Organochlorine pesticides and female puberty in South Kazakhstan.

Abstract: The purpose of the study was to assess the puberty of females living in cotton-growing regions of South Kazakhstan, where organochlorine pesticides are widely used. The physical growth and sexual development were assessed; organochlorine pesticides, gonadotropic and steroid hormones, as well as insulin-like growth factor 1 in the peripheral blood were determined. 524 females (adolescents aged 10-17) were examined. They were divided into 2 groups, depending on their place of residence. The clinical research included the assessment of physical and sexual development. All examined females lived in rural areas, i.e. they were comparable in terms of social, welfare, and climatographic factors. A high concentration of organochlorine pesticides (lindane-18.51±0.16mg/l, dieldrin-169.16±3.13mg/l, DDT-177.78±2.71mg/l, endrin-37.57±0.9mg/l) in the blood of females living in regions exposed to pesticides compared to their peers (4.05±0.41mg/l, 30.8±3.7mg/l, 109.7±2.58mg/l, 4.85±0.69mg/l respectively) was found (p<0.001). The physical and sexual development of such females was delayed. The research established a correlation between the concentration of pesticides and the endocrine status, as well as with the insulin-like growth factor 1. This shows the adverse effect of organochlorine pesticides on the development of the female reproductive system during puberty.

Bapayeva|Gauri|G| Issayeva|Raushan|R| Zhumadilova|Akmaral|A| Nurkasimova|Raushan|R| Kulbayeva|Saltanat|S| Tleuzhan|Renata|R|

Pesticides
Puberty
Sexual development
Physical development
Reproductive health


EGFR mutation status of paired cerebrospinal fluid and plasma samples in EGFR mutant non-small cell lung cancer with leptomeningeal metastases.

Abstract:
PURPOSE
Central nervous system (CNS) is the prevalent site for metastases in epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI)-relapsed NSCLC patients. To understand the EGFR mutation status in paired cerebrospinal fluid (CSF) and plasma samples after EGFR-TKI treatment failure might be useful to guide the treatment of intra- and extracranial tumors in those patients.

METHODS
Paired CSF and plasma samples were collected from seven NSCLC patients with CNS metastases after EGFR-TKI failure. EGFR mutations were tested by amplification refractory mutation system (ARMS) and droplet digital PCR (ddPCR) methods. Gefitinib concentrations were evaluated by high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS).

RESULTS
EGFR mutations were detected in all seven CSF samples, including three of E19-Del, three of L858R and one of E19-Del&T790M by both methods. On the other hand, majority of the matched plasma samples (5/7) were negative for EGFR mutations by both methods. The other two plasma samples were positive for E19-Del&T790M by ddPCR, and one of them had undetectable T790M by ARMS. Gefitinib concentration in CSF was much lower than that in plasma (mean CSF/plasma ratio: 1.8 %).

CONCLUSIONS
After EGFR-TKI failure, majority of the NSCLC patients with CNS metastases remained positive detection of EGFR sensitive mutations in CSF, but much less detection in the matched plasma. Significantly low exposure of gefitinib in CSF might explain the intracranial protection of the EGFR sensitive mutation positive tumor cells.

Zhao|Jing|J| Ye|Xin|X| Xu|Yan|Y| Chen|Minjiang|M| Zhong|Wei|W| Sun|Yun|Y| Yang|Zhenfan|Z| Zhu|Guanshan|G| Gu|Yi|Y| Wang|Mengzhao|M|

Cerebrospinal fluid
Non-small cell lung cancer
Brain metastasis
EGFR mutation testing
Leptomeningeal metastasis


Quantification of plant surface metabolites by matrix-assisted laser desorption-ionization mass spectrometry imaging: glucosinolates on Arabidopsis thaliana leaves.

Abstract: The localization of metabolites on plant surfaces has been problematic because of the limitations of current methodologies. Attempts to localize glucosinolates, the sulfur-rich defense compounds of the order Brassicales, on leaf surfaces have given many contradictory results depending on the method employed. Here we developed a matrix-assisted laser desorption-ionization (MALDI) mass spectrometry protocol to detect surface glucosinolates on Arabidopsis thaliana leaves by applying the MALDI matrix through sublimation. Quantification was accomplished by spotting glucosinolate standards directly on the leaf surface. The A. thaliana leaf surface was found to contain approximately 15 nmol of total glucosinolate per leaf with about 50 pmol mm(-2) on abaxial (bottom) surfaces and 15-30 times less on adaxial (top) surfaces. Of the major compounds detected, 4-methylsulfinylbutylglucosinolate, indol-3-ylmethylglucosinolate, and 8-methylsulfinyloctylglucosinolate were also major components of the leaf interior, but the second most abundant glucosinolate on the surface, 4-methylthiobutylglucosinolate, was only a trace component of the interior. Distribution on the surface was relatively uniform in contrast to the interior, where glucosinolates were distributed more abundantly in the midrib and periphery than the rest of the leaf. These results were confirmed by two other mass spectrometry-based techniques, laser ablation electrospray ionization and liquid extraction surface analysis. The concentrations of glucosinolates on A. thaliana leaf surfaces were found to be sufficient to attract the specialist feeding lepidopterans Plutella xylostella and Pieris rapae for oviposition. The methods employed here should be easily applied to other plant species and metabolites.

Shroff|Rohit|R| Schramm|Katharina|K| Jeschke|Verena|V| Nemes|Peter|P| Vertes|Akos|A| Gershenzon|Jonathan|J| Svatoš|Aleš|A|

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

Arabidopsis thaliana
leaf surface
liquid extraction surface analysis
Plutella xylostella
Pieris rapae
MALDI imaging
abaxial surface
adaxial surface
insect oviposition
technical advance


Novel fluorescent staining protocol for thick sections of human osteochondral tissues to facilitate correlation with MRI and CT.

Abstract:
OBJECTIVE
To describe a novel fluorescent histochemical protocol to visualize osteoclasts, vasculature, and nerves in thick sections of human osteochondral tissues and to demonstrate its feasibility for use in radiologic-pathologic research correlation studies.

MATERIALS AND METHODS
Consecutive patients scheduled for total knee arthroplasty surgeries underwent pre-operative MRI. CT imaging was performed after tissue collection, and abnormal osteochondral regions were sectioned to 1-2 mm in thickness and decalcified. Fluorescent labeling of osteoclasts was performed by staining for tartrate-resistant alkaline phosphatase activity with a fluorescent substrate. Vascular structure was visualized with fluorescently labeled lectin Ulex europaeus Agglutinin I (UEA-I). Immunostaining was performed for proteins including smooth muscle actin expressed in smooth muscle cells surrounding arterioles and fibrotic myofibroblasts, as well as for neuropeptide Y expressed in sympathetic nerves. Sections were then recut at 5 μm and stained with hematoxylin and eosin (H&E).

RESULTS
Edema-like and cyst-like regions identified with MRI and CT were easily located in fluorescent images and appeared to have increased osteoclast activity. Fibrotic regions were identified with thickened arterioles and increased myofibroblasts. Sympathetic nerve fibers traveled alongside arborizing blood vessels. Stained sections became transparent in a water-based refractive index-matched medium, permitting deep 3D visualization of the elaborate neurovascular network in bone. Sequential staining procedures were successfully performed with the same sections, demonstrating the potential to compare multiple cellular markers from the same locations. Routine H&E staining could be performed after the fluorescent staining protocol.

CONCLUSION
We have developed a multimodal framework to facilitate comparisons between histology and clinical MRI and CT.

D006801:Humans
D008279:Magnetic Resonance Imaging
D013194:Staining and Labeling
D014057:Tomography, X-Ray Computed

Fluorescence
Immunohistochemistry
Microscopy
Osteoarthritis
Radiologic-pathologic correlation


Service user integration into social work education: lessons learned from nordic participatory action projects.

Abstract: Service users have lacked substantial influence, access, and participation in social work education in Norway and Sweden. In this article the author presents comparative analyses of two participatory projects that have developed and implemented practices that integrate service users into academic social work education and empower service users. The Norwegian HUSK project and the Social Work as Mobilization and Entrepreneurship course, also known as the "Mobilization course," at Lund University in Sweden demonstrate collaboration between research, social work education, and service users. The conclusions focus on the importance of the empowering processes by including recognition and dialogue, co-learning in practice, and the use of neutral venues to ensure effective user participation. The inclusion of service users in social work education can improve both practice and education.

social work education
Nordic
participatory
Service user participation
empowerment


Utilizing a Digital Multi-Language Patient Questionnaire for Diagnostic Imaging Examinations.

Abstract: In diagnostic imaging (DI) practice, patient questionnaires allow clinical staff to gather medical history information directly from patients. However, language barriers can prevent patients from completing the questionnaires and may endanger patient safety if the patient fails to indicate critical medical information. Interpreters are commonly employed to help patients convey important medical details; however, there are limits to their practical utilization. Thus, the purpose of this study was to evaluate the feasibility and practicality of a digital multi-language questionnaire designed to help overcome the language barriers between patients and clinical staff. The standard English-language questionnaire for bone mineral density (BMD) examinations was used in this study. It was translated into several languages and presented in an electronic form to patients in a language most suitable for them. The completed questionnaires, along with the patient responses, were automatically converted into English, allowing them to be reviewed by DI staff through a radiological information system (RIS) and picture archiving and communication system (PACS). Patients and clinical staff commented on the comfort of using the translated questionnaires. The modified Wald method was used to establish the confidence interval. The results showed that all patients and clinical staff were comfortable using the translated questionnaires. Ultimately, in this study we have developed a digital multi-language questionnaire for BMD examinations which can be converted into different languages and be stored in RIS and PACS. To the best of our knowledge, this approach had not been applied or tested elsewhere.

Maizlin|Nick N|NN|
Singh|Nina P|NP|
Somers|Sat|S|

Multi-language patient questionnaire
Diagnostic imaging


Persistent Müllerian Duct Syndrome: A Rare But Important Etiology of Inguinal Hernia and Cryptorchidism.

Abstract: Homozygous loss of function mutations in genes encoding anti-Müllerian hormone (AMH) or its receptor (AMHRII) lead to persistent Müllerian duct syndrome (PMDS). PMDS is characterized by the presence of a uterus, fallopian tubes, cervix, and upper vagina in fully virilised 46,XY males. Both surgical management and long-term follow-up of these patients are challenging. Four cases with PMDS presented with cryptorchidism and inguinal hernia, and laparoscopic inguinal exploration revealed Müllerian remnants. Three of the patients had homozygous mutations in the AMH gene, one with a novel c.1673G>A (p.Gly558Asp) mutation, and one patient had an AMHRII mutation. All patients underwent a single-stage laparotomy in which the fundus of the uterus was split along the midline to release testes and to avoid damaging the vas deferens or the deferential artery. Biopsy of Müllerian remnants did not reveal any malignancy. The cases presented here expand the clinical and molecular presentation of PMDS. Cryptorchidism and inguinal hernia in the presence of Müllerian structures in an appropriately virilised 46,XY individual should suggest PMDS. Long-term reproductive and endocrinological surveillance is necessary.

Bugrul|Fuat|F|
Abali|Zehra Yavas|ZY|
Kirkgoz|Tarik|T|
Cerit|Kivilcim K|KK|
Canmemis|Arzu|A|
Turan|Serap|S|
Tugtepe|Halil|H|
Picard|Jean-Yves|JY|
Bereket|Abdullah|A|
Guran|Tulay|T|

Persistent Müllerian duct
Inguinal hernia
Cryptorchidism
AMH
AMHRII


Recovery of circulating CD56dim NK cells and the balance of Th17/Treg after nucleoside analog therapy in patients with chronic hepatitis B and low levels of HBsAg.

