Body condition scoring (BCS) in corn snakes (Pantherophis guttatus) and comparison to pre-existing body condition index (BCI) for snakes.

Abstract: In the veterinary profession, the body condition score (BCS) plays an important role in the assessment of patients. It is a subjective, tactile method of evaluating body fat and muscle mass and is used in numerous species. Recognizing obesity (or the contrary, emaciation) is important for veterinarians treating reptiles and could be facilitated by a BCS. An existing form of body condition assessment already used is the body condition index (BCI), where the residuals from a regression of body mass on body length are calculated. Therefore, the goal of this study was to provide practitioners with a BCS system for corn snakes (Pantherophis guttatus) and to test it against the BCI. A total of 22 corn snakes (Pantherophis guttatus), stationed at the "Auffangstation für Reptilien" in Munich (reptile rescue centre, RRC), were subject of this study. Each had the following measurements taken: body weight (BW), snout-tail tip length (STL), snout-vent length (SVL) and circumference in the middle (C). Manual palpation of spine, area between vertebral spinous and transverse process, ribs and neck of each snake was performed by three veterinarians and assigned to specific scores by each examiner. A BCS (mean of examiners' scores) was given to each snake according to manual palpation. The BCS system was chosen to be out of 5 in 0.5-point steps with 2.5 considered as ideal BCS. In the studied snakes, the BCS ranged from 1.5 to 3.5, with a median of 2.5. The median BW was 309 g (75-967 g), the median STL was 123 cm (79-153 cm), the median SVL was 104 cm (73-133 cm) and the median C was 7.5 cm (4.3-11 cm). BCS and BCI were positively correlated. A BCS includes a manual palpation of the animal and thus gives the examiner additional information to the objectively measured/calculated index.

body condition score
corn snake
Pantherophis guttatus
body condition index
reptile


Transmissibility of tuberculosis among school contacts: an outbreak investigation in a boarding middle school, China.

Abstract: Tuberculosis (TB) outbreak occurred in a boarding middle school of China. We explored its probable sources and quantified the transmissibility and pathogenicity of TB. Clinical evaluation, tuberculin skin testing and chest radiography were conducted to identify TB cases. Mycobacterium tuberculosis isolates underwent genotyping analysis to identify the outbreak source. A chain-binomial transmission model was used to evaluate transmissibility and pathogenicity of TB. A total of 46 active cases were ascertained among 258 students and 15 teachers/staff, an attack rate of 16.8%. Genetic analyses revealed two groups of M. tuberculosis cocirculating during the outbreak and possible importation from local communities. Secondary attack rates among students were 4.1% (2.9%, 5.3%) within grade and 7.9% (4.9%, 11%) within class. An active TB case was estimated to infect 8.4 (7.2, 9.6) susceptible people on average. The smear-positive cases were 28 (8, 101) times as infective as smear-negative cases. Previous BCG vaccination could reduce the probability of developing symptoms after infection by 70% (1.4%, 91%). The integration of clinical evaluation, genetic sequencing, and statistical modeling greatly enhanced our understanding of TB transmission dynamics. Timely diagnosis of smear-positive cases, especially in the early phase of the outbreak, is the key to preventing further spread among close contacts.

Ma|Mai-Juan|MJ|
Yang|Yang|Y|
Wang|Hai-Bin|HB|
Zhu|Yi-Fan|YF|
Fang|Li-Qun|LQ|
An|Xiao-Ping|XP|
Wan|Kang-Lin|KL|
Whalen|Christopher C|CC|
Yang|Xiao-Xian|XX|
Lauzardo|Michael|M|
Zhang|Zhi-Yi|ZY|
Cao|Jin-Feng|JF|
Tong|Yi-Gang|YG|
Dai|Er-Hei|EH|
Cao|Wu-Chun|WC|

Transmission
Tuberculosis
Outbreak
Chain-binomial transmission model
Genome sequencing


Intestinal transcriptomes in Kazakh sheep with different haplotypes after experimental Echinococcus granulosus infection.

Abstract: Cystic echinococcosis (CE) is a chronic zoonosis caused by infection with the larval stage of the cestode Echinococcus granulosus. As the intermediate host, sheep are highly susceptible to this disease. Our previous studies have shown that sheep with haplotype MHC Mva Ibc-Sac IIab-Hin1I ab were resistant to CE infection, while their counterparts without this haplotype were not. In order to reveal the molecular mechanism of resistance in Kazakh sheep, after selecting the differential miRNA in our previous study, herein, transcriptome analyses were conducted to detect the differential expression genes in the intestinal tissue of Kazakh sheep with resistant and non-resistant MHC haplotypes, after peroral infection with E. granulosus eggs. A total of 3835 differentially expressed genes were identified between the two groups, with 2229 upregulated and 1606 downregulated. Further function analysis showed that the most significant genes were related to both innate immune response and adaptive response participating in the defense against E. granulosus infection and the metabolic changes associated with it. The results suggest that genes related to lectin receptors, NK cells activation, chemokines, and tumor necrosis factor, may play important roles in the response of intestinal tissue to E. granulosus.

Echinococcus granulosus
Differentially expressed genes
Intestinal tissue
Disease resistance
Transcriptome analysis


Balancing risks and benefits of therapy for patients with favorable-risk limited-stage Hodgkin lymphoma: the role of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy alone.

Abstract: Because long-term survival of patients with nonbulky stage IA to IIA Hodgkin lymphoma is dependent on disease control and avoidance of late toxic effects associated with the treatment received, the initial choice of treatment can be associated with trade-offs that balance optimum disease control with avoidance of these late effect risks. Health professionals and patients face the dilemma of making treatment decisions without the benefit of completely understanding the risk-benefit balances associated with how current treatments affect all outcomes of interest. Optimum management of these patients requires careful multidisciplinary evaluation and communication strategies that account for patient preferences.

D000971:Antineoplastic Combined Chemotherapy Protocols

Hodgkin lymphoma
Chemotherapy
Combined modality therapy
Radiation therapy
Review


How to make an impact in surgical research: a consensus summary from the #SoMe4Surgery community.

Abstract: Understanding and interpreting medical literature through critical thinking and applying this knowledge to evidence-based practice is an integral part of surgical training. Participating in research accelerates this process; however, young doctors' involvement in research may be suboptimal. Our aim was to provide young surgeons with recommendations on how to properly engage in surgical research. An online twitter conversation focused on recommendations about how a young physician can succeed in research was undertaken. Twitter activity for that conversation and hashtags was analyzed. A consensus based on the recommendations extracted from the discussion is summarized. Key opinion leaders were engaged to promote the conversation. Discussion was opened to all participants related to surgery or surgical research, including surgeons, medical students, nurses, patients, and healthcare workers. A total of 244 participants engaged in the Twitter conversation. The highest tweeted hashtags were #SoMe4Surgery and #SurgicalResearch with 855 and 847 tweets, respectively. Themes that came out of the conversation included 'Mentorship', which was the most essential recommendation. 'International collaboratives' and 'foreign research fellowship' were also deemed important factors for a successful path in research. Additionally, routine read of online journals, use of social media for scientific purposes, often engagement in manuscript drafting and proper time management were also recommended. Research is demanding and time consuming but an essential part of surgical education. We believe that any young surgeon can have greater chances to succeed in surgical research by following our recommendations and by academically using social media platforms.

Surgical research
Young surgeons
Medical students
Trainee


Stringent Response in Bacteria and Plants with Infection.

Abstract: Stringent response (SR), a primary stress reaction in bacteria and plant chloroplasts, is a molecular switch that provides operational stress-induced reprogramming of transcription under conditions of abiotic and biotic stress. Because the infection is a stressful situation for both partners (the host plant and the pathogen), we analyzed the expression of bacterial and plastid SR-related genes during plant-microbial interaction. In the phytopathogenic bacterium Pectobacterium atrosepticum, SpoT-dependent SR was induced after contact with potato or tobacco plants. In plants, two different scenarios of molecular events developed under bacterial infection. Plastid SR was not induced in the host plant potato Solanum tuberosum, which co-evolved with the pathogen for a long time. In this case, the salicylic acid defense pathway was activated and plants were more resistant to bacterial infection. SR was activated in the tobacco Nicotiana tabacum (experimental host) along with activation of jasmonic acid-related genes, resulting in plant death. These results are important to more fully understand the evolutionary interactions between plants and symbionts/pathogens.

Petrova|Olga|O|0000-0003-1618-5479 Parfirova|Olga|O| Gogolev|Yuri|Y| Gorshkov|Vladimir|V|

stringent response
host plant
bacterial infection
(p)ppGpp
RelA-SpoT homologs
jasmonic acid defense pathway


Coordination of seed dormancy and germination processes by MYB96.

Abstract: The transition between seed dormancy and germination is an important stage that initiates plant life cycle. Hormonal balances of abscisic acid (ABA) and gibberellin (GA) contribute to determining the proper timing to germinate. Here, we demonstrate that the R2R3-type MYB96 transcription factor, a key ABA signaling mediator, coordinates seed dormancy and germination processes through distinct downstream events. This transcription factor controls ABA-INSENSITIVE 4 (ABI4) expression to inhibit seed germination by suppressing breakdown of lipid reserves in embryo. In addition, it also induces seed dormancy by stimulating ABA biosynthesis in an ABI4-independent manner. We propose that MYB96 integrates a multitude of environmental stress signals and acts as a master regulator in the determination of timing for seed germination.

seed dormancy
MYB96
abscisic acid
ABI4
seed germination
Arabidopsis


Response of Microbial Communities to Changing Climate Conditions During Summer Cyanobacterial Blooms in the Baltic Sea.

Abstract: Frequencies and biomass of Baltic Sea cyanobacterial blooms are expected to be higher in future climate conditions, but also of longer duration as a result of increased sea surface temperature. Concurrently, climate predictions indicate a reduced salinity in the Baltic Sea. These climate-driven changes are expected to alter not solely the phytoplankton community but also the role of microbial communities for nutrient remineralization. Here, we present the response of summer plankton communities (filamentous cyanobacteria, picocyanobacteria, and heterotrophic bacteria) to the interplay of increasing temperature (from 16 to 18°C and 20°C) and reduced salinity (from salinity 6.9 to 5.9) in the Baltic Proper (NW Gotland Sea) using a microcosm approach. Warmer temperatures led to an earlier peak of cyanobacterial biomass, while yields were reduced. These conditions caused a decrease of nitrogen-fixers (Dolichospermum sp.) biomass, while non nitrogen-fixers (Pseudanabaena sp.) increased. Salinity reduction did not affect cyanobacterial growth nor community composition. Among heterotrophic bacteria, Actinobacteria showed preference for high temperature, while Gammaproteobacteria thrived at in situ temperature. Heterotrophic bacteria community changed drastically at lower salinity and resembled communities at high temperature. Picocyanobacteria and heterotrophic bacterial biomass had a pronounced increase associated with the decay of filamentous cyanobacteria. This suggests that shifts in community composition of heterotrophic bacteria are influenced both directly by abiotic factors (temperature and salinity) and potentially indirectly by cyanobacteria. Our findings suggest that at warmer temperature, lower yield of photosynthetic cyanobacteria combined with lower proportion of nitrogen-fixers in the community could result in lower carbon export to the marine food web with consequences for the decomposer community of heterotrophic bacteria.

