Illness perceptions and beliefs about medication: impact on health-related quality of life in adolescent kidney transplant recipients.

Abstract: Adolescents diagnosed with chronic kidney disease (CKD) who undergo kidney transplantation have to adjust to pervasive effects of chronic illness and life-long treatment maintenance, alongside normative developmental stressors. The way in which adolescent transplant recipients experience and think about their illness as well as their medication regimen can be a crucial factor impacting psychosocial outcomes. Participants were 26 adolescent kidney transplant recipients (μ = 16.8 years, σ = 1.69 years) who completed self-report surveys during a clinic visit. Multiple linear regressions were used to investigate whether adolescents' beliefs about medications and attitudes and perceptions of their illness are associated with their overall quality of life. Adolescents' negative illness perceptions contributed to lower transplant-specific health-related quality of life ratings (ΔR2 =.305, p < .01). Additionally, adolescent beliefs about their specific medication regimens (ie, personal medication concerns) (ΔR2 =.342, p < .01), and general beliefs about medication use (ie, harm, overuse) (ΔR2 =.241, p < .05) also contribute significantly to the variance in their overall quality of life ratings. Adolescent transplant patients in older grades and those in special education endorsed lower quality of life. Cognitive components (eg, beliefs, perceptions) of an adolescent kidney transplant recipient's experience contribute to transplant-related quality of life outcomes. This highlights a point of intervention where cognitive change interventions may be utilized and efficacious in improving health outcomes.

illness perceptions
quality of life
chronic kidney disease
cognitions
well-being


Psychotropic Medication Informed Consent: A Cross-Specialty Role-Playing Skill Builder.

Abstract:
Introduction
Obtaining informed consent (IC) is an essential medical practice. Utilization of IC role-playing training with medication study cards and self-peer-supervisor review should improve student fund of knowledge and strengthen IC skills for clerkship-level medical students.

Methods
Between 2017 and 2020, approximately 555 clerkship medical students used our formative role-playing exercise tools. Students independently prepared psychotropic medication study cards and role-played IC during group didactics. Peer and supervisor reviews were not recorded but were discussed as a group. Students completed routine anonymous postclerkship surveys regarding the IC exercise. An enhanced IC curriculum was deployed in 2020, adding a training video and peer/supervisor feedback form. Student feedback and specialty shelf exam scores were reviewed to assess the exercise's effectiveness.

Results
Surveys indicated satisfaction with the exercise and increased confidence in obtaining IC. Interestingly, the student group that received enhanced IC training had fewer shelf exam failures than those without, perhaps indicating improved fund of psychotropic medication knowledge.

Discussion
Peer role-playing IC training is well accepted by students, allows practice of essential elements of IC and shared decision-making, and provides an engaging way to improve medication fund of knowledge. Our clerkship has initiated development of an IC objective structured clinical examination station and is adapting the exercise across specialties for longitudinal learning in response to the positive feedback and ease of use. Structured review of psychotropics and peer IC role-playing can be tailored for other specialties, medications, and procedures and further developed for use in pre- and postclerkship education.

Diana|Emily|E|
Hamaoka|Derrick|D|
Goldenberg|Matthew|M|
Cozza|Kelly L|KL|

D002982:Clinical Clerkship
D003479:Curriculum
D006801:Humans
D007258:Informed Consent
D012381:Role Playing
D013337:Students, Medical

Competency-Based Medical Education (Competencies, Milestones, EPAs)


A Noise Tolerant Spread Spectrum Sound-Based Local Positioning System for Operating a Quadcopter in a Greenhouse.

Abstract: Quadcopters are beginning to play an important role in precision agriculture. In order to localize and operate the quadcopter automatically in complex agricultural settings, such as a greenhouse, a robust positioning system is needed. In previous research, we developed a spread spectrum sound-based local positioning system (SSSLPS) with a 20 mm accuracy within a 30 × 30 m greenhouse area. In this research, a noise tolerant SSSLPS was developed and evaluated. First, the acoustic noise spectrum emitted by the quadcopter was documented, and then the noise tolerance properties of SSSounds were examined and tested. This was done in a greenhouse with a fixed quadcopter (9.75 N thrust) with the positioning system mounted on it. The recorded quadcopter noise had a broadband noise compared to the SSSound. Taking these SSSound properties into account, the noise tolerance of the SSSLPS was improved, achieving a positioning accuracy of 23.2 mm and 31.6 mm accuracy within 12 × 6 m for both Time-division Multiple Access (TDMA) and Frequency-division Multiple Access (FDMA) modulation. The results demonstrate that the SSSLPS is an accurate, robust positioning system that is noise tolerant and can used for quadcopter operation even within a small greenhouse.

Huang|Zichen|Z|0000-0003-4053-0201
Tsay|Lok Wai Jacky|LWJ|
Shiigi|Tomoo|T|
Zhao|Xunyue|X|
Nakanishi|Hiroaki|H|
Suzuki|Tetsuhito|T|0000-0003-1367-4402
Ogawa|Yuichi|Y|
Kondo|Naoshi|N|

local positioning system
quadcopter
precision agriculture
acoustic noise tolerance
spread spectrum sound


Bioflocculation of cyanobacteria with pellets of Aspergillus niger: Effects of carbon supplementation, pellet diameter, and other factors in biomass densification.

Abstract: One of the hurdles of renewable energy production from photosynthetic microorganisms is separating the biomass from water in cultures. Bioflocculation with filamentous fungus Aspergillus niger, an alternative low-cost method used for such separation, was studied with four cyanobacteria. Cocultures with Spirulina maxima and Synechococcus subsalsus resulted in bioflocculation efficiencies up to 94%, while with Anabaena variabilis and Anabaena siamensis bioflocculation did not occur. S. subsalsus was selected to evaluate the effect of cyanobacterial initial concentration, fungal:cyanobacterial ratio, carbon supplementation, and pH on biomass densification. Bioflocculation efficiencies up to 98% in 48 h were obtained with fungal:cyanobacterial ratio 1:5 and carbon supplementation. Despite the lower efficiency (54%), the highest concentration factor of S. subsalsus suspension (62.8 - from 0.9 to 56.5 g/L) was obtained with ratio 1:5 without supplementation. This result was attributed to the smaller pellet diameter (2.5 mm) and indicated that lower pellet growth is better for biomass densification.

Oliveira|Helena R|HR|
Bassin|Isabelli D|ID|
Cammarota|Magali C|MC|

Bioflocculation
Cyanobacteria
Aspergillus niger
Biomass densification
Synechococcus subsalsus


Color stability of glass-fiber-reinforced polypropylene for non-metal clasp dentures.

Abstract:
PURPOSE
The purpose of this study was to investigate the color stability of a glass-fiber-reinforced thermoplastic (GFRTP), for use in non-metal clasp dentures (NMCDs).

METHODS
GFRTPs composed of E-glass fibers and polypropylene with 2 mass% of pigments were fabricated using injection molding. According to our previous study on the optimum fiber content for GFRTPs, we prepared GFRTPs with fiber contents of 0, 10, and 20 mass% (GF0, GF10, and GF20). Commercially available NMCD and PMMA materials were used as controls. The color changes of GFRTPs at 24h, and at 1, 2, and 4 weeks of coffee immersion at 37°C were measured by colorimetry, using the Commission Internationale de l'Eclairage (CIE) Lab system. The color stabilities of the GFRTPs were evaluated in two units: the color difference (ΔE∗) and National Bureau of Standards (NBS) units.

RESULTS
After immersion, none of the GFRTPs showed visible color change. From the colorimetry measurement using the CIE Lab system, the ΔE∗ values of the GFRTPs were 0.65-2.45. The NBS values of the GFRTPs were 0.60-2.25, all lower than the threshold level of 3.0, demonstrating clinically acceptable color changes. On the other hand, an available polyamide-based NMCD material exhibited "appreciable" color change, as measured in NBS units.

CONCLUSIONS
The results indicate that the GFRTPs showed clinically acceptable color stability and might be satisfactory for clinical use. Therefore, GFRTPs are expected to become attractive materials for esthetic dentures.

Color stability
Non-metal clasp denture
Glass-fiber-reinforced thermoplastic
Removable prosthodontics


Engineering Quick- and Long-acting Naloxone Delivery Systems for Treating Opioid Overdose.

Abstract:
PURPOSE
Opioids have been the main factor for drug overdose deaths in the United States. Current naloxone delivery systems are effective in mitigating the opioid effects only for hours. Naloxone-loaded poly(lactide-co-glycolide) (PLGA) microparticles were prepared as quick- and long-acting naloxone delivery systems to extend the naloxone effect as an opioid antidote.

METHODS
The naloxone-PLGA microparticles were made using an emulsification solvent extraction approach with different formulation and processing parameters. Two PLGA polymers with the lactide:glycolide (L:G) ratios of 50:50 and 75:25 were used, and the drug loading was varied from 21% to 51%. Two different microparticles of different sizes with the average diameters of 23 μm and 50 μm were produced using two homogenization-sieving conditions. All the microparticles were critically characterized, and three of them were evaluated with β-arrestin recruitment assays.

RESULTS
The naloxone encapsulation efficiency (EE) was in the range of 70-85%. The EE was enhanced when the theoretical naloxone loading was increased from 30% to 60%, the L:G ratio was changed from 50:50 to 75:25, and the average size of the particles was reduced from 50 μm to 23 μm. The in vitro naloxone release duration ranged from 4 to 35 days. Reducing the average size of the microparticles from 50 μm to 23 μm helped eliminate the lag phase and obtain the steady-state drug release profile. The cellular pharmacodynamics of three selected formulations were evaluated by applying DAMGO, a synthetic opioid peptide agonist to a μ-opioid receptor, to recruit β-arrestin 2.

CONCLUSIONS
Naloxone released from the three selected formulations could inhibit DAMGO-induced β-arrestin 2 recruitment. This indicates that the proposed naloxone delivery system is adequate for opioid reversal during the naloxone release duration.

naloxone
opioid overdose
drug loading
encapsulation efficiency
DAMGO
PLGA microparticles
zero-order release
β-arrestin 2 inhibition


Nonalcoholic fatty liver disease and liver transplantation - Where do we stand?

Abstract: Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a challenging and multisystem disease that has a high socioeconomic impact. NAFLD/NASH is a main cause of macrovesicular steatosis and has multiple impacts on liver transplantation (LT), on patients on the waiting list for transplant, on post-transplant setting as well as on organ donors. Current data indicate new trends in the area of chronic liver disease. Due to the increased incidence of metabolic syndrome (MetS) and its components, NASH cirrhosis and hepatocellular carcinoma caused by NASH will soon become a major indication for LT. Furthermore, due to an increasing incidence of MetS and, consequently, NAFLD, there will be more steatotic donor livers and less high quality organs available for LT, in addition to a lack of available liver allografts. Patients who have NASH and are candidates for LT have multiple comorbidities and are unique LT candidates. Finally, we discuss long-term grafts and patient survival after LT, the recurrence of NASH and NASH appearing de novo after transplantation. In addition, we suggest topics and areas that require more research for improving the health care of this increasing patient population.

Mikolasevic|Ivana|I| Filipec-Kanizaj|Tajana|T| Mijic|Maja|M| Jakopcic|Ivan|I| Milic|Sandra|S| Hrstic|Irena|I| Sobocan|Nikola|N| Stimac|Davor|D| Burra|Patrizia|P|

D065626:Non-alcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease
Liver transplantation
Nonalcoholic steatohepatitis
Chronic liver disease
Outcome


The Rule of 10: a simple 3D ultrasonographic method for the diagnosis of T-shaped uterus.

