Disparities in Bladder Cancer Outcomes Based on Key Sociodemographic Characteristics.

Abstract:
PURPOSE OF REVIEW
A review of the impact of several key patient characteristics on oncologic outcomes in bladder cancer (BC) summarized and analyzed in a narrative fashion.

RECENT FINDINGS
The bulk of the published literature suggests that females and blacks have poorer cancer-specific outcomes. Both groups tend to present with worse disease, which may be driven by differences in access to timely and quality care. Attempts to assess the association between smoking status and history and BC outcomes have been hindered by the quality and heterogeneity of the data, although several studies have linked smoking with higher rates of recurrence and poorer survival. Being married, particularly in men, may improve survival after radical cystectomy (RC). Limited data suggests that socioeconomic and education levels may be associated with poorer survival; however, the data is limited. A growing body of investigation suggests that there are significant differences in oncologic outcomes in BC patients based on race, gender, smoking status, socioeconomic status, and others. Further focus and investigation is needed to validate these findings, investigate the root cause of these differences, and offer solutions to mitigate them.

Yip|Wesley|W|
Cacciamani|Giovanni|G|
Bhanvadia|Sumeet K|SK|

D004522:Educational Status
D054624:Health Status Disparities
D006801:Humans
D007182:Income
D017533:Marital Status
D009364:Neoplasm Recurrence, Local
D000076782:Race Factors
D012737:Sex Factors
D012907:Smoking
D015996:Survival Rate
D001749:Urinary Bladder Neoplasms

Oncologic outcomes
Genitourinary malignancy
Urothelial bladder cancer


Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden.

Abstract:
OBJECTIVE
Internet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated the national diagnostic outcome of this service.

METHODS
Requests for data on both self-sampling at home and clinic-based sampling for CT testing were sent to the laboratories in 18 of 21 counties. Four laboratories were also asked to provide data on testing patterns at the individual level for the years 2013-2017.

RESULTS
The proportion of self-sampling increased gradually from 2013, comprising 22.0% of all CT tests in Sweden in 2017. In an analysis of 14 counties (representing 83% of the population), self-sampling increased by 115% between 2013 and 2017 for women, compared with 71% for men, while test volumes for clinic-based sampling were fairly constant for both sexes (1.8% increase for women, 15% increase for men). In 2017 self-sampling accounted for 20.3% of all detected CT cases, and the detection rate was higher than, but similar to, clinic-based testing (5.5% vs 5.1%). The proportion of self-sampling men was also higher, but similar (33.7% vs 30.8%). Analysis of individual testing patterns in four counties over 5 years showed a higher proportion of men using self-sampling only (67%, n=10 533) compared with women (40%, n=8885).

CONCLUSIONS
Self-sampling has increased substantially in recent years, especially among women. This service is at least as beneficial as clinic-based screening for detection of CT, and self-sampling reaches men more than clinic-based testing.

Söderqvist|Joakim|J| Gullsby|Karolina|K| Stark|Lisa|L| Wikman|Maria|M| Karlsson|Roger|R| Herrmann|Bjőrn|B|0000-0001-8729-2306

chlamydia trachomatis
testing
diagnostics
microbiology


Is gold a hedge against inflation? New evidence from a nonlinear ARDL approach.

Abstract: This paper aims to study the role of gold as a hedge against inflation based on local monthly gold prices in China, India, Japan, France, the United Kingdom and the United States of America in periods ranging from 1955 to 2015. We extend the literature by using a novel approach with the nonlinear autoregressive distributed lags (NARDL) model (Shin et al., 2014). The main advantage of this model relies on its ability to simultaneously capture the short- and long-run asymmetries through positive and negative partial sum decompositions of changes in the independent variable(s). Moreover, we rely on local gold prices instead of those from London converted into local currencies like in most of previous studies. The results show that gold is not a hedge against inflation in the long run in all cases. In the short run, gold is an inflation hedge only in the UK, USA, and India. Furthermore, there is no long-run equilibrium between gold prices and the CPI in China, India and France. This difference may be due to traditional aspects of gold and custom controls for gold trade in these countries. Our robustness check suggests that the data time-frequency does not change the specification of the NARDL model but can change conclusions regarding the role of gold as a hedge against inflation in certain countries.

Hoang|Thi Hong Van|THV|
Lahiani|Amine|A|
Heller|David|D|

Nonlinear autoregressive distributed lags model (NARDL)


Breast involvement in mixed connective tissue disease.

Abstract: To date, mammographic involvement in mixed connective tissue disease has not been described in the literature to the authors' knowledge. In addition, only 2 case reports have described panniculitis in mixed connective tissue disease. We present a patient with mixed connective tissue disease with coarse sheet-like calcifications on mammography bilaterally, which increased over time corresponding to rise in levels of anti-dsDNA. Biopsy showed fat necrosis with calcifications, chronic inflammation and fibrosis, vasculitis, as well as CD3, CD4, and CD8+ T cells and CD20+ B cells. These findings are similar histologically and mammographically to "lupus mastitis."

Mixed connective tissue disease
Mammography
Lupus mastitis
Mastitis
MCTD
MCTD panniculitis


Tracking cortical entrainment in neural activity: auditory processes in human temporal cortex.

Abstract: A primary objective for cognitive neuroscience is to identify how features of the sensory environment are encoded in neural activity. Current auditory models of loudness perception can be used to make detailed predictions about the neural activity of the cortex as an individual listens to speech. We used two such models (loudness-sones and loudness-phons), varying in their psychophysiological realism, to predict the instantaneous loudness contours produced by 480 isolated words. These two sets of 480 contours were used to search for electrophysiological evidence of loudness processing in whole-brain recordings of electro- and magneto-encephalographic (EMEG) activity, recorded while subjects listened to the words. The technique identified a bilateral sequence of loudness processes, predicted by the more realistic loudness-sones model, that begin in auditory cortex at ~80 ms and subsequently reappear, tracking progressively down the superior temporal sulcus (STS) at lags from 230 to 330 ms. The technique was then extended to search for regions sensitive to the fundamental frequency (F0) of the voiced parts of the speech. It identified a bilateral F0 process in auditory cortex at a lag of ~90 ms, which was not followed by activity in STS. The results suggest that loudness information is being used to guide the analysis of the speech stream as it proceeds beyond auditory cortex down STS toward the temporal pole.

Thwaites|Andrew|A|
Nimmo-Smith|Ian|I|
Fonteneau|Elisabeth|E|
Patterson|Roy D|RD|
Buttery|Paula|P|
Marslen-Wilson|William D|WD|

MNE source space
fundamental frequency contour
information encoding
magnetoencephalography
model expression
neural computation
speech envelope


Properties of Single-Component Metal-Organic Framework Crystal-Glass Composites.

Abstract: The formation, and subsequent structural, thermal and adsorptive properties of single-component metal-organic framework crystal-glass composites (MOF-CGCs) are investigated. A series of novel materials exhibiting chemically identical glassy and crystalline phases within the same material were produced, where crystalline ZIF-62(Zn) was incorporated within an agZIF-62(Zn) matrix. X-ray diffraction showed that the crystalline phase was still present after heating to above the glass transition temperature of agZIF-62(Zn), and interfacial compatibility between the crystalline and glassy phases was investigated using a mixed-metal (ZIF-62(Co))0.5(agZIF-62(Zn))0.5 analogue. CO2 gas adsorption measurements showed that the CO2 uptakes of the MOF-CGCs were between those of the crystalline and glassy phases.

McHugh|Lauren N|LN|
Thorne|Michael F|MF|
Robertson|Georgina|G|
Divitini|Giorgio|G|
Bennett|Thomas D|TD|

Metal-Organic Frameworks
composites
Gas adsorption
Amorphous materials
Thermal Analysis


A randomized multi-institutional crossover comparison of the GlideScope® Cobalt Video laryngoscope to the flexible fiberoptic bronchoscope in a Pierre Robin manikin.

Abstract:
BACKGROUND
The GlideScope Cobalt Video laryngoscope is being used more often in children with challenging laryngoscopy. There are, however, no pediatric trials comparing it to flexible fiberoptic bronchoscopy, the current accepted gold standard. This preliminary manikin study compares the first-attempt intubation success of the GlideScope Cobalt video laryngoscope to the flexible fiberoptic bronchoscope when performed by attending pediatric anesthesiologists at two major pediatric centers.

METHODS
This prospective randomized, crossover study evaluated 120 attempts (60 with each study device) to intubate the AirSim Pierre Robin manikin (PRM) with fiberoptic bronchoscopy and video laryngoscopy (VL). Attending pediatric anesthesiologists from two quaternary pediatric centers were eligible to participate. Each attending anesthesiologist randomly performed a single tracheal intubation attempt with one of the study devices followed by the alternate method. The primary outcome was the first-attempt success rate of tracheal intubation. Blinding was not feasible. We hypothesized that first-attempt success would be higher with fiberoptic bronchoscopy.

RESULTS
Thirty anesthesiologists from each center were randomized to use one of the study devices followed by the alternate method. We analyzed all participants' data. There was no overall difference in first-attempt success between VL and fiberoptic bronchoscopy (88.3% vs 85% respectively, P = 0.59). There were significant institutional differences in first-attempt success using VL (76.7% vs 100%).

CONCLUSIONS
There was no difference in first-attempt success of tracheal intubation using VL vs fiberoptic bronchoscopy when performed by attending anesthesiologists at two large pediatric centers. However, institutional differences exist in success rates with VL across the two centers. Results from single-center device evaluations should be verified by multi-center evaluations. A significant proportion of attending anesthesiologists lack experience with advanced airway devices; targeted education may enhance intubation success and patient safety.

Fiadjoe|John E|JE|
Hirschfeld|Matthew|M|
Wu|Stephan|S|
Markley|James|J|
Gurnaney|Harshad|H|
Jawad|Abbas F|AF|
Stricker|Paul|P|
Kilbaugh|Todd|T|
Ross|Patrick|P|
Kovatsis|Pete|P|

video laryngoscopy
difficult airway
difficult laryngoscopy
flexible fiberoptic intubation
tracheal intubation infant


On the evolutionary significance of horizontal gene transfers in plants.

Abstract: Horizontal gene transfer (HGT) has long been seen as a crucial process in the evolution of prokaryotic species, but until recently it was thought to have little, if any, effect on the evolution of eukaryotic life forms. Detecting and describing HGT events in eukaryotes is difficult, making this phenomenon at times controversial. However, modern advances in genomics and bioinformatics have radically altered our view of HGT in eukaryotes, especially in plants. It now appears that HGT to and from plant lineages is more common than previously suspected. Importantly, the transfer of functional nuclear genes with adaptive significance has been reported in numerous taxa. Here we review several recent studies that have found evidence of the horizontal transfer of nuclear genes, and argue that HGT has undoubtedly had profound impacts on plant evolution as a whole.

adaptation
C4 photosynthesis
evolutionary novelty
ferns
parasitic plants


Silencing Heat Shock Protein 47 (HSP47) in Fibrogenic Precision-Cut Lung Slices: A Surprising Lack of Effects on Fibrogenesis?

