Creation of virtual patients for midwifery education.

Abstract:
OBJECTIVE
The objective of the study was to create several new, original virtual patients (VPs) in the Slovak language, especially for educational purposes in midwifery.

SETTING
Virtual patients have been created for the needs of university midwifery education in Slovakia.

MODEL
The creation of the six virtual patients basically consisted of three fixed stages: preparation, design and development, implementation into the virtual environment. We used the Open Labyrinth (OL) virtual environment, an open-source system for creating VPs. The VPs include six various scenarios of the most common problems seen in midwifery practice: preterm birth, perinatal loss, gestational diabetes, ineffective breastfeeding, postpartum bleeding and sudden home birth.

FINDINGS
Currently, six original virtual patients are used in university midwifery education in Slovakia. We use them for contact teaching as well as self-study of students. They present the first VPs in Slovakia and the Czech Republic created in academic settings in these countries.

CONCLUSIONS
The future perspective of a virtual patient as an interactive process between the student and the medium is that it can deepen and improve learning outcomes, solve specific midwifery issues, and reduce mistakes in the clinical environment.

Urbanová|Eva|E| Bašková|Martina|M| Maskálová|Erika|E| Kvaltínyová|Eva|E|

Creation of virtual patients
Midwifery
First experiences


The role of data and safety monitoring boards in implementation trials: When are they justified?

Abstract: The National Institutes of Health requires data and safety monitoring boards (DSMBs) for all phase III clinical trials. The National Heart, Lung and Blood Institute requires DSMBs for all clinical trials involving more than one site and those involving cooperative agreements and contracts. These policies have resulted in the establishment of DSMBs for many implementation trials, with little consideration regarding the appropriateness of DSMBs and/or key adaptations needed by DSMBs to monitor data quality and participant safety. In this perspective, we review the unique features of implementation trials and reflect on key questions regarding the justification for DSMBs and their potential role and monitoring targets within implementation trials.

Clinical trials data monitoring committee


Pharmacokinetics of Rhodamine 110 and Its Organ Distribution in Rats.

Abstract: Rhodamine dyes have been banned as food additives due to their potential tumorigenicity. Rhodamine 110 is illegal as a food additive, although its pharmacokinetics have not been characterized, and no accurate bioanalytical methods are available to quantify rhodamine 110. The aim of this study was to develop and validate a fast, stable, and sensitive method to quantify rhodamine 110 using high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS) to assess its pharmacokinetics and organ distribution in awake rats. Rhodamine 110 exhibited linear pharmacokinetics and slow elimination after oral administration. Furthermore, its oral bioavailability was approximately 34-35%. The distribution in the liver and kidney suggests that these organs are primarily responsible for rhodamine 110 metabolism and elimination. Our investigation describes the pharmacokinetics and a quantification method for rhodamine 110, improving our understanding of the food safety of rhodamine dyes.

D002851:Chromatography, High Pressure Liquid

pharmacokinetics
rhodamine 110
rhodamine dyes
food additives
HPLC-MS/MS
toxicokinetics


Why do general practitioners prescribe antidepressants to their patients? A pilot study.

Abstract:
BACKGROUND
The frequency of antidepressant (ADs) prescription is high, with general practitioners (GPs) responsible for about 80% of the prescriptions. Some studies considered prescriptions meet DSM criteria, while others stress inadequate use. The importance of biological and psychosocial determinants of GP prescription behaviour remains little explored. We aimed to describe the importance of these biological and psychosocial determinants and their weight in the daily practice of GPs'.

METHODS
During a week chosen at random, 28 GPs collected the AD prescriptions made within the previous six months, regardless of the reason for the patient contact. Bio psychosocial and AD treatment characteristics were recorded for all patients. In a random sample of 50 patients, patient characteristics were assessed via a structured face-to-face interview with the GP.

RESULTS
The frequency of AD prescription was 8.90% [3.94 -17.02]. The GPs initiated 65.6% [60.1-70.8] of the prescriptions. The rate of AD prescription for non-psychiatric conditions was 18%. Patients had from 1 to 9 conditions, showing a high level of multi-morbidity. There was a strong influence of past medical history and contextual problems, such as work related problems.

CONCLUSION
AD prescription is related to complex contextual situations and multi-morbid patients. GPs use a bio psycho social approach, rather than a purely biological assessment. Awareness of these influences could improve prescription by GPs.

Mercier|Alain|A|
Auger-Aubin|Isabelle|I|
Lebeau|Jean-Pierre|JP|
Schuers|Matthieu|M|
Boulet|Pascal|P|
Van Royen|Paul|P|
Peremans|Lieve|L|

General practitioner
Antidepressants
Prescription
Off label use
Primary care


Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy: a population-based regional cohort study from southern Sweden.

Abstract:
Objective
The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA).

Methods
Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends.

Results
The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean work-loss days (including both sick leave and disability pension) in the nr-axSpA group decreased significantly from 3.4 to 1.9 times more than among the population references. The effect was seen on sick leave, whereas disability pension levels remained similar in both groups throughout.

Conclusion
Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. However, the proportion of work-loss days remained almost twice as high as in the general population at the end of follow-up.

Wallman|Johan K|JK|
Jöud|Anna|A|
Olofsson|Tor|T|
Jacobsson|Lennart T H|LTH|
Bliddal|Henning|H|
Kristensen|Lars E|LE|


The differential diagnosis of trunk and extremity dermal and sub-dermal lesions referred to a musculoskeletal oncology service.

Abstract:
OBJECTIVES
To determine the differential diagnosis of dermal and sub-dermal soft tissue masses which do not extend to the deep fascia that are referred to a specialist musculoskeletal oncology service.

MATERIALS AND METHODS
Review of all patients referred to a specialist musculoskeletal oncology service over a 13-month period with a dermal or sub-dermal soft tissue mass which did not extend to the deep fascia based on MRI appearances. Data collected included age, gender, site and maximal lesion size, and final histological diagnosis for biopsied and/or excised lesions.

RESULTS
56 patients were included, 21 (37.5%) males and 35 (62.5%) females with mean age 49.75 years (range 5-86 years). 3 patients had 2 lesions making a total of 59 lesions, 11 (18.6%) dermal and 48 (81.4%) sub-dermal. Histological diagnosis was available in 44 (74.6%) cases, of which 11 (25%) were non-neoplastic, 23 (52.3%) were benign neoplasms, and 10 (22.7%) were malignant neoplasms. Although older age at presentation and greater mean maximal tumour dimension were seen with malignant lesions, these did not reach statistical significance (p = 0.154 and 0.102 respectively). There was also no relationship between skin involvement from sub-dermal lesions and malignancy, but 5 of 6 dermal lesions which showed an exophytic growth pattern were malignant.

CONCLUSIONS
The differential diagnosis of dermal and sub-dermal lesions which do not reach the deep fascia is wide with a malignant lesion being the cause in almost one-quarter of cases.

Saifuddin|Asif|A| Ali|Sania|S| Sabahuddin|Ahmad|A| Malhotra|Karan|K| Khoo|Michael|M|

Differential diagnosis
Sub-dermal
Soft tissue mass
MRI
Superficial


Melatonin enhances lipid production in Monoraphidium sp. QLY-1 under nitrogen deficiency conditions via a multi-level mechanism.

Abstract: In this study, melatonin (MT) promoted lipid accumulation in Monoraphidium sp. QLY-1 under nitrogen deficiency conditions. The lipid accumulation increased 1.22- and 1.36-fold compared with a nitrogen-starved medium and a normal BG-11 medium, respectively. The maximum lipid content was 51.38%. The reactive oxygen species (ROS) level in the presence of melatonin was lower than that in the control group, likely because of the high antioxidant activities. The application of melatonin upregulated the gibberellin acid (GA) production and rbcL and accD expression levels but downregulated the abscisic acid (ABA) content and pepc expression levels. These findings demonstrated that exogenous melatonin could further improve the lipid production in Monoraphidium sp. QLY-1 by regulating antioxidant systems, signalling molecules, and lipid biosynthesis-related gene expression under nitrogen deficiency conditions.

Zhao|Yongteng|Y| Li|Dafei|D| Xu|Jun-Wei|JW| Zhao|Peng|P| Li|Tao|T| Ma|Huixian|H| Yu|Xuya|X|

Melatonin
Lipid
Nitrogen deficiency
Antioxidant systems
Signalling molecules
Microalgae


Reactive Arthritis.

Abstract: Reactive arthritis is classified as a spondyloarthropathy. Current concepts of disease suggest an infectious trigger, followed by inflammatory arthritis. Several mechanisms have been proposed to explain the interaction of host susceptibility and microorganism. Diagnosis relies on a compatible clinical syndrome and microbiologic confirmation of the pathogen. Antibiotic therapy seems useful in Chlamydia-triggered arthritis. The role of antibiotics in arthritis triggered by enteric pathogens is less clear. The role of tumor necrosis factor alpha inhibitors in therapy is evolving. Many patients have a course limited to a few months, but others experience extraarticular disease and more prolonged courses.

D000900:Anti-Bacterial Agents
D016918:Arthritis, Reactive
D002169:Campylobacter Infections
D002690:Chlamydia Infections
D004405:Dysentery, Bacillary
D005260:Female
D006801:Humans
D008297:Male
D012480:Salmonella Infections
D015009:Yersinia Infections

Reactive arthritis
Spondyloarthropathy
Inflammatory arthritis
Campylobacter
Chlamydia
Salmonella
Shigella
Yersinia


Late season pharmaceutical fate in wetland mesocosms with and without phosphorous addition.

Abstract: The fate of six human-use drugs was assessed and predicted in mesocosms designed to mimic shallow constructed wetlands during the onset of fall and senescence. Mesocosms were monitored for 28 days after the addition of carbamazepine, clofibric acid, fluoxetine and naproxen (nominal initial concentrations of 5 μg/L each), sulfamethoxazole, and sulfapyridine (nominal initial concentrations of 150 μg/L each), with and without phosphorous (P) addition at 1.6 mg/L. We hypothesized that addition of P would stimulate primary productivity and enhance removal of pharmaceuticals from the water column. Carbamazepine, clofibric acid, fluoxetine, and naproxen had half-lives of 8.7, 11, 1.5, and 2.5, and 8.6, 11.0, 1.4, and 2.5 days in treatments with and without P amendment, respectively. Sulfamethoxazole and sulfapyridine had half-lives of 17 and 4.9 days in mesocosms with P amendment and 17 and 4.7 days without amendment. A concurrent pulse of P with pharmaceuticals did not significantly enhance the removal of these compounds. Predicted half-lives from modeling efforts were consistent with observed values, with photolysis the greatest contributor to chemical attenuation.

Cardinal|Pascal|P|
Anderson|Julie C|JC|
Carlson|Jules C|JC|
Low|Jennifer E|JE|
Challis|Jonathan K|JK|
Wong|Charles S|CS|
Hanson|Mark L|ML|

Pharmaceutical fate
Macrophytes
Treatment wetland
Wastewater


White spots on enamel: treatment protocol by superficial or deep infiltration (part 2).

Abstract: In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures.

