Investigating the contributing factors to HIV/AIDS infection from the perspective of HIV-infected patients.

Abstract:
BACKGROUND
People with HIV have always faced stigma and discrimination. Given the numerous papers that have addressed the psychological and social risk factors in spreading HIV, a pressing question is whether individuals' mere careless and behavioural flaws can still account for the spread of HIV. Barriers and opposing politic made a hard position for HIV and sex education in Iran.

METHODS
The present study investigated the causes of contracting HIV/AIDS from the perspective of HIV-infected patients. To accomplish this, 150 patients referring to the voluntary counseling and testing Center, Shiraz were convenient selected based on the convenient sampling method and responded to a researcher-made questionnaire From June to August 2019. The data were analyzed through descriptive statistics (mean, SD, frequency tables) and inferential statistics (chi-square).

RESULTS
Results revealed that the main cause of HIV infection amongst males was the injection of narcotics, and in the females it was sexual intercourse with an infected individual. Meanwhile, 57% of the females and 66% of the males blamed themselves for contracting and transmitting the disease. The patients stated that if they could return to pre-infection period, they would use one of the following ways to prevent the disease: (a) they would pay attention to hygienic/sanitary principles; (b) they would not get married; and (c) they would prevent drug addiction. Also only 44% of the individuals had successful siblings (those who were neither addicts nor HIV/AIDS-infected individuals), which was an observation that emphasizes on the epidemic of high-risk behaviors in the patients' families.

CONCLUSIONS
According to participants' statements collected in our study, weakness in governmental public health education, along with family-related and individual factors, are important causes of HIV spread.

D007722:Health Knowledge, Attitudes, Practice


FUNDC1-dependent mitophagy induced by tPA protects neurons against cerebral ischemia-reperfusion injury.

Abstract: Autophagy of mitochondria, termed mitophagy, plays an important role in cerebral ischemia-reperfusion (IR) injury, but the mechanism is not yet clear. Tissue-type plasminogen activator (tPA) is the most important thrombolytic drug in the clinical treatment of ischemic stroke and has neuroprotective effects. Here, we explored the effects of tPA on neuronal apoptosis and mitophagy following IR. We found that knocking out the tPA gene significantly aggravated brain injury and increased neuronal apoptosis and mitochondrial damage. Exposure of neurons to tPA reduced injury severity and protected mitochondria. Further studies demonstrated that this protective effect of tPA was achieved via regulation of FUNDC1-mediated mitophagy. Furthermore, we found that tPA enhanced the expression level of FUNDC1 by activating the phosphorylation of AMPK. In summary, our results confirm that tPA exerts neuroprotective effects by increasing the phosphorylation of AMPK and the expression of FUNDC1, thereby inhibiting apoptosis and improving mitochondrial function.

Cai|Ying|Y| Yang|Eryan|E| Yao|Xiuhua|X| Zhang|Xuebin|X| Wang|Qixue|Q| Wang|Yunfei|Y| Liu|Ji|J| Fan|Weijia|W| Yi|Kaikai|K| Kang|Chunsheng|C| Wu|Jialing|J|


Incidental finding of a membranous interventricular septum aneurysm.

Abstract: We present the case of a 34-year-old female who was admitted to our hospital due to community-acquired pneumonia and had a transthoracic echocardiogram which revealed an aneurysm of the membranous interventricular septum. This was further investigated with a transesophageal echocardiogram which showed in detail the anatomical features of this very rare condition.

septum
aneurysm
congenital heart defects
transesophageal echocardiography
transthoracic echocardiography


The IRF4 Gene Regulatory Module Functions as a Read-Write Integrator to Dynamically Coordinate T Helper Cell Fate.

Abstract: Transcriptional regulation during CD4+ T cell fate decisions enables their differentiation into distinct states, guiding immune responses toward antibody production via Tfh cells or inflammation by Teff cells. Tfh-Teff cell fate commitment is regulated by mutual antagonism between the transcription factors Bcl6 and Blimp-1. Here we examined how T cell receptor (TCR) signals establish and arbitrate Bcl6-Blimp-1 counter-antagonism. We found that the TCR-signal-induced transcription factor Irf4 is essential for the differentiation of Bcl6-expressing Tfh and Blimp-1-expressing Teff cells. Increased TCR signaling raised Irf4 amounts and promoted Teff cell fates at the expense of Tfh ones. Importantly, orthogonal induction of Irf4 expression redirected Tfh cell fate trajectories toward those of Teff. Mechanistically, we linked greater Irf4 abundance with its recruitment toward low-affinity binding sites within Teff cell cis-regulatory elements, including those of Prdm1. We propose that the Irf4 locus functions as the "reader" of TCR signal strength, and in turn, concentration-dependent activity of Irf4 "writes" T helper fate choice.

Krishnamoorthy|Veena|V|
Kannanganat|Sunil|S|
Maienschein-Cline|Mark|M|
Cook|Sarah L|SL|
Chen|Jianjun|J|
Bahroos|Neil|N|
Sievert|Evelyn|E|
Corse|Emily|E|
Chong|Anita|A|
Sciammas|Roger|R|

Irf4
transcription factors
Bcl6
Blimp-1
CD4 T cell differentiation
T cell receptor
T effector cells
T follicular helper cells
antibody responses


The Characteristics of Binary Spike-Time-Dependent Plasticity in HfO2-Based RRAM and Applications for Pattern Recognition.

Abstract: A binary spike-time-dependent plasticity (STDP) protocol based on one resistive-switching random access memory (RRAM) device was proposed and experimentally demonstrated in the fabricated RRAM array. Based on the STDP protocol, a novel unsupervised online pattern recognition system including RRAM synapses and CMOS neurons is developed. Our simulations show that the system can efficiently compete the handwritten digits recognition task, which indicates the feasibility of using the RRAM-based binary STDP protocol in neuromorphic computing systems to obtain good performance.

Zhou|Zheng|Z| Liu|Chen|C| Shen|Wensheng|W| Dong|Zhen|Z| Chen|Zhe|Z| Huang|Peng|P| Liu|Lifeng|L| Liu|Xiaoyan|X| Kang|Jinfeng|J|

RRAM
Pattern recognition
STDP
ALD
Unsupervised online learning


Metabolic syndrome in children with chronic kidney disease: PON1 and treatment modality.

Abstract:
BACKGROUND AND AIMS
We undertook this study to evaluate the relationship between PON1, SOD and metabolic syndrome (MetS) in pediatric patients undergoing peritoneal dialysis, hemodialysis and patients in early stages of CKD.

METHODS
We carried out an analytical cross-sectional study of 134 children 6-17 years old. We registered anthropometric variables, vital signs, basic biochemical parameters, intact PTH (iPTH), high sensitivity CRP (hs-CRP), paraoxonase-1; SOD; PON1/HDL-cholesterol and homocysteine. For statistical analyses we used t test, Mann Whitney U test, χ(2), Fisher exact test, linear or logistic regression models, using SPSS v.16.0. p values <0.05 were considered as significant.

RESULTS
There were 66 (49.3%) females; 39 (29.1%) had CKD stages 2-4 (predialysis), 42 (31.3%) on hemodialysis (HD) and 53 (39.6%) on automated peritoneal dialysis (PD). Time from diagnosis was 26 months. Significant differences were observed in mean, systolic and diastolic blood pressure, C-peptide, triglycerides, and HDL-cholesterol as well as PON1/HDL-cholesterol ratio and SOD.

CONCLUSIONS
This study demonstrates that PON1 and SOD may be predictors for the presence of MetS in pediatric patients under treatment with peritoneal dialysis. The positive correlation observed in PON1/HDL-cholesterol ratio may reflect the protector effect of HDL-cholesterol in patients with CKD according with the modality of treatment.

Gómez-Díaz|Rita A|RA|
García-Bello|Juan Antonio|JA|
Mondragón-González|Rafael|R|
Díaz-Flores|Margarita|M|
Valladares-Salgado|Adán|A|
Gallardo|Juan Manuel|JM|
Talavera|Juan O|JO|
Wacher|Niels H|NH|


Landmark papers in cerebrovascular neurosurgery 2015.

Abstract: The management of cerebrovascular disease has advanced considerably in 2015. Five randomized control trials have firmly established the role of endovascular thrombectomy for ischemic strokes due to large vessel occlusion. The randomized trial of intraarterial treatment for acute ischemic stroke (MR CLEAN) (Berkhemer et al. NEJM 2015;372:11-20) was the first of a series on the topic. There was a total of 5 randomized controlled trials published showing benefit in terms of functional outcomes at 90days for mechanical thrombectomy including the Endovascular Therapy for Ischemic stroke with perfusion-imaging selection (EXTEND IA) (Campbell et al. NEJM 2015;372:1009-18), the Randomized assessment of rapid endovascular treatment of ischemic stroke (ESCAPE) (Goyal et al. NEJM 2015;372:1019-30) trials, the stent-retriever thrombectomy after IV t-PA is t-PA alone in stroke (SWIFT-PRIME) (Saver et al. NEJM 2015;372:2285-95), and the thrombectomy within 8h after symptom onset in Ischemic stroke (REVASCAT) trial (Jovin et al. NEJM 2015; 372:2296-306). Six-year results from randomized controlled Barrow Ruptured Aneurysm Trial (BRAT) found no significant difference in functional outcomes in patients ruptured aneurysms treated surgically clippings versus endovascular treatment (Spetzler et al. JNS 2015;123:609-17. The 10-year results of the International Subarachnoid Aneurysm trial (ISAT) reported similar mortality rates and good functional outcomes between clipped and coiled patients (Molyneux et al. Lancet 2015;385:691-7). We also discuss the impact of genome wide sequencing studies in familial aneurysms, the largest publication on stent assisted coiling and flow diverter for aneurysms and noteworthy papers relevant to Moyamoya and cavernous malformations (Yang et al. Neurosurgery 2015;77:241-7).

Moore|Justin M|JM|
Griessenauer|Christoph J|CJ|
Gupta|Raghav|R|
Adeeb|Nimer|N|
Patel|Apar S|AS|
Ogilvy|Christopher S|CS|
Thomas|Ajith J|AJ|

Cerebrovascular 2015 Endovascular Aneurysm Stoke


Replica state exchange metadynamics for improving the convergence of free energy estimates.

Abstract: Metadynamics (MTD) is a powerful enhanced sampling method for systems with rugged energy landscapes. It constructs a bias potential in a predefined collective variable (CV) space to overcome barriers between metastable states. In bias-exchange MTD (BE-MTD), multiple replicas approximate the CV space by exchanging bias potentials (replica conditions) with the Metropolis-Hastings (MH) algorithm. We demonstrate that the replica-exchange rates and the convergence of free energy estimates of BE-MTD are improved by introducing the infinite swapping (IS) or the Suwa-Todo (ST) algorithms. Conceptually, IS and ST perform transitions in a replica state space rather than exchanges in a replica condition space. To emphasize this, the proposed scheme is called the replica state exchange MTD (RSE-MTD). Benchmarks were performed with alanine polypeptides in vacuum and water. For the systems tested in this work, there is no significant performance difference between IS and ST.

metadynamics
free energy
enhanced sampling
infinite swapping
Metropolis-Hastings algorithm
Suwa-Todo algorithm


Delayed post-hypoxic leukoencephalopathy in an adult with COVID-19.