Abstract: Idiopathic pulmonary fibrosis (IPF) is a chronic disease that is characterized by the excessive deposition of scar tissue in the lungs. As currently available treatments are unable to restore lung function in patients, there is an urgent medical need for more effective drugs. Developing such drugs, however, is challenging because IPF has a complex pathogenesis. Emerging evidence indicates that heat shock protein 47 (HSP47), which is encoded by the gene Serpinh1, may be a suitable therapeutic target as it is required for collagen synthesis. Pharmacological inhibition or knockdown of HSP47 could therefore be a promising approach to treat fibrosis. The objective of this study was to assess the therapeutic potential of Serpinh1-targeting small interfering RNA (siRNA) in fibrogenic precision-cut lung slices prepared from murine tissue. To enhance fibrogenesis, slices were cultured for up to 144 h with transforming growth factor β1. Self-deliverable siRNA was used to knockdown mRNA and protein expression, without affecting the viability and morphology of slices. After silencing HSP47, only the secretion of fibronectin was reduced while other aspects of fibrogenesis remained unaffected (e.g., myofibroblast differentiation as well as collagen secretion and deposition). These observations are surprising as others have shown that Serpinh1-targeting siRNA suppressed collagen deposition in animals. Further studies are therefore warranted to elucidate downstream effects on fibrosis upon silencing HSP47.

Ruigrok|Mitchel J R|MJR|
El Amasi|Khaled E M|KEM|
Leeming|Diana J|DJ|
Sand|Jannie M B|JMB|
Frijlink|Henderik W|HW|
Hinrichs|Wouter L J|WLJ|
Olinga|Peter|P|

Gp46
HSP-47
RNA interference
collagen chaperone
gene silencing
lung explant culture
lung fibrosis


Of timelines and timeliness: lessons from Typhoon Haiyan in early disaster response.

Abstract: Typhoon Haiyan struck the Philippines on 8 November 2013 with maximum sustained winds of 235 kilometres per hour, adversely affecting at least 11 million people and displacing some 673,000 in the central regions of the country. The disaster clearly overwhelmed the Philippine government despite its seemingly well-crafted disaster management plan. Using timelines of different organisations, this paper identifies gaps in the government's response, mainly due to its failure in coordinating and managing relief operations, which adversely affected its effectiveness and efficiency in the delivery of critical goods and services following the disaster. The paper also demonstrates how non-governmental organisations (NGOs), the United Nations, foreign governments and other organisations provided assistance, mainly through aid niching, to cover the government's shortcomings. The paper recommends a paradigm shift in the government's disaster response by integrating collaborative arrangements between government agencies and NGOs, and giving local governments the lead role, with the national government as support, in disaster planning and response.

Santiago|J Sedfrey S|JS|
Manuela|Wilfred S|WS|
Tan|Marion Lara L|ML|
Sañez|Siegfried Kiel|SK|
Tong|Aldo Zelig U|AZ|

Haiyan
disaster
Philippines
disaster management
relief operations
assistance
aid niching


Enhancing gilthead seabream immune status and protection against bacterial challenge by means of antigens derived from Vibrio parahaemolyticus.

Abstract: In an attempt to control the proliferation of the pathogenic bacterium Vibrio parahaemolyticus in gilthead seabream (Sparus aurata), the immunostimulant effect of lysate and ToxA from this bacterium was evaluated. Fish were intraperitoneally injected twice (first injection, day 1 of the experiment; second injection, day 7) and sampled after one week (on days 8 and 15). Afterwards, all fish specimens were experimentally infected with V. parahaemolyticus and mortality was recovered for 1 week. Fish injected with lysate, ToxA and phosphate buffer saline (control) showed 100%, 50% and 0% survival, respectively, when challenged with the pathogen. Skin mucus immune parameters and immune-related gene expression in skin and spleen were also evaluated. The results showed that mucus immune parameters were enhanced in the lysate and ToxA groups compared with the values obtained for fish from the control group. Expression of IL-1β, TNF-α, C3 and IgM genes was significantly up-regulated in the lysate and ToxA groups, principally after infection with the bacterium. Interestingly, TLR5 gene expression increased in fish immunized with lysate. The most prominent histological characteristic in gut from infected fish was the presence of a great number of intraepithelial leucocytes as well as inflammation of the submucosa, while severe hydropic degeneration and hemosiderosis were detected in liver from infected fish. Injection of lysate or ToxA had a protective effect against the deleterious consequences of subsequent infection with V. parahaemolyticus in gut and liver. The findings underline the potential of lysate and ToxA as potent preventive antigens against this kind of vibriosis.

Reyes-Becerril|Martha|M|
Guluarte|Crystal|C|
Ceballos-Francisco|Diana|D|
Angulo|Carlos|C|
Esteban|M Ángeles|MÁ|

D000276:Adjuvants, Immunologic
D000818:Animals
D001427:Bacterial Toxins
D001428:Bacterial Vaccines
D005393:Fish Diseases
D015870:Gene Expression
D007113:Immunity, Innate
D007274:Injections, Intraperitoneal
D009093:Mucus
D021541:Sea Bream
D012867:Skin
D014735:Vibrio Infections
D014736:Vibrio parahaemolyticus

Gilthead seabream
Vibrio parahaemolyticus
Lysate
ToxA
Gene expression
Mucosal immunity
PirA-like


The application of nanomaterials in controlled drug delivery for bone regeneration.

Abstract: Bone regeneration is a complicated process that involves a series of biological events, such as cellular recruitment, proliferation and differentiation, and so forth, which have been found to be significantly affected by controlled drug delivery. Recently, a lot of research studies have been launched on the application of nanomaterials in controlled drug delivery for bone regeneration. In this article, the latest research progress in this area regarding the use of bioceramics-based, polymer-based, metallic oxide-based and other types of nanomaterials in controlled drug delivery for bone regeneration are reviewed and discussed, which indicates that the controlling drug delivery with nanomaterials should be a very promising treatment in orthopedics. Furthermore, some new challenges about the future research on the application of nanomaterials in controlled drug delivery for bone regeneration are described in the conclusion and perspectives part.

Shi|Shuo|S|
Jiang|Wenbao|W|
Zhao|Tianxiao|T|
Aifantis|Katerina E|KE|
Wang|Hui|H|
Lin|Lei|L|
Fan|Yubo|Y|
Feng|Qingling|Q|
Cui|Fu-zhai|FZ|
Li|Xiaoming|X|

nanomaterials
controlled drug delivery
bone regeneration


[1,2,4]Triazolo[1,5-c]pyrimidines as adenosine receptor antagonists: Modifications at the 8 position to reach selectivity towards A3 adenosine receptor subtype.

Abstract: [1,2,4]Triazolo[1,5-c]pyrimidine is a promising platform to develop adenosine receptor antagonists. Here, we tried to investigate the effect of the substituent at the 8 position of [1,2,4]triazolo[1,5-c]pyrimidine derivatives on affinity and selectivity at the human A3 adenosine receptor subtype. In particular, we have introduced both esters and amides, principally with a benzylic nature. In addition, a small series of 5-substituted [1,2,4]triazolo[1,5-c]pyrimidines was designed in order to complete the structure-activity relationship analysis. Several of these new compounds showed affinity towards human A3 adenosine receptor in the low nanomolar range, with the most potent derivative of the series bringing a 4-ethylbenzylester at the 8 position (compound 18, hA3AR Ki = 1.21 nM). Docking studies performed on the synthesized compounds inside models of human A1, A2A and A3 adenosine receptors showed similar binding modes, comparable with the typical crystallographic binding mode of the inverse agonist ZM-241,385.

Federico|Stephanie|S| Margiotta|Enrico|E| Salmaso|Veronica|V| Pastorin|Giorgia|G| Kachler|Sonja|S| Klotz|Karl-Norbert|KN| Moro|Stefano|S| Spalluto|Giampiero|G|

D058915:Purinergic P1 Receptor Antagonists

[1,2,4]triazolo[1,5-c]pyrimidine
Adenosine receptor
Docking
A(3) antagonist
G protein-coupled receptor
Molecular modeling


The role of mouse models in colorectal cancer research-The need and the importance of the orthotopic models.

Abstract: Colorectal cancer is a worldwide health burden, with high incidence and mortality, especially in the advanced stages of the disease. Preclinical models are very important and valuable to discover and validate early and specific biomarkers as well as new therapeutic targets. In order to accomplish that, the animal models must replicate the clinical evolution of the disease in all of its phases. In this article, we review the existent mouse models, with their strengths and weaknesses in the replication of human cancer disease progression, with major focus on orthotopic models.

mouse model
colorectal cancer
orthotopic model


An updated review on the versatile role of chrysin in neurological diseases: Chemistry, pharmacology, and drug delivery approaches.

Abstract: Neurological diseases are responsible for a large number of morbidities and mortalities in the world. Flavonoids are phytochemicals that possess various health-promoting impacts. Chrysin, a natural flavonoid isolated from diverse fruits, vegetables, and even mushrooms, has several pharmacological activities comprising antioxidant, anti-inflammatory, antiapoptotic, anticancer, and neuroprotective effects. The current study was designed to review the relationship between chrysin administration and neurological complications by discussing the feasible mechanism and signaling pathways. Herein, we mentioned the sources, pharmacological properties, chemistry, and drug delivery systems associated with chrysin pharmacotherapy. The role of chrysin was discussed in depression, anxiety, neuroinflammation, Alzheimer's disease, Parkinson's disease, Huntington's disease, epilepsy, cerebral ischemia, spinal cord injury, neuropathy, Multiple Sclerosis, and Guillain-Barré Syndrome. The findings indicate that chrysin has protective effects against neurological conditions by modulating oxidative stress, inflammation, and apoptosis in animal models. However, more studies should be done to clear the neuroprotective effects of chrysin.

Talebi|Marjan|M|
Talebi|Mohsen|M|
Farkhondeh|Tahereh|T|
Kopustinskiene|Dalia M|DM|
Simal-Gandara|Jesus|J|
Bernatoniene|Jurga|J|
Samarghandian|Saeed|S|

Chrysin
Neurological diseases
Neuroprotective
Signaling pathways
Brain-targeted drug delivery
Neurodegenerative disease


Spatial survey of non-collagenous proteins in mineralizing and non-mineralizing vertebrate tissues ex vivo.

Abstract: Bone biomineralization is a complex process in which type I collagen and associated non-collagenous proteins (NCPs), including glycoproteins and proteoglycans, interact closely with inorganic calcium and phosphate ions to control the precipitation of nanosized, non-stoichiometric hydroxyapatite (HAP, idealized stoichiometry Ca10(PO4)6(OH)2) within the organic matrix of a tissue. The ability of certain vertebrate tissues to mineralize is critically related to several aspects of their function. The goal of this study was to identify specific NCPs in mineralizing and non-mineralizing tissues of two animal models, rat and turkey, and to determine whether some NCPs are unique to each type of tissue. The tissues investigated were rat femur (mineralizing) and tail tendon (non-mineralizing) and turkey leg tendon (having both mineralizing and non-mineralizing regions in the same individual specimen). An experimental approach ex vivo was designed for this investigation by combining sequential protein extraction with comprehensive protein mapping using proteomics and Western blotting. The extraction method enabled separation of various NCPs based on their association with either the extracellular organic collagenous matrix phases or the inorganic mineral phases of the tissues. The proteomics work generated a complete picture of NCPs in different tissues and animal species. Subsequently, Western blotting provided validation for some of the proteomics findings. The survey then yielded generalized results relevant to various protein families, rather than only individual NCPs. This study focused primarily on the NCPs belonging to the small leucine-rich proteoglycan (SLRP) family and the small integrin-binding ligand N-linked glycoproteins (SIBLINGs). SLRPs were found to be associated only with the collagenous matrix, a result suggesting that they are mainly involved in structural matrix organization and not in mineralization. SIBLINGs as well as matrix Gla (γ-carboxyglutamate) protein were strictly localized within the inorganic mineral phase of mineralizing tissues, a finding suggesting that their roles are limited to mineralization. The results from this study indicated that osteocalcin was closely involved in mineralization but did not preclude possible additional roles as a hormone. This report provides for the first time a spatial survey and comparison of NCPs from mineralizing and non-mineralizing tissues ex vivo and defines the proteome of turkey leg tendons as a model for vertebrate mineralization.

