Temporal Dynamics of the Interaction between Reward and Time Delay during Intertemporal Choice.

Abstract: Intertemporal choice involves the processes of valuation and choice. Choice is often the result of subjective valuation, in which reward is integrated with time delay. Here, using event-related potential (ERP) signals as temporal hallmarks, we aim to investigate temporal dynamics of how reward interacts with time delay during a delayed discounting task. We found that participants preferred immediate rewards when delayed rewards were small or over long-term delays. Our ERP results suggested that the P200 component reflected an initial valuation of reward and time delay, while the frontal N2 component correlated with individual choices of immediate option of rewards. The LPP component was modulated by the N2 component. These findings demonstrate that the N2 component is the key component in temporal dynamics of the interaction between reward and time valuation.

Gui|Dan-Yang|DY| Li|Jin-Zhen|JZ| Li|Xiaoli|X| Luo|Yue-Jia|YJ|

ERP
delayed discounting task
economic decision-making
subjective value
temporal discounting


John XXI, the Pope Philosopher and Physician-Scientist of Portuguese Origins Died of Crush Syndrome in 1277.

Abstract: The aim of this work is to refer on the death due to crush syndrome in 1277 of Pope John XXI, philosopher, logician, anatomist, physician scientist, university professor of medicine at the university of Siena and author of books adopted for nearly 4 centuries in universities in the Middle Ages. The Pope died crushed by the ceiling of his office which had been built in rush to meet his need for a quiet and warm place, his need of light and nature. There he attended to his duties of governing the church, studied fine theological questions, inspected the stars, made experiments and discussed with the renowned ophthalmologists who in those days made Viterbo the center of the study on vision. Following the fall of the ceiling of his apartment, John XXI was extracted alive from among the pieces of wood and stones. However, a few days after the disaster, he died in bad conditions (miserabiliter). He experienced a typical death due to crush syndrome which was described for the first time by Antonino D'Antona, following the Messina-Reggio Calabria 1908 earthquake. He was born (c. 1210-1220) in Lisbon as Pedro Hispano (Peter of Spain). He had regular trivium and quadrivium courses at the University of Paris under Albertus Magnus, a talented naturalist. He became Master of Arts, then studied medicine out of Paris (probably Montpellier or Salerno). He wrote three treatises (On the eye (De oculo), The Treasury of Medicines for the Poor (Thesaurus Pauperum) and Little Summaries of Logic (Summulae Logicales)) which were used in the European universities from the 13th to the beginning of the 18th century. Pedro Hispano was advisor of King Alphonso III for affairs inherent to the Church, bishop of Braga and then Cardinal Bishop of Tusculum and Pope as John XXI. He was buried in the Cathedral of Viterbo, the city where he had settled the seat of the Pontiff.

Death due to crush syndrome
Pope John XXI
Thesaurus pauperum
Summulae Logicales
Deoculo


Research on the Evolution of the Express Packaging Recycling Strategy, Considering Government Subsidies and Synergy Benefits.

Abstract: With the year-on-year growth of e-commerce transactions and the increasing popularity of the concept of ecological civilization, the waste and recycling of express packages have aroused widespread discussion and attention. On the issue of express package recycling, how consumers, e-commerce enterprises, and e-commerce platforms choose their own strategies, how to better promote the recycling of express packages, and what is the effect mechanism of government subsidies on different players. These are the questions that this article wants to answer. Since this article involves many stakeholders, in order to better identify the strategic choice and evolution of different entities and to better study the influence of government subsidies on the strategic choice of game players, this article uses two triparty evolutionary game models. The results show that without subsidies, changes in the rate of return and the initial probability will affect the evolution of the equilibrium strategy, while the synergistic benefits will have a corrective effect in some cases; when government subsidies are included and the probability of the three parties choosing "green strategies" is relatively low, subsidies should be paid to e-commerce companies mainly; lower subsidies can only provide incentives for e-commerce platforms. This article can provide certain references and value for government policymakers.

express packaging
government subsidies
evolutionary game
heterogeneous parties


Multiple genes of the renin-angiotensin system are novel targets of Wnt/β-catenin signaling.