Abstract:
PURPOSE
To investigate and propose a new simple tridimensional (3D) ultrasonographic method to diagnose a T-shaped uterus (Class U1a).

METHODS
A multicenter non-experimental case-control diagnostic accuracy study was conducted between January 2018 and December 2019, including 50 women (cases) diagnosed with T-shaped uterus (U1a class) and 50 women with a "normal uterus" (controls). All the enrolled women underwent 3D ultrasound, drawing four lines and recording the length of three of them as follow: draw and measure the interostial line (R0); draw from the midpoint of R0 a perpendicular line length 20 mm; draw and measure in the uterine cavity a line parallel to R0 at 10 mm below R0 (R10) and a second line parallel to R0 at 20 mm below R0 (R20). The diagnostic performance of all sonographic parameters statistically significantly different between T-shaped and normal uteri was estimated using the receiver operator characteristic (ROC) curve analysis.

RESULTS
R10 and R20 were statistically significantly shorter in the T-shaped than the normal uterus. R10 reported the highest diagnostic accuracy with an area under the ROC curve of 0.973 (95% CI 0.940-1.000). R10 length maximizing the Youden's J statistic was 10.5 mm. Assuming R10 length equal to or shorter than 10 mm as the cut off value for defining a woman as having a T-shaped uterus, the new ultrasonographic method following the proposed protocol (R0, R10, and R20) reported sensitivity for T-shaped uterus of 91.1% (95% CI 0.78-0.97%) and a specificity of 100% (95% CI 0.89-100%). The positive likelihood ratio was higher than 30, and the negative likelihood ratio was 0.09 (95% CI 0.04-0.26).

CONCLUSIONS
Measuring the length of the intracavitary line parallel to the interostial line at 10 mm from it and using a length ≤ of 10 mm as cut off value (the "Rule of 10") appears a simple and accurate 3D ultrasonographic method for the diagnosis of a T-shaped uterus.

Diagnosis
T-shaped uterus
Diagnostic accuracy
3D ultrasound
Uterine malformations


Prospective Cohort Study of Micafungin Population Pharmacokinetic Analysis in Plasma and Peritoneal Fluid in Septic Patients with Intra-abdominal Infections.

Abstract: The objective of this study was to describe the pharmacokinetics (PK) of micafungin in plasma and peritoneal fluid in septic patients with intra-abdominal infections. Twelve patients with secondary peritonitis in septic shock receiving 100 mg micafungin once daily were included. Total micafungin plasma and peritoneal fluid were subjected to a population pharmacokinetic analysis using Pmetrics. Monte Carlo simulations were performed considering the total area under the curve from 0 to 24 h (AUC0-24)/MIC ratios in plasma. Micafungin concentrations in both plasma and the peritoneal exudate were best described by a three-compartmental PK model with the fat-free mass (FFM) as a covariate of clearance (CL) and the volume of the central compartment (Vc). The mean parameter estimates (standard deviations [SD]) were 1.18 (0.40) liters/h for CL and 12.85 (4.78) liters for Vc. The mean peritoneal exudate/plasma ratios (SD) of micafungin were 25% (5%) on day 1 and 40% (8%) between days 3 and 5. Dosing simulations supported the use of standard 100-mg daily dosing for Candida albicans (FFM, <60 kg), C. glabrata (FFM, <50 kg), and C. tropicalis (FFM, <30 kg) on the second day of therapy. There is a moderate penetration of micafungin into the peritoneal cavity (25 to 40%). For empirical treatment, a dose escalation of at least a loading dose of 150 mg depending on the FFM of patients and the Candida species is suggested to be effective from the first day of therapy.

Garbez|Nicolas|N|
Mbatchi|Litaty|L|
Wallis|Steven C|SC|
Muller|Laurent|L|
Lipman|Jeffrey|J|
Roberts|Jason A|JA|
Lefrant|Jean-Yves|JY|
Roger|Claire|C|

micafungin
pharmacokinetics
peritoneal fluid
secondary peritonitis
septic shock
Monte Carlo simulations
intensive care unit


A mutispectroscopic study on the structure-affinity relationship of the interactions of bisphenol analogues with bovine serum albumin.

Abstract: Bisphenol A (BPA) is a recognized endocrine-disrupting chemical (EDC), and its analogues also exert negative effects on health. The structure-affinity relationship between the structures of nine bisphenol (BP) analogues and the conformational changes of bovine serum albumin (BSA) was studied by various characterization methods and molecular docking. BPs including BPA and its analogues, bisphenol B (BPB), bisphenol C (BPC), bisphenol AP (BPAP), bisphenol M (BPM), bisphenol P (BPP), bisphenol Z (BPZ), diethylstilbestrol (DES) and dienestrol (DS) interacted with BSA. At the concentration of 3.85 × 10-5 mol l-1, DS was found to lead to 64% quenching, while BPAP, BPM and DES quenched 60%, 59% and 55% of BSA fluorescence, respectively. The values of ΔH (-19.31-135.42 kJ mol-1) and ΔS (12.52-495.63 J mol-1 K-1) indicated that hydrophobic interactions and hydrogen bonds played important roles in the binding process. The binding constants of DS (8.87 × 104 l mol-1), DES (3.05 × 104 l mol-1), BPAP (1.52 × 104 l mol-1), BPC (1.16 × 104 l mol-1) and BPM (1.10 × 104 l mol-1) to BSA were greater than that of BPA (1.18 × 103 l mol-1) to BSA, indicating that they may exert more negative effects than BPA. The molecular structure differences of these BPs partly affected their ability to bind to BSA. The binding constants of BPB/BPP to BSA were smaller due to the steric hindrance of ethyl and benzene ring. BPs with conjugated double bond structures (DS and DES) and benzene ring structures (BPM, BPP, BPAP) had a greater influence on the conformation of BSA.

Gu|Jiali|J| Huang|Xiyao|X| Liu|Hongrui|H| Dong|Dianbo|D| Sun|Xuekai|X|

Bisphenol analogues
Bovine serum albumin
Structure–affinity


Effect of recombinant serine protease from adult stage of Trichinella spiralis on TNBS-induced experimental colitis in mice.

Abstract: Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is a chronic autoimmune disease. At present, worms and their products has been shown to have protective effects on immune-mediated diseases. Therefore, we aimed to investigate the effect of the recombination Trichinella spiralis (T. spiralis, Ts) adult serine protease-like protein rTs-ADSp-7 on a 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced CD mouse model. Colitis was induced by intrarectal administration of a TNBS solution. The disease activity index (DAI), which included weight loss, diarrhoea, and bloody stool, was measured. Colon segments were stained with haematoxylin and eosin (H.E.) for histopathological score. Cytokine release in the serum was analysed by meso scale discovery (MSD). Cytokine release in the colon was detected by ELISA. Splenocytes were separated, and the cytokine profiles of Th1 (IFN-γ), Th2 (IL-4), Th17 (IL-17A) and Treg cells were analysed by flow cytometry. Our result showed that rTs-ADSp-7 reduced the clinical disease activity of TNBS-induced colitis in mice. In addition, we found that rTs-ADSp-7 reduced the production of Th1- and Th17-related cytokines while upregulating the expression of Th2- and Treg-related cytokines in TNBS-induced colitis mice. rTs-ADSp-7 also increased the population of Th2 and Treg cells in TNBS-induced colitis mice. rTs-ADSp-7 alleviated the severity of TNBS-induced colitis while balancing the CD4+ T cell immune response. rTs-ADSp-7 has therapeutic potential for colitis treatment and can be used as a helminth-derived protein therapy for CD or other Th1 immunity-mediated diseases.

Pang|Jianda|J| Ding|Jing|J| Zhang|Lixiao|L| Zhang|Yuanyuan|Y| Yang|Yaming|Y| Bai|Xue|X| Liu|Xiaolei|X| Jin|Xuemin|X| Guo|Heng|H| Yang|Yong|Y| Liu|Mingyuan|M|

Trichinella spiralis
Th2
TNBS-induced colitis
Adult serine protease
Regulatory T cell


Diminished alternative reinforcement as a mechanism linking conduct problems and substance use in adolescence: a longitudinal examination.

Abstract:
AIMS
To determine whether diminished alternative reinforcement (i.e. engagement and enjoyment from substance-free activities) mediated the longitudinal association of conduct problems with substance use in early-mid-adolescence.

DESIGN
Structural equation modeling tested whether the association between wave 1 (baseline) conduct problems and wave 3 (24-month follow-up) substance use outcomes was mediated by diminished alternative reinforcement at wave 2 (12-month follow-up). Additional analyses tested whether sex and socio-economic status moderated this association.

SETTING
Ten high schools in Los Angeles, CA, USA, 2013-15.

PARTICIPANTS
Students (n = 3396, 53.5% female, mean [standard deviation (SD)] age at wave 1 baseline = 14.1 (0.42) years).

MEASUREMENTS
Self-reported conduct problems (11-item questionnaire), alternative reinforcement (44-item questionnaire) and use of alcohol, marijuana and combustible cigarettes during the past 6 months (yes/no) and the past 30 days (nine-level ordinal response based on days used in past 30 days).

RESULTS
Significant associations of wave 1 conduct problems with wave 3 marijuana use during the past 6 months (β = 0.25) and past 30 days (β = 0.26) were mediated by wave 2 diminished alternative reinforcement (βindirect effect : 6 months = 0.013, 30 days = 0.017, Ps < 0.001). Associations of conduct problems with alcohol or combustible cigarette use were not mediated by alternative reinforcement. All associations did not differ by sex and socio-economic status.

CONCLUSIONS
Diminished alternative reinforcement may be a modifiable mechanism linking early adolescent conduct problems and subsequent marijuana use that could be targeted in prevention programs to offset the adverse health and social sequelae associated with comorbid conduct problems and marijuana use in early-mid adolescence.

Khoddam|Rubin|R|
Cho|Junhan|J|
Jackson|Nicholas J|NJ|
Leventhal|Adam M|AM|0000-0002-3539-7656

D000293:Adolescent
D000294:Adolescent Behavior
D000073865:Cigarette Smoking
D019955:Conduct Disorder
D005260:Female
D006801:Humans
D008137:Longitudinal Studies
D008297:Male
D000074609:Marijuana Use
D012054:Reinforcement, Psychology
D000066608:Underage Drinking
D014481:United States

alternative reinforcers
conduct problems
substance use
Adolescents
alcohol
marijuana
cigarette
behavioral economics


Macrozoobenthos in the Adriatic Sea ports: Soft-bottom communities with an overview of non-indigenous species.

Abstract: The present paper is a contribution to the first initiative of the Port Baseline Survey (PBS) for Non-indigenous species (NIS) in the Mediterranean Sea. It presents a report on the soft-bottom macrobenthos from the five Adriatic ports: Bari, Ancona (Italy), Koper (Slovenia), Pula, Rijeka (Croatia), with a focus on the presence and contribution of NIS to native assemblages. Out of 451 species identified, only four were common to all ports. A total of eight NIS were recorded, five in surveyed ports and three in the lagoon connected to the Port of Koper. The highest number of NIS was recorded in Bari, and the highest abundance in Ancona and Bari. Generally, the number, abundance and contribution of NIS seems too low to cause a substantial impact on native communities in surveyed ports. The suitability of methods adopted for PBS for soft-bottom NIS was discussed and suggestion for methodological improvement is provided.