Abstract:
BACKGROUND AND AIMS
Much evidence indicates that the soluble antigens secreted by hepatitis B virus (HBV) inhibit the function of the immune system. The aim of this study is to investigate, after treatment with nucleoside (acid) analogs (NAs) and the inhibition of viral replication, whether the immune systems of patients with a peripheral blood HBV-DNA level <1000 IU/mL, hepatitis B e antigen (HBeAg) disappearance, and a decrease in hepatitis B surface antigen (HBsAg) levels could be reconstructed.

METHODS
The frequency and phenotype of circulating natural killer (NK) cells, dendritic cells (DCs), T-helper (Th) cells, regulatory T (Treg) cells, CD4+, CD8+ T cells, T follicular helper (Tfh) cells and B cells subtypes were tested by flow cytometry in chronic hepatitis B (CHB) patients and healthy controls (HCs). The levels of HBV-related serum HBsAg, HBeAg, HBV-DNA load, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined.

RESULTS
Regarding the innate immune system, an increased frequency of CD56dim NK cells was found in the therapeutic response (TR) group compared with that in the immune-active phase (IA) group. Additionally, regarding the adaptive immune system, the Th17/CD4+CD25+CD127dimTreg ratio was reduced in the TR group. Additionally, the frequency of CD40L+CXCR5+CD4+T cells and CD40+CD19+CD27+CD38+B cells was significantly higher than that of HCs, while that of PDL1+CD19+ B cells was lower. Furthermore, the frequencies of CTLA4+CD4+T cells and CTLA4+CD8+T cells in patients with CHB were significantly higher than those in HCs.

CONCLUSION
After NA treatment and the inhibition of viral replication, circulating CD56dim NK cells and the balance of Th17/Treg can be recovered. Restoring circulating CD56dim NK cells and the Th17/Treg balance may help reduce HBsAg levels in patients.

Liu|Nianqiu|N| Liu|Bin|B| Zhang|Li|L| Li|Hu|H| Chen|Zhiwei|Z| Luo|Aoran|A| Chen|Min|M| Peng|Mingli|M| Yin|Wenwei|W| Ren|Hong|H| Hu|Peng|P|

D000328:Adult
D000998:Antiviral Agents
D019002:CD56 Antigen
D016022:Case-Control Studies
D004279:DNA, Viral
D005260:Female
D006147:Guanine
D006514:Hepatitis B Surface Antigens
D006513:Hepatitis B e Antigens
D006515:Hepatitis B virus
D019694:Hepatitis B, Chronic
D006801:Humans
D007694:Killer Cells, Natural
D008297:Male
D008875:Middle Aged
D012720:Severity of Illness Index
D050378:T-Lymphocytes, Regulatory
D058504:Th17 Cells
D016896:Treatment Outcome
D019562:Viral Load
D055815:Young Adult

Nucleoside analogs
Hepatitis B virus
Natural killer cells
Regulatory T cells
T-helper cells


Immune Checkpoint Molecules in Reproductive Immunology.

Abstract: Immune checkpoint molecules, like CTLA-4, TIM-3, PD-1, are negative regulators of immune responses to avoid immune injury. Checkpoint regulators are thought to actively participate in the immune defense of infections, prevention of autoimmunity, transplantation, and tumor immune evasion. Maternal-fetal immunotolerance represents a real immunological challenge for the immune system of the mother: beside acceptance of the semiallogeneic fetus, the maternal immune system has to be prepared for immune defense mostly against infections. In this particular situation, the role of immune checkpoint molecules could be of special interest. In this review, we describe current knowledge on the role of immune checkpoint molecules in reproductive immunology.

Miko|Eva|E| Meggyes|Matyas|M| Doba|Katalin|K| Barakonyi|Aliz|A| Szereday|Laszlo|L|


An Improved Calibration Technique for MEMS Accelerometer-Based Inclinometers.

Abstract: Micro-electro-mechanical system (MEMS) accelerometer-based inclinometers are widelyused to measure deformations of civil structures. To further improve the measurement accuracy, anew calibration technique was proposed in this paper. First, a single-parameter calibration modelwas constructed to obtain accurate angles. Then, an image-processing-based method was designedto obtain the key parameter for the calibration model. An ADXL355 accelerometer-basedinclinometer was calibrated to evaluate the feasibility of the technique. In this validationexperiment, the technique was proven to be reliable and robust. Finally, to evaluate theperformance of the technique, the calibrated MEMS inclinometer was used to measure thedeflections of a scale beam model. The experimental results demonstrate that the proposedtechnique can yield accurate deformation measurements for MEMS inclinometers.&nbsp.

Zhu|Jiaxin|J| Wang|Weifeng|W| Huang|Shiping|S| Ding|Wei|W|


Microneedle-based devices for point-of-care infectious disease diagnostics.

Abstract: Recent infectious disease outbreaks, such as COVID-19 and Ebola, have highlighted the need for rapid and accurate diagnosis to initiate treatment and curb transmission. Successful diagnostic strategies critically depend on the efficiency of biological sampling and timely analysis. However, current diagnostic techniques are invasive/intrusive and present a severe bottleneck by requiring specialist equipment and trained personnel. Moreover, centralised test facilities are poorly accessible and the requirement to travel may increase disease transmission. Self-administrable, point-of-care (PoC) microneedle diagnostic devices could provide a viable solution to these problems. These miniature needle arrays can detect biomarkers in/from the skin in a minimally invasive manner to provide (near-) real-time diagnosis. Few microneedle devices have been developed specifically for infectious disease diagnosis, though similar technologies are well established in other fields and generally adaptable for infectious disease diagnosis. These include microneedles for biofluid extraction, microneedle sensors and analyte-capturing microneedles, or combinations thereof. Analyte sampling/detection from both blood and dermal interstitial fluid is possible. These technologies are in their early stages of development for infectious disease diagnostics, and there is a vast scope for further development. In this review, we discuss the utility and future outlook of these microneedle technologies in infectious disease diagnosis.

Dixon|Rachael V|RV|
Skaria|Eldhose|E|
Lau|Wing Man|WM|
Manning|Philip|P|
Birch-Machin|Mark A|MA|
Moghimi|S Moein|SM|
Ng|Keng Wooi|KW|

ASSURED, affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free and deliverable to end-users

CMOS, complementary metal-oxide semiconductor

ELISA, enzyme-linked immunosorbent assay

HPLC, high performance liquid chromatography

OBMT, one-touch-activated blood multidiagnostic tool

SERS, surface-enhanced Raman spectroscopy

VEGF, vascular endothelial growth factor

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


Prevalence of talon cusp: Systematic literature review, meta-analysis and new scoring system.

Abstract:
OBJECTIVES
Talon cusp is a developmental anomaly consisting of a vertical ridge or cusp projecting labially or lingually from an anterior permanent or primary tooth. A range of prevalence between 0.06 % and 40.8 % has been reported in the literature. Although many epidemiological studies have been conducted, no synthesis of these data has been performed to date. The aim of this paper was to determine the prevalence of talon cusp and to investigate the link between sex and talon cusp.

SOURCE
A systematic search was undertaken using the PubMed/Medline, Embase and Cochrane Library electronic databases for publications from 1981 to 2020 investigating the prevalence of talon cusp and the link between talon cusp and sex.

STUDY SELECTION
Three reviewers selected the studies independently, extracted the data in accordance with the PRISMA statement, and assessed the risk of bias via the GRADE & Cochrane approaches.

RESULTS
From 39 potentially eligible studies, 9 were selected for full text analysis and 8 were included in the meta-analysis, representing 35,224 participants. The meta-analyses were performed with a random model, calculating a weighted-mean prevalence (at least one talon cusp per individual) of 1.67 %. Sex and talon cusp were not statistically significantly associated in our study (OR = 1.10; 95 % CI [0.82-1.47]; p > 0.05).

DISCUSSION
We report the first prevalence of talon cusp provided by meta-analysis in a non-syndromic sample. A non-statistically significant association between sex and talon cusp is relevant in terms of genetic etiology. In order to improve the homogeneity and accuracy of the results of further studies, we propose a new universal scoring system for talon cusp.

CLINICAL SIGNIFICANCE
Talon cusp is a developmental anomaly with various clinical implications. Therapeutics may vary from simple monitoring to extraction of the supporting tooth. This condition occurs in approximately 1.67 % of the population.

Prevalence
Talon cusp
Developmental anomaly
Classification
Systematic review


Structure-Activity Relationship Study on Col-003, a Protein-Protein Interaction Inhibitor between Collagen and Hsp47.

Abstract: This study demonstrates the structure-activity relationship of Col-003, a potent collagen-heat-shock protein 47 (Hsp47) interaction inhibitor. Col-003 analogues were successfully synthesized by Pd(0)-catalyzed cross-coupling reactions of 5-bromosalicylaldehyde derivatives with alkyl-metal species, and the inhibitory activities of the synthetic analogues were evaluated using surface plasmon resonance analysis (BIAcore). We succeeded in discovering two potent inhibitors that showed 85 and 81% inhibition at a concentration of 1.9 µM against the collagen-Hsp47 interaction. This indicates that elongation of an alkyl linker between two aromatic rings could considerably improve inhibitory activity due to the adjustment of a pendant phenyl moiety to an appropriate position, in addition to the hydrophobic interaction with an alkyl linker moiety.

Yoshida|Masahito|M| Saito|Masazumi|M| Ito|Shinya|S| Ogawa|Koji|K| Goshima|Naoki|N| Nagata|Kazuhiro|K| Doi|Takayuki|T|

collagen
heat-shock protein 47
protein–protein interaction
small-molecule inhibitor


CTGF: A potential therapeutic target for Bronchopulmonary dysplasia.

Abstract: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that often occurs in preterm infants. However, there is still no effective treatment for BPD. Recent studies demonstrated that connective tissue growth factor (CTGF) is involved in the development of BPD in experimental models. CTGF, also known as CCN2, is the second member of the CCN family and is necessary for normal lung development. The expression of CTGF is increased in lung tissues in infants with BPD. Hyperoxia, inflammation and mechanic ventilation increase CTGF expression which may promote fibroblast proliferation, matrix production and vascular remodeling. Conditional overexpression of CTGF in alveolar epithelial type II cells disrupts alveolarization and vascular development, induces vascular remodeling, and results in pulmonary hypertension, the pathological hallmarks of severe BPD. Further studies have shown that inhibition of CTGF by a CTGF monoclonal antibody improved alveolarization and vascular development, and decreased pulmonary vascular remodeling and pulmonary hypertension in a rodent model of BPD induced by hyperoxia. CTGF may be a novel target for BPD therapy in preterm infants.

Bronchopulmonary dysplasia
Connective tissue growth factor
Therapy


Risk factors predisposing to cardia gastric adenocarcinoma: Insights and new perspectives.