Abstract: Activation of the renin-angiotensin system (RAS) plays an essential role in the pathogenesis of CKD and cardiovascular disease. However, current anti-RAS therapy only has limited efficacy, partly because of compensatory upregulation of renin expression. Therefore, a treatment strategy to simultaneously target multiple RAS genes is necessary to achieve greater efficacy. By bioinformatics analyses, we discovered that the promoter regions of all RAS genes contained putative T-cell factor (TCF)/lymphoid enhancer factor (LEF)-binding sites, and β-catenin induced the binding of LEF-1 to these sites in kidney tubular cells. Overexpression of either β-catenin or different Wnt ligands induced the expression of all RAS genes. Conversely, a small-molecule β-catenin inhibitor ICG-001 abolished RAS induction. In a mouse model of nephropathy induced by adriamycin, either transient therapy or late administration of ICG-001 abolished established proteinuria and kidney lesions. ICG-001 inhibited renal expression of multiple RAS genes in vivo and abolished the expression of other Wnt/β-catenin target genes. Moreover, ICG-001 therapy restored expression of nephrin, podocin, and Wilms' tumor 1, attenuated interstitial myofibroblast activation, repressed matrix expression, and inhibited renal inflammation and fibrosis. Collectively, these studies identify all RAS genes as novel downstream targets of Wnt/β-catenin. Our results indicate that blockade of Wnt/β-catenin signaling can simultaneously repress multiple RAS genes, thereby leading to the reversal of established proteinuria and kidney injury.

Zhou|Lili|L|
Li|Yingjian|Y|
Hao|Sha|S|
Zhou|Dong|D|
Tan|Roderick J|RJ|
Nie|Jing|J|
Hou|Fan Fan|FF|
Kahn|Michael|M|
Liu|Youhua|Y|

D019086:Bridged Bicyclo Compounds, Heterocyclic

Wnt
β-catenin
CKD
renal fibrosis
renin angiotensin system


Low frequency magnetic field therapy in patients with cytostatic-induced polyneuropathy: a phase II pilot study.

Abstract: Cytostatic-induced polyneuropathy (CIPN) is a common and serious toxicity in tumor patients. Treatment and prophylactic measures are mainly ineffective. Therefore, there is an urgent need to establish a sufficient therapy for pPNP. Between July 2007 and August 2008, 20 patients were treated with low frequency (4-12 Hz) magnetic field therapy (MFT), and neurological examinations were conducted at the trial therapy's beginning, as well as after 3-4 weeks. Standardized testing methods were applied, i.e., the Common Toxicity Criteria questionnaire of the National Cancer Institute and the measurement of nerve conduction velocity (NCV) in the electrophysiological examination. In terms of the components sensory ataxia and neuropathy as well as neuropathic pain, an improvement was achieved using MFT. This effect was confirmed by an increase in NCV. Using low frequency MFT, CIPN was influenced positively on both hands and feet. This could represent a future therapy principle for these patients.

Geiger|Georg|G| Mikus|Eberhard|E| Dertinger|Hermann|H| Rick|Oliver|O|


Effect of appetite-conditioned reflex stimulation on early enteral nutrition tolerance after surgery.

Abstract:
Objective
This study aimed to discuss the effects of appetite-conditioned reflex stimulation on the early enteral nutrition (EEN) tolerance, complications, and postoperative hospital stay in patients who underwent surgery.

Methods
Seventy patients who underwent laparoscopic radical resection of colorectal cancer surgery in our hospital between February and December 2017 were randomly divided into a stimulated appetite group (experimental group, including visual stimulation, nasal stimulation, taste stimulation and hearing stimulation) and a control group (n = 35). Both groups received EEN. EEN tolerance, complications, and postoperative hospital stay were then compared between the groups.

Results
Sixty-six patients, including 34 in the experimental group and 32 in the control group, completed the relevant experiment. The experimental group had significantly lower incidence rates of nausea, vomiting, bloating, use of prokinetic drugs, and gastric tube replacement (P < 0.05), and shorter tolerable regular eating time (5.0 ± 1.0 d vs 6.4 ± 1.9 d, P < 0.05) and postoperative hospital stay (7.0 ± 2.0 d vs 8.0 ± 1.8 d, P < 0.05) than the control group. No significant difference in complication rate was detected (P > 0.05).

Conclusion
Appetite-conditioned reflex stimulation can improve EEN tolerance, decrease the risk of complications, and shorten ordinary diet recovery time and hospital stay.

Sun|Y-B|YB| Li|Y-L|YL| Li|W-M|WM| Sun|D-L|DL| Li|S-M|SM| Xu|Q-W|QW| Li|Y-J|YJ| Lin|Y-Y|YY| Cen|Y-Y|YY| Xu|P-Y|PY|

D013505:Digestive System Surgical Procedures

tolerance
early enteral nutrition (EEN)
colorectal cancer


In vivo and in vitro toxicity evaluation of liposome-encapsulated sirolimus.