Travizi|A|A| Balković|I|I| Bacci|T|T| Bertasi|F|F| Cuicchi|C|C| Flander-Putrle|V|V| Grati|F|F| Grossi|L|L| Jaklin|A|A| Lipej|L|L| Mavrič|B|B| Mikac|B|B| Marusso|V|V| Montagnini|L|L| Nerlović|V|V| Penna|M|M| Salvalaggio|V|V| Santelli|A|A| Scirocco|T|T| Spagnolo|A|A| Trabucco|B|B| Vani|D|D|

Macrozoobenthos
Adriatic
Ports
Soft-bottom community
Non-indigenous species
Mediterranean


Ovum pick-up and in vitro maturation in spotted paca (Cuniculus paca-Linnaeus, 1766).

Abstract: We tested FSHp, eCG and FSHp + eCG to establish ovum pick-up (OPU) and in vitro maturation method in spotted paca. Eight healthy adult females were subjected to each of four treatments to stimulate ovarian follicular growth. All females were subjected to a hormonal protocol using a single dose of 45 mg of injectable progesterone and single intramuscular injection of 0.075 mg d-cloprostenol on day 6. Ovarian stimulation was carried out as follows: in Group TFE (FSHp and eCG), animals were treated with a single dose of 80 mg of FSHp and 200 IU of eCG intramuscularly on day 6 after the application of progesterone; in Group TF (FSHp), they were treated with a single dose of 80 mg of FSHp intramuscularly on day 6 after application of progesterone; in Group treatment eCG, they were treated with 200 IU of eCG intramuscularly on day 6 after application of progesterone; and in Group TC (saline solution), 1 ml of saline solution was administered to control does. The OPU was performed between 22 and 26 hr after gonadotropin treatments. All recovered oocytes were placed into maturation media and incubated for 24 hr. There were no differences among the mean number of observed follicles, aspirated follicles and oocytes recovered per treatment. Oocyte maturation rates did not differ among groups, except, TF and treatment eCG oocytes had greater maturation rates than TC oocytes. In this study, gonadotropin administration failed to superovulate treated does and increase oocyte retrieval efficiency. Despite the feasibility of the procedure, further studies are needed to develop and refine hormonal protocols for oocyte recovery and in vitro maturation in this species.

Barros|Felipe Farias Pereira da Câmara|FFPDC|

D059471:In Vitro Oocyte Maturation Techniques

hormonal protocol
gonadotropin
oocyte maturation
follicular aspiration
rodent


The role of regional analgesia in personalized postoperative pain management.

Abstract: Pain management plays a fundamental role in enhanced recovery after surgery pathways. The concept of multimodal analgesia in providing a balanced and effective approach to perioperative pain management is widely accepted and practiced, with regional anesthesia playing a pivotal role. Nerve block techniques can be utilized to achieve the goals of enhanced recovery, whether it be the resolution of ileus or time to mobilization. However, the recent expansion in the number and types of nerve block approaches can be daunting for general anesthesiologists. Which is the most appropriate regional technique to choose, and what skills and infrastructure are required for its implementation? A multidisciplinary team-based approach for defining the goals is essential, based on each patient's needs, and incorporating patient, surgical, and social factors. This review provides a framework for a personalized approach to postoperative pain management with an emphasis on regional anesthesia techniques.

Chitnis|Shruti S|SS|
Tang|Raymond|R|
Mariano|Edward R|ER|

Pain management
Enhanced recovery
Multimodal analgesia
Nerve block
Acute pain
Opioid
Persistent postsurgical pain


In vitro evaluation of cytotoxicity, possible alteration of apoptotic regulatory proteins, and antibacterial activity of synthesized copper oxide nanoparticles.

Abstract: Copper oxide nanoparticles (CuO-NPs) were synthesized using a urea-based thermal decomposition technique, and characterized using different techniques. X-ray diffraction (XRD) and Raman spectroscopy confirmed the phase purity and crystalline structure of CuO-NPs. The size of CuO-NPs was investigated using XRD and was confirmed via dynamic light scattering analysis. CuO-NPs showed an average diameter of ∼20nm. The possible cytotoxicity of CuO-NPs was evaluated in HT-29 and SW620 cancer cell lines. The median inhibitory concentration of CuO-NPs in HT-29 and SW-620 cells was 4.99 and 3.75μg/mL, respectively. The underlying mechanism responsible for apoptosis in colon cancer cells after CuO-NP exposure has not been well understood. In this study, we investigated the possible mechanisms of induction of apoptosis via analysis of the expression of Bcl-2 and Bcl-xL proteins in HT-29 human colon cancer cells after CuO-NP exposure. Western blot assay showed downregulation of Bcl-2 and Bcl-xL protein expression after CuO-NP exposure. Our findings may aid in the understanding of the potential mechanisms responsible for induction of apoptosis owing to inhibition of Bcl-2 and Bcl-xL protein expression. Furthermore, the antibacterial activity assay showed that the synthesized CuO-NPs did not exert significant inhibitory effects against different gram-positive and gram-negative bacteria in vitro.

Khan|Shahanavaj|S|
Ansari|Anees A|AA|
Khan|Azmat Ali|AA|
Abdulla|Maha|M|
Al-Obaid|Omar|O|
Ahmad|Rehan|R|

D004354:Drug Screening Assays, Antitumor

Cytotoxicity
Copper oxide nanoparticles
Western blot
Colon cancer cell lines
MTT assay


Insights Into the Inside - A Quantitative Histological Study of the Explosively Moving Style in Marantaceae.

Abstract: This study aims to identify the histological basis for the extraordinary, fast movement of the style in Marantaceae. Although this explosive pollination mechanism was subject of many studies, quantitative measurements to document volumetric changes have never been conducted. Based on physical parameters and limitations (poroelastic time), the movement itself is by far too fast to be explained by turgor changes solely. Therefore, we address the hypothesis that the style contains elastic structures to store energy allowing the fast movement. We provide an experimental approach in Goeppertia bachemiana to identify histological differences of styles in various states, i.e., steady, unreleased, and released state. Cross and longitudinal sections were used to reconstruct the cell volume in different sectors of the style. Histological data were discussed with respect to a putative water shift (turgor movement) and elastic instabilities that were proposed to explain the style movement of Marantaceae. Current data show, that the upper epidermis is under tensile stress in the unreleased state. After style release, the lower side of the style revealed an enormous water up-take. According to our results, we hypothesize that the fast style movement of G. bachemiana is likely based on an elastically stretched upper epidermis, whereas a "soaking tissue" at the lower side presumably mediates the up curling of the style. The experimental data show that at least for G. bachemiana, physical limitations such as the poroelastic time are suitable parameters to predict movements that are based on elastic instabilities.

Marantaceae
movement
turgor
tensile stress
anatomy
cell volume reconstruction
elastic energy


The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset.

Abstract: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are recognised and proven interventions for patients with advanced arthritis. Studies to date have demonstrated a steady increase in the requirement for primary and revision procedures. Projected estimates made for the United States show that by 2030 the demand for primary TKA will grow by 673% and for revision TKA by 601% from the level in 2005. For THA the projected estimates are 174% and 137% for primary and revision surgery, respectively. The purpose of this study was to see if those predictions were similar for England and Wales using data from the National Joint Registry and the Office of National Statistics. Analysis of data for England and Wales suggest that by 2030, the volume of primary and revision TKAs will have increased by 117% and 332%, respectively between 2012 and 2030. The data for the United States translates to a 306% cumulative rate of increase between 2012 and 2030 for revision surgery, which is similar to our predictions for England and Wales. The predictions from the United States for primary TKA were similar to our upper limit projections. For THA, we predicted an increase of 134% and 31% for primary and revision hip surgery, respectively. Our model has limitations, however, it highlights the economic burden of arthroplasty in the future in England and Wales as a real and unaddressed problem. This will have significant implications for the provision of health care and the management of orthopaedic services in the future.

Patel|A|A|
Pavlou|G|G|
Mújica-Mota|R E|RE|
Toms|A D|AD|

Epidemiology
Financial Burden
Total Hip Replacement
Total Knee Replacement


Cognitive stimulation therapy as a sustainable intervention for dementia in sub-Saharan Africa: feasibility and clinical efficacy using a stepped-wedge design.

Abstract:
BACKGROUND
Cognitive stimulation therapy (CST) is a psychosocial group-based intervention for dementia shown to improve cognition and quality of life with a similar efficacy to cholinesterase inhibitors. Since CST can be delivered by non-specialist healthcare workers, it has potential for use in low-resource environments, such as sub-Saharan Africa (SSA). We aimed to assess the feasibility and clinical effectiveness of CST in rural Tanzania using a stepped-wedge design.

METHODS
Participants and their carers were recruited through a community dementia screening program. Inclusion criteria were DSM-IV diagnosis of dementia of mild/moderate severity following detailed assessment. No participant had a previous diagnosis of dementia and none were taking a cholinesterase inhibitor. Primary outcomes related to the feasibility of conducting CST in this setting. Key clinical outcomes were changes in quality of life and cognition. The assessing team was blind to treatment group membership.

RESULTS
Thirty four participants with mild/moderate dementia were allocated to four CST groups. Attendance rates were high (85%) and we were able to complete all 14 sessions for each group within the seven week timeframe. Substantial improvements in cognition, anxiety, and behavioral symptoms were noted following CST, with smaller improvements in quality of life measures. The number needed to treat was two for a four-point cognitive (adapted Alzheimer's Disease Assessment Scale-Cognitive) improvement.

CONCLUSIONS
This intervention has the potential to be low-cost, sustainable, and adaptable to other settings across SSA, particularly if it can be delivered by non-specialist health workers.

Paddick|Stella-Maria|SM|
Mkenda|Sarah|S|
Mbowe|Godfrey|G|
Kisoli|Aloyce|A|
Gray|William K|WK|
Dotchin|Catherine L|CL|
Ternent|Laura|L|
Ogunniyi|Adesola|A|
Kissima|John|J|
Olakehinde|Olaide|O|
Mushi|Declare|D|
Walker|Richard W|RW|

D011569:Psychiatric Status Rating Scales

cognitive stimulation therapy
dementia
sub-Saharan Africa
Tanzania
low- and middle-income countries


An effective and recyclable deproteinization method for polysaccharide from oyster by magnetic chitosan microspheres.

Abstract: The aim of this study was to synthesize magnetic chitosan microspheres (MCM) for the deproteinization of crude polysaccharides from Ostrea rivularis Gould (ORP), and evaluate their adsorption properties. Firstly, MCM were synthesized by microemulsion process. Then they were characterized by Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD) and vibrating-sample magnetometer (VSM). At last, MCM was applied as a magnetic separable adsorbent for deproteinization of ORP. The results showed that MCM had smooth surface with particle diameter of 2-6 μm. The adsorption kinetics and adsorption isotherms were well fitted by the pseudo-second order equation and the Freundlich equation, respectively. Comparing with the Sevag method, MCM exhibited higher deproteinization ratio, higher polysaccharides recovery, and miner pollution. In addition, the deprotenaization capacity can be regenerated. Therefore, MCM would be used as promising adsorbents for the deproteinization of polysaccharides.

