ng/dL and a high TSH level of 228 mIU/L was detected with an increased urinary iodine excretion level of 178 mg/L (reference range 0.30-1.97 mg/L). The thyroid ultrasound was normal. Levothyroxine was started immediately but thyroid function did not recover fully during admission and levothyroxine was required beyond term corrected. This case highlighted how susceptible extremely preterm infants are to iodine induced hypothyroidism, even short-term topical exposure. Delayed treatment of hypothyroidism can lead to profound neurodevelopmental delay. As surgical advances allow for interventions at earlier gestations, the importance of early thyroid function testing postexposure to iodine is highlighted and ultimately topical iodine should be avoided in these susceptible infants.

drugs: endocrine system
interventional cardiology
neonatal intensive care


Abstract:
INTRODUCTION
In cases of explantation and delayed reimplantation of an infected penile prosthesis, the scarring that afflicts the corporal bodies renders reimplantation difficult and risky, with potential loss in penile size.

AIM
Mitomycin C is an antitumor, antibiotic agent with a potent antifibrotic action that can be used to limit corporal scarring following explantation with the aim of achieving easy and safe subsequent reimplantation, in addition to preserving penile size.

METHODS
This was a prospective study involving 5 patients with infected penile prostheses who were referred to our tertiary implantation center. The infected prostheses were explanted, followed by corporal washout with antiseptics and antibiotics. Patients were rescrubbed and redraped. Mitomycin C, 10 mg in 250 cc saline, was instilled into the corpora cavernosa (125 cc each), avoiding extracavernous spilling and contact with corporotomy and skin edges. Corporotomy and skin edges were freshened and closed. Reimplantation was performed 10 to 12 weeks later.

MAIN OUTCOME MEASURE
We evaluated the ease of blunt dilatation upon reimplantation and success in implanting cylinders the same size as the ones explanted.

RESULTS
We were able to dilate the corporal bodies with ease in all cases using blunt Hegar dilators. All cases received the same size implant as the one explanted, in terms of length and girth, with the exception of a case where the length was only 1 cm shorter.

CONCLUSIONS
Irrigation of the cavernous spaces with mitomycin C upon explantation of an infected penile prosthesis appears to ameliorate corporal scarring and keep the cavernous spaces open. On a larger scale, this approach could render the most feared complication of penile prosthesis implantation surgery much more manageable. Shaeer O, Abdel Rahman IFS, Shaeer K. Shaeer's Anti-Scarring Technique: A Preventive Measure Against Corporal Fibrosis Upon Explantation of Infected Penile Implants. Sex Med 2019; 7:357-360.

Shaeer|Osama|O|
Abdel Rahman|Islam Fathy Soliman|IFS|
Shaeer|Kamal|K|

Corporal fibrosis
Delayed reimplantation
Corporal scarring
Penile implant extrusion
Penile prosthesis infection
Salvage


Cancer killers in the human gut microbiota: diverse phylogeny and broad spectra.

Abstract: Cancer as a large group of complex diseases is believed to result from the interactions of numerous genetic and environmental factors but may develop in people without any known genetic or environmental risks, suggesting the existence of other powerful factors to influence the carcinogenesis process. Much attention has been focused recently on particular members of the intestinal microbiota for their potential roles in promoting carcinogenesis. Here we report the identification and characterization of intestinal bacteria that exhibited potent anti-malignancy activities on a broad range of solid cancers and leukemia. We collected fecal specimens from healthy individuals of different age groups (preschool children and university students), inspected their effects on cancer cells, and obtained bacteria with potent anti-malignancy activities. The bacteria mostly belonged to Actinobacteria but also included lineages of other phyla such as Proteobacteria and Firmicutes. In animal cancer models, sterile culture supernatant from the bacteria highly effectively inhibited tumor growth. Remarkably, intra-tumor administration of the bacterial products prevented metastasis and even cleared cancer cells at remote locations from the tumor site. This work demonstrates the prevalent existence of potent malignancy-killers in the human intestinal microbiota, which may routinely clear malignant cells from the body before they form cancers.

Zhou|Yu-Jie|YJ| Zhao|Dan-Dan|DD| Liu|Huidi|H| Chen|Hao-Ting|HT| Li|Jia-Jing|JJ| Mu|Xiao-Qin|XQ| Liu|Zheng|Z| Li|Xia|X| Tang|Le|L| Zhao|Zhan-Yi|ZY| Wu|Ji-Heng|JH| Cai|Yu-Xuan|YX| Huang|Ya-Zhuo|YZ| Wang|Peng-Ge|PG| Jia|Yi-Yue|YY| Liang|Pei-Qiang|PQ| Peng|Xue|X| Chen|Si-Yu|SY| Yue|Zhi-Lin|ZL| Yuan|Xin-Yuan|XY| Lu|Tammy|T| Yao|Bing-Qing|BQ| Li|Yong-Guo|YG| Liu|Gui-Rong|GR| Liu|Shu-Lin|SL|

cancer
gut microbiota
leukemia
Actinobacteria
malignancy killer


Positive Predictive Value of the Giant Cell Arteritis Diagnosis in the Danish National Patient Registry: A Validation Study.

Abstract:
Purpose
To investigate the positive predictive value (PPV) of the giant cell arteritis (GCA) diagnosis in the Danish National Patient Registry (DNPR).

Patients and Methods
A total of 293 patients aged ≥50 years with a first-time diagnosis of GCA in the DNPR between January 2012 and December 2017 were included. Patients were sampled from two secondary and one tertiary care hospitals in the Central Region Denmark. Two independent investigators (PH & PT) reviewed all medical files, including medical records, treatment, biochemistry, histopathology and imaging, and either confirmed or dismissed the diagnosis of GCA. In case of disagreement, a consensus agreement was reached. Sub-analyses including number of redeemed prescriptions performed temporal artery biopsies (TABs), and number of GCA-related hospital contacts were performed.

Results
We confirmed the diagnosis of GCA in 183/293 patients resulting in a PPV of 62% (95% CI: 57-68). In patients with ≥3 redeemed prescriptions of glucocorticoids (GCs), we confirmed the diagnosis in 166/214 resulting in a PPV of 78% (95% CI: 71-83). In patients with ≥3 redeemed prescriptions of GCs and ≥3 GCA-related hospital contacts, we confirmed the diagnosis in 88/95 resulting in a PPV of 93% (95% CI: 85-96); however, this only included 88/183 confirmed GCA patients.

Conclusion
This is the first study to validate the diagnostic code of GCA in the DNPR. The overall PPV of GCA in the DNPR was 62%. Requiring redeemed prescriptions of GCs and/or GCA-related hospital contacts increase the PPV, but also excludes a significant number of GCA patients.

positive predictive value
giant cell arteritis
Danish National Patient Registry
validation
rheumatology


The effects of inhaled albuterol in transient tachypnea of the newborn.

Abstract:
PURPOSE
Transient tachypnea of the newborn (TTN) is a disorder caused by the delayed clearance of fetal alveolar fluid. β-adrenergic agonists such as albuterol (salbutamol) are known to catalyze lung fluid absorption. This study examined whether inhalational salbutamol therapy could improve clinical symptoms in TTN. Additional endpoints included the diagnostic and therapeutic efficacy of salbutamol as well as its overall safety.

METHODS
From January 2010 through December 2010, we conducted a prospective study of 40 newborns hospitalized with TTN in the neonatal intensive care unit. Patients were given either inhalational salbutamol (28 patients) or placebo (12 patients), and clinical indices were compared.

RESULTS
The duration of tachypnea was shorter in patients receiving inhalational salbutamol therapy, although this difference was not statistically significant. The duration of supplemental oxygen therapy and the duration of empiric antibiotic treatment were significantly shorter in the salbutamol-treated group. No adverse effects were observed in either treatment group.

CONCLUSIONS
Inhalational salbutamol therapy reduced the duration of supplemental oxygen therapy and the duration of empiric antibiotic treatment, with no adverse effects. However, the time between salbutamol therapy and clinical improvement was too long to allow definitive conclusions to be drawn. Further studies examining a larger number of patients with strict control over dosage and frequency of salbutamol inhalations are necessary to better direct the treatment of TTN.