Abstract:
Background
To evaluate the in vivo and in vitro toxicity of a new formulation of liposome-encapsulated sirolimus (LES).

Methods
In vitro experiments were done using ARPE-19 and HRP cells. An MTT assay was used to determine cell metabolic activity and a TUNEL assay for detecting DNA fragmentation. In vivo experiments were conducted on New Zealand albino rabbits that received intravitreal injections of empty liposomes (EL) or different concentrations of LES. Histopathological and immunohistochemical analyses were performed on the rabbit's eyes following injection.

Results
Eighteen eyes of nine rabbits were used. MTT assay cell viability was 95.04% in group 1 (12.5 µL/mL LES). 92.95% in group 2 (25 µL/mL LES), 91.59% in group 3 (50 µL/mL LES), 98.09% in group 4 (12.5 µL/mL EL), 95.20% on group 5 (50 µL/mL EL), 98.53% in group 6 (50 µL/mL EL), and 2.84% on group 8 (50 µL/mL DMSO). There was no statistically significant difference among groups 1 to 7 in cell viability (p = 1.0), but the comparison of all groups with group 8 was significant (p < 0.0001). The TUNEL assay comparing two groups was not statistically significant from groups 1 to 7 (p = 1.0). The difference between groups 1 to 7 and group 8 (p < 0.0001) was significant. Histopathological changes were not found in any group. No activation of Müller cells was detected.

Conclusion
A novel formulation of LES delivered intravitreally did not cause in vitro toxicity, as evaluated by MTT and TUNEL assays, nor in vivo toxicity as evaluated by histopathology and immunohistochemistry in rabbit eyes.

Abud|Murilo Batista|MB|
Louzada|Ricardo Noguera|RN|
Isaac|David Leonardo Cruvinel|DLC|
Souza|Leonardo Gomes|LG|
Dos Reis|Ricardo Gomes|RG|
Lima|Eliana Martins|EM|
de Ávila|Marcos Pereira|MP|


Development of a novel rhesus macaque model with an infectious R5 simian-human immunodeficiency virus encoding HIV-1 CRF08_BC env.

Abstract:
BACKGROUND
The CRF08_BC strain is one of the most predominant circulating Human immunodeficiency virus type 1 (HIV-1) strains in the Chinese pandemic. A simian-human immunodeficiency virus (SHIV) encoding HIV-1 CRF08_BC env is highly desirable to evaluate candidate AIDS vaccines in non-human primates.

METHODS
SHIV-KBQJ-12, which carries the envelope glycoprotein from QJ001, an infectious molecular clone of HIV-1 CRF08_BC, was generated. The replication capacity of SHIV-KBQJ-12 was determined both in human and rhesus macaque (Macaca mulatta) peripheral blood mononuclear cells (PBMCs) and in Chinese rhesus macaques.

RESULTS
SHIV-KBQJ-12 replicated efficiently in human and macaque PBMCs and displayed a preference for CCR5 as an entry coreceptor. Productive infection of two macaques by intravenous inoculation with SHIV-KBQJ-12 was confirmed.

CONCLUSIONS
SHIV-KBQJ-12 is an R5-tropic chimeric virus that can establish productive infection both in vitro and in vivo in Chinese rhesus macaques and will be useful to assess candidate HIV-1 CRF08_BC vaccines in China.

Huang|Li|L| Kusagawa|Shigeru|S| Zeng|Haiyan|H| Yang|Guibo|G| Sun|Binlian|B| Miura|Tomoyuki|T| Yang|Rongge|R|

D020133:Reverse Transcriptase Polymerase Chain Reaction

D054299:env Gene Products, Human Immunodeficiency Virus


Tooth Loss and Risk of Dementia in the Community: the Hisayama Study.

Abstract:
OBJECTIVES
To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population.

DESIGN
Prospective cohort study.

SETTING
The Hisayama Study, Japan.

PARTICIPANTS
Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for 5 years (2007-2012).

MEASUREMENTS
Participants were classified into four categories according to baseline number of remaining teeth (≥20, 10-19, 1-9, 0). The risk estimates of the effect of tooth loss on the development of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were computed using a Cox proportional hazards model.