Attal|Jean-Pierre|JP| Atlan|Anthony|A| Denis|Maud|M| Vennat|Elsa|E| Tirlet|Gilles|G|

D055115:Light-Curing of Dental Adhesives

White spot
Deep infiltration
Superficial infiltration
Fluorosis
MIH
Traumatic hypomineralization


A new modelling framework for assessing the relative burden of antimicrobial resistance in aquatic environments.

Abstract: The infections caused by antibiotic resistant bacteria (ARB) can lead to higher medical costs, prolonged hospital stays, and increased mortality compared to bacteria that are susceptible to antibiotics. Challenges exist in quantifying the potential risk/burden associated with antimicrobial resistance (AMR) as there is a lack of dose-response models available for pathogens which are resistant to antibiotics, in addition to the fact that very little is known regarding the health risks posed by antibiotic resistant genes (ARG). In this paper, we proposed a new modelling framework to evaluate the relative burden of AMR in natural aquatic environments. With this framework, an AMR burden score for each sample was calculated based on burden coefficients assigned for each ARB and ARG, as well as weighted burdens for the separate ARBs and ARGs components. The method developed in this study was applied to assess the relative burden of AMR in local aquatic environments with different land uses at different seasons. The collected filed data were used to verify the applicability of the proposed relative burden assessment method. Through the established method, the spatial and temporal hotspots of AMR were identified, which could provide useful information to agencies for better control and management of AMR emergence in natural aquatic environments.

Goh|Shin Giek|SG|
Jiang|Peng|P|
Ng|Charmaine|C|
Le|Thai-Hoang|TH|
Haller|Laurence|L|
Chen|Hongjie|H|
Charles|Francis Rathinam|FR|
Chen|Huiting|H|
Liu|Xiao|X|
He|Yiliang|Y|
Gin|Karina Yew-Hoong|KY|

Antibiotic resistant bacteria (ARB)
Antimicrobial resistance (AMR)
Antibiotic resistant genes (ARG)
Relative burden assessment
Occurrence


Uncommon runs of homozygosity disclose homozygous missense mutations in two ciliopathy-related genes (SPAG17 and WDR35) in a patient with multiple brain and skeletal anomalies.

Abstract: We describe a patient severely affected with multiple congenital anomalies, including brain malformations and skeletal dysplasia suggestive of cranioectodermal dysplasia (CED) ciliopathy, who unusually carries several homozygosity tracts involving homozygous missense mutations in SPAG17 (exon 8; c.1069G > C; p.Asp357His) and WDR35 (exon 13; c.1415G > A; p.Arg472Gln) as revealed by homozygosity mapping and next generation sequencing. SPAG17 is essential for the function and structure of motile cilia, while WDR35 belongs to the same intraflagellar transport (IFT) gene family whose protein products are part of functional IFT A and B complexes. Formerly, SPAG17 was related - through polymorphic variants - to an influence on individuals' height; more recently, Spag17-/- mice models were reported to present skeletal and bone defects, reduced mucociliary clearance, respiratory distress, and cerebral ventricular enlargement. Homozygous or compound heterozygous mutations in WDR35 have mainly been related to CED2 or short-rib thoracic dysplasia 7, with only three cases showing some brain anomalies. Given that our patient presents these clinical features and the close functional relationship between SPAG17 and WDR35, it is feasible that the combined effects from both mutations contribute to his phenotype. To our knowledge, this patient is the first to harbor a likely pathogenic homozygous mutation in both genes at the same time. Thus, the resulting complex phenotype of this patient illustrates the heterogeneity associated with ciliopathies and further expands the clinical and mutational spectrum of these diseases. Finally, we highlight the combined use of high-throughput tools to diagnose and support the proper handling of this and other patients.

Córdova-Fletes|Carlos|C|
Becerra-Solano|Luis E|LE|
Rangel-Sosa|Martha M|MM|
Rivas-Estilla|Ana María|AM|
Alberto Galán-Huerta|Kame|K|
Ortiz-López|Rocío|R|
Rojas-Martínez|Augusto|A|
Juárez-Vázquez|Clara I|CI|
García-Ortiz|José E|JE|

D047908:Intracellular Signaling Peptides and Proteins

SPAG17
WDR35
Ciliopathies
Exome sequencing
LCSH/ROH
SNP arrays


Gender Differences in Static and Dynamic Postural Stability of Soldiers in the Army's 101st Airborne Division (Air Assault).

Abstract:
CONTEXT
Postural stability is essential for injury prevention and performance. Differences between genders may affect training focus.

OBJECTIVE
To examine static and dynamic postural stability in male and female soldiers.

DESIGN
Descriptive laboratory study.

SETTING
Biomechanics laboratory.

PARTICIPANTS
25 healthy female soldiers (26.4 ± 5.3 y) and 25 healthy male soldiers (26.4 ± 4.9 y) matched on physical demand rating and years of service from the Army's 101st Airborne Division (Air Assault).

INTERVENTIONS
Each person underwent static and dynamic postural stability testing.

MAIN OUTCOME MEASURES
Standard deviation of the ground reaction forces during static postural stability and the dynamic stability index for dynamic postural stability.

RESULTS
Female soldiers had significantly better static postural stability than males but no differences were observed in dynamic postural stability.

CONCLUSIONS
Postural stability is important for injury prevention, performance optimization, and tactical training. The differences observed in the current study may indicate the need for gender-specific training emphasis on postural stability.

Sell|Timothy C|TC|
Lovalekar|Mita T|MT|
Nagai|Takashi|T|
Wirt|Michael D|MD|
Abt|John P|JP|
Lephart|Scott M|SM|


Should we overcome the resistance to bioelectrical impedance in heart failure?

Abstract:
INTRODUCTION
Heart failure is associated with increased neurohormonal activation that results in changes in body composition including volume overload and the loss of skeletal muscle, body fat, and bone density. Bioelectrical impedance measures body composition based on the conduction of electrical current through body fluids.

AREAS COVERED
The PubMed and Scopus databases were reviewed up to the third week of June 2020. Cross-sectional studies, retrospective observational studies, prospective observational studies, and randomized controlled trials have examined numerous bioelectrical impedance monitoring strategies to guide the diagnosis, prognosis, and treatment of heart failure. These monitoring strategies include intrathoracic impedance, lung impedance, bioelectrical impedance vector analysis, leg bioelectrical impedance, and thoracic bioreactance.

EXPERT COMMENTARY
Based on the current evidence, more studies are needed to validate bioelectrical impedance in heart failure. Lung impedance appears to be useful for guiding heart failure treatment in patients with ST-elevation myocardial infarction and improving outcomes in outpatients with heart failure. Furthermore, bioelectrical impedance has potential as a noninvasive, quantitative heart failure variable for population-based research.

Hankinson|Stephen J|SJ|
Williams|Charles H|CH|
Ton|Van-Khue|VK|
Gottlieb|Stephen S|SS|
Hong|Charles C|CC|

Bioelectrical impedance
heart failure
intrathoracic impedance
lung impedance
bioelectrical impedance vector analysis
leg bioelectrical impedance
bioreactance
bioimpedance


Effect of hydraulic retention time on electricity generation using a solid plain-graphite plate microbial fuel cell anoxic/oxic process for treating pharmaceutical sewage.

Abstract: Treatment efficiency and electricity generation were evaluated using a solid plain-graphite plate microbial fuel cell (MFC) anoxic/oxic (A/O) process that treated pharmaceutical sewage using different hydraulic retention times (HRT). Short HRTs increased the volumetric organic loading rate, thereby reducing the MFC performance due to rapid depletion of the substrate (carbon/nitrogen source). The COD removal efficiency decreased from 96.28% at a HRT of 8 h to 90.67% at a HRT of 5 h. The removal efficiency of total nitrogen was reduced from 74.16% at a HRT of 8 h to 53.42% at a HRT of 5 h. A shorter HRT decreased the efficiency in treatment of the pharmaceutical products (PPs), which included acetaminophen, ibuprofen and sulfamethoxazole in an aerobic reactor because these antibiotic compounds inhibited the microbial activity of the aerobic activated sludge in the MFC A/O system. The average power density and coulombic efficiency values were 162.74 mW m-2 and 7.09% at a HRT of 8 h and 29.12 mW m-2 and 2.23% at a HRT of 5 h, respectively. The dominant bacterial species including Hydrogenophaga spp., Rubrivivax spp. and Leptothrix spp., which seem to be involved in PP biodegradation; these were identified in the MFC A/O system under all HRT conditions for the first time using next generation sequencing. Bacterial nanowires were involved in accelerating the transfer of electrons and served as mediators in the SPGRP biofilm. In conclusion, a SPGRP MFC A/O system at a HRT of 8 h gave better removal of COD, T-N and PPs, as well as generated more electricity.

Chang|Ting-J|TJ| Chang|Yun-H|YH| Chao|Wei-L|WL| Jane|Wann-N|WN| Chang|Yi-T|YT|

Hydraulic retention time
volumetric organic loading rate
power density
bacterial nanowires
columbic efficiency


First clinical trial of a newly developed capsule endoscope with panoramic side view for small bowel: a pilot study.

Abstract:
BACKGROUND AND STUDY AIMS
Capsule endoscopy is the first-line diagnostic technique for the small bowel. However, the inability to visualize the duodenal papilla is an inherent limitation of this method. In the present study, we evaluated feasibility of a newly developed CapsoCam SV1 capsule.

PATIENTS AND METHODS
This is a prospective dual center study of a newly developed video capsule CapsoCam SV1 from Capsovision, CA, providing panoramic 360° imaging. A high frequency of 20 frames occurs per second for the first 2 h and thereafter 12 frames/s, with a battery life of 15 h. We evaluated feasibility and completeness of small bowel examination together with secondary endpoints of duodenal papilla detection in 33 patients. Patients swallowed the capsules following colonoscopy or were prepared with 2 L of polyethylene glycol solution prior to the examination. All patients swallowed 20 mg of metoclopramide and 160 mg of simethicone 30 min before ingestion of the capsule.

RESULTS
Thirty-one of the 33 patients' data could be evaluated. Small bowel examination was complete in all procedures. Mean time to pass the small bowel was 258 ± 136 min. Average small bowel cleanliness was 3.3 ± 0.5. In 71% of the patients, we identified the duodenal papilla. No adverse reaction in relation to the capsule examination was observed.

CONCLUSIONS
CapsoCam SV1 is a safe and efficient tool in small bowel examination. The duodenal papilla as the only landmark in small bowel is detected in more than 70% of the patients.

Friedrich|Kilian|K| Gehrke|Sven|S| Stremmel|Wolfgang|W| Sieg|Andreas|A|

CapsoCam SV1 capsule
360° panoramic side view
small bowel endoscopy


Disease-modifying antirheumatic drugs and organising pneumonia.