Berner|Christoffer|C| Bertos-Fortis|Mireia|M| Pinhassi|Jarone|J| Legrand|Catherine|C|

Baltic Sea
biomass
cyanobacteria
heterotrophic bacteria
16S rRNA
climate change
microscopy
summer bloom


Intermittent demand forecasting for medical consumables with short life cycle using a dynamic neural network during the COVID-19 epidemic.

Abstract: Accurate demand forecasting is always critical to supply chain management. However, many uncertain factors in the market make this issue a huge challenge. Especially during the current COVID-19 outbreak, the shortage of certain types of medical consumables has become a global problem. The intermittent demand forecast of medical consumables with a short life cycle brings some new challenges, such as the demand occurring randomly in many time periods with zero demand. In this research, a seasonal adjustment method is introduced to deal with seasonal influences, and a dynamic neural network model with optimized model selection procedure and an appropriate model selection criterion are introduced as the main forecasting models. In addition, in order to reduce the impact of zero demand, it adds some input nodes to the neural network by preprocessing the original input data. Lastly, a modified error measurement method is proposed for performance evaluation. Experimental results show that the proposed forecasting framework is superior to other intermittent demand models.

intermittent demand forecasting
short life cycle
dynamic neural network
optimized model selection
accuracy measurement


Nitrous oxide emissions in response to straw incorporation is regulated by historical fertilization.

Abstract: The incorporation of crop straw with fertilization is beneficial for soil carbon sequestration and cropland fertility improvement. Yet, relatively little is known about how fertilization regulates the emissions of the greenhouse gas nitrous oxide (N2O) in response to straw incorporation, particularly in soils subjected to long-term fertilization regimes. Herein, the arable soil subjected to a 31-year history of five inorganic or organic fertilizer regimes (unfertilized; chemical fertilizer application, NPK; 200% NPK application, 2 × NPK; manure application, M; NPK plus manure application, NPKM) was incubated with and without rice straw to evaluate how historical fertilization influences the impact of straw addition on N2O emissions. The results showed that compared to the unfertilized treatment, historical fertilization strongly increased N2O emissions by 0.48- to 34-fold, resulting from increased contents of hot water-extracted organic carbon (HWEOC), NO3-, and available phosphorus (Olsen-P). Straw addition had little impact on N2O emission from the unfertilized and NPK treatments, primarily due to Olsen-P limitation. In contrast, straw addition increased N2O emissions by 102-316% from the 2 × NPK, M, and NPKM treatments as compared to the corresponding straw-unamended treatments. These results indicated that N2O emissions in response to straw addition were largely regulated by historical fertilization. The N2O emissions were closely associated with the depletion of NO3- and decoupled from change in NH4+ content, suggesting that NO3- was the main substrate for N2O production upon straw addition. The stoichiometric ratios of HWEOC to mineral N and mineral N to Olsen-P were key factors affecting N2O emissions, underscoring the importance of resource stoichiometry in regulating N2O emissions. In conclusion, historical fertilization largely regulated the impacts of crop straw incorporation on N2O emissions via shifts in NO3- depletion and the stoichiometry of HWEOC, mineral N, and Olsen-P.

Wu|Lei|L| Hu|Ronggui|R| Tang|Shuirong|S| Shaaban|Muhammad|M| Zhang|Wenju|W| Shen|Huaping|H| Xu|Minggang|M|

Historical fertilization
Straw addition
Stoichiometric ratio
N(2)O emission
NO(3)(−) depletion


Occupational diseases in Italian national priority contaminated sites.

Abstract:
BACKGROUND
The aim of this study was to evaluate the occupational health risks in the Italian National Priority Contaminated Sites (NPCSs).

METHODS
Established cases of occupational diseases in 2010-2014 were extracted from the Italian National Institute for Insurance against Accidents at Work (INAIL) archives. Standardized incidence ratios with 95% confidence intervals were estimated by site and by disease group separately for genders.

RESULTS
In the 44 NPCSs evaluated, 11 015 cases of occupational diseases (8877 in men and 2138 in women) were ascertained. Overall, an excess of occupational diseases with respect to expected cases of 24.2% was found in men residing in NPCSs. An increased occurrence was detected in 21 NPCSs for men and in eight for women.

CONCLUSIONS
The findings suggest a role of occupational diseases in the health profile of NPCSs, reinforcing the need for a permanent surveillance system.

D002318:Cardiovascular Diseases
D004427:Ear Diseases
D004787:Environmental Pollution
D005128:Eye Diseases
D005260:Female
D064371:Hazardous Waste Sites
D006801:Humans
D015994:Incidence
D007558:Italy
D008297:Male
D001523:Mental Disorders
D009140:Musculoskeletal Diseases
D009369:Neoplasms
D009422:Nervous System Diseases
D009784:Occupational Diseases
D012140:Respiratory Tract Diseases
D012871:Skin Diseases
D014876:Water Pollution

occupational diseases
contaminated sites
surveillance systems
Italy


Spatial Information in a Non-retinotopic Visual Cortex.

Abstract: Turtle dorsal cortex (dCx), a three-layered cortical area of the reptilian telencephalon, receives inputs from the retina via the thalamic lateral geniculate nucleus and constitutes the first cortical stage of visual processing. The receptive fields of dCx neurons usually occupy the entire contralateral visual field. Electrophysiological recordings in awake and anesthetized animals reveal that dCx is sensitive to the spatial structure of natural images, that dCx receptive fields are not entirely uniform across space, and that adaptation to repeated stimulation is position specific. Hence, spatial information can be found both at the single-neuron and population scales. Anatomical data are consistent with the absence of a clear retinotopic mapping of thalamocortical projections. The mapping and representation of visual space in this three-layered cortex thus differ from those found in mammalian primary visual cortex. Our results support the notion that dCx performs a global, rather than local, analysis of the visual scene.

Fournier|Julien|J|
Müller|Christian M|CM|
Schneider|Ingmar|I|
Laurent|Gilles|G|

receptive field
adaptation
Bayesian decoding
brain evolution
dLGN
extracellular recording
oscillation
reptile
vision


Mapping epidemiology's past to inform its future: metaknowledge analysis of epidemiologic topics in leading journals, 1974-2013.

Abstract: An empiric perspective on what epidemiology has studied over time might inform discussions about future directions for the discipline. We aimed to identify the main areas of epidemiologic inquiry and determine how they evolved over time in 5 high-impact epidemiologic journals. We analyzed the titles and abstracts of 20,895 articles that were published between 1974 and 2013. In 5 time periods that reflected approximately equal numbers of articles, we identified the main topics by clustering terms based on co-occurrence. Infectious disease and cardiovascular disease epidemiology were the prevailing topics over the 5 periods. Cancer epidemiology was a major topic from 1974 to 2001 but disappeared thereafter. Nutritional epidemiology gained relative importance from 1974 to 2013. Environmental epidemiology appeared during 1996-2001 and continued to be important, whereas 2 clusters related to methodology and meta-analysis in genetics appeared during 2008-2013. Several areas of epidemiology, including injury or psychiatric epidemiology, did not make an appearance as major topics at any time. In an ancillary analysis of 6 high-impact general medicine journals, we found patterns of epidemiologic articles that were overall consistent with the findings in epidemiologic journals. This metaknowledge investigation allowed identification of the dominant topics in and conversely those that were absent from 5 major epidemiologic journals. We discuss implications for the field.

D016000:Cluster Analysis
D004813:Epidemiology
D010506:Periodicals as Topic

bibliometrics
knowledge
periodicals as topic
terminology as topic


Spatial variation in reproductive effort of a southern Australian seagrass.

Abstract: In marine environments characterised by habitat-forming plants, the relative allocation of resources into vegetative growth and flowering is an important indicator of plant condition and hence ecosystem health. In addition, the production and abundance of seeds can give clues to local resilience. Flowering density, seed bank, biomass and epiphyte levels were recorded for the temperate seagrass Zostera nigricaulis in Port Phillip Bay, south east Australia at 14 sites chosen to represent several regions with different physicochemical conditions. Strong regional differences were found within the large bay. Spathe and seed density were very low in the north of the bay (3 sites), low in the centre of the bay (2 sites) intermediate in the Outer Geelong Arm (2 sites), high in Swan Bay (2 sites) and very high in the Inner Geelong Arm (3 sites). In the south (2 sites) seed density was low and spathe density was high. These regional patterns were largely consistent for the 5 sites sampled over the three year period. Timing of flowering was consistent across sites, occurring from August until December with peak production in October, except during the third year of monitoring when overall densities were lower and peaked in November. Seagrass biomass, epiphyte load, canopy height and stem density showed few consistent spatial and temporal patterns. Variation in spathe and seed density and morphology across Port Phillip Bay reflects varying environmental conditions and suggests that northern sites may be restricted in their ability to recover from disturbance through sexual reproduction. In contrast, sites in the west and south of the bay have greater potential to recover from disturbances due to a larger seed bank and these sites could act as source populations for sites where seed production is low.

Smith|Timothy M|TM|
York|Paul H|PH|
Macreadie|Peter I|PI|
Keough|Michael J|MJ|
Ross|D Jeff|DJ|
Sherman|Craig D H|CD|

Seagrass
Vegetative growth
Flowering
Seed bank
Sexual reproduction
Heterozostera tasmanica
Reproductive investment


Duration of short-acting granulocyte colony-stimulating factor for primary prophylaxis and risk of neutropenia-related hospitalization in older patients with cancer.

Abstract:
PURPOSE
Evaluate the relationship between duration of primary prophylactic short-acting granulocyte colony-stimulating factor (PP-sG-CSF) and risk of neutropenia-related hospitalization (NRH) in older patients receiving myelosuppressive chemotherapy.

METHODS
Using the Medicare claims database, we conducted a nested case-control study in a cohort of patients aged ≥66 years with breast, colorectal, lung, ovarian, or prostate cancer, or non-Hodgkin lymphoma who initiated a first cycle of any myelosuppressive chemotherapy January 1, 2008-September 30, 2016, and received PP-sG-CSF. We matched up to four controls to each NRH case by age, cancer type, regimen febrile neutropenia (FN) risk category, and year using incidence density sampling. We used conditional logistic regression adjusted for race, sex, and modified Charlson comorbidity index (CCI) to estimate relative risk of NRH related to duration of PP-sG-CSF categorized as <5 and ≥ 5 days.

RESULTS
Of 2148 patients receiving PP-sG-CSF, 108 (5%) experienced NRH in the first cycle. We matched 333 controls to 96 cases. Cases were similar to controls in mean age, tumor type, and intermediate/high-risk regimen, but were more likely to have CCI ≥5 and less likely to use PP-sG-CSF ≥5 days (31% vs. 39%). Adjusted ORs (95% CI) for NRH were 0.69 (0.40-1.19) for ≥5 vs. <5 days of PP-sG-CSF among patients receiving any myelosuppressive chemotherapy, 0.43 (0.21-0.89) for intermediate/high-risk regimen, and 0.42 (0.19-0.89) for any myelosuppressive chemotherapy with all agents given on cycle day one only.

CONCLUSIONS
Among older patients with cancer who are receiving PP-sG-CSF, ≥5 days of use was associated with substantial reduction in NRH risk.

Li|Shuling|S|
Liu|Jiannong|J|
Gong|Tingting|T|
Guo|Haifeng|H|
Gawade|Prasad L|PL|
Kelsh|Michael A|MA|
Bradbury|Brian D|BD|
Belani|Rajesh|R|
Lyman|Gary H|GH|

Short-acting granulocyte colony-stimulating factors


Some neck swellings are serious; a case of Lemierre's Syndrome.