Song|Zhuoyue|Z| Hu|Youdong|Y| Qi|Longkai|L| Xu|Tingting|T| Yang|Yongsheng|Y| Xu|Zhanchi|Z| Lai|Xiaoping|X| Wang|Xiaoli|X| Zhang|Danyan|D| Li|Shijie|S|

Deproteinization
Polysaccharides
Magnetic chitosan microsphere
Ostrea rivularis Gould
Adsorption properties


Effect of statins on coronary blood flow after percutaneous coronary intervention in patients with stable coronary artery disease.

Abstract:
AIMS
Statins have favourable effects on the vascular system. However, few data are available regarding the effect of these drugs on patients undergoing percutaneous coronary intervention (PCI). We sought to determine the impact of prior statin use on coronary blood flow after PCI in patients with stable coronary artery disease (CAD) by using the corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC).

METHODS
A total of 80 consecutive eligible patients (mean age: 60 ± 7 years, 65 % male) with the diagnosis of stable CAD who were hospitalised for elective PCI were retrospectively enrolled in our study. The study population was divided into two groups according to statin use at least 6 months before PCI. Group 1 comprised of 51 patients (67 % male; mean age: 58 ± 4 years) taking statins and group 2 comprised of 29 patients (62 % male; mean age: 60 ± 3 years) not taking statins. PCI was applied to de novo type A lesions. CTFC was calculated for the treated vessels at baseline and after PCI.

RESULTS
The two groups had similar characteristics in terms of age, sex, concomitant medications, lesion characteristics, pre-procedural CTFC, lipid parameters, and risk factors for CAD. Post-PCI CTFC (16 ± 3 vs. 22 ± 5, p = 0.01) and hs-CRP (2.1 ± 0.7 mg/l vs. 6.1 ± 2 mg/l, p = 0.01) in patients receiving statins before PCI were significantly lower than in patients without statin therapy. Multiple logistic regression analysis showed that statin pre-treatment (OR 2.5, 95 % CI 1.2 to 3.8, p < 0.001) and hs-CRP level (OR 1.8, 95 % CI 1.2 to 2.4, p = 0.001) were independent predictors of post-PCI CTFC.

CONCLUSIONS
In patients with stable CAD undergoing PCI, receipt of long-term statin therapy was associated with improvement in epicardial perfusion after PCI.

Cerit|L|L| Duygu|H|H| Gulsen|K|K| Gunsel|A|A|

Statin
Coronary blood flow
Stable coronary artery disease


Greater auricular nerve masquerading as lymph node.

Abstract: Hansen's disease is on the verge of being eliminated from India and often missed by clinicians due to low index of suspicion. We present an unusual case in which greater auricular nerve thickening masqueraded as enlarged lymph node in the neck. The patient was referred for fine needle aspiration cytology, which revealed epithelioid cell granulomas suggestive of Hansen's disease. Further clinical examination and investigations including the skin biopsy confirmed the disease, highlighting the role of pathologist in the management of such unusual presentation of a common disease.

Saxena|Shilpi|S|
Deb|Prabal|P|
Nijhawan|Vijay Shrawan|VS|
Kharayat|Veena|V|
Verma|Rajesh|R|

greater auricular nerve
Hansen's disease
fine needle aspiration cytology
Epithelioid cell granuloma


Association of IDH mutation and 1p19q co-deletion with tumor immune microenvironment in lower-grade glioma.

Abstract: Although the successful clinical trials of immunotherapy show promising strategies for many cancers, its application in glioma has lagged in comparison with the progress seen in other cancers. Both isocitrate dehydrogenase (IDH) mutations and 1p/19q codeletions are critical molecular alterations affecting therapeutic response in lower-grade glioma (LGG). The systematic and comprehensive characterization of the immunological phenotypes with different molecular subtypes is key to improving our understanding and application of immunotherapies in LGG. Here, we collected the RNA-sequencing, somatic mutation, and clinical data from 1,052 patients from The Cancer Genome Atlas and Chinese Glioma Genome Atlas and stratified patients into three genetic subgroups: IDH mutations with 1p/19q codeletions (IDH mut-codel), IDH mutations without 1p/19q codeletions (IDH mut-noncodel), and IDH wild-type. Our evaluations revealed that IDH mutations and 1p/19q codeletions were associated with distinct immunological tumor microenvironments in LGG. In addition, immune cell infiltration, the expression of immune checkpoint and human leukocyte antigen (HLA) gene, and the activity of immune signaling pathways shared gradual increase from IDH mut-codel to IDH wild-type. We further constructed and validated an immune-related prognostic signature that presented high value in predicting the overall survival time in LGG. In conclusion, our study may provide valuable information for immunotherapy strategies in LGG patients.

Lin|Wanzun|W|
Qiu|Xianxin|X|
Sun|Pian|P|
Ye|Yuling|Y|
Huang|Qingting|Q|
Kong|Lin|L|
Lu|Jiade J|JJ|

IDH mutations
tumor immune microenvironment
lower-grade glioma
1p/19q codeletions
molecular subtypes
bioinformatics


Combination dolutegravir-abacavir-lamivudine in the management of HIV/AIDS: clinical utility and patient considerations.

Abstract: The current standard of care for human immunodeficiency virus (HIV) treatment is a three-drug regimen containing a nonnucleoside reverse transcriptase inhibitor, a protease inhibitor, or an integrase strand transfer inhibitor (INSTI) plus two nucleoside/tide reverse transcriptase inhibitors. Given their potency, safety, and distinctive mechanism of action, INSTIs represent an important advance in HIV type 1 (HIV-1) therapy. Dolutegravir (DTG) is a new-generation INSTI recently approved for the treatment of HIV-1-infected adult patients, with distinct advantages compared with other available antiretroviral agents. In well-designed, large clinical trials, DTG-containing regimens have demonstrated either noninferiority or superiority to current first-line agents such as raltegravir-, darunavir/ritonavir-, and efavirenz-containing regimens. The favorable safety profile, low potential for drug interactions, minimal impact on lipids, good tolerability, and high resistance barrier of DTG makes this compound one of the preferred choices for HIV therapy in multiple clinical scenarios, including treatment-naïve and treatment-experienced patients. DTG is the only antiretroviral drug not yet associated with de novo emergence of resistance mutations in treatment-naïve individuals. However, data from in vitro studies and clinical trial suggest the possibility of cross-resistance between first- and second-generation INSTIs. Even though these profiles are infrequent at the moment, they need to be monitored in all current patients treated with INSTIs. With its potent activity, good tolerability, simplicity of dosing, and minimal drug interaction profile, DTG will likely play a major role in the management of patients with HIV-1 infection. On the basis of clinical trial data, current guidelines endorse DTG in combination with nucleoside/tide reverse transcriptase inhibitors as one of the recommended regimens in antiretroviral therapy-naïve patients. Most of the favorable clinical experiences from clinical trials are based on the combination of DTG with abacavir/lamivudine, and DTG is planned to be coformulated with abacavir/lamivudine. This will provide a further advantage, given that single tablet regimens are associated with higher adherence rates as well as improvement in quality of life and enhanced patient preference.

HIV-1
dolutegravir
antiretroviral agents
abacavir/lamivudine
review


A New Strategy Against Peri-Implantitis: Antibacterial Internal Coating.

Abstract: The bacterial biofilm formation in the oral cavity and the microbial activity around the implant tissue represent a potential factor on the interface between bone and implant fixture that could induce an inflammatory phenomenon and generate an increased risk for mucositis and peri-implantitis. The aim of the present clinical trial was to investigate the bacterial quality of a new antibacterial coating of the internal chamber of the implant in vivo at six months. The PIXIT implant (Edierre srl, Genova Italy) is prepared by coating the implant with an alcoholic solution containing polysiloxane oligomers and chlorhexidine gluconate at 1%. A total of 15 healthy patients (60 implants) with non-contributory past medical history (nine women and six men, all non-smokers, mean age of 53 years, ranging from 45-61 years) were scheduled to receive bilateral fixed prostheses or crown restorations supported by an implant fixture. No adverse effects and no implant failure were reported at four months. All experimental sites showed a good soft tissue healing at the experimental point times and no local evidence of inflammation was observed. Real-Time Polymerase Chain Reaction (PCR) analysis on coated and uncoated implants showed a decrease of the bacterial count in the internal part of the implant chamber. The mean of total bacteria loading (TBL) detected in each PCR reaction was lower in treated implants (81038 units/reaction) compared to untreated implants (90057 units/reaction) (p < 0.01). The polymeric chlorhexydine coating of the internal chamber of the implant showed the ability to control the bacterial loading at the level of the peri-implant tissue. Moreover, the investigation demonstrated that the coating is able to influence also the quality of the microbiota, in particular on the species involved in the pathogenesis of peri-implantitis that are involved with a higher risk of long-term failure of the dental implant restoration.

Carinci|Francesco|F|
Lauritano|Dorina|D|
Bignozzi|Carlo Alberto|CA|
Pazzi|Daniele|D|
Candotto|Valentina|V|
Santos de Oliveira|Paulo|P|
Scarano|Antonio|A|

peri-implantitis
coating
chlorhexidine gluconate
bacterial loading
implant dentistry


Abstract: Cytochrome c (Cytc) is a multifunctional protein that operates as an electron carrier in the mitochondrial electron transport chain and plays a key role in apoptosis. We have previously shown that tissue-specific phosphorylations of Cytc in the heart, liver, and kidney play an important role in the regulation of cellular respiration and cell death. Here, we report that Cytc purified from mammalian brain is phosphorylated on S47 and that this phosphorylation is lost during ischemia. We have characterized the functional effects in vitro using phosphorylated Cytc purified from pig brain tissue and a recombinant phosphomimetic mutant (S47E). We crystallized S47E phosphomimetic Cytc at 1.55 Å and suggest that it spatially matches S47-phosphorylated Cytc, making it a good model system. Both S47-phosphorylated and phosphomimetic Cytc showed a lower oxygen consumption rate in reaction with isolated Cytc oxidase, which we propose maintains intermediate mitochondrial membrane potentials under physiologic conditions, thus minimizing production of reactive oxygen species. S47-phosphorylated and phosphomimetic Cytc showed lower caspase-3 activity. Furthermore, phosphomimetic Cytc had decreased cardiolipin peroxidase activity and is more stable in the presence of H2O2. Our data suggest that S47 phosphorylation of Cytc is tissue protective and promotes cell survival in the brain.-Kalpage, H. A., Vaishnav, A., Liu, J., Varughese, A., Wan, J., Turner, A. A., Ji, Q., Zurek, M. P., Kapralov, A. A., Kagan, V. E., Brunzelle, J. S., Recanati, M.-A., Grossman, L. I., Sanderson, T. H., Lee, I., Salomon, A. R., Edwards, B. F. P, Hüttemann, M. Serine-47 phosphorylation of cytochrome c in the mammalian brain regulates cytochrome c oxidase and caspase-3 activity.

Kalpage|Hasini A|HA|
Vaishnav|Asmita|A|
Liu|Jenney|J|
Varughese|Ashwathy|A|
Wan|Junmei|J|
Turner|Alice A|AA|
Ji|Qinqin|Q|
Zurek|Matthew P|MP|
Kapralov|Alexandr A|AA|
Kagan|Valerian E|VE|
Brunzelle|Joseph S|JS|
Recanati|Maurice-Andre|MA|
Grossman|Lawrence I|LI|
Sanderson|Thomas H|TH|
Lee|Icksoo|I|
Salomon|Arthur R|AR|
Edwards|Brian F P|BFP|
Hüttemann|Maik|M|

electron transport chain
apoptosis
respiration
ischemia
signaling


Interaction Effects between HIV and Aging on Selective Neurocognitive Impairment.