Abstract: Organising pneumonia (OP) in rheumatoid arthritis (RA) may be part of pulmonary manifestation (disease related) or disease-modifying antirheumatic drugs (DMARDs) related. We report a case series of RA patients with DMARDs related OP. A 65-year-old woman developed OP 3 weeks after initiation of methotrexate (MTX). High-resolution CT (HRCT) scan of the thorax revealed bilateral consolidations in the lung bases. She had complete radiological resolution 6 months after corticosteroid therapy with cessation of MTX. The second case was of a 60-year-old woman on MTX with recent addition of leflunomide due to flare of RA. She developed worsening cough 4 months later and HRCT scan revealed consolidation in the left upper lobe with biopsy proven OP. She responded within 6 months of corticosteroid therapy with clinical and radiological resolution. This case series highlights that OP may developed with low-dose MTX (as early as 3 weeks) and leflunomide and the diagnosis requires a high index of suspicion.

rheumatoid arthritis
interstitial lung disease
respiratory medicine
rheumatology


Entrepreneurial Learning, Self-Efficacy, and Firm Performance: Exploring Moderating Effect of Entrepreneurial Orientation.

Abstract: Although the impact entrepreneurial learning on firm performance has attracted significant attention, a comprehensive understanding by integrating entrepreneurial orientation and individual self-efficacy remain poorly understood. We fill this void by integrating the above variables into a model and examine these relations. Findings from a sample of 411 nascent entrepreneurs support that entrepreneurial learning is positively related to firm performance, and this relationship is fully mediated by entrepreneurial self-efficacy (ESE). We also found entrepreneurial orientation strengthens the positive impact of entrepreneurial learning on ESE. The findings indicate that ESE must be in place to maximize the effect of entrepreneurial learning on performance, and entrepreneurial orientation is an important contingency in shaping entrepreneurial learning's impact on nascent entrepreneur's self-efficacy.

Shen|Yan|Y| Wang|Qi|Q| Hua|Danni|D| Zhang|Zhetao|Z|

entrepreneurial learning
firm performance
entrepreneurial orientation
entrepreneurial self-efficacy
formal organizational learning
intergenerational learning
social network learning


Bone health status of postmenopausal Chinese women.

Abstract:
OBJECTIVES
To evaluate the prevalence of osteoporosis in treatment-naïve postmenopausal women, their treatment adherence, and the risk factors for osteoporosis.

DESIGN
Cross-sectional study of bone density reports, a self-administered health checklist, and computerised consultation records.

SETTING
Primary care sexual and reproductive health service in Hong Kong.

PARTICIPANTS
Postmenopausal Chinese women who had never received osteoporosis treatment or hormone replacement therapy.

INTERVENTION
Each woman completed a checklist of risk factors for osteoporosis, menopause age, history of hormone replacement therapy, and osteoporosis treatment prior to undergoing bone mineral density measurement at the postero-anterior lumbar spine and left femur. The consultation records of those with osteoporosis were reviewed to determine their treatment adherence.

MAIN OUTCOME MEASURES
T-score at the spine and hip, presence or absence of risk factors for osteoporosis, and treatment adherence.

RESULTS
Between January 2008 and December 2011, 1507 densitometries were performed for eligible women; 51.6% of whom were diagnosed with osteopenia and 25.7% with osteoporosis. The mean age of women with normal bone mineral density, osteopenia, and osteoporosis was 57.0, 58.0, and 59.7 years, respectively. Approximately half of them had an inadequate dietary calcium intake, performed insufficient weight-bearing exercise, or had too little sun exposure. Logistic regression analysis revealed that age, body mass index of <18.5 kg/m(2), parental history of osteoporosis or hip fracture, and duration of menopause were significant risk factors for osteoporosis. Among those with osteoporosis, 42.9% refused treatment, 30.7% complied with treatment, and 26.3% discontinued treatment or defaulted from follow-up. Those who refused treatment were significantly older.

CONCLUSIONS
Osteoporosis is prevalent in postmenopausal women. Only 50% adopted primary prevention strategies. Almost 70% refused treatment or stopped prematurely.

D015502:Absorptiometry, Photon
D000367:Age Factors
D044466:Asians
D015992:Body Mass Index
D015519:Bone Density
D001851:Bone Diseases, Metabolic
D002136:Calcium, Dietary
D003430:Cross-Sectional Studies
D015444:Exercise
D005260:Female
D005269:Femur
D006304:Health Status
D006723:Hong Kong
D020249:Hormone Replacement Therapy
D006801:Humans
D016015:Logistic Models
D008159:Lumbar Vertebrae
D008875:Middle Aged
D015663:Osteoporosis, Postmenopausal
D010349:Patient Compliance
D017698:Postmenopause
D012307:Risk Factors
D013472:Sunlight
D013997:Time Factors
D016312:Treatment Refusal


Respiratory syncytial virus in young children: community cohort study integrating serological surveys, questionnaire and electronic health records, Born in Bradford cohort, England, 2008 to 2013.

Abstract: BackgroundBronchiolitis caused by respiratory syncytial virus (RSV) is a major cause of mortality and morbidity in infants.AimTo describe RSV epidemiology in children in the community in a high-income setting.MethodsWe used stored blood samples from the United Kingdom Born in Bradford cohort study that had been collected at birth, age 1 and 2 years old, tested for IgG RSV postfusion F antibody and linked to questionnaires and primary and hospital care records. We used finite mixture models to classify children as RSV infected/not infected according to their antibody concentrations at age 1 and 2 years. We assessed risk factors for primary RSV infection at each age using Poisson regression models.ResultsThe study cohort included 700 children with cord blood samples; 490 had additional blood samples taken at both ages 1 and 2 years old. Of these 490 children, 258 (53%; 95% confidence interval (CI): 48-57%) were first infected with RSV at age 1, 99 of whom (38%; 95% CI: 33-43%) had been in contact with healthcare during peak RSV season (November-January). Having older siblings, birth in October-June and attending formal childcare were associated with risk of RSV infection in infancy. By age 2, a further 164 of 490 children (33%; 95% CI: 29-38%) had been infected.ConclusionOver half of children experienced RSV infection in infancy, a further one third had evidence of primary RSV infection by age 2, and one in seven remained seronegative by their second birthday. These findings will inform future analyses to assess the cost-effectiveness of RSV vaccination programmes in high-income settings.

Zylbersztejn|Ania|A|
Pembrey|Lucy|L|
Goldstein|Harvey|H|
Berbers|Guy|G|
Schepp|Rutger|R|
van der Klis|Fiona|F|
Sande|Charles|C|
Mason|Dan|D|
Wright|John|J|
Smyth|Rosalind|R|
Hardelid|Pia|P|

D018357:Respiratory Syncytial Virus Infections

respiratory syncytial virus
serological survey
RSV
infant
child
respiratory viruses


Effects of bullying on job insecurity and deviant behaviors in nurses: Roles of resilience and support.

Abstract:
AIM
The present study tested a moderated mediation model in the Hospital industry of Pakistan. Extending the Conservation of Resources theory, we conducted a joint investigation of the mediating role of (a) Job Insecurity in linking Workplace Bullying with victim's deviant work behaviors and (b) the moderating roles of Resilience and Perceived Supervisor Support in influencing the mediation.

BACKGROUND
Although the direct effects of bullying on deviant work were well established, the mechanisms and the boundary conditions through which bullying triggers deviant behaviors are still unknown.

METHOD
Utilizing temporally segregated field data from a sample of nurses and their fellow colleagues (n = 251 dyads), a quantitative study was conducted in Pakistani hospitals.

RESULTS
Results were consistent with our hypothesized moderated mediation (mod-med) framework in which workplace bullying led to deviant work behaviors in nurses via job insecurity. Moreover, this indirect effect was salient under nurses' low resilience and perceptions of supervisor support.

CONCLUSION
Based on these findings, the relationship between workplace bullying and deviant work behaviors appears to be more complex than what is commonly believed.

IMPLICATIONS FOR NURSING MANAGEMENT
The findings of the present study emphasize how and why bullying at workplace (particularly nurses) generates deviant work behavior.

Job Insecurity
Resilience
Workplace Bullying
deviant work behaviors
Perceived Supervisor Support


Epidemiology of pandemic influenza A/H1N1 virus during 2009-2010 in Taiwan.

Abstract: Outbreak of swine-origin influenza A/H1N1 virus (pdmH1N1) occurred in 2009. Taiwanese authorities implemented nationwide vaccinations with pdmH1N1-specific inactivated vaccine as of November 2009. This study evaluates prevalence, HA phylogenetic relationship, and transmission dynamic of influenza A and B viruses in Taiwan in 2009-2010. Respiratory tract specimens were analyzed for influenza A and B viruses. The pdmH1N1 peaked in November 2009, was predominant from August 2009 to January 2010, then sharply dropped in February 2010. Significant prevalence peaks of influenza B in April-June of 2010 and H3N2 virus in July and August were observed. Highest percentage of pdmH1N1- and H3N2-positive cases appeared among 11-15-year-olds; influenza B-positive cases were dominant among those 6-10 years old. Maximum likelihood phylogenetic trees showed 11 unique clusters of pdmH1N1, seasonal H3N2 influenza A and B viruses, as well as transmission clusters and mixed infections of influenza strains in Taiwan. The 2009 pdmH1N1 virus was predominant in Taiwan from August 2009 to January 2010; seasonal H3N2 influenza A and B viruses exhibited small prevalence peaks after nationwide vaccinations. Phylogenetic evidence indicated transmission clusters and multiple independent clades of co-circulating influenza A and B strains in Taiwan.

Lan|Yu-Ching|YC| Su|Mei-Chi|MC| Chen|Chao-Hsien|CH| Huang|Su-Hua|SH| Chen|Wan-Li|WL| Tien|Ni|N| Lin|Cheng-Wen|CW|

Pandemic influenza
Mixed infection
HA subtyping
Phylogenetic analysis
Surveillance


Visual and haptic verticality misperception and trunk control within 72 h after stroke.

Abstract:
INTRODUCTION
Stroke patients often exhibit an altered perception of verticality, but there are no studies evaluating verticality perception in the first 72 h after stroke and its relationship with trunk control. Therefore, this study aimed to analyze visual and haptic verticality in the acute phase of stroke.

METHODS
This was a cross-sectional study conducted with two groups: (a) 13 individuals with stroke and (b) 12 healthy participants. We assessed verticality via the subjective visual vertical (SVV) and the subjective haptic vertical (SHV); and we measured trunk control with the Trunk Impairment Scale (TIS). We performed t-tests to compare the SVV and SHV between groups. Pearson correlation was performed between verticality tests with National Institutes of Health Stroke Scale (NIHSS) and the TIS.

RESULTS
Participants with recent stroke presented higher true and absolute SVV deviation values than did the control group. There was significant negative correlation between absolute (r = -0.57; p = 0.02) and true SVV (r = -0.54; p = 0.01) with TIS scores There was also significant positive correlation between absolute (r = 0.63; p = 0.009) and true SVV (r = 0.61; p = 0.003) with NIHSS. A significant negative correlation between NIHSS and TIS scores also was found (r = -0.80; p = 0.005).

CONCLUSION
Individuals with acute stroke presented larger variability in their perceptions of visual verticality than did healthy controls, and verticality perceptions were positively correlated with trunk impairment.

Pascucci Sande de Souza|Luciane Aparecida|LA|

D003430:Cross-Sectional Studies
D064368:Healthy Volunteers
D006801:Humans
D013028:Space Perception
D020521:Stroke
D014481:United States
D014796:Visual Perception

Verticality
Trunk
Stroke
Subjective visual vertical
Subjective haptic vertical


Genotypic distribution of human oncogenic papillomaviruses in sexually active women in Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions.