Abstract: Lemierre's syndrome also termed post-anginal septicemia, is a disease characterized by internal jugular septic thrombophlebitis leading to Fusobacterium septicemia with multiple metastatic foci following an oropharyngeal infection. Diagnosis and management is challenging and can result in fatal consequences due to potential multisystem involvement and multiple complications. We describe here a case of Lemierre's syndrome with multifocal pneumonia, acute renal failure and protracted course of illness over forty days with successful recovery. A brief overview of literature is also presented.

Ghani|Ali Raza|AR|
Hamid|Mohsin|M|
Raza|Ahsan|A|
Naseer|Rizwan|R|
Crocetti|Joseph|J|


Comparison of Different Temperature Conditions for Microbial Enumeration of Aspergillus brasiliensis in the Preservative Efficacy Test.

Abstract: The preservative efficacy test is an important method for assessing the antimicrobial effect of cosmetic products. In this study, the optimum conditions for the efficient microbial enumeration of Aspergillus brasiliensis were investigated. Cosmetic products, inoculated with A. brasiliensis spore suspensions, were cultivated at 22.5°C, 32.5°C, or 40°C and the detection rate and the number of colonies were determined using the pour culture method. There was no difference in the viable counts of visible colonies among different temperature conditions. However, the viable counts after 3 days of culture were significantly greater for the cultures maintained at 32.5°C or 40°C compared with those maintained at 22.5°C. This effect was attenuated in products containing fatty acids, which could inhibit fungal growth. Overall, these results demonstrate that cultivating A. brasiliensis at 32.5°C reduces the time required for enumeration in the preservative efficacy test. Thus, the results of this study are expected to help improve and expedite microbiological quality control in the cosmetic industry.

Aspergillus brasiliensis
Preservative efficacy test
Cosmetics


Women's Health and the Military.

Abstract: Approximately 1.8 million American women are veterans of the Armed Services, and an additional 200,000 women are currently serving on active duty. With the increasing number of women in the military, there has been an increase in the number of women who have faced prolonged deployment in combat environments. This article discusses reproductive health concerns, family planning and contraceptive considerations, intimate partner violence and military sexual assault, posttraumatic stress disorder, and postdeployment health issues. It concludes with a list of available resources accessible to veterans and their providers.

van den Berk Clark|Carissa|C|
Chang|Jennifer|J|
Servey|Jessica|J|
Quinlan|Jeffrey D|JD|

Veteran
Intimate partner violence
Military sexual trauma
PTSD


The link between sleep disturbance and depression among Mexican Americans: a Project FRONTIER study.

Abstract:
OBJECTIVE
To examine the link between disturbed sleep and depression scores in Mexican Americans and non-Hispanic Whites.

METHODS
Data were analyzed for 566 participants (45% Mexican Americans) who were part of a rural healthcare study, Project FRONTIER. Mean age was 55.5 years for Mexican Americans (70% female) and 65.6 years for non-Hispanic Whites (69% female). Self-reported sleep disturbance was entered as the predictor, GDS-30 total and factor scores as the outcome variables, and age, sex, education, BMI, and medical diagnoses (hyperlipidemia, diabetes mellitus, and hypertension) entered as covariates.

RESULTS
Mexican Americans reported higher rates of sleep disturbances (25%) than non-Hispanic whites (17%). Sleep disturbances were significantly associated with GDS-30 total scores and the factors Dysphoria and Cognitive Impairment in both Mexican Americans and non-Hispanic whites.

CONCLUSIONS
In this study, Mexican Americans reported higher rates of sleep disturbances than non-Hispanic whites. Disturbed sleep was positively associated with depression and the factor scores for Dysphoria and Cognitive Impairment in both groups. Given the paucity of research on sleep disorders in Mexican Americans, identifying what sleep disorders are present and the impact treating these sleep disorders have on depression warrant further investigation.

Roane|Brandy M|BM|
Johnson|Leigh|L|
Edwards|Melissa|M|
Hall|James|J|
Al-Farra|Sherif|S|
O'Bryant|Sid E|SE|

sleep
sleep disturbance
depression
Mexican American


Pedicled lower extremity fillet flap for coverage of massive pelvic wounds.

Abstract: Fillet flaps are traditionally harvested from nonsalvagable extremities to reconstruct complex soft tissue defects. This method results in minimal donor site morbidity, and can be effective in reconstructing large pelvic wounds requiring significant soft tissue coverage. Here, we present their application in three young patients with extensive pelvic wounds secondary to trauma and its sequelae. In each case, neurologic injury limited limb function, and fillet flaps were used to fill soft tissue defects and pad bony prominences. The fillet flaps have been successful in providing wound coverage in all cases, and have all remained intact to date, with a mean follow up time of 29 months. These results demonstrate a role for fillet flaps in the management challenging pelvic wounds, as they can provide both satisfactory tissue coverage and improved functional outcomes.

Jones|Christine M|CM|
Phelan|Alannah L|AL|
Samson|Thomas D|TD|

Fillet flap
Massive pelvic wounds
Lower extremity trauma
Pelvic reconstruction
Pelvic trauma


Preparation of a functional fluorescent human Fas ligand extracellular domain derivative using a three-dimensional structure guided site-specific fluorochrome conjugation.

Abstract:
BACKGROUND
Human Fas ligand extracellular domain has been investigated as an important target protein in the field of medical biotechnology. In a recent study, the author developed an effective method to produce biologically active human Fas ligand extracellular domain derivatives using site-specific chemical modifications.

FINDINGS
A human Fas ligand extracellular domain derivative containing a reactive cysteine residue within its N-terminal tag sequence, which locates not proximal to the binding interface between the ligand and the receptor in terms of the three-dimensional structure, was modified by Fluorescein-5-Maleimide without impairing the specific binding activity toward human Fas receptor extracellular domain. The purified protein sample free of low molecular-weight contaminants showed a characteristic fluorescence spectrum derived from the attached Fluorescein moieties, and formed a stable binding complex with human Fas receptor extracellular domain-human IgG1 Fc domain fusion protein in solution. The conjugation number of the fluorochrome was estimated to be 2.5 per a single human Fas ligand extracellular domain trimer from the ratio of the absorbance value at 280 nm to that at 495 nm.

CONCLUSIONS
A functional fluorescent human Fas ligand extracellular domain derivative was prepared via a site-specific conjugation of fluorochrome, which was guided by the three-dimensional structure information on the ligand-receptor complex. Fluorescent derivatives created by this method may contribute to the development of an improved diagnosis system for the diseases related to Fas receptor.

Human Fas ligand
Extracellular domain
Three-dimensional structure
Fluorochrome
Site-specific conjugation
Receptor-binding activity


Dissecting methanogenesis for temperature-phased anaerobic digestion: Impact of temperature on community structure, correlation, and fate of methanogens.

Abstract: This study investigated the relationship between the temperature (35, 42, and 55 °C) used in temperature-phased anaerobic digestion (TPAD) and fate of methanogens between the two anaerobic digestion (AD) phases. Methanogens were profiled by using next generation sequencing (NGS) and droplet digital PCR approaches. The results showed that optimal combined temperatures for methane production were 55 °C during biological hydrolysis (BH) and 35 or 42 °C during AD. BH exhibited much lower archaeal population and was more susceptible to changes in temperature, compared to the AD phase. Additionally, we demonstrated, for the first time, that the BH step could affect the subsequent AD phase by altering AD methanogen composition and improve the stability of the process by enriching the rapidly growing Methanosarcina in the BH-AD process. These results are significant for understanding the mechanisms and stability of methane production in TPAD systems.

Temperature
Methanogen
Methane production
Sewage sludge
Temperature phased anaerobic digestion


Validated Method for the Characterization and Quantification of Extractable and Nonextractable Ellagitannins after Acid Hydrolysis in Pomegranate Fruits, Juices, and Extracts.

Abstract: Pomegranates are one of the main highly valuable sources of ellagitannins. Despite the potential health benefits of these compounds, reliable data on their content in pomegranates and derived extracts and food products is lacking, as it is usually underestimated due to their complexity, diversity, and lack of commercially available standards. This study describes a new method for the analysis of the extractable and nonextractable ellagitannins based on the quantification of the acid hydrolysis products that include ellagic acid, gallic acid, sanguisorbic acid dilactone, valoneic acid dilactone, and gallagic acid dilactone in pomegranate samples. The study also shows the occurrence of ellagitannin C-glycosides in pomegranates. The method was optimized using a pomegranate peel extract. To quantify nonextractable ellagitannins, freeze-dried pomegranate fruit samples were directly hydrolyzed with 4 M HCl in water at 90 °C for 24 h followed by extraction of the pellet with dimethyl sulfoxide/methanol (50:50, v/v). The method was validated and reproducibility was assessed by means of an interlaboratory trial, showing high reproducibility across six laboratories with relative standard deviations below 15%. Their applicability was demonstrated in several pomegranate extracts, different parts of pomegranate fruit (husk, peels, and mesocarp), and commercial juices. A large variability has been found in the ellagitannin content (150-750 mg of hydrolysis products/g) and type (gallagic acid/ellagic acid ratios between 4 and 0.15) of the 11 pomegranate extracts studied.

García-Villalba|Rocío|R|
Espín|Juan Carlos|JC|
Aaby|Kjersti|K|
Alasalvar|Cesarettin|C|
Heinonen|Marina|M|
Jacobs|Griet|G|
Voorspoels|Stefan|S|
Koivumäki|Tuuli|T|
Kroon|Paul A|PA|
Pelvan|Ebru|E|
Saha|Shikha|S|
Tomás-Barberán|Francisco A|FA|

D002851:Chromatography, High Pressure Liquid

D021241:Spectrometry, Mass, Electrospray Ionization

ellagitannin
acid hydrolysis
pomegranate
ellagic acid
interlaboratory reproducibility


Neuroblastoma of the elderly, an oncologist's nightmare: case presentation, literature review and SEER database analysis.

Abstract: Neuroblastoma is considered a pediatric malignancy as over 95% of cases are diagnosed in patients ≤10 years old. This cancer is extremely rare in elderly patients. We conducted a Surveillance, Epidemiology, and End Results (SEER) database analysis in the USA between 1973-2007 that revealed only 35 elderly patients (>60 years of age) with neuroblastoma of whom only 2 patients had primary mediastinal neuroblastoma. There is a paucity of treatment and survival outcomes data for the elderly owing to the rarity of neuroblastoma in this population. Currently there are no standard guidelines or protocols for treatment of adult neuroblastoma. We report a rare and challenging case of an 86-year old patient presenting with mediastinal neuroblastoma and syndrome of inappropriate antidiuretic hormone secretion (SIADH) successfully treated with resection. Herein, we also provide a review of the literature and updated survival data on neuroblastoma based on results of our SEER database review.

Rogowitz|Elisa|E|
Babiker|Hani M|HM|
Kanaan|Mohammed|M|
Millius|Rebecca A|RA|
Ringenberg|Q Scott|QS|
Bishop|Maria|M|


Proposal and Evaluation of Visual Haptics for Manipulation of Remote Machine System.