Abstract: As the novel coronavirus, SARS-CoV-2, has enveloped the world in a pandemic, it has become clear that the symptoms extend far beyond the respiratory system and have particularly caused a wide range of neurologic CNS complications, including diffuse leukoencephalopathy. Here, we describe a case of a 59-year-old male with severe COVID-19 infection who developed severe encephalopathy, which persisted well after his acute infection had subsided and had begun to improve from his respiratory dysfunction. He was found to have diffuse leukoencephalopathy with concomitant diffusion restriction on MR imaging. This case represents a delayed onset of leukoencephalopathy secondary to hypoxia in a small but growing cohort of COVID-related leukoencephalopathy due to similarities in imaging features and lack of superior alternate diagnosis. Patient's clinical improvement suggests reversibility with likely pathology being demyelination rather than infarction.

Vines|Brannon L|BL|0000-0003-2219-4865
Agnihotri|Shruti P|SP|

Coronavirus
SARS-CoV-2
Encephalopathy
Demyelination
White matter


Navigating School Reentry in Lung Transplant Recipients With Cystic Fibrosis.

Abstract: In addition to medical and psychological support, social support plays a key role in the success of lung transplant recipients, especially in children. An important component of that social support for pediatric lung transplant recipients is school reentry. These children face daily challenges, which often have to be addressed by the transplant team with little existing guidance in the medical literature. In this article, we discuss relevant practice issues for pediatric lung transplant recipients with cystic fibrosis including heightened concern for infection risk, bullying, school performance, and body image concerns. In addition to discussing these important issues, we provide recommendations based on our experiences.

Groh|Jaclyn D|JD|
Dempster|Nicole R|NR|
Cole|Tina|T|
Hayes|Don|D|0000-0002-6734-6052

school reentry
lung
transplantation
cystic fibrosis
pediatric


Efficacy and safety of lacosamide as an adjunctive therapy for refractory focal epilepsy in paediatric patients: a retrospective single-centre study.

Abstract:
AIM
Lacosamide is an antiepileptic drug approved for the treatment of focal epilepsy in adult patients. The aim of this observational study was to review our centre's experience with lacosamide and to characterize its effectiveness and tolerability as an adjunctive antiepileptic drug in a retrospective cohort of children with refractory focal epilepsy.

METHODS
We retrospectively reviewed the medical records of 22 patients who received lacosamide from November 2009 to April 2014 at the CHU Ste-Justine, University of Montreal. Treatment responders were defined as children with a ≥50% reduction in seizure frequency compared to baseline, and this was determined three months after the initiation of treatment and at the last follow-up visit.

RESULTS
We included 14 boys and eight girls with a mean age of 12.9 years (SD: 5.2; range: 5.2-20.7 years) at the initiation of treatment. The average length of follow-up was 11.9 months. Patients had previously received an average of 7.5 antiepileptic drugs. The mean number of concomitant antiepileptic drugs was 2.3. The mean initial and maintenance doses were 2.9 and 8.4 mg/kg/d, respectively. Thirteen (59%) and ten (45%) patients were responders after three months of treatment and at the last follow-up visit, respectively. One became seizure-free. Adverse effects were reported in 11 patients and none were severe. Responders and non-responders were identical with respect to all studied parameters except gender, with the proportion of responders being greater in girls than in boys (75% vs 29%; p=0.035).

CONCLUSION
Our study adds evidence that lacosamide appears to be a safe and effective adjunctive therapy for children with refractory focal epilepsy.

Toupin|Jean-François|JF| Lortie|Anne|A| Major|Philippe|P| Diadori|Paola|P| Vanasse|Michel|M| Rossignol|Elsa|E| D'Anjou|Guy|G| Perreault|Sebastien|S| Larbrisseau|Albert|A| Carmant|Lionel|L| Birca|Ala|A|

lacosamide
antiepileptic drug
treatment
pediatric patients
refractory epilepsy


Occult gastric cancer presenting as hypoxia from pulmonary tumor thrombotic microangiopathy.

Abstract: Pulmonary tumor thrombotic microangiopathy (PTTM) causing fatal pulmonary hypertension is a rare presentation of malignancy. In general, patients with PTTM rapidly succumb to death due to severe hypoxia. To date, very few cases of PTTM have been reported in the literature; and most of these cases were from gastric cancer and were diagnosed on post mortem autopsy, as it is extremely challenging to make an ante mortem diagnosis. We here report on a case of undiagnosed diffuse gastric cancer, presenting as worsening hypoxia. The clinical, radiographic, and echocardiographic features, and laboratory and pathological results were consistent with PTTM from gastric cancer. The patient was started on anticoagulation therapy, corticosteroids, and high-flow oxygen. However, her hypoxia worsened to the extent that she required ventilator support, and she died soon after intubation due to cardiac arrest. Since diffuse gastric cancer is associated with hereditary diffuse gastric cancer syndrome, cadherin 1 gene mutation analysis was performed to estimate the risk to her daughters. The test came back negative.

Mandaliya|Rohan|R| Farhat|Salman|S| Uprety|Dipesh|D| Balla|Mamtha|M| Gandhi|Apurva|A| Goldhahn|Richard|R| Auerbach|Herbert|H| Christensen|Chris|C| Reed|Conrad|C| Cohen|Sidney|S|


Is Rescuer Cardiopulmonary Resuscitation Jeopardised by Previous Fatiguing Exercise?

Abstract: Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuer's fatigue can compromise CPR delivery. We investigated the effect of a 100-m maximal run on CPR and physiological variables in 14 emergency medical technicians (age 29.2 ± 5.8 years, height 171.2 ± 1.1 cm and weight 73.4 ± 13.1 kg). Using an adult manikin and a compression-ventilation ratio of 30:2, participants performed 4-min CPR after 4-min baseline conditions (CPR) and 4-min CPR after a 100-m maximal run carrying emergency material (CPR-run). Physiological variables were continuously measured during baseline and CPR conditions using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and analyzed using two HD video cameras (Sony, HDR PJ30VE, Japan). Higher VO2 (14.4 ± 2.1 and 22.0 ± 2.5 mL·kg-1·min-1) and heart rate (123 ± 17 and 148 ± 17 bpm) were found for CPR-run. However, the compression rate was also higher during the CPR-run (373 ± 51 vs. 340 ± 49) and between every three complete cycles (81 ± 9 vs. 74 ± 14, 99 ± 14 vs. 90 ± 10, 99 ± 10 vs. 90 ± 10, and, 101 ± 15 vs. 94 ± 11, for cycle 3, 6, 9 and 12, respectively). Fatigue induced by the 100-m maximal run had a strong impact on physiological variables, but a mild impact on CPR emergency medical technicians' performance.

cardiopulmonary resuscitation
fatigue
physiology
oxygen uptake


Identification and Computational Analysis of Novel Pathogenic Variants in Pakistani Families with Diverse Epidermolysis Bullosa Phenotypes.

Abstract: Epidermolysis bullosa (EB) includes a group of rare gesnodermatoses that result in blistering and erosions of the skin and mucous membranes. Genetically, pathogenic variants in around 20 genes are known to alter the structural and functional integrity of intraepidermal adhesion and dermo-epidermal anchorage, leading to four different types of EB. Here we report the underlying genetic causes of EB phenotypes segregating in seven large consanguineous families, recruited from different regions of Pakistan. Whole exome sequencing, followed by segregation analysis of candidate variants through Sanger sequencing, identified eight pathogenic variants, including three novel (ITGB4: c.1285G>T, and c.3373G>A; PLEC: c.1828A>G) and five previously reported variants (COL7A1: c.6209G>A, and c.1573C>T; FERMT1: c.676insC; LAMA3: c.151insG; LAMB3: c.1705C>T). All identified variants were either absent or had very low frequencies in the control databases. Our in-silico analyses and 3-dimensional (3D) molecular modeling support the deleterious impact of these variants on the encoded proteins. Intriguingly, we report the first case of a recessively inherited form of rare EBS-Ogna associated with a homozygous variant in the PLEC gene. Our study highlights the clinical and genetic diversity of EB in the Pakistani population and expands the mutation spectrum of EB; it could also be useful for prenatal diagnosis and genetic counseling of the affected families.

Khan|Fehmida F|FF|
Khan|Naima|N|
Rehman|Sakina|S|0000-0003-2253-0750
Ejaz|Amir|A|
Ali|Uzma|U|
Erfan|Muhammad|M|
Ahmed|Zubair M|ZM|0000-0003-2914-4502
Naeem|Muhammad|M|0000-0002-3894-3085

epidermolysis bullosa
whole exome sequencing
ITGB4
PLEC
EBS-Ogna


Can interpersonal contact help improve attitudes toward soldiers with intellectual disability? An Israeli study.

Abstract:
BACKGROUND
It has been argued that interpersonal contact is the best intervention for reducing negative attitudes and discrimination toward individuals with intellectual disabilities (ID). In Israel, the Equal in Uniform project makes it possible for individuals with ID to serve alongside soldiers without ID in ordinary military units in the Israeli Defense Forces. The project provided the opportunity to examine the effect of contact on the attitudes of soldiers without ID.

METHODS
Data analyses are based on data collected from 220 soldiers without ID via a self-administered questionnaire based on the Multidimensional Attitudes Scale. Of these, 138 were in contact with soldiers with ID as part of the project.

RESULTS
A mediation model showed that the impact of contact with a soldier with ID on withdrawal behaviour was mediated by cognitive attributions and negative affect. Contact was directly associated with prosocial behaviour.

DISCUSSION
Results support the importance of contact between soldiers with and without ID to bring about improved attitudes toward the former.

military
withdrawal
behaviours
prosocial
social distance


Food consumption, meat cooking methods and diet diversity and the risk of bladder cancer.

Abstract:
BACKGROUND
Since food metabolites are eliminated by the urinary tract, several studies have investigated the association between diet and bladder cancer risk. Recently, the World Cancer Research Fund International/American Institute for Cancer Research (WCRF/AICR) suggested a potential beneficial effect of some foods (mainly vegetables, fruit, and milk) in the development of bladder cancer. We investigated the association between food groups and bladder cancer risk, seeking insights into food diversity as well as meat cooking methods.

METHODS
Data were derived from an Italian multicentre case-control study, conducted between 2003 and 2014, including 690 bladder cancer cases and 665 frequency-matched controls. Odds ratios (ORs) and the corresponding 95% confidence intervals (95%CIs) for various dietary aspects were estimated by unconditional logistic regression models adjusted for energy intake and the major known risk factors for bladder cancer.

RESULTS
Comparing the highest versus the lowest quartiles, consumption of vegetables (OR = 0.62; 95%CI: 0.44-0.88) and milk/yogurt (OR = 0.62; 95%CI: 0.44-0.87) reduced the risk of bladder cancer. Conversely, consumption of meat increased bladder cancer risk with an OR of 1.57 (95%CI: 1.07-2.31), particularly when the meat was stewed (OR = 1.47; 95%CI: 1.03-2.09) or roasted (OR = 1.41; 95%CI: 1.00-1.99). There was a suggestion that a diversified diet reduced the risk of bladder cancer, but this was not significant.

CONCLUSIONS
Our study consolidates the role of diet in bladder cancer aetiology, showing a reduced risk for vegetable and milk/yogurt consumption and an increased risk for meat consumption, especially when the meat is stewed or roasted.