Abstract:
OBJECTIVE
this study was conducted to determine the distribution of high-risk human papillomavirus (HR-HPV) genotypes in women in the general population of three regions of Burkina Faso.

METHOD
This multicenter, descriptive cross-sectional study involved 1321 sexually active women in five cities in three regions of Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions. After collection of endocervical specimens, pre-cervical lesions were screened by visual inspection with acetic acid and lugol (VIA / VILI). HR-HPV genotypes were characterized by multiplex real-time PCR after extraction of viral DNA.

RESULTS
The mean age of women was 31.98 ± 10.09 years. The HR-HPV infection in the three regions ranged from 26.16% to 43.26% with 35.42% as overall prevalence in women. The most common HR-HPV genotypes in descending order were: HPV 56, 52, 66, 59, 39, 51, 18, 35. The prevalence of bivalent vaccine genotypes (HPV16 / 18) was 7.83% against 63.78% of genotypes not covered by HPV vaccine; 36.32% (170/468) of women had multiple concomitant HR-HPV infections.

CONCLUSION
this study showed significant regional variation and high prevalence of HR-HPV infection in women. The predominant genotypes differ from those covered by available vaccines in Burkina Faso. These results will help guide our health policies towards better prevention of cervical cancer. The diversity of oncogenic genotypes is sparking a large-scale study in the West African sub-region, particularly in cases of cancer and the introduction of the nonavalent vaccine which includes HPV 52 found among the predominant genotypes in this study.

Ouedraogo|Rogomenoma Alice|RA|
Zohoncon|Théodora Mahoukèdè|TM|
Traore|Ina Marie Angèle|IMA|
Ouattara|Abdoul Karim|AK|
Guigma|Sindimalgdé Patricia|SP|
Djigma|Florencia Wendkuuni|FW|
Obiri-Yeboah|Dorcas|D|
Ouedraogo|Charlemagne|C|
Simpore|Jacques|J|

genotypes
women
Burkina Faso
epidemiology
high-risk HPV


Exploring the relationship between disease-related pain and cortisol levels in women with osteoarthritis.

Abstract:
OBJECTIVES
To determine if (1) Osteoarthritis (OA)-related pain is associated with the diurnal cortisol pattern and cortisol levels; (2) the diurnal pattern of cortisol varies with severity of OA pain and (3) the association between OA pain and cortisol is mediated by daily experience variables (DEV).

DESIGN
In a community-based study of changes in regional and widespread pain among women with OA, participants (n = 31) completed daily diaries and collected three saliva samples daily for 7 days. Severity of OA-related pain was assessed by the validated Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. Multilevel regression analyses estimated associations between OA pain and diurnal cortisol levels and slopes, controlling for body mass index (BMI), medication use, time and day. Mediation analyses examined DEV as potential mediators of the association between OA pain and cortisol.

RESULTS
The mean age was 57 years and average BMI 31 kg/m2. Mean WOMAC pain subscale score was 8.8. Women with higher WOMAC pain scores had higher cortisol throughout the day. The estimated association of WOMAC with cortisol [β 0.083(0.02, 0.15) P = 0.009] represents a ∼9% increase in cortisol for every unit increase in WOMAC pain score. Women with WOMAC pain scores ≥9 had higher cortisol levels than those with scores <9. Examination of DEV revealed no significant mediated associations between these relationships at the daily level.

CONCLUSION
In women with OA, disease-related pain is positively associated with cortisol production, particularly with greater pain severity. Future studies should explore biologic mediating variables between OA pain and cortisol.

Carlesso|L C|LC|
Sturgeon|J A|JA|
Zautra|A J|AJ|


The prevalence of hypomagnesaemia in pediatric patients with mitral valve prolapse syndrome and the effect of mg therapy.

Abstract:
BACKGROUND
A paucity of data exists regarding the prevalence and relationship of hypomagnesaemia with clinical symptoms of mitral valve prolapse (MVP) in pediatric patients.

OBJECTIVE
In this study we evaluated the prevalence of magnesium (Mg) deficiency in pediatric patients with MVP syndrome and attempted to clarify the effect of Mg therapy on alleviating their symptoms.

METHODS
The present study was conducted from April 2010 to January 2012, and included 230 patients (90 males and 140 females) with symptoms of mitral valve prolapse and mean age of 11.6±3.66. Serum magnesium (Mg) level less than 1.5 mg/dl was defined as hypomagnesaemia. Patients with 2 mm leaflet displacement and maximum leaflet thickness of 5 mm in echocardiography were considered to have classic MVP, while those with leaflet thickness less than 5 mm were considered as non-classic MVP. Patients with hypomagnesaemia were orally treated with 4.5 mg/kg/day Mg chloride for 5 weeks followed by re-evaluation of symptoms of chest pain, palpitation, fatigue and dyspnea.

RESULTS
Hypomagnesaemia was found in 19 (8.2 %) of 230 patients with mitral valve prolapse. The re-evaluation of patients with Hypomagnesaemia after 5 weeks of Mg therapy, showed statistically significant relief of chest pain (P=0.01). However, no significant changes was detected in regard to palpitation (P=0.06), fatigue (P= 0.5) and dyspnea (P=0.99).

CONCLUSION
This study revealed that the prevalence of hypomagnesaemia in pediatric patients with mitral valve prolapse is relatively low compared to adults, but treatment with oral Mg in patient with hypomagnesaemia decreases chest pain.

Amoozgar|Hamid|H| Rafizadeh|Hashem|H| Ajami|Gholamhossein|G| Borzoee|Mohammad|M|

Hypomagnesaemia
Mitral Valve Prolapse
Mitral Valve Prolapse Syndrome
Echocardiography
Dysautonomia


Significant increase in plasma 4β-hydroxycholesterol concentration in patients after kidney transplantation.

Abstract: Several previous studies have shown that renal failure decreases not only renal elimination but also metabolic clearance of drugs, particularly those metabolized by CYP3A. However, whether recovery of renal function results in recovery of hepatic CYP3A activity remains unknown. In this study, we evaluated the effect of renal function on CYP3A activity after kidney transplantation in patients with end-stage renal disease (ESRD) by measuring the change in CYP3A activity using plasma concentration of 4β-hydroxycholesterol as a biomarker. The study enrolled 13 patients with ESRD who underwent the first kidney allograft transplantation. Morning blood samples were collected before and 3, 7, 10, 14, 21, 30, 60, 90, 120, 150 and 180 days after kidney transplantation. Plasma concentration of 4β-hydroxycholesterol was measured using GC-MS. Compared with before kidney transplantation, creatinine clearance increased significantly from day 3 after kidney transplantation and stabilized thereafter. Plasma concentration of 4β-hydroxycholesterol was elevated significantly on days 90 and 180 after kidney transplantation. In conclusion, this study suggests the recovery of CYP3A activity with improvement in renal function after kidney transplantation in patients with ESRD.

Suzuki|Yosuke|Y| Itoh|Hiroki|H| Sato|Fuminori|F| Kawasaki|Kanako|K| Sato|Yukie|Y| Fujioka|Takashi|T| Sato|Yuhki|Y| Ohno|Keiko|K| Mimata|Hiromitsu|H| Kishino|Satoshi|S|

plasma
renal failure
CYP3A activity
end-stage renal disease


Inactivation of nucleus reuniens impairs spatial working memory and behavioral flexibility in the rat.

Abstract: The hippocampal formation (HF) and medial prefrontal cortex (mPFC) play critical roles in spatial working memory (SWM). The nucleus reuniens (RE) of the ventral midline thalamus is an important anatomical link between the HF and mPFC, and as such is crucially involved in SWM functions that recruit both structures. Little is known, however, regarding the role of RE in other behaviors mediated by this circuit. In the present study, we examined the role of RE in spatial working memory and executive functioning following reversible inactivation of RE with either muscimol or procaine. Rats were implanted with an indwelling cannula targeting RE and trained in a delayed nonmatch to sample spatial alternation T-maze task. For the task, sample and choice runs were separated by moderate or long delays (30, 60, and 120 s). Following asymptotic performance, rats were tested following infusions of drug or vehicle. Muscimol infused into RE impaired SWM at all delays, whereby procaine only impaired performance at the longest delays. Furthermore, RE inactivation with muscimol produced a failure in win-shift strategy as well as severe spatial perseveration, whereby rats persistently made re-entries into incorrect arms during correction trials, despite the absence of reward. This demonstrated marked changes in behavioral flexibility and response strategy. These results strengthen the role of nucleus reuniens as a pivotal link between hippocampus and prefrontal cortex in cognitive and executive functions and suggest that nucleus reuniens may be a potential target in the treatment of CNS disorders such as schizophrenia, attention deficit hyperactivity disorder, addiction, and obsessive-compulsive disorder, whose symptoms are defined by hippocampal-prefrontal dysfunctions.

Viena|Tatiana D|TD|
Linley|Stephanie B|SB|
Vertes|Robert P|RP|0000-0001-7403-4164

D000818:Animals
D002491:Central Nervous System Agents
D056344:Executive Function
D008297:Male
D018782:Maze Learning
D008570:Memory, Short-Term
D009118:Muscimol
D011343:Procaine
D020318:Rats, Long-Evans
D065852:Spatial Memory
D013997:Time Factors
D020651:Ventral Thalamic Nuclei

medial prefrontal cortex
hippocampus
goal directed behavior
orbital cortex
perseverative behavior


CD21lo/-CD27-IgM- Double-Negative B Cells Accumulate in the Joints of Patients With Antinuclear Antibody-Positive Juvenile Idiopathic Arthritis.

Abstract: Juvenile idiopathic arthritis (JIA) encompasses a heterogeneous group of diseases. The appearance of antinuclear antibodies (ANAs) in almost half of the patients suggests B cell dysregulation as a distinct pathomechanism in these patients. Additionally, ANAs were considered potential biomarkers encompassing a clinically homogenous subgroup of JIA patients. However, in ANA+ JIA patients, the site of dysregulated B cell activation as well as the B cell subsets involved in this process is still unknown. Hence, in this cross-sectional study, we aimed in an explorative approach at characterizing potential divergences in B cell differentiation in ANA+ JIA patients by assessing the distribution of peripheral blood (PB) and synovial fluid (SF) B cell subpopulations using flow cytometry. The frequency of transitional as well as switched-memory B cells was higher in PB of JIA patients than in healthy controls. There were no differences in the distribution of B cell subsets between ANA- and ANA+ patients in PB. However, the composition of SF B cells was different between ANA- and ANA+ patients with increased frequencies of CD21lo/-CD27-IgM- "double negative" (DN) B cells in the latter. DN B cells might be a characteristic subset expanding in the joints of ANA+ JIA patients and are potentially involved in the antinuclear immune response in these patients. The results of our explorative study might foster further research dissecting the pathogenesis of ANA+ JIA patients.

Dirks|Johannes|J| Fischer|Jonas|J| Haase|Gabriele|G| Holl-Wieden|Annette|A| Hofmann|Christine|C| Girschick|Hermann|H| Morbach|Henner|H|

B cells
juvenile idiopathic arthritis
antinuclear antibodies
synovial fluid
double negative B cells


Intracranial Arterial Fenestration and Risk of Aneurysm: A Systematic Review and Meta-Analysis.