Ustriyana|Putu|P|
Schulte|Fabian|F|
Gombedza|Farai|F|
Gil-Bona|Ana|A|
Paruchuri|Sailaja|S|
Bidlack|Felicitas B|FB|
Hardt|Markus|M|
Landis|William J|WJ|
Sahai|Nita|N|

G, guanidine-HCl-only extract (for non-mineralizing tissues)

SIBLING, small integrin-binding ligand N-linked glycoprotein

TNAP, tissue-nonspecific alkaline phosphatase

P P P P P M M M M M M M M M M M R M M M M R R M M M


Recent advances in magnetic resonance imaging for peripheral artery disease.

Abstract: The global burden of peripheral artery disease (PAD) is significant. This has led to numerous recent advances in magnetic resonance imaging (MRI) techniques in PAD. Older techniques such as time of flight MRI or phase contrast MRI are burdened by long acquisition times and significant issues with artifacts. In addition, the most used MRI modality, contrast-enhanced MR angiography (CE-MRA) is limited by the use of gadolinium contrast and its potential toxicity. Novel MRI techniques such as arterial spin labeling (ASL), blood-oxygen-level dependent imaging (BOLD), and first-pass perfusion gadolinium enhancement are advancing the field by providing skeletal muscle perfusion/oxygenation data while maintaining excellent spatial and temporal resolution. Perfusion data can be critical to providing objective clinical data of a visualized stenosis. In addition, there are a number of new MRI sequences assessing plaque composition and lesion severity in the absence of contrast. These approaches used in combination can provide useful clinical and prognostic data and provide critical endpoints in PAD research.

Mathew|Roshin C|RC|0000-0002-7927-4607
Kramer|Christopher M|CM|

D001158:Arteries
D003287:Contrast Media
D006801:Humans
D018810:Magnetic Resonance Angiography
D008279:Magnetic Resonance Imaging
D018482:Muscle, Skeletal
D058729:Peripheral Arterial Disease

peripheral artery disease (PAD)
magnetic resonance imaging (MRI)
arterial spin labeling
blood-oxygen-level dependent imaging
first-pass gadolinium enhanced imaging
magnetic resonance angiography (MRA)
magnetic resonance spectroscopy
peripheral artery plaque
phosphocreatine


A local stabilized approach for approximating the modified time-fractional diffusion problem arising in heat and mass transfer.

Abstract:
Introduction
During the last years the modeling of dynamical phenomena has been advanced by including concepts borrowed from fractional order differential equations. The diffusion process plays an important role not only in heat transfer and fluid flow problems, but also in the modelling of pattern formation that arises in porous media. The modified time-fractional diffusion equation provides a deeper understanding of several dynamic phenomena.

Objectives
The purpose of the paper is to develop an efficient meshless technique for approximating the modified time-fractional diffusion problem formulated in the Riemann-Liouville sense.

Methods
The temporal discretization is performed by integrating both sides of the modified time-fractional diffusion model. The unconditional stability of the time discretization scheme and the optimal convergence rate are obtained. Then, the spatial derivatives are discretized through a local hybridization of the cubic and Gaussian radial basis function. This hybrid kernel improves the condition of the system matrix. Therefore, the solution of the linear system can be obtained using direct solvers that reduce significantly computational cost. The main idea of the method is to consider the distribution of data points over the local support domain where the number of points is almost constant.

Results
Three examples show that the numerical procedure has good accuracy and applicable over complex domains with various node distributions. Numerical results on regular and irregular domains illustrate the accuracy, efficiency and validity of the technique.

Conclusion
This paper adopts a local hybrid kernel meshless approach to solve the modified time-fractional diffusion problem. The main results of the research is the numerical technique with non-uniform distribution in irregular grids.

Nikan|O|O|
Avazzadeh|Z|Z|
Machado|J A Tenreiro|JAT|

Modified time fractional diffusion problem


Physical Activity and Exergames Among Older Adults: A Scoping Review.

Abstract: Recently, exergames have been widely applied as exercise platforms among older adults. However, studies on the influence of exergames on older adults' physical activity remain scarce. The review article highlights the potential benefit of exergames as a physical activity tool for older adults. The literature search followed the PRISMA guidelines on databases PubMed (Public/Publisher MEDLINE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, and Scopus. The literature included studies that evaluated the influence of exergames on older adults' physical activity. Articles were excluded if the mixed intervention was used, emphasizing specific limbs, improving specific tasks, or not mentioning intervention. The review article identified 25 studies that reported on 855 older adults 55 years of age and older. In addition, the common exergaming technology platforms examined were Microsoft Kinect™, Nintendo® Wii™, cybercycling, and interactive video dance games. Meanwhile, 11 studies used a pretest/post-test design and randomized controlled trial design in 14 studies. The review found that exergames significantly impacted the older adults' physical activity level as participants experienced improved balance and cognitive function, and enjoyed playing exergame, thus prolonging their game engagement. Although research on exergames is still new, current evidence showed a significant potential benefit of exergames as a physical activity tool for older adults. To overcome the limitation on various parameters that showed different effects and outcomes of exergames, the study recommends implementing randomized controlled trials with long-term observation using a mixed-method approach. Moreover, a multidisciplinary method involving exercise and neuromotor control experts could determine potential mechanisms of action that benefited from the exercises.

Exergames
Older adults
Scoping review
Exercise
Virtual reality


Evolutionary aspects of resurrection ecology: Progress, scope, and applications-An overview.

Abstract: This perspective provides an overview to the Special Issue on Resurrection Ecology (RE). It summarizes the contributions to this Special Issue, and provides background information and future prospects for the use of RE in both basic and applied evolutionary studies.

resurrection
ecology
dormant propagules
seed/egg banks


Dynamic Hip Screw Fixation Vs. Proximal Femur Nail For Unstable Per-Trochanteric Fractures: A Comparative Analysis Of Outcomes And Complications.

Abstract:
BACKGROUND
There are various implant choices to fix unstable per- trochanteric fractures. The aim of this study was to compare the outcomes of dynamic hip screw and proximal femur nail for unstable per-trochanteric fractures including complications associated with both fixations.

METHODS
A retrospective analysis done on pertrochanteric fractures of femur who were treated with Dynamic hip Screw (DHS) and Proximal Femur Nail (PFN). The data was taken from our hospital hip data base for the past two years from January 2017 to January 2019. Data of 174 patients was analysed, divided in to Group A with DHS (n=122) and Group B with PFN (n=52). Follow up included X-ray (anteroposterior and lateral) views for fracture union and collapse, femur neck shortening, implant position and identification of mode of failure or collapse (cut out risk) by using tip-apex distance. The Harris hip score used to evaluate mobility status and other functional outcomes.

RESULTS
The mean age in years of patients treated with PFN and DHS were 55.9 and 59.8, ranging from 39-83 years. The mean of Harris hip score at 2 year was 69.28±9.99 in DHS group and 72.12±9.71 in PFN group with the p-value 0.31. The mean of limb shortening was 12mm in DHS and 9 mm in PFN group. In DHS group, four cases had tip-apex distance of 39 mm and reported implant cut out that needs revision of surgery.

CONCLUSIONS
Proximal Femur Nail group demonstrated no implant cut out and less mean limb length shortening where as other parameter like functional outcomes, fracture union, rate of infection, hospital stay and postoperative pain are not significantly different in two groups.

Memon|Kashif|K|
Siddiqui|Athar M|AM|
Khan|Zainab Aqeel|ZA|
Zahoor|AlWardha|A|

D000328:Adult
D000368:Aged
D000369:Aged, 80 and over
D001858:Bone Nails
D001863:Bone Screws
D005269:Femur
D005593:Fracture Fixation, Internal
D006620:Hip Fractures
D006801:Humans
D007902:Length of Stay
D008875:Middle Aged
D011183:Postoperative Complications
D016896:Treatment Outcome

Dynamic hip screw
Proximal femur nail
Functional outcomes
Per trochanteric fracture


Possibility of Autonomous Estimation of Shiba Goat's Estrus and Non-Estrus Behavior by Machine Learning Methods.

Abstract: Mammalian behavior is typically monitored by observation. However, direct observation requires a substantial amount of effort and time, if the number of mammals to be observed is sufficiently large or if the observation is conducted for a prolonged period. In this study, machine learning methods as hidden Markov models (HMMs), random forests, support vector machines (SVMs), and neural networks, were applied to detect and estimate whether a goat is in estrus based on the goat's behavior; thus, the adequacy of the method was verified. Goat's tracking data was obtained using a video tracking system and used to estimate whether they, which are in "estrus" or "non-estrus", were in either states: "approaching the male", or "standing near the male". Totally, the PC of random forest seems to be the highest. However, The percentage concordance (PC) value besides the goats whose data were used for training data sets is relatively low. It is suggested that random forest tend to over-fit to training data. Besides random forest, the PC of HMMs and SVMs is high. However, considering the calculation time and HMM's advantage in that it is a time series model, HMM is better method. The PC of neural network is totally low, however, if the more goat's data were acquired, neural network would be an adequate method for estimation.

estimation
shiba goat
Estrus
machine learning


Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations.

Abstract:
BACKGROUND
Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. Reported prevalence of AP ranges from 27% to 83% while the data about most post-Soviet countries are still missing. Knowing the prevalence of AP within a certain population helps to plan the treatment need and evaluate the success of endodontic interventions. We aimed to collect data about prevalence and determining factors of AP for the first time in Estonia.

METHODS
The cross-sectional study included 6552 patients (age 35.5±19.2 years). Radiographic examination was applied to investigate the prevalence of AP and quality of endodontic treatment.

RESULTS
AP was diagnosed in 54.7% of subjects. Endodontically treated teeth were present in 58.2% of subjects. Periapical finding was present in 44.6% of endodontically treated and in 30.8% of untreated teeth. Out of 181,495 teeth, 52.7% were intact. AP was diagnosed in 6.3% of teeth, 6.9% of teeth were endodontically treated. Risk factors for AP included caries (OR = 2.30), male gender (OR = 1.44), too short (OR = 1.76) or too long root canal filling (OR = 2.51), root canal filling of low density (OR = 1.61) while not orthodontic appliance. Lower AP risk was associated with restoration of the tooth - filling (OR = 0.45), crown (OR = 0.34) and bridge (OR = 0.33).

CONCLUSIONS
AP is highly prevalent in Southern Estonian population. Most cases are associated with root canal-treated teeth. The overall quality of root canal fillings tends to be low, consistent with the mediocre outcome of treatment. Considerable efforts are required to improve the standards of endodontic treatment.

Apical periodontitis
Quality of root canal filling
Epidemiology
Quality of restoration


Resveratrol is a promising agent for colorectal cancer prevention and treatment: focus on molecular mechanisms.