Di Maso|Matteo|M|
Turati|Federica|F|
Bosetti|Cristina|C|
Montella|Maurizio|M|
Libra|Massimo|M|
Negri|Eva|E|
Ferraroni|Monica|M|
La Vecchia|Carlo|C|
Serraino|Diego|D|
Polesel|Jerry|J|

Meat cooking methods
Diet diversity
Bladder cancer
Food groups
Case–control study


"Not Just One, It's Both of Us": Low-Income Mothers' Perceptions of Structural Family Therapy Delivered in a Semi-rural Community Mental Health Center.

Abstract: Qualitative methods were used to explore mothers' perceptions of structural family therapy (SFT) delivered in a semi-rural community mental health clinic. In-depth, semi-structured interviews were conducted with sixteen mothers who received SFT after seeking services for their children. Thematic analysis suggests mothers found SFT acceptable and valuable. Mothers reported using SFT strategies to regain parental authority, which they believed improved their ability to manage their child's needs and decreased their own stress. SFT also increased some mothers' receptivity to individual treatment. Mothers identified their low dose of treatment and lack of father involvement as impediments to improvement, raising concerns about intervention sustainability.

Weaver|Addie|A|0000-0002-6865-3740
Greeno|Catherine G|CG|
Fusco|Rachel|R|
Zimmerman|Tina|T|
Anderson|Carol M|CM|

Qualitative methods
High-risk families
Maternal treatment engagement
Treatment acceptability


Serum sickness-like reactions in Iranian children: a registry-based study in a referral center.

Abstract:
INTRODUCTION AND OBJECTIVES
Considering that no studies have been done on a comprehensive review of Serum sickness-like reactions patients (SSLRs) at a referral center in Iran so far, this study aimed to determine the clinical and laboratory characteristics of children with SSRL in Tehran Children's Medical Center.

PATIENTS
The present study was a registry-based study in which the data of 94 SSLRs patients registered in a two-year period were investigated. Confirmation of fever, rash, urticaria, arthralgia / arthritis and history of antibiotic consumption up to three weeks before were the criteria for the diagnosis.

RESULTS
Fifty-one (54 %) patients were male with mean age of 56 ± 30 months and there was no significant difference in the age of the two genders. The mean onset of symptoms before hospitalization were 3.8 ± 2.7 days (1-14 days); this mean was significantly higher in males than in females (4.6 ± 2.9 versus 2.9 ± 1.7 days, P-value = 0.003). Among antibiotics, Co-amoxiclav and Cefixime antibiotics had the most frequency by 31 % and 33 %, respectively as the most important incidence factor of SSLRs. The mean duration of consumption of culprit medications in the incidence of SSLRs was 5.6 ± 2.9 days with a range of 1-15 days.

CONCLUSIONS
This study showed that among the antibiotics, Co-amoxiclav and Cefixime are more prevalent and a review of prescribing these two antibiotics for the treatment of the children's infections is essential if this finding is confirmed by other Iranian scholars.

Mohsenzadeh|Azam|A| Movahedi|Masoud|M| Saatchi|Mohammad|M| Parvaneh|Nima|N| Shariat|Mansoureh|M| Aghamohammadi|Asghar|A| Gharagozlou|Mohammad|M|

serum sickness-like reactions
Iranian children
Antibiotics


Interprofessional Perceptions and Attitudes Among Pharmacy and Family Nurse Practitioner Students.

Abstract:
INTRODUCTION
Interprofessional education (IPE) activities involving pharmacy (PharmD) and family nurse practitioner (FNP) students is understudied. Interactions between PharmD and FNP students have become important since most recent Accreditation Council for Pharmacy Education standards included a requirement for schools of pharmacy to have IPE. The primary objective of this study is to evaluate the perceptions and attitudes among PharmD and FNP students towards an IPE activity.

METHODS
Atleast 1 student from each discipline was assigned to one team and participated in simulated ambulatory care scenarios. A survey was completed by students after the activity, which mapped each survey statement to an Interprofessional Education Collaborative (IPEC) core competency.

RESULTS
Perceptions and attitudes between PharmD and FNP students were similar, with no significant differences except with 2 statements, one survey statement in the Teams and Teamwork core competency and another in the Roles/Responsibilities core competency. A less favorable response with more than half of FNP students reporting "strongly agree" (18%) and "agree" (35%) resulted for the statement regarding their professional roles in the IPE activity.

CONCLUSION
PharmD and FNP students reported favorable perceptions and attitudes in each IPEC core competency after participation in the IPE activity. There may be a need to review the discipline's professional role before participating in the activity.

Vinluan|Celeste M|CM|
Verdell|Amber|A|
Ibarra|Claudia|C|
Giri|Namita|N|
Thai|Diem|D|

pharmacy
family nurse practitioner
student
interprofessional education


Melanin and humic acid-like polymer complex from olive mill waste waters. Part I. Isolation and characterization.

Abstract: A water soluble humic acid and melanin-like polymer complex (OMWW-ASP) was isolated from olive mill waste waters (OMWW) by ammonium sulfate fractionation to be used as natural additive in food preparations. The dark polymer complex was further characterized by a variety of biochemical, physicochemical and spectroscopic techniques. OMWW-ASP is composed mainly of proteins associated with polyphenols and carbohydrates and the distribution of its relative molecular size was determined between about 5 and 190 kDa. SDS-PAGE shows the presence of a well separated protein band of 21.3 kDa and a low molecular weight peptide. The OMWW-ASP complex exhibits a monotonically increasing UV-Vis absorption spectrum and it contains stable radicals. Antioxidant activity measurements reveal the ability of the OMWW protein fraction to scavenge both the cationic 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS(+)) radical, as well as the stable nitroxide free radical 4-hydroxy-2,2,6,6-tetramethylpiperidine 1-oxyl (TEMPOL).

Khemakhem|Maissa|M|
Papadimitriou|Vassiliki|V|
Sotiroudis|Georgios|G|
Zoumpoulakis|Panagiotis|P|
Arbez-Gindre|Cécile|C|
Bouzouita|Nabiha|N|
Sotiroudis|Theodore G|TG|

Melanin
Ammonium sulfate fractionation
Humic acid size measurements
Oil mill waste water
Scavenging activity
Spectroscopic characterization


Cluster of ulceroglandular tularemia cases in Slovenia.

Abstract: In Slovenia, a small Central European country, where tularemia cases are very rare and mostly sporadic, six cases of ulceroglandular tularemia were recognised in 2012-2013 in patients residing in or visiting a small geographical area of <6km2. Epidemiological data indicated transmission by a tick bite in at least 3/6 patients.

Rojko|Tereza|T| Korva|Miša|M| Lotrič-Furlan|Stanka|S| Strle|Franc|F| Avšič-Županc|Tatjana|T|

Cluster
Tularemia
Slovenia
Ticks
Francisella tularensis


A novel cross-linked enzyme aggregates (CLEAs) of papain and neutrase-production, partial characterization and application.

Abstract: The neutrase (EC 3.4.24.4) and papain (EC 3.4.22.2) were together immobilized ascross-linked enzyme aggregates (N-P-CLEAs) and their properties were characterized. The influence of the precipitant, cross-linking ratio of glutaraldehyde and cross-linking time were investigated. Ethanol was selected as the more efficient precipitant compared with ammonium sulfate. The proper cross-linking ratio of enzyme and glutaraldehyde was 1:5 (v/v) and the optimized cross-linking time was 4h. N-P-CLEAs showed obvious improvement in thermal stability and pH stability than the free enzyme (P<0.05) and could hold relatively high activity retention in nonpolar and hydrophilic solvents and without activity loss at 4°C for more than six months. The cross-linking reaction had been appeared in N-P-CLEAs and more orderly microscopic surface morphology of N-P-CLEAs was observed. The molecular weight and thermal denaturation temperature of N-P-CLEAs were increased while the isoelectric point was decreased compared with those of the free enzymes. Application of N-P-CLEAs in bean proteins and zein showed a higher degree of hydrolysis, such as the hydrolysis degree of mung bean protein hydrolyzed by N-P-CLEAs was 12%, increased by approximately 4.5% compared to that of free enzyme. The results demonstrated that the N-P-CLEAs was suitable for application in food protein hydrolysis.

Chen|Zhongqin|Z| Wang|Yanwei|Y| Liu|Wei|W| Wang|Jingya|J| Chen|Haixia|H|

Cross-linked enzyme aggregates (CLEAs)
Papain
Characterization
Neutrase
Protein hydrolysis


Spinal Cord Hemorrhage.

Abstract:
BACKGROUND AND PURPOSE
Spinal cord hemorrhages are rare conditions that can be classified based on the primary location of bleeding into intramedullary (hematomyelia), subarachnoid hemorrhage (SAH), subdural hemorrhage, and epidural hemorrhage. We conducted a literature review to better understand the presenting symptoms, etiology, diagnosis, and treatment of spinal cord hemorrhages.

METHODS
We performed a literature search using PubMed with the key words spinal hemorrhage, hematomyelia, spinal subarachnoid hemorrhage, spinal subdural hematoma, and spinal epidural hematoma RESULTS: Most commonly, spinal hematomas present with acute onset of pain and myelopathy but a more insidious course also may occur. Spinal SAH may be especially difficult as it may cause cerebral symptoms. The etiologies vary based on the type (location). The most common causes are trauma, iatrogenic causes, vascular malformations, and bleeding diatheses. Management is often aimed toward rapid surgical decompression and correction of the underlying etiology if possible. Conservative management, including administration of large doses of corticosteroids, reversal of anticoagulation, and close monitoring, has been used as bridging for surgical procedure or as the mainstay of treatment for patients with mild or improving symptoms.

CONCLUSIONS
The variable and overlapping presentations of spinal cord hemorrhages make the diagnosis challenging. Maintaining high levels of clinical suspicion and utilizing magnetic resonance imaging may help in making the right diagnosis. Future studies should aim to create standardized outcome grading system and management guidelines for patients with spinal hemorrhage.

Shaban|Amir|A|
Moritani|Toshio|T|
Al Kasab|Sami|S|
Sheharyar|Ali|A|
Limaye|Kaustubh S|KS|
Adams|Harold P|HP|

Spinal cord
hemorrhage
hematomyelia
subarachnoid hemorrhage
subdural hematoma
vascular malformations
anticoagulation


Molecular dynamics simulations of mutated Mycobacterium tuberculosis L-alanine dehydrogenase to illuminate the role of key residues.

Abstract: L-Alanine dehydrogenase from Mycobacterium tuberculosis (L-MtAlaDH) catalyzes the NADH-dependent interconversion of l-alanine and pyruvate, and it is considered to be a potential target for the treatment of tuberculosis. The experiment has verified that amino acid replacement of the conserved active-site residues which have strong stability and no great changes in biological evolutionary process, such as His96 and Asp270, could lead to inactive mutants [Ågren et al., J. Mol. Biol. 377 (2008) 1161-1173]. However, the role of these conserved residues in catalytic reaction still remains unclear. Based on the crystal structures, a series of mutant structures were constructed to investigate the role of the conserved residues in enzymatic reaction by using molecular dynamics simulations. The results show that whatever the conserved residues were mutated, the protein can still convert its conformation from open state to closed state as long as NADH is present in active site. Asp270 maintains the stability of nicotinamide ring and ribose of NADH through hydrogen bond interactions, and His96 is helpful to convert the protein conformation by interactions with Gln271, whereas, they would lead to the structural rearrangement in active site and lose the catalytic activity when they were mutated. Additionally, we deduce that Met301 plays a major role in catalytic reaction due to fixing the nicotinamide ring of NADH to prevent its rotation, and we propose that Met301 would be mutated to the hydrophobic residue with large steric hindrance in side chain to test the activity of the protein in future experiment.