Abstract: Remote machine systems have drawn a lot of attention owing to accelerations of virtual reality (VR), augmented reality (AR), and the fifth generation (5G) networks. Despite recent trends of developing autonomous systems, the realization of sophisticated dexterous hand that can fully replace human hands is considered to be decades away. It is also extremely difficult to reproduce the sensilla of complex human hands. On the other hand, it is known that humans can perceive haptic information from visual information even without any physical feedback as cross modal sensation between visual and haptics sensations or pseudo haptics. In this paper, we propose a visual haptic technology, where haptic information is visualized in more perceptual images overlaid at the contact points of a remote machine hand. The usability of the proposed visual haptics was evaluated by subject's brain waves aiming to find out a new approach for quantifying "sense of oneness." In our proof-of-concept experiments using VR, subjects are asked to operate a virtual arm and hand presented in the VR space, and the performance of the operation with and without visual haptics information as measured with brain wave sensing. Consequently, three results were verified. Firstly, the information flow in the brain were significantly reduced with the proposed visual haptics for the whole α, β, and θ-waves by 45% across nine subjects. This result suggests that superimposing visual effects may be able to reduce the cognitive burden on the operator during the manipulation for the remote machine system. Secondly, high correlation (Pearson correlation factor of 0.795 at a p-value of 0.011) was verified between the subjective usability points and the brainwave measurement results. Finally, the number of the task successes across sessions were improved in the presence of overlaid visual stimulus. It implies that the visual haptics image could also facilitate operators' pre-training to get skillful at manipulating the remote machine interface more quickly.

visual haptics
manipulation
remote machine system
brain wave
EEG


MitoNEET in Perivascular Adipose Tissue Prevents Arterial Stiffness in Aging Mice.

Abstract:
PURPOSE
Arterial stiffness is an inevitable consequence of the aging process and is considered an early stage in the development of cardiovascular diseases. The perivascular adipose tissue (PVAT) is a distinct functional integral layer of the vasculature actively involved in blood pressure regulation and atherosclerosis development via PVAT-derived paracrine/autocrine factors. However, there is little knowledge regarding the relationship between PVAT and arterial stiffness.

METHODS
Using unique mice lacking PVAT, high-fat diet-induced obesity, and in mice overexpressing brown adipocyte selective mitoNEET, we investigated the relationship between PVAT and arterial stiffness in mice.

RESULTS
We found that lack of PVAT enhanced arterial stiffness in aging mice. High-fat diet feeding of aging C57BL/6J wild-type mice significantly induced hypertrophic PVAT and enhanced arterial stiffness. Furthermore, the expression of mitoNEET, a mitochondrial membrane protein related to energy expenditure, was significantly increased by pioglitazone treatment, while reduced in the hypertrophic PVAT induced by high-fat diet. Overexpression of mitoNEET in PVAT reduced the expression of inflammatory genes and was associated with lower pulse wave velocity in aging mice.

CONCLUSIONS
These data indicate that local PVAT homeostasis especially inflammation in PVAT is associated with arterial stiffness development. Pioglitazone-induced mitoNEET in PVAT prevents PVAT inflammation and is negatively associated with arterial stiffness. These findings provide new experimental insight into the roles of pioglitazone on PVAT in arterial stiffness and indicate that PVAT might be a target to treat or prevent cardiovascular disease.

Chang|Lin|L|0000-0002-5621-8426
Zhao|Xiangjie|X|
Garcia-Barrio|Minerva|M|
Zhang|Jifeng|J|
Eugene Chen|Y|Y|

D002001:Adipose Tissue, Brown
D050154:Adiposity
D000367:Age Factors
D000375:Aging
D000818:Animals
D002318:Cardiovascular Diseases
D059305:Diet, High-Fat
D004195:Disease Models, Animal
D033862:Iron-Binding Proteins
D008297:Male
D008565:Membrane Proteins
D008810:Mice, Inbred C57BL
D000074085:Mice, Knockout, ApoE
D009765:Obesity
D047495:PPAR gamma
D000077205:Pioglitazone
D015398:Signal Transduction
D059289:Vascular Stiffness

mitoNEET
Perivascular adipose tissue
Arterial stiffness
Brown adipose tissue


Phantom Limbs, Neuroprosthetics, and the Developmental Origins of Embodiment.

Abstract: Amputees who wish to rid themselves of a phantom limb must weaken the neural representation of the absent limb. Conversely, amputees who wish to replace a lost limb must assimilate a neuroprosthetic with the existing neural representation. Whether we wish to remove a phantom limb or assimilate a synthetic one, we will benefit from knowing more about the developmental process that enables embodiment. A potentially critical contributor to that process is the spontaneous activity - in the form of limb twitches - that occurs exclusively and abundantly during active (REM) sleep, a particularly prominent state in early development. The sensorimotor circuits activated by twitching limbs, and the developmental context in which activation occurs, could provide a roadmap for creating neuroprosthetics that feel as if they are part of the body.

development
REM sleep
body schema
brain–machine interface
cerebellum
motor cortex
myoclonic twitching
neural circuit


Does the Arthroscopic Latarjet Procedure Effectively Correct "Off-Track" Hill-Sachs Lesions?

Abstract:
BACKGROUND
The glenoid track concept describes the dynamic interaction of bipolar bone loss in anterior glenohumeral instability. Initial studies have successfully demonstrated this concept's application in clinical populations. In clinical practice, the Latarjet procedure is commonly the preferred treatment in addressing "off-track" Hill-Sachs lesions. The effectiveness of this procedure in restoring such lesions to an "on-track" state, however, has not yet been evaluated or described in the literature.

HYPOTHESIS
The Latarjet procedure would transform "off-track" Hill-Sachs lesions to "on-track" lesions. Lesions would remain "on-track" during follow-up, despite glenoid remodeling.

STUDY DESIGN
Case series; Level of evidence, 4.

METHODS
Patients with "off-track" Hill-Sachs lesions treated with the arthroscopic Latarjet procedure between March 2013 and May 2014 were included. Glenoid track and coracoid graft contact surface area measurements using 3-dimensional computed tomography (3D-CT) were performed preoperatively and at 6-week, 6-month, and at least 12-month (final) follow-up. The mean final follow-up was 23 months. The glenoid diameter, as a percentage of the native glenoid, was also calculated from this imaging.

RESULTS
Twenty-six patients met the inclusion criteria. 3D-CT scans were available for all patients preoperatively and postoperatively, with 21 patients (81%) undergoing 6-month follow-up CT and 19 patients (73%) undergoing final follow-up CT. Hill-Sachs lesions remained "on-track" at all follow-up time points. The mean glenoid diameter changed significantly from 84.6% preoperatively to 122.8% at 6 weeks ( P < .001) and from 120.5% at 6 months to 113.9% at final follow-up ( P = .005). This was also reflected in significant remodeling seen in the coracoid graft articular contact area (6 weeks to 6 months, P = .024; 6 months to final follow-up, P = .002). This persisting glenoid arc enlargement at final follow-up avoided "off-track" Hill-Sachs lesions in 6 of 19 patients (32%), which would otherwise have occurred had the coracoid graft remodeled to native glenoid dimensions.

CONCLUSION
The Latarjet procedure provides an effective treatment for "off-track" engaging Hill-Sachs lesions, despite an evident glenoid remodeling process. At a mean of 23 months postoperatively, a mean persisting enlargement of the glenoid arc of 14% beyond native dimensions remained, avoiding a recurrent "off-track" lesion in 32% of patients, which would otherwise have occurred with complete remodeling.

Plath|Johannes E|JE|
Henderson|Daniel J H|DJH|
Coquay|Julien|J|
Dück|Klaus|K|
Haeni|David|D|
Lafosse|Laurent|L|

Latarjet
glenoid track
glenoid remodeling
“off-track” lesion


Patient and healthcare provider experiences of hepatitis C treatment with direct-acting antivirals in Rwanda: a qualitative exploration of barriers and facilitators.

Abstract:
BACKGROUND
Direct-acting antivirals (DAAs) are increasingly accessible to patients with hepatitis C (HCV) worldwide and are being introduced through national health systems in sub-Saharan Africa. DAAs are highly efficacious when tested in controlled trials, yet patients treated outside of study settings often encounter challenges in completing the full treatment and follow-up sequence. Little information is available on the influences of successful DAA implementation in sub-Saharan Africa. This qualitative study explored the individual- and system-level barriers and enablers of DAA treatment in Rwanda between March 2015 and November 2017.

METHODS
Face-to-face interviews were conducted with 39 patients who initiated care at one of four referral hospitals initially offering DAAs. Ten healthcare providers who managed HCV treatment participated in face-to-face interviews to examine system-level barriers and facilitators. Interview data were analyzed using a general inductive approach in alignment with the a priori objective of identifying barriers and facilitators of HCV care.

RESULTS
Barriers to successful treatment included patients' lack of knowledge surrounding HCV and its treatment; financial burdens associated with paying for medication, laboratory testing, and transportation; the cumbersome nature of the care pathway; the relative inaccessibility of diagnostics technology; and heavy workloads of healthcare providers accompanied by a need for additional HCV-specific training. Patients and healthcare providers were highly aligned on individual- and system-level barriers to care. The positive patient-provider relationship, strong support from community and family members, lack of stigma, and mild side effect profile of DAAs all positively influenced patients' engagement in treatment.

CONCLUSIONS
Several interrelated factors acted as barriers and facilitators to DAA treatment in Rwanda. Patients' and healthcare providers' perceptions were in agreement, suggesting that the impeding and enabling factors were well understood by both groups. These results can be used to enact evidence-informed interventions to help maximize the impact of DAAs as Rwanda moves towards HCV elimination.

D007722:Health Knowledge, Attitudes, Practice

D010342:Patient Acceptance of Health Care

Hepatitis C
Direct-acting antivirals
Rwanda
Qualitative
Sub-Saharan Africa


Role of tissue expanders in patients with loss of abdominal domain awaiting intestinal transplantation.

Abstract: Abdominal closure is a complex surgical problem in intestinal transplant recipients with loss of abdominal domain, as graft exposure results in profound morbidity. Although intraoperative coverage techniques have been described, this is the first report of preoperative abdominal wall augmentation using tissue expanders in patients awaiting intestinal transplantation. We report on five patients who received a total of twelve tissue expanders as a means to increase abdominal surface area. Each patient had a compromised abdominal wall (multiple prior operations, enterocutaneous fistulae, subcutaneous abscesses, stomas) with loss of domain and was identified as high risk for an open abdomen post-transplant. Cross-sectional imaging and dimensional analysis were performed to quantify the effect of the expanders on total abdominal and intraperitoneal cavity volumes. The overall mean increase in total abdominal volume was 958 cm(3) with a mean expander volume of 896.5 cc. Two expanders were removed in the first patient due to infection, but after protocol modification, there were no further infections. Three patients eventually underwent small bowel transplantation with complete graft coverage. In our preliminary experience, abdominal tissue expander placement is a safe, feasible, and well-tolerated method to increase subcutaneous domain and facilitate graft coverage in patients undergoing intestinal transplantation.

Watson|Melissa J|MJ|
Kundu|Neilendu|N|
Coppa|Christopher|C|
Djohan|Risal|R|
Hashimoto|Koji|K|
Eghtesad|Bijan|B|
Fujiki|Masato|M|
Diago Uso|Teresa|T|
Gandhi|Namita|N|
Nassar|Ahmed|A|
Abu-Elmagd|Kareem|K|
Quintini|Cristiano|C|

tissue expanders
intestinal transplantation
loss of domain


Age and Obesity Promote Methylation and Suppression of 5α-Reductase 2: Implications for Personalized Therapy of Benign Prostatic Hyperplasia.