Abstract: Recent decades have seen an alarming increase in the incidence of cardia gastric adenocarcinoma (CGA) while noncardia gastric adenocarcinoma (NCGA) has decreased. In 2012, 260 000 CGA cases (age-standardised rate (ASR); 3.3/100 000) and 691 000 NCGA cases (ASR; 8.8/100 000) were reported worldwide. Compared with women, men had greater rates for both the subsites, especially for CGA. Recently, four molecular subtypes of GC have been proposed by the Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG); however, these classifications do not take into account predisposing germline variants and their possible interaction with somatic alterations in carcinogenesis. The etiology of adenocarcinoma of the cardia and the gastroesophageal junction (GEJ) is not known. It is thought that CGA is distinct from adenocarcinomas located in the esophagus or distal stomach, both epidemiologically and biologically. Moreover, CGA is often identified in the advanced stage having a poor prognosis. Therefore, understanding the risk and the role of predisposing factors in etiology of CGA can inform clinical practice and counseling for risk reduction. In this paper, we showed that GC family history, lifestyle, demographics, gastroesophageal reflux disease, Helicobacter pylori infection, and multiple genetic and epigenetic risk factors as well as several predisposing conditions may underlie susceptibility to CGA. However, several genome-wide association studies (GWASs) should be conducted to identify novel high-penetrance genes and pathways as well as causal germline variants predisposing to CGA. They must include different ethnic groups, especially from high-incidence countries for CGA, because some risk loci are ancestry-specific. In parallel, statistical methods can be developed to identify cancer predisposition genes (CPGs) from tumor sequencing data. It is also necessary to find novel long noncoding RNAs related to the risk of CGA. Taken altogether, new cancer risk prediction models, including all genetic and nongenetic factors influencing risk, should be developed to facilitate risk assessment, disease prevention, and early diagnosis and intervention of CGA in the future.

D020022:Genetic Predisposition to Disease

cardia gastric adenocarcinoma
Helicobacter pylori
risk biomarkers


Influence of storage condition on properties of MCC II-based pellets with theophylline-monohydrate.

Abstract: Microcrystalline cellulose II (MCC II(1)) is a polymorph of commonly used MCC I; in 2010 it was introduced as new pelletization aid in wet-extrusion/spheronization leading to fast disintegrating pellets. Previous investigations suggested that the storage of the resulting pellets affect the disintegration behavior, the non-hygroscopic substance chloramphenicol that showed no polymorphism or hydrate formation due to relative humidity was used for the investigations. Therefore, theophylline-monohydrate that can dehydrate during storage, but also during manufacturing and drying was used for this study to confirm the results of the previous study and give a more detailed overview of the influence of recrystallization of theophylline monohydrate on disintegration. Storage recommendations should be derived. MCC II-based pellets were prepared of binary mixtures containing 10%, 20% or 50% MCCII as pelletization aid and theophylline-monohydrate as API. These pellets were stored at different relative humidity (0-97%rH; 20°C); the influence on their disintegration and drug release was investigated. The storage conditions had an impact on pellet disintegration. Low relative humidities (⩽ 40%rH) led to a conversion of the monohydrate to the anhydrous form. Newly grown crystals formed a kind of network around the pellet and inhibited the disintegration. High relative humidity (>80%rh) affected the disintegration caused by changes in the MCCII as already seen in the previous study. Due to the changed disintegration behavior also the drug release and release kinetic changed. Therefore, for theophylline containing pellets a storage humidity of 55%rH to 80%rH (20°C) is recommended. All in all, these investigations substantiate the knowledge of MCCII-based pellets providing a better basis for adequate storage conditions of MCCII based pellets.

Storage condition
MCC
Pellet
Theophylline-monohydrate
Spheronization
Disintegration
Relative humidity
Extrusion


Wet deposition of acidifying substances in different regions of China and the rest of East Asia: modeling with updated NAQPMS.

Abstract: The traditional way to study Sources-Receptor Relationships (SRRs) of wet deposition is based on sensitivity simulation, which has weakness in dealing with the non-linear secondary formation pollutants (e.g. ozone and nitrate). An on-line source tracking method has been developed in the Nested Air Quality Prediction Modeling System (NAQPMS) coupled with cloud-process module for the first time. The new model can not only quantify the total volume of the sulfate, nitrate and ammonium wet deposition with more accuracy, but also trace these acidic species to their emitted precursors. Compared with previous studies, our result clearly shows: (1) East China and Central China, which are the two primary export regions, have 15-30% and 10% effect on wet deposition in other areas, respectively; (2) Besides the above two regions, the total acid deposition in Southwestern and Northeastern China have reached or exceeded the critical loads under their own environmental conditions.

Ge|B Z|BZ|
Wang|Z F|ZF|
Xu|X B|XB|
Wu|J B|JB|
Yu|X L|XL|
Li|J|J|

Wet deposition
Acidity substances
Long-range transport
Model simulation
Source–receptor relationships


Synthesis, anticonvulsant and neurotoxicity evaluation of some new pyrimidine-5-carbonitrile derivatives.

Abstract: A series of 2-[2-(substituted benzylidene) hydrazinyl]-4-(4-methoxyphenyl)-6-oxo-1,6-dihydro-pyrimidine-5-carbonitrile (3-16) were synthesized by refluxing 2-hydrazino-4-(4-methoxy-phenyl)-6-oxo-1,6-dihydro-pyrimidine-5-carbonitrile (2) with different substituted aromatic aldehydes in glacial acetic acid and absolute alcohol mixture (8:2). The compounds were evaluated for their anticonvulsant and neurotoxicity effect. In MES test compounds 2-[2-(4-bromo-benzylidene)-hydrazinyl]-4-(4-methoxyphenyl)-6-oxo-1,6-dihydro-pyrimidine-5-carbonitrile (5), 2-[2-(4-hydroxy-benzylidene)-hydrazinyl]-4-(4-methoxyphenyl)-6-oxo-1,6-dihydro-pyrimidine-5-carbonitrile (9), and 2-[2-(3-fluoro-benzylidene)-hydrazinyl]-4-(4-methoxyphenyl)-6-oxo-1,6-dihydro-pyrimidine-5-carbonitrile (16) were found to be highly active at a dose level of 30 mgkg(-1) at 0.5 h time interval, indicating their ability to prevent seizure spread at a relatively low dose.

Shaquiquzzaman|Mohammad|M|
Khan|Suroor Ahmad|SA|
Amir|Mohammad|M|
Alam|Mohammad Mumtaz|MM|

Neurotoxicity
Anticonvulsant activity
Cyanopyrimidine
Lipophilicity
Schiff’s base


An epidemic of coxsackievirus B3 infection in infants and children in Jiangsu Province, China: a prospective cohort study.

Abstract: To investigate the epidemiological data on coxsackievirus B3 (CVB3) infection and its incidence in infants and children, a prospective cohort study was carried out from 2012 to 2014 in Jiangsu Province, China. According to the results of seropositive rates and NTAb titers of CVB3, an epidemic of CVB3 infection was found, and a dynamic change in CVB3 neutralizing antibody was also observed. One case was recorded with CVB3-associated hand, foot and mouth disease (HFMD), and the isolates belonged to the CVB3 D2 subtype. Our data help us to better understand the epidemic characteristics of CVB3 infection in infants and children.

Gao|Fan|F| Bian|Lian-Lian|LL| Mao|Qun-Ying|QY| Chen|Pan|P| Yao|Xin|X| Li|Jing-Xin|JX| Zhu|Feng-Cai|FC| Liang|Zheng-Lun|ZL|

Coxsackievirus B3
Prospective cohort study
Hand, foot and mouth disease


The frequency and influence of dementia risk factors in prodromal Alzheimer's disease.

Abstract: We investigated whether dementia risk factors were associated with prodromal Alzheimer's disease (AD) according to the International Working Group-2 and National Institute of Aging-Alzheimer's Association criteria, and with cognitive decline. A total of 1394 subjects with mild cognitive impairment from 14 different studies were classified according to these research criteria, based on cognitive performance and biomarkers. We compared the frequency of 10 risk factors between the subgroups, and used Cox-regression to examine the effect of risk factors on cognitive decline. Depression, obesity, and hypercholesterolemia occurred more often in individuals with low-AD-likelihood, compared with those with a high-AD-likelihood. Only alcohol use increased the risk of cognitive decline, regardless of AD pathology. These results suggest that traditional risk factors for AD are not associated with prodromal AD or with progression to dementia, among subjects with mild cognitive impairment. Future studies should validate these findings and determine whether risk factors might be of influence at an earlier stage (i.e., preclinical) of AD.

Bos|Isabelle|I|
Vos|Stephanie J|SJ|
Frölich|Lutz|L|
Kornhuber|Johannes|J|
Wiltfang|Jens|J|
Maier|Wolfgang|W|
Peters|Oliver|O|
Rüther|Eckhart|E|
Engelborghs|Sebastiaan|S|
Niemantsverdriet|Ellis|E|
De Roeck|Ellen Elisa|EE|
Tsolaki|Magda|M|
Freund-Levi|Yvonne|Y|
Johannsen|Peter|P|
Vandenberghe|Rik|R|
Lleó|Alberto|A|
Alcolea|Daniel|D|
Frisoni|Giovanni B|GB|
Galluzzi|Samantha|S|
Nobili|Flavio|F|
Morbelli|Silvia|S|
Drzezga|Alexander|A|
Didic|Mira|M|
van Berckel|Bart N|BN|
Salmon|Eric|E|
Bastin|Christine|C|
Dauby|Solene|S|
Santana|Isabel|I|
Baldeiras|Inês|I|
de Mendonça|Alexandre|A|
Silva|Dina|D|
Wallin|Anders|A|
Nordlund|Arto|A|
Coloma|Preciosa M|PM|
Wientzek|Angelika|A|
Alexander|Myriam|M|
Novak|Gerald P|GP|
Gordon|Mark Forrest|MF|
|||
Wallin|Åsa K|ÅK|
Hampel|Harald|H|
Soininen|Hilkka|H|
Herukka|Sanna-Kaisa|SK|
Scheltens|Philip|P|
Verhey|Frans R|FR|
Visser|Pieter Jelle|PJ|

Risk factors
Alzheimer's disease
Biomarkers
IWG-2 criteria
NIA-AA criteria
Prognosis


Application of metabolomics in autoimmune diseases: insight into biomarkers and pathology.

Abstract: Metabolomics has recently become a new technology using mass spectrometry (MS) and high-resolution proton nuclear magnetic resonance (NMR) to access metabolite profiles in biofluids or tissue extracts for the detection of biomarker molecules and biochemical effects induced by a disease or its therapeutic intervention. This review outlines recent advances in the use of metabolomic techniques to study autoimmune diseases (ADs), including multiple sclerosis (MS), rheumatoid arthritis (RA), inflammatory bowel diseases (IBD), autoimmune diabetes et al. Many studies have demonstrated that AD patients including subtypes of some diseases, and healthy individuals can be distinguished using metabolic profiling accompanied with well-established data analysis tools including principal component analysis (PCA) and partial least squares (PLS). These metabolites not only affect glucose, amino acid and lipid metabolism, but also involve alteration of neurotransmitters, nucleotides, immune responses and anti-inflammatory responses. Knowledge of unique metabolomic fingerprint in ADs could be useful for diagnosis, treatment, and detection mechanisms of diseases.

Kang|Jian|J| Zhu|Ling|L| Lu|Jingli|J| Zhang|Xiaojian|X|

Metabolomics
Autoimmune diseases
Biomarkers
Mass spectrometry
Nuclear magnetic resonance


Unusual case of bilateral hand weakness.