Ling|Baoping|B| Bi|Siwei|S| Sun|Min|M| Jing|Zhihong|Z| Li|Xiaoping|X| Zhang|Rui|R|

D050788:Alanine Dehydrogenase
D006860:Hydrogen Bonding
D008958:Models, Molecular
D056004:Molecular Dynamics Simulation
D009169:Mycobacterium tuberculosis
D011487:Protein Conformation
D013816:Thermodynamics

Molecular dynamics simulations
Mycobacterium tuberculosis
l-Alanine dehydrogenase
Essential dynamics analysis
Mutated residues


Isoleucine 44 Hydrophobic Patch Controls Toxicity of Unanchored, Linear Ubiquitin Chains through NF-κB Signaling.

Abstract: Ubiquitination is a post-translational modification that regulates cellular processes by altering the interactions of proteins to which ubiquitin, a small protein adduct, is conjugated. Ubiquitination yields various products, including mono- and poly-ubiquitinated substrates, as well as unanchored poly-ubiquitin chains whose accumulation is considered toxic. We previously showed that transgenic, unanchored poly-ubiquitin is not problematic in Drosophila melanogaster. In the fruit fly, free chains exist in various lengths and topologies and are degraded by the proteasome; they are also conjugated onto other proteins as one unit, eliminating them from the free ubiquitin chain pool. Here, to further explore the notion of unanchored chain toxicity, we examined when free poly-ubiquitin might become problematic. We found that unanchored chains can be highly toxic if they resemble linear poly-ubiquitin that cannot be modified into other topologies. These species upregulate NF-κB signaling, and modulation of the levels of NF-κB components reduces toxicity. In additional studies, we show that toxicity from untethered, linear chains is regulated by isoleucine 44, which anchors a key interaction site for ubiquitin. We conclude that free ubiquitin chains can be toxic, but only in uncommon circumstances, such as when the ability of cells to modify and regulate them is markedly restricted.

Blount|Jessica R|JR|
Libohova|Kozeta|K|
Silva|Gustavo M|GM|
Todi|Sokol V|SV|0000-0003-4399-5549

ubiquitination
NF-κB signaling
unanchored poly-ubiquitin
Drosophila melanogaster
innate immunity


Intratumoral hemorrhage because of primary spinal mixed germ cell tumor presenting with atypical radiological features in an adult.

Abstract:
BACKGROUND CONTEXT
Germ cell tumors are known to arise in the central nervous system, usually in the intracranial regions. However, primary spinal mixed germ cell tumors are extremely rare.

PURPOSE
This is the first reported case of intratumoral hemorrhage because of a primary spinal mixed germ cell tumor consisting of germinoma and immature teratoma in the conus medullaris of an adult patient that presented with rapid changes on magnetic resonance image (MRI). We report this rare case and discuss the clinical manifestations of an intramedullary spinal mixed germ cell tumor in adult.

STUDY DESIGN
A case report.

METHODS
A 42-year-old woman experienced buttock numbness, and a spinal cord tumor was observed on the conus medullaris on MRI. The patient was scheduled for an operation in 1 month, but she developed sudden-onset neurologic deterioration. Rapid progression of the tumor was observed on follow-up MRI. The tumor was removed by emergency surgery and was identified as a primary mixed germinoma and immature teratoma.

RESULTS
The patient received adjuvant chemotherapy and radiotherapy after gross total resection. The neurologic deficit of the patient was relieved, and recurrence of the tumor was not observed 26 months after the surgery.

CONCLUSIONS
We present this rare case and emphasize the necessity of precise diagnosis and early treatment of primary spinal germ cell tumor. Close observation on MRI is required after surgery, and adjuvant chemotherapy and radiotherapy should be considered according to the pathologic features.

Yamamoto|Junkoh|J| Takahashi|Mayu|M| Nakano|Yoshiteru|Y| Saito|Takeshi|T| Kitagawa|Takehiro|T| Ueta|Kunihiro|K| Miyaoka|Ryo|R| Nakamura|Eiichiro|E| Nishizawa|Shigeru|S|

D009373:Neoplasms, Germ Cell and Embryonal

Intratumoral hemorrhage
Germinoma
Immature
Teratoma
Spinal cord tumor


Advanced glycation end products as a biomarker for incisional hernia.

Abstract:
BACKGROUND
Incisional hernia is one of the most frequent complications after abdominal surgery, with incidences up to 30%. A reliable biomarker for the prediction of this complication is lacking. Advanced glycosylation end products (AGEs), also known as non-enzymatic collagen crosslinks, are correlated with aging, smoking, hyperglycemia, hyperlipidemia and oxidative stress. In this study the accumulation of AGEs and the relation between AGEs and incisional hernia were investigated.

MATERIALS AND METHODS
In an exploratory case-control study, 23 patients with incisional hernia after midline incision were compared with 17 patients without clinical or radiological signs of incisional hernia after midline incision, AGEs were measured using a Skin Auto Fluorescence (SAF)-reader.

RESULTS
Twenty-three patients with a clinically significant incisional hernia and 17 control patients were included. The study groups had significant differences in mean BMI. There was a significant difference between mean AGEs in patients with and without incisional hernia after midline incision (3.00 ± 0.15 vs. 2.56 ± 0.11, T test p = 0.03).

CONCLUSION
AGE accumulation measured in the skin indirectly with autofluorescence might be associated with incisional hernia. Prospective larger trials should confirm this finding.

Harlaar|J J|JJ|
Eker|H H|HH|
Vakalopoulos|K A|KA|
Cabezas|M C|MC|
van der Ham|A C|AC|
Vrijland|W W|WW|
Jeekel|J|J|
Lange|J F|JF|

D017127:Glycation End Products, Advanced

Biomarker
Incisional hernia
Advanced glycation endproducts
Collagen cross links


Across all solid organs, adolescent age recipients have worse transplant organ survival than younger age children: A US national registry analysis.

Abstract: Univariate analyses suggest that adolescents have worse long-term allograft survival versus younger children across different SOT. This study's objective was to determine whether multivariate analyses of a large national database recording all deceased SOT (KI; LI; HR; LU) also show worse adolescent allograft survival in the different organs. Using data from the national Scientific Registry for Transplant Recipients in the USA for pediatric primary SOT from 1989 to 2010, we calculated median half-lives and constructed K-M graft survival curves. Recipient age at transplant (<12 or adolescent 12-17 yr) was fitted with other identical covariates into multivariate Cox proportional hazards models. In all SOT recipients, unadjusted graft survival curves demonstrated better graft survival for adolescents initially, followed by crossing of the lines, such that adolescent SOT recipients had worse survival after one yr (KI), 4.6 yr (LI), 4.4 yr (HR), and 1.6 yr (LU). Multivariate models of the post-cross period showed a significantly higher AHR for worse graft survival in adolescent age across all four SOTs: AHR 1.400 (KI), 1.958 (LI), 1.414 (HR), and 1.576 (LU). Improving adolescent long-term outcomes across all four organs will be a defining issue in the future.

Dharnidharka|Vikas R|VR|
Lamb|Kenneth E|KE|
Zheng|Jie|J|
Schechtman|Kenneth B|KB|
Meier-Kriesche|Herwig-Ulf|HU|

adolescents transplant heart kidney liver lung


TALKING ABOUT TEETH: EGOCENTRIC NETWORKS AND ORAL HEALTH OUTCOMES IN A MEXICAN AMERICAN IMMIGRANT COMMUNITY.

Abstract: Latinos in the United States have poor outcomes for periodontal and dental health. However, a detailed description of the mechanisms driving these patterns has only recently started to be addressed in the literature. In the current study, we explore relationships between individual-level characteristics of Mexican immigrants, properties of their networks, and experiences of dental problems. Specifically, using data from an urban community of Mexican immigrants to the American Midwest (n = 332), this study examines how characteristics of oral health matters (OHM) discussion networks and individual-level sociodemographic characteristics are associated with four adverse oral health outcomes. The results provide strong support for relationships between immigrants' network characteristics and dental problems. We find that people with more dental problems talk about these issues more frequently with network ties. Conversely, stronger relationships with OHM discussion networks, as measured by mean closeness, are predictive of fewer dental problems. In addition, we identify a link between perceptions of alters' knowledge about teeth, mouth, and gums and egos reporting better oral health outcomes. The observed patterns are suggestive of mechanisms of social influence that are well replicated in the social, medical, and public health literatures, but that have seldom been empirically tested in the domain of oral health. Though preliminary, our findings suggest a potential explanatory role for social networks in some of the most important questions and problems in oral health disparities research. In all, our findings suggest that social network members are active participants in the management and response to oral health problems in this immigrant group and should be considered an important factor in the development and course of diseases.

Pullen|Erin|E|
Perry|Brea L|BL|
Maupome|Gerardo|G|

oral health
Social networks
health disparities
Latino immigrants
immigrant health


Vitamin C Activates Osteoblastogenesis and Inhibits Osteoclastogenesis via Wnt/β-Catenin/ATF4 Signaling Pathways.

Abstract: This study evaluated the effects of vitamin C on osteogenic differentiation and osteoclast formation, and the effects of vitamin C concentration on bone microstructure in ovariectomized (OVX) Wistar rats. Micro-computed tomography analysis revealed the recovery of bone mineral density and bone separation in OVX rats treated with vitamin C. Histomorphometrical analysis revealed improvements in the number of osteoblasts, osteoclasts, and osteocytes; the osteoblast and osteoclast surface per bone surface; and bone volume in vitamin C-treated OVX rats. The vitamin C-treated group additionally displayed an increase in the expression of osteoblast differentiation genes, including bone morphogenetic protein-2, small mothers against decapentaplegic 1/5/8, runt-related transcription factor 2, osteocalcin, and type I collagen. Vitamin C reduced the expression of osteoclast differentiation genes, such as receptor activator of nuclear factor kappa-B, receptor activator of nuclear factor kappa-B ligand, tartrate-resistant acid phosphatase, and cathepsin K. This study is the first to show that vitamin C can inhibit osteoporosis by promoting osteoblast formation and blocking osteoclastogenesis through the activation of wingless-type MMTV integration site family/β-catenin/activating transcription factor 4 signaling, which is achieved through the serine/threonine kinase and mitogen-activated protein kinase signaling pathways. Therefore, our results suggest that vitamin C improves bone regeneration.

Choi|Hyeon Kyeong|HK|
Kim|Gyeong-Ji|GJ|
Yoo|Han-Seok|HS|
Song|Da Hye|DH|
Chung|Kang-Hyun|KH|
Lee|Kwon-Jai|KJ|
Koo|Young Tae|YT|
An|Jeung Hee|JH|

D051701:Activating Transcription Factor 4

Vitamin C
osteoclasts
osteoblasts
osteoporosis
ovariectomized rats


Gold Nanorods, DNA Origami, and Porous Silicon Nanoparticle-functionalized Biocompatible Double Emulsion for Versatile Targeted Therapeutics and Antibody Combination Therapy.

Abstract: Gold nanorods, DNA origami, and porous silicon nanoparticle-functionalized biocompatible double emulsion are developed for versatile molecular targeted therapeutics and antibody combination therapy. This advanced photothermal responsive all-in-one biocompatible platform can be easily formed with great therapeutics loading capacity for different cancer treatments with synergism and multidrug resistance inhibition, which has great potential in advancing biomedical applications.