Abstract:
BACKGROUND
Previous studies have been inconsistent regarding risk for intracranial aneurysm related to intracranial arterial fenestration. We conducted a meta-analysis to examine the association between intracranial arterial fenestration and risk of aneurysm.

METHODS
We performed a systematic review of PubMed and Embase through August 2017 for potentially relevant articles. Summary odds ratios with 95% confidence intervals were pooled using a random-effects model.

RESULTS
Of 446 articles found, 7 were selected for meta-analysis. Pooled odds ratios revealed an increased risk of aneurysm owing to fenestration of 1.50 (95% confidence interval, 0.61-3.71; P = 0.38). Subgroup analyses based on the population presenting with various indications suggested that pooled odds ratios indicated a significant increase in risk for aneurysm of 2.43 (95% confidence interval, 1.04-5.69; P = 0.04).

CONCLUSIONS
Our findings indicate that intracranial arterial fenestration may be associated with increased risk for aneurysm formation.

Guo|Xiang|X| Gao|Lingyun|L| Shi|Zhitao|Z| Liu|Deguo|D| Wang|Yuhong|Y| Sun|Zhanguo|Z| Chen|Yueqin|Y| Chen|Weijian|W| Yang|Yunjun|Y|

D020785:Central Nervous System Vascular Malformations

Central nervous system vascular malformations


An unusual presentation of Langerhans cell histiocytosis.

Abstract: Langerhans cell histiocytosis (LCH) is a relatively rare and unique disease. An incidence of 7.9% in the jaws is reported. We report a case of 9-year-old male child referred to us from dental outpatient department, who presented with a firm swelling in right lower jaw along with bilateral submandibular lymphadenopathy for 1-month. Fine-needle aspiration was done from lytic lesion in the body of mandible and multiple smears were prepared. On the basis of the clinical and cytomorphological findings, a diagnosis of LCH was suggested. The diagnosis was confirmed on histology. Thus, a high possibility of LCH should be considered in children presenting with lytic lesions in head and neck region.

Langerhans cell histiocytosis
mandible
Fine needle aspiration cytology


Long term outcome of functional hemispherectomy for refractory epilepsy: Experience from a single center.

Abstract:
BACKGROUND
Hemispherectomy has an established role as a treatment of last resort in patients with unilateral hemispheric lesions suffering from refractory epilepsy.

METHODS
Seven patients were evaluated at our Epilepsy Unit. We compared the seizure outcome at 6 months, 1, 2, 5 years post-surgery, as well as at end follow-up (mean 7.1 years) using Engel classification. Reduction of antiepileptic drugs (AEDs) was also assessed utilizing equal time frames.

RESULTS
The mean age of seizure onset was 5.4 years. Engel I was achieved in 5 patients at 6 months (71.4%). Engel at 1 year was predicted by the Engel at 6 months (p=0.013) with a similar number of patients being classified as Engel I outcome. Engel at 2 years was also predicted by Engel at 6 months and at 1 year (p=0.030). At end follow-up only 3 patients (42.9%) remained categorized as Engel I outcome. There was a trend toward a stability in Engel classification. All patients with developmental causes for their epilepsy experienced some deterioration of the surgical outcomes. Conversely, all patients with acquired causes were stable throughout follow-up. Seizure outcome at 6 months was worse in the patients who had post-op complications (p=0.044). Adult and pediatric populations did not differ significantly in any tested variable.

CONCLUSIONS
Hemispherectomy is a valuable resource for seizure control in properly selected patients. Engel patient's evolution could be predicted at 6 months interval. Hemispherectomy could be considered a useful attitude in difficult cases.

Sousa|Sérgio|S|
Sá Pinto|Vasco|V|
Chaves|João|J|
Martins da Silva|António|A|
Ramalheira|João|J|
Lopes|João|J|
Temudo|Teresa|T|
Lopes Lima|José Manuel|JM|
Calheiros|Alfredo|A|
Rangel|Rui|R|

Hemispherectomy
Refractory epilepsy
Cirugía de la epilepsia
Epilepsia refractaria
Epilepsy surgery
Hemisferectomía


Using 'Omic Approaches to Compare Temporal Bacterial Colonization of Lolium perenne, Lotus corniculatus, and Trifolium pratense in the Rumen.

Abstract: Understanding rumen plant-microbe interactions is central for development of novel methodologies allowing improvements in ruminant nutrient use efficiency. This study investigated rumen bacterial colonization of fresh plant material and changes in plant chemistry over a period of 24 h period using three different fresh forages: Lolium perenne (perennial ryegrass; PRG), Lotus corniculatus (bird's foot trefoil; BFT) and Trifolium pratense (red clover; RC). We show using 16S rRNA gene ion torrent sequencing that plant epiphytic populations present pre-incubation (0 h) were substantially different to those attached post incubations in the presence of rumen fluid on all forages. Thereafter primary and secondary colonization events were evident as defined by changes in relative abundances of attached bacteria and changes in plant chemistry, as assessed using Fourier transform infrared (FTIR) spectroscopy. For PRG colonization, primary colonization occurred for up to 4 h and secondary colonization from 4 h onward. The changes from primary to secondary colonization occurred significantly later with BFT and RC, with primary colonization being up to 6 h and secondary colonization post 6 h of incubation. Across all 3 forages the main colonizing bacteria present at all time points post-incubation were Prevotella, Pseudobutyrivibrio, Ruminococcus, Olsenella, Butyrivibrio, and Anaeroplasma (14.2, 5.4, 1.9, 2.7, 1.8, and 2.0% on average respectively), with Pseudobutyrivibrio and Anaeroplasma having a higher relative abundance during secondary colonization. Using CowPI, we predict differences between bacterial metabolic function during primary and secondary colonization. Specifically, our results infer an increase in carbohydrate metabolism in the bacteria attached during secondary colonization, irrespective of forage type. The CowPI data coupled with the FTIR plant chemistry data suggest that attached bacterial function is similar irrespective of forage type, with the main changes occurring between primary and secondary colonization. These data suggest that the sward composition of pasture may have major implications for the temporal availability of nutrients for animal.

Elliott|Christopher L|CL|
Edwards|Joan E|JE|
Wilkinson|Toby J|TJ|
Allison|Gordon G|GG|
McCaffrey|Kayleigh|K|
Scott|Mark B|MB|
Rees-Stevens|Pauline|P|
Kingston-Smith|Alison H|AH|
Huws|Sharon A|SA|

rumen
perennial ryegrass
red clover
16S rRNA gene
FTIR
CowPI
birds foot trefoil
microbiome


Synthesis of Chlorophyll-Binding Proteins in a Fully Segregated Δycf54 Strain of the Cyanobacterium Synechocystis PCC 6803.

Abstract: In the chlorophyll (Chl) biosynthesis pathway the formation of protochlorophyllide is catalyzed by Mg-protoporphyrin IX methyl ester (MgPME) cyclase. The Ycf54 protein was recently shown to form a complex with another component of the oxidative cyclase, Sll1214 (CycI), and partial inactivation of the ycf54 gene leads to Chl deficiency in cyanobacteria and plants. The exact function of the Ycf54 is not known, however, and further progress depends on construction and characterization of a mutant cyanobacterial strain with a fully inactivated ycf54 gene. Here, we report the complete deletion of the ycf54 gene in the cyanobacterium Synechocystis 6803; the resulting Δycf54 strain accumulates huge concentrations of the cyclase substrate MgPME together with another pigment, which we identified using nuclear magnetic resonance as 3-formyl MgPME. The detection of a small amount (~13%) of Chl in the Δycf54 mutant provides clear evidence that the Ycf54 protein is important, but not essential, for activity of the oxidative cyclase. The greatly reduced formation of protochlorophyllide in the Δycf54 strain provided an opportunity to use (35)S protein labeling combined with 2D electrophoresis to examine the synthesis of all known Chl-binding protein complexes under drastically restricted de novo Chl biosynthesis. We show that although the Δycf54 strain synthesizes very limited amounts of photosystem I and the CP47 and CP43 subunits of photosystem II (PSII), the synthesis of PSII D1 and D2 subunits and their assembly into the reaction centre (RCII) assembly intermediate were not affected. Furthermore, the levels of other Chl complexes such as cytochrome b 6 f and the HliD- Chl synthase remained comparable to wild-type. These data demonstrate that the requirement for de novo Chl molecules differs completely for each Chl-binding protein. Chl traffic and recycling in the cyanobacterial cell as well as the function of Ycf54 are discussed.

Hollingshead|Sarah|S|
Kopečná|Jana|J|
Armstrong|David R|DR|
Bučinská|Lenka|L|
Jackson|Philip J|PJ|
Chen|Guangyu E|GE|
Dickman|Mark J|MJ|
Williamson|Michael P|MP|
Sobotka|Roman|R|
Hunter|C Neil|CN|

Mg-protoporphyrin IX methylester cyclase


Viewpoint: personalizing statin therapy.

Abstract: Cardiovascular disease (CVD), associated with vascular atherosclerosis, is the major cause of death in Western societies. Current risk estimation tools, such as Framingham Risk Score (FRS), based on evaluation of multiple standard risk factors, are limited in assessment of individual risk. The majority (about 70%) of the general population is classified as low FRS where the individual risk for CVD is often underestimated but, on the other hand, cholesterol lowering with statin is often excessively administered. Adverse effects of statin therapy, such as muscle pain, affect a large proportion of the treated patients and have a significant influence on their quality of life. Coronary artery calcification (CAC), as assessed by computed tomography, carotid artery intima-media thickness (CIMT), and especially presence of plaques as assessed by B-mode ultrasound are directly correlated with increased risk for cardiovascular events and provide accurate and relevant information for individual risk assessment. Absence of vascular pathology as assessed by these imaging methods has a very high negative predictive value and therefore could be used as a method to reduce significantly the number of subjects who, in our opinion, would not benefit from statins and only suffer from their side-effects. In summary, we suggest that in very-low-risk subjects, with the exception of subjects with low FRS with a family history of coronary artery disease (CAD) at young age, if vascular imaging shows no CAC or normal CIMT without plaques, statin treatment need not be administered.

statin
cardiovascular disease
atherosclerosis
Framingham Risk Score
coronary artery calcification
carotid artery intima-media thickness


Recent Advances of Cellulose-Based Materials and Their Promising Application in Sodium-Ion Batteries and Capacitors.

Abstract: Cellulose as the most abundant natural biopolymer on earth has shown promising potential because of its excellent physical, mechanical, and biocompatible properties, which are very important for sustainable energy storage systems (ESSs). In this review, a comprehensive summary of the applications involving all kinds and forms of cellulose in the advanced Na-related ESSs, including sodium ion batteries (SIBs) and sodium ion capacitors (SICs), is presented. For cellulose, the impact of various structures and surface chemical properties on the electrochemical performance is focused on. In particular, the latest developments in cellulose-based binders and separators are highlighted. In addition, an in-depth understanding of the structure and performance of electrode materials and the storage mechanism of a hard carbon anode derived from cellulose for SIBs is provided. Further, the manufacturing of full-cellulose-based SICs assembled by all parts of devices including hard carbon anodes, active carbon cathodes, binders, and separator based on cellulose or cellulose derivatives is reviewed. Finally, the prospects of cellulose-based energy storage systems on several issues that need further exploration are presented.

cellulose
sodium ion batteries
sodium ion capacitors
binders
separator


A new classification of viviparous brotulas (Bythitidae) - with family status for Dinematichthyidae - based on molecular, morphological and fossil data.