Abstract: A 35-year-old man presented with myalgia and bilateral hand weakness, 3 days after the onset of lethargy, fevers and rigours. The hand weakness caused functional impairment including difficulty pressing keys on his mobile phone. On examination, there was mild bilateral hand weakness with normal reflexes. His serum creatine kinase was mildly raised at 503 U/L (24-195), viral PCR throat swab was negative and electromyogram showed subtle myopathic changes in the distal forearm muscles. Nerve conduction studies found no evidence of neuropathy. Forced vital capacity was reduced on admission (1.5 L) but improved within 24 hours (2.3 L). We gave supportive intravenous fluids and his weakness improved within 48 hours. He was discharged and reported that the weakness had fully resolved within weeks. The diagnosis was viral myositis. Distal forearm myositis rarely follows H1N1 influenza in adults but is an important differential for postinfective neurological symptoms.

viral myositis
Influenza
guillain-barre syndrome
neurophysiology


Long-term sequelae treatment of peripheral facial paralysis with botulinum toxin type A: Repartition and kinetics of doses used.

Abstract:
STUDY OBJECTIVES
Botulinum toxin is a key therapeutic tool in the comprehensive treatment of peripheral facial paralysis. It fights spasms, synkinesis and overactivity of the different skin muscles responsible of facial expressions. Even though injection techniques as well as target muscles have been well identified, doses used remain quite imprecise and often not detailed muscle by muscle, further more dosage progression has not been monitored over time. Our retrospective study is the first one to refine the repartition of botulinum toxin doses on each of the relevant skin muscles and assess dosage kinetics.

PATIENTS AND METHODS
Thirty patients were included since 2008 with a mean follow-up of 2.3years. Each patient had at least 3 injections, with a delay of 4 to 6months between each injection.

RESULTS
Mean doses are indicated for each muscle injected on the paralyzed and healthy sides. Dose kinetics suggests an initial dosage increase after the first injection followed by a decrease over time. No treatment resistance was observed.

CONCLUSION
Our study represents a didactic help in using botulinum toxin for sequelae of peripheral facial paralysis by providing more details on the effective mean doses for each muscle and their progression over time.

Risoud|M|M| Aljudaibi|N|N| Duquennoy-Martinot|V|V| Guerreschi|P|P|

Botulinum toxin
Kinetics
Dosage
Cinétique
Facial palsy
Paralysie faciale
Posologies
Toxine botulique


Burnout in pediatric residents over a 2-year period: a longitudinal study.

Abstract:
OBJECTIVE
Burnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA). We hypothesized that the transition into an environment of high physical, intellectual, and emotional demands of the medical profession would lead to an increase in the prevalence of burnout in pediatric residents, which would remain high throughout residency.

METHODS
The Maslach Burnout Inventory (MBI) was administered to pediatric residents at Lucile Packard Children's Hospital 6 times between February 2010 and February 2012. These times corresponded to the start of residency, mid-intern year, end-intern year, mid-junior year, end-junior year, and mid-senior year.

RESULTS
Mean values of burnout components changed significantly between the start of residency and mid-intern year. EE increased from 15.8 to 24.5 (P < .001), DP increased from 4.5 to 9.2 (P < .001), and PA decreased from 40.2 to 38.3 (P = .04). Similarly, the prevalence of burnout increased from 17% to 46% (P = .012), or 2% to 24% (P = .002) using more restrictive criteria, between the start of residency and mid-intern year. Significant changes in mean scores or prevalence of burnout were not found between any other consecutive times throughout residency.

CONCLUSIONS
This longitudinal study documented a significant increase in the components of burnout among pediatric residents between the start of residency and mid-intern year, which persisted through the PGY2 and PGY3 years. Further studies are warranted to identify correlates of resident burnout and to develop preventative strategies to reduce its occurrence.

Pantaleoni|Julie L|JL|
Augustine|Erin M|EM|
Sourkes|Barbara M|BM|
Bachrach|Laura K|LK|

burnout
pediatric residency
longitudinal


Antibiotic Use Prior to Hospital Presentation Among Individuals With Suspected Enteric Fever in Nepal, Bangladesh, and Pakistan.

Abstract:
BACKGROUND
Antibiotic use prior to seeking care at a hospital may reduce the sensitivity of blood culture for enteric fever, with implications for both clinical care and surveillance. The Surveillance for Enteric Fever in Asia Project (SEAP) is a prospective study of enteric fever incidence in Nepal, Bangladesh, and Pakistan. Nested within SEAP, we evaluated the accuracy of self-reported antibiotic use and investigated the association between antibiotic use and blood culture positivity.

METHODS
Between November 2016 and April 2019, we collected urine samples among a subset of SEAP participants to test for antibiotic use prior to the hospital visit using an antibacterial activity assay. All participants were asked about recent antibiotic use and had a blood culture performed. We used mixed-effect logit models to evaluate the effect of antimicrobial use on blood culture positivity, adjusted for markers of disease severity.

RESULTS
We enrolled 2939 patients with suspected enteric fever. Antibiotics were detected in 39% (1145/2939) of urine samples. The correlation between measured and reported antibiotic use was modest (κ = 0.72). After adjusting for disease severity, patients with antibiotics in their urine were slightly more likely to be blood culture positive for enteric fever; however, the effect was not statistically significant (prevalence ratio, 1.22 [95% confidence interval, .99-1.50]).

CONCLUSIONS
The reliability of self-reported prior antibiotic use was modest among individuals presenting with fever to tertiary hospitals. While antibiotics are likely to reduce the sensitivity of blood culture, our findings indicate that there is still considerable value in performing blood culture for individuals reporting antibiotic use.

Vaidya|Krista|K|
Aiemjoy|Kristen|K|
Qamar|Farah N|FN|
Saha|Samir K|SK|
Tamrakar|Dipesh|D|
Naga|Shiva R|SR|
Saha|Shampa|S|
Hemlock|Caitlin|C|
Longley|Ashley T|AT|
Date|Kashmira|K|
Bogoch|Isaac I|II|
Garrett|Denise O|DO|
Luby|Stephen P|SP|
Andrews|Jason R|JR|

enteric fever
blood culture
antimicrobial resistance
typhoid


Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009-2010.

Abstract: The possible association between low skeletal muscle mass and cardiovascular disease (CVD) risk factors necessitates estimation of muscle mass even in subjects with normal body mass index (BMI). This study was aimed to investigate optimal cutoffs for skeletal muscle mass reflecting CVD risk factors and to evaluate the relationship between skeletal muscle mass and CVD risk factors in the general population and in subjects with normal BMI using these cutoffs. This cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey 2009-2010. We enrolled 5120 men and 6559 women aged ≥20 years. Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass measured by dual-energy X-ray absorptiometry. Using receiver operating characteristic curve analyses, SMI cutoffs associated with CVD risk factors were determined. Lower SMI was significantly associated with an increased prevalence of CVD risk factors. The first cutoffs in men and women were 32 and 25%, respectively, and the second cutoffs were 30 and 23.5%. Subjects in stage I and stage II SMI categories showed increased prevalence and risk for several CVD risk factors. These tendencies persisted in the association between cardiometabolic characteristics and SMI even in subjects with normal BMI. Using cutoffs of low skeletal muscle mass reflecting CVD risk factors, lower skeletal muscle mass was associated with increased prevalence and risk of several CVD risk factors. A higher prevalence of cardiometabolic abnormalities was observed among subjects with normal BMI but low skeletal muscle mass.

Kim|Yirang|Y|
Han|Byoung-Duck|BD|
Han|Kyungdo|K|
Shin|Koh Eun|KE|
Lee|Halla|H|
Kim|Tae Ri|TR|
Cho|Kyung Hwan|KH|
Kim|Do Hoon|DH|
Kim|Yang Hyun|YH|
Kim|Hyunjin|H|
Nam|Ga Eun|GE|

Skeletal muscle mass
Cardiovascular disease
Skeletal muscle index
Duel energy X-ray absorptiometry
Sarcopenia


Mesenchymal Stem Cells for Spinal Cord Injury: Current Options, Limitations, and Future of Cell Therapy

Abstract: Spinal cord injury (SCI) constitutes an inestimable public health issue. The most crucial phase in the pathophysiological process of SCI concerns the well-known secondary injury, which is the uncontrolled and destructive cascade occurring later with aberrant molecular signaling, inflammation, vascular changes, and secondary cellular dysfunctions. The use of mesenchymal stem cells (MSCs) represents one of the most important and promising tested strategies. Their appeal, among the other sources and types of stem cells, increased because of their ease of isolation/preservation and their properties. Nevertheless, encouraging promise from preclinical studies was followed by weak and conflicting results in clinical trials. In this review, the therapeutic role of MSCs is discussed, together with their properties, application, limitations, and future perspectives.

Cofano|Fabio|F| Boido|Marina|M|0000-0003-1211-1552 Monticelli|Matteo|M| Zenga|Francesco|F| Ducati|Alessandro|A| Vercelli|Alessandro|A| Garbossa|Diego|D|

D036101:Cord Blood Stem Cell Transplantation

D045164:Mesenchymal Stem Cell Transplantation

mesenchymal stem cells
spinal cord injury
regenerative medicine
translational medicine


Clinical trial participation as part of end-of-life cancer care: associations with medical care and quality of life near death.

Abstract:
CONTEXT
Clinical trials are a common therapeutic option for patients with advanced incurable cancer.

OBJECTIVES
To examine the associations between trial participation and end-of-life (EOL) outcomes, including aggressive care and quality of life (QOL).

METHODS
Coping with Cancer, a multicenter prospective cohort study of patients with metastatic cancer, progressed after at least first-line chemotherapy. Baseline chart review documented clinical trial participation. Baseline interviews assessed psychosocial characteristics and EOL preferences. Caregiver interview and chart review assessed medical care and QOL near death. The primary outcome was aggressive EOL care (ventilation, resuscitation, or intensive care unit admission in last week of life). Propensity score weighting balanced patient characteristics that differed by trial participation, including care preferences and EOL discussion. Propensity score-weighted regression models estimated the effect of trial participation on outcomes.

RESULTS
Of 352 patients followed to death, 37 were enrolled in a clinical trial at baseline. In propensity score-weighted analyses, trial participation was significantly associated with aggressive EOL care (21.6% vs. 12.0%, adjusted odds ratio [AOR] 2.04, 95% confidence interval [CI] 1.00-4.15), late hospice enrollment (51.4% vs. 42.2%, AOR 1.96, 95% CI 1.10-3.50), hospital death (48.6% vs. 25.7%, AOR 2.74, 95% CI 1.37-5.47), intensive care unit death (16.2% vs. 6.3%, AOR 3.53, 95% CI 1.29-9.65), and inferior QOL near death (least squares mean 5.93 vs. 7.69, P<0.001). Controlling for EOL care, trial enrollment was no longer associated with QOL near death (P=0.342).

CONCLUSION
Clinical trial participation is associated with aggressive EOL care. Aggressive EOL care appears to explain the association between trial participation and QOL near death.

Enzinger|Andrea C|AC|
Zhang|Baohui|B|
Weeks|Jane C|JC|
Prigerson|Holly G|HG|

D032722:Advance Care Planning
D017028:Caregivers
D002986:Clinical Trials as Topic
D003422:Critical Care
D005260:Female
D017051:Hospice Care
D006801:Humans
D007407:Interviews as Topic
D008297:Male
D008875:Middle Aged
D009369:Neoplasms
D057240:Patient Preference
D011446:Prospective Studies
D011788:Quality of Life
D012044:Regression Analysis
D013727:Terminal Care

clinical trials
cancer
Palliative care
end-of-life care


Imaging of Small Airways Diseases.