Kong|Feng|F|
Zhang|Hongbo|H|
Qu|Xiangmeng|X|
Zhang|Xu|X|
Chen|Dong|D|
Ding|Ruihua|R|
Mäkilä|Ermei|E|
Salonen|Jarno|J|
Santos|Hélder A|HA|
Hai|Mingtan|M|

DNA origami
multidrug resistance inhibition
biomedical applications
drug delivery
silicon nanoparticles


MITF Regulates Downstream Genes in Response to Vibrio parahaemolyticus Infection in the Clam Meretrix Petechialis.

Abstract: The microphthalmia-associated transcription factor (MITF) is a basic helix-loop-helix-leucine zipper protein that plays a key role in cell proliferation, survival and immune defense through the direct transcriptional control of downstream genes. We have found that MITF participates in the immune response to Vibrio parahaemolyticus infection in the clam Meretrix petechialis. In this study, we focused on how MITF functions in immunity. First, PO, CTSK, and BCL-2 were identified as the target genes of MpMITF in the clam by RNAi. EMSAs showed direct binding between the MpMITF protein and the E-box of the MpPO, MpCTSK, and MpBCL-2 promoters. Yeast one-hybrid assays also suggested that MpMITF could activate the expression of these three downstream genes. These results demonstrated that the transcriptional expression of MpPO, MpCTSK, and MpBCL-2 is directly regulated by MpMITF. Second, we analyzed the roles of MpPO, MpCTSK, and MpBCL-2 in clam immunity. The mRNA expression of MpPO, MpCTSK, and MpBCL-2 increased significantly after V. parahaemolyticus challenge, which implied that these genes might take part in the immune defense against V. parahaemolyticus challenge in clams. The purified recombinant proteins, MpPO and MpCTSK, inhibited the growth of V. parahaemolyticus. Additionally, the apoptosis rate of clam haemocytes rose significantly when the activity of MpBCL-2 was suppressed. These results revealed that MpPO, MpCTSK, and MpBCL-2 are involved in the immune defense against V. parahaemolyticus. This study supports the idea that the MpMITF pathway plays a key role in immune defense through the direct regulation of the downstream genes MpPO, MpCTSK, and MpBCL-2 in the clam, M. petechialis.

Zhang|Shujing|S| Yue|Xin|X| Yu|Jiajia|J| Wang|Hongxia|H| Liu|Baozhong|B|

MITF
Vibrio parahaemolyticus
clam
immune response
signaling pathway


Salidroside - Can it be a Multifunctional Drug?

Abstract:
BACKGROUND
Salidroside is a glucoside of tyrosol found mostly in the roots of Rhodiola spp. It exhibits diverse biological and pharmacological properties. In the last decade, enormous research is conducted to explore the medicinal properties of salidroside; this research reported many activities like anti-cancer, anti-oxidant, anti-aging, anti-diabetic, anti-depressant, anti-hyperlipidemic, anti-inflammatory, immunomodulatory, etc. Objective: Despite its multiple pharmacological effects, a comprehensive review detailing its metabolism and therapeutic activities is still missing. This review aims to provide an overview of the metabolism of salidroside, its role in alleviating different metabolic disorders, diseases and its molecular interaction with the target molecules in different conditions. This review mostly concentrates on the metabolism, biological activities and molecular pathways related to various pharmacological activities of salidroside.

CONCLUSION
Salidroside is produced by a three-step pathway in the plants with tyrosol as an intermediate molecule. The molecule is biotransformed into many metabolites through phase I and II pathways. These metabolites, together with a certain amount of salidroside may be responsible for various pharmacological functions. The salidroside based inhibition of PI3k/AKT, JAK/ STAT, and MEK/ERK pathways and activation of apoptosis and autophagy are the major reasons for its anti-cancer activity. AMPK pathway modulation plays a significant role in its anti-diabetic activity. The neuroprotective activity was linked with decreased oxidative stress and increased antioxidant enzymes, Nrf2/HO-1 pathways, decreased inflammation through suppression of NF-κB pathway and PI3K/AKT pathways. These scientific findings will pave the way to clinically translate the use of salidroside as a multi-functional drug for various diseases and disorders in the near future.

Magani|Sri Krishna Jayadev|SKJ|
Mupparthi|Sri Durgambica|SD|
Gollapalli|Bhanu Prakash|BP|
Shukla|Dhananjay|D|
Tiwari|A K|AK|
Gorantala|Jyotsna|J|
Yarla|Nagendra Sastry|NS|
Tantravahi|Srinivasan|S|

Salidroside
tyrosol
4-hydroxyphenyl acetaldehyde (4-HPAA)
cancer
diabetis
glucronidation


An Aplysia-like synaptic switch for rapid protection against ethanol-induced synaptic inhibition in a mammalian habit circuit.

Abstract: Decades of work in Aplysia californica established the general rule that principles of synaptic plasticity and their molecular mechanisms are evolutionarily conserved from mollusks to mammals. However, an exquisitely sensitive, activity-dependent homosynaptic mechanism that protects against the depression of neurotransmitter release in Aplysia sensory neuron terminals has, to date, not been uncovered in other animals, including mammals. Here, we discover that depression at a mammalian synapse that is implicated in habit formation and habit learning acceleration by ethanol, the fast-spiking interneuron (FSI) to medium spiny principal projection neuron (MSN) synapse of the dorsolateral striatum, is subject to this type of synaptic protection. We show that this protection against synaptic depression is calcium- and PDZ domain interaction-dependent. These findings support activity dependent protection against synaptic depression as an Aplysia-like synaptic switch in mammals that may represent a leveraging point for treating alcohol use disorders.

Patton|Mary H|MH|
Padgett|Katherine E|KE|
McKeon|Paige N|PN|
Lu|Shao-Gang|SG|
Abrams|Thomas W|TW|
Mathur|Brian N|BN|

D002492:Central Nervous System Depressants

FSI
MSN
Striatum
Alcohol
Delta opioid receptor
LTD
PKA
PKC
Parvalbumin


Positive and negative influences of social participation on physical and mental health among community-dwelling elderly aged 65-70 years: a cross-sectional study in Japan.

Abstract:
BACKGROUND
Although numerous investigations have indicated that social participation (SP) has positive effects on the health of older adults, there have been few studies on its negative health consequences. We examined the cross-sectional associations of the type, frequency, and autonomy for SP with physical and mental health.

METHODS
The analytical subjects were 5126 males and 7006 females who were functionally independent, born between 1945 and 1949, and covered by A City's medical insurance system. Physical and mental health were measured using the SF-8 Health Survey. SP was measured through six types of social groups. These social groups included volunteer groups, sports groups, hobby clubs, senior citizens' clubs, neighborhood community associations, and cultural groups. Analysis of covariance was conducted to compare adjusted physical health component summary scores (PCS) and mental health component summary scores (MCS) by the frequency and autonomy of SP. Age, family size, body mass index, chronic conditions, smoking, alcohol intake, depression and cognitive functioning were included as covariates. To examine whether the associations between SP and PCS/MCS are different between genders, we performed analyses stratified by gender.

RESULTS
Overall, positive associations of the frequency and autonomy of SP with PCS and MCS were stronger in females than males. As to frequency, frequent participation in sports groups and hobby clubs had significantly better PCS among both genders and better MCS among females than non-participation. None of the groups differed significantly in the MCS among males. As to autonomy, among both genders, voluntary participation in sports groups and hobby clubs had significantly better PCS than non-participation, and better MCS than not only non-participation, but also obligatory participation. Among females, obligatory participation in all groups had significantly poorer MCS than voluntary participation, and obligatory participation in sports groups had significantly poorer MCS than non-participation.

CONCLUSIONS
Obligatory SP had significantly poorer MCS than voluntary participation, occasionally than non-participation; there is a possibility that obligatory SP has harmful influences on mental health of community-dwelling elderly. Measures to promote SP with consideration for individuals' autonomy may be effective in the public health approach to maintaining mental health.

Social participation
Mental health
Elderly
Autonomy
Physical health
Gender differences


A successful hybrid emergency medicine postgraduate partnership in Southern Africa.

Abstract: Emergency Medicine (EM) development is established worldwide and fast developing in Sub-Saharan Africa. Medical specialty development requires multiple human resources and logistics which are frequently not available in LMICs. This article describes an innovative hybrid EM specialization program in Botswana that involved partnership with a neighbouring country in Sub-Saharan Africa. Many initial problems challenged its development, but significant local and regional support led to success. Botswana graduated its first three EM specialists in 2018 and now has an ongoing and sustainable EM program. This regional partnership resulted in numerous academic, research and clinical EM developments for Botswana and SA. UB-UCT EM training Partnership Model is a novel and sustainable cross- African collaboration with significant benefits for both health systems as well as for the individual trainees. This hybrid arrangement should be considered by other LMICs looking for EM specialty training and development.

Emergency Medicine
Botswana
Education
Medical education
South Africa


The effects and safety of omega-3 fatty for acute lung injury: a systematic review and meta-analysis.

Abstract:
BACKGROUND
Several randomized controlled trials (RCTs) have compared the treatment of acute lung injury (ALI) with omega-3 fatty, yet the results remained inconsistent. Therefore, we attempted this meta-analysis to analyze the role of omega-3 fatty in the treatment of ALI patients.

METHODS
We searched PubMed databases from inception date to October 31, 2019, for RCTs that compared the treatment of ALI with or without omega-3 fatty. Two authors independently screened the studies and extracted data from the published articles. Summary mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome by fixed- or random-effects model.

RESULTS
Six RCTs with a total of 277 patients were identified, of whom 142 patients with omega-3 fatty acid treatment and 135 patients without omega-3 fatty treatment. Omega-3 fatty treatments significantly improve the PaO2 (MD = 13.82, 95% CI 8.55-19.09), PaO2/FiO2 (MD = 33.47, 95% CI 24.22-42.72), total protein (MD = 2.02, 95% CI 0.43-3.62) in ALI patients, and omega-3 fatty acid treatments reduced the duration of mechanical ventilation (MD = - 1.72, 95% CI - 2.84 to - 0.60) and intensive care unit stay (MD = - 1.29, 95% CI - 2.14 to - 0.43) in ALI patients.

CONCLUSIONS
Omega-3 fatty can effectively improve the respiratory function and promote the recovery of ALI patients. Future studies focused on the long-term efficacy and safety of omega-3 fatty use for ALI are needed.

Huang|Zhongjie|Z| Zheng|Jianming|J| Huang|Wencheng|W| Yan|Meihao|M| Hong|Liyue|L| Hong|Yuancheng|Y| Jin|Runnv|R| Huang|Xincheng|X| Fan|Hongtao|H| Chen|Huiling|H| Yang|Heping|H| Su|Weiping|W| Huang|Xiaoping|X|

D055371:Acute Lung Injury
D015525:Fatty Acids, Omega-3
D006801:Humans
D007362:Intensive Care Units
D011379:Prognosis
D012121:Respiration, Artificial

Omega-3 fatty
Acute lung injury
Review
Meta-analysis
Treatment


Oral Health Status of Male Swedish Citizens at Admission to Prison.

Abstract: The aim of the study was to describe oral health status as well as risk factors related to the oral health in a prison inmate population at admission. A sample of 186 men admitted to one of Sweden's prisons were examined and interviewed to collect information. The results indicate a high prevalence of untreated oral disease and oral health risk factors in the sample. Seventy-one percent of the study population indicated drug abuse. Only 4.9% were assessed with completely healthy periodontal tissues, and 66% showed at least one tooth with untreated caries. According to the current regulations on dental care for inmates, only 11% of the study population was entitled to basic dental treatment (except emergency).

oral health
prisoner
drug abuse
dental caries
periodontal disease


Appropriate Use of Linear Growth Measures to Assess Impact of Interventions on Child Development and Catch-Up Growth.