Abstract: Colorectal cancer (CRC) is the third most common cancer and one of the main causes of cancer death entire the world. Environmental, dietary, and lifestyle factors including red meat consumption, cigarette smoking, alcohol intake and family history are the most important risk factors of CRC. Multiple pathways including inflammation, oxidative stress, and apoptosis are involved in its incidence and progression. Resveratrol, a polyphenolic compound, has different pharmacologic functions including anti-inflammation, cancer prevention, lipid-lowering effect, and hypoglycemic effect. Many studies have proved that resveratrol might also represent a chemo preventive effect on CRC. Thus, the aim of the current review is to depict the role of resveratrol in treatment of CRC in a molecular manner.

Honari|Mohadese|M|
Shafabakhsh|Rana|R|
Reiter|Russel J|RJ|
Mirzaei|Hamed|H|
Asemi|Zatollah|Z|

Resveratrol
Colorectal cancer
Anti-inflammatory
Anti-oncotic


Minimally Important Difference of the Absolute and Functional Claudication Distance in Patients with Intermittent Claudication.

Abstract:
OBJECTIVE
Disease severity and treatment outcomes in patients with intermittent claudication (IC) are commonly assessed using walking distance measured with a standardized treadmill test. It is unclear what improvement or deterioration in walking distance constitutes a meaningful, clinically relevant, change from the patients' perspective. The purpose of the present study was to estimate the minimally important difference (MID) for the absolute claudication distance (ACD) and functional claudication distance (FCD) in patients with IC.

METHOD
The MIDs were estimated using an anchor based approach with a previously defined clinical anchor derived from scores of the walking impairment questionnaire (WIQ) in a similar IC population. Baseline and 3 month follow up data on WIQ scores and walking distances (ACD and FCD) were used from 202 patients receiving supervised exercise therapy from the 2010 EXITPAD randomized controlled trial. The external WIQ anchor was used to form three distinct categories: patients with "clinically relevant improvement," "clinically relevant deterioration," and "no clinically relevant change." The MIDs for improvement and deterioration were defined by the upper and lower limits of the 95% confidence interval of the mean change in ACD and FCD, for the group of IC patients that remained unchanged according to the WIQ anchor.

RESULTS
For the estimation of the MID of the ACD and FCD, 102 and 101 patients were included, respectively. The MID for the ACD was 305 m for improvement, and 147 m for deterioration. The MID for the FCD was 250 m for improvement, and 120 m for deterioration.

CONCLUSION
The MIDs for the treadmill measured ACD and FCD can be used to interpret the clinical relevance of changes in walking distances after supervised exercise therapy and may be used in both research and individual care.

van den Houten|M M L|MM|
Gommans|L N M|LN|
van der Wees|P J|PJ|
Teijink|J A W|JA|

Intermittent claudication
Supervised exercise therapy
Peripheral arterial disease


Wicking Property of Graft Material Enhanced Bone Regeneration in the Ovariectomized Rat Model.

Abstract:
Background
Recruitment and homing cells into graft materials from host tissue is crucial for bone regeneration.

Methods
Highly porous, multi-level structural, hydroxyapatite bone void filler (HA-BVF) have been investigated to restore critical size bone defects. The aim was to investigate a feasibility of bone regeneration of synthetic HA-BVF compared to commercial xenograft (Bio-Oss). HA-BVF of 0.7 mm in average diameter was prepared via template coating method. Groups of animals (n = 6) were divided into two with normal (Sham) or induced osteoporotic conditions (Ovx). Subsequently, subdivided into three treated with HA-BVF as an experiment or Bio-Oss as a positive control or no treatment as a negative control (defect). The new bone formation was analyzed by micro-CT and histology.

Results
At 4 weeks post-surgery, new bone formation was initiated from all groups. At 8 weeks post-surgery, new bone formation in the HA-BVF groups was greater than Bio-Oss groups. Extraordinarily greater bone regeneration within the Ovx-HA group than Sham-Bio-Oss or Ovx-Bio-Oss group (p < 0.05).

Conclusion
This study suggests that the immediate wicking property of HA-BVF from host tissue activates a natural healing cascade without the addition of exogeneous factors or progenitor cells. HA-BVF may be an effective alternative for repairing bone defects under both normal and osteoporotic bone conditions.

Kim|Seunghyun|S|
Ahn|Taeho|T|
Han|Myung-Ho|MH|
Bae|Chunsik|C|
Oh|Daniel S|DS|

Bone regeneration
Hydroxyapatite
Bone void filler
Osteoporosis


High drug related mortality rates following prison release: Assessing the acceptance likelihood of a naltrexone injection and related concerns.

Abstract:
BACKGROUND AND AIMS
High drug related mortality amongst former prisoners in the 4 weeks following release is an internationally recognised problem. Naltrexone injections at release could diminish this by blockading opioid receptors, but naltrexone is not licensed for injection for treating opiate misuse in the United Kingdom and some other countries. This study examined the likelihood of accepting a naltrexone injection at release, and the relationship of this likelihood to other relevant variables.

METHOD
Sixty-one male prisoners with a history of heroin use, who were approaching release from two prisons in the north-west of England, provided likelihood ratings for accepting a naltrexone injection if it were to have been available. Additional data was gathered regarding demographic and drug use histories, and also from psychometric instruments relevant to drug misuse and treatment preparedness.

RESULTS
Maximum likelihood ratings for accepting a naltrexone injection were recorded by 55.7% of the sample with only 9.8% indicating no likelihood of accepting an injection. Likelihood ratings were positively related to serving a current sentence for an acquisitive offence compared to drug related or violence offences, and negatively related to peak methadone dosages during the current sentence.

CONCLUSIONS
Although naltrexone injections were not available to participants in this study, the findings suggest that the potential uptake for this intervention is sufficient to warrant a clinical trial with this population of British prisoners, with a view to potential changes to its current licencing status. However, the importance of individual patient readiness for such an abstinence orientated intervention is emphasised by the negative correlation between the likelihood ratings and recent methadone doses.

Murphy|Philip N|PN|
Mohammed|Faizal|F|
Wareing|Michelle|M|
Cotton|Angela|A|
McNeill|John|J|
Irving|Paula|P|
Jones|Steve|S|
Sharples|Louisa|L|
Monk|Rebecca|R|
Elton|Peter|P|

D010342:Patient Acceptance of Health Care

Prisoners Naltrexone Injections Heroin Readiness Death


Correlation between Restless Leg Syndrome and Superficial Venous Reflux.

Abstract: Restless leg syndrome (RLS) is a common cause of lower extremity discomfort. We hypothesized that patients with RLS symptoms have higher rates of deep and superficial venous reflux (SVR). Retrospective review of patients ≥18 years of age evaluated in a venous center from December 2018 to February 2019. Differences in rates of RLS symptoms, demographics, comorbidities, and clinical and radiologic presence of venous disease were analyzed. Overall, 207 patients were analyzed; 140 (67.6%) reported RLS symptoms ( n  = 25 with prior RLS diagnosis). RLS symptoms were more common with superficial or combined superficial and deep venous reflux (DVR) compared with those without reflux ( p  < 0.001). Patients with RLS symptoms as opposed to those without had similar demographics and comorbidities (all p  > 0.05) but increased rates of venous pain, phlebitis, family history of venous disease, lower extremity swelling and SVR, and combined SVR and DVR (all p  < 0.05). Our multivariable logistic regression found presence of SVR, and family history of venous reflux was associated with RLS symptomatology (all p  < 0.001). Ninety-nine patients with RLS underwent ablation; of them, 93 had duplex-proven reflux resolution of which 81 (87%) reported RLS symptom improvement. This included 13 of 16 (81.3%) with prior RLS diagnosis. SVR is associated with increased rates of RLS symptoms in a vein center population. Therefore, RLS symptoms should trigger a targeted venous evaluation. Our results suggest that venous ablation may lead to resolution of RLS symptoms in patients with SVR, but randomized prospective trials with strict RLS definition criteria are warranted to confirm these outcomes.

Dezube|Aaron R|AR|0000-0001-5510-8746
Rauh|Jake|J|
Dezube|Michael|M|
Iafrati|Mark|M|
Rigo|JoAnn|J|
Muto|Paula|P|

restless leg syndrome
superficial venous reflux
superficial venous incompetency
venous duplex


Clinical presentation and treatment considerations of a ruptured posterior spinal artery pseudoaneurysm.

Abstract: Spinal artery pseudoaneurysms are rare vascular lesions with poorly defined natural history, diagnostic paradigms, and treatment strategies. We present a 68-year-old woman with severe back pain and left lower extremity weakness with spinal subarachnoid hemorrhage due to a ruptured T5 region posterior spinal artery pseudoaneurysm, and review issues related to radiologic diagnosis and endovascular and open neurosurgical interventions.

Bell|Donnie L|DL|
Stapleton|Christopher J|CJ|
Terry|Anna R|AR|
Stone|James R|JR|
Ogilvy|Christopher S|CS|

D000368:Aged
D017541:Aneurysm, False
D017542:Aneurysm, Ruptured
D005260:Female
D006801:Humans
D018810:Magnetic Resonance Angiography
D008279:Magnetic Resonance Imaging
D013345:Subarachnoid Hemorrhage
D014711:Vertebral Artery

Posterior spinal artery
Pseudoaneurysm
Spinal subarachnoid hemorrhage
Endovascular neurosurgery
Vascular neurosurgery


Genes in the pathway of tooth mineral tissues and dental caries risk: a systematic review and meta-analysis.

Abstract:
OBJECTIVES
To perform a systematic review of the literature, investigating the influence of tooth mineral tissues genes on dental caries.

MATERIALS AND METHODS
Five databases were searched. Only human studies with cross-sectional, longitudinal, and case-control design were included. Meta-analysis was performed for each polymorphism, providing allele and genotype estimates. A meta-analysis was performed, pooling several polymorphisms for each gene. A Funnel Plot and Egger's test were also performed.

RESULTS
A total of 1124 records were found. Of these, 25 papers were included in the systematic review and 18 in the meta-analysis. Most of the studies (52%) were of medium quality. With regard to the allele analysis, the T allele of rs134136 (TFIP11) (OR 1.51; 95%CI 1.02-2.22) showed an association with high experience of caries and the summarization of polymorphisms investigated in the TFIP11 gene, after exclusion of SNP linkage disequilibrium, showed an association with caries experience (OR 1.64; 95%CI 1.08-2.50). An analysis of the homozygous genotype did not show any significant association. The pooled SNPs of AMBN showed associations with caries (OR 0.45; 95%CI 0.29-0.72). The pooled polymorphisms of AMELX were associated with caries experience (OR 1.78; 95%CI 1.23-2.56). In the analysis of the homozygous genotype, no SNP showed a significant association. Egger's test showed no significant publication bias for all models (p > 0.05).

CONCLUSION
The present findings showed that the genes TFIP11, AMBN, and AMELX play an important role in dental caries.

CLINICAL RELEVANCE
Several single nucleotide polymorphisms related to the genes in the formation of tooth mineral are linked to the occurrence of dental caries, and these genes have proved to be important for an explanation of differences in the risk of dental caries.

Gene
Mineral tissues
Dental caries
Polymorphisms
Genetic


Judgments of Monkey's (Macaca mulatta) Facial Expressions by Humans: Does Housing Condition "Affect" Countenance?