Abstract: Small airways disease, or bronchiolitis, encompasses many conditions that result in bronchiolar inflammation and/or fibrosis. Bronchioles are distal airways within secondary pulmonary lobules that are only visible on imaging when abnormal. High-resolution computed tomography plays an important role in diagnosing small airways disease. The predominant direct high-resolution computed tomography sign of bronchiolitis includes centrilobular nodules, whereas air trapping is the main indirect finding. This article reviews bronchiolar anatomy, discusses the differential diagnosis for cellular and constrictive bronchiolitis with a focus on key imaging features, and discusses how to distinguish important mimics.

Berniker|Abigail V|AV|
Henry|Travis S|TS|

Small airways diseases
Bronchiolitis
High-resolution computed tomography
Centrilobular nodules
Air trapping
Constrictive bronchiolitis
Tree-in-bud


Turkish inappropriate medication use in the elderly (TIME) criteria to improve prescribing in older adults: TIME-to-STOP/TIME-to-START.

Abstract:
PURPOSE
To improve prescribing in older adults, criterion sets have been introduced from different countries. While current criterion sets are useful to some extent, they do not meet the need in some European countries. Turkish inappropriate medication use in the elderly (TIME) criteria was planned to meet this need.

METHODS
In phase 1, the user friendly sets: STOPP/START version2 and CRIME criteria were combined. National experts composed of geriatricians and non-geriatricians were invited to review and comment. In phase 2, thorough literature review was performed and reference-based revisions, omissions, and additions were made. Explanatory additions were added to some criteria to improve application in practice. In phase 3, all working group members reviewed the criteria/explanations and agreed on the final content.

RESULTS
Phase 1 was performed by 49 expert academicians between May and October 2016. Phase 2 was performed by 23 working group academicians between October 2016 and November 2018 and included face-to-face interviews between at least two geriatrician members and one criterion-related specialist. Phase 3 was completed between November 2018-March 2019 with review and approval of all criteria by working group academicians. As a result, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified from the first draft. A total of 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced.

CONCLUSION
TIME criteria is an update screening tool that differs from the current useful tools by the interactive study of experts from geriatrics and non-geriatrics, inclusion of practical explanations for some criteria and by its eastern European origin. TIME study respectfully acknowledges its roots from STOPP/START and CRIME criteria. Studies are needed whether it would lead improvements in older adults' health.

D000067561:Potentially Inappropriate Medication List

Inappropriate medication use
Elderly
Prescribing
TIME criteria
Screening
Polypharmacy


Equating spatial summation in visual field testing reveals greater loss in optic nerve disease.

Abstract:
PURPOSE
To test the hypothesis that visual field assessment in ocular disease measured with target stimuli within or close to complete spatial summation results in larger threshold elevation compared to when measured with the standard Goldmann III target size. The hypothesis predicts a greater loss will be identified in ocular disease. Additionally, we sought to develop a theoretical framework that would allow comparisons of thresholds with disease progression when using different Goldmann targets.

METHODS
The Humphrey Field Analyser (HFA) 30-2 grid was used in 13 patients with early/established optic nerve disease using the current Goldmann III target size or a combination of the three smallest stimuli (target size I, II and III). We used data from control subjects at each of the visual field locations for the different target sizes to establish the number of failed points (events) for the patients with optic nerve disease, as well as global indices for mean deviation (MD) and pattern standard deviation (PSD).

RESULTS
The 30-2 visual field testing using alternate target size stimuli showed that all 13 patients displayed more defects (events) compared to the standard Goldmann III target size. The median increase for events was seven additional failed points: (range 1-26). The global indices also increased when the new testing approach was used (MD -3.47 to -6.25 dB and PSD 4.32 to 6.63 dB). Spatial summation mapping showed an increase in critical area (Ac) in disease and overall increase in thresholds when smaller target stimuli were used.

CONCLUSIONS
When compared to the current Goldmann III paradigm, the use of alternate sized targets within the 30-2 testing protocol revealed a greater loss in patients with optic nerve disease for both event analysis and global indices (MD and PSD). We therefore provide evidence in a clinical setting that target size is important in visual field testing.

D000328:Adult
D000368:Aged
D000369:Aged, 80 and over
D015350:Contrast Sensitivity
D018450:Disease Progression
D005260:Female
D006801:Humans
D008297:Male
D008875:Middle Aged
D009901:Optic Nerve Diseases
D015203:Reproducibility of Results
D014785:Vision, Ocular
D058609:Visual Field Tests
D014794:Visual Fields
D055815:Young Adult

spatial summation
Ricco's law
automated perimetry
glaucoma
humphrey field analyzer
octopus visual field
optic nerve head drusen


Bi-polymeric Spongy Matrices Through Cross-linking Polymerization: Synthesized and Evaluated for Solubility Enhancement of Acyclovir.

Abstract: In this study, two hydrophilic polymers hydroxypropyl methyl cellulose and beta-cyclodextrin (β-CD) are used to synthesize highly responsive and spongy polymeric matrices. Porous and stimulus-responsive polymeric network was developed to improve the solubility of acyclovir (ACV) at significant level. Grafting was successfully carried out by free radical polymerization technique. Spongy matrices were characterized by percentage entrapment efficiency, drug loading, solubility studies, FTIR, powder X-ray diffraction, TGA, DSC, XRD, SEM, swelling studies, and in vitro studies. Acute oral toxicity studies were conducted to determine the safety of oral administration of prepared HPMC-βCD-g-poly(AMPS) formulation. Porous and spongy structures were depicted in SEM images. Complex formation and thermal stability of constituents and drug (ACV) were analyzed by FTIR, TGA, and DSC spectra. XRD analysis revealed reduction in acyclovir crystallinity in spongy matrices. Particle size of optimized formulation was found in the range of 197 ± 2.55 nm. The momentous difference with reference product committed that drug solubility and release characteristics were markedly enhanced by the developed spongy matrices. Toxicity studies endorsed that developed spongy matrices were non-toxic and compatible to biological system. The efficient method of preparation, enhanced solubility, excellent physico-chemical characteristics, high dissolution, and non-toxic HPMC-βCD-g-poly(AMPS) spongy matrices may be a promising approach for oral delivery of poorly soluble drugs.

Asghar|Saima|S|
Akhtar|Naveed|N|
Minhas|Muhammad Usman|MU|
Khan|Kifayat Ullah|KU|

D017550:Spectroscopy, Fourier Transform Infrared

solubility
acyclovir
spongy bi-polymeric matrices
β-cyclodextrin


Understanding social adversity and stress and mood symptoms: The Bayesian network approach.

Abstract: Social adversity events commonly occur in our daily lives. However, an individual's perception of social adversity experienced may be more important than actual events in impacting an individual's psychological functioning and reactions. In the current study, we examined how individuals' perception of social adversity events they experienced is associated with their traumatic stress symptoms as well as mood and anxiety symptoms using the Bayesian network model. The findings indicated that individuals with a perception of social adversity events as traumatic and frequent showed an increase in the probability of displaying a high level of posttraumatic stress symptoms.

social adversities
Bayesian network
traumatic stress symptoms
causal link
individuals’ perception


THE RELATIONSHIP BETWEEN TRUNK ROTATION, UPPER QUARTER DYNAMIC STABILITY, AND THE KERLAN-JOBE ORTHOPAEDIC CLINIC OVERHEAD ATHLETE SHOULDER AND ELBOW SCORE IN DIVISION I COLLEGIATE PITCHERS.

Abstract:
Hypothesis/Purpose
The purpose of this study was to assess relationships between active trunk rotation range of motion (TROM), upper quarter dynamic stability, and composite and individual item KJOC scores in collegiate baseball pitchers. A secondary purpose was to determine whether differences exist between baseball pitchers with and without an injury history in terms of their performance on TROM, upper quarter dynamic stability, and composite and individual KJOC scores. It was hypothesized that increased TROM and upper quarter dynamic stability are associated with better (higher) KJOC scores and pitchers with an injury history would exhibit lower KJOC scores compared to uninjured pitchers.

Study Design
Cross-sectional Cohort Study.

Methods
Thirty-six college pitchers were assessed for TROM, performance on the Upper Quarter Y-Balance Test (YBT-UQ) and they also completed the KJOC. Subjects were grouped based on previous injury history: injured, required surgery, (IS, n=9), injured, no surgery, (INS, n=6), and uninjured (UI, n=21). Pearson's Correlations were used to assess relationships between clinical measurements and the KJOC. One-way ANOVAs were used to assess differences in TROM, YBT-UQ, and KJOC scores between groups (P<0.05).

Results
No significant relationships were detected between TROM measures and KJOC composite scores (throwing arm: r = .239, p = 0.16; non-throwing arm: r=.291, p = 0.09). A moderate relationship was found between the YBT-UQ and the KJOC scores (throwing arm: r = .413, p = 0.01; non-throwing arm: r=.380, p = 0.02). The mean KJOC scores for item 1 (warm-up limitations) were significantly different between all three groups (IS: 6.7, INS: 9.7, UI: 9.1; p = 0.015). Mean scores on item 5 (strain on relationships with coaches) and item 8 (limitations in competition endurance) were significantly different between the IS and UI groups (Item 5 = IS: 7.8, UI: 9.5, p = 0.02; Item 8=IS: 6.4, UI: 8.8, p = 0.04).

Conclusion
A positive moderate association was found between upper quarter dynamic stability as measured by the YBT-UQ and the KJOC. Pitchers with no surgical history had better KJOC scores for warm up time, competitive endurance, and impact on team relationships.

Level of Evidence
3.

Chasse|Patrick|P|
Bullock|Garrett S|GS|
Schmitt|Abigail C|AC|
Little|Barrett A|BA|
Diehl|Lee H|LH|
Butler|Robert J|RJ|

Baseball
Y-Balance Test
Throwing
Trunk Mobility


Magnetite Synthesis in the Presence of Cyanide or Thiocyanate under Prebiotic Chemistry Conditions.

Abstract: Magnetite is an iron oxide mineral component of primitive Earth. It is naturally synthesized in different ways, such as magma cooling as well as olivine decomposition under hydrothermal conditions. It is probable magnetite played a significant role in biogenesis. The seawater used in the current work contained high Mg2+, Ca2+ and SO42- concentrations, unlike the seawater of today that has high Na+ and Cl- concentrations. It is likely that this seawater better resembled the ion composition of the seas of the Earth from 4 billion years ago. Cyanide and thiocyanate were common molecules in prebiotic Earth, and especially in primitive oceans, where they could act on the magnetite mechanism synthesis via Fe2+ interaction. In this research, magnetite samples that were synthesized under prebiotic conditions in the presence of cyanide or thiocyanate, (both with and without artificial seawater), showed that, besides magnetite, goethite and ferrihydrite can be produced through different Fe2+-ion interactions. Cyanide apparently acts as a protective agent for magnetite production; however, thiocyanate and seawater 4.0 Gy ions produced goethite and ferrihydrite at different ratios. These results validate that Fe3+ oxides/hydroxides were possibly present in primitive Earth, even under anoxic conditions or in the absence of UV radiation. In addition, the results show that the composition of water in early oceans should not be neglected in prebiotic chemistry experiments, since this composition directly influences mineral formation.

da Costa|Antônio Carlos Saraiva|ACS|0000-0003-0702-5529

magnetite
cyanide
thiocyanate
prebiotic chemistry


Supervisors' Visual Attention Allocation Modeling Using Hybrid Entropy.