Abstract:
PURPOSE
In men with symptomatic benign prostatic hyperplasia 5α-reductase inhibitors are a main modality of treatment. More than 30% of men do not respond to the therapeutic effects of 5α-reductase inhibitors. We have found that a third of adult prostate samples do not express 5α-reductase type 2 secondary to epigenetic modifications. We evaluated whether 5α-reductase type 2 expression in benign prostatic hyperplasia specimens from symptomatic men was linked to methylation of the 5α-reductase type 2 gene promoter. We also identified associations with age, obesity, cardiac risk factors and prostate specific antigen.

MATERIALS AND METHODS
Prostate samples from men undergoing transurethral prostate resection were used. We determined 5α-reductase type 2 protein expression and gene promoter methylation status by common assays. Clinical variables included age, body mass index, hypertension, hyperlipidemia, diabetes, prostate specific antigen and prostate volume. Univariate and multivariate statistical analyses were performed followed by stepwise logistic regression modeling.

RESULTS
Body mass index and age significantly correlated with methylation of the 5α-reductase type 2 gene promoter (p <0.05) whereas prostate volume, prostate specific antigen or benign prostatic hyperplasia medication did not correlate. Methylation highly correlated with 5α-reductase protein expression (p <0.0001). In a predictive model increasing age and body mass index significantly predicted methylation status and protein expression (p <0.01).

CONCLUSIONS
Increasing age and body mass index correlate with increased 5α-reductase type 2 gene promoter methylation and decreased protein expression in men with symptomatic benign prostatic hyperplasia. These results highlight the interplay among age, obesity and gene regulation. Our findings suggest an individualized epigenetic signature for symptomatic benign prostatic hyperplasia, which may be important to choose appropriate personalized treatment options.

Bechis|Seth K|SK|
Otsetov|Alexander G|AG|
Ge|Rongbin|R|
Wang|Zongwei|Z|
Vangel|Mark G|MG|
Wu|Chin-Lee|CL|
Tabatabaei|Shahin|S|
Olumi|Aria F|AF|

obesity
prostatic hyperplasia
5-alpha reductase inhibitors
epigenomics
lower urinary tract symptoms


Injectable thermosensitive hydrogel-based drug delivery system for local cancer therapy.

Abstract: Injectable thermosensitive hydrogel has been regarded as attractive drug delivery system, which displays a sol-gel phase transition upon injection in response to temperature. Recently, thermosensitive hydrogel has become a matter of importance in cancer therapy, providing high local drug concentration, sustained release characteristics, minimal invasiveness, and low systemic toxicities. Here, we review the extensive application of thermosensitive hydrogel in local cancer therapy, including chemotherapy, photothermal therapy, photodynamic therapy, gene therapy, chemo-photothermal combined therapy, and chemo-/immuno- combined therapy.

Xiao|Yin|Y| Gu|Yuhong|Y| Qin|Li|L| Chen|Lin|L| Chen|Xiaoliang|X| Cui|Weiheng|W| Li|Fuling|F| Xiang|Ni|N| He|Xiaoai|X|

D020136:Hydrogel, Polyethylene Glycol Dimethacrylate

Drug delivery system
Cancer therapy
Thermosensitive hydrogel


Infection status of hydatid cysts in humans and sheep in Uzbekistan.

Abstract: Uzbekistan is endemic of cystic echinococcosis (CE). In order to estimate endemicity of CE, we collected data from emergency surgery due to CE in 2002-2010 and also investigated the prevalence of hydatid cysts in the liver and lungs of sheep at an abattoir in Uzbekistan from July 2009 to June 2010. In 14 emergency hospitals, 8,014 patients received surgical removal or drainage of CE during 2002-2010, and 2,966 patients were found in 2010. A total of 22,959 sheep were grossly examined of their liver and lungs, and 479 (2.1%) and 340 (1.5%) of them were positive for the cyst in the liver and lungs, respectively. Echinococcus granulosus is actively transmitted both to humans and sheep, and CE is a zoonotic disease of public health priority in Uzbekistan.

Hong|Sung-Tae|ST| Jin|Yan|Y| Anvarov|Khikmat|K| Khadjibaev|Abdukhakim|A| Hong|Samin|S| Ahmedov|Yusufjon|Y| Otaboev|Utkir|U|

sheep
Uzbekistan
emergency surgery
Echinococcus granulosus


Incidence of postoperative nausea and vomiting after laparoscopic sleeve gastrectomy with staple line reinforcement with oversewing and staple line inversion vs buttressing material: A randomized clinical trial.

Abstract:
BACKGROUND
Postoperative nausea and vomiting are relevant complications after restrictive bariatric procedures, such as sleeve gastrectomy, mainly secondary to a drastic reduction in the gastric volume. However, other causes can be involved. The aim of this study was to determine the incidence of postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG), with staple line reinforcement with oversewing vs buttressing material.

PATIENTS AND METHODS
A prospective randomized clinical trial of all the patients undergoing LSG was performed. Patients were divided into 2 groups: patients undergoing staple line inversion (Group 1) and patients undergoing staple line reinforcement with buttressing material (Group 2). Nausea and vomiting were assessed by the Postoperative Nausea and Vomiting Intensity Scale.

RESULTS
A total of 100 females were included in the study, 50 in each group. Mean operative time was 66.1 ± 11.6 min in Group 1 and 55.4 ± 9.4 in Group 2 (p < 0.001). There were no significant differences in staple line leaks and bleeds between groups. The PONV intensity score at 6 h was 316.4 in Group 1 and 77.1 in Group 2 (p < 0.001). 24 h after surgery, the PONV intensity score was 86 in Group 1 and 7.9 in Group 2 (p = 0.022).

CONCLUSION
The reinforcement with a running suture in LSG creates more PONV and increases the duration of the symptoms during the first hours after surgery, and prevents from early oral intake in a greater number of cases, when compared with the use of buttressing material as reinforcement method.

Ruiz-Tovar|Jaime|J|
Zubiaga|Lorea|L|
Muñoz|Jose Luis|JL|
Llavero|Carolina|C|

D020250:Postoperative Nausea and Vomiting

Postoperative nausea and vomiting
Sleeve gastrectomy
Staple line reinforcement
Oversewing
Buttressing material


Delivery Platforms for CRISPR/Cas9 Genome Editing of Glial Cells in the Central Nervous System.

Abstract: Glial cells (astrocytes, oligodendrocytes, and microglia) are emerging as key players in several physiological and pathological processes of the central nervous system (CNS). Astrocytes and oligodendrocytes are not only supportive cells that release trophic factors or regulate energy metabolism, but they also actively modulate critical neuronal processes and functions in the tripartite synapse. Microglia are defined as CNS-resident cells that provide immune surveillance; however, they also actively contribute to shaping the neuronal microenvironment by scavenging cell debris or regulating synaptogenesis and pruning. Given the many interconnected processes coordinated by glial cells, it is not surprising that both acute and chronic CNS insults not only cause neuronal damage but also trigger complex multifaceted responses, including neuroinflammation, which can critically contribute to the disease progression and worsening of symptoms in several neurodegenerative diseases. Overall, this makes glial cells excellent candidates for targeted therapies to treat CNS disorders. In recent years, the application of gene editing technologies has redefined therapeutic strategies to treat genetic and age-related neurological diseases. In this review, we discuss the advantages and limitations of clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9-based gene editing in the treatment of neurodegenerative disorders, focusing on the development of viral- and nanoparticle-based delivery methods for in vivo glial cell targeting.

Meneghini|Vasco|V| Peviani|Marco|M| Luciani|Marco|M| Zambonini|Giada|G| Gritti|Angela|A|

editing
astrocytes
oligodendrocytes
microglia
CRISPR/Cas9 system
adeno-associated viral vectors
lentiviral vectors
nanoparticles


Protein accumulation and rumen stability of wheat γ-gliadin fusion proteins in tobacco and alfalfa.

Abstract: The nutritional value of various crops can be improved by engineering plants to produce high levels of proteins. For example, because methionine deficiency limits the protein quality of Medicago Sativa (alfalfa) forage, producing alfalfa plants that accumulate high levels of a methionine-rich protein could increase the nutritional value of that crop. We used three strategies in designing methionine-rich recombinant proteins that could accumulate to high levels in plants and thereby serve as candidates for improving the protein quality of alfalfa forage. In tobacco, two fusion proteins, γ-gliadin-δ-zein and γ-δ-zein, as well as δ-zein co-expressed with β-zein, all formed protein bodies. However, the γ-gliadin-δ-zein fusion protein accumulated to the highest level, representing up to 1.5% of total soluble protein (TSP) in one transformant. In alfalfa, γ-gliadin-δ-zein accumulated to 0.2% of TSP, and in an in vitro rumen digestion assay, γ-gliadin-δ-zein was more resistant to microbial degradation than Rubisco. Additionally, although it did not form protein bodies, a γ-gliadin-GFP fusion protein accumulated to much higher levels, 7% of TSP, than a recombinant protein comprised of an ER localization signal fused to GFP in tobacco. Based on our results, we conclude that γ-gliadin-δ-zein is a potential candidate protein to use for enhancing methionine levels in plants and for improving rumen stability of forage protein. γ-gliadin fusion proteins may provide a general platform for increasing the accumulation of recombinant proteins in transgenic plants.

Sun|Xiaodong|X|
Chi-Ham|Cecilia L|CL|
Cohen-Davidyan|Tamar|T|
DeBen|Christopher|C|
Getachew|Girma|G|
DePeters|Edward|E|
Putnam|Daniel|D|
Bennett|Alan|A|

protein accumulation
rumen stability
tobacco
alfalfa
KDEL
N-terminal γ-gliadin


Non-surgical management of the auto-amputated adnexa in the neonate: a report on two cases.

Abstract:
BACKGROUND
Prenatal ovarian torsion is a rare but significant gynecologic abnormality. Current literature has yet to establish standard management in the case of auto-amputated adnexa secondary to ovarian torsion in the neonate.

CASES
We report 2 cases of abdominal masses that were diagnosed in the antenatal period and were clinically consistent with auto-amputated adnexa followed with serial ultrasonography until resolution.

SUMMARY AND CONCLUSION
To our knowledge this is the first report in the literature to document resolution of 2 pelvic masses due to auto-amputated adnexa with expectant management. This suggests expectant management is an appropriate alternative to surgical management in carefully selected cases.

Trotman|Gylynthia E|GE|
Zamora|Melodie|M|
Gomez-Lobo|Veronica|V|

D000291:Adnexal Diseases
D005260:Female
D005315:Fetal Diseases
D006801:Humans
D007231:Infant, Newborn
D010049:Ovarian Diseases
D014102:Torsion Abnormality
D016216:Ultrasonography, Prenatal
D057832:Watchful Waiting

antenatal ovarian torsion
autoamputation
neonatal ovarian cysts
neonatal pelvic mass


Effectiveness of group discussions and commitment in improving cleaning behaviour of shared sanitation users in Kampala, Uganda slums.