Kim|Myo-Jing|MJ| Yoo|Jae-Ho|JH| Jung|Jin-A|JA| Byun|Shin-Yun|SY|

inhalation
albuterol
Transient tachypnea of the newborn


Ciclopirox and Efinaconazole Transungual Permeation, Antifungal Activity, and Proficiency To Induce Resistance in Trichophyton rubrum.

Abstract: Onychomycosis is a nail fungal infection, mostly caused by dermatophytes. The treatment efficacy is impaired by difficulties of reaching effective drug levels at the site of infection; frequent relapses occur after cessation of antifungal therapy. The aim of the study was to compare two commercial products containing ciclopirox or efinaconazole for antimycotic activity and antifungal drug resistance. A study of permeation and penetration through bovine hoof membranes, as a nail model, was performed to evaluate the antimycotic activity of permeates against clinical isolates of selected fungi, and the frequency of spontaneous in vitro Trichophyton rubrum-resistant strains was assessed by broth microdilution assays. The results suggest that ciclopirox creates a depot in the nail, leading to a gradual release of the drug over time with action on both the nail plate and bed. Conversely, efinaconazole, mildly interacting with nail keratin, mainly exerts its antifungal activity in the nail bed. However, in the case of T. rubrum, the antifungal activities of the drugs in the nail plate seem comparable. Finally, efinaconazole showed a potential for induction of resistance in T. rubrum, which may limit its efficacy over time. Ciclopirox did not show any potential to induce resistance in T. rubrum and appears endowed with a more complete activity than efinaconazole in the management of onychomycosis as the nail keratin is a substrate for the growth of fungal cells, and the availability of drug in large concentration just in the nail bed may not be sufficient to guarantee the complete eradication of pathogens.

Monti|Daniela|D| Mazzantini|Diletta|D| Tampucci|Silvia|S|0000-0002-8927-6083 Vecchione|Alessandra|A| Celandroni|Francesco|F| Burgalassi|Susi|S| Ghelardi|Emilia|E|

ciclopirox
efinaconazole
transungual permeation
Trichophyton rubrum
bovine hoof membranes
antifungal resistance


Clinical bioanalysis of treosulfan and its epoxides: The importance of collected blood processing for valid pharmacokinetic results.

Abstract: Currently, there is an urgent need to establish the optimal dosing of TREO in conditioning prior to hematopoietic stem cell transplantation, especially in children. For that purpose, pharmacokinetic analyses are ongoing within clinical phase II and III trials. In this paper, HPLC methods for determination of prodrug treosulfan and/or its biologically active epoxides in human plasma or serum are reviewed for the first time, including the spectrum of analytes being quantified, detection type, and derivatization methodology. The major focus is addressed to the stability of TREO and its monoepoxide related with different strategies of patients' blood processing, e.g. blood pH lowering to different values, no pH adjustment; centrifugation of blood immediately after collection or within a few hours later. This issue is crucially important for the robust bioanalysis because the epoxytransformation of TREO is a nonenzymatic, highly pH and temperature-dependent reaction. In-depth analysis of the literature results demonstrates that some methodologies of blood treatment could produce the systematic underestimation of TREO concentrations. Consequently, the drug clearance and volume of distribution will be overestimated, which might false the association of the drug exposure with the regimen-related toxicity and clinical outcomes. The paper indicates the deficiencies of the blood processing strategies and offers hints for their refinement. The provided information ought to be important in the current investigations of the personalized TREO pharmacokinetics.

D002851:Chromatography, High Pressure Liquid

Bioanalysis
HPLC
Prodrugs
Blood pH
Chemical stability


Decreased MMP1 gene expression in acute myeloid leukaemia.

Abstract: Acute myeloid leukaemia (AML) is a heterogeneous disorder of haematopoietic stem cells or progenitor cells. Metalloproteinases (MMPs) are proteolytic enzymes whose activity is increased in different types of solid tumours. These enzymes regulate many processes associated with tumour progression. In haematological malignancy, the role of MMPs seems to be underestimated, and only metalloproteinase 2 (MMP2) and metalloproteinase 9 (MMP9) have been widely examined so far. In this work, differences in metalloproteinase 1 (MMP1) gene expression between patients with AML and healthy individuals were assessed. The relative expression level of the MMP1 gene was obtained by a real time PCR method preceded by reverse transcription. The relative level of MMP1 gene expression in patients with AML was decreased when compared to that of the control group. The role of MMP1 in AML could be different from that in solid tumours. Decreased MMP1 gene expression in AML similar to that of MMP9, shows a greater role for MMP1 in normal haematopoiesis than in the development of leukaemic cells.

D015973:Gene Expression Regulation, Leukemic

MMP1
MMP1 gene expression
Acute myeloid leukaemia
Real time PCR


Factors Affecting Set Shot Goal-kicking Performance in the Australian Football League.

Abstract: Set shot goal-kicking is recognized as an important skill in Australian Football (AF), accounting for over half of all goals kicked in the Australian Football League (AFL). However, as knowledge surrounding its performance is limited, this study described the frequency, types, and outcomes of set shots in the AFL and investigated the impact of task, personal, and environmental constraints on goal-kicking performance. We analyzed video footage of set shots from all 198 matches of the 2012 season, collecting data for kick distance, kick angle, player position, player experience (i.e., general and specific), kick outcome, and weather status. We found an average of 23.0 (standard deviation [ SD] = 4.5) set shots/match, with a mean accuracy of 55.0% ( SD = 0.7%). Kicking accuracy decreased with incremental increases in kick distance, with accuracy ranging from 97% (0-15 m) to 36% (≥50 m). Key forwards were more accurate kickers than other players. There was no significant effect of player experience. The number of set shots taken decreased by 13% in wet weather conditions. The primary determinant of elite set shot goal-kicking performance was the interaction of kick distance and angle (task difficulty). This research adds to an understanding of how personal, environmental, and match constraints influence this closed skill performance in AF match play.

Anderson|Darren|D| Breed|Ray|R| Spittle|Michael|M| Larkin|Paul|P|

goal-kicking
constraints
coaching
performance analysis
tactical


Diabetes and Cardiovascular Complications: The Epidemics Continue.

Abstract:
PURPOSE OF REVIEW
The cardiovascular complications of type 1 and 2 diabetes are major causes of morbidity and mortality. Extensive efforts have been made to maximize glycemic control; this strategy reduces certain manifestations of cardiovascular complications. There are drawbacks, however, as intensive glycemic control does not impart perennial protective benefits, and these efforts are not without potential adverse sequelae, such as hypoglycemic events.

RECENT FINDINGS
Here, the authors have focused on updates into key areas under study for mechanisms driving these cardiovascular disorders in diabetes, including roles for epigenetics and gene expression, interferon networks, and mitochondrial dysfunction. Updates on the cardioprotective roles of the new classes of hyperglycemia-targeting therapies, the sodium glucose transport protein 2 inhibitors and the agonists of the glucagon-like peptide 1 receptor system, are reviewed. In summary, insights from ongoing research and the cardioprotective benefits of the newer type 2 diabetes therapies are providing novel areas for therapeutic opportunities in diabetes and CVD.

D000077203:Sodium-Glucose Transporter 2 Inhibitors

Diabetes
Epigenetics
Mitochondrial dysfunction
Cardiovascular disease
Interferon pathways
Therapeutic agents


Computational fluid dynamics characterization of pulsatile flow in central and Sano shunts connected to the pulmonary arteries: importance of graft angulation on shear stress-induced, platelet-mediated thrombosis.

Abstract:
OBJECTIVES
Central (aorta) and Sano (right ventricle)-to-pulmonary artery (PA) shunts, palliative operations for infants with complex heart defects, can develop life-threatening thrombosis. We employed computational fluid dynamics (CFD) to study pulsatile flow in these shunts, with the goal to identify haemodynamic characteristics conducive to thrombus formation.

METHODS
CFD, using the finite volume method with cardiac catheterization data, and computer simulations, based on angiography, were employed to determine flow-velocity field, wall shear stress (WSS) profile and oscillatory shear index (OSI).