Abstract: The order Ophidiiformes is a large but not very well known group of fishes, unique among teleosts for showing high diversity in both deep sea and shallow reef habitats. The current classification includes more than 500 species, 115 genera and four families, based primarily on mode of reproduction: viviparous Aphyonidae and Bythitidae vs oviparous Carapidae and Ophidiidae. Since 2004 we revised the bythitid tribe Dinematichthyini, described more than 100 new species and noticed that this group has unique morphological characters, perhaps supporting a higher level of classification than the current status. Here we study the viviparous families phylogenetically with partial mitochondrial (nd4, 16s) and nuclear (Rag1) DNA sequences (2194bp). We use a fossil calibration of otolith-based taxa to calibrate the age of the clade comprising bythitid and dinematicththyid representatives, together with fossil calibrations adopted from previous phylogenetic studies. The separation of the order into two major lineages, the viviparous Bythitoidei and the oviparous Ophidioidei is confirmed. At the familial level, however, a new classification is presented for the viviparous clades, placing Aphyonidae as a derived, pedomorphic member of Bythitidae (new diagnosis provided, 33 genera and 118 species). The current subfamily Brosmophycinae is considered polyphyletic and we propose family status for Dinematichthyidae (25 genera, 114 species), supported by unique, morphological synapomorphic characters in the male copulatory apparatus. Previous use of the caudal fin separation or fusion with vertical fins is ambiguous. Age estimates based on calibrated molecular phylogeny agrees with fossil data, giving an origin within the Cretaceous (between 84 and 104mya) for a common ancestor to Ophidiiformes.

Møller|Peter Rask|PR|
Knudsen|Steen Wilhelm|SW|
Schwarzhans|Werner|W|
Nielsen|Jørgen G|JG|

Aphyonidae
Pedomorphism
Bythitinae
Cave fishes
Coral reef fishes
Deep-sea fishes


Synthesis and antimicrobial studies of novel derivatives of 4-(4-formyl-3-phenyl-1H-pyrazol-1-yl)benzoic acid as potent anti-Acinetobacter baumannii agents.

Abstract: Microbial resistance to antibiotics is a global concern. The World Health Organization (WHO) has identified antimicrobial resistance as one the three greatest threats for human beings in the 21st century. Without urgent and coordinated action, the world is moving toward a post-antibiotic era, in which normal infections or minor injuries may become fatal. In an effort to find new agents, we report the synthesis and antimicrobial activities of 40 novel 1,3-diphenyl pyrazole derivatives. These compounds have shown zones of growth inhibition up to 85mm against Acinetobacter baumannii. We tested the active compounds against this Gram-negative bacterium in minimum inhibitory concentration (MIC) tests and found activity with concentration as low as 4μg/mL.

Allison|Devin|D|
Delancey|Evan|E|
Ramey|Hunter|H|
Williams|Conrad|C|
Alsharif|Zakeyah Ali|ZA|
Al-Khattabi|Hessa|H|
Ontko|Allyn|A|
Gilmore|David|D|
Alam|Mohammad A|MA|

D024901:Drug Resistance, Multiple, Bacterial

Methicillin-resistant Staphylococcus aureus (MRSA)


Effects of xylo-oligosaccharide and flavomycin on the immune function of broiler chickens.

Abstract: This study investigated the effects of xylo-oligosaccharide (XOS) and flavomycin (FLA) on the performance and immune function of broiler chickens. A total of 150 ArborAcres broilers were randomly divided into three groups and fed for six weeks from one day of age in cascade cages. The diets of each test group were (1) a basal diet, (2) the basal diet supplemented with 2 mg/kg FLA, and (3) the basal diet supplemented with 2 mg/kg XOS. At 21 and 42 days, the growth performance index values and short-chain fatty acid (SCFA) concentrations in the cecum were quantified. Furthermore, immunoglobulin G (IgG) and plasma interleukin 2 (IL-2) as well as mRNA expression of LPS-Induced TNF-alpha Factor (LITAF), Toll-like receptor-5 (TLR5) and interferon gamma (IFN ) in the jejunum were quantified. The results showed that administration of XOS or FLA to chickens significantly improved the average daily gain. Supplementation with XOS increased acetate and butyrate in the cecum, while FLA supplementation increased propionate in the cecum. An increase in plasma IgG was observed in XOS-fed 21-day-old broilers, but FLA supplementation decreased IgG in the plasma of 42-day-old broilers and increased plasma IL-2. Furthermore, FLA or XOS supplementation downregulated mRNA expression of IFN , LITAF and TLR5. The above data suggest that addition of XOS and FLA to the diet could improve the growth performance of broilers and reduce the expression of cytokine genes by stimulating SCFA.

Yuan|Lin|L| Li|Wanli|W| Huo|Qianqian|Q| Du|Chenhong|C| Wang|Zhixiang|Z| Yi|Baodi|B| Wang|Mingfa|M|

Broiler
XOS
FLA
SCFA
Immune-related gene


Intravitreal bevacizumab-induced exacerbation of proteinuria in diabetic nephropathy, and amelioration by switching to ranibizumab.

Abstract: Certain diabetic and hypertensive patients started on intravitreal vascular endothelial growth factor inhibition for diabetic retinopathy may experience worsening of hypertension and proteinuria. The etiology of this is the newly recognized absorption of intravitreally injected vascular endothelial growth factor inhibitors, and the susceptibility of patients with pre-existing renal disease to exacerbations depends on the degree of systemic absorption. There are eighteen reported cases of worsening hypertension, woresening proteinuria, worsening renal function, thrombotic microangiopathy, and glomerular disease noted after initiation of intravitreal vascular endothelial growth factor blockade. This nineteenth case demonstrates worsening hypertension and proteinuria with the start of bevacizumab. Both blood pressure and proteinuria parameters showed overall improvement with switching to the less absorbed and lower potency agent ranibizumab. There was a slight rise in serum creatinine after bevacizumab therapy, which stabilized at a new baseline, and the serum creatinine remained stable on ranibizumab. There were no other nephrotoxic exposures that explained the mild rise in serum creatinine. Because of improvement in renal function and proteinuria, a renal biopsy was deferred for the time. This case re-demonstrates the risk of worsening proteinuria with vascular endothelial growth factor inhibitors when given intravitreally in some patients. The demonstration of improvement in blood pressure and proteinuria with the use of lower potency agents like ranibizumab is novel and an important concept confirming observations from pharmacokinetic studies. The switch to ranibizumab offers a therapeutic option when proteinuria worsens with intravitreal vascular endothelial growth factor blockade, and the patient requires ongoing intravitreal therapy for treatment of diabetic retinopathy.


Rationing cancer treatment: a qualitative study of perceptions of legitimate limit-setting.

Abstract:
BACKGROUND
Governments are facing tough choices about whether to fund new, promising but highly expensive drugs within the public healthcare system. Decisions that some drugs are not sufficiently beneficial relative to their cost to merit public funding are often contentious. The importance of making decisions that stakeholders can understand and accept as legitimate is increasingly recognized and is commonly understood to be a crucial component for stakeholder support and successful implementation. Yet, little is known about clinicians' perceptions of legitimate limit-setting. This study aimed to examine oncologists' perceptions of the legitimacy of governmental decisions to deny patients access to new cancer drugs because effectiveness and cost-effectiveness of the drugs has not been demonstrated.

METHODS
Semi-structured in-depth interviews with 12 Norwegian oncologists were carried out. Data were interpreted with the use of theory driven thematic analysis. The analytical framework of Accountability for reasonableness aided data gathering and interpretation.

RESULTS
The participants endorsed the ideal of explicit criteria-based priority setting. Yet, when confronted with actual rationing decisions, they were far more equivocal. They advocated for increased access to drugs and were not always prepared to accept rationing of drugs they felt would benefit their patient. Distrust in the Norwegian centralised drug review process was found and different rationales were identified: i) Lack of engagement with the process, ii) Disagreement with the use of rationing criteria, iii) Lack of transparency and lack of dispute resolution procedures. Concerns about the wider implications of rationing decisions were reported. Most importantly, these related to negative impact on patient-doctor relationship of micro-level rationing and to inequities in drug availability resulting from privatisation of high-cost cancer treatment.

CONCLUSIONS
Drawing on the analytical framework, we conclude that perceptions of legitimacy regarding rationing of high-cost drugs include procedural fairness. However, notions of substantive justice also seem to be important for accepting reasons given for decisions. Regulatory legitimacy may further warrant a more sophisticated theoretical account of second-order beliefs about the justifiability of rationing new technologies. These findings indicate a need for a broader concept of legitimacy than is commonly used in the literature on healthcare prioritisation.

D007722:Health Knowledge, Attitudes, Practice

Rationing
Clinicians
Legitimacy
Cancer drugs
Thematic analysis
High-cost
Norway
Priority-setting


Characterization of Aluminum-Based-Surface Matrix Composites with Iron and Iron Oxide Fabricated by Friction Stir Processing.

Abstract: Surface composite layers were successfully fabricated on an A 1050-H24 aluminum plate by dispersed iron (Fe) and magnetite (Fe₃O₄) particles through friction stir processing (FSP). Fe and Fe₃O₄ powders were packed into a groove of 3 mm in width and 1.5 mm in depth, cut on the aluminum plate, and covered with an aluminum sheet that was 2-mm thick. A friction stir processing (FSP) tool of square probe shape, rotated at a rate of 1000-2000 rpm, was plunged into the plate through the cover sheet and the groove, and moved along the groove at a travelling speed of 1.66 mm/s. Double and triple passes were applied. As a result, it is found that the Fe particles were homogenously distributed in the whole nugget zone at a rotation speed of 1000 rpm after triple FSP passes. Limited interfacial reactions occurred between the Fe particles and the aluminum matrix. On the other hand, the lower rotation speed (1000 rpm) was not enough to form a sound nugget when the dispersed particles were changed to the larger Fe₃O₄. The Fe₃O₄ particles were dispersed homogenously in a sound nugget zone when the rotation speed was increased to 1500 rpm. No reaction products could be detected between the Fe₃O₄ particles and the aluminum matrix. The saturation magnetization (Ms) of the Fe-dispersed nugget zone was higher than that of the Fe₃O₄-dispersed nugget zone. Moreover, there were good agreement between the obtained saturation magnetization values relative to that of pure Fe and Fe₃O₄ materials and the volume content of the dispersed particles in the nugget zone.

Mahmoud|Essam R I|ERI|
Tash|Mahmoud M|MM|

friction stir processing
surface composites
aluminum
magnetization
Fe3O4
iron powder


Ureteric patency after Deflux® injection for the treatment of vesicoureteric reflux in children confirmed by a novel epidural catheter-assisted endoscopic technique.

Abstract:
PURPOSE
We present EDCAT (epidural catheter-assisted Deflux(®) treatment) for treating vesicoureteral reflux (VUR) and confirming ureteric patency after Deflux(®) treatment.