Abstract: Linear growth is increasingly used as the sole or primary outcome for evaluating interventions, but impact is often not seen. Sometimes there is interest in whether children catch up to where they otherwise would have been had detrimental conditions not occurred, but the literature is confusing because of claims for evidence of catch-up growth based on inappropriate methods. This article examines the use of linear growth measures to evaluate intervention impact and catch-up. Focus on linear growth as a measure of impact has resulted in a lack of demonstrable intervention effects, evaluations that do not use measures responsive to nutrition-sensitive and integrated interventions, insufficient emphasis on adolescent girls and women before conception and children after the first 1000 d, and insufficient investment in developing other measures. Nutrition interventions may benefit children but may not discernibly affect linear growth deficits in immediate or intermediate periods. Interventions intended to affect one domain may have positive or negative impacts on others. Child nutrition and growth are part of early childhood development; the focus should be on improving conditions in which children grow and develop throughout childhood and adolescence because poor conditions in a population affect all children. To assess the impact of nutrition interventions, it is important to use a broad set of measures and indicators of outcomes and immediate and underlying determinants. The 4 criteria for demonstrating catch-up in growth, which are much more stringent than those for demonstrating intervention impact, require demonstration of the following: 1) an inhibiting condition and 2) reduced velocity during 1 period, 3) followed by alleviation of or compensation for the inhibiting condition, and 4) higher-than-normal velocity during a subsequent period. Partial catch-up growth is sometimes possible when constraints are removed, but whether it is beneficial to the child is not clear. Research is needed to develop, refine, and validate measures and indicators for the purposes intended.

Frongillo|Edward A|EA|
Leroy|Jef L|JL|
Lapping|Karin|K|

D002664:Child Nutritional Physiological Phenomena

linear growth
measures
child development
catch-up growth
children
height
length
stunting


Gene Therapy for Duchenne Muscular Dystrophy.

Abstract: Duchenne muscular dystrophy (DMD) is an X-linked, muscle wasting disease that affects 1 in 5000 males. Affected individuals become wheelchair bound by the age of twelve and eventually die in their third decade due to respiratory and cardiac complications. The disease is caused by mutations in the DMD gene that codes for dystrophin. Dystrophin is a structural protein that maintains the integrity of muscle fibres and protects them from contraction-induced damage. The absence of dystrophin compromises the stability and function of the muscle fibres, eventually leading to muscle degeneration. So far, there is no effective treatment for deteriorating muscle function in DMD patients. A promising approach for treating this life-threatening disease is gene transfer to restore dystrophin expression using a safe, non-pathogenic viral vector called adeno-associated viral (AAV) vector. Whilst microdystrophin gene transfer using AAV vectors shows extremely impressive therapeutic success so far in large animal models of DMD, translating this advanced therapy medicinal product from bench to bedside still offers scope for many optimization steps. In this paper, the authors review the current progress of AAV-microdystrophin gene therapy for DMD and other treatment strategies that may apply to a subset of DMD patients depending on the mutations they carry.

Gene therapy
duchenne
muscular dystrophy
dystrophin
microdystrophin
adeno-associated virus
antisense
exon skipping


Abstract: Obesity is a complex metabolic disease, attributed to diverse and interactive genetic and environmental factors. The associated health consequences of obesity are pleiotropic, with individuals being more susceptible to chronic diseases such as type 2 diabetes mellitus, hypertension, and lipotoxicity-related chronic diseases. The contribution of maternal obesity to the offspring's predisposition to both obesity and its complications is increasingly recognized. Understanding the mechanisms underlying these "transmissible" effects is critical to develop therapeutic interventions to reduce the risk for "programmed" obesity. Sirtuins (SIRTs), particularly SIRT1 and SIRT3, are NAD(+)-dependent deacetylases that regulate metabolic balance and stress responses in both central and peripheral tissues, of which dysregulation is a well-established mediator for the development and effects of obesity. Nevertheless, their implication in the transmissible effects of maternal obesity across generations remains largely elusive. In this review, we examine multiple pathways and systems that are likely to mediate such effects, with particular emphasis on the role of SIRTs.-Nguyen, L. T., Chen, H., Pollock, C. A., Saad, S. Sirtuins-mediators of maternal obesity-induced complications in offspring?

Nguyen|Long T|LT|
Chen|Hui|H|
Pollock|Carol A|CA|
Saad|Sonia|S|

D039382:Maternal Nutritional Physiological Phenomena

metabolism
chronic diseases
fetal programming


Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi.

Abstract:
Background
Ideal cardiovascular health (ICH) measures four ideal health behaviours (non-smoking, body mass index <25 kg/m2, healthy diet, and physical activity) and three health factors (total cholesterol <200 mg/dL, blood pressure <120/<80 mmHg, and fasting blood glucose <100 mg/dL).

Objective
This study aimed to determine the prevalence, distribution, and correlates of ICH among adults in Malawi.

Methods
National cross-sectional survey data of 3,441 persons aged 18-69 years with complete ICH measurements in Malawi in 2017 were analysed.

Results
Almost one in ten (7.4%) of respondents had 0-2 ICH metric), 21.2% 3-4 ICH metrics, and 71.5% 5-7 ICH metrics). Only 3.3% had all seven ICH metrics, 15.3% had intermediate ICH (≥1 metric in the intermediate category and none in the poor category), and 81.5% poor ICH (≥1 metric in poor category). In adjusted logistic regression analysis, older age (50-69 years) (Adjusted Odds Ratio-AOR: 0.25, 95% Confidence Interval-CI: 0.17-0.36) and urban residence (AOR: 0.56, 95% CI: 0.40-0.78) were negatively associated with meeting 5-7 ICH metrics. In addition, in unadjusted analysis, higher education was positively associated with meeting 5-7 ICH metrics.

Conclusion
The proportion of meeting 5-7 ICH metrics was high in Malawian adults. Both high-risk and population-wide intervention programmes targeting older adults and urban residents should be implemented in aiding to improve cardiovascular health in Malawi.

Highlights
The proportion of meeting 5-7 ideal cardiovascular health (ICH) metrics was 71.5% in Malawian adults (18-69 years, median age 32 years).In a sub-group analysis (45-69 years, median age 55 years), 55.9% had 5-7 ideal ICH metrics.ICH was lower with increasing age and among urban residents.


Effect of mild hyperbaric oxygen therapy on children diagnosed with autism.

Abstract:
Introduction
Hyperbaric oxygen (HBO2) therapy is emerging internationally as the primary treatment modality for inflammatory pathways related to neurological disorders. Currently, literature concerning its effectiveness in autistic children is limited. Using neurocognitive tests and clinical-diagnostic evaluations, this study evaluates the clinical, cognitive and behavioral effects of HBO2 on children diagnosed with autism.

Methods
An experimental HBO2 group (EXP: F = 1; M = 7; mean age: 7 ± 2.33; years) and a control non-HBO2 group of autistic children (CTRL: F = 2; M= 5; mean age: 6.6 ± 2.7 years) correctly completed the Aberrant Behavior Checklist-Community (ABC) before HBO2 (T0), after 40 sessions of HBO2 (T1), and one month after the end of treatments (T2). Additionally, the experimental HBO2 group was evaluated with the Childhood Autism Rating Scale at T0 and T2.

Results
Total ABC score was lower at T2 (mean ± SD: 50.38 ± 18.55; p ⟨ 0.001) compared to scores obtained at T0 (mean ± SD: 57.5 ± 19.01). Similarly, in the control group the total ABC score differed statistically (p ⟨ 0.05) between T0 (103.6 ± 20.38) and (T2: 59 ± 25.25).

Conclusion
Despite the improvements reported in both groups, our results do not support the utility of HBO2 in children diagnosed with autism..

Rizzato|Alex|A| D'Alessandro|Natalie|N| Berenci|Elisabetta|E| Rinchi|Alice|A| Enten|Garrett|G| Vezzani|Giuliano|G| Proietti|Maurizio|M| Fiorito|Alberto|A| Camporesi|Enrico|E| Bosco|Gerardo|G|

hyperbaric oxygen therapy
children
autism
psychology


High-Yield Production of Water-Soluble MoS2 Quantum Dots for Fe3+ Detection and Cell Imaging.

Abstract: Uniform water-soluble MoS2 quantum dots (WS-MSQDs) were synthesized via a sequential combination of sintering/etching/exfoliation method and solvothermal route. The obtained WS-MSQDs with average size of approximately 3.4 nm exhibited sufficient water solubility and remarkable fluorescence properties. The WS-MSQDs were utilized as a probe for detection of Fe3+ ions with high selectivity and specificity. Furthermore, the WS-MSQDs exhibited high fluorescence stability under different conditions. Finally, the WS-MSQDs were successfully applied for the fluorescence imaging of Fe3+ in living cells, which exhibited practical potential for biomedical applications.

Xu|Benhua|B| Zhang|Zhiqi|Z| Zhang|Peng|P|0000-0002-9418-0684 Wang|Li|L| Yuan|Rui|R| Ju|Zhenghua|Z| Liu|Weisheng|W|

water-soluble MoS2 quantum dots
living cells
Fe3+ ion sensor
fluorescent probe


Changing frequency of equivocal HER-2/neu scores and factors predictive of negative HER 2/neu fluorescent in situ hybridisation in invasive carcinomas of the breast.

Abstract:
BACKGROUND
Analysis of human epidermal growth factor receptor 2 (HER-2) status has become standard of care in breast cancer patients due to its important prognostic and therapeutic implications. Immunohistochemistry (IHC) is the most commonly used primary method for detection of HER-2 overexpression. Controversy exists on the interpretation of samples that are equivocal for HER 2 status (IHC 2+). Recent guidelines state that samples equivocal for HER 2 status require validation with fluorescent in situ hybridisation (FISH). The use of FISH, however, despite higher accuracy comes at a higher cost that is not affordable to all patients.

METHODS
This study is a retrospective study conducted at the American University of Beirut Medical Center, including women diagnosed with breast cancer with equivocal IHC scores presenting between 2009 and 2011. We attempted to correlate clinicopathological characteristics of patients diagnosed with breast cancer that can influence conclusions made on HER 2 status when analysing IHC equivocal samples in an effort to decrease the need for FISH testing. 113 patients in our records were included; charts were reviewed for different patient clinical characteristics and samples were analysed for pathological characteristics.

RESULTS
Using logistic regression, progesterone receptor status and HER-2 staining of the normal glands around the tumour by IHC were the two statistically significant variables that showed association with FISH results. The strength of progesterone receptor status positivity and HER-2 staining of the normal glands around the tumour were proportional to the likelihood of a negative FISH. Also, the presence of strong and diffuse hormone receptor positivity in low-grade tumours was predictive of negative HER-2 status.

CONCLUSIONS
In countries where resources are strained, oncologists need to think of measures to minimise the increasing financial burden of cancer care. Our study serves to highlight a few clinicopathological characteristics that might eliminate the need for further testing through FISH.