RESULTS
During follow-up, 180 (11.5%) subjects developed all-cause dementia; 127 (8.1%) had AD, and 42 (2.7%) had VaD. After adjusting for potential confounders, there was a tendency for the multivariable-adjusted hazard ratio of all-cause dementia to increase with decrease in number of remaining teeth (P for trend = .04). The risk of all-cause dementia was 1.62 times as great in subjects with 10 to 19 teeth, 1.81 times as great in those with one to nine teeth, and 1.63 times as great in those with no teeth as in those with 20 teeth or more. An inverse association was observed between number of remaining teeth and risk of AD (P for trend = .08), but no such association was observed with risk of VaD (P for trend = .20).

CONCLUSION
Tooth loss is associated with an increased risk of all-cause dementia and AD in the Japanese population.

Takeuchi|Kenji|K| Ohara|Tomoyuki|T| Furuta|Michiko|M| Takeshita|Toru|T| Shibata|Yukie|Y| Hata|Jun|J| Yoshida|Daigo|D| Yamashita|Yoshihisa|Y| Ninomiya|Toshiharu|T|

prospective cohort study
Alzheimer's disease
vascular dementia
epidemiology
oral health


Adsorption of arsenic(V) onto single sheet iron oxide: X-ray absorption fine structure and surface complexation.

Abstract: Adsorption onto two-dimensional nanosheet materials offers new possibilities for fast and efficient removal of contaminants from waters. Here, the adsorption of As(V) to a new type of iron oxides - single sheet iron oxide (SSI) - has been studied as a function of time, loading and pH. Adsorption of As(V) onto SSI was very fast compared to other iron oxides, with 80% of total As(V) adsorbed within 10 min. Examination by extended X-ray absorption fine structure analysis showed that As(V) forms a bidentate inner-sphere surface complex with SSI. Arsenic(V) adsorption isotherms and adsorption envelopes were well described using a 1-pK Basic Stern surface complexation model involving protonated (Fe2O2AsO2H-) and unprotonated (Fe2O2AsO2-2) inner-sphere surface complexes. The surface complexation constants for As(V) binding to SSI is similar to constants found for goethite and ferrihydrite. Simulated adsorption isotherms for intermediate As(V) concentrations also demonstrate that SSI is performing equally well as goethite and ferrihydrite based on surface area normalized adsorption capacities. The binding affinities at micromolar to submicromolar As(V) solution concentrations are similar for SSI and ferrihydrite. SSI has interesting potential as a stable, high-affinity sorbent for use in applications where efficient and fast removal is required.

Yin|Zhou|Z|
Lützenkirchen|Johannes|J|
Finck|Nicolas|N|
Celaries|Noémie|N|
Dardenne|Kathy|K|
Hansen|Hans Chr Bruun|HCB|

Single sheet iron oxide
Surface complexation
Arsenate
Basic stern model
Delamination


Briefest Time to Perform a Series of Preoperative Nerve Blocks in Multiple Patients: A Simulation Study.

Abstract: Introduction To mitigate first-case delays in operating rooms, sufficient additional time must be allotted when anesthesiologists perform preoperative nerve blocks in multiple patients who are scheduled as the initial cases of the day. We used spinal anesthetics performed in dedicated block rooms located just outside the operating room suite to estimate the briefest times needed to complete a series of spinal, epidural, peripheral, or other regional nerve blocks. We followed this approach because even though the studied hospital had a busy regional anesthesia service, sample sizes were insufficient and electronic data were not available to directly study the time to perform the many other nerve blocks they perform. Methods We studied a historical cohort of 8,462 adult patients undergoing spinal anesthesia between 2005 and 2017. Preoperative evaluation, consent, and holding area tasks were completed before entering the block room; the times to complete these tasks were not available for study. Upon block room entry, the electronic anesthetic record was started, a timeout conducted with patient participation, vital signs taken, and the spinal performed. The interval from entry until intrathecal injection was the spinal block time. Because fits of these times to probability distributions previously used for anesthesia times were poor (p < 0.001), percentiles of times to perform one or more spinal anesthetics were calculated using Monte-Carlo simulation (100,000 samples with replacement) from the empirical distributions. Results The mean spinal block time was 8.8 minutes. The 90% upper prediction limit for one block was 14 minutes, with progressively decreasing times for each subsequent block for a 90% chance of finishing on time. For example, for three first-case regional or neuraxial blocks performed outside the operating room by one anesthesiologist, the first patient needs to arrive at least 38 minutes earlier than non-block patients to mitigate operating room start delays. Conclusions These minimum time estimates can help nursing leadership ensure that sufficient time will be available after patients are ready for anesthesia to avoid first-case delays when preoperative regional anesthesia is performed outside the operating room. Given that inadequate sample size and documentation issues likely exist universally for the various non-neuraxial preoperative nerve blocks, we recommend that hospitals use our estimates as a minimum starting point rather than try to calculate times using their own data. Then, as a systems-based metric to assess all steps in the process, track the percentages of days for which all blocks were completed in sufficient time to avoid a first-case delay for those patients. Adjustments to the arrival times would then be implemented, if needed, to meet hospital objectives for on-time starts.