RESULTS
At prominent angulation, in central shunts (4 and 3.5 mm), WSS reached 245 and 123 (Pascal-Pa), peak systole and 137 and 46 Pa, end diastole; and, in Sano shunts (5 and 6 mm), WSS attained 203 and 133 Pa, peak systole and 1.6 and 1.5 Pa, end diastole. Counter-rotating flow vortices augmented WSS. These high WSSs can promote platelet aggregation, leading to thrombus formation. The OSIs averaged 0.39, indicative of multidirectional shearing forces. Shunt burden was assessed by averaging WSS, over its luminal area and the cardiac cycle. For the central shunts, these WSSs were 73.0 and 67.2 Pa; whereas, for the Sano shunts, 34.9 and 19.6 Pa. For modified Blalock-Taussig shunts (4 and 3.5 mm), the averaged WSSs were significantly lower at 26.0 and 27.5 Pa, respectively.

CONCLUSIONS
CFD modelling is an important tool to determine blood flow behaviour in shunts. Graft angulation presents a risk for shear stress-induced, platelet- mediated thrombosis, which is more likely to occur in elongated central than in Sano shunts.

Ascuitto|Robert|R| Ross-Ascuitto|Nancy|N| Guillot|Martin|M| Celestin|Carey|C|

D001013:Aorta, Thoracic
D001792:Blood Platelets
D006348:Cardiac Surgical Procedures
D003198:Computer Simulation
D006083:Graft Occlusion, Vascular
D006352:Heart Ventricles
D006801:Humans
D057446:Hydrodynamics
D008955:Models, Cardiovascular
D011474:Prosthesis Design
D011651:Pulmonary Artery
D011673:Pulsatile Flow
D013314:Stress, Mechanical
D013927:Thrombosis

Computational fluid dynamics
Sano shunts
Thrombosis
Wall shear stress
Oscillatory shear index
Central shunts
Platelet aggregation


Circularly polarized luminescence spectroscopy reveals low-energy excited states and dynamic localization of vibronic transitions in CP43.

Abstract: Circularly polarized luminescence (CPL) spectroscopy is an established but relatively little-used technique that monitors the chirality of an emission. When applied to photosynthetic pigment assemblies, we find that CPL provides sensitive and detailed information on low-energy exciton states, reflecting the interactions, site energies and geometries of interacting pigments. CPL is the emission analog of circular dichroism (CD) and thus spectra explore the optical activity only of fluorescent states of the pigment-protein complex and consequently the nature of the lowest-energy excited states (trap states), whose study is a critical area of photosynthesis research. In this work, we develop the new approach of temperature-dependent CPL spectroscopy, over the 2-120 K temperature range, and apply it to the CP43 proximal antenna protein of photosystem II. Our results confirm strong excitonic interactions for at least one of the two well-established emitting states of CP43 named "A" and "B". Previous structure-based models of CP43 spectra are evaluated in the light of the new CPL data. Our analysis supports the assignments of Shibata et al. [Shibata et al. J. Am. Chem. Soc. 135 (2013) 6903-6914], particularly for the highly-delocalized B-state. This state dominates CPL spectra and is attributed predominantly to chlorophyll a's labeled Chl 634 and Chl 636 (alternatively labeled Chl 43 and 45 by Shibata et al.). The absence of any CPL intensity in intramolecular vibrational sidebands associated with the delocalized "B" excited state is attributed to the dynamic localization of intramolecular vibronic transitions.

Hall|Jeremy|J| Renger|Thomas|T| Picorel|Rafael|R| Krausz|Elmars|E|

Circularly polarized luminescence
Dynamic localization
Circular dichroism
Fluorescence
Photosystem II
Lowest excited states


Therapeutic Dissolution of Aberrant Phases by Nuclear-Import Receptors.

Abstract: Nuclear-import receptors (NIRs) bind nuclear-localization signals (NLSs) of protein cargo in the cytoplasm and transport them into the nucleus. Here, we review advances establishing that NIRs also function in the cytoplasm to prevent and reverse functional and aberrant phase transitions of their cargo, including neurodegenerative disease-linked RNA-binding proteins (RBPs) with prion-like domains, such as TDP-43, FUS, hnRNPA1, and hnRNPA2. NIRs selectively extract cargo from condensed liquid phases thereby regulating functional phase separation. Consequently, NIRs sculpt cytoplasmic membraneless organelles and regulate cellular organization beyond their canonical role in nuclear import. Elevating NIR expression dissolves cytoplasmic RBP aggregates, restores functional RBPs to the nucleus, and rescues disease-linked RBP toxicity. Thus, NIRs could be leveraged therapeutically to restore RBP homeostasis and mitigate neurodegeneration.

Guo|Lin|L|
Fare|Charlotte M|CM|
Shorter|James|J|

D018160:Receptors, Cytoplasmic and Nuclear

nuclear-import receptor
phase transition
FUS
neurodegeneration
amyotrophic lateral sclerosis
karyopherin-β2


Prevalence of lameness, claw lesions, and associated risk factors in dairy farms in Selangor, Malaysia.

Abstract: The objectives of this cross-sectional study were to estimate the prevalence of lameness, claw lesions, and associated risk factors in dairy farms in Selangor, Malaysia. The sample population was 251 lactating cows from 8 farms assessed for lameness and claw lesions by locomotion scoring and claw assessment respectively while specific animal-based measures were hypothesized as cow-level risk factors. The Wilcoxon rank test and logistic regression were applied to assess the prevalence of lameness, claw lesions, and association with potential risk factors, respectively. The prevalence of lameness was 19.1% ranging from 10.0 to 33.3% while 31.1% of cows had claw lesions and ranged from 16.3-40%. Claw lesions were recorded in 87.5% of the lame cows with highest being those affected with sole lesions (54.2%) and white line disease (61.2%). Overall, the occurrence of overgrown claws, sole lesions, white line disease, and digital dermatitis were 37, 18.2, 10.9, and 8.3%, respectively. More than one claw lesion per cow was present in 71.8% of the affected cows. Lameness was associated with early lactation (OR = 3.3; 95% CI 2-7), injured hocks (OR = 4.8; 95% CI 5-17), and dirty legs hygiene (OR = 2.6; 95% CI 1.3-6.2), whereas presence of claw lesions was associated with dirty legs hygiene (OR = 4.7; 95% CI 4-11) and overgrown claw (OR = 2.7; 95% CI 1.4-5.3). To reduce the prevalence of lameness, farmers need to improve the management of cows with overgrown claw, injured hocks, and cleanliness by establishing routine claw trimming and efficient stall design.

Sadiq|M B|MB|
Ramanoon|S Z|SZ|
Mansor|R|R|
Syed-Hussain|S S|SS|
Shaik Mossadeq|W M|WM|

Claw lesions
Risk factors
Locomotion
Dairy cows
Lameness prevalence


Compound Risks of Hurricane Evacuation Amid the COVID-19 Pandemic in the United States.

Abstract: The 2020 Atlantic hurricane season was extremely active and included, as of early November, six hurricanes that made landfall in the United States during the global coronavirus disease 2019 (COVID-19) pandemic. Such an event would necessitate a large-scale evacuation, with implications for the trajectory of the pandemic. Here we model how a hypothetical hurricane evacuation from four counties in southeast Florida would affect COVID-19 case levels. We find that hurricane evacuation increases the total number of COVID-19 cases in both origin and destination locations; however, if transmission rates in destination counties can be kept from rising during evacuation, excess evacuation-induced case numbers can be minimized by directing evacuees to counties experiencing lower COVID-19 transmission rates. Ultimately, the number of excess COVID-19 cases produced by the evacuation depends on the ability of destination counties to meet evacuee needs while minimizing virus exposure through public health directives. These results are relevant to disease transmission during evacuations stemming from additional climate-related hazards such as wildfires and floods.

hurricane
evacuation
COVID‐19
climate
epidemiology
extreme events


Activation of organic chloramine by UV photolysis: A non-negligible oxidant for micro-pollutant abatement and disinfection by-product formation.