Abstract: With the improvement in automation technology, humans have now become supervisors of the complicated control systems that monitor the informative human-machine interface. Analyzing the visual attention allocation behaviors of supervisors is essential for the design and evaluation of the interface. Supervisors tend to pay attention to visual sections with information with more fuzziness, which makes themselves have a higher mental entropy. Supervisors tend to focus on the important information in the interface. In this paper, the fuzziness tendency is described by the probability of correct evaluation of the visual sections using hybrid entropy. The importance tendency is defined by the proposed value priority function. The function is based on the definition of the amount of information using the membership degrees of the importance. By combining these two cognitive tendencies, the informative top-down visual attention allocation mechanism was revealed, and the supervisors' visual attention allocation model was built. The Building Automatic System (BAS) was used to monitor the environmental equipment in a subway, which is a typical informative human-machine interface. An experiment using the BAS simulator was conducted to verify the model. The results showed that the supervisor's attention behavior was in good agreement with the proposed model. The effectiveness and comparison with the current models were also discussed. The proposed attention allocation model is effective and reasonable, which is promising for use in behavior analysis, cognitive optimization, and industrial design.

attention allocation
hybrid entropy
attention behavior
information entropy


Full-Endoscopic Decompression with the Application of an Endoscopic-Matched Ultrasonic Osteotome for Removal of Ossification of the Thoracic Ligamentum Flavum.

Abstract:
BACKGROUND
Resection of the ossification of the thoracic ligamentum flavum (OTLF) with a high-speed burr may cause a high rate of perioperative complications, such as dural laceration and/or iatrogenic spinal cord injury.

OBJECTIVES
The aim of this study was to investigate the safety and feasibility of the endoscopic-matched ultrasonic osteotome in full-endoscopic spinal surgery for direct removal of OTLF.

STUDY DESIGN
Retrospective study.

SETTING
All data were from Honghui Hospital in Xi'an.

METHODS
This study conducted between December 2017 and December 2018, included 27 consecutive patients who met the study criteria, had single-level OTLF, and underwent full-endoscopic decompression under local anesthesia. The postoperative follow-up was scheduled at 1, 3, 6, and 12 months postoperatively. Outcomes evaluations included the Visual Analog Scale (VAS) score for lower extremity pain and the modified Japanese Orthopaedic Association (mJOA) score and improvement rate for the assessment of thoracic myelopathy. Removal of OTLF was measured by comparing the pre- and postoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans.

RESULTS
The operation was completed in all patients without conversion to open surgery. The operation time ranged from 65 to 125 minutes (average, 83.7 ± 12.3 minutes). All patients were followed up for 12 to 18 months, with an average follow-up of 14.3 ± 1.3 months. Satisfactory neurologic decompression was confirmed by postoperative CT and MRI, and no revision surgery was required. The VAS and mJOA scores showed statistically higher improvement at the 1-month follow-up and the last follow-up compared with the preoperative assessment (P < 0.05). According to the improvement rate at the final follow-up, 20 cases were classified as good, 6 cases were fair, and 1 case remained unchanged.

LIMITATIONS
A single-center, noncontrol study.

CONCLUSIONS
The endoscopic-matched ultrasonic osteotome can be considered quite safe and feasible for direct removal of OTLF during full-endoscopic spinal surgery in strictly selected patients, as this allows for effective direct decompression of OTLF while minimizing trauma and instability. In addition, because of the design characteristics of the ultrasonic osteotome, surgical complications, especially dural tears and spinal cord injury, can also be effectively controlled.

Yang|Jun-Song|JS| Gong|Han-Lin|HL| Chen|Hao|H| Wei|Jian-Min|JM| Chen|Chien-Min|CM| Gao|Zi-Jun|ZJ| Zhang|Zi-Long|ZL| Hao|Ding-Jun|DJ| Zhao|Yuan-Ting|YT| Chu|Lei|L|

D019299:Decompression, Surgical
D006801:Humans
D017843:Ligamentum Flavum
D008159:Lumbar Vertebrae
D009999:Ossification, Heterotopic
D010012:Osteogenesis
D012189:Retrospective Studies
D013904:Thoracic Vertebrae
D016896:Treatment Outcome
D014465:Ultrasonics

ossification of thoracic ligamentum flavum


Food and wellbeing. Towards a consumer-based approach.

Abstract: Interest in understanding how foods affect consumers' perceived wellbeing has grown in the last decade due to the increasing need to modify dietary patterns. Considering that wellbeing is a broad concept that lacks of a unique definition, in order to use and measure this concept it is necessary to explore how consumers understand it, particularly in the context of food consumption. The aim of the present work was to investigate consumers' perception of wellbeing in a food-related context using an exploratory qualitative approach. A study was carried out with 120 Uruguayan participants using three qualitative techniques: word association, open-ended questions and free listing. Wellbeing in a food-related context was strongly associated with physical health. The expected effects of foods on wellbeing were mainly related to non-communicable diseases such as high cholesterol levels, hypertension, and cardiovascular diseases. However, hedonic and emotional aspects of food consumption were also salient for consumers perceived wellbeing. The information gathered in this study can contribute to the development of scales for measuring consumer perceived wellbeing when consuming foods.

Ares|Gastón|G|
De Saldamando|Luis|L|
Giménez|Ana|A|
Deliza|Rosires|R|

Word association
Free listing
Consumer studies
Qualitative studies
Wellness


The Bergen Shopping Addiction Scale: reliability and validity of a brief screening test.

Abstract: Although excessive and compulsive shopping has been increasingly placed within the behavioral addiction paradigm in recent years, items in existing screens arguably do not assess the core criteria and components of addiction. To date, assessment screens for shopping disorders have primarily been rooted within the impulse-control or obsessive-compulsive disorder paradigms. Furthermore, existing screens use the terms 'shopping,' 'buying,' and 'spending' interchangeably, and do not necessarily reflect contemporary shopping habits. Consequently, a new screening tool for assessing shopping addiction was developed. Initially, 28 items, four for each of seven addiction criteria (salience, mood modification, conflict, tolerance, withdrawal, relapse, and problems), were constructed. These items and validated scales (i.e., Compulsive Buying Measurement Scale, Mini-International Personality Item Pool, Hospital Anxiety and Depression Scale, Rosenberg Self-Esteem Scale) were then administered to 23,537 participants (M age = 35.8 years, SD age = 13.3). The highest loading item from each set of four pooled items reflecting the seven addiction criteria were retained in the final scale, The Bergen Shopping Addiction Scale (BSAS). The factor structure of the BSAS was good (RMSEA = 0.064, CFI = 0.983, TLI = 0.973) and coefficient alpha was 0.87. The scores on the BSAS converged with scores on the Compulsive Buying Measurement Scale (CBMS; 0.80), and were positively correlated with extroversion and neuroticism, and negatively with conscientiousness, agreeableness, and intellect/imagination. The scores of the BSAS were positively associated with anxiety, depression, and low self-esteem and inversely related to age. Females scored higher than males on the BSAS. The BSAS is the first scale to fully embed shopping addiction within an addiction paradigm. A recommended cutoff score for the new scale and future research directions are discussed.

Andreassen|Cecilie S|CS|
Griffiths|Mark D|MD|
Pallesen|Ståle|S|
Bilder|Robert M|RM|
Torsheim|Torbjørn|T|
Aboujaoude|Elias|E|

shopping addiction
scale
assessment
compulsive buying
personality
self-esteem
psychological distress
psychometrics


Knowledge, Attitudes, and Practices among Members of Households Actively Monitored or Quarantined to Prevent Transmission of Ebola Virus Disease - Margibi County, Liberia: February-March 2015.

Abstract:
BACKGROUND
In early 2015, a patient from a cluster of cases of Ebola Virus Disease (EVD) in Monrovia, Liberia traveled to a rural village in Margibi County, potentially exposing numerous persons. The patient died in the village and post-mortem testing confirmed Ebola Virus infection. Problem The Margibi County Health Team (CHT; Kakata, Margibi, Liberia) needed to prevent further transmission of EVD within and outside of the affected villages, and they needed to better understand the factors that support or impede compliance with measures to stop the spread of EVD.

METHODS
In February-March 2015, the Margibi CHT instituted a 21-day quarantine and active monitoring for two villages where the patient had contact with numerous residents, and a 21-day active monitoring for five other villages where the patient had possible contact with an unknown number of persons. One contact developed EVD and quarantine was extended an additional 12 days in one village. In April 2015, the Margibi CHT conducted a household-based EVD knowledge, attitudes, and practices (KAP) survey of the seven villages. From April 24-29, 2015, interview teams approached every household in the seven villages and collected information on demographics, knowledge of EVD, attitudes about quarantine to prevent the spread of EVD, and their quarantine experiences and practices. Descriptive statistics were calculated.

RESULTS
One hundred fifteen interviews were conducted, representing the majority of the households in the seven villages. Most (99%) correctly identified touching an infected person's body fluids and contact with the body of someone who has died from EVD as transmission routes. However, interviewees sometimes incorrectly identified mosquito bites (58%) and airborne spread (32%) as routes of EVD transmission, and 72% incorrectly identified the longest EVD incubation period as ≤seven days. Eight of 16 households in the two quarantined villages (50%) reported times when there was not enough water or food during quarantine. Nine of 16 (56%) reported that a household member had illnesses or injuries during quarantine; of these, all (100%) obtained care from a clinic, hospital, or Ebola treatment unit (ETU).

CONCLUSION
Residents' knowledge of EVD transmission routes and incubation period were suboptimal. Public health authorities should consider assessing residents' understanding of Ebola transmission routes and effectively educate them to ensure correct understanding. Quarantined residents should be provided with sufficient food, water, and access to medical care. Wilken JA , Pordell P , Goode B , Jarteh R , Miller Z , Saygar BG Sr. , Maximore L , Borbor WM , Carmue M , Walker GW , Yeiah A . Knowledge, attitudes, and practices among members of households actively monitored or quarantined to prevent transmission of Ebola Virus Disease - Margibi County, Liberia: February-March 2015. Prehosp Disaster Med. 2017;32(6):673-678.

Wilken|Jason A|JA|
Pordell|Paran|P|
Goode|Brant|B|
Jarteh|Rachel|R|
Miller|Zayzay|Z|
Saygar|Benjamin G|BG|
Maximore|Leroy|L|
Borbor|Watta M|WM|
Carmue|Moses|M|
Walker|Gregory W|GW|
Yeiah|Adolphus|A|

D007722:Health Knowledge, Attitudes, Practice

CDC Centers for Disease Control and Prevention


Maternal complications in pregnancy and wheezing in early childhood: a pooled analysis of 14 birth cohorts.

Abstract:
BACKGROUND
Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient.

METHODS
A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥ 30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes included both ever and recurrent wheezing from birth up to 12-24 months of age. Cohort-specific crude and adjusted risk ratios (RR) were calculated using log-binomial regression models and then pooled using a random effects model.

RESULTS
The study included 85509 subjects. Cohort-specific prevalence of ever wheezing varied from 20.0% to 47.3%, and of recurrent wheezing from 3.0% to 14.3%. Adjusted pooled RR for ever and recurrent wheezing were: 1.02 (95% CI: 0.98-1.06) and 1.20 (95% CI: 0.98-1.47) for hypertensive disorders; 1.09 (95% CI: 1.01-1.18) and 1.23 (95% CI: 1.07-1.43) for preeclampsia; 1.04 (95% CI: 0.97-1.13) and 1.24 (95% CI: 0.86-1.79) for diabetes; 1.08 (95% CI: 1.05-1.11) and 1.19 (95% CI: 1.12-1.26) for overweight; 1.12 (95% CI: 1.08-1.17) and 1.16 (95% CI: 0.97-1.39) for obesity. No heterogeneity was found in RR estimates among the cohorts, except for diabetes and recurrent wheezing (P=0.027).