METHODS
We treated 147 ureters in 101 children (M:F 62:39; VUR ≤ grade III: n = 72; VUR ≥ grade IV: n = 75) using EDCAT between 2011 and 2014. EDCAT involves injecting 1-3 mL of diluted indigo carmine solution through an epidural anesthesia catheter inserted into the Deflux(®)-treated ureter and observing for up to 15 min to confirm patency.

RESULTS
For EDCAT, mean age was 4.9 years and mean operative time was 30.1 ± 12.1 min; overall cure of VUR after initial treatment was 87.7 % for VUR grades I-V, 88.9 % for VUR ≤ grade III, and 86.6 % for VUR ≥ grade IV; VUR was cured in 129/147 after 1 treatment, 7/18 after 2 treatments, 7/11 after 3 treatments, and persistent in 4/4. We experienced 1 case of obstruction after an EDCAT catheter was removed before confirming patency. EDCAT catheters were left overnight in 2 ureters in 2 cases when patency could not be confirmed after 15 min to prevent obstruction. Both did not develop obstruction. Four ureters with recurrence of VUR (all grade ≤ II) are being observed.

CONCLUSION
EDCAT allows ureteric patency to be confirmed immediately and prevents obstruction.

Okawada|Manabu|M|
Shibuya|Soichi|S|
Doi|Takashi|T|
Miyano|Go|G|
Koga|Hiroyuki|H|
Lane|Geoffrey J|GJ|
Okazaki|Tadaharu|T|
Yamataka|Atsuyuki|A|

Deflux®
Vesicoureteral reflux
Epidural catheter


A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report.

Abstract: This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occlusion has been established only on the right side. The left side could not be restored to an ideal class I relationship due to the pontic prosthesis. The original collapsed right posterior occlusion was corrected. A stable posterior occlusion was established, and the balancing interference was eliminated. Centric relation and centric occlusion were established at the same vertical dimension of occlusion. The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet.Multidisciplinary management, including endodontic and restorative dentistry, periodontics, corticotomy-assisted orthodontics, implants, and prosthetics, was used for a young female patient with multiple missing teeth, anterior deep bite, and a malocclusion with cant of the occlusal plane. The interaction of interdisciplinary specialties and careful treatment planning were required. The patient also benefited esthetically from our effort.

Gelpi|Federico|F|
De Santis|Daniele|D|
Marconcini|Simone|S|
Briguglio|Francesco|F|
Finotti|Marco|M|

Corticotomies
Multidisciplinary approach
Piezo device
Oral implantology


Chiral Self-Assembly of Porphyrins Induced by Chiral Carbon Dots.

Abstract: Chirality plays a key role in many fields ranging from life to natural sciences. For a long time, chiral materials have been developed and used to interact with chiral environments. In recent years, fluorescent carbon dots (CDots) are a new class of carbon nanomaterials exhibit excellent optical properties, good biocompatibility, excellent water solubility, and low cost. However, chirality transfer between semiconductor CDots and organics remains a challenge. Herein, a facile one-step hydrothermal method was used to synthesize chiral CDs from cysteine (cys). The obtained chiral CDots can act as chiral templates to induce porphyrins to form chiral supramolecular assemblies. The successful transmission of chiral information provides more options for the development of various chiral composite materials and the preservation of chiral information in the future.

Liu|Xiaowei|X| Lu|Jiayi|J| Chen|Jingqi|J| Zhang|Mengtian|M| Chen|Yingying|Y| Xing|Feifei|F| Feng|Lingyan|L|

self-assembly
porphyrin
chiral carbon dots
chirality transfer
chiral templates


Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards.

Abstract:
BACKGROUND
A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented.

METHODS
This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden.

RESULTS AND CONCLUSION
The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way.

Bergh|Ingrid H E|IH|
Johansson|Anna|A|
Bratt|Annelie|A|
Ekström|Anette|A|
Mårtensson|Lena B|LB|

Documentation
Childbirth
Midwifery
Pain assessment
Visual analogue scale


Assessment of Bottle-Feeding Practices in Kassala, Eastern Sudan: A Community-Based Study.

Abstract:
BACKGROUND
The World Health Organization encourages exclusive breastfeeding up to six months and avoidance of bottle-feeding. There are few published research articles on the practice of bottle-feeding and associated factors in Sudan.

AIM
The study aimed to assess the usage and factors associated with bottle-feeding practices during the first six months of life among mothers with children aged between 6 and 24 months in Kassala, Eastern Sudan.

METHODS
A community-based cross-sectional study was conducted from July to September 2017. A structured questionnaire was used to collect relevant data from interviewed mothers.

RESULTS
A total of 242 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children's age was 27.13 (5.73) years and 12.2 (6.7) months, respectively. From the total, 96/242 (39.7%) used bottle-feeding for their children in the first six months of life. In multivariable analysis, urban residence (Adjusted Odds Ratio [AOR] 1.96, 95% Confidence Interval [CI] (1.06, 3.63), not receiving breastfeeding education (AOR 1.92, 95% CI 1.07, 3.45) and child hospitalization (AOR 1.83, 95% CI 1.02, 3.28) were significantly associated with bottle-feeding.

CONCLUSION
There was a high usage of bottle-feeding and it was found to be associated with child hospitalisation. To avoid bottle-feeding, urgent actions are required to support and educate mothers regarding breastfeeding with special attention to urban-residence ones.

Hassan|Ahmed A|AA|
Taha|Zainab|Z|
Abdulla|Mohamed A|MA|
Ali|AbdelAziem A|AA|
Adam|Ishag|I|

Bottle-feeding
Sudan
Urban residence
Breastfeeding education
Child hospitalisation


Acetyl-CoA Carboxylase Inhibitor CP640.186 Increases Tubulin Acetylation and Impairs Thrombin-Induced Platelet Aggregation.

Abstract: Acetyl-CoA carboxylase (ACC) is the first enzyme regulating de novo lipid synthesis via the carboxylation of acetyl-CoA into malonyl-CoA. The inhibition of its activity decreases lipogenesis and, in parallel, increases the acetyl-CoA content, which serves as a substrate for protein acetylation. Several findings support a role for acetylation signaling in coordinating signaling systems that drive platelet cytoskeletal changes and aggregation. Therefore, we investigated the impact of ACC inhibition on tubulin acetylation and platelet functions. Human platelets were incubated 2 h with CP640.186, a pharmacological ACC inhibitor, prior to thrombin stimulation. We have herein demonstrated that CP640.186 treatment does not affect overall platelet lipid content, yet it is associated with increased tubulin acetylation levels, both at the basal state and after thrombin stimulation. This resulted in impaired platelet aggregation. Similar results were obtained using human platelets that were pretreated with tubacin, an inhibitor of tubulin deacetylase HDAC6. In addition, both ACC and HDAC6 inhibitions block key platelet cytoskeleton signaling events, including Rac1 GTPase activation and the phosphorylation of its downstream effector, p21-activated kinase 2 (PAK2). However, neither CP640.186 nor tubacin affects thrombin-induced actin cytoskeleton remodeling, while ACC inhibition results in decreased thrombin-induced reactive oxygen species (ROS) production and extracellular signal-regulated kinase (ERK) phosphorylation. We conclude that when using washed human platelets, ACC inhibition limits tubulin deacetylation upon thrombin stimulation, which in turn impairs platelet aggregation. The mechanism involves a downregulation of the Rac1/PAK2 pathway, being independent of actin cytoskeleton.

acetyl-CoA carboxylase
tubulin
acetylation
platelet
platelet aggregation
actin cytoskeleton
Rac1 signaling


Creating an amateur press corps of graduate students and postdoctoral fellows to cover breaking science and improve lay-writing skills.

Abstract: The Science Writing Initiative for Trainees is a science communications internship program for biomedical graduate students and postdoctoral fellows at the Medical University of South Carolina. Interns serve as an amateur press corps, writing news stories and press releases about recent high-impact research articles. Since 2016, 25 interns have written more than 100 EurekAlert! press releases that have received more than a half million views. Interns learn to explain science across the translational spectrum and to convey findings in plain language to a lay audience, serving as ambassadors for science.

science writing
Science communications
internship
plain language
career development
general public
graduate education
interdisciplinary
lay public


A prospective randomized controlled trial comparing early postoperative complications in patients undergoing loop colostomy with and without a stoma rod.

Abstract:
AIM
A stoma rod or bridge has been traditionally placed under the bowel loop while constructing a loop colostomy. This is believed to prevent stomal retraction and provide better faecal diversion. However, the rod can cause complications such as mucosal congestion, oedema and necrosis. This single-centre prospective randomized controlled trial compared outcomes after creation of loop colostomy with and without a supporting stoma rod. The primary outcome studied was stoma retraction rate; other stoma-related complications were studied as secondary outcomes.

METHOD
One hundred and fifty-one patients were randomly allotted to one of two arms, colostomy with or without a supporting rod. Postoperative complications such as retraction, mucocutaneous separation, congestion and re-exploration for stoma-related complications were recorded.

RESULTS
There was no difference in the stoma retraction rate between the two arms (8.1% in the rod arm and 6.6% in the no-rod arm; P = 0.719). Stomal necrosis (10.7% vs 1.3%; P = 0.018), oedema (23% vs 3.9%; P = 0.001), congestion (20.3% vs 2.6%; P = 0.001) and re-admission rates (8.5% vs 0%; P = 0.027) were significantly increased in the arm randomized to the rod.

CONCLUSION
The stoma rod does not prevent stomal retraction. However, complication rates are significantly higher when a stoma rod is used. Routine use of a stoma rod for construction of loop colostomy can be avoided.

Franklyn|J|J|
Varghese|G|G|
Mittal|R|R|
Rebekah|G|G|
Jesudason|M R|MR|
Perakath|B|B|

Colostomy
stomal retraction
colostomy rod
supporting bridge


Supplementation of Bacillus subtilis GM5 enhances broiler body weight gain and modulates cecal microbiota.

Abstract:
We investigated the effect of the strain Bacillus subtilis GM5 on growth, feed conversion, and the composition of cecum microbiota in broiler chickens. Half of which received a control diet, while the other half was fed a diet supplemented with GM5 spores. Cecal contents on days 1, 10, and 42 were subjected to metataxonomic analysis. Principal Component Analysis showed that the control and probiotic groups formed three separate clusters, indicating changes, which occurred gradually in microbial communities. On day 1, Firmicutes (53.87-57.61%) and Proteobacteria (43.77-38.93%) were prevalent in both groups, whereas samples of days 10 and 42 were predominantly occupied by Firmicutes (54.55-81.79%) and Bacteroidetes (26.94-30.45%). In the group of chickens treated with probiotic, the average daily gain in body weight was higher, while feed conversion decreased by 1.44%. A surge in the presence of beneficial bacteria of the Ruminococcaceae family was observed. The introduction of the probiotic led to an elevated Firmicutes/Bacteroidetes ratio, which positively correlated with chickens' bodyweight (Spearman ρ = 1.0, P < 0.05). Supplementing broiler feed with B. subtilis GM5 spores leads to improved feed intake and digestibility, which is paramount in reducing the cost of the final product. Thus, the probiotic strain GM5 modulates the cecal microbiota of broiler chickens and increases microbial diversity, which is well exhibited on the 42nd day.