Abstract: Due to the wide-presence of organic amines in natural waters, organic chloramines are commonly formed during (pre-)chlorination. With the increasing application of UV disinfection in water treatment, both the activation mechanism of organic chloramine by UV photolysis and its subsequent impact on water quality are not clear. Using sarcosine (Sar) as an amine group-containing compound, it was found that organic chloramines (i.e., Cl-Sar) would be firstly formed during chlorination even in the presence of natural organic matter. Compared with self-decay of Cl-Sar, UV photolysis accelerated Cl-Sar decomposition and induced NCl bond cleavage. Using metoprolol (MTP) as a model micro-pollutant, UV-activated Cl-Sar (UV/Cl-Sar) can accelerate micro-pollutant degradation, attributed to reactive radicals formation. HO• and Cl• were important contributors, with a total contribution of 45%‒64%. Moreover, the degradation rate of MTP by UV/Cl-Sar was pH-dependent, which monotonically increased from 0.044 to 0.065 min‒1 under pHs 5.5‒8.5. Although the activation of organic chloramine by UV could accelerate micro-pollutant degradation, UV/Cl-Sar treatment could also enhance disinfection by-products formation. Trichloromethane (TCM) formation was observed during MTP degradation by UV/Cl-Sar. After post-chlorination, TCM, 1,1-dichloropropanone, 1,1,1-trichloropropanone, and dichloroacetonitrile were detected. Their individual and total concentrations were all positively proportional to UV/Cl-Sar treatment time. The total concentration with 30 min treatment (66.93 μg L‒1) was about 2.3 times that with 1 min treatment (28.76 μg L‒1). Finally, the accelerated effect was verified with Cl-glycine and Cl-alanine. It is expected to unravel the non-negligible role of organic chloramine on water quality during UV disinfection.

Wang|Yan|Y| Dong|Huiyu|H| Qin|Wenlei|W| Li|Jin|J| Qiang|Zhimin|Z|

UV photolysis
Disinfection by-products formation
Organic amine
Mechanism
Kinetics


Single-port access compared with three-port laparoscopic adnexal surgery in a randomized controlled trial.

Abstract:
OBJECTIVE
Scar-related cosmetic outcomes were compared prospectively between conventional three-port and single-port access laparoscopic adnexal gynaecological surgery.

METHODS
Enrolled patients were randomly assigned to a single- or three-port surgery group. Scar-related outcomes were evaluated at 1 month, 6 months and 1 year. Scars were assessed by an independent observer using the modified Vancouver Scar Scale (mVSS). All patients were asked about pain related to the scar and scar satisfaction; results were recorded using a numerical rating scale.

RESULTS
Seventy-three patients were enrolled between June 2010 and June 2011. Demographic and surgical outcomes did not differ between the groups. mVSS results were similar in the two groups at each follow-up point. The scar satisfaction profile measured at 1 month showed no significant difference between the groups, but the single-port access group had better results than the conventional group at all other follow-up timepoints.

CONCLUSION
Cosmetic outcome was better for single-port than for three-port adnexal gynaecological surgery at 6-month and 1-year follow-up.

adnexal surgery
gynaecology
Single-port surgery
laparoscopic surgery


Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience.

Abstract: Background: Apical hypertrophic cardiomyopathy (aHCM) is thought to have a more benign clinical course compared to septal HCM (sHCM), but most data have been derived from Asian cohorts. Comparative data on clinical outcome in Caucasian aHCM cohorts are scarce, and the results are conflicting. The aim of this study was to estimate the prevalence and outcome of aHCM in French-Canadians of Caucasian descent. Methods and results: We conducted a retrospective, single-center cohort study. The primary endpoint was a composite of documented sustained ventricular arrhythmia (VA), appropriate ICD therapy, arrhythmogenic syncope, cardiac arrest, or all-cause mortality. A total of 301 HCM patients (65% males) were enrolled including 80/301 (27%) with aHCM and 221/301 (73%) with sHCM. Maximal wall thickness was similar in both groups. Left ventricular apical aneurysm was significantly more common in aHCM (10 vs. 0.5%; p < 0.001). The proportion of patients with myocardial fibrosis ≥ 15% of the left ventricular mass was similar between aHCM and sHCM (21 vs. 24%; p = 0.68). Secondary prevention ICDs were more often implanted in aHCM patients (16 vs. 7%; p = 0.02). The primary endpoint occurred in 26% of aHCM and 10.4% of sHCM patients (p = 0.001) and was driven by an increased incidence of sustained VA (10 vs. 2.3%; p = 0.01). Multivariate analysis identified apical aneurysm and a phenotype of aHCM as independent predictors of the primary endpoint and the occurrence of sustained ventricular tachycardia. Unexplained syncope and a family history of sudden cardiac death were additional predictors for sustained VA. Apical HCM was associated with an increased risk of ventricular arrhythmia even when excluding patients with apical aneurysm. Conclusions: The phenotype of apical HCM is much more common in French-Canadians (27%) of Caucasian descent compared to other Caucasian HCM populations. Apical HCM in French-Canadians is associated with an increased risk for ventricular arrhythmia.

Steinberg|Christian|C| Nadeau-Routhier|Charles|C| André|Philippe|P| Philippon|François|F| Sarrazin|Jean-François|JF| Nault|Isabelle|I| O'Hara|Gilles|G| Blier|Louis|L| Molin|Franck|F| Plourde|Benoit|B| Roy|Karine|K| Larose|Eric|E| Arsenault|Marie|M| Champagne|Jean|J|

ventricular arrhythmia
apical hypertrophic cardiomyopathy
hypertrophic cardiomyopathy
French-Canadian
septal hypertrophic cardiomyopathy


Coronary Microvascular Dysfunction and Estrogen Receptor Signaling.

Abstract: Chest pain with non-obstructive coronary artery disease (NOCAD) occurs more frequently in women than in men and is mainly related to coronary microvascular disease (CMD). The majority of CMD patients are postmenopausal women, suggesting a role for lack of estrogens in the development and progression of CMD. Patients are often discharged without a clear treatment plan due to the limited understanding of etiology and diagnostic parameters of CMD and have significantly higher rates of future cardiovascular events. Thus, there is a need for a better understanding of the underlying biology, and CMD-specific diagnostic tests and therapies. In this article, we reviewed recent studies on CMD, estrogen action in coronary microvasculature, and diagnosis and treatment options for CMD in postmenopausal women.

Tunc|Elif|E|
Eve|Alicia Arredondo|AA|
Madak-Erdogan|Zeynep|Z|

coronary microvascular dysfunction
estrogen receptor signaling
estrogens
diagnostic test
HRT
menopause


Quantifying morphological adaptations using direct measurements: The carnivoran appendicular skeleton as a case study.

Abstract: Here, I study whether locomotor adaptations can be detected in limb bones using a univariate approach, and whether those results are affected by size and/or shared evolutionary history. Ultimately, it tests whether classical papers on locomotor adaptations should be trusted. To do that, I analyzed the effect of several factors (size, taxonomic group, and locomotor habit) on limb bone morphology using a set of 43 measurements of the scapula, long bones, and calcaneus, of 435 specimens belonging to 143 carnivoran species. Size was the main factor affecting limb morphology. Size-corrected analyses revealed artifactual differences between various locomotion-related categories in the analyses of raw data. Additionally, several between-group differences were new to the size-corrected analyses, suggesting that they were masked by the size-effect. Phylogeny had also an important effect, although it only became apparent after removing the effect of size, probably due to the strong covariation of both factors. Regarding locomotor adaptations, locomotor type was used to represent locomotor specialization, and utilized habitat as an indicator of the capacity to adopt different modes of locomotion (running, swimming, climbing, and digging) and thus maximize resource exploitation by being capable of navigating all the substrates in the habitat they use. Locomotor type produced better results than utilized habitat, suggesting that carnivorans use locomotor specialization to minimize locomotion costs. The characteristic limb bone morphology for each locomotor type studied is described, including several adaptations and trends that are novel to the present study. Finally, the results presented here support the hypothesis of a "viverrid-like", forest-dwelling carnivoran ancestor, either arboreal or terrestrial.

adaptation
limb bones
size
phylogeny
locomotor type
Carnivora


Factors associated with uptake of post-abortion family planning in Shire town, Tigray, Ethiopia.

Abstract:
OBJECTIVES
Post-abortion contraceptive service is pivotal for the prevention of unwanted pregnancy and alleviation of its complication. Worldwide half of the pregnancy is unplanned, whereas unwanted pregnancy ends up with abortion. This study assessed post-abortion contraceptive uptake and associated factors among abortion service users at health institution in Shire town, North Ethiopia. Institutional based cross-sectional study was conducted from December 15/2016 to March 15, 2017, in Shire town. Data were collected using systematic random sampling technique. Bivariate and multivariable analyses were done to determine the association of each independent variable with the dependent variable.