Epstein|Richard H|RH|
Dexter|Franklin|F|
Mojica|Jeffrey J|JJ|
Schwenk|Eric S|ES|

anesthesiologists
spinal anesthesia
computer simulation
conduction anestehsia
healthcare quality assurance
monte carlo method
preoperative period


Comparison of ranolazine and trimetazidine on glycemic status in diabetic patients with coronary artery disease - a randomized controlled trial.

Abstract:
INTRODUCTION
Cardiovascular diseases have become the leading cause of death around the globe and diabetes mellitus (DM) is considered to be a coronary artery disease (CAD) risk equivalent. Ranolazine, an anti anginal drug has been found to reduce Glycated haemoglobin (HbA1c) in diabetes patients with chronic angina. However the effect of another antianginal drug trimetazidine, on glycemic status is not clear.

AIM
To compare the effect of ranolazine and trimetazidine on glycemic status in diabetic patients with CAD.

SETTINGS AND DESIGN
Patients diagnosed with CAD and diabetes mellitus attending Cardiology Out Patient Department (OPD), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India were recruited for this randomized open label parallel arm trial.

MATERIALS AND METHODS
The study conducted from January-2012 to April-2013 had 47 eligible patients diagnosed with CAD and diabetes mellitus. They were randomized to receive either ranolazine 500 mg BD or trimetazidine 35 mg BD for 12 weeks. HbA1c levels, fasting blood glucose (FBG), lipid profile, QT and QTc intervals were measured at baseline and after 12 weeks.

STATISTICAL ANALYSIS
Unpaired t-test was used to compare the baseline characteristics of between the groups while comparison within the groups were done using Paired t-test. Wilcoxon and Mann Whitney U-tests were used for non parametric data. Graph pad instat version-3 was used for statistical analysis. Values were expressed as mean ± SD. A p < 0.05 was considered statistically significant.

RESULTS
The study could not find any change in HbA1c levels in both ranolazine and trimetazidine groups. The adverse effects reported from patients on ranolazine include angina, constipation, postural hypotension, headache, dizziness, nausea and weakness while patients on trimetazidine complained of constipation, weakness, palpitations, angina, dizziness, nausea, dyspepsia, headache, gastric discomfort, joint pain, etc.

CONCLUSION
In patients with chronic angina and diabetes mellitus Ranolazine 500mg BD and Trimetazidine 35mg BD did not show any effect on HbA1c and fasting blood glucose lebel.

Sandhiya|Selvarajan|S|
Dkhar|Steven Aibor|SA|
Pillai|Ajith Ananthakrishna|AA|
George|Melvin|M|
Jayaraman|Balachander|B|
Chandrasekaran|Adithan|A|

Ranolazine
Trimetazidine
Glycemic status
HbA1c
QTc


Optical Elemental Analysis of Metals Using Shewanella oneidensis.

Abstract: A simple method for the detection of metal ions in solution is proposed, using Shewanella oneidensis, which has the ability to reduce metal ions into metal nanoparticles on the cell surface. The method can be used to identify metal ions in solution using the light-scattering characteristics of the metal nanoparticles formed on the cells.

D053768:Metal Nanoparticles
D061848:Optical Imaging
D020592:Shewanella
D013055:Spectrophotometry, Infrared
D013499:Surface Properties

elemental analysis
Shewanella oneidensis
metal nanoparticle
dark-field microscopy
light-scattering properties


Non-coding stem-bulge RNAs are required for cell proliferation and embryonic development in C. elegans.

Abstract: Stem bulge RNAs (sbRNAs) are a family of small non-coding stem-loop RNAs present in Caenorhabditis elegans and other nematodes, the function of which is unknown. Here, we report the first functional characterisation of nematode sbRNAs. We demonstrate that sbRNAs from a range of nematode species are able to reconstitute the initiation of chromosomal DNA replication in the presence of replication proteins in vitro, and that conserved nucleotide sequence motifs are essential for this function. By functionally inactivating sbRNAs with antisense morpholino oligonucleotides, we show that sbRNAs are required for S phase progression, early embryonic development and the viability of C. elegans in vivo. Thus, we demonstrate a new and essential role for sbRNAs during the early development of C. elegans. sbRNAs show limited nucleotide sequence similarity to vertebrate Y RNAs, which are also essential for the initiation of DNA replication. Our results therefore establish that the essential function of small non-coding stem-loop RNAs during DNA replication extends beyond vertebrates.