Abstract: HIV infection and aging are each associated with neurocognitive impairment (NCI). This study examined the combined effects of HIV infection and aging on NCI. We performed a cross-sectional survey among 345 HIV-infected and 345 HIV-uninfected participants aged at least 40 years. The International HIV Dementia Scale (IHDS) and Chinese version of Mini-mental State Examination (MMSE) were administered to screen for NCI. HIV-infected individuals had higher prevalence of NCI than uninfected individuals (46.7% vs 15.1% for IHDS using cut-off of ≤ 10; 17.1% vs 2.6% for MMSE). Significant main effects of HIV and age were observed on IHDS and MMSE composite scores and all domains except for HIV on attention and calculation. Significant interaction effects between HIV and age were observed on motor speed, orientation, registration and recall, and mainly attributed to the inferior performance of HIV-infected patients aged over 60 years. Among HIV-infected individuals, in multivariable logistic models, older age, depressive symptoms and history of nevirapine treatment were associated with NCI using both IHDS and MMSE, whereas lower education current smoker and current CD4 ≥ 800 cells/μL were associated only with NCI using IHDS, and hypertension was associated only with NCI using MMSE. Findings suggest that HIV and older age may confer interactive effects on cognitive function in several domains with older HIV-infected adults experiencing greater NCI, which requires further longitudinal investigation. Furthermore, HIV early diagnosis and treatment may prevent or reverse NCI, but extra attention should be given to adverse effects including metabolic changes associated with long-term treatment.

Ding|Yingying|Y| Lin|Haijiang|H| Shen|Weiwei|W| Wu|Qionghai|Q| Gao|Meiyang|M| He|Na|N|

HIV
Neurocognitive impairment
Older age
Accelerated aging
CD4 count
China


New therapy from old drugs: synergistic bactericidal activity of sulfadiazine with colistin against colistin-resistant bacteria, including plasmid-mediated colistin-resistant mcr-1 isolates.

Abstract: The recent emergence of colistin (COL) resistance, particularly mcr-1 plasmid-mediated COL resistance in Gram-negative bacteria, has led to renewed interest in antibiotic combinations to overcome clinical therapeutic impasses. The aim of this study was to evaluate the potential of the synergistic and bactericidal activity of COL in combination with sulphonamide compounds, including sulfadiazine (SDI), sulfamethoxazole (SMX) and trimethoprim/sulfamethoxazole (SXT), as well as trimethoprim (TMP) against clinical COL-resistant bacterial strains, including strains with the plasmid-encoded mcr-1 gene. A collection of 55 COL-resistant and -susceptible strains from different origins (Laos, Thailand and France) was used in this study. Several in vitro methods were used to determine the potential of the synergistic activity of these combinations, including Etest on agar pre-treated plates, the Etest cross method and the chequerboard assay. A time-kill assay was performed to evaluate the potential bactericidal activity of combinations in addition to synergistic activity. Significant synergistic activity was observed with all combinations tested. The combination of COL + SDI presented the highest synergistic effect against the various species of COL-resistant strains (92.7%). For the other combinations, a synergistic effect was also observed but with lower frequency for COL + SMX (33.3%), COL + TMP (47.3%) and COL + SXT (31.5%). Synergy was observed independently of the COL resistance mechanism. These in vitro results suggest that the combination of COL + SDI would appear to be justifiable in patients with multidrug-resistant bacterial infections that cannot be treated with COL monotherapy.

Okdah|Liliane|L|
Le Page|Stéphanie|S|
Olaitan|Abiola Olumuyiwa|AO|
Dubourg|Grégory|G|
Hadjadj|Linda|L|
Rolain|Jean-Marc|JM|

D024901:Drug Resistance, Multiple, Bacterial

D015662:Trimethoprim, Sulfamethoxazole Drug Combination

Sulfadiazine Colistin Resistance Synergy


Platelet count and platelet-lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta-analysis.

Abstract:
BACKGROUND
Thrombocytosis is associated with the prognosis of various types of cancer. The purpose of this study was to quantify the prognostic impact of platelet count and platelet-lymphocyte ratio (PLR) in head and neck squamous cell carcinoma (HNSCC).

METHODS
We systematically searched electronic databases and identified articles reporting an association between platelet count or PLR and HNSCC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) were extracted, and the pooled HRs were estimated using random effect models.

RESULTS
Eight studies that enrolled 4096 patients and 9 studies that enrolled 2327 patients were included in the platelet count and PLR analyses, respectively. A platelet count greater than the cutoff value was associated with poor OS (HR 1.81; 95% CI 1.16-2.82) and any PLR greater than the cutoff value was associated with poor OS (HR 1.64; 95% CI 1.13-2.37).

CONCLUSION
Elevated platelet count and PLR are associated with poor prognosis in patients with HNSCC.

Takenaka|Yukinori|Y|0000-0002-3135-5635 Oya|Ryohei|R| Kitamiura|Takahiro|T| Ashida|Naoki|N| Shimizu|Kotaro|K| Takemura|Kazuya|K| Yamamoto|Yoshifumi|Y| Uno|Atsuhiko|A|

D000077195:Squamous Cell Carcinoma of Head and Neck

platelet
thrombocytosis
head and neck cancer
inflammation
lymphocyte


Intravenous salt supplementation with low-dose furosemide for treatment of acute decompensated heart failure.

Abstract:
BACKGROUND
Theoretically, salt supplementation should promote diuresis through increasing the glomerular filtration rate (GFR) during treatment of acute decompensated heart failure (ADHF) even with low-dose furosemide; however, there is little evidence to support this idea.

METHODS AND RESULTS
This was a prospective, randomized, open-label, controlled trial that compared the diuretic effectiveness of salt infusion with that of glucose infusion supplemented with low-dose furosemide in 44 consecutive patients with ADHF. Patients were randomly administered 1.7% hypertonic saline solution supplemented with 40 mg furosemide (salt infusion group) or glucose supplemented with 40 mg furosemide (glucose infusion group). Our major end points were 24-hour urinary volume and GFR. Urinary volume was greater in the salt infusion group than in the glucose infusion group (2,701 ± 920 vs 1,777 ± 797 mL; P < .001). There was no significant difference in the estimated GFR at baseline. Creatinine clearance for 24 h was greater in the salt infusion group than in the glucose infusion group (63.5 ± 52.6 vs 39.0 ± 26.3 mL min(-1) 1.73 m(-2); P = .048).

CONCLUSIONS
Salt supplementation rather than salt restriction evoked favorable diuresis through increasing GFR. The findings support an efficacious novel approach of the treatment of ADHF.

Okuhara|Yoshitaka|Y| Hirotani|Shinichi|S| Naito|Yoshiro|Y| Nakabo|Ayumi|A| Iwasaku|Toshihiro|T| Eguchi|Akiyo|A| Morisawa|Daisuke|D| Ando|Tomotaka|T| Sawada|Hisashi|H| Manabe|Eri|E| Masuyama|Tohru|T|

heart failure
glomerular filtration rate
Salt restriction
loop diuretics


Visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy.

Abstract:
BACKGROUND
Pulmonary visceral subpleural hematoma is rare. We report visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy. This very rare case was difficult to distinguish from thoracic abscess.

CASE PRESENTATION
A 68-year-old man with hypertension had undergone video-assisted thoracoscopic left upper division segmentectomy for suspected lung carcinoma. Deep vein thrombosis of the lower leg was identified and edoxaban, a so-called novel oral anticoagulant, was started on postoperative day 7. The chest drainage tube was removed on postoperative day 12 because of persistent air leakage, but fever appeared the same day. Computed tomography revealed a cavity with mixed air and fluid, so antibiotics were started on suspicion of abscess. Computed tomography-guided drainage was attempted, but proved unsuccessful. Fever continued and surgical investigation was therefore performed. Visceral subpleural hematoma was identified under the diaphragmatic surface of the left basal lung. We excised the pleura, then performed drainage and applied running sutures. The parenchyma and visceral pleura were covered with polyglycolic acid sheet and fibrin glue. Edoxaban was restarted on postoperative day 12 of video-assisted thoracoscopic surgery and no recurrence of hematoma has been revealed.

CONCLUSIONS
Visceral subpleural hematoma after thoracic surgery is extremely rare. Furthermore, correct diagnosis was difficult and surgery offered a good diagnostic and therapeutic procedure.

Mizukami|Yasushi|Y| Ueda|Nobuhito|N| Adachi|Hirofumi|H| Arikura|Jun|J|

Visceral subpleural hematoma
Segmentectomy
Lung resection
Vats


The Impact of Job Stress and Job Satisfaction on Workforce Productivity in an Iranian Petrochemical Industry.

Abstract:
BACKGROUND
Job stress and job satisfaction are important factors affecting workforce productivity. This study was carried out to investigate the job stress, job satisfaction, and workforce productivity levels, to examine the effects of job stress and job satisfaction on workforce productivity, and to identify factors associated with productivity decrement among employees of an Iranian petrochemical industry.

METHODS
In this study, 125 randomly selected employees of an Iranian petrochemical company participated. The data were collected using the demographic questionnaire, Osipow occupational stress questionnaire to investigate the level of job stress, Job Descriptive Index to examine job satisfaction, and Hersey and Goldsmith questionnaire to investigate productivity in the study population.

RESULTS
The levels of employees' perceived job stress and job satisfaction were moderate-high and moderate, respectively. Also, their productivity was evaluated as moderate. Although the relationship between job stress and productivity indices was not statistically significant, the positive correlation between job satisfaction and productivity indices was statistically significant. The regression modeling demonstrated that productivity was significantly associated with shift schedule, the second and the third dimensions of job stress (role insufficiency and role ambiguity), and the second dimension of job satisfaction (supervision).

CONCLUSION
Corrective measures are necessary to improve the shift work system. "Role insufficiency" and "role ambiguity" should be improved and supervisor support must be increased to reduce job stress and increase job satisfaction and productivity.

Hoboubi|Naser|N|
Choobineh|Alireza|A|
Kamari Ghanavati|Fatemeh|F|
Keshavarzi|Sareh|S|
Akbar Hosseini|Ali|A|

job stress
job satisfaction
productivity
petrochemical industry


Pathophysiology and clinical presentations of salt-losing tubulopathies.

Abstract: At least three renal tubular segments are involved in the pathophysiology of salt-losing tubulopathies (SLTs). Whether the pathogenesis starts either in the thick ascending limb of the loop of Henle (TAL) or in the distal convoluted tubule (DCT), it is the function of the downstream-localized aldosterone sensitive distal tubule (ASDT) to contribute to the adaptation process. In isolated TAL defects (loop disorders) ASDT adaptation is supported by upregulation of DCT, whereas in DCT disorders the ASDT is complemented by upregulation of TAL function. This upregulation has a major impact on the clinical presentation of SLT patients. Taking into account both the symptoms and signs of primary tubular defect and of the secondary reactions of adaptation, a clinical diagnosis can be made that eventually leads to an appropriate therapy. In addition to salt wasting, as occurs in all SLTs, characteristic features of loop disorders are hypo- or isosthenuric polyuria and hypercalciuria, whereas characteristics of DCT disorders are hypokalemia and (symptomatic) hypomagnesemia. In both SLT categories, replacement of urinary losses is the primary goal of treatment. In loop disorders COX inhibitors are also recommended to mitigate polyuria, and in DCT disorders magnesium supplementation is essential for effective treatment. Of note, the combination of a salt- and potassium-rich diet together with an adequate fluid intake is always the basis of long-term treatment in all SLTs.