RESULTS
Overall post-abortion contraceptive utilization in this study was 61.5%. Married [AOR 2.59, 95% CI (1.16, 5.65)], completed College education [AOR 5.69, 95% CI (1.61, 20.11)], previous contraceptive used [AOR 3.62, 95% CI (1.77, 7.40)], counseling of family planning [AOR 3.53 95% CI (1.69, 7.37)], grand multipara [AOR 7.91, 95% CI (1.66, 37.74)] and public health institution [AOR 5.95, 95% CI (3.03, 11.72)] were significantly associated with the post-abortion contraceptive utilization. In this study, post-abortion contraceptive utilization was about two-third. Being married, had been completing a college education, had been receiving family planning counseling, previous contraceptive usage, abortion care service at public health institution, and being grand multiparty were determinants of post-abortion contraceptive utilization.

Moges|Yohannes|Y| Hailu|Tesfay|T| Dimtsu|Balem|B| Yohannes|Zemenu|Z| Kelkay|Bayew|B|

Post-abortion
Ethiopia
Contraceptive utilization


Dietary diversity predicts dietary quality regardless of season in 6-12-month-old infants in south-west Ethiopia.

Abstract:
OBJECTIVE
Simple, cost-effective and convenient instruments like food group-based scores are proposed to assess micronutrient adequacy of children in developing countries. We assessed the predictive ability and seasonal stability of a dietary diversity score (DDS) to indicate dietary quality of infants.

DESIGN
A 24 h dietary recall assessment was carried out on a sample of 320 and 312 breast-fed infants aged 6-12 months during harvest (HS) and pre-harvest (PHS) seasons, respectively, in Ethiopia. DDS was calculated based on seven food groups, while mean micronutrient density adequacy (MMDA) was calculated for eight micronutrients. Multiple linear regression models were used to assess the relationship between DDS and MMDA, and differences in nutrient intake between the two seasons. A receiver-operating characteristic curve analysis was performed to derive DDS cut-offs that maximized sensitivity and specificity of assessing dietary quality.

SETTING
The study was conducted in the catchment of the Gilgel Gibe Field Research Centre of Jimma University, south-west Ethiopia.

RESULTS
The mean (sd) DDS for HS and PHS was 2·1 (0·94) and 2·3 (1·1), respectively. The DDS was associated with MMDA (β=0·045, P<0·0001 in HS; β=0·044, P<0001 in PHS). A DDS of ≤2 food groups best predicted 'low' MMDA (<50 %) with 84 % and 92 % sensitivity, 36 % and 43 % specificity, and 47 % and 51 % correct classification for the HS and PHS, respectively.

CONCLUSIONS
DDS is predictive of dietary quality of breast-fed infants. The study supports the use of DDS to indicate inadequate intakes of micronutrients by breast-fed infants in different seasons.

D007227:Infant Nutritional Physiological Phenomena

Dietary diversity
Ethiopia
Breast-fed infants
Micronutrient density adequacy


Marked reductions in visual impairment due to diabetic retinopathy achieved by efficient screening and timely treatment.

Abstract:
PURPOSE
Diabetic retinopathy (DR) is the most common complication of diabetes and needs to be diagnosed early to prevent severe sight-threatening retinopathy. Digital photography with telemedicine connections is a novel way to deliver cost-effective, accessible screening to remote areas. Screening for DR in a mobile eye examination unit (EyeMo) is compared to traditional service models (i.e. local municipal services or a commercial service provider). The quality of images, delays from screening to treatment, the stage of DR, coverage of screening and the rate of visual impairment due to DR are evaluated.

METHODS
EyeMo utilizes telemedicine technology. The electronic databases of the hospital and information from the Finnish Register of Visual Impairment were used to determine delays and the rate of visual impairment.

RESULTS
Fourteen thousand eight hundred and sixty-six fundus photographs were taken in EyeMo in 2007-2011. Coverage reached 78% of potential clients. No DR was detected in 43%, mild background retinopathy in 23%, moderate or severe background retinopathy in 31% and proliferative retinopathy in 3% of the evaluations. The quality of images was higher (p < 0.01) and delays shorter (p < 0.01) in EyeMo as compared to traditional service models. The rate of visual impairment due to DR decreased by 86% in the area covered by EyeMo, and the change compared favourably to the situation in the entire Finland (p < 0.0005).

CONCLUSION
EyeMo is a feasible model of telemedicine application for screening of DR. Effective screening and timely access to care may indeed have influenced the reduced rate of visual damage.

Hautala|Nina|N| Aikkila|Riittaliisa|R| Korpelainen|Juha|J| Keskitalo|Antti|A| Kurikka|Anne|A| Falck|Aura|A| Bloigu|Risto|R| Alanko|Hannu|H|

visual impairment
diabetes
diabetic retinopathy
screening
telemedicine


Patient and provider perspectives on adherence to and care coordination of lynch syndrome surveillance recommendations: findings from qualitative interviews.

Abstract:
Background
Patients with a genetic variant associated with Lynch syndrome (LS) are recommended to undergo frequent and repeated cancer surveillance activities to minimize cancer-related morbidity and mortality. Little is known about how patients and primary care providers (PCPs) track and manage these recommendations. We conducted a small exploratory study of patient and PCP experiences with recommended LS surveillance activities and communication with family members in an integrated health care system.

Methods
We used in-depth interviews with patients and providers to understand how surveillance is coordinated and monitored following confirmation of LS. We recruited patients with a range of ages/gender, and providers with at least at least one patient with a molecular diagnosis of LS. All interviews were recorded, transcribed, and content analyzed by a trained qualitative methodologist.

Results
Twenty-two interviews were completed with 12 patients and 10 providers. Most patients (10) had detailed knowledge of surveillance recommendations, but were less sure of time intervals. While all patients reported receiving initial education about their surveillance recommendations from a genetic counselor, seven did not follow-up with a genetic counselor in subsequent years. A third of patients described taking sole responsibility for managing their LS surveillance care. Lack of routine communication from the health system (e.g., prompts for surveillance activities), and provider engagement were surveillance barriers. PCPs were generally aware of LS, but had limited familiarity with surveillance recommendations. Most PCPs (7) viewed LS as rare and relied on patient and specialist expertise and support. Providers typically had 1 patient with LS in a panel of 1800 patients overall. Providers felt strongly that management of LS should be coordinated by a dedicated team of specialists. Most patients (92%) had at least one family member that sought LS testing, and common barriers for family members included lack of insurance, affordability, and fear of result.

Conclusion
The maximal benefits of screening for confirmation of LS will only be realized with adherence to recommended preventive care. Important factors to ensure patients receive recommended LS care include a comprehensive and coordinated monitoring program that includes reminder prompts, and increased PCP education of LS and associated surveillance recommendations.

Schneider|Jennifer L|JL|
Goddard|Katrina A B|KAB|
Muessig|Kristin R|KR|
Davis|James V|JV|
Rope|Alan F|AF|
Hunter|Jessica E|JE|
Peterson|Susan K|SK|
Acheson|Louise S|LS|
Syngal|Sapna|S|
Wiesner|Georgia L|GL|
Reiss|Jacob A|JA|

Patient and provider perspectives
Lynch syndrome
Surveillance recommendations
Qualitative


Optimized saturation pulse train for human first-pass myocardial perfusion imaging at 7T.

Abstract:
PURPOSE
To investigate whether saturation using existing methods developed for 3T imaging is feasible for clinical perfusion imaging at 7T, and to propose a new design of saturation pulse train for first-pass myocardial perfusion imaging at 7T.

METHODS
The new design of saturation pulse train consists of four hyperbolic-secant (HS8) radiofrequency pulses, whose peak amplitudes are optimized for a target range of static and transmit field variations and radiofrequency power deposition restrictions measured in the myocardium at 7T. The proposed method and existing methods were compared in simulation, phantom, and in vivo experiments.

RESULTS
In healthy volunteer experiments without contrast agent, average saturation efficiency with the proposed method was 97.8%. This is superior to results from the three previously published methods at 86/95/90.8%. The first series of human first-pass myocardial perfusion images at 7T have been successfully acquired with the proposed method.

CONCLUSION
Existing saturation methods developed for 3T imaging are not optimal for perfusion imaging at 7T. The proposed new design of saturation pulse train can saturate effectively, and with this method first-pass myocardial perfusion imaging is feasible in humans at 7T.