Kowalski|Madzia P|MP|
Baylis|Howard A|HA|
Krude|Torsten|T|

D000818:Animals
D017173:Caenorhabditis elegans
D049109:Cell Proliferation
D004261:DNA Replication
D047108:Embryonic Development
D022661:RNA, Untranslated

Cell proliferation
DNA replication
Non-coding RNA


The orthopterans of the rice agroecosystem in western Lomellina (Lombardy, Italy).

Abstract: Rice fields represent a valuable surrogate habitat for many wetland species, playing an important role for biodiversity conservation in human-managed landscapes. Despite the fact that several taxonomic groups have been thoroughly investigated in this agroecosystem, little is known about the orthopteran fauna which lives in and around rice paddies, especially in Europe. In this paper, we provide a first description of the orthopteran assemblages hosted in the rice agroecosystems of northern Italy, trying to evaluate their conservation value through an analysis of species ecological traits (habitat specificity and dispersal capacity). During field samplings in summer 2016, we detected 25 orthopteran species. The 24% of the community was composed by habitat specialist species and the 56% of the sampled taxa was characterised by high dispersal capacities. Rice fields are an extremely dynamic ecosystem, characterised by the continuous succession of flooding and drying periods and conditioned by many other farming activities. Consequently, the orthopteran fauna in rice crops is mainly composed of species well adapted to sudden environmental changes. On the other hand, rice fields represent a particular biotope, providing a suitable habitat especially for hygrophilous species, which are otherwise restricted to scattered marsh areas. In order to preserve orthopteran diversity in rice agroecosystems, sustainable farming practices should be applied, especially by preserving and restoring marginal semi-natural habitats, by reducing grass management intensity on paddy banks and by discouraging rice cultivation in dry soils.

rice fields
northern Italy
habitat specificity
dispersal capacity
farming practices
Orthoptera
check-list


Patients' motivations and interest in research: characteristics of volunteers for patient-led projects on PatientsLikeMe.

Abstract:
Plain English summary
PLM is an online platform that provides tools for individuals to track their health and connect with other patients and while PLM has invited patients to participate in various research projects throughout the years, an examination into what motivates patients to want to get involved in clinical research has not been done. During our analysis of applications submitted by members of the PLM community, we looked for reasons patients want to participate in research and their overall beliefs about clinical research, in general. In addition, we analyzed obstacles and barriers toward patients' research participation. We observed the following:Patients are typically motivated by their individual needs and are most interested in research specific to their own condition.To get the most from patients' involvement and to enhance patients' contribution towards research goals, researchers should explain the research goal and requirements of each goal in clear and transparent terms, making it easy for patients to understand, thus avoiding any potential miscommunication.Future studies are needed to determine the best methods for involving patients in clinical research.

Background
Historically, throughout the clinical and medical research arenas, patients have been perceived as passive "subjects" rather than as individuals who may have thoughts regarding research development, research plans, implementation of research studies, and data analysis. However, it is becoming more clear that patients increasingly want to have a more active role in clinical research studies and in the management of their own medical conditions as evidenced by a "no decision about us without us" stance, meaning patients want to make informed decisions about their health while working alongside their healthcare professionals. The central aim of this research study was to determine patients' motivations for being involved in research design and understand their perceptions of current research practices.

Methods
Two independent qualitative studies were conducted. In Study 1, we analyzed applications submitted by self-identified patients from within the PatientsLikeMe (PLM) community, for acceptance onto our advisory panel. The advisory panel was tasked with developing a best practice guide for how to involve patients in research. During the qualitative analysis, we identified major reasons for and topics of interest associated with PLM members' motivation to apply to the advisory panel. In Study 2, we analyzed applications from PLM community members and from patients outside the PLM community for a patient-led patient-reported-outcome (PRO) development project. Similar to Study 1, we identified themes associated with patients' motivations to participate in developing a new PRO.

Results
PLM members are interested in being involved in medical research for various reasons, including facilitating provider-patient communication, improving comprehension of medical information, understanding their disease, and bringing a more individualized approach to health care in general.