CONCLUSIONS
Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring.

Zugna|Daniela|D|
Galassi|Claudia|C|
Annesi-Maesano|Isabella|I|
Baïz|Nour|N|
Barros|Henrique|H|
Basterrechea|Mikel|M|
Correia|Sofia|S|
Duijts|Liesbeth|L|
Esplugues|Ana|A|
Fantini|Maria Pia|MP|
Forastiere|Francesco|F|
Gascon|Mireia|M|
Gori|Davide|D|
Inskip|Hazel|H|
Larsen|Pernille S|PS|
Mommers|Monique|M|
Nybo Andersen|Anne-Marie|AM|
Penders|John|J|
Petersen|Maria S|MS|
Pike|Katharine|K|
Porta|Daniela|D|
Sonnenschein-van der Voort|Agnes|A|
Steuerwald|Ulrike|U|
Sunyer|Jordi|J|
Torrent|Maties|M|
Vrijheid|Martine|M|
Richiardi|Lorenzo|L|
Rusconi|Franca|F|

Overweight
Obesity
Gestational diabetes
Pre-eclampsia
Pregnancy induced hypertension


Diabetoporosis: Role of nitric oxide.

Abstract: Diabetoporosis, diabetic-related decreased bone quality and quantity, is one of the leading causes of osteoporotic fractures in subjects with type 2 diabetes (T2D). This is associated with lower trabecular and cortical bone quality, lower bone turnover rates, lower rates of bone healing, and abnormal posttranslational modifications of collagen. Decreased nitric oxide (NO) bioavailability has been reported within the bones of T2D patients and can be considered as one of the primary mechanisms by which diabetoporosis is manifested. NO donors increase trabecular and cortical bone quality, increase the rate of bone formation, accelerate the bone healing process, delay osteoporosis, and decrease osteoporotic fractures in T2D patients, suggesting the potential therapeutic implication of NO-based interventions. NO is produced in the osteoblast and osteoclast cells by three isoforms of NO synthase (NOS) enzymes. In this review, the roles of NO in bone remodeling in the normal and diabetic states are discussed. Also, the favorable effects of low physiological levels of NO produced by endothelial NOS (eNOS) versus detrimental effects of high pathological levels of NO produced by inducible NOS (iNOS) in diabetoporosis are summarized. Available data indicates decreased bone NO bioavailability in T2D and decreased expression of eNOS, and increased expression and activity of iNOS. NO donors can be considered novel therapeutic agents in diabetoporosis.

Diabetoporosis
Diabetoporosis
nitric oxide
diabetoporosis


Surgical thresholds for bicuspid aortic valve associated aortopathy.

Abstract:
OBJECTIVES
This systematic review seeks to present the outcomes of the natural history of aortopathy associated with bicuspid aortic valve (ABAV) and after interventions.

BACKGROUND
Aortopathy is common in patients with ABAV, and early intervention has been proposed to reduce the risk of dissection. In asymptomatic patients, the timing of surgical management is based upon imaging of aortic size, but the actual threshold is based upon observational data and expert opinion. As evidence of high risk would justify early intervention, we sought to define the natural history of this condition and after interventions.

METHODS
We undertook a systemic review of the evidence from observational studies of ABAV published up to June 2013. The primary outcome was annualized all-cause mortality. Secondary outcomes included acute aortic events, rates of aneurysm enlargement, and peri-operative complications. A random-effects model was used to combine outcomes. A meta-regression was undertaken to assess the impact of potential covariates.

RESULTS
The 32 eligible papers involved 11,045 patients (9,441 BAV and 1,604 control subjects, age 46 ± 14 years). There were 3 major groups, nonoperated bicuspid aortic valve (BAV) patients (ages from 30 to 40 years), patients after aortic surgery (generally 40 to 60 years of age) and after isolated valve replacement (>60 years of age). The respective annualized mortality of nonoperated BAV patients was 0.56% (95% confidence interval [CI]: 0.13 to 0.99), compared with 0.78% (95% CI: 0.20 to 1.36) in patients after aortic surgery and 2.39% (95% CI: 1.61 to 3.16) after isolated valve replacement. The annualized acute event rate in nonoperated BAV patients was 0.29% (95% CI: 0.23 to 0.35), this risk being no different from that of a tricuspid aortic valve (risk ratio: 0.68, 95% CI: 0.34 to 1.36). In the post-surgical series, 30-day mortality varied from 0% to 2.5%, and the risk of acute events was 0.16% (95% CI: 0.0 to 0.32) in patients after aortic surgery and 0.68% (95% CI: 0.42 to 0.94) after isolated valve replacement. Aortic dilation was at a rate of 0.16 mm/year over 6 decades in healthy BAV subjects and 1.1 ± 0.15 mm/year in older aortic valve replacement patients.

CONCLUSIONS
The risk associated with ABAV varies according to age and clinical setting. Nonetheless, despite aortic dilatation, the acute aortic event risk of ABAV appears low in current practice. Decision-making regarding the timing of intervention needs to be made on the basis of the balance between this low risk and both the morbidity and mortality of surgery.

Hardikar|Ashutosh A|AA|
Marwick|Thomas H|TH|

D000082882:Bicuspid Aortic Valve Disease

D019918:Heart Valve Prosthesis Implantation

bicuspid aortic valve
aortic valve
AS
BAV
confidence interval
CI
tricuspid aortic valve
aortic valve replacement
AA
ARS
AV
AVR
TAV
aortic root surgery
aortic stenosis
ascending aorta
ascending aortic aneurysm
bicuspid aortic valve aortopathy


Polydioxanone plates are safe and effective for L-strut support in functional septorhinoplasty.

Abstract:
OBJECTIVES/HYPOTHESIS
To evaluate the safety, efficacy, and result stability of polydioxanone (PDS) plate use for L-strut stabilization.

STUDY DESIGN
Retrospective analysis of a prospective cohort.

METHODS
Patients who underwent functional septorhinoplasty with the use of PDS plates between January 2013 and January 2017 were administered the Nasal Obstruction Symptom Evaluation (NOSE) scale pre- and postoperatively at 2, 4, 6, and 12 months. Patient demographics, reason for PDS use, graft type, complications, and outcomes were analyzed.

RESULTS
Eighty-eight patients aged 34.3 years (standard deviation [SD] = 15.7 years; range, 7.5-71.5 years) were included. All patients were found to have a fracture and/or severe deviation of the L-strut for which the PDS plate was used for rigid support. Mean preoperative NOSE score 65.2 (SD = 22.1) significantly decreased to 19.6 (SD = 21.6) at 7.2 months (SD = 5.5 months) postoperatively. There were no significant differences in NOSE scores between follow-up time points. There was one complication, a septal abscess, and one revision.

CONCLUSIONS
A PDS plate is a safe and effective material to be utilized in functional septorhinoplasty for patients with a fracture or iatrogenic injury to the septal L-strut or poor quality septal cartilage that requires stability without additional width. Outcomes are stable at 6 and 12 months, after the plate has dissolved. The use of a PDS plate may decrease the need for rib grafting in patients with a history of previous septoplasty and persistent nasal obstruction with a dorsal or caudal C-shaped septal deformity or fracture of the L-strut.

LEVEL OF EVIDENCE
2c. Laryngoscope, 127:2725-2730, 2017.

polydioxanone
Septorhinoplasty
nasal valve


Intermittent urethral catheterization-descriptive study at a Brazilian service.

Abstract:
AIMS AND BACKGROUND
The rehabilitation process of patients with neurogenic bladder involves psychosocial, cultural, political and economic human factors, representing a challenge for patients/caregivers as well as health professionals. This study was aimed at characterizing patients with neurogenic bladder who use intermittent urethral catheterization and were going through rehabilitation at a teaching hospital.

METHOD
This descriptive study was undertaken in the interior of São Paulo State-Brazil. All ethical guidelines were complied with. To collect the data, interviews were held during nursing consultations with patients more than 18years of age suffering from neurogenic bladder who used intermittent urethral catheterization.

RESULTS
Most patients had spinal cord trauma, are single, male and gain a low income. They have been using catheterization for several years, at irregular frequencies, using polyethylene catheters.

CONCLUSIONS
No standardization exists in the accomplishment of the practices used and strategies are needed to remodel the service.

Mazzo|Alessandra|A|
Souza-Junior|Valtuir D|VD|
Jorge|Beatriz M|BM|
Nassif|Aline|A|
Biaziolo|Cintia F B|CF|
Cassini|Marcelo F|MF|
Santos|Raquel C R|RC|
Mendes|Isabel Amélia Costa|IA|

Rehabilitation
Intermittent urethral catheterization
Nursing
Health education
Urinary bladder neurogenic dysfunction


Evaluation of the efficacy and safety of percutaneous biopsy of lung.

Abstract:
INTRODUCTION
Percutanous needle biopsy of the lung (PNBL), under image guidance, has established itself as a safe and effective minimally-invasive method of obtaining a tissue diagnosis of pulmonary lesions, for selected patients with suspected pathologic processes. The purpose of this study was to evaluate the diagnostic yield and safety of percutaneous core biopsy of the lung (PCBL) without Fine Needle Aspiration Biopsy (FNAB), with specific attention to potential risk factors that may predict post-biopsy pneumothorax.

MATERIALS AND METHODS
A retrospective analysis of 75 consecutive PCBL procedures between January 2006 to March 2008 involving 72 patients with a documented pulmonary nodule or mass lesion on CT scan of Thorax. The study population included 38 males (52.8%) and 34 females (47.2%) aged 20-85 years (mean age 63.6 years). A co-axial cutting system with a 19-gauge outer needle and a 20-gauge inner automated cutting needle (Temno, Allegiance Healthcare Corporation, Ohio, USA) was used in all patients.

RESULTS
Lesions varied in size from 0.7cm to 10.7cm (mean maximum trans-axial diameter 3.1cm). The mean number of core biopsy samples obtained was 3.1 (range 1-5). Of the 75 PCBL procedures, 71 yielded specimens adequate for histopathologic evaluation, consistent with a technical success rate of 95%. Malignancy was detected in 48 specimens (64%) and benign diagnoses were identified in 23 specimens (31%). As mentioned, 4 specimens (5%) were nondiagnostic. The most common biopsy-induced complication was pneumothorax, occurring in 15 patients (20%), with 4 (5.3%) requiring thoracostomy tube placement.

CONCLUSION
PCBL without FNAB, under CT fluoroscopy guidance, has an excellent diagnostic accuracy in obtaining a conclusive histologic diagnosis of thoracic lesions and is comparable to FNAB in terms of safety and rates of occurence of complications.

McSweeney|Sean E|SE|
O'Regan|Kevin N|KN|
Mc Laughlin|Patrick D|PD|
Crush|Lee|L|
Maher|Michael M|MM|

efficacy
Percutaneous biopsy of lung
non-fine needle
safety.


The preparation of mass producible, highly-cycling stable Si/C anode materials with nano-sized silicon crystals embedded in highly amorphous silicon matrix.

Abstract: The commercial applications of silicon nanomaterials as anode in lithium-ion batteries must solve two important problems, namely low expansion and long-term cycle stability. The former is related to nano-silicon structure, while the latter depends on silicon/carbon composite structure and preparation process. In order to suppress volume expansion appeared during lithiation, this paper selects a kind of silicon nanoparticles (SiNPs) with a high degree of amorphization (81.9%), and designs a stable silicon/carbon composite material structure. Inside this structure, graphite nanoflakes (GNFs) with high specific surface are used as the skeleton, which can provide enough surface area for SiNPs to adhere and avoid the local accumulation of SiNPs. Outside this structure is uniformly coated with a layer of amorphous carbon. Raman and x-ray diffraction results show that after the high-temperature carbonization, the nano-silicon in the composite material still maintains a high degree of amorphization (67.1%) and the average crystallite size of Si has only increased from 3.7 to 9.5 nm. The initial Coulombic efficiency and reversible specific capacity of the composite material are 86.7% and 1374.8 mAh g-1, respectively. After mixing with commercial graphite, the initial Coulombic efficiency and reversible specific capacity are 93.7% and 426.4 mAh g-1, respectively. LiNi0.8Co0.1Mn0.1O2(NCM811) is used as the cathode to produce a soft-pack battery. After 900 cycles at room temperature, the capacity remains 86.2%. The silicon/carbon anode material reported in this paper is of great potential for commercialization.

anode material
amorphous
graphite nanoflakes
Si nanoparticles
Si/C composite


Molecular Identification and Virulence Potential of the Genus Aeromonas Isolated from Wild Rainbow Trout (Oncorhynchus mykiss) in Mexico.

Abstract: The members of the Aeromonas genus are important foodborne pathogens, with a worldwide distribution. Wild rainbow trout, from the national protected area Santuario del Agua State Park, Corral de Piedra, were analyzed. Species of Aeromonas were isolated from the trout, and their pathogenic potential was analyzed based on different pathogenicity and virulence factors. The isolates were identified as A. allosaccharophila (n = 15), A. sobria (n = 8), A. veronii (n = 3), A. rivipollensis (n = 2), A. piscicola (n = 2), and A. popoffii (n = 1), by RNA polymerase sigma factor (rpoD) gene sequencing. Sequence similarity with the type strain was 92.2 to 99.6% for A. sobria isolates, 97.8 to 98.0% for A. allosaccharophila isolates, 99.2% for the A. popoffii isolate, 99.2 to 100% for A. piscicola isolates, and 98.2 to 99.2% for A. veronii isolates. Notably, isolates A30T2-gills and A30T2-spleen showed sequence similarity of 98.0% with strain A. media CECT 4232T and 99.0% with strain A. rivipollensis P2G1T. Virulence genes were detected by PCR at the following frequencies: fla and serine protease, 96.77%; aerA, 93.54%; aexT, 87.09%; lipases, 74.19%; ascV and ahyB, 67.74%; exu, 61.29%; act, 41.93%; ascF-G, 38.70%; lafA, 32.26%; alt, 6.46%; aopP, 9.67%; and ast, 3.23%. These results indicate that several Aeromonas species had the potential pathogenicity to infect wild rainbow trout in the waterway created by the Corral de Piedra dam, suggesting they could be an emerging zoonotic pathogen.

Reyes-Rodríguez|Nydia E|NE|
Salgado-Miranda|Celene|C|
Flores-Valle|Izanami T|IT|
González-Gómez|Maricruz|M|
Soriano-Vargas|Edgardo|E|
Peláez-Acero|Armando|A|
Vega-Sánchez|Vicente|V|

Virulence
Aeromonas
Wild rainbow trout
Foodborne pathogen
Aquatic environment


The accuracy of virtual-surgical-planning-assisted treatment of hemifacial microsomia in adult patients: distraction osteogenesis vs. orthognathic surgery.

Abstract: Hemifacial microsomia (HFM) is a common congenital craniofacial deformity with a high prevalence. Orthognathic surgery and distraction osteogenesis are two conventionally used treatments of HFM. The main objective of this retrospective study was to evaluate the accuracy of two treatments with the help of virtual surgical planning in adult HFM patients. Sixty-eight adult patients with unilateral HFM were enrolled in this study. Preoperative surgical planning and simulation were performed on three-dimensional computed tomography models. Orthognathic surgery or distraction osteogenesis was performed under the guidance of three-dimensional surgical templates. Postoperative evaluation of the intervention was performed by comparison of the affected ramus height, chin deviation and the occlusal cant in surgical planning and actual result. Outcome and feedback information (an average of 14 months) showed that virtual surgical planning was accurately transferred to actual surgery in both surgical approaches. There were no statistical differences between the accuracy of affected ramus height and the occlusal cant in two surgical approaches. The orthognathic group showed significantly higher accuracy in chin deviation. In conclusion, virtual surgical planning and three-dimensional surgical templates were proved to facilitate treatment planning and offer an accurate surgical result in the treatment of adult HFM patients.

Wang|P|P| Zhang|Z|Z| Wang|Y|Y| Li|X|X| Ye|B|B| Li|J|J|

hemifacial microsomia
distraction osteogenesis
orthognathic surgery
3D printing
virtual surgery planning


Mite communities (Acari: Mesostigmata, Oribatida) in the red belt conk, Fomitopsis pinicola (Polyporales), in Polish forests.

Abstract: The fruiting bodies of bracket fungi are a specific microhabitat colonized by various invertebrates of which mites (Acari) are rarely studied, and if they are, the study is usually faunistic. The aim of the research was to determine whether the diversification of mite assemblages (Mesostigmata, Oribatida) inhabiting the fruiting bodies of Fomitopsis pinicola (Sw.) P. Karst. (Polyporales) are connected with the character of the forests and/or the degree of decay (DD) of the fruiting bodies. The research was conducted at Białowieża National Park (BNP), in forests close to natural ones and in Karkonosze National Park (KNP) which was affected by a large-scale forest dieback in the 1980s. Eighty fruiting bodies (40 at each study site) of F. pinicola belonging to four DD categories were collected. In total, 4,345 individuals of 120 mite species were recorded at BNP, and 13,912 individuals of 96 species were recorded at KNP. Analyses revealed that the sample dispersion at each study site was comparable, nevertheless the samples from each study site were clearly grouped into slightly overlapping sets which allow observation of the differences between them. In the less decayed fungi (DD 1 and 2) there were fewer mite species and individual mites than in the more decayed samples (DD 3 and 4). There were also significant differences between the fauna of the fungi in each particular DD: the fauna of DD 1 differed from all others, whereas the fauna of heavily decayed fungi (DD 3 and 4) was more comparable.

Fruiting bodies
Bracket fungi
Anthropopressure
Microarthropods
Natural forest


An ultrasensitive UPLC-MS/MS assay for the quantification of the therapeutic peptide liraglutide in plasma to assess the oral and nasal bioavailability in beagle dogs.

Abstract: Aim: An ultrasensitive UPLC-MS/MS assay for liraglutide was developed and validated according to US FDA and EMA guidelines and applied to the quantification of plasma concentrations after intravenous, nasal and oral administration of liraglutide to beagle dogs. Results: Liraglutide isolation was performed with a combined protein precipitation and solid-phase extraction protocol. The calibrated concentration range of 0.1-200 ng/ml was linear with correlation coefficients >0.998. Precise analysis was achieved through the utilization of an isotopically labeled internal standard. Absolute bioavailability of liraglutide after nasal and oral administration of liraglutide to beagle dogs was 0.03 and 0.006%, respectively. Conclusion: The assay matches the performance in sensitivity of the previously applied immunoassay and optimally covers the therapeutic range of liraglutide.

Sauter|Max|M|
Uhl|Philipp|P|
Majewsky|Marius|M|
Fresnais|Margaux|M|
Haefeli|Walter E|WE|
Burhenne|Jürgen|J|

D002851:Chromatography, High Pressure Liquid

liraglutide oral nasal bioavailability MS/MS UPLC


Neuromyelitis Optica Spectrum Disorders (NMOSD) and Connective Tissue Disease (CTD): an Update for the Rheumatologist.

Abstract:
PURPOSE OF REVIEW
To review the pathophysiology, presentation, and treatment of neuromyelitis optica spectrum disorder (NMOSD) and its association with systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS).

RECENT FINDINGS
NMOSD is an autoimmune disorder of the central nervous system that primarily targets astrocytes. Although the prevalence is unknown, the coexistence of NMOSD and SLE/SS is well-recognized. Patients with both NMOSD and SLE or SS require may require unique approaches to diagnosis and management. Coexistence of NMOSD and SLE/SS is important for the rheumatologist and neurologist to be able to recognize. For the rheumatologist, NMOSD and its neurologic symptoms represent a distinct disease process from neurologic complications of the patient's underlying connective tissue disease, and it requires distinct acute and chronic management. For the neurologist, the coexistence of SLE and SS can help to establish a diagnosis of NMOSD, or in some situations, the development of neurologic symptoms secondary to NMOSD can lead to the diagnosis of connective tissue disease.

Cruz|Roberto A|RA|
Chaudhary|Sana|S|
Guevara|Myriam|M|
Meltzer|Ethan|E|0000-0002-0467-936X

D003240:Connective Tissue Diseases
D006801:Humans
D008180:Lupus Erythematosus, Systemic
D009471:Neuromyelitis Optica
D000072140:Rheumatologists
D012859:Sjogren's Syndrome

NMOSD
Connective tissue disease
Devic’s disease
NMO
Sjogren’s syndrome
Systemic lupus disease


Web-based patient portal access in an orthopedic adult reconstruction patient population.

Abstract:
Background
We surveyed patients in an adult reconstruction practice as to their use of the Web-based portal provided by our electronic health record, seeking to reveal patterns of use and helpfulness.

Methods
A total of 150 completed surveys were received. The survey queried demographics, the number of clinic visits, Internet access, portal activation, portal use frequency, and portal information questions and how patients answered them. Helpfulness was rated from 1 (not helpful) to 5 (very helpful). Statistical analysis included bivariate analysis and logistic regression, with odds ratio (OR) and 95% confidence interval (CI) reported.

Results
The mean age was 67.6 years. Most were females (n = 97, 65.1%). Most (68.7%) patients used the portal. Younger age (OR, 0.94; CI, 0.90-0.99) and access to Internet (OR, 31.8; CI, 8.5-119.4) predicted portal use (P < .005), whereas gender and number of clinic visits did not (P > .373). Of all, 47.5% of patients were unclear about online chart information. Older age indicated being unclear of portal information (68.5 vs 66, P = .0002). Of those who clarified doubts regarding information (n = 67), 23 used the Internet (34.3%), 32 (47.7%) called the physician, and 12 (17.9%) asked a friend and/or family member. Most (90.3%) patients felt the portal was helpful in gathering health information.

Conclusions
Age and Internet access affected portal usage; ability to understand chart information decreased with age. Most patients used the Internet or a family member to clarify doubts regarding portal information. The use of portal data resulted in 32 extra communications to the physician.

Kolodychuk|Nicholas L|NL|
Wong|Michael|M|
Chimento|George|G|
Adams|Tyler|T|
Gastanaduy|Mariella|M|
Waddell|Bradford S|BS|

Patient portal
Access
Electronic
Online
Personal


Automated Solid-Phase Peptide Synthesis.

Abstract: The development of solid-phase peptide synthesis by Bruce Merrifield paved the way for a synthesis carried out by machines. Automated peptide synthesis is a fast and convenient way of synthesizing many peptides simultaneously. This chapter tries to give a general guidance for the development of synthesis protocols for the peptide synthesizer. It also provides some suggestions for the modification of the synthesized peptides. Additionally, many examples of possible challenges during and after the synthesis are given in order to support the reader in finding the best synthesis strategy. Numerous references are given to many of the described matters.

Solid-phase peptide synthesis
Difficult peptides
Peptide modifications
Side reactions