Tao|Yuehui|Y|
Hess|Aaron T|AT|
Keith|Graeme A|GA|
Rodgers|Christopher T|CT|
Liu|Alexander|A|
Francis|Jane M|JM|
Neubauer|Stefan|S|
Robson|Matthew D|MD|

saturation
myocardial perfusion
7T
radiofrequency pulse
B1 inhomogeneity
cardiac magnetic resonance imaging


The miR-193a-3p-MAP3k3 Signaling Axis Regulates Substrate Topography-Induced Osteogenesis of Bone Marrow Stem Cells.

Abstract: Substrate topographical features induce osteogenic differentiation of bone marrow stem cells (BMSCs), but the underlying mechanisms are unclear. As microRNAs (miRNAs) play key roles in osteogenesis and bone regeneration, it would be meaningful to elucidate the roles of miRNAs in the intracellular signaling cascade of topographical cue-induced osteogenic differentiation. In this study, the miRNA expression profile of the topographical feature-induced osteogenic differentiation group is different from that of the chemical-factors-induced osteogenic differentiation group. miR-193a-3p is sensitive to substrate topographical features and its downregulation enhances osteogenic differentiation only in the absence of osteogenesis-inducing medium. Also, substrate topographical features specifically activate a nonclassical osteogenetic pathway-the mitogen-activated protein kinase (MAPK) pathway. Loss- and gain-of-function experiments demonstrate that miR-193a-3p regulates the MAPK pathway by targeting the MAP3k3 gene. In conclusion, this data indicates that different osteogenic-lineage-related intracellular signaling cascades are triggered in BMSCs subjected to biophysical or chemical stimulation. Moreover, the miR-193a-3p-MAP3k3 signaling axis plays a pivotal role in the transduction of biophysical cues from the substrate to regulate the osteogenic lineage specification of BMSCs, and hence may be a promising molecular target for bone regenerative therapies.

biophysical cues induced‐osteogenic differentiation


Successful delayed non-operative management of C2 neurosynchondrosis fractures in a pediatric patient: a case report and review of management strategies and considerations for treatment.

Abstract: Upper cervical synchondrosis fractures are the most common types of cervical fractures in the pediatric population less than 7 years of age (Blauth et al (Eur Spine J 5:63-70, 1996); Connolly et al (Pediatr Radiol 25(Suppl1):S129-133, 1995); Mandabach et al (Pediatr Neurosurg 19(5):225-232, 1993); Schippers et al (Acta Neurochir 138:524-530, 1990)) The vast majority occur through the dentocentral or basilar synchondrosis. We present the second reported case in recent literature of a unilateral neurosynchondrosis fracture. The patient, a 4-year-old male, was initially managed conservatively with a rigid cervical collar for a period of 3 months. Despite multiple counseling sessions with family, the patient remained poorly compliant with cervical immobilization. After 3 months, imaging demonstrated partial fusion with persistent anterolisthesis of C2 on C3. The decision was made to place the child in external halo fixation as an attempt to achieve fusion prior to committing to internal surgical fixation and the associated sequelae. Immobilization with a hard cervical collar is often first line treatment. In the case of failed fusion, debate exists regarding surgical fixation in children. Occipito-atlanto-axial fusion leads to permanent loss of a significant degree of flexion, extension, and rotatory movement. The pediatric population has a strong propensity to fuse; however, compliance is often a barrier to conservative treatment due to age-related behavioral practices. We demonstrate that even with initial failed fusion and progression of deformity while in a cervical collar, conservative management with external halo fixation can potentially obviate the need for internal fixation.

Shammassian|Berje|B|
Wright|Christina Huang|CH|
Wright|James|J|
Onwuzulike|||
Tomei|Krystal L|KL|

D001268:Atlanto-Axial Joint
D002574:Cervical Vertebrae
D002675:Child, Preschool
D000013:Congenital Abnormalities
D006801:Humans
D008297:Male
D009809:Odontoid Process
D016103:Spinal Fractures
D013123:Spinal Fusion
D014057:Tomography, X-Ray Computed

Pediatric
Cervical
Synchondrosis fracture
Spine
Instability
Trauma


Reconsidering Diagnosis, Treatment, and Postoperative Care in Children with Cloacal Malformations.

Abstract: Cloacal malformations are among the most complex types of anorectal malformation and are characterized by the urological, genital, and intestinal tracts opening through a single common channel in the perineum. Long-term outcome is affected by multiple factors, which include anatomical variants of the malformation itself, associated anomalies, and the surgical approach. Reconsidering these variables and their influence on "patient important" function might lead to strategies that are more outcome-driven than focused on the creation of normal anatomy. Key outcomes reflect function in each of the involved tracts and the follow-up needed should therefore not only include the classical fields of colorectal surgery and urology but also focus on items such as gynecology, sexuality, family-building, and quality of life as well as other psychological aspects. Involving patients and families in determining optimal treatment strategies and outcome measures could lead to improved outcomes for the individual patient. A strategy to support delivery of personalized care for patients with cloacal malformations by aiming to define the best functional outcomes achievable for any individual, then select the treatment pathway most likely deliver that, with the minimum morbidity and cost, would be attractive. Combining the current therapies with ongoing technological advances such as tissue expansion might be a way to achieve this.

Versteegh|Hendt P|HP|
Gardner|David S|DS|
Scriven|Lucy|L|
Martens|Lisanne|L|
Kluivers|Kirsten|K|
Hewitt|Geri|G|
de Blaauw|Ivo|I|
Wood|Richard J|RJ|
Williams|Alun|A|
Sutcliffe|Jonathan|J|
|||

Cloacal malformation
Anorectal malformation
Follow-up
Congenital anomalies
Multidisciplinary treatment


Dynamic regulation of FGF23 by Fam20C phosphorylation, GalNAc-T3 glycosylation, and furin proteolysis.

Abstract: The family with sequence similarity 20, member C (Fam20C) has recently been identified as the Golgi casein kinase. Fam20C phosphorylates secreted proteins on Ser-x-Glu/pSer motifs and loss-of-function mutations in the kinase cause Raine syndrome, an often-fatal osteosclerotic bone dysplasia. Fam20C is potentially an upstream regulator of the phosphate-regulating hormone fibroblast growth factor 23 (FGF23), because humans with FAM20C mutations and Fam20C KO mice develop hypophosphatemia due to an increase in full-length, biologically active FGF23. However, the mechanism by which Fam20C regulates FGF23 is unknown. Here we show that Fam20C directly phosphorylates FGF23 on Ser(180), within the FGF23 R(176)XXR(179)/S(180)AE subtilisin-like proprotein convertase motif. This phosphorylation event inhibits O-glycosylation of FGF23 by polypeptide N-acetylgalactosaminyltransferase 3 (GalNAc-T3), and promotes FGF23 cleavage and inactivation by the subtilisin-like proprotein convertase furin. Collectively, our results provide a molecular mechanism by which FGF23 is dynamically regulated by phosphorylation, glycosylation, and proteolysis. Furthermore, our findings suggest that cross-talk between phosphorylation and O-glycosylation of proteins in the secretory pathway may be an important mechanism by which secreted proteins are regulated.

Tagliabracci|Vincent S|VS|
Engel|James L|JL|
Wiley|Sandra E|SE|
Xiao|Junyu|J|
Gonzalez|David J|DJ|
Nidumanda Appaiah|Hitesh|H|
Koller|Antonius|A|
Nizet|Victor|V|
White|Kenneth E|KE|
Dixon|Jack E|JE|

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

Fam20
chronic kidney disease
familial tumoral calcinosis
phosphate homeostasis
rickets


360-degree intra-operative laser retinopexy for the prevention of retinal re-detachment in patients treated with primary pars plana vitrectomy.

Abstract:
PURPOSE
To investigate the effect of 360° intra-operative laser retinopexy (ILR) for the prevention of retinal re-detachment in patients treated with pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD).

METHODS
A retrospective single-institution cohort study was performed. Consecutive patients with primary uncomplicated RRD who underwent 23-gauge PPV with gas endotamponade between July 2013 and July 2016 were included in the study (n = 151). Two cohorts were compared: one which received laser retinopexy only around identified tears/holes/lattice zones (Control group, n = 86), and one which received additional 360° intra-operative laser retinopexy (360° ILR group, n = 65).