Conclusion
Challenges in the process of appropriate involvement of patients in research are discussed. In both studies, the applicants shared their interests in being involved in research. However, in Study 2, many of the patients shared ideas that were not appropriate for the development of a PRO, which indicated limitations in how the invitation and application explained the project to patients. Future studies should contribute to determining the most appropriate method for involving patients in various settings.

Bradley|Meaghan|M|0000-0003-0345-1440 Braverman|Julia|J| Harrington|Magdalena|M| Wicks|Paul|P|

PatientsLikeMe
PRO development
Patient advocacy
Patient centeredness
Patient motivation
Qualitative research


PCR-Based Sequence Analysis on Multiple Genes Other than 16S rRNA Gene for Differentiation of Phytoplasmas.

Abstract: Differentiation and classification of phytoplasmas have been primarily based on the highly conserved 16S rRNA gene, for which "universal" primers are available. To date, 36 ribosomal (16Sr) groups and more than 150 subgroups have been delineated by RFLP analysis of 16S rRNA gene sequences. However, in recent years, the use of moderately conserved genes as additional genetic markers has enhanced the resolving power in delineating distinct phytoplasma strains among members of some 16Sr subgroups.This chapter describes the methodology of amplification, differentiation, and classification of phytoplasma based on less-conserved non-ribosomal genes, named rp and secY. Actual and virtual RFLP analyses of amplicons obtained by semi-universal or group-specific rp and secY gene-based primers are used for finer differentiation of phytoplasma strains within a given group. The rp and secY gene-based classification not only readily resolves 16Sr subgroups within a given 16Sr group, but also provides finer differentiation of closely related phytoplasma strains within a given 16Sr subgroup.

Martini|Marta|M|
Bottner-Parker|Kristi D|KD|
Lee|Ing-Ming|IM|

D001426:Bacterial Proteins
D015373:Bacterial Typing Techniques
D001483:Base Sequence
D017124:Conserved Sequence
D058885:Multilocus Sequence Typing
D010802:Phylogeny
D045582:Phytoplasma
D010944:Plants
D016133:Polymerase Chain Reaction
D012336:RNA, Ribosomal, 16S

Virtual RFLP
secY
16Sr group-specific primers
Phytoplasma strain differentiation
Restriction enzymes
Semi-universal primers
rplV (rpl22)
rpsC (rps3)


Exploring the predictors of health-protective behavior during the COVID-19 pandemic: A multi-country comparison.

Abstract: In recent years, examining the determinants of health behaviors on a multi-country level remains limited. Therefore, the purpose of this study is to explore the key factors that may enhance the adoption of health-protective behaviors during the COVID-19 pandemic in Morocco and India. A theoretical framework derived from the health belief model (HBM) was used for this research. Data was collected from a sample of 444 adult individuals split across Morocco (n = 215) and India (n = 229). Data analysis was carried out using two-stage multiple-analytic techniques. First, structural equation modeling (SEM) was employed to test the hypothesized relationships. Second, an artificial neural network (ANN) model was employed to rank the significant independent variables obtained from SEM analysis. The results of SEM showed that perceived benefit is the key predictor of the protective behavior in Morocco, followed by self-efficacy, and then perceived severity. By contrast, ANN analysis showed that perceived severity was the most vital factor for predicting the protective behavior in Morocco, followed by perceived benefits, and then self-efficacy. For the Indian sample, both SEM analysis and the ANN model revealed that the impact of perceived susceptibility on the adoption of the protective measure is stronger than that of cues to action. Theoretical contributions and managerial implications are also discussed toward the end.

COVID-19
Health belief model
Structural equation modeling
Artificial neural network
Protective behavior


Field study on the uptake and translocation of PBDEs by wheat (Triticum aestivum L.) in soils amended with sewage sludge.

Abstract: Field experiments were conducted to explore the effects of different sewage sludge amendment strategies on the accumulation and translocation of polybrominated diphenyl ethers (PBDEs) in soil-wheat systems. Two types of application methods (single or annual application) and four annual application rates (5, 10, 20, and 40 t ha(-1) year(-1)) were investigated. BDE 209 was detected in all of the sewage sludge amended soils and different parts of wheat plants collected from the contaminated soils. However, the other seven PBDE congeners (BDE 28, BDE 47, BDE 99, BDE 100, BDE 153, BDE 154, and BDE 183) were not detected or were only observed at very low levels. A single application of sewage sludge in large quantities would likely increase accumulation of BDE 209 in soil and its subsequent uptake and translocation by wheat. The concentrations of BDE 209 in soils, wheat roots and straws increased with the increasing sewage sludge application rate. There is a negative correlation between the root accumulation factors (the ratios of concentrations in wheat roots to those in soils) and soil total organic carbon (R(2)=0.84,P<0.05), demonstrating that the bioavailability of BDE 209 was controlled by the soil total organic carbon. BDE 209 concentrations in the grains from the sewage sludge amended soils were not significantly different from those of the control soils, suggesting that atmospheric deposition was the main source of BDE 209 detected in the grains.