Boulos|Fouad|F|
Farra|Chantal G|CG|
Saad Aldin|Ehab M|EM|
Masaad|Cleo|C|
Hassoun|Yasmin|Y|
Fedda|Faysal|F|
Doumiati|Hassan|H|
Tawil|Ayman N|AN|
Nasser|Zeina|Z|
Nahleh|Zeina|Z|
Tfayli|Arafat|A|

D020022:Genetic Predisposition to Disease

D017404:In Situ Hybridization, Fluorescence


Feasibility and Acceptability of an HIV/AIDS Self-Management Education Program for HIV-Positive Men Who Have Sex With Men in Thailand.

Abstract: This pilot study examined the feasibility and acceptability of the HIV/AIDS self-management education program-Thai (HASMEP-T) for HIV-positive Thai men who have sex with men (MSM). HASMEP-T is a group-based adaptation of the evidence-based intervention, HASMEP. Participants were 40 Thai MSM living with HIV aged 18 years or older, recruited from an HIV clinic housed in a hospital in Thailand. Results support the feasibility of recruitment, screening, eligibility, and retention methods. The majority of the participants reported that the intervention was acceptable and met their initial expectations. Furthermore, all recruited participants in the intervention group (n = 20) completed HASMEP-T. Overall, intervention group participants demonstrated significant increases in all aspects of HIV self-management (p < .05), as well as improvement in quality of life in the psychological domain (p < .05). Our findings provide preliminary support for the large-scale, randomized-controlled trial of the efficacy of HASMEPT to promote self-management behaviors among HIV-positive Thai MSM.

D010342:Patient Acceptance of Health Care

feasibility
acceptability
HIV
MSM
self-management program


Effect of different radial hole designs on pullout and structural strength of cannulated pedicle screws.

Abstract: Cannulated pedicle screws are designed for bone cement injection to enhance fixation strength in severely osteoporotic spines. However, the screws commonly fracture during insertion. This study aims to evaluate how different positions/designs of radial holes may affect the pullout and structural strength of cannulated pedicle screws using finite element analysis. Three different screw hole designs were evaluated under torsion and bending conditions. The pullout strength for each screw was determined by axial pullout failure testing. The results showed that when the Von Mises stress reached the yield stress of titanium alloy the screw with four radial holes required a greater torque or bending moment than the nine and twelve hole screws. In the pullout test, the strength and stiffness of each screw with cement augmentation showed no significant differences, but the screw with four radial holes had a greater average pullout strength, which probably resulted from the significantly greater mean maximum lengths of cement augmentation. Superior biomechanical responses, with lower stress around the radial holes and greater pullout strength, represented by cannulated pedicle screw with four radial holes may worth recommending for clinical application.

Chen|Hsin-Chang|HC| Lai|Yu-Shu|YS| Chen|Wen-Chuan|WC| Chen|Jou-Wen|JW| Chang|Chia-Ming|CM| Chen|Yi-Long|YL| Wang|Shih-Tien|ST| Cheng|Cheng-Kung|CK|

Radial hole
Pullout strength
Cannulated screw
Finite element model


Sheathing the blade: Significant contribution of sheaths to daytime and nighttime gas exchange in a grass crop.

Abstract: Despite representing a sizeable fraction of the canopy, very little is known about leaf sheath gas exchange in grasses. Specifically, estimates of sheath stomatal conductance, transpiration and photosynthesis along with their responses to light, CO2 and vapour pressure deficit (VPD) are unknown. Furthermore, the anatomical basis of these responses is poorly documented. Here, using barley as a model system, and combining leaf-level gas exchange, whole-plant gravimetric measurements, transpiration inhibitors, anatomical observations, and biophysical modelling, we found that sheath and blade stomatal conductance and transpiration were similar, especially at low light, in addition to being genotypically variable. Thanks to high abaxial stomata densities and surface areas nearly half those of the blades, sheaths accounted for up to 17% of the daily whole-plant water use, which -surprisingly- increased to 45% during the nighttime. Sheath photosynthesis was on average 17-25% that of the blade and was associated with lower water use efficiency. Finally, sheaths responded differently to the environment, exhibiting a lack of response to CO2 but a strong sensitivity to VPD. Overall, these results suggest a key involvement of sheaths in feedback loops between canopy architecture and gas exchange with potentially significant implications on adaptation to current and future climates in grasses.

stomatal conductance
photosynthesis
vapour pressure deficit
barley
stomata density
climate change
drought tolerance
nighttime transpiration


Internet Addiction and Excessive Social Networks Use: What About Facebook?

Abstract: Facebook is notably the most widely known and used social network worldwide. It has been described as a valuable tool for leisure and communication between people all over the world. However, healthy and conscience Facebook use is contrasted by excessive use and lack of control, creating an addiction with severely impacts the everyday life of many users, mainly youths. If Facebook use seems to be related to the need to belong, affiliate with others and for self-presentation, the beginning of excessive Facebook use and addiction could be associated to reward and gratification mechanisms as well as some personality traits. Studies from several countries indicate different Facebook addiction prevalence rates, mainly due to the use of a wide-range of evaluation instruments and to the lack of a clear and valid definition of this construct. Further investigations are needed to establish if excessive Facebook use can be considered as a specific online addiction disorder or an Internet addiction subtype.

Guedes|Eduardo|E|
Sancassiani|Federica|F|
Carta|Mauro Giovani|MG|
Campos|Carlos|C|
Machado|Sergio|S|
King|Anna Lucia Spear|AL|
Nardi|Antonio Egidio|AE|

Internet Addiction
Social Networks
Facebook
Excessive Use


Visual search for feature conjunctions: an fMRI study comparing alcohol-related neurodevelopmental disorder (ARND) to ADHD.

Abstract:
BACKGROUND
Alcohol-related neurodevelopmental disorder (ARND) falls under the umbrella of fetal alcohol spectrum disorder (FASD). Diagnosis of ARND is difficult because individuals do not demonstrate the characteristic facial features associated with fetal alcohol syndrome (FAS). While attentional problems in ARND are similar to those found in attention-deficit/hyperactivity disorder (ADHD), the underlying impairment in attention pathways may be different.

METHODS
Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) was conducted at 3 T. Sixty-three children aged 10 to 14 years diagnosed with ARND, ADHD, and typically developing (TD) controls performed a single-feature and a feature-conjunction visual search task.

RESULTS
Dorsal and ventral attention pathways were activated during both attention tasks in all groups. Significantly greater activation was observed in ARND subjects during a single-feature search as compared to TD and ADHD groups, suggesting ARND subjects require greater neural recruitment to perform this simple task. ARND subjects appear unable to effectively use the very efficient automatic perceptual 'pop-out' mechanism employed by TD and ADHD groups during presentation of the disjunction array. By comparison, activation was lower in ARND compared to TD and ADHD subjects during the more difficult conjunction search task as compared to the single-feature search. Analysis of DTI data using tract-based spatial statistics (TBSS) showed areas of significantly lower fractional anisotropy (FA) and higher mean diffusivity (MD) in the right inferior longitudinal fasciculus (ILF) in ARND compared to TD subjects. Damage to the white matter of the ILF may compromise the ventral attention pathway and may require subjects to use the dorsal attention pathway, which is associated with effortful top-down processing, for tasks that should be automatic. Decreased functional activity in the right temporoparietal junction (TPJ) of ARND subjects may be due to a reduction in the white matter tract's ability to efficiently convey information critical to performance of the attention tasks.

CONCLUSIONS
Limited activation patterns in ARND suggest problems in information processing along the ventral frontoparietal attention pathway. Poor integrity of the ILF, which connects the functional components of the ventral attention network, in ARND subjects may contribute to the attention deficits characteristic of the disorder.

O'Conaill|Carrie R|CR|
Malisza|Krisztina L|KL|
Buss|Joan L|JL|
Bolster|R Bruce|RB|
Clancy|Christine|C|
de Gervai|Patricia Dreessen|PD|
Chudley|Albert E|AE|
Longstaffe|Sally|S|


Association between endometrial thickness and neonatal outcomes in intrauterine insemination cycles: a retrospective analysis of 1,016 live-born singletons.

Abstract:
BACKGROUND
Decreased endometrial thickness (EMT) has been suggested to be associated with reduced birthweight of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) newborns. Considering the differences in ovarian stimulation degree and laboratory procedures between IVF/ICSI and IUI treatment, we aim to investigate whether EMT has any influence on IUI infant outcomes as well.

METHODS
This was a retrospective cohort study of 1016 patients who had singleton livebirths after IUI treatment cycles from January 2008 to December 2018 at a tertiary-care academic medical center in China. Patients were categorized into three groups by the 10th and 90th percentile of peak EMT: ≤7.6, 7.7-13.0 and ≥ 13.1 mm. The primary outcomes of the study were preterm birth (PTB), low birthweight (LBW) and small-for-gestational age (SGA). Multiple regression analyses were performed after controlling for a variety of potential confounders.

RESULTS
No significant differences were found among the three groups in gestational age, birthweight and birthweight Z-score. Compared with the EMT 7.7-13.0 mm group, the incidences of PTB, LBW and SGA were 5.5% (adjusted odds ratio [aOR] 0.81, 95% confidence interval [CI] 0.33-2.01), 6.4% (aOR 1.44, 95% CI 0.58-3.58) and 7.3% (aOR 1.21, 95% CI 0.53-2.76) in the EMT ≤7.6 mm group, respectively. Similarly, EMT ≥13.1 mm was not significantly associated with risks of PTB (aOR 0.63, 95% CI 0.24-1.65), LBW (aOR 0.57, 95% CI 0.17-1.95) and SGA (aOR 0.73, 95% CI 0.28-1.92). The odds of other adverse neonatal outcomes, including macrosomia, large-for-gestational age and major congenital malformations, did not show significant differences before and after adjustment in both EMT ≤7.6 and ≥ 13.1 mm groups.

CONCLUSIONS
EMT is not independently associated with adverse perinatal outcomes in IUI cycles. This novel finding would provide reassuring information for IUI patients with thin endometrial linings regarding their neonatal health. However, further prospective cohort studies with larger datasets are needed to confirm the conclusion.

Huang|Jialyu|J| Lin|Jiaying|J| Lu|Xuefeng|X| Gao|Hongyuan|H| Song|Ning|N| Cai|Renfei|R| Kuang|Yanping|Y|

Endometrial thickness
Neonatal outcomes
Intrauterine insemination
Birthweight
Gestational age


Lower limb volume in healthy individuals after walking with compression stockings.

Abstract:
OBJECTIVE
Despite the modern appeal of wearing compressive garments during physical activities, the literature is lacking in quality data and controversial in the investigations dealing with the pathophysiologic mechanism by which graduated compression stockings (GCS) affect the calf pump activation in healthy individuals. The aim of the investigation was to provide insight into the clinical effects of GCS use during a standardized walking exercise.

METHODS
Twenty physically active healthy volunteers (mean age, 34 ± 5 years; body mass index, 22 ± 2 kg/m2) underwent lower limb ultrasound scanning to exclude vascular impairment. All individuals performed continuous aerobic exercise, walking for 30 minutes on a treadmill, under cardiac monitoring, at 70% of individual estimated maximal heart rate according to the Tanaka equation. The study population performed the standardized walk without GCS (baseline) and at 1 week performed the same standardized walk wearing knee-length 20 to 30 mm Hg GCS (compression). All individuals underwent a lower limb volume assessment by truncated cone formula before and after the walk and a perceived exertion assessment by means of the validated Borg scale at the end of the exercise protocol.