Abstract:
RATIONALE AND OBJECTIVE
Access to and use of hygienic shared sanitation facilities is fundamental in reducing the high risk of diseases such as diarrhoea and respiratory infections. We evaluated the effectiveness of group discussions and commitment in improving the cleaning behaviour of shared sanitation users in three urban slums in Kampala, Uganda. The study follows the risk, attitudes, norms, abilities and self-regulation (RANAS) model of behaviour change and some factors of the social dilemma theory.

METHODS
A pre-versus post-intervention survey was conducted in three slums of Kampala, Uganda, between December 2012 and September 2013. From the pre-intervention findings, users of dirty sanitation facilities were randomly assigned to discussions, discussions + commitment and control interventions. The interventions were implemented for 3 months with the aim of improving cleaning behaviour. This paper provides an analysis of 119 respondents who belonged to the intervention discussion-only (n = 38), discussions + commitment (n = 41) and the control (no intervention, n = 40) groups.

RESULTS
Compared to the control, discussions and discussions + commitment significantly improved shared toilet users' cleaning behaviour. The rate of improvement was observed through behavioural determinants such as cleaning obligation, cleaning ease, cleaning approval and affective beliefs.

CONCLUSION
Our study findings show that group discussions and commitment interventions derived from RANAS model of behaviour change are effective in improving the shared sanitation users' cleaning behaviour.

Group discussions
Commitment
Cleaning behaviour
Shared sanitation
Uganda
Urban slums
RANAS


Understanding the influence of the MomConnect programme on antenatal and postnatal care service utilisation in two South African provinces: a realist evaluation protocol.

Abstract:
INTRODUCTION
Timely antenatal care (ANC) and postnatal care (PNC) attendance decrease maternal and child mortality by improving maternal and child health (MCH) outcomes. Mobile health or mHealth has been identified as an effective way of improving the uptake of MCH services. The MomConnect programme is an mHealth initiative launched by the National Department of Health of South Africa in August 2014 to support MCH. Although widely used, there is a limited understanding of how, why, for whom and under which health system conditions, the implementation of MomConnect improves the health-seeking behaviour of pregnant women and mothers of infants in ANC and PNC facilities. This paper describes the protocol for a realist evaluation of the MomConnect programme, to provide a theory-based understanding of how, why and under what healthcare conditions the MomConnect programme works or not.

METHOD AND ANALYSIS
We will use the realist evaluation approach through its research cycle conducted in three phases. In phase I, a multimethod elicitation study design will be used, including a document review, key informant interviews and a scoping review to formulate an initial programme theory of the MomConnect intervention. Content and thematic analytic approaches will be used to analyse the data that will be fitted into a realist framework to formulate the initial programme theory. In phase II, a multi-case study design will be applied using a multimethod approach in two South African provinces. In each case, a theory-testing approach underpinned by the hypothetico-deduction analytic model will be used to test the initial programme theory. Surveys, interviews and focus group discussions will be conducted with various programme actors and analysed using appropriate methods. Phase III will entail refining the tested/modified programme theory through cross-case analysis.

EXPECTED OUTCOMES
An improved understanding of how and why the MomConnect intervention improves the health-seeking behaviour of pregnant women and mothers of infants, and the health system conditions that influence its implementation.

ETHICS AND DISSEMINATION
Ethics approval was granted by the Stellenbosch University Ethics Committee (S18/09/189). The protocol has been designed and the study will be conducted in line with the principles of the Declaration of Helsinki (1964).

primary care
public health
quality In healthcare


Molecular underpinnings of integrin binding to collagen-mimetic peptides containing vascular Ehlers-Danlos syndrome-associated substitutions.

Abstract: Collagens carry out critical extracellular matrix (ECM) functions by interacting with numerous cell receptors and ECM components. Single glycine substitutions in collagen III, which predominates in vascular walls, result in vascular Ehlers-Danlos syndrome (vEDS), leading to arterial, uterine, and intestinal rupture and an average life expectancy of <50 years. Collagen interactions with integrin α2β1 are vital for platelet adhesion and activation; however, how these interactions are impacted by vEDS-associated mutations and by specific amino acid substitutions is unclear. Here, we designed collagen-mimetic peptides (CMPs) with previously reported Gly → Xaa (Xaa = Ala, Arg, or Val) vEDS substitutions within a high-affinity integrin α2β1-binding motif, GROGER. We used these peptides to investigate, at atomic-level resolution, how these amino acid substitutions affect the collagen III-integrin α2β1 interaction. Using a multitiered approach combining biological adhesion assays, CD, NMR, and molecular dynamics (MD) simulations, we found that these substitutions differentially impede human mesenchymal stem cell spreading and integrin α2-inserted (α2I) domain binding to the CMPs and were associated with triple-helix destabilization. Although an Ala substitution locally destabilized hydrogen bonding and enhanced mobility, it did not significantly reduce the CMP-integrin interactions. MD simulations suggested that bulkier Gly → Xaa substitutions differentially disrupt the CMP-α2I interaction. The Gly → Arg substitution destabilized CMP-α2I side-chain interactions, and the Gly → Val change broke the essential Mg2+ coordination. The relationship between the loss of functional binding and the type of vEDS substitution provides a foundation for developing potential therapies for managing collagen disorders.

Hoop|Cody L|CL|0000-0003-4441-8321
Kemraj|Allysa P|AP|
Wang|Baifan|B|
Gahlawat|Sonal|S|
Godesky|Madison|M|
Zhu|Jie|J|
Warren|Haley R|HR|
Case|David A|DA|
Shreiber|David I|DI|
Baum|Jean|J|

D019943:Amino Acid Substitution
D001665:Binding Sites
D002448:Cell Adhesion
D002460:Cell Line
D003094:Collagen
D004535:Ehlers-Danlos Syndrome
D006801:Humans
D038982:Integrin alpha2beta1
D059630:Mesenchymal Stem Cells
D062105:Molecular Docking Simulation
D010455:Peptides
D011485:Protein Binding

integrin
collagen
vascular Ehlers-Danlos syndrome
cell spreading
cell surface receptor
collagen mutations
connective tissue disorder
extracellular matrix protein
protein-protein interaction
triple helix


Synchronized and controlled release of metformin hydrochloride/glipizide from elementary osmotic delivery.

Abstract: The combination of metformin hydrochloride (MTF) and glipizide (GLZ) is second-line medication for diabetes mellitus type 2 (DMT2). In the present study, elementary osmotic pump ( EOP) tablet is designed to deliver the combination of MTF and GLZ in a sustained and synchronized manner. By analyzing different variables of the formulation, sodium hydrogen carbonate is introduced as pH modifier to improve the release of GLZ, while ethyl cellulose acts as release retardant to reduce the burst release phase of MTF. A two-factor, three-level face-centered central composite design (FCCD) is applied to investigate the impact of different factors on drug release profile. Compared with conventional tablets, the EOP tablet demonstrates a controlled release behavior with relative bioavailability of 99.2% for MTF and 99.3% for GLZ. Data also shows EOP tablet is able to release MTF and GLZ in a synchronized and sustained manner both in vitro and in vivo.

Pan|Hao|H| Jing|Hengpan|H| Yang|Xinggang|X| Pan|Weisan|W| Chen|Tianbao|T|

metformin hydrochloride/glipizide
Elementary osmotic pump (EOP)
face-centered central composite design
synchronized and sustained release


Rapamycin Promotes the Survival and Adipogenesis of Ischemia-Challenged Adipose Derived Stem Cells by Improving Autophagy.

Abstract:
BACKGROUND/AIMS
Ischemia is one of the main causes of the high rate of absorption of transplanted autologous fat. Autophagy allows cells to survive by providing energy under starvation. Rapamycin has been found to play a role in promoting autophagy. In this study, we investigated whether rapamycin participates in the survival and adipogenesis of ischemia-challenged adipose-derived stem cells (ADSCs) by regulating autophagy.

METHODS
Before the cells were exposed to oxygen-glucose deprivation (OGD), a simulated ischemic microenvironment, the level of autophagy was reduced or increased by lentiviral transfection with short hairpin RNA targeting microtubule-associated protein 1-light chain 3 gene (shRNA-LC3) or treatment with rapamycin, respectively. The level of autophagy was assessed by western blotting, transmission electron microscopythen the apoptosis ratio was determined through terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and flow cytometry. Adipogenesis was further evaluated by oil red O staining and the expressions level of some specific proteins for adipocytes.

RESULTS
shRNA-LC3 and rapamycin treatment effectively decreased and improved the level of autophagy in cells with or without OGD challenge, respectively. In addition, autophagy inhibition increased the apoptosis rate and activated caspase-3 expression level in response to OGD, and these were markedly inhibited by rapamycin preconditioning. During adipogenesis, autophagy inhibition decreased not only oil droplet accumulation but also lipoprotein lipase (LPL) and peroxisome proliferator-activated receptor gamma (PPARγ) expression in cells with or without OGD challenge. However, autophagy promotion by rapamycin increased oil droplet accumulation and LPL and PPARγ expression.

CONCLUSIONS
Rapamycin may promote the survival and adipogenesis of ischemia-challenged ADSCs by upregulating autophagy.

Li|Chichi|C| Ye|Lechi|L| Yang|Li|L| Yu|Xiaofang|X| He|Yucang|Y| Chen|Zhuojie|Z| Li|Liqun|L| Zhang|Dan|D|

Rapamycin
Adipogenesis
Autophagy
Ischemia
Adipose-derived stem cells


Nutrient profile and digestibility of tubers and agro-industrial coproducts determined using an in vitro model of swine.

Abstract: Exploring and evaluating alternative feed ingredients to be used in swine diet is essential due to highly variable cost and limited availability of conventional feed ingredients. Tubers and agro-industrial coproducts could provide the basis for producing affordable swine feed. However, information on the nutritional value of these potential alternative feedstuffs is necessary while considering their use in swine feeding program. Four tubers (purple sweet potato [PSP], okinawan sweet potato, taro and cassava) and 3 coproducts (okara, wheat millrun [WMR] and barley brewers grain [BBG]) were analyzed for their proximate nutrients, starch, fibers and gross energy (GE) content. Two independent in vitro studies were carried out for tubers and coproducts to determine their nutrients digestibility using a 3-step enzymatic assay (which mimics the digestion occurring in the gastrointestinal tract of swine) with 9 replicates of each sample digested in 3 batches equally. All replicate samples were used to determine in vitro dry matter digestibility (IVDDM) while 2 replicates from each batch were used to determine in vitro GE digestibility (IVDGE). Among tubers, CP content was the highest in taro (8.8%) and the lowest in cassava (3.7%), while CP content among coproducts was the highest in okara (22.7%) and the lowest in WMR (11.8%). Ether extract content among tubers ranged from 1.1% to 2.8%. The GE content among tubers, ranged from 4,134 to 4,334 kcal/kg whereas among coproducts it ranged from 4,270 to 4,794 kcal/kg. Among tubers, IVDDM for PSP was significantly higher (86.8%, P < 0.001) than taro (70.3%). Among coproducts, IVDDM of okara (74.1%) was significantly higher (P < 0.05) than BBG (61.3%). In conclusion, both tubers and coproducts can be used as a partial substitute of conventional energy feedstuffs in swine diets as these are rich in GE and other nutrients and are fairly digestible.

Tubers
Coproducts
Swine
Alternative feedstuffs
In vitro digestibility


A pharmacoeconomic analysis to compare cost-effectiveness of metformin plus teneligliptin with metformin plus glimepiride in patients of type-2 diabetes mellitus.