D015499:Renal Tubular Transport, Inborn Errors

Pathophysiology
Loop disorders
DCT disorders
Clinical diagnostics
Physiologic classification
Therapeutic recommendation
Tubular adaptation processes


Personality differences among patients with chronic aphasia predict improvement in speech-language therapy.

Abstract:
BACKGROUND
Negative affectivity and neurocognitive deficits including executive dysfunction have been shown to be detrimental to rehabilitation therapies. However, research on the relationship between neuropsychological deficits and improvement in speech-language therapy (SLT) for aphasia is sparse.

OBJECTIVE
To examine the relationships among neurocognitive and psychological functioning and improvement in SLT following aphasia due to stroke.

METHODS
Fifty patients who were ≥ 9 months post stroke and enrolled in outpatient SLT to treat aphasia participated. Using standard language assessment measures, the authors evaluated language functioning at initiation of the study and after participants completed various SLT protocols. Executive functioning, visuospatial skills, attention, and memory also were assessed to provide indices of convergent and discriminant validity. Participants' mood and affectivity were evaluated by self-report, and their functional abilities and recovery of function since stroke were assessed via caregiver report.

RESULTS
A multiple regression model testing the combined powers of neurocognitive and psychological variables was significant (P = .004, R2 = 0.33), with psychological and neurocognitive functioning accounting for 15% of the variance in relative language change beyond that accounted for by stroke severity and gross cognitive functioning. Negative affectivity expressed on the Positive and Negative Affectivity Scale made unique contributions to the model.

CONCLUSIONS
Improvement in SLT is substantially related to neurocognitive and psychological functioning, particularly affectivity. Assessment of these characteristics may assist in identifying patients who are likely to improve and in tailoring treatment programs to yield optimal outcomes.

Votruba|Kristen L|KL|
Rapport|Lisa J|LJ|
Whitman|R Douglas|RD|
Johnson|Alex|A|
Langenecker|Scott|S|

speech-language therapy
affectivity
executive functioning
depression


Family Medicine Panel Size with Care Teams: Impact on Quality.

Abstract:
PURPOSE
The demand for comprehensive primary health care continues to expand. The development of team-based practice allows for improved capacity within a collective, collaborative environment. Our hypothesis was to determine the relationship between panel size and access, quality, patient satisfaction, and cost in a large family medicine group practice using a team-based care model.

METHODS
Data were retrospectively collected from 36 family physicians and included total panel size of patients, percentage of time spent on patient care, cost of care, access metrics, diabetic quality metrics, patient satisfaction surveys, and patient care complexity scores. We used linear regression analysis to assess the relationship between adjusted physician panel size, panel complexity, and outcomes.

RESULTS
The third available appointments (P < .01) and diabetic quality (P = .03) were negatively affected by increased panel size. Patient satisfaction, cost, and percentage fill rate were not affected by panel size. A physician-adjusted panel size larger than the current mean (2959 patients) was associated with a greater likelihood of poor-quality rankings (≤25th percentile) compared with those with a less than average panel size (odds ratio [OR], 7.61; 95% confidence interval [CI], 1.13-51.46). Increased panel size was associated with a longer time to the third available appointment (OR, 10.9; 95% CI, 1.36-87.26) compared with physicians with panel sizes smaller than the mean.

CONCLUSIONS
We demonstrated a negative impact of larger panel size on diabetic quality results and available appointment access. Evaluation of a family medicine practice parameters while controlling for panel size and patient complexity may help determine the optimal panel size for a practice.

Angstman|Kurt B|KB|
Horn|Jennifer L|JL|
Bernard|Matthew E|ME|
Kresin|Molly M|MM|
Klavetter|Eric W|EW|
Maxson|Julie|J|
Willis|Floyd B|FB|
Grover|Michael L|ML|
Bryan|Michael J|MJ|
Thacher|Tom D|TD|

D001071:Appointments and Schedules
D003920:Diabetes Mellitus
D005194:Family Practice
D006297:Health Services Accessibility
D006801:Humans
D017060:Patient Satisfaction
D011320:Primary Health Care
D011787:Quality of Health Care
D012189:Retrospective Studies
D011795:Surveys and Questionnaires

Primary Health Care
Patient Satisfaction
Group Practice
Family Physicians
Patient Care
Regression Analysis
Diabetes Mellitus
Family Practice
Retrospective Studies


Structural Insights into Transcription Initiation from De Novo RNA Synthesis to Transitioning into Elongation.

Abstract: In bacteria, the dissociable σ subunit of the RNA polymerase (RNAP) is responsible for initiating RNA synthesis from specific DNA sites. As nascent RNA grows, downstream DNA unwinds and is pulled into the RNAP, causing stress accumulation and initiation complex destabilization. Processive transcription elongation requires at least partial separation of the σ factor from the RNAP core enzyme. Here, we present a series of transcription complexes captured between the early initiation and elongation phases via in-crystal RNA synthesis and cleavage. Crystal structures of these complexes indicate that stress accumulation during transcription initiation is not due to clashing of the growing nascent RNA with the σ3.2 loop, but results from scrunching of the template strand DNA that is contained inside the RNAP by the σ3 domain. Our results shed light on how scrunching of template-strand DNA drives both abortive initiation and σ-RNAP core separation to transition transcription from initiation to elongation.

Zuo|Yuhong|Y|
De|Swastik|S|
Feng|Yingang|Y|
Steitz|Thomas A|TA|

Biochemistry
Crystallography
Structural Biology


Cochlear implantation in chronic otitis media and previous middle ear surgery: 20 years of experience.

Abstract: Cochlear implantation in the setting of chronic otitis media or previous middle ear surgery poses several problems for the surgeon: possible spread of infection to the cochlea and the subarachnoid spaces with consequent meningitis, risk of electrode array extrusion and possible recurrence of the original disease. Several surgical strategies have been proposed to overcome these problems. In the present study, clinical and functional results of cochlear implantation in 26 patients with chronic otitis media (8 cases) or previous middle ear surgery (18 cases) in the ear most suitable for implantation were retrospectively reviewed. Among the 8 patients with chronic otitis media, in 7 cases a subtotal petrosectomy associated with external auditory canal closure and mastoid and Eustachian tube obliteration was performed, while in the remaining patient cochlear implantation was done 6 months after a myringoplasty. The only complication observed was a reperforation of the tympanic membrane in this latter patient. Among the 18 patients with previous middle ear surgery, 2 had undergone intact canal wall tympanomastoidectomy and were implanted utilising the previous surgical approach. In the remaining 16 patients who had a radical cavity, an open technique was maintained in 3 cases; a cavity revision associated to external auditory canal closure, Eustachian tube and mastoid obliteration was performed in 12 patients, while in one case a middle cranial fossa approach was utilised. Two of the 3 patients in whom an open technique was maintained have experienced electrode array extrusion. The only complication observed in the remaining patients was the breakdown of the external auditory canal closure in one case. No problems were noted in patients who had undergone intact canal wall tympanomastoidectomy as well as in the subject implanted via the middle cranial fossa approach. All patients achieved and maintained good hearing performance over time. Subtotal petrosectomy associated with external auditory canal closure, Eustachian tube occlusion and mastoid obliteration is an effective procedure to facilitate cochlear implantation in presence of chronic otitis media. The open cavity technique offers the advantage of a close clinical examination, but may expose the patient to the risk of electrode array extrusion, mainly in the long-term period.

Vincenti|V|V| Pasanisi|E|E| Bacciu|A|A| Bacciu|S|S| Zini|C|C|

Cochlear implantation
Chronic otitis media
Cholesteatoma
Sensorineural hearing loss


Are trans diagnostic models of eating disorders fit for purpose? A consideration of the evidence for food addiction.

Abstract: Explanatory models for eating disorders have changed over time to account for changing clinical presentations. The transdiagnostic model evolved from the maintenance model, which provided the framework for cognitive behavioural therapy for bulimia nervosa. However, for many individuals (especially those at the extreme ends of the weight spectrum), this account does not fully fit. New evidence generated from research framed within the food addiction hypothesis is synthesized here into a model that can explain recurrent binge eating behaviour. New interventions that target core maintenance elements identified within the model may be useful additions to a complex model of treatment for eating disorders.

food addiction
bulimia nervosa
binge eating disorder
insulin
neuroadaptation


The Positive and Negative Syndrome Scale for Schizophrenia Autism Severity Scale (PAUSS) in young people with autism and schizophrenia.

Abstract:
INTRODUCTION
Schizophrenia spectrum disorders (SSD) share symptoms with autism spectrum disorders (ASD). Autistic phenotypic profiles in SSD may be associated with a poor prognosis. We aimed to assess the evidences for reliability and convergent validity of the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) Autism Severity Scale (PAUSS) in a sample of young people with ASD and SSD, and to use the PAUSS to explore correlates of "autistic profiles" in the SSD sample.

MATERIALS AND METHODS
ASD (n=33, age=13-27 years) and SSD subjects (n=26, age=16-35 years) underwent PANSS, Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and Social Responsiveness Scale (SRS) assessments. We derived PAUSS total/domain scores from the PANSS and applied these back-to-back with ADOS calibrated severity scores (CSS), ADI-R current behavior algorithm (CBA) scores, and SRS scores.

RESULTS
Our results show evidence for an acceptable PAUSS score reliability and convergent validity both in the ASD and SSD samples. PAUSS total and socio-communication scores significantly correlated with ADOS Overall/Social Affect CSS, both in ASD and in SSD. SSD with higher PAUSS scores ("autistic-SSD") showed Overall/Social Affect CSS scores positioned in between ASD and "non-autistic SSD". The PAUSS total score was significantly associated with global functioning in SSD (adjusted R2=0.311).

CONCLUSIONS
There seems to be evidence for the reliability and validity of PAUSS scores for quantifying autism symptom severity transdiagnostically and to identify "autistic phenotypes" in adolescents/young adults with SSD.

Pina-Camacho|Laura|L|
Boada|Leticia|L|
Díaz-Caneja|Covadonga M|CM|
García-Alcón|Alicia|A|
Burdeus|Mónica|M|
Serrano-Drozdowskyj|Elena|E|
Fraguas|David|D|
Moreno|Carmen|C|
Parellada|Mara|M|

Trastornos del espectro de la esquizofrenia


Intergametophytic selfing and microgeographic genetic structure shape populations of the intertidal red seaweed Chondrus crispus.

Abstract: Understanding how abiotic factors influence the spatial distribution of genetic variation provides insight into microevolutionary processes. The intertidal seascape is characterized by highly heterogeneous habitats which probably influence the partitioning of genetic variation at very small scales. The effects of tidal height on genetic variation in both the haploid (gametophytes) and diploid (tetrasporophytes) stages of the red alga Chondrus crispus were studied. Fronds were sampled every 25 cm within a 5 m × 5 m grid and along a 90-m transect at two shore heights (high and low) in one intertidal site in France. The multilocus genotype of 799 fronds was determined (Nhaploid  = 586; Ndiploid  = 213) using eight microsatellite loci to test the following hypotheses: (i) high and low shore fronds belong to genetically differentiated populations, (ii) gene flow is restricted within the high shore habitat due to tidal-influenced isolation and (iii) significant FIS values are driven by life history characteristics. Pairwise FST estimates between high and low shore levels supported the hypothesis that high and low shore fronds were genetically differentiated. The high shore was characterized by the occurrence of within-shore genetic differentiation, reduced genetic diversity and increased levels of intergametophytic selfing, suggesting it is a marginal environment. These results suggest at fine scales within the intertidal seascape the same mechanisms as those over the species' distributional range are at work with core and marginal population dynamics.