RESULTS
All individuals had normal venous and arterial ultrasound examination findings. No significant postural defects were reported. Both legs were assessed in all 20 individuals for a total of 40 cases with and 40 cases without GCS. In the baseline group, the median (interquartile range) lower limb volume changed from 2496 (770) mL before exercise to 2512 (805) mL (P = .2597) after exercise. The compression group reported a significant lower limb volume change from 2466 (670) mL before exercise to 2276 (567) mL (P = .0001) after exercise. Mean perceived exertion was 13 (11) and 11 (1) in the baseline and compression groups, respectively (P = .0001). The interface pressure exerted by the GCS was 24 (2) mm Hg. No complaints in terms of discomfort were reported after use of GCS.

CONCLUSIONS
In healthy individuals, GCS (24 [2] mm Hg) use during a continuous standardized walk of 30 minutes is associated with a significant decrease in lower limb volume and a decrease in perceived exertion. The mechanism by which GCS impart their effect during physical activity may involve improved muscle pump function and reductions in inflammatory pathways. Further study will need to validate the mechanisms of the function of GCS used during physical exercise.

Gianesini|Sergio|S|
Mosti|Giovanni|G|
Sibilla|Maria Grazia|MG|
Maietti|Elisa|E|
Diaz|Jose Antonio|JA|
Raffetto|Joseph D|JD|
Zamboni|Paolo|P|
Menegatti|Erica|E|

Volume
Compression
Stockings
Aerobic exercise
Exertion


Long-term follow-up after cardiac resynchronization therapy-optimization in a real-world setting: A single-center cohort study.

Abstract:
BACKGROUND
Suboptimal device programming is among the reasons for reduced response to cardiac resynchronization therapy (CRT). However, whether systematic optimization is beneficial remains unclear, particularly late after CRT implantation. The aim of this single-center cohort study was to assess the effect of systematic atrioventricular delay (AVD) optimization on echocardiographic and device parameters.

METHODS
Patients undergoing CRT optimization at the University Hospital Zurich between March 2011 and January 2013, for whom a follow-up was available, were included. AVD optimization was based on 12-lead electrocardiography (ECG) and echocardiographic left ventricular inflow characteristics. Parameters were assessed at the time of CRT optimization and follow-up, and were compared between patients with AVD optimization (intervention group) and those for whom no AVD optimization was deemed necessary (control group).

RESULTS
Eighty-one patients with a mean age of 64 ± 11 years were included in the analysis. In 73% of patients, AVD was deemed suboptimal and was changed accordingly. After a median follow-up time of 10.4 (IQR 6.2 to 13.2) months, the proportion of patients with sufficient biventricular pacing (> 97% pacing) was greater in the intervention group (78%) compared to controls (50%). Furthermore, AVD adaptation was associated with an improvement in interventricular mechanical delay (decrease of 6.6 ± 26.2 ms vs. increase of 4.3 ± 17.7 ms, p = 0.034) and intraventricular septal-to-lateral delay (decrease of 0.9 ± 48.1 ms vs. increase of 15.9 ± 15.7 ms, p = 0.038), as assessed by tissue Doppler imaging. Accordingly, a reduction was observed in mitral regurgitation along with a trend towards reduced left ventricular volumes.

CONCLUSIONS
In this "real-world" setting systematic AVD optimization was associated with beneficial effects regarding biventricular pacing and left ventricular remodeling. These data show that AVD optimization may be advantageous in selected CRT patients.

Korach|Raphael|R|
Kahr|Peter C|PC|
Ruschitzka|Frank|F|
Steffel|Jan|J|
Flammer|Andreas J|AJ|
Winnik|Stephan|S|

cardiac resynchronization therapy
atrioventricular delay
biventricular pacing
left ventricular remodeling


Fitting Health Care to People: Understanding and Adapting to the Epidemiology and Health Literacy of People Affected by Viral Hepatitis from Culturally and Linguistically Diverse Migrant Backgrounds.

Abstract: This study explored the epidemiology and health literacy of people affected by viral hepatitis (VH) from migrant culturally and linguistically diverse (CALD) backgrounds attending a community-based general practitioner and specialty hepatology shared-care (HEPREACH) clinic in Brisbane, Australia. Patient-reported data on health literacy and clinical information from adult patients (n = 66) of CALD background recruited from the liver clinic were analyzed. Health literacy was assessed using a 5-question, 12-point scale. Variance weighted multiple linear regression was used to identify factors associated with knowledge about VH. About three-quarters of patients (74.2%) were diagnosed with hepatitis B. The median knowledge score was 7.8 (interquartile range [IQR] 6‒9). One in five patients did not understand the infective nature of VH, 30.3% did not understand mother-to-child transmission risk, and 30-40% of patients thought activities such as kissing, sharing food or mosquito bites could spread VH. Only 6% of patients understood the risk of liver cancer and the need for regular screening. Higher educational level (secondary, β = 4.8, p < 0.0001 or tertiary, β = 8.1, p < 0.0001 vs. primary) was associated with better knowledge, and transition through a refugee camp (vs. not, β = - 1.2, p = 0.028) and country of diagnosis (overseas vs. Australia, β = - 1.9, p = 0.016) were associated with poorer knowledge. Country of origin, refugee status and opportunities for tertiary education impact patients' understanding of VH. Ensuring delivery of culturally appropriate care and education is critical to improve knowledge, reduce misconceptions to improve care and outcomes for VH in CALD migrant communities.

Health literacy
Viral hepatitis
Culturally and linguistically diverse
Australia
Migration


Validity of an FFQ to measure nutrient and food intakes in Tanzania.

Abstract:
OBJECTIVE
FFQ are often used to estimate food and nutrient intakes to rank individuals by their level of intake. We evaluated the relative validity of a semi-quantitative FFQ created for use in Tanzania by comparing it with two 24 h diet recalls.

DESIGN
We measured relative validity of the FFQ with deattenuated energy-adjusted rank correlations for nutrients, deattenuated rank correlations for food groups, and performed a cross-classification analysis of energy-adjusted nutrient quartiles using percentage of agreement and Bland-Altman analysis.

SETTING
Interviews were conducted in 2014 in participants' homes in Ukonga, Dar es Salaam, Tanzania.

SUBJECTS
We surveyed 317 adults aged 40 years or older from the general public.

RESULTS
Deattenuated energy-adjusted rank correlation coefficients of nutrients ranged from -0·03 for riboflavin to 0·41 for percentage of energy from carbohydrates, with a median correlation of 0·21. Coefficients for food groups ranged from 0·00 for root vegetables to 0·51 for alcohol, with a median of 0·35. Relative to the average of the two 24 h diet recalls, the FFQ overestimated energy intake and intakes of all nutrients and food groups, other than tea, with ratios among nutrients ranging from 1·34 for SFA to 7·08 for vitamin A; and among food groups from 0·92 for tea to 9·00 for fruit. The percentage of participants classified into the same nutrient intake quartile ranged from 23 % for SFA to 32 % for both niacin and pantothenic acid, with a median of 28 %.

CONCLUSIONS
The FFQ performed moderately well in urban Tanzanian adults.

Zack|Rachel M|RM|0000-0003-1048-8938
Irema|Kahema|K|
Kazonda|Patrick|P|
Leyna|Germana H|GH|
Liu|Enju|E|
Gilbert|Susan|S|
Lukmanji|Zohra|Z|
Spiegelman|Donna|D|
Fawzi|Wafaie|W|
Njelekela|Marina|M|
Killewo|Japhet|J|
Danaei|Goodarz|G|

Validation
FFQ
Tanzania
Nutritional epidemiology
Sub-Saharan Africa


Interaction between warfarin and short-term intravenous amiodarone in intensive care unit patients after cardiac surgery.

Abstract:
Background
Amiodarone and warfarin are sometimes administered immediately after cardiac surgery. Although the interaction between long-term oral amiodarone and warfarin has been reported, the interaction between warfarin and short-term intravenous amiodarone has not been reported. In this study, we investigated the effect of short-term intravenous amiodarone on the anticoagulant effect of warfarin in patients who underwent cardiac surgery.

Methods
We retrospectively reviewed the medical records of 11 patients who received oral warfarin before and after cardiac surgery, and loading doses of 125-150 mg or a 750 mg continuous infusion of amiodarone, or both in the intensive care unit (ICU) within 5 days after the surgery between July 2011 and January 2017. The prothrombin time-international normalized ratio (PT-INR)/daily warfarin dose (PT-INR/dose) was used as an indicator of anticoagulant effect. The values before surgery were considered as the baseline.

Results
The PT-INR and PT-INR/dose values were elevated in 7 and 10 patients, respectively, after amiodarone administration. The mean PT-INR values were not significantly different before and after amiodarone administration (2.13 ± 0.58 vs 2.29 ± 0.50, respectively, p = 0.643). In contrast, the mean PT-INR/dose values were significantly elevated after the administration of amiodarone (0.93 ± 0.46 vs 1.54 ± 0.63, respectively, p = 0.002).

Conclusions
Short-term intravenous amiodarone enhanced the anticoagulant effect of warfarin in patients admitted to the ICU after cardiac surgery. We suggest that the dose of warfarin should be carefully adjusted for a few days after cardiac surgery if intravenous amiodarone is coadministered.

Takase|Tomoki|T| Ikesue|Hiroaki|H|0000-0002-8499-131X Tohi|Makiko|M| Ueta|Hiroshi|H| Mima|Hiroyuki|H| Koyama|Tadaaki|T| Hashida|Tohru|T|

Interaction
Warfarin
Short-term
Intravenous
Amiodarone
Intensive care unit
Cardiac surgery
Prothrombin time


An Anisotropic Hydrogel Based on Mussel-Inspired Conductive Ferrofluid Composed of Electromagnetic Nanohybrids.

Abstract: Anisotropic hydrogels with a hierarchical structure can mimic biological tissues, such as neurons or muscles that show directional functions, which are important factors for signal transduction and cell guidance. Here, we report a mussel-inspired approach to fabricate an anisotropic hydrogel based on a conductive ferrofluid. First, polydopamine (PDA) was used to mediate the formation of PDA-chelated carbon nanotube-Fe3O4 (PFeCNT) nanohybrids and also used as a dispersion medium to stabilize the nanohybrids to form a conductive ferrofluid. The ferrofluid can respond to an orientated magnetic field and be programed to form aligned structures, which were then frozen in a hydrogel network formed via in situ free-radical polymerization and gelation. The resulted hydrogel shows directional conductive and mechanical properties, mimicking an oriented biological tissue. Under external electrical stimulation, the orientated PFeCNT nanohybrids can be sensed by the myoblasts cultured on the hydrogel, resulting in the oriented growth of cells. In summary, the mussel-inspired anisotropic hydrogel with its aligned structural complexity and anisotropic properties together with the cell affinity and tissue adhesiveness is a potent multifunctional biomaterial for mimicking oriented tissues to guide cell proliferation and tissue regeneration.

Liu|Kezhi|K| Han|Lu|L| Tang|Pengfei|P| Yang|Kaiming|K| Gan|Donglin|D| Wang|Xiao|X| Wang|Kefeng|K|0000-0002-2504-4662 Ren|Fuzeng|F|0000-0002-9310-2174 Fang|Liming|L| Xu|Yonggang|Y| Lu|Zhifeng|Z| Lu|Xiong|X|0000-0001-6367-430X

Anisotropic hydrogels
ferrofluid
carbon nanotube
conductive hydrogels
magnetic nanoparticles
mussel-inspired adhesive hydrogels