Abstract: The ability to interpret facial expressions of others is one of the more important abilities possessed by humans. However, is it possible for humans to accurately interpret the facial expressions of another species of primate, namely rhesus monkeys (Macaca mulatta)? We investigated this possibility by taking digital photos of four rhesus monkeys housed either singly or socially and allowing thirty-one participants to judge these photographs as representing either a happy, sad, or neutral monkey. Results indicated that the photographs of monkeys that were socially housed were more likely to be rated as happy or neutral than were photographs of singly housed monkeys. We suggest that these results imply important parallels between the perception of human and nonhuman primate facial expressions as well as introduce a potential new method for assessing nonhuman primate well-being.

Gulledge|Jonathan P|JP|
Fernández-Carriba|Samuel|S|
Rumbaugh|Duane M|DM|
Washburn|David A|DA|

judgment monkey housing countenance enrichment face


Is Anatomical Healing Essential for Better Clinical Outcome in Type II SLAP Repair? Clinico-Radiological Outcome after Type II SLAP Repair.

Abstract:
Background
We hypothesized that anatomical healing in superior labrum anterior to posterior (SLAP) repair is associated with good clinical outcome. The purposes of this study were to assess the failure rate of anatomical healing after arthroscopic repair of SLAP lesions using computed tomography arthrography (CTA), investigate correlation of the rate with clinical outcomes, and identify prognostic factors for anatomical failure following SLAP repair.

Methods
We retrospectively evaluated the outcome of 43 patients at a minimum follow-up of 1 year after arthroscopic surgery for SLAP lesions or SLAP lesions associated with Bankart lesions. Twenty-eight patients underwent isolated SLAP repair and 15 patients underwent Bankart repair with SLAP repair. The anatomical outcome was assessed using CTA at 1 year after surgery. Clinical outcomes including visual analogue scale for pain and satisfaction and Constant score were assessed at the final follow-up. We investigated clinical failure that was defined as stiffness, loss of maximum rotation, deterioration of pain, and/or need for revision of surgery.

Results
Anatomical failure occurred in 32.6% of patients (14/43), whereas 16.3% of patients (7/43) had clinical failure. Clinicoradiological assessment revealed that clinical failure occurred only in 7.1% of patients (1/14) with unhealed SLAP lesions, whereas it occurred in 20.7% of patients (6/29) with healed SLAP lesions. Isolated SLAP repair resulted in a higher risk of anatomical failure (risk ratio, 7.0) than combined SLAP repair (p = 0.015). Nonoverhead activities were associated with higher risk of anatomical failure (risk ratio, 2.9; p = 0.041). Patients above 35 years of age had more risk of anatomical failure (risk ratio, 3.5; p = 0.010). Clinical outcomes significantly improved regardless of anatomical failure (p < 0.001) and were not significantly different between unhealed and healed repairs (all p > 0.05).

Conclusions
Since patients with unhealed SLAP lesions had less clinical failure than patients with healed SLAP lesions, anatomical healing does not seem essential for better clinical outcome of SLAP II repair, especially in patients with higher healing failure risk (isolated SLAP repair, nonoverhead activities, and above 35 years of age). Therefore, we believe the indications of SLAP repair should be narrowed to avoid overtreatment.

Nashikkar|Piyush Suresh|PS|
Rhee|Sung-Min|SM|
Desai|Chintan Vinod|CV|
Oh|Joo Han|JH|

Superior labrum from anterior to posterior injuries


Repair of abdominal aortic aneurysms: preoperative imaging and evaluation.

Abstract: Imaging is a critical component of the pre-procedure evaluation and planning of endovascular aneurysm repair (EVAR). Imaging is the mainstay for proper assessment of procedural candidacy, relevant vascular anatomy, device selection, and surgical approach. Computed tomography angiography (CTA) has long been considered the preferred modality for pre-operative imaging and evaluation prior to EVAR. Recently, advances in image quality and software technology have further enhanced the proceduralist's ability to plan and perform EVAR. In this review, we highlight the current state of the art to provide interventionalists a contemporary assessment of the available tools for pre-operative imaging and evaluation prior to EVAR.

Hu|David K|DK|
Pisimisis|George T|GT|
Sheth|Rahul A|RA|

Endovascular aneurysm repair (EVAR)
computed tomography angiography (CTA)
abdominal aortic aneurysm (AAA)


Breathe easy: 5 steps to better breathing with your metered-dose inhaler (MDI).

Abstract: Proper use of the metered-dose inhaler (MDI) is essential for medications to prevent and treat acute asthma exacerbations. This training video teaches children and clinicians correct technique for MDI use.

Allie|Evan H|EH|
O'Kelley|Ellen B|EB|
Fischesser|Katie H|KH|
Stack|Lawrence B|LB|
Arnold|Donald H|DH|

D000280:Administration, Inhalation
D000293:Adolescent
D001249:Asthma
D001993:Bronchodilator Agents
D005260:Female
D006801:Humans
D055118:Medication Adherence
D036501:Metered Dose Inhalers
D010353:Patient Education as Topic
D017410:Practice Guidelines as Topic
D012646:Self Administration
D014481:United States

Metered-dose inhaler
Prevention
Asthma
Exacerbation
Inhaled corticosteroid


Activating the Intrinsic Pathway of Apoptosis Using BIM BH3 Peptides Delivered by Peptide Amphiphiles with Endosomal Release.

Abstract: Therapeutic manipulation of the BCL-2 family using BH3 mimetics is an emerging paradigm in cancer treatment and immune modulation. For example, peptides mimicking the BIM BH3 helix can directly target the full complement of anti- and pro-apoptotic BCL-2 proteins to trigger apoptosis. This study has incorporated the potent BH3 α-helical death domain of BIM into peptide amphiphile (PA) nanostructures designed to facilitate cellular uptake and induce cell death. This study shows that these PA nanostructures are quickly incorporated into cells, are able to specifically bind BCL-2 proteins, are stable at physiologic temperatures and pH, and induce dose-dependent apoptosis in cells. The incorporation of a cathepsin B cleavable linker between the BIM BH3 peptide and the hydrophobic tail resulted in increased intracellular accumulation and mitochondrial co-localization of the BIM BH3 peptide while also improving BCL-2 family member binding and apoptotic reactivation. This PA platform represents a promising new strategy for intracellular therapeutic peptide delivery for the disruption of intracellular protein:protein interactions.

apoptosis
BIM
peptide amphiphile
BCL-2 family
cathepsin
BH3-only
peptide therapeutics


Antioxidant responses related to temozolomide resistance in glioblastoma.

Abstract: Glioblastoma remains one of the most challenging and devastating cancers, with only a very small proportion of patients achieving 5-year survival. The current standard of care consists of surgery, followed by radiation therapy with concurrent and maintenance chemotherapy with the alkylating agent temozolomide. To date, this drug is the only one that provides a significant survival benefit, albeit modest, as patients end up acquiring resistance to this drug. As a result, tumor progression and recurrence inevitably occur, leading to death. Several factors have been proposed to explain this resistance, including an upregulated antioxidant system to keep the elevated intracellular ROS levels, a hallmark of cancer cells, under control. In this review, we discuss the mechanisms of chemoresistance -including the important role of glioblastoma stem cells-with emphasis on antioxidant defenses and how agents that impair redox balance (i.e.: sulfasalazine, erastin, CB-839, withaferin, resveratrol, curcumin, chloroquine, and hydroxychloroquine) might be advantageous in combined therapies against this type of cancer.

Campos-Sandoval|José A|JA|
Gómez-García|María C|MC|
Santos-Jiménez|Juan de Los|JL|
Matés|José M|JM|
Alonso|Francisco J|FJ|
Márquez|Javier|J|

Antioxidant Temozolomide Glioblastoma ROS


Formation of Dislocations and Stacking Faults in Embedded Individual Grains during In Situ Tensile Loading of an Austenitic Stainless Steel.

Abstract: The formation of stacking faults and dislocations in individual austenite (fcc) grains embedded in a polycrystalline bulk Fe-18Cr-10.5Ni (wt.%) steel was investigated by non-destructive high-energy diffraction microscopy (HEDM) and line profile analysis. The broadening and position of intensity, diffracted from individual grains, were followed during in situ tensile loading up to 0.09 strain. Furthermore, the predominant deformation mechanism of the individual grains as a function of grain orientation was investigated, and the formation of stacking faults was quantified. Grains oriented with [100] along the tensile axis form dislocations at low strains, whilst at higher strains, the formation of stacking faults becomes the dominant deformation mechanism. In contrast, grains oriented with [111] along the tensile axis deform mainly through the formation and slip of dislocations at all strain states. However, the present study also reveals that grain orientation is not sufficient to predict the deformation characteristics of single grains in polycrystalline bulk materials. This is witnessed specifically within one grain oriented with [111] along the tensile axis that deforms through the generation of stacking faults. The reason for this behavior is due to other grain-specific parameters, such as size and local neighborhood.

Neding|Benjamin|B|
Pagan|Darren C|DC|
Hektor|Johan|J|0000-0003-3454-2660
Hedström|Peter|P|

high-energy X-ray diffraction microscopy


The Bcl-2 inhibitor venetoclax inhibits Nrf2 antioxidant pathway activation induced by hypomethylating agents in AML.

Abstract: Induction of reactive oxygen species (ROS), an important process for the cytotoxicity of various acute myeloid leukemia (AML) therapies including hypomethylating agents (HMAs), concurrently activates the NF-E2-related factor 2 (Nrf2) antioxidant response pathway which in turn results in induction of antioxidant enzymes that neutralize ROS. In this study, we demonstrated that Nrf2 inhibition is an additional mechanism responsible for the marked antileukemic activity in AML seen with the combination of HMAs and venetoclax (ABT-199). HMA and venetoclax combined treatment augmented mitochondrial ROS induction and apoptosis compared with treatment HMA alone. Treatment of AML cell lines as well as primary AML cells with venetoclax disrupted HMA decitabine-increased nuclear translocation of Nrf2 and induction of downstream antioxidant enzymes including heme oxygenase-1 and NADP-quinone oxidoreductase-1. Venetoclax treatment also leads to dissociation of B-cell lymphoma 2 from the Nrf2/Keap-1 complex and targets Nrf2 to ubiquitination and proteasomal degradation. Thus, our results here demonstrated an undiscovered mechanism underlying synergistic effect of decitabine and venetoclax in AML cells, elucidating for impressive results in antileukemic activity against AML in preclinical and early clinical studies by combined treatment of these drugs.

D019086:Bridged Bicyclo Compounds, Heterocyclic

D015973:Gene Expression Regulation, Leukemic

D000072019:Kelch-Like ECH-Associated Protein 1

venetoclax
Nrf2
hypomethylating agents
reactive oxygen species
acute myeloid leukemia
antioxidant response
ubiquitination


Broadband Anisotropic Photoresponse of the "Hydrogen Atom" Version Type-II Weyl Semimetal Candidate TaIrTe4.