Abstract:
Background
With the available evidence of early combined oral drug therapies being more effective in lowering blood glucose levels than maximal doses of a single drug, many clinicians are taking the aggressive approach of adding a sulfonylurea or a dipeptidyl peptidase-4 (DPP-4) inhibitor to metformin as the initial therapy in type 2 diabetes mellitus (T2DM). Pharmacotherapy for a chronic disease like diabetes has substantial economic implications for patients especially in a developing country like India. So it is important to scientifically evaluate the cost-effectiveness of these commonly practiced combination therapies in the management of T2DM.

Materials and Methods
This was a prospective observational randomized comparative study conducted over 8 weeks on patients of T2DM who were prescribed either of the two therapies of metformin (500 mg) plus glimepiride (1 mg) or metformin (500 mg) plus teneligliptin (20 mg). Cost-effectiveness analysis was done by calculating the expense incurred on 0.1% reduction in HbA1 c and 1 mg/dl reduction in fasting plasma glucose (FPG)/post-prandial plasma glucose (PPG) levels after 8 weeks and compared for both the groups. The same was also evaluated for differences in BMI levels.

Results
The cost-effectiveness for per unit reduction in HbA1c and FPG was significant in metformin plus glimepiride group as compared to the metformin plus teneligliptin group though it was comparable for both the groups for per unit PPG reduction. There was no significant change in BMI levels between the groups.

Conclusion
Compared to metformin plus teneligliptin, metformin plus glimepiride is a significantly cost-effective therapy when used as an initial combination therapy in patients of T2DM in lowering HbA1c and FPG.

Tandon|Tanya|T|
Dubey|Ashok K|AK|
Srivastava|Saurabh|S|
Manocha|Sachin|S|
Arora|Ekta|E|
Hasan|Nazer|N|


The bagworm genome reveals a unique fibroin gene that provides high tensile strength.

Abstract: Arthropod silk is known as a versatile tool, and its variability makes it an attractive biomaterial. Eumeta variegata is a bagworm moth (Lepidoptera, Psychidae) that uses silk throughout all life stages. Notably, the bagworm-specific uses of silk include larval development in a bag coated with silk and plant materials and the use of silk attachments to hang pupae. An understanding at the molecular level of bagworm silk, which enables such unique purposes, is an opportunity to expand the possibilities for artificial biomaterial design. However, very little is known about the bagworm fibroin gene and the mechanical properties of bagworm silk. Here, we report the bagworm genome, including a silk fibroin gene. The genome is approximately 700 Mbp in size, and the newly found fibroin gene has a unique repetitive motif. Furthermore, a mechanical property test demonstrates a phylogenetic relationship between the unique motif and tensile strength of bagworm silk.

D012091:Repetitive Sequences, Nucleic Acid

Biomaterials
Comparative genomics
Evolutionary ecology


New onset seizures as a sole clinical presentation of multiple sclerosis.

Abstract:
BACKGROUND AND OBJECTIVES
Epileptic seizures frequently occur in people with multiple sclerosis (MS) and are thought to represent a manifestation of cortical pathology. However, at present, seizures are not considered to be a typical clinical presentation of demyelination.

METHODS AND RESULTS
In this case series, we identified four people, who presented with seizures as a sole presenting feature, with demyelinating imaging abnormalities that satisfy current diagnostic criteria for a clinically isolated syndrome (CIS) or early MS.

CONCLUSION
Based on this case series, we propose that people presenting with de novo seizures, with concurrent radiological abnormalities suggestive of demyelination could potentially be considered to have a CIS.

Al Hussona|Mariam|M|
Kearney|Hugh|H|
Fisher|Arie|A|
Lynch|John|J|
Looby|Seamus|S|
Delanty|Norman|N|

Multiple sclerosis
cortical lesions
electroencephalogram
epilepsy
temporal lobe


Transcriptomic analyses of Aedes aegypti cultured cells and ex vivo midguts in response to an excess or deficiency of heme: a quest for transcriptionally-regulated heme transporters.

Abstract:
BACKGROUND
Aedes aegypti is the principle vector of many arboviruses, including dengue virus and Zika virus, which are transmitted when an infected female mosquito takes a blood meal in order to initiate vitellogenesis. During blood digestion, ~ 10 mM heme-iron is ingested into the midgut lumen. While heme acts as both a nutrient and signaling molecule during blood digestion, it can also be highly toxic if left unchaperoned. Both signaling by, and degradation of, heme are intracellular processes, occurring in the nucleus and cytoplasm, respectively. However, the precise mechanism of heme uptake into the midgut epithelium is not currently known.

RESULTS
We used next generation RNA sequencing with the goal to identify genes that code for membrane bound heme import protein(s) responsible for heme uptake into the midgut epithelium. Heme deprivation increased uptake of a heme fluorescent analog in cultured cells, while treatment of midguts with an excess of heme decreased uptake, confirming physiological changes were occurring in these heme-sensitive cells/tissues prior to sequencing. A list of candidate genes was assembled for each of the experimental sample sets, which included Aag2 and A20 cultured cells as well as midgut tissue, based on the results of a differential expression analysis, soft cluster analysis and number of predicted transmembrane domains. Lastly, the functions related to heme transport were examined through RNAi knockdown.

CONCLUSIONS
Despite a large number of transmembrane domain containing genes differentially expressed in response to heme, very few were highly differentially expressed in any of the datasets examined. RNAi knockdown of a subset of candidates resulted in subtle changes in heme uptake, but minimal overall disruption to blood digestion/egg production. These results could indicate that heme import in Ae. aegypti may be controlled by a redundant system of multiple distinct transport proteins. Alternatively, heme membrane bound transport in Ae. aegypti could be regulated post-translationally.

Transcriptomes
Aedes aegypti
Heme
Transporter
RNAi
Mosquito midgut


Use of Silodosin to Visualize the Posterior Urethra in Pelvic Floor Urethral Distraction Defect Patients.

Abstract:
BACKGROUND
Retrograde urethrogram and voiding cystourethrogram are used to define length and location of urethral stricture prior to surgery. We used a single dose of silodosin prior to VCUG to relax the bladder neck and achieve visualization of posterior urethra.

OBJECTIVES
To evaluate the efficacy of silodosin in visualization of posterior urethra during VCUG, and to compare the findings with a control group.

PATIENTS AND METHODS
Patients were divided into two groups A and B containing 20 and 15 patients, respectively. Patients in group A were given a single dose of silodosin prior to radiological studies.

RESULTS
In group A 19 out of 20 patients were able to achieve satisfactory bladder neck opening while in group B 10 out of 15 patients were able to achieve bladder neck opening.

CONCLUSIONS
Silodosin use prior to VCUG confers a statistically significant increase in bladder neck opening and visualization of posterior urethra.

Ranjan|Nikhil|N|
Singh|Rana Pratap|RP|
Ahmed|Ahsan|A|
Kumar|Vijoy|V|
Singh|Mahendra|M|

Silodosin
Retrograde Urethrogram
Voiding Cystourethrogram
Urethral Stricture
Vcug
Mcu
Urinary Bladder Neck Obstruction


Nursing Students' Spiritual Orientations and Their Attitudes Toward the Principles of Dying with Dignity: A Sample from Turkey.

Abstract: Nurses' attitudes toward spiritual care and death are influenced by their personal belief systems and world-views. The aim of this study is to reveal the attitudes of nursing students toward spiritual orientation and principles of dying with dignity. The study was conducted with the participation of 478 nursing students. As a result of the study, it was found that the average score of the students' spiritual orientation scale was high and the average score of the assessment scale of attitudes toward the principles of dying with dignity was found to be moderate.

Nursing student
Spiritual orientation
Dying with dignity


Health promoting lifestyles and influencing factors among empty nesters and non-empty nesters in Taiyuan, China: a cross-sectional study.

Abstract:
BACKGROUND
In China, the problems of population aging and empty nesting have become important issues which will affect the social stability and economic development. The aim of this study was to explore the health promoting lifestyles and influencing factors among empty nesters and compare with non-empty nesters to find out their differences, so as to provide a scientific evidence for people to formulate health management strategies for elderly.

METHODS
A cross-sectional survey which used a stratified random cluster sampling method, was conducted among 500 elders in six districts of Taiyuan, China, there were 288 empty nesters and 212 non-empty nesters. The general information and health- promoting lifestyles were investigated by using the self-made General Information Questionnaire and Health Promoting Lifestyle Scale(HPLP). Two-sample t-test and Chi-square test were used to compare the sociodemographic factors, HPLP scores of empty nesters to non-empty nesters; Multiple stepwise linear regression was performed to estimate influencing factors related to the HPLP of empty nesters and non-empty nesters.

RESULTS
The current findings showed that there were differences between the empty nesters and non-empty nesters in gender, resident, marital status, education and income, self-care ability, source of income, relationship with spouse and social activities (P < 0.05). Empty nesters were mostly male, married, had a higher education level, self-care ability and income and lived in urban compared with non-empty nesters. The health promoting lifestyles of the elderly in this survey were in the medium level, the highest score for all dimensions in both groups was in nutrition, whereas health responsibility was executed worst. The HPLP and six subscales scores of the empty nesters were higher than non-empty nesters, there were significant differences in total score of HPLP, self-realization and health responsibility (P < 0.01). Multiple regression analysis showed that the main predictive factors for the empty nesters were education, self-care ability and resident, whereas the main predictive factors for the non-empty nesters were parents-child relationship, source of income and age; social activity was the common factor for two group.

CONCLUSION
The health promoting lifestyles of the empty nesters was better than that of the non-empty nesters. Health responsibility, interpersonal relations and stress management were key dimensions to be improved. Except social activity, education, self-care ability and resident were the unique influencing factors of health-promoting lifestyles for empty nesters, while the parents-child relationship, income and age were unique factors for non-empty nesters. The main target of Intervention strategy for elderly health promoting lifestyles should be the enhance of health responsibility, interpersonal relations and stress management by improving social activities, parent-child relationship, education and income of elderly.

Influencing factors
Elderly
Cross-sectional survey
Health behavior


Curcumol Overcomes TRAIL Resistance of Non-Small Cell Lung Cancer by Targeting NRH:Quinone Oxidoreductase 2 (NQO2).

Abstract: Resistance to tumor-necrosis-factor-related apoptosis-inducing ligand (TRAIL) of cancer cell remains a key obstacle for clinical cancer therapies. To overcome TRAIL resistance, this study identifies curcumol as a novel safe sensitizer from a food-source compound library, which exhibits synergistic lethal effects in combination with TRAIL on non-small cell lung cancer (NSCLC). SILAC-based cellular thermal shift profiling identifies NRH:quinone oxidoreductase 2 (NQO2) as the key target of curcumol. Mechanistically, curcumol directly targets NQO2 to cause reactive oxygen species (ROS) generation, which triggers endoplasmic reticulum (ER) stress-C/EBP homologous protein (CHOP) death receptor (DR5) signaling, sensitizing NSCLC cell to TRAIL-induced apoptosis. Molecular docking analysis and surface plasmon resonance assay demonstrate that Phe178 in NQO2 is a critical site for curcumol binding. Mutation of Phe178 completely abolishes the function of NQO2 and augments the TRAIL sensitization. This study characterizes the functional role of NQO2 in TRAIL resistance and the sensitizing function of curcumol by directly targeting NQO2, highlighting the potential of using curcumol as an NQO2 inhibitor for clinical treatment of TRAIL-resistant cancers.

tumor‐necrosis‐factor‐related apoptosis‐inducing ligand resistance


Complementary and alternative treatments in sports medicine.