RESULTS
Retinal re-detachment was seen in 4/65 eyes (6%) in the 360° ILR group compared to 18/86 eyes (21%) in the control group. In multiple logistic regression, the 360° ILR was associated with a 75% reduction in the odds of retinal re-detachment compared to control (OR = 0.248, 95% CI [0.079-0.772], p = 0.016). There was no statistically significant difference in the incidence of epiretinal membrane formation between the two groups.

CONCLUSIONS
Intra-operative 360° laser retinopexy during PPV with gas endotamponade resulted in a significant reduction in the odds of postoperative retinal re-detachment in eyes with uncomplicated primary RRD.

Dirani|Ali|A| Antaki|Fares|F| Rhéaume|Marc-André|MA| Gauthier|Danny|D| Corriveau|Louis|L| Arbour|Jean-Daniel|JD| Hammamji|Karim|K|

Pars plana vitrectomy
Rhegmatogenous retinal detachment
Endolaser retinopexy
Surgical technique


Janus Particles at Fluid Interfaces: Stability and Interfacial Rheology.

Abstract: The use of the Janus motif in colloidal particles, i.e., anisotropic surface properties on opposite faces, has gained significant attention in the bottom-up assembly of novel functional structures, design of active nanomotors, biological sensing and imaging, and polymer blend compatibilization. This review is focused on the behavior of Janus particles in interfacial systems, such as particle-stabilized (i.e., Pickering) emulsions and foams, where stabilization is achieved through the binding of particles to fluid interfaces. In many such applications, the interface could be subjected to deformations, producing compression and shear stresses. Besides the physicochemical properties of the particle, their behavior under flow will also impact the performance of the resulting system. This review article provides a synopsis of interfacial stability and rheology in particle-laden interfaces to highlight the role of the Janus motif, and how particle anisotropy affects interfacial mechanics.

Janus particles
fluid interfaces
interfacial rheology
Pickering emulsions and foams


Bishop Fulton J. Sheen: America's public critic of psychoanalysis, 1947-1957.

Abstract: This paper examines the role of Bishop Fulton Sheen in the popularization of Freudian psychoanalysis in the United States during the 1940s and 50s. Social historians argue that Freudian ideas were pervasive in American culture during this period. While their claim speaks mainly to the impact of psychoanalysis on the cultural elite and college educated, they also suggest that Freudian ideas affected ordinary men and women. In the former case, the group impacted is small and not representative of the population as a whole; in the latter, the evidence is sparse and impressionistic. Neglected in their consideration is the influence of Fulton Sheen whose opinions on Freud reached an audience of 30,000,000 during the height of the popularity of his TV show, Life is Worth Living. Sheen's audience was more inclusive and representative of mainstream America. The negative and highly cautionary view of psychoanalysis he presented to many Americans was contrary to that which was promoted to and embraced by many of the college educated and likely shaped both their views of Freud and psychoanalytic therapy.

Fulton Sheen
popularization of psychology


Simulation and beyond - Principles of effective obstetric training.

Abstract: Simulation training provides a safe, non-judgmental environment where members of the multi-professional team can practice both their technical and non-technical skills. Poor teamwork and communication are recurring contributing factors to adverse maternal and neonatal outcomes. Simulation can improve outcomes and is now a compulsory part of the national training matrix. Components of successful training include involving the multi-professional team, high fidelity models, keeping training on-site, and focussing on human factors training; a key factor in adverse patient outcomes. The future of simulation training is an exciting field, with the advent of augmented reality devices and the use of artificial intelligence.

Simulation
Teamwork
Communication
Human factors
Multi-professional training


Non-adaptive territory selection by a bird with exceptionally long parental care.

Abstract: High-quality territories are expected to provide greater fitness return for breeding individuals and, thus, are likely to have higher long-term occupation rate in comparison to low-quality territories. However, if environmental and ecological cues used for territory selection cannot reliably predict true territory quality, a mismatch between preferences and fitness may occur. We suggest that this kind of non-adaptive territory selection is more likely in species with long reproductive cycles, as a long time interval between territory establishment and young fledgling should reduce predictability of conditions during the critical stages of brood care. In this study, we investigated adaptiveness of territory selection in a migratory bird with exceptionally long parental care, the mute swan Cygnus olor, which requires over four months to complete the entire reproductive cycle from egg laying to young fledging. For this purpose, we collected information on the long-term (10-19 years) occupancy of 222 swan breeding territories and correlated it with reproductive performance (n = 1,345 breeding attempts) and body condition of breeding adults. We found that long-term occupancy positively correlated with the timing of breeding, suggesting that individuals settled earlier in the attractive, frequently occupied territories. By contrast, we found no relationship between territory occupancy and reproductive output (hatching and fledging success) or adult body condition. The results indicate that at the time of territory selection swans might not be able to reliably assess territory quality, likely due to: (1) exceptionally long period of parental care, which reduces temporal correlation between the conditions at the time of territory selection and conditions during chick rearing; and (2) unpredictability of human-related activities that had a major impact on reproductive output of swan pairs in our population.

Territory selection
Occupancy
Mute swan
Cygnus olor
Body condition
Reproductive success


Morphological and functional assessment of the uterus: "one-stop shop imaging" using a compressed-sensing accelerated, free-breathing T1-VIBE sequence.

Abstract:
BACKGROUND
The combination of motion-insensitive, high-temporal, and spatial resolution imaging with evaluation of quantitative perfusion has the potential to increase the diagnostic capabilities of magnetic resonance imaging (MRI) in the female pelvis.

PURPOSE
To compare a free-breathing compressed-sensing VIBE (fbVIBE) with flexible temporal resolution (range = 4.6-13.8 s) with breath-hold VIBE (bhVIBE) and to evaluate the potential value of quantifying uterine perfusion.

MATERIAL AND METHODS
A total of 70 datasets from 60 patients (bhVIBE: n = 30; fbVIBE: n = 40) were evaluated by two radiologists. Only temporally resolved reconstruction (fbVIBE) was performed on 30 of the fbVIBE datasets. For a subset (n = 10) of the fbVIBE acquisitions, a time- and motion-resolved reconstruction (mrVIBE) was evaluated. Image quality (IQ), artifacts, diagnostic confidence (DC), and delineation of uterine structures (DoS) were graded on Likert scales (IQ/DC/DoS: 1 (non-diagnostic) to 5 (perfect); artifacts: 1 (no artifacts) to 5 (severe artifacts)). A Tofts model was applied for perfusion analysis. Ktrans was obtained in the myometrium (Mm), junctional zone (Jz), and cervix (Cx).

RESULTS
The median IQ/DoS/DC scores of fbVIBE (4/5/5 κ >0.7-0.9) and bhVIBE (4/4/4; κ = 0.5-0.7; P > 0.05) were high, but Artifacts were graded low (fbVIBE/bhVIBE: 2/2; κ = 0.6/0.5; P > 0.05). Artifacts were only slightly improved by the additional motion-resolved reconstruction (fbVIBE/mrVIBE: 2/1.5; P = 0.08); fbVIBE was preferred in most cases (7/10). Significant differences of Ktrans values were found between Cx, Jz, and Mm (0.12/0.21/0.19; P < 0.05).

CONCLUSION
The fbVIBE sequence allows functional and morphological assessment of the uterus at comparable IQ to bhVIBE.

uterus
Magnetic resonance imaging
female
artifacts
cervix uteri
magnetic resonance perfusion


Pathohistological changes of tracheal epithelium in laryngectomized patients.

Abstract: Total laryngectomy results in a permanent disconnection of the upper and lower airways. Thus, the upper airways are bypassed and can no longer condition, humidify, and filter the inhaled air, leading to damage of the tracheobronchial epithelium. There is little scientific information available about the effects of tracheostoma breathing and the degree of mucosal damage in laryngectomized patients. The aims of this study were to determine the histopathologic findings and investigate the potential impact of using a heat and moisture exchanger (HME) on the tracheal epithelium in long-term tracheostomy patients. Tracheal mucosal biopsies were taken from a total of 70 patients. Specimens were stained with hematoxylin and eosin and examined by a light microscope. Normal pseudostratified ciliated columnar epithelium was found in only 9 (12.9%) cases; while, 17 (24.3%) cases had some degree of basal cell hyperplasia. Squamous metaplasia was the most common finding (50%). Pre-invasive lesions (mild and moderate squamous dysplasia) were found in only one patient who used an HME, and in eight (11.4%) non-users. Although the HME cannot completely restore the physiological functions of the upper respiratory track, it delivers a better quality of air to the lower airways and has a positive effect on tracheal mucosa.