Li|Helian|H| Qu|Ronghui|R| Yan|Liangguo|L| Guo|Weilin|W| Ma|Yibing|Y|

Uptake
Translocation
PBDEs
Wheat
Sewage sludge


Preeclampsia and HELLP syndrome, the role of the liver.

Abstract: Preeclampsia is a multisystemic disorder which accounts for the high prevalence of maternal and perinatal morbidity and mortality, especially in middle and low-income countries. Currently, the primary intervention is the urgent delivery of the fetus, hence it would be advantageous to identify those who are likely to develop preeclampsia and the maternal and fetal outcomes. However, an array of risk factors makes these challenging. This review explores the potentials of liver biomarkers in predicting the occurrence and outcome of preeclampsia, which could be beneficial in reducing the burden of the disease. Liver dysfunction in preeclampsia results in a severe condition, hence liver function tests are specific predictors of outcome.

Hepatic dysfunction
hypertension
liver enzymes
pregnancy
proteinuria


Obstetrical transfusion medicine knowledge among faculty and trainee obstetricians: a prospective knowledge assessment study.

Abstract:
OBJECTIVES
To evaluate the current state of transfusion medicine (TM) knowledge among obstetricians using a valid assessment tool.

BACKGROUND
Transfusion issues are common in obstetrical patients.

METHODS
Knowledge topics were identified and rated by experts in obstetrics, anaesthesia, haematology and TM using a modified Delphi method. A knowledge assessment tool was developed and validated during pilot testing. The assessment tool, consisting of 15 multiple choice questions, was administered electronically to members of the Society of Obstetricians and Gynaecologists of Canada (SOGC).

RESULTS
A total of 192 SOGC members completed the assessment tool: 121 faculty obstetricians and 71 trainees. The average score was 65·8% ± 15·5. Scores for faculty were higher than trainees (68·9% ± 13·5 vs 60·6% ± 17·2; P < 0·001). Respondents performed well on questions related to red blood cell (RBC) transfusion and anaemia management but had lower scores on questions related to non-RBC transfusion and management of alloantibodies and fetomaternal haemorrhage (FMH) testing. There was no improvement in scores with increasing trainee level, years of practice, hours of formal TM training or experience with massive haemorrhage. Only self-rated knowledge was associated with scores ['no knowledge' or 'beginner' 63·1% ± 15 vs 'intermediate' or 'advanced' 68·9% ± 13·3 (P = 0·007)]. Of the respondents, 93·8% felt additional training in TM would be helpful.

CONCLUSIONS
Overall knowledge assessment scores indicate the need for educational intervention, particularly with respect to non-RBC blood product use, management of FMH and management of pregnancies complicated by alloantibodies. The study also demonstrated a desire for additional TM training.

Morris|S|S|
Yudin|M H|MH|
Callum|J|J|
Alam|A|A|
Herold|J|J|
Lin|Y|Y|

obstetrics
transfusion
knowledge assessment tool
medical education


Glycosylation Analysis of Therapeutic Glycoproteins Produced in CHO Cells.

Abstract: In the last decades, the number of approved therapeutic proteins drugs is increasing exponentially and a large number of new therapeutic entities are progressing through clinical trials, solidifying biologics as the most promising class of pharmaceuticals on the market. Several cell lines are available for biopharmaceutical processes but mammalian cells are preferred since they give fewer problems for immunogenicity as they produce human-like post-translational modifications (PTMs). Glycosylation is the most common and complex (for both bioprocess engineering and quality control) of these modifications. Obtaining the desired glycosylation pattern is crucial for therapeutic proteins as it can impact significantly stability, half-life and safety as well as driving molecular processes, modifying the way drug interacts with patients' cells. As a consequence, glycosylation (like other PTMs) needs to be regulated and accurately analyzed during biopharmaceutical production. Herein we describe and discuss the analytical approaches for glycosylation analysis of therapeutic glycoproteins produced in CHO (Chinese Hamster Ovary) cells. This chapter will describe glycoprotein purification after separation from producing cell lines, N-glycan release and their variants fine structural characterization through mass spectrometry techniques.

Carillo|Sara|S