Abstract: The layered ternary compound TaIrTe4 is an important candidate to host the recently predicted type-II Weyl Fermions that break Lorentz invariance. Photodetectors based on Weyl semimetal promise extreme performance in terms of highly sensitive, broadband, and self-powered operation owing to its topologically protected band structures. In this work, we report the realization of a broadband self-powered photodetector based on TaIrTe4. The photocurrent generation mechanisms are investigated with power- and temperature-dependent photoresponse measurements. The prototype metal-TaIrTe4-metal photodetector exhibits a responsivity of 20 μA W-1 or a specific detectivity of 1.8 × 106 Jones with 27 μs response time at 10.6 μm. Broadband responses from 532 nm to 10.6 μm are experimentally tested with potential detection range extendable to far-infrared and terahertz. Furthermore, anisotropic response of the TaIrTe4 photodetector is identified using polarization-angle-dependent measurement with linearly polarized light. The anisotropy is found to be wavelength dependent, and the degree of anisotropy increases as the excitation wavelength gets closer to the Weyl nodes. Our results suggest this emerging class of materials can be harnessed for broadband, polarization angle-sensitive, self-powered photodetection with reasonable responsivities.

Lai|Jiawei|J| Liu|Yinan|Y| Ma|Junchao|J| Zhuo|Xiao|X| Peng|Yu|Y| Lu|Wei|W| Liu|Zheng|Z|0000-0002-8825-7198 Chen|Jianhao|J| Sun|Dong|D|0000-0002-0898-4548

Weyl semimetal
photodetector
anisotropic response
2D layered materials
mid-infrared
thermoelectric


Accuracy of the MedGem® portable indirect calorimeter for measuring resting energy expenditure in adults with class II or III obesity.

Abstract:
BACKGROUND AND AIMS
The accuracy of some portable indirect calorimeters in estimating resting energy expenditure (REE) - and hence energy recommendations - among pre-bariatric patients is unknown. Our objective was to assess the accuracy of the MedGem® among individuals with class II or III obesity awaiting bariatric surgery.

METHODS
Male and female adults who were awaiting bariatric surgery were recruited to this cross-sectional study. MedGem-derived oxygen consumption (O2) and REE were compared to O2 and REE from a metabolic cart. REE was also calculated using several common equations to assess the clinical utility of this portable tool. Body composition was assessed by dual energy X-Ray absorptiometry. Paired t-test and Bland-Altman analysis (expressed as bias [average difference] and limits of agreement [bias ± 2 standard deviations]) evaluated O2 and REE accuracy.

RESULTS
Twenty-six individuals were included (34 ± 9 years old; n = 20, 76.9% female), with the majority (n = 15, 57.7%) having class II obesity. Neither O2 (MedGem: 283 ± 63 vs. metabolic cart: 293 ± 64 ml/min, p = 0.114) nor REE (MedGem: 1963 ± 437 vs. metabolic cart: 2047 ± 440 kcal/day, p = 0.057) were different between devices. Body composition did not relate to bias. The MedGem had wide limits of agreement for REE (-504 to 336 kcal/day), which was similar to predictive equations.

CONCLUSIONS
Although REE from the MedGem was not different than REE from the metabolic cart, individual-level accuracy was poor and similar to predictive equations in patients with class II or III obesity. Nonetheless, efficacy of repeated assessments during weight loss warrant future investigation.

Purcell|Sarah A|SA|
Johnson-Stoklossa|Carlene|C|
Braga Tibaes|Jenneffer Rayane|JR|
Frankish|Alena|A|
Elliott|Sarah A|SA|
Padwal|Raj|R|
Prado|Carla M|CM|

Obese
Indirect calorimetry
Nutrition support
Overweight
Portable device
RMR
Resting metabolic rate


Trace determination of volatile polycyclic aromatic hydrocarbons in natural waters by magnetic ionic liquid-based stir bar dispersive liquid microextraction.

Abstract: In this work, a novel hybrid approach called stir bar dispersive liquid microextraction (SBDLME) that combines the advantages of stir bar sorptive extraction (SBSE) and dispersive liquid-liquid microextraction (DLLME) has been employed for the accurate and sensitive determination of ten polycyclic aromatic hydrocarbons (PAHs) in natural water samples. The extraction is carried out using a neodymium stir bar magnetically coated with a magnetic ionic liquid (MIL) as extraction device, in such a way that the MIL is dispersed into the solution at high stirring rates. Once the stirring is ceased, the MIL is magnetically retrieved onto the stir bar, and subsequently subjected to thermal desorption (TD) coupled to a gas chromatography-mass spectrometry (GC-MS) system. The main parameters involved in TD, as well as in the extraction step affecting the extraction efficiency (i.e., MIL amount, extraction time and ionic strength) were evaluated. Under the optimized conditions, the method was successfully validated showing good linearity, limits of detection and quantification in the low ng L-1 level, good intra- and inter-day repeatability (RSD < 13%) and good enrichment factors (18 - 717). This sensitive analytical method was applied to the determination of trace amounts of PAHs in three natural water samples (river, tap and rainwater) with satisfactory relative recovery values (84-115%), highlighting that the matrices under consideration do not affect the extraction process.

Benedé|Juan L|JL|
Anderson|Jared L|JL|
Chisvert|Alberto|A|


Secrets, Psychological Health, and the Fear of Discovery.

Abstract: Keeping secrets from one's partner has been associated with lower well-being and relationship satisfaction. Previous research has suggested that individual differences in self-concealment account for these effects. However, we propose that the fear of discovery (FoD)-defined as the fear that one's secret may be revealed by means other than deliberate disclosure-predicts the extent to which secrets affect well-being beyond the effects attributable to individual differences. Both a cross-sectional and a longitudinal survey (combined N = 471; 54.4% female; M = 39.5) of adults in romantic relationships confirmed that FoD predicted greater preoccupation with the secret, more negative affect, and less relationship satisfaction and commitment beyond that of self-concealment. Multilevel modeling in Study 2 indicated that changes in FoD predicted changes in preoccupation over time. The data are consistent with the notion that FoD promotes greater preoccupation, greater negative affect, and lower levels of relationship well-being.

secrets
fear of discovery
self-concealment
romantic relationships
preoccupation


Understanding the distributional impacts of health insurance reform: Evidence from a consumer cost-sharing program.

Abstract: We examine the heterogeneous effects of reference pricing, a health insurance reform introduced by the California Public Employees' Retirement System (CalPERS), on the distribution of spending by patients and insurers. Using medical claims data for CalPERS and a comparison group not subject to reference pricing, we use the changes-in-changes approach to estimate the quantile treatment effects of the program across different medical procedures. We find that the quantile treatment effects vary across the patient spending distributions, with a range of positive and negative estimates of the QTE, depending on the medical procedure considered. However, across all procedures, the insurer's spending distributions tend to shift left, with the largest reductions occurring in the right-tail of the spending distributions. These effects are not captured by mean estimates but have important policy implications.

Aouad|Marion|M|0000-0002-7838-1793
Brown|Timothy T|TT|0000-0002-5334-0768
Whaley|Christopher M|CM|

D017047:Cost Sharing
D005102:Health Expenditures
D006801:Humans
D007343:Insurance Carriers
D007348:Insurance, Health

health insurance
quantile treatment effects
distributional effects
insurance design


Investigating Associations Between Screen Time and Symptomatology in Individuals With Serious Mental Illness: Longitudinal Observational Study.

Abstract:
BACKGROUND
Increasing screen time exposure from digital devices like smartphones has shown a variety of mixed associations with cognition, behavior, and well-being in adults and children but little is known about its associations with symptomatology in individuals with serious mental illness.

OBJECTIVE
To determine the range of associations between screen time and symptoms of individuals with mental illness, we utilized a method called specification curve analysis.

METHODS
In this observational study, we recruited smartphone-owning adults (≥18 years old) with schizophrenia and healthy controls. We installed 2 research-source smartphone apps, mindLAMP and Beiwe, to collect survey results, cognitive test results, and screen time metrics over a period of 3 months. Surveys were scheduled for twice a week, but participants were instructed to take the surveys naturally as much or as little as they wanted. Screen time was collected continuously in the background. A total of 140 participants was recruited from the outpatient clinic population as well as through general public advertising. Age-matched, smartphone-owning healthy controls were also part of the recruitment pool. A specification curve analysis was a priori designed to explore the relationship between every combination of independent variable and dependent variable in order to demonstrate to what degree screen time relates to symptoms in individuals with serious mental illness.

RESULTS
The sample consisted of 88 participants (54 with schizophrenia and 34 healthy controls) who completed both the initial and follow-up visits, completed at least one self-reported survey, and had a minimum passive data cutoff of 5 consecutive days. While we found an association between smartphone screen time metrics and cognition (adjusted R2=0.107, P<.001), specification curve analysis revealed a wide range of heterogenous associations with screen time from very negative to very positive. The effects differed based on diagnostic group, age bracket, type of regression model used, and the specific independent and dependent variables selected for analysis.

CONCLUSIONS
The associations between screen time and mental health in patients with schizophrenia are heterogenous when examined with methods that reduce analytical bias. The heterogeneity in associations suggests that complex and personalized potential effects must be understood in the greater context of an individual. This analysis of longitudinally collected screen time data shows potential for future research that could benefit from high resolution metrics on smartphone use.

screen time
schizophrenia
apps
mHealth
mobile


Practise what you preach: health behaviours and stress among non-consultant hospital doctors.

Abstract: High rates of psychological distress, depression and suicide have been reported among doctors. Furthermore, many doctors do not access healthcare by conventional means. This study aimed to increase understanding regarding non-consultant hospital doctors' (NCHDs') response to stress and barriers to accessing supports, and identify possible solutions. Medical manpower departments in 58 hospitals distributed a 25-item questionnaire to 4,074 NCHDs; we received 707 responses (response rate, 17.4%). 60% of NCHDs were unable to take time off work when unwell; 'letting teammates down' (90.8%) and 'difficulty covering call' (85.9%) were the leading reasons. 'Being too busy' (85%), 'self-prescription' (66.6%) and 'self-management' (53.1%) were ranked highest in deterring NCHDs from visiting a general practitioner (GP). 22.9% of NCHDs would not attend a GP with anxiety or depression until they began to feel hopeless, helpless or suicidal. 12.2% would not seek help at all. 55% of respondents (n = 330) had to move away from partners or dependants due to work, negatively affecting the social supports of 82.9%. Possible practical solutions were explored. NCHDS are a vulnerable population and have a particularly challenging lifestyle. Key recommendations include improved GP and counselling access for NCHDs, and addressing the culture of self-treatment and poor health behaviours through undergraduate and postgraduate education.

Feeney|Sinéad|S|
O'Brien|Kevin|K|
O'Keeffe|Neasa|N|
Iomaire|Anna Nic Con|AN|
Kelly|Maureen E|ME|
McCormack|John|J|
McGuire|Genevieve|G|
Evans|David S|DS|

stress
solutions
Burnout
doctors’ health
wellbeing


Increased Glycated Hemoglobin Levels in Patients With Helicobacter pylori Infection Are Associated With the Grading of Chronic Gastritis.

Abstract:
Background
Recent studies have found an association between Helicobacter pylori infection and prediabetes. Whether H. pylori per se or host factors are involved in the disturbance of glycated hemoglobin needs further investigation. The aim of this study was to determine the association of glycated hemoglobin levels with endoscopic diagnosis and the inflammatory response in H. pylori infection.