Krueger-Hadfield|S A|SA|
Roze|D|D|
Mauger|S|S|
Valero|M|M|

D044723:Chondrus
D017753:Ecosystem
D005602:France
D051456:Gene Flow
D014644:Genetic Variation
D005828:Genetics, Population
D055993:Germ Cells, Plant
D018895:Microsatellite Repeats
D008969:Molecular Sequence Data
D058885:Multilocus Sequence Typing
D011003:Ploidies
D011157:Population Dynamics
D014872:Water Movements

intergametophytic selfing
algae
haploid-diploid life cycles
intertidal zone
mating system
population genetics
seascape influence


Kimura's disease involving bilateral lacrimal glands and extraocular muscles along with ipsilateral face: A unique case report.

Abstract: A 23 year female presented with bilateral recurrent swelling of eyelids along with ptosis and proptosis for last 3 years. She also had swellings over the right cheek, parotid gland, and retro auricular area along with regional lymphadenopathy. Systemic laboratory workup revealed raised serum IgE and a high peripheral eosinophil count. Computed tomography and magnetic resonance imaging showed bilateral enlargement of extraocular muscles, lacrimal glands, and ipsilateral parotid gland. Excision biopsy of the retro-auricular lymph node was suggestive of Kimura's disease (KD). The patient responded well to systemic corticosteroid. KD rarely affects orbit, but it should be included in the differential diagnosis of inflammatory diseases of the orbit. To our knowledge, this is the first reported case of KD from India involving the orbit, lacrimal gland, extraocular muscles, parotid gland and buccal area.

Chakraborti|Chandana|C|
Saha|Ajoy Kumar|AK|
Bhattacharjee|Ankita|A|
Lakra|Rupanjili|R|

D000796:Angiolymphoid Hyperplasia with Eosinophilia

Kimura's disease
Bilateral lacrimal gland swelling
eosinophilia
extraocular muscles enlargement


Lung cancer cell line sensitivity to Zoledronic acid is BAX-dependent.

Abstract:
BACKGROUND
Zoledronate (Zol), an anti-osteoclastic and anticancer drug, is used to control bone metastasis in several cancer types, including non-small cell lung cancer (NSCLC). However, the mechanisms behind Zol resistance in NSCLC are unclear.

MATERIALS AND METHODS
Zol-resistant cell lines were developed by repeated treatment of A549 and H1650 NSCLC cell lines with Zol. We measured cell proliferation and apoptosis following Zol treatment and also examined the BCL2 superfamily expression. RNAi was used to confirm the role of key molecules in development of resistance.

RESULTS
Repeated Zol treatment engendered resistance, in which apoptosis induction was attenuated. From the BCL2 superfamily, BAX was commonly down-regulated in resistant cells, and silencing of BAX in parental cell lines also induced drug resistance.

CONCLUSION
Repeated treatment of NSCLC cell lines with Zol leads to drug resistance, which is in part due to BAX down-regulation.

Aoyagi|Takayuki|T| Morii|Takeshi|T| Ohtsuka|Kouki|K| Ohnishi|Hiroaki|H| Tajima|Takashi|T| Yoshiyama|Akira|A| Mochizuki|Kazuo|K| Satomi|Kazuhiko|K| Ichimura|Shoichi|S|

Lung cancer
zoledronic acid
BAX
drug resistance


Does Living with Grandparents Affect Children's and Adolescents' Health? Evidence from China.

Abstract: The level of nutritional health of children and adolescents is an important indicator of social development, and grandparents, as common co-caregivers, may have a considerable impact on the health level of their grandchildren. In this paper, we investigated the effects of grandparents' coresidence on children's and adolescents' nutritional health levels using the CHNS (China Health and Nutrition Survey) database using the PSM (Propensity Score Matching) method' and identified heterogeneity in the effects of grandparents' coresidence by PSM grouping in terms of urban and rural areas, age, and the mothers' education level. It was found that grandparents' coresidence is beneficial for children's and adolescents' health to a certain extent. Overfeeding and spoil that many people worried when grandparents involved in childcare did not happen in our samples. Moreover, grandparents' coresidence had a more significant effect on the health level of children and adolescents in rural areas at a younger age and with a lower level of maternal education. Government and families should put more effort into equipping caregivers with knowledge on how to raise their grandchildren better.

childhood obesity
children and adolescent health
grandparents’ coresidence
nutritional balance


The Role of Frontal Cortical and Medial-Temporal Lobe Brain Areas in Learning a Bayesian Prior Belief on Reversals.

Abstract:
UNLABELLED
Reversal learning has been extensively studied across species as a task that indexes the ability to flexibly make and reverse deterministic stimulus-reward associations. Although various brain lesions have been found to affect performance on this task, the behavioral processes affected by these lesions have not yet been determined. This task includes at least two kinds of learning. First, subjects have to learn and reverse stimulus-reward associations in each block of trials. Second, subjects become more proficient at reversing choice preferences as they experience more reversals. We have developed a Bayesian approach to separately characterize these two learning processes. Reversal of choice behavior within each block is driven by a combination of evidence that a reversal has occurred, and a prior belief in reversals that evolves with experience across blocks. We applied the approach to behavior obtained from 89 macaques, comprising 12 lesion groups and a control group. We found that animals from all of the groups reversed more quickly as they experienced more reversals, and correspondingly they updated their prior beliefs about reversals at the same rate. However, the initial values of the priors that the various groups of animals brought to the task differed significantly, and it was these initial priors that led to the differences in behavior. Thus, by taking a Bayesian approach we find that variability in reversal-learning performance attributable to different neural systems is primarily driven by different prior beliefs about reversals that each group brings to the task.

SIGNIFICANCE STATEMENT
The ability to use prior knowledge to adapt choice behavior is critical for flexible decision making. Reversal learning is often studied as a form of flexible decision making. However, prior studies have not identified which brain regions are important for the formation and use of prior beliefs to guide choice behavior. Here we develop a Bayesian approach that formally characterizes learning set as a concept, and we show that, in macaque monkeys, the amygdala and medial prefrontal cortex have a role in establishing an initial belief about the stability of the reward environment.

Bayesian prior
reversal learning
learning set
amygdala
medial prefrontal cortex
orbitofrontal cortex


Relationship Between Patients with Clinical Auditory Neuropathy Spectrum Disorder and Mutations in Gjb2 Gene.

Abstract:
The auditory neuropathy is a condition which there is a dyssynchrony in the nerve conduction of the auditory nerve fibers. There is no evidence about the relationship between patients with clinical auditory neuropathy spectrum disorder and mutations in GJB2 gene. There are only two studies about this topic in the medical literature. Connexin 26 (GJB2 gene) mutations are common causes of genetic deafness in many populations and we also being reported in subjects with auditory neuropathy.

OBJECTIVE
To analyze the pattern of clinical relationship between patients with clinical diagnosis with auditory neuropathy spectrum disorder and GJB2 gene.

PATIENTS AND METHODS
Study Design - Retrospective analysis and genetic evaluation. Setting - Tertiary referral center. Subjects - 40 patients with Auditory Neuropathy Spectrum Disorder. Intervention - Clinical information and genetic evaluation (GJB2 gene) were analyzed.

RESULTS
Biallelic mutations that accounted for hearing loss (HL) were found in three patients, both with c.35delG mutation in homozygous state. The splice site mutation IVS1+1G>A was detected in heterozygous state in one individual. However, since the second mutant allele was not identified, it was not possible to establish its correlation with the phenotype.

CONCLUSION
Mutations in GJB2 gene mutations were found in 7.5% of the patients with ANSD. We found no relationship between patients with clinical auditory neuropathy spectrum disorder and mutations in GJB2 gene (p>0.05).

de Carvalho|Guilherme M|GM|
Z Ramos|Priscila|P|
M Castilho|Arthur|A|
C Guimarães|Alexandre|A|
L Sartorato|Edi|E|

Auditory neuropathy spectrum disorder
GJB2
Hearing loss
Evoked auditory brainstem response
Otoacoustic emissions


Routine Early Antibiotic Use in SymptOmatic Preterm Neonates: A Pilot Randomized Controlled Trial.

Abstract: We enrolled 98 infants (gestational age <33 weeks) in a pilot randomized trial of antibiotics vs no antibiotics; 55 were randomized (lower maternal infectious risk; symptoms expected for gestation). Adverse events did not differ significantly between the randomization arms. This trial establishes a framework for a larger multicentered trial.

Ruoss|J Lauren|JL|
Bazacliu|Catalina|C|
Russell|Jordan T|JT|
Cruz|Diomel de la|D|
Li|Nan|N|
Gurka|Matthew J|MJ|
Filipp|Stephanie L|SL|
Polin|Richard A|RA|
Triplett|Eric W|EW|
Neu|Josef|J|

D000367:Age Factors
D000900:Anti-Bacterial Agents
D005260:Female
D006801:Humans
D007231:Infant, Newborn
D007234:Infant, Premature
D008297:Male
D010865:Pilot Projects
D013290:Streptococcal Infections
D013292:Streptococcus agalactiae


Hydroxyapatite precipitation with Hydron Blue dye.

Abstract: Calcium phosphate, in the form of amorphous hydroxyapatite, precipitates out of neutral water solutions containing calcium and phosphate ions in the form of small agglomerates of 18 μm average size. When Hydron Blue dye (HB) is added, the insoluble particles gradually agglomerate further to 50 μm sizes. However, the removal capacity of hydroxyapatite for the dye is increased when the calcium phosphate nucleates and forms in the presence of dye. When coprecipitates form, the particules average 20 μm size and contain up to 60% organic matter. Nascent calcium phosphate particles have strong capacity for Hydron Blue dye removal. Thus smaller calcium phosphate particles increase the amount of dye molecules in water pollution control.

Oubagha|Noura|N|
Lemlikchi|Wahiba|W|
Sharrock|Patrick|P|
Fiallo|Marina|M|
Mecherri|Med Oimar|MO|

Hydroxyapatite
Agglomeration
Coprecipitation
Adsorption
Flocculation
Particle-size distributions


Empowering the detection of ChIP-seq "basic peaks" (bPeaks) in small eukaryotic genomes with a web user-interactive interface.

Abstract:
OBJECTIVE
bPeaks is a peak calling program to detect protein DNA-binding sites from ChIPseq data in small eukaryotic genomes. The simplicity of the bPeaks method is well appreciated by users, but its use via an R package is challenging and time-consuming for people without programming skills. In addition, user feedback has highlighted the lack of a convenient way to carefully explore bPeaks result files. In this context, the development of a web user interface represents an important added value for expanding the bPeaks user community.

RESULTS
We developed a new bPeaks application (bPeaks App). The application allows the user to perform all the peak-calling analysis steps with bPeaks in a few mouse clicks via a web browser. We added new features relative to the original R package, particularly the possibility to import personal annotation files to compare the location of the detected peaks with specific genomic elements of interest of the user, in any organism, and a new organization of the result files which are directly manageable via a user-interactive genome browser. This significantly improves the ability of the user to explore all detected basic peaks in detail.