Rosso|Marinela|M| Prgomet|Drago|D| Marjanović|Ksenija|K| Pušeljić|Silvija|S| Kraljik|Nikola|N|

Laryngectomy
Heat and moisture exchanger
Pulmonary rehabilitation
Trachea


A preliminary association study between serotonin transporter (5-HTTLPR), receptor polymorphisms (5-HTR1A, 5-HTR2A) and depression symptom-clusters in a north Indian population suffering from Major Depressive Disorder (MDD).

Abstract:
INTRODUCTION
Major Depressive Disorder (MDD) is a broad heterogeneous diagnostic construct. Previous studies have shown that it can be resolved into several symptom-clusters which are proposed to be associated with single nucleotide polymorphisms (SNPs) of the serotonergic pathway (5-HTTLPR, 5HTR1A, 5-HTR2A).

METHODS AND MATERIAL
In a cross-sectional study conducted at a tertiary level mental health care set-up in north India, 80 out-patients with MDD were evaluated with Montgomery Asberg Depression Rating Scale (MADRS) and then genotyping was done. The different clinical and genetic variables were compared across the factor structures of MADRS. Also, the comparison of the genetic data of cases was done with the pre-existing database of the non-blood related healthy ethnically-matched controls.

RESULTS
There was no significant association between age, gender, other clinical variables, SNPs like 5-HTTLPR SS/SL, rs6295 CC/CG/GG, rs6311GG/GA/AA, rs6313 CC/CT/TT and different factor-structures like 'detachment' consisting of items like concentration difficulty, lassitude, inability to feel; 'psychic anxiety' consisting of suicidal thoughts and inner tension; 'mood-pessimism' consisting of symptoms like apparent sadness, reported sadness, pessimistic thoughts and 'vegetative symptoms' like decreased sleep, poor appetite. Neither there was any association between genotype of the cases compared with the controls.

CONCLUSIONS
No significant association was obtained between the four-factor structures of depression in MADRS and serotonin transporter and receptor SNPs in a study with a small sample size. This study evaluates whether depression symptom-clusters have distinct genotypic determinants and necessitates more comprehensive studies for unravelling the genetic determinants of depression.

Basu|Aniruddha|A|
Chadda|R K|RK|
Sood|Mamta|M|
Kaur|Harpreet|H|
Kukreti|Ritushree|R|

D050486:Serotonin Plasma Membrane Transport Proteins

Serotonin receptor polymorphism (5-HTR1A,5-HTR2A)

Serotonin transporter (5-HTTLPR) polymorphism


Incidence and predictors of Uveitis in juvenile idiopathic arthritis in a Nordic long-term cohort study.

Abstract:
BACKGROUND
The incidence of uveitis associated with juvenile idiopathic arthritis (JIA) varies around the world. Our aim was to investigate the incidence and predictors of uveitis in a Nordic population-based cohort.

METHODS
Consecutive JIA cases from defined geographical areas in Denmark, Finland, Sweden and Norway with disease onset between January 1997 to June 2000 were followed for median 98 months in this prospective longitudinal cohort study. Potential clinical and immunological predictors of uveitis were identified with logistic regression analysis.

RESULTS
Uveitis occurred in 89 (20.5%) of the 435 children with regular ophtalmologic follow-up among the 500 included. Chronic asymptomatic uveitis developed in 80 and acute symptomatic uveitis in 9 children. Uveitis developed at a median interval of 0.8 (range - 4.7 to 9.4) years after onset of arthritis. Predictors of uveitis were age < 7 years at JIA onset (Odds ratio (OR) 2.1, 95% confidence interval (CI) 1.3 to 3.5), presence of antihistone antibodies (AHA) > 15 U/ml (OR 4.8 (1.8 to 13.4)) and antinuclear antibodies (ANA) (OR 2.4 (1.5 to 4.0)). Mean combined IgM/IgG AHA was significantly higher in the uveitis group (19.2 U/ml) than in the non-uveitis group (10.2 U/ml) (p = 0.002). Young age at JIA onset predicted uveitis in girls (p < 0.001), but not in boys (p = 0.390).

CONCLUSION
Early-onset arthritis and presence of AHA in girls, as well as presence of ANA in both genders, were significant predictors of chronic uveitis. The high incidence of uveitis in this long-term Nordic JIA cohort may have severe implications in a lifelong perspective.

D012537:Scandinavian and Nordic Countries

Uveitis
Juvenile idiopathic arthritis
Antinuclear antibody
Biomarkers
Epidemiology
Histones


The effect of dimethyl sulfoxide on hepatic differentiation of mesenchymal stem cells.

Abstract:
INTRODUCTION
Adipose tissue-derived mesenchymal stem cells (AT-MSCs) are suitable choices in autologous stem cell treatment of liver-associated diseases due to their hepatic differentiation potential. Dimethyl sulfoxide (DMSO) is an amphipathic molecule with potential of delivering both lipophilic and hydrophilic agents into cells, also a common cryoprotectant for freezing of the cells. DMSO was used in some protocols for induction of AT-MSCs towards hepatocyte like cells. However, the effect of DMSO on hepatogenic differentiation of AT-MSCs were not surveyed, previously. In the present study, we aimed at evaluation of the effect of DMSO on differentiation of AT-MSCs into hepatic lineage.

METHODS
We isolated mesenchymal stem cells (MSCs) from adipose tissue, and then verifies multi-potency and surface markers of AT-MSCs . Isolated AT-MSCs randomly dispensed in four groups including Group 1: HGF treated, 2: HGF+ DMSO treated, 3: HGF+ DMSO+ OSM treated, and group control for a period of 3 weeks in the expansion medium without serum; EGF and bFGF were also included in the first days of inductions. The morphologic changes during induction period was observed with microscopy. The secretion of albumin (ALB) of the differentiating MSCs was investigated using ELISA, and urea production was evaluated using colorimetric assay. The qRT-PCR was performed for quantitation of hepatocyte marker genes including AFP, ALB, CK18, HNF4a, and HNF6. The glycogen storage of differentiated cells was visualized by periodic-acid Schiff‘s staining.

RESULTS
The results demonstrate that DMSO speeds up hepatic differentiation of AT-MSCs characterized by rapid changes in morphology; higher expression of hepatic marker gene (ALB) in both mRNA and protein level (P < 0.05); also increased transcriptional levels of other liver genes including CK18, HNF4a, and HNF6 (P < 0.01); and moreover, greater percentage of glycogen storage(p < 0.05) in DMSO-treated groups.

CONCLUSION
DMSO catalyzes hepatic differentiation; therefore, using DMSO for acceleration of the hepatogenic protocols of AT-MSCs appears advantageous.

Alizadeh|Effat|E|
Zarghami|Nosratollah|N|
Eslaminejad|Mohamadreza Baghaban|MB|
Akbarzadeh|Abolfazl|A|
Barzegar|Abolfazl|A|
Mohammadi|Seyed Abolghasem|SA|

hepatic differentiation
DMSO
AFP
CK18
HNF4a
HNF6
glycogen storage
Adipose tissue&ndash
derived mesenchymal stem cells


Notes on the orb-weaving spider genus Alpaida (Araneae, Araneidae) with description of four new species from Rio de Janeiro, Brazil.

Abstract: Four new species of the orb-weaving spider genus Alpaida O. P.-Cambridge, 1889 from Rio de Janeiro state, Brazil are illustrated and described based on males and females from the following municipalities: Alpaida imperatrix new species (Macaé and Rio de Janeiro); Alpaida imperialis new species (Mendes and Rio de Janeiro); Alpaida marista new species (Mendes and Pinheiral); and Alpaida mendensis new species (Mendes). Furthermore, two new synonymies are herein proposed: Alpaida lanei Levi, 1988 = Alpaida atomaria (Simon, 1895) and Alpaida caxias Levi, 1988 = Alpaida tijuca Levi, 1988, alongside new records for both species and also Alpaida venger Castanheira Baptista, 2015.

Baptista|Renner Luiz Cerqueira|RLC|
De Souza Castanheira|Pedro|P|
Prado|AndrÉ Wanderley do|AWD|

Araneae, Neotropical Region, Araneoidea, taxonomy, Atlantic Forest