Methods
A cross-sectional study was carried out in 88 dyspeptic non-diabetic adults who underwent esophagogastroduodenoscopy. The diagnosis of H. pylori infection was performed through urease test and histopathological exam. Cases were initially distributed into two groups: control (without H. pylori infection, n = 22) and HP (patients with H. pylori infection, n = 66). HbA1c was measured to determine prediabetes status according to the American Diabetes Association criteria, and then the groups were subdivided into non-prediabetic (n = 14), prediabetic (n = 8), non-prediabetic HP (n = 26) and prediabetic HP (n = 40) groups. Gastric mucosa was histologically evaluated to determine H. pylori density and inflammatory activity according to Sydney System. To investigate the balance of anti-inflammatory and pro-inflammatory cytokines we measured interleukin 10 (anti-inflammatory) and Tumor Necrosis Factor-a (pro-inflammatory) in the plasma or in the gastric mucosa.

Results
Patients with H. pylori infection had higher mean HbA1c levels than those without H. pylori infection. However, increased HbA1c levels were not associated with H. pylori-related factors but with the bacterial density, the intensity of inflammation and the activity of the chronic gastritis. In addition, H. pylori infection per se did not alter IL-10 and TNF-α neither in the plasma nor in the gastric mucosa, but the bacterial density was negatively correlated with systemic and local IL-10 expression. Although no correlation was found between systemic cytokines and HbA1c levels, local anti-inflammatory cytokine was correlated with HbA1c levels.

Conclusion
Long-term H. pylori infection is associated with prediabetes. This association is not related to the presence of H. pylori per se but depends on the extent of bacterial colonization and the degree of both local inflammation and activity of the chronic gastritis.

Maluf|Selma|S|
Salgado|João Victor|JV|
Cysne|Dalila Nunes|DN|
Camelo|Daniel Monte Freire|DMF|
Nascimento|Johnny Ramos|JR|
Maluf|Bianca Vitória T|BVT|
Silva|Luís Douglas Miranda|LDM|
Belfort|Marta Regina de Castro|MRC|
Silva|Lucilene Amorim|LA|
Guerra|Rosane Nassar Meireles|RNM|
Salgado Filho|Natalino|N|
Nascimento|Flávia Raquel F|FRF|

glycated hemoglobin
Helicobacter pylori
chronic gastritis
prediabetes
cytokines
inflammation


Determination of medicinal and illicit drugs in post mortem dental hard tissues and comparison with analytical results for body fluids and hair samples.

Abstract: In burnt or skeletonized bodies dental hard tissue sometimes is the only remaining specimen available. Therefore, it could be used as an alternative matrix in post mortem toxicology. Additionally, analysis of dental tissues could provide a unique retrospective window of detection. For forensic interpretation, routes and rates of incorporation of different drugs as well as physicochemical differences between tooth root, tooth crown and carious material have to be taken into account. In a pilot study, one post mortem tooth each from three drug users was analyzed for medicinal and illicit drugs. The pulp was removed in two cases; in one case the tooth was root canal treated. The teeth were separated into root, crown and carious material and drugs were extracted from the powdered material with methanol under ultrasonication. The extracts were screened for drugs by LC-MS(n) (ToxTyper™) and quantitatively analyzed with LC-ESI-MS/MS in MRM mode. The findings were compared to the analytical results for cardiac blood, femoral blood, urine, stomach content and hair. In dental hard tissues, 11 drugs (amphetamine, MDMA, morphine, codeine, norcodeine, methadone, EDDP, fentanyl, tramadol, diazepam, nordazepam, and promethazine) could be detected and concentrations ranged from approximately 0.13pg/mg to 2,400pg/mg. The concentrations declined in the following order: carious material>root>crown. Only the root canal treated tooth showed higher concentrations in the crown than in the root. In post mortem toxicology, dental hard tissue could be a useful alternative matrix facilitating a more differentiated consideration of drug consumption patterns, as the window of detection seems to overlap those for body fluids and hair.

Klima|Miriam|M|
Altenburger|Markus J|MJ|
Kempf|Jürgen|J|
Auwärter|Volker|V|
Neukamm|Merja A|MA|

Post mortem toxicology
Teeth
Alternative matrices
Drugs of abuse
Forensic toxicology


"I want us to be a normal family": Toward an understanding of the functions of anonymity among U.S. oocyte donors and recipients.

Abstract:
BACKGROUND
Anonymity remains the more common practice in gamete donations, but legislation prohibiting anonymity with a goal of protecting donor-conceived children's right to know their genetic origins is becoming more common. However, given the dearth of research investigating the function of anonymity for donors and recipients, it is unclear whether these policies will accomplish their goals. The aim of this study was to explore experiences with anonymity among oocyte donors and recipients who participated in an anonymous donor oocyte program and to understand the ways in which anonymity functions for them.

METHODS
Semistructured interviews were conducted with 50 women: 28 oocyte donors and 22 recipients who were recruited from an academic center for reproductive medicine in the United States.

RESULTS
Donors and recipients view anonymity both as a mechanism to protect the interests of all parties (recipients, donors, and donor-conceived children) and as a point of conflict. Specifically, three key areas were identified where both donors and recipients saw anonymity as having an important role: relieving anxieties about family structures and obligations; protecting their interests and those of donor-conceived children (while acknowledging where interests conflict); and managing the future.

CONCLUSION
As gamete donation increasingly moves away from the practice of anonymity, examining why anonymity matters to stakeholders will be helpful in devising strategies to successfully implement identity-release options.

anonymity
oocyte donors
gamete donation
identity release
oocyte recipients


Effect of propolis supplementation on athletic performance, body composition, inflammation, and oxidative stress following intense exercise: A triple-blind randomized clinical trial.

Abstract:
Background
Emerging evidence indicates that propolis as a novel potential antioxidant has unique benefits. This study aimed to evaluate the effect of propolis on oxidative stress, inflammation, body composition, and athletic performance in healthy active subjects.

Methods
This clinical trial was conducted on 54 male military cadets. Eligible subjects were randomly allocated to receive a single dose of 450 mg propolis twice daily for four weeks or a matching placebo containing microcrystalline cellulose. Cooper 12-min run test and running-based anaerobic sprint test were performed to measure aerobic and anaerobic performance. Blood samples were obtained immediately after Cooper's test to evaluate oxidative stress and inflammation status. Fat mass and fat-free mass were analyzed using bioelectrical impedance.

Results
Mean changes in fat mass, fat-free mass, anaerobic powers, fatigue index, and VO2 max did not differ significantly between the two groups after the adjustment for baseline values (P-value>0.05). A significant change was observed in plasma levels of IL-6 (-1.43 ± 0.11pg/mL), total oxidant status (-3.9 ± 0.2µmol/L), total antioxidant capacity (164 ± 12 µmol/L), malondialdehyde (-0.52 ± 0.03µmol/L), oxidative stress index (-0.45 ± 0.04), and glutathione (48.72±2µmol/L) in the propolis group compared with the placebo group after the adjustment for baseline values and weight changes (P-value<0.05). Although IL-10 concentrations had no significant changes in both groups, the ratio of IL-6/IL-10 significantly reduced in the propolis group compared with the placebo group (-0.174 ± 0.015 versus. 0.051 ± 0.014; P-value: 0.041).

Conclusions
Our results indicated that propolis might have beneficial effects on oxidative stress and inflammation following intense activities in healthy male subjects.

propolis
athletic performance
body composition
inflammation
oxidative stress
VO2 max


Clinical impact of Gram-negative nonfermenters on adults with community-onset bacteremia in the emergency department.

Abstract:
BACKGROUND
To determine clinical predictors and impact of Gram-negative nonfermenters (GNNFs) infections among adults with community-onset bacteremia in the emergency department (ED).

METHODS
Adults with bacteremia visiting the ED from January 2007 to June 2008 were identified retrospectively. Demographic characteristics, underlying illnesses, clinical conditions, bacteremic pathogens, antimicrobial agents, and outcome, were retrieved from chart records.

RESULTS
After the exclusion of 261 patients with contamination of blood cultures and 24 patients referred from other hospitals, 518 adults with community-onset bacteremia were eligible; their mean age was 65.1 years, with slight predominance of female (262 patients, 50.6%). Of a total of 565 bacteremic isolates, Escherichia coli (228 isolates, 40.4%) and Klebsiella pneumoniae (100, 17.7%) were the major microorganisms. GNNFs caused bacteremia in 31 (6.0%) patients. A higher proportion of inappropriate antibiotic therapy in the ED (87.1% vs. 26.5%, p < 0.001) and higher 28-day crude mortality rate (19.4% vs. 8.4%, p = 0.05) were observed in bacteremic patients caused by GNNFs than those not caused by GNNFs. In further analysis of Kaplan-Meier survival curve, patients with GNNF bacteremia had a worse outcome than those due to other pathogens (p = 0.04). Multivariate analysis revealed that the independent predictors related to GNNF bacteremia included surgery during previous 4 weeks prior to ED arrival [odds ratio (OR), 10.79; 95% confidence interval (CI), 1.84-63.24; p = 0.01], residents in long-term healthcare facilities (OR, 4.62; 95% CI, 2.08-10.29; p < 0.001), and malignancy (OR, 2.24; 95% CI, 1.10-5.40; p = 0.02).

CONCLUSION
For adults with bacteremia visiting the ED, GNNF is associated with a higher mortality rate and more inappropriate empirical antibiotic therapy in the ED. To allow early administration of empirical antibiotics, several clinical predictors of GNNF infections were identified.

Chiu|Chun-Wei|CW| Li|Ming-Chi|MC| Ko|Wen-Chien|WC| Li|Chia-Wen|CW| Chen|Po-Lin|PL| Chang|Chia-Ming|CM| Lee|Nan-Yao|NY| Lee|Ching-Chi|CC|

Gram-negative nonfermenters
Bacteremia
Emergency department


Simultaneous determination of free methamphetamine, pethidine, ketamine and tramadol in urine by dispersive liquid-liquid microextraction combined with GC-MS.

Abstract: A simple and rapid dispersive liquid-liquid microextraction (DLLME) technique coupled with gas chromatography-ion trap mass spectrometry (GC-MS) was developed for the extraction and analysis of methamphetamine (MA), pethidine (PD), ketamine (KT) and tramadol (TD) from human urine. In this study, different parameters affecting the extraction process such as the type and volume of extraction solvent, type and volume of disperser solvent, extraction time and pH value and salt effect were studied and optimized. Under optimized conditions, the enrichment factor ranged from 185 to 226 and the average recovery ranged from 80.45% to 95.55%. The linear range was 10.0-1000.0 µg/L, the limit of detection and quantitation were in the range 0.43-1.96 µg/L and 1.44-6.53 µg/L, respectively. The relative standard deviations were in the range 1.98%-3.90% (n = 7). The obtained results show that DLLME combined with GC-MS is a fast and simple method for the determination of MA, PD, KT and TD in human urine.


Hepatitis C services at harm reduction centres in the European Union: a 28-country survey.

Abstract:
BACKGROUND
In the context of the WHO's 2016 Viral Hepatitis Strategy and the introduction of treatment that can cure more than 95% of cases with hepatitis C virus (HCV) infection, the European Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT) undertook a study in the member states of the European Union (EU). It aimed to determine service providers' understanding of the current services in their respective countries and the barriers experienced by PWID in accessing HCV testing, care and treatment services in their country.

METHODS
In 2017, 38 purposively selected harm reduction service providers completed a 26-item English-language online survey addressing the availability, accessibility and funding of HCV services at harm reduction centres. HCV-related data and reported findings were extracted by country or by responding organization.