Abstract: Many patients suffering from pain and dysfunction attributable to musculoskeletal conditions will use some form of complementary and alternative medicine (CAM). Unfortunately, there is a paucity of both the quantity and quality of CAM treatments for specific musculoskeletal conditions. Many CAM treatments are used for a variety of musculoskeletal conditions, but may be more commonly used for specific conditions. This article addresses the use of CAM for specific musculoskeletal conditions, followed by a review of other CAM treatments and their potential indications for a multitude of conditions, based on the current medical literature and traditional use.

D015670:Acupuncture Therapy
D001265:Athletic Injuries
D001924:Brain Concussion
D000529:Complementary Therapies
D015525:Fatty Acids, Omega-3
D015775:Fractures, Stress
D006801:Humans
D026441:Mind-Body Therapies
D009140:Musculoskeletal Diseases
D010003:Osteoarthritis
D013178:Sports Medicine
D014807:Vitamin D

Sports medicine
Pain
Musculoskeletal
Complementary and alternative medicine
Acupuncture
Holistic
Integrative


Indole-3-lactic acid associated with Bifidobacterium-dominated microbiota significantly decreases inflammation in intestinal epithelial cells.

Abstract:
BACKGROUND
Bifidobacterium longum subsp. infantis (B. infantis) is a commensal bacterium that colonizes the gastrointestinal tract of breast-fed infants. B. infantis can efficiently utilize the abundant supply of oligosaccharides found in human milk (HMO) to help establish residence. We hypothesized that metabolites from B. infantis grown on HMO produce a beneficial effect on the host.

RESULTS
In a previous study, we demonstrated that B. infantis routinely dominated the fecal microbiota of a breast fed Bangladeshi infant cohort (1). Characterization of the fecal metabolome of binned samples representing high and low B. infantis populations from this cohort revealed higher amounts of the tryptophan metabolite indole-3-lactic acid (ILA) in feces with high levels of B. infantis. Further in vitro analysis confirmed that B. infantis produced significantly greater quantities of the ILA when grown on HMO versus lactose, suggesting a growth substrate relationship to ILA production. The direct effects of ILA were assessed in a macrophage cell line and intestinal epithelial cell lines. ILA (1-10 mM) significantly attenuated lipopolysaccharide (LPS)-induced activation of NF-kB in macrophages. ILA significantly attenuated TNF-α- and LPS-induced increase in the pro-inflammatory cytokine IL-8 in intestinal epithelial cells. ILA increased mRNA expression of the aryl hydrogen receptor (AhR)-target gene CYP1A1 and nuclear factor erythroid 2-related factor 2 (Nrf2)-targeted genes glutathione reductase 2 (GPX2), superoxide dismutase 2 (SOD2), and NAD(P) H dehydrogenase (NQO1). Pretreatment with either the AhR antagonist or Nrf-2 antagonist inhibited the response of ILA on downstream effectors.

CONCLUSIONS
These findings suggest that ILA, a predominant metabolite from B. infantis grown on HMO and elevated in infant stool high in B. infantis, and protects gut epithelial cells in culture via activation of the AhR and Nrf2 pathway.

Ehrlich|Amy M|AM|
Pacheco|Alline R|AR|
Henrick|Bethany M|BM|
Taft|Diana|D|
Xu|Gege|G|
Huda|M Nazmul|MN|
Mishchuk|Darya|D|
Goodson|Michael L|ML|
Slupsky|Carolyn|C|
Barile|Daniela|D|
Lebrilla|Carlito B|CB|
Stephensen|Charles B|CB|
Mills|David A|DA|
Raybould|Helen E|HE|0000-0002-7501-8091

Nuclear factor erythroid 2–related factor 2


Stereochemistry of residues in turning regions of helical proteins.

Abstract: We have developed a geometrical approach to quantify differences in the stereochemistry of α-helical and turning regions in four iron proteins. Two spatial signatures are used to analyze residue coordinate data for each protein; and a third is employed to analyze amino-acid molecular volume data. The residue-by-residue analysis of the results, taken together with the finding that two major factors stabilize an α-helix (minimization of side-chain steric interference and intrachain H-bonding), lead to the conclusion that certain residues are preferentially selected for α-helix formation. In the sequential, de novo synthesis of a turning region, residues are preferentially selected such that the overall molecular volume profile (representing purely repulsive, excluded-volume effects) spans a small range Δ of values (Δ = 39.1 Å3) relative to the total range that could be spanned (Δ = 167.7 Å3). It follows that excluded-volume effects are of enormous importance for residues in helical regions as well as those in adjacent turning regions. Once steric effects are taken into account, down-range attractive interactions between residues come into play in the formation of α-helical regions. The geometry of α-helices can be accommodated by conformational changes in less-structured turning regions of a polypeptide, thereby producing a globally optimized (native) protein structure.

D000596:Amino Acids
D006860:Hydrogen Bonding
D008962:Models, Theoretical
D017510:Protein Folding
D017433:Protein Structure, Secondary
D011506:Proteins
D013237:Stereoisomerism


End-stage kidney disease patients from ethnic minorities and mortality in coronavirus disease 2019.

Abstract:
INTRODUCTION
Coronavirus disease 2019 (COVID-19) adversely affects patients who are older, multimorbid, and from Black, Asian or minority ethnicities (BAME). We assessed whether being from BAME is independently associated with mortality in end-stage kidney disease (ESKD) patients with COVID-19.

METHODS
Prospective observational study in a single UK renal center. A study was conducted between March 10, 2020 and April 30, 2020. Demographics, socioeconomic deprivation (index of multiple deprivation), co-morbidities (Charlson comorbidity index [CCI]), and frailty data (clinical frailty score) were collected. The primary outcome was all-cause mortality. Data were censored on the 1st June 2020.

FINDINGS
Overall, 191 of our 3379 ESKD patients contracted COVID-19 in the 8-week observation period; 84% hemodialysis, 5% peritoneal dialysis, and 11% kidney transplant recipients (KTR). Of these, 57% were male and 67% were from BAME groups (43% Asian, 17% Black, 2% mixed race, and 5% other). Mean CCI was 7.45 (SD 2.11) and 3.90 (SD 2.10) for dialysis patients and KTR, respectively. In our cohort, 60% of patients lived in areas classified as being in the most deprived 20% in the United Kingdom, and of these, 77% of patients were from BAME groups. The case fatality rate was 29%. Multivariable cox regression demonstrated that BAME (hazard ratio [HR]: 2.37, 95% CI: 1.22-4.61) was associated with all-cause mortality after adjustment for age, deprivation, co-morbidities, and frailty. Associations with all-cause mortality persisted in sensitivity analyses in patients from South Asian (HR: 2.52, 95% CI: 1.24-5.12) and Black (HR: 2.43, 95% CI: 1.04-5.67) ethnic backgrounds.

DISCUSSION
BAME ESKD patients with COVID-19 are just over twice as likely to die compared to White patients, despite adjustment for age, deprivation, comorbidity, and frailty. This study highlights the need to develop strategies to improve BAME patient outcomes in future outbreaks of COVID-19.

end-stage kidney disease
ethnicity
coronavirus disease 2019
health care inequality
renal replacement therapy


Cytotoxic drugs in combination with the CXCR4 antagonist AMD3100 as a potential treatment option for pediatric rhabdomyosarcoma.

Abstract: Rhabdomyosarcoma (RMS) is the most common type of pediatric soft tissue sarcoma. The prognosis of advanced stage RMS remains poor, and metastatic invasion is a major cause of treatment failure. Therefore, there is an urgent need for treatment alternatives focusing on metastatic invasion and drug resistance. The stromal cell‑derived factor‑1 (SDF‑1)/chemokine receptor 4 (CXCR4) axis is a crucial factor for metastatic invasion in RMS. Clinical data has revealed that high CXCR4 expression is associated with a poor outcome and a high metastatic rate in several malignancies, including RMS. Thus, targeting CXCR4 in addition to classical chemotherapy may improve the effectiveness of RMS treatment. In the present study, flow cytometry and reverse transcription‑quantitative PCR were used to assess the effects of the combined treatment with a CXCR4 antagonist and chemotherapy on CXCR4 expression in the embryonal RMS (RME) cell line RD and in the alveolar RMS (RMA) cell line RH30. The functional effect of CXCR4 expression on the migratory behavior of RMS cells was analyzed using Transwell assays. Treatment with cytotoxic agents modulated CXCR4 expression in RMS cells in a dose‑, drug‑ and cell line dependent manner; however, this was not observed in RD cells with vincristine. The expression levels of CXCR4 significantly increased the migratory behavior of RMA and did not affect RME cell migration towards stromal cell‑derived factor‑1α (SDF‑1α). AMD3100 markedly reduced the migration of RH30 cells in the Transwell assays compared with SDF‑1α alone, and the cytotoxic agents doxorubicin and vincristine increased this effect. The results of the combined treatment in RMS cells using the CXCR4 antagonist AMD3100 together with cytotoxic drugs demonstrated that this approach may be a promising alternative for the treatment of advanced stage pediatric RMS. The observed effects of circumventing metastatic invasion and drug resistance should be further investigated in vivo.

Regenbogen|Stephan|S|
Stagno|Matias Julian|MJ|
Schleicher|Sabine|S|
Schilbach|Karin|K|
Bösmüller|Hans|H|
Fuchs|Jörg|J|
Schmid|Evi|E|
Seitz|Guido|G|

D004354:Drug Screening Assays, Antitumor

CXCR4
AMD3100
rhabdomyosarcoma
vincristine
doxorubicin
chemotherapeutic agents


Central amygdalar nucleus treated with orexin neuropeptides evoke differing feeding and grooming responses in the hamster.

Abstract: Interaction of the orexinergic (ORXergic) neuronal system with the excitatory (glutamate, l-Glu) or the inhibitory (GABA) neurosignaling complexes evokes major homeostatic physiological events. In this study, effects of the two ORXergic neuropeptides (ORX-A/B) on their receptor (ORX-2R) expression changes were correlated to feeding and grooming actions of the hibernating hamster (Mesocricetus auratus). Infusion of the central amygdala nucleus (CeA) with ORX-A caused hamsters to consume notable quantities of food, while ORX-B accounted for a moderate increase. Interestingly the latter neuropeptide was responsible for greater frequencies of grooming with respect to both controls and the hamsters treated with ORX-A. These distinct behavioral changes turned out to be even greater in the presence of l-Glu agonist (NMDA) while the α1 GABAA receptor agonist (zolpidem, Zol) greatly reduced ORX-A-dependent feeding bouts. Moreover, ORX-A+NMDA mainly promoted greater ORX-2R expression levels with respect to ORX-A-treated hamsters while ORX-B+Zol was instead largely responsible for a down-regulatory trend. Overall, these features point to CeA ORX-2R sites as key sensory limbic elements capable of regulating eating and grooming responses, which may provide useful insights regarding the type of molecular mechanism(s) operating during feeding bouts.

Alò|Raffaella|R|
Avolio|Ennio|E|
Mele|Maria|M|
Di Vito|Anna|A|
Canonaco|Marcello|M|

Orexin
Amygdala
NMDA
Feeding behaviors
GABA(A) receptor