ChIP-seq
bPeaks
Small eukaryotic genomes
Peak calling
Protein DNA-binding sites


ortho-Carboranylphenoxyacetanilides as inhibitors of hypoxia-inducible factor (HIF)-1 transcriptional activity and heat shock protein (HSP) 60 chaperon activity.

Abstract: ortho-Carboranylphenoxy derivatives were synthesized and evaluated for their ability to inhibit hypoxia-induced HIF-1 transcriptional activity using a cell-based reporter gene assay. Among the compounds synthesized, compound 1d showed the most significant inhibition of hypoxia-induced HIF-1 transcriptional activity with the IC50 of 0.53μM. Furthermore, compound 1h was found to possess the most significant inhibition of heat shock protein (HSP) 60 chaperon activity among the reported inhibitors: the IC50 toward the porcine heart malate dehydrogenase (MDH) refolding assay was 0.35μM.

Li|Guangzhe|G| Azuma|Soyoko|S| Sato|Shinichi|S| Minegishi|Hidemitsu|H| Nakamura|Hiroyuki|H|

D051795:Hypoxia-Inducible Factor 1, alpha Subunit

Inhibitor
Heat shock protein (HSP) 60
Angiogenesis
Carborane
Hypoxia-inducible factor (HIF)-1α


Bayesian Network Meta-analysis of Multiple Outcomes in Dental Research.

Abstract:
OBJECTIVES
Dental research typically targets multiple outcomes. Interdental cleaning devices such as interdental brushes (IB) and water jet devices (WJ) share a sizable portion of the medical device market. However, recommendations for device selection are limited by the conflicting evidence from multiple outcomes in available studies and the lack of an appropriate synthesis approach to summarize evidences taken from multiple outcomes. In particular, both pairwise meta-analyses and single-outcome network meta-analyses can give discordant results. The purpose of this multioutcome, Bayesian network meta-analysis is to introduce this innovative method to the dental research community using data from interdental cleaning device studies for illustrative purposes.

METHODS
We reanalyzed a network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation, which included 22 trials assessing 10 interproximal oral hygiene aids. We focused on the primary outcome of gingival inflammation, which was measured by 2 correlated outcome variables, the Gingival Index (GI) and bleeding on probing (BOP).

RESULTS
In our previous single-outcome analysis, we concluded that IB and WJ rank high for reducing gingival inflammation while toothpick and flossing rank last. In this multioutcome Bayesian network meta-analysis with equal weight on GI and BOP, the surface under the cumulative ranking curve was 0.87 for WJ and 0.85 for IB. WJ and IB remained ranked as the 2 best devices across different sets of weightings for the GI and BOP.

CONCLUSION
In conclusion, multioutcome Bayesian network meta-analysis naturally takes the correlations among multiple outcomes into account, which in turn can provide more comprehensive evidence.

Liang|Menglu|M|
Lian|Qinshu|Q|
Kotsakis|Georgios A|GA|
Michalowicz|Bryan S|BS|
John|Mike T|MT|
Chu|Haitao|H|

D001499:Bayes Theorem
D003742:Dental Devices, Home Care
D003773:Dental Plaque
D018865:Dental Research
D006801:Humans
D000071076:Network Meta-Analysis
D014099:Toothbrushing

Bayesian network meta-analysis
Meta-analysis
Multiple outcomes
Dental hygiene
Evidence-based dentistry/health care


Structure of bacterial and eukaryote communities reflect in situ controls on community assembly in a high-alpine lake.

Abstract: Recent work suggests that microbial community composition in high-elevation lakes is significantly influenced by microbes entering from upstream terrestrial and aquatic habitats. To test this idea, we conducted 18S and 16S rDNA surveys of microbial communities in a high-alpine lake in the Colorado Rocky Mountains. We compared the microbial community of the lake to water entering the lake and to uphill soils that drain into the lake. Utilizing hydrological and abiotic data, we identified potential factors controlling microbial diversity and community composition. Results show a diverse community entering the lake at the inlet with a strong resemblance to uphill terrestrial and aquatic communities. In contrast, the lake communities (water column and outlet) showed significantly lower diversity and were significantly different from the inlet communities. Assumptions of neutral community assembly poorly predicted community differences between the inlet and lake, whereas "variable selection" and "dispersal limitation" were predicted to dominate. Similarly, the lake communities were correlated with discharge rate, indicating that longer hydraulic residence times limit dispersal, allowing selective pressures within the lake to structure communities. Sulfate and inorganic nitrogen and phosphorus concentrations correlated with community composition, indicating "bottom up" controls on lake community assembly. Furthermore, bacterial community composition was correlated with both zooplankton density and eukaryotic community composition, indicating biotic controls such as "top-down" interactions also contribute to community assembly in the lake. Taken together, these community analyses suggest that deterministic biotic and abiotic selection within the lake coupled with dispersal limitation structures the microbial communities in Green Lake 4.

Gendron|Eli Michael S|EMS|
Darcy|John L|JL|
Hell|Katherinia|K|
Schmidt|Steven K|SK|

Hydrurus
co-occurrence patterns
deterministic community assembly
landscape connectivity


Lasers and energy-based devices marketed for vaginal rejuvenation: A cross-sectional analysis of the MAUDE database.

Abstract:
INTRODUCTION
The FDA issued a statement on July 30, 2018, expressing concern over the marketing of lasers and energy-based devices to promote "vaginal rejuvenation." The FDA stated that there is insufficient data to recommend this modality for optimization of sexual function and alleviation of genitourinary syndrome of menopause (GSM)-related symptoms in postmenopausal or postpartum women. This analysis aims to characterize the mandatory and voluntary reports concerning laser and energy-based procedures marketed for vaginal rejuvenation.

METHODS
Cross-sectional analysis of the FDA database, Manufacturer and User Facility Device Experience (MAUDE), for events related to laser and energy-based devices for vaginal rejuvenation.

RESULTS
Between October 2015 and January 2019, 45 distinct events describing 46 patients were recorded and reviewed. The most commonly reported adverse event related to the procedure was pain (vulvar, bladder, urethral, or unspecified) (n = 19). The majority of patients sought medical care for their injuries, which included evaluation by urgent care, urology, gynecology, neurology, gastroenterology, pelvic floor therapy, primary care providers, and the device operator. Thirty-three patients indicated chronicity of their injury, which included long-term pain, numbness, burning, bladder disturbances, infections, scarring, dyspareunia, worsening symptoms, aggravation of lichen sclerosis, and disfigurement.

CONCLUSIONS
A variety of adverse events associated with the use of laser and energy-based devices for "vaginal rejuvenation" was reported to the MAUDE database. Although the circumstances surrounding these events were unclear, these reports signify the importance of clinical trials that investigate the efficacy and safety profile of laser and energy-based devices for optimization of sexual function and treatment of GSM-related symptoms. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Ahluwalia|Jusleen|J|
Avram|Mathew M|MM|
Ortiz|Arisa E|AE|

D014486:United States Food and Drug Administration

vaginal rejuvenation
MAUDE
FDA
energy based device


Coding strategies in the otolith system differ for translational head motion vs. static orientation relative to gravity.

Abstract: The detection of gravito-inertial forces by the otolith system is essential for our sense of balance and accurate perception. To date, however, how this system encodes the self-motion stimuli that are experienced during everyday activities remains unknown. Here, we addressed this fundamental question directly by recording from single otolith afferents in monkeys during naturalistic translational self-motion and changes in static head orientation. Otolith afferents with higher intrinsic variability transmitted more information overall about translational self-motion than their regular counterparts, owing to stronger nonlinearities that enabled precise spike timing including phase locking. By contrast, more regular afferents better discriminated between different static head orientations relative to gravity. Using computational methods, we further demonstrated that coupled increases in intrinsic variability and sensitivity accounted for the observed functional differences between afferent classes. Together, our results indicate that irregular and regular otolith afferents use different strategies to encode naturalistic self-motion and static head orientation relative to gravity.

D000818:Animals
D018466:Gravity Sensing
D019416:Head Movements
D008252:Macaca fascicularis
D008297:Male
D009039:Motion Perception
D000072458:Orientation, Spatial
D010037:Otolithic Membrane

translation
self-motion
otolith afferents
spike timing
neural coding
neuroscience
rhesus macaque
tilt


Cannibalism Affects Core Metabolic Processes in Helicoverpa armigera Larvae-A 2D NMR Metabolomics Study.

Abstract: Cannibalism is known in many insect species, yet its impact on insect metabolism has not been investigated in detail. This study assessed the effects of cannibalism on the metabolism of fourth-instar larvae of the non-predatory insect Helicoverpa armigera (Lepidotera: Noctuidea). Two groups of larvae were analyzed: one group fed with fourth-instar larvae of H. armigera (cannibal), the other group fed with an artificial plant diet. Water-soluble small organic compounds present in the larvae were analyzed using two-dimensional nuclear magnetic resonance (NMR) and principal component analysis (PCA). Cannibalism negatively affected larval growth. PCA of NMR spectra showed that the metabolic profiles of cannibal and herbivore larvae were statistically different with monomeric sugars, fatty acid- and amino acid-related metabolites as the most variable compounds. Quantitation of ¹H-(13)C HSQC (Heteronuclear Single Quantum Coherence) signals revealed that the concentrations of glucose, glucono-1,5-lactone, glycerol phosphate, glutamine, glycine, leucine, isoleucine, lysine, ornithine, proline, threonine and valine were higher in the herbivore larvae.

cannibalism
Helicoverpa armigera
NMR
metabolomics
HSQC


Ecological Momentary Assessment of the Breakfast, Lunch, and Dinner Family Meal Environment in Racially/Ethnically Diverse and Immigrant Households.

Abstract:
OBJECTIVE
To describe meal characteristics across breakfast, lunch, and dinner family meals in racially/ethnically diverse and immigrant/refugee households via ecological momentary assessment; identify real-time meal characteristics associated with family meal frequency; and identify qualitative themes regarding parents' perspectives about meal characteristics and meal types that influence family meal frequency.

DESIGN
Cross-sectional study.

SETTING
In-home visits.

PARTICIPANTS
Children aged 5-7 years (n = 150) and their families from diverse and low-income households.

MAIN OUTCOME MEASURE(S)
Mixed methods.

ANALYSIS
Multiple linear regression and hybrid deductive and inductive content analysis.

RESULTS
Quantitative results indicated several similar meal characteristics occurring across weekdays and weekend days and by meal type (eg, parent prepared the meal, food mostly homemade, meal eaten at table) and some significant negative associations (P < .05) between meal characteristics and family meal frequency (eg, fast food for family meals). Eight main qualitative themes with several subthemes supported and expanded the quantitative findings and added depth to interpretation of the findings.

CONCLUSIONS AND IMPLICATIONS
Results identified specific meal characteristics both quantitatively and qualitatively that may inform the development of interventions to increase the frequency of family meals so that more families can benefit from the protective nature of family meals.

Berge|Jerica M|JM|
Beebe|Maureen|M|
Smith|Mireya Carmen-Martinez|MC|
Tate|Allan|A|
Trofholz|Amanda|A|
Loth|Katie|K|

Ecological Momentary Assessment
family meals
qualitative
mixed methods
parenting practices