RESULTS
Responses were received from all EU member states. Respondents from 23 countries reported that HCV tests are offered by harm reduction services in their countries, and eight countries reported that addiction specialists in their countries are able to prescribe HCV therapy. Almost half of the respondents (45%) said that their respective organizations had established referral systems with centres providing HCV treatment.

CONCLUSIONS
Not all EU member states have harm reduction services that provide HCV tests, and many do not have established referral systems with treatment providers. Moreover, the inability of addiction specialists to prescribe HCV treatment points to missed opportunities to make treatment more accessible. Further, discrepancies were noted between the available HCV services and stakeholders' knowledge about their availability.

D000998:Antiviral Agents
D005062:European Union
D040261:Harm Reduction
D006297:Health Services Accessibility
D006526:Hepatitis C
D006801:Humans
D012017:Referral and Consultation
D019966:Substance-Related Disorders
D011795:Surveys and Questionnaires

Hepatitis C
European Union
Survey
Cascade of care
Direct-acting antivirals


Structural characterization of polysaccharides from Saposhnikovia divaricata and their antagonistic effects against the immunosuppression by the culture supernatants of melanoma cells on RAW264.7 macrophages.

Abstract: Two purified native polysaccharides, namely, SDNP-1 and SDNP-2 with apparent molecular weight of 67.9×103 and 5.2×103, separately, were isolated from the water extract of Saposhnikovia divaricata by combined ion-exchange and gel permeation chromatography. The structures of these polysaccharides were characterized by high-performance gel permeation chromatography, chemical derivative analysis, GC-MS, FT-IR spectroscopy, and NMR spectroscopy. Results showed that SDNP-1 and SDNP-2 were composed of arabinose and galactose with molar ratio of approximately 1:1. The polysaccharides were deduced to be AGII-type arabinogalactans with distinct molecular weights and backbone chains. The backbone chain of SDNP-2 mainly consisted of (1→3)-linked and (1→6)-linked Galp residues with an approximate molar ratio of 1:3. Approximately half of the (1→6)-linked Galp residues were substituted at O-3, and small amounts of (1→6)-linked Galp were substituted at O-3 and O-4 by branches that mainly consisted of terminal and (1→5)-linked Araf residues. Bioactivity tests showed that SDNP-2 exhibited significant antagonistic effect against immunosuppression as shown by the cell viability of the culture supernatants of melanoma cells on RAW264.7 macrophages. However, SDNP-1 showed no effect. Thus, molecular weight and backbone chain may be the key factors for the antagonistic effects against immunosuppression.

Dong|Cai-Xia|CX| Liu|Liu|L| Wang|Chang-Ying|CY| Fu|Zheng|Z| Zhang|Ying|Y| Hou|Xuan|X| Peng|Chao|C| Ran|Rui-Xue|RX| Yao|Zhi|Z|

Structural characterization
Polysaccharide
Saposhnikovia divaricata
Antagonistic effect
Immunosuppression


Swine diets impact manure characteristics and gas emissions: Part I sulfur level.

Abstract: Sulfur is an essential nutrient for animal growth but is also associated with odor and morbidity of animals from swine operations. A study was conducted to determine the effects of increasing dietary S levels in swine diets on DM, pH, C, N, S, VFA, indole, and phenol concentrations in the manure, and on the emissions of C-, N-, and S-containing gases. A total of 24 gilts averaging 152 kg BW were fed diets containing 0.19, 0.30, 0.43, or 0.64% dietary S, as supplied by CaSO4, for 31 d, with an ADFI of 3.034 kg d-1. Feces and urine were collected after each feeding and added to manure storage containers. At the end of the study, manure slurries were monitored for gas emissions and chemical properties. Increasing dietary S lowered manure pH by 0.3 units and increased DM, N, and S by 10% for each 1.0 g S increase kg-1 feed intake. Increased dietary S increased NH3, sulfide, butanoic, and pentanoic acid concentrations in manure. Carbon and N emissions were not significantly impacted by dietary S, but S emissions in the form of hydrogen sulfide (H2S) increased by 8% for each 1.0 g S increase kg-1 feed intake. Odor increased by 2% for each 1.0 g increase of S consumed kg-1 feed intake. Phenolic compounds and H2S were the major odorants emitted from manure that increased with increasing dietary S.

Trabue|S L|SL|
Kerr|B J|BJ|
Scoggin|K D|KD|


Nutritional management of Crohn's disease.

Abstract: Nutritional care and therapy forms an integral part of the management of patients with Crohn's disease (CD). Nutritional deficiencies result from reduced oral intake, malabsorption, medication side effects and systemic inflammation due to active disease. Enteral nutrition has a role in support for the malnourished patient, as well as in primary therapy to induce and maintain remission. The use of parenteral nutrition in CD is mainly limited to the preoperative setting or for patients with intestinal failure, but does not offer any additional advantage over EN in disease control. Dietary modifications, including elimination-reintroduction diets and a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet may improve symptoms but there are currently no data to suggest that these approaches have any role in the induction or maintenance of remission.

Donnellan|Clare F|CF|
Yann|Lee H|LH|
Lal|Simon|S|

enteral nutrition
parenteral nutrition
intestinal failure
Crohn’s disease
micronutrient deficiency
protein energy malnutrition


Point-of-care heart-type fatty acid binding protein versus high-sensitivity troponin T testing in emergency patients at high risk for acute coronary syndrome.

Abstract:
BACKGROUND
High-sensitivity cardiac troponin testing is used to detect myocardial damage in patients with acute chest pain. Heart-type fatty acid binding protein (H-FABP) may be an alternative, available as point-of-care test.

METHODS
Patients (n=203) referred by general practitioners for suspected acute coronary syndrome or presenting with typical chest pain and one major cardiovascular risk factor at the emergency department were prospectively included in a single-centre cohort study. High-sensitivity cardiac troponin T (hs-TnT) and point-of-care H-FABP testing were concomitantly performed at admission and after 6h.

RESULTS
Maximal hs-TnT levels above the 99th percentile were observed in 152 patients (75%) with 127 (63%) fulfilling criteria for myocardial infarction. Upon admission, hs-TnT and H-FABP were associated with an area under the curve (95% CI) of 0.83 (0.77-0.89) and 0.79 (0.73-0.85), respectively, to predict myocardial infarction, which increased to 0.93 (0.90-0.97) and 0.88 (0.84-0.93), respectively, after 6h. The diagnostic accuracy for non-ST-segment elevation myocardial infarction was somewhat lower with an area under the curve (95% CI) of 0.80 (0.72-0.87), 0.90 (0.84-0.96), 0.73 (0.64-0.81) and 0.77 (0.67-0.86), respectively. When assessment was performed within 3h of chest pain onset, diagnostic accuracy of H-FABP versus hs-TnT was similar. Each standard deviation increase in admission H-FABP was associated with a 68% relative risk increase of all-cause mortality (p-value=0.027) during 666 ± 155 days of follow-up.

CONCLUSIONS
Point-of-care H-FABP testing has lower diagnostic accuracy compared with hs-TnT assessment in patients with high pre-test acute coronary syndrome probability, but might be of interest when assessment is possible early after chest pain onset.

Kellens|Sebastiaan|S|
Verbrugge|Frederik H|FH|
Vanmechelen|Maxime|M|
Grieten|Lars|L|
Van Lierde|Johan|J|
Dens|Joseph|J|
Vrolix|Mathias|M|
Vandervoort|Pieter|P|

D054058:Acute Coronary Syndrome
D000368:Aged
D019540:Area Under Curve
D015331:Cohort Studies
D042241:Early Diagnosis
D004636:Emergency Service, Hospital
D000074026:Fatty Acid Binding Protein 3
D050556:Fatty Acid-Binding Proteins
D005260:Female
D006801:Humans
D008297:Male
D008875:Middle Aged
D019095:Point-of-Care Systems
D012680:Sensitivity and Specificity
D020107:Troponin T

Acute coronary syndrome
myocardial infarction
FABP3 protein
prognosis


Surgery for chronic subdural hematoma in nonagenarians: A Scandinavian population-based multicenter study.

Abstract:
OBJECTIVE
Chronic subdural hematoma (cSDH) is a prevalent condition often seen in the elderly, with surgery being the treatment of choice when symptomatic. So far, few have explored the surgical outcomes in patients 90 years or older. The aim of this study was to investigate outcome after cSDH surgery in nonagenarians (≥90 y/o group) compared to younger adult patients (<90 y/o group).

MATERIALS
In a Scandinavian population-based cohort we conducted a retrospective review of 1,254 patients undergoing primary burr-hole procedures for cSDH between January 1, 2005 and December 31, 2010 at three neurosurgical centers. In a comparative analysis, the primary end-point was difference in hematoma recurrence rates between the ≥90 y/o and <90 y/o groups. The secondary end-points were differences in perioperative morbidity and mortality between groups.

RESULTS
75 patients were 90 years or older. There was no significant difference in recurrences resulting in reoperation between the age groups (10.7% vs 13.6%, P=.47). There was also no significant difference in overall complication rate (4.1% vs 8.1%, P=.21) or severe complications (1.4% vs 2.0%, P=.68). There were three (4.0%) perioperative deaths within 30 days in the ≥90 y/o group and 40 (3.4%) in the <90 y/o group (P=.78).

CONCLUSION
Patients 90 years or older had similar rates of recurrence, perioperative morbidity and perioperative mortality as compared to younger patients. Age alone should not be a contraindication for surgery in patients with cSDH.

surgery
chronic subdural hematoma
nonagenarians
outcome
old


Excellent Infrared Nonlinear Optical Crystals BaMO(IO₃)₅ (M = V, Ta) Predicted by First Principle Calculations.

Abstract: Two nonlinear optical crystals, BaVO(IO₃)₅ and BaTaO(IO₃)₅, are designed by substituting Nb with V and Ta, respectively, in BaNbO(IO₃)₅, which is itself a recently synthesized infrared nonlinear optical (NLO) material. The designs of BaVO(IO₃)₅ and BaTaO(IO₃)₅ from BaNbO(IO₃)₅ are based on the following motivation: BaVO(IO₃)₅ should have a larger second-harmonic generation (SHG) coefficient than BaNbO(IO₃)₅, as V will result in a stronger second-order Jahn-Teller effect than Nb due to its smaller ion radius; at the same time, BaTaO(IO₃)₅ should have a larger laser-damage threshold, due to the fact that Ta has a smaller electronegativity leading to a greater band-gap. Established on reliable first-principle calculations, it is demonstrated that BaVO(IO₃)₅ has a much larger SHG coefficient than BaNbO(IO₃)₅ (23.42 × 10-9 vs. 18.66 × 10-9 esu); and BaTaO(IO₃)₅ has a significantly greater band-gap than BaNbO(IO₃)₅ (4.20 vs. 3.55 eV). Meanwhile, the absorption spectra and birefringences of both BaVO(IO₃)₅ and BaTaO(IO₃)₅ are acceptable for practice, suggesting that these two crystals can both be expected to be excellent infrared NLO materials.

Li|Yingfeng|Y| Cui|Mengqi|M| Yan|Hejin|H| Yu|Yangxin|Y| Li|Meicheng|M|0000-0002-0731-741X Li|Xiang|X| Chu|Lihua|L| Jiang|Bing|B| Qin|Mingde|M|

SOJT
density functional theory
laser damage threshold
second harmonic generation