Supplementary Information
The online version contains supplementary material available at 10.1007/s13205-020-02634-2.

Hadieva|Guzel|G|0000-0002-9281-3994 Lutfullin|Marat|M| Pudova|Daria|D| Akosah|Yaw|Y| Shagimardanova|Elena|E| Gogoleva|Natalia|N| Sharipova|Margarita|M| Mardanova|Ayslu|A|

Broiler
Cecum
Metataxonomic
Probiotics
16S rRNA gene
GIT of chickens


MicroRNA as Crucial Regulators of Gene Expression in Estradiol-Treated Human Endothelial Cells.

Abstract:
BACKGROUND/AIMS
Estrogen signalling plays an important role in vascular biology as it modulates vasoactive and metabolic pathways in endothelial cells. Growing evidence has also established microRNA (miRNA) as key regulators of endothelial function. Nonetheless, the role of estrogen regulation on miRNA profile in endothelial cells is poorly understood. In this study, we aimed to determine how estrogen modulates miRNA profile in human endothelial cells and to explore the role of the different estrogen receptors (ERα, ERβ and GPER) in the regulation of miRNA expression by estrogen.

METHODS
We used miRNA microarrays to determine global miRNA expression in human umbilical vein endothelial cells (HUVEC) exposed to a physiological concentration of estradiol (E2; 1 nmol/L) for 24 hours. miRNA-gene interactions were computationally predicted using Ingenuity Pathway Analysis and changes in miRNA levels were validated by qRT-PCR. Role of ER in the E2-induced miRNA was additionally confirmed by using specific ER agonists and antagonists.

RESULTS
miRNA array revealed that expression of 114 miRNA were significantly modified after E2 exposition. Further biological pathway analysis revealed cell death and survival, lipid metabolism, reproductive system function, as the top functions regulated by E2. We validated changes in the most significantly increased (miR-30b-5p, miR-487a-5p, miR-4710, miR-501-3p) and decreased (miR-378h and miR-1244) miRNA and the role of ER in these E2-induced miRNA was determined. Results showed that both classical, ERα and ERβ, and membrane-bound ER, GPER, differentially regulated specific miRNA. In silico analysis of validated miRNA promoters identified specific ER binding sites.

CONCLUSION
Our findings identify differentially expressed miRNA pathways linked to E2 in human endothelial cells through ER, and provide new insights by which estrogen can modulate endothelial function.

Vidal-Gómez|Xavier|X|
Pérez-Cremades|Daniel|D|
Mompeón|Ana|A|
Dantas|Ana Paula|AP|
Novella|Susana|S|
Hermenegildo|Carlos|C|

D061307:Human Umbilical Vein Endothelial Cells

D020411:Oligonucleotide Array Sequence Analysis

Endothelial cells
MiRNA
Estrogen receptors
Estradiol
Epigenetic regulation


Responses of milk production of dairy cows to jugular infusions of a mixture of essential amino acids with or without exclusion leucine or arginine.

Abstract: The purpose of this study was to determine effects of jugular infusion of either balanced or imbalanced amino acid mixture on milk production and composition in dairy cows. Eight mid-lactation Holstein cows were randomly assigned to 5-d continuous jugular infusions of saline (CTL), essential amino acid (EAA) mixture prepared on the profile of casein (CSN, 160 g/d), EAA mixture excluding leucine (Leu) (-Leu, 163 g/d) or EAA mixture excluding arginine (Arg) (-Arg, 158 g/d) in a duplicated 4 × 4 Latin square design with 4 infusion periods separated by a 7-d interval period. The basal diet was formulated with corn grain, soybean meal, cottonseed meal, corn silage, alfalfa hay and Chinese wildrye grass hay according to NRC (2001) and supplied 1.6 Mcal net energy for lactation (NEL) and 94.4 g metabolizable protein (MP) per kg dry matter (DM) to meet requirements for lactation. The results showed that the dry matter intake (DMI) and normal physiological status were not affected by amino acid mixture infusions. Compared with CTL treatment, the CSN treatment increased milk yield (14.9%, P < 0.001), milk lactose yield (14.5%, P = 0.001), milk fat yield (16.6%, P = 0.01), milk protein yield (18.2%, P < 0.001) and the contents of αS1-casein (αS1-CN, 11.8%, P = 0.007), β-casein (β-CN, 4.2%, P = 0.035) and κ-casein (κ-CN, 8.5%, P = 0.003). However, the -Leu and -Arg treatments had lower milk yield (6.3%, P = 0.058 and 5.7%, P = 0.073, respectively), milk protein yield (8.8%, P = 0.010 and 8.2%, P = 0.011, respectively) and the contents of αS1-CN (7.3%, P = 0.057 and 8.4%, P = 0.026, respectively), β-CN (4.2%, P = 0.033 and 3.8%, P = 0.048, respectively) and κ-CN (5.8%, P = 0.023 and 7.6%, P = 0.003, respectively) than those of the CSN treatment. Milk lactose yield (5.9%, P = 0.076) tended to decrease when Leu was removed from amino acid mixture infusate. In conclusion, the supply of casein profile can increase milk production in dairy cows, but a deficiency of Leu or Arg had negative effects on milk yield and milk protein yield.

Tian|Wen|W| Wu|Tianyou|T| Zhao|Rui|R| Xu|Jinhao|J| He|Yao|Y| Wang|Hongrong|H|

Dairy cows
Leucine
Arginine
Casein
Lactation performance


IMMUNONUTRITION IN CERVICAL CANCER: IMMUNE RESPONSE MODULATION BY DIET.

Abstract: In the development of cervical cancer (CC), the immune response plays an essential role, from the elimination of human papillomavirus (HPV) infection to the response against the tumor. For optimal function of the immune response, various factors are required, one of the most important being an adequate nutrition. The complex interaction between nutrients and microbiota maintains the immune system in homeostasis and in case of infection, it provides the ability to fight against pathogen invasion, as occurs in HPV infection. The purpose of this article is to describe the role of diet, food, and specific nutrients in the immune response from the onset of infection to progression to precancerous lesions and CC, as well as the role of diet and nutrition during oncological treatment. The immunomodulatory role of microbiota is also discussed. A detailed analysis of the evidence leads us to recommend a nutritional pattern very similar to the Mediterranean diet or the prudent diet for an optimal immune response. Moreover, pre- and probiotics favorably modulate the microbiota and induce preventive and therapeutic effects against cancer.

Medina-Contreras|Oscar|O|
Luvián-Morales|Julissa|J|
Valdez-Palomares|Fernanda|F|
Flores-Cisneros|Laura|L|
Sánchez-López|Miriam S|MS|
Soto-Lugo|Jaime H|JH|
Castro-Eguiluz|Denisse|D|

Immunonutrition
Cervical cancer
Diet
Human papillomavirus
Microbiota


Complete remission with romidepsin in a patient with T-cell acute lymphoblastic leukemia refractory to induction hyper-CVAD.

Abstract: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL) are neoplasms that originate from T-cell precursors. Outcomes in adult patients with T-ALL/LBL remain unsatisfactory; early relapse following intensive induction chemotherapy is a concern, and patients with relapsed or refractory disease have a poor prognosis. Romidepsin is a potent, class 1 selective histone deacetylase inhibitor approved for the treatment of patients with peripheral T-cell lymphoma who have had ≥1 prior therapy and patients with cutaneous T-cell lymphoma who have had ≥1 prior systemic therapy. Here, we report the case of an adult patient with T-ALL refractory to induction hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD). Treatment with romidepsin was initiated, and romidepsin in combination with hyper-CVAD resulted in complete remission, with mild tumor lysis syndrome as the only detectable additional toxicity. The patient eventually underwent allogeneic stem cell transplant while in first complete remission. Prior studies have shown that romidepsin is capable of inducing durable responses with manageable toxicities in patients with mature T-cell lymphomas. This case study describes the successful use of romidepsin in combination with hyper-CVAD in an adult patient with refractory T-ALL and highlights the activity of romidepsin in the T-cell lineage. The potential of romidepsin-containing regimens in patients with T-ALL/LBL deserves further study.

D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma

early T-cell precursor acute lymphoblastic leukemia/lymphoma


Physical rupture of the xylem in developing sweet cherry fruit causes progressive decline in xylem sap inflow rate.

Abstract: Xylem flow is progressively shut down during maturation beginning with minor veins at the stylar end and progressing to major veins and finally to bundles at the stem end. This study investigates the functionality of the xylem vascular system in developing sweet cherry fruit (Prunus avium L.). The tracers acid fuchsin and gadoteric acid were fed to the pedicel of detached fruit. The tracer distribution was studied using light microscopy and magnetic resonance imaging. The vasculature of the sweet cherry comprises five major bundles. Three of these supply the flesh; two enter the pit to supply the ovules. All vascular bundles branch into major and minor veins that interconnect via numerous anastomoses. The flow in the xylem as indexed by the tracer distribution decreases continuously during development. The decrease is first evident at the stylar (distal) end of the fruit during pit hardening and progresses basipetally towards the pedicel (proximal) end of the fruit at maturity. That growth strains are the cause of the decreased conductance is indicated by: elastic strain relaxation after tissue excision, the presence of ruptured vessels in vivo, the presence of intrafascicular cavities, and the absence of tyloses.

Grimm|Eckhard|E|
Pflugfelder|Daniel|D|
van Dusschoten|Dagmar|D|
Winkler|Andreas|A|
Knoche|Moritz|M|

D001692:Biological Transport
D004396:Coloring Agents
D005638:Fruit
D058526:Plant Vascular Bundle
D000068220:Prunus avium
D012394:Rosaniline Dyes
D013312:Stress, Physiological
D014867:Water
D052584:Xylem

Acid fuchsin
Gadoteric acid
Magnetic resonance imaging
Strain
Conductance
Stress


A microbial metabolite synergizes with endogenous serotonin to trigger C. elegans reproductive behavior.

Abstract: Natural products are a major source of small-molecule therapeutics, including those that target the nervous system. We have used a simple serotonin-dependent behavior of the roundworm Caenorhabditis elegans, egg laying, to perform a behavior-based screen for natural products that affect serotonin signaling. Our screen yielded agonists of G protein-coupled serotonin receptors, protein kinase C agonists, and a microbial metabolite not previously known to interact with serotonin signaling pathways: the disulfide-bridged 2,5-diketopiperazine gliotoxin. Effects of gliotoxin on egg-laying behavior required the G protein-coupled serotonin receptors SER-1 and SER-7, and the Gq ortholog EGL-30. Furthermore, mutants lacking serotonergic neurons and mutants that cannot synthesize serotonin were profoundly resistant to gliotoxin. Exogenous serotonin restored their sensitivity to gliotoxin, indicating that this compound synergizes with endogenous serotonin to elicit behavior. These data show that a microbial metabolite with no structural similarity to known serotonergic agonists potentiates an endogenous serotonin signal to affect behavior. Based on this study, we suggest that microbial metabolites are a rich source of functionally novel neuroactive molecules.

serotonin
C. elegans
animal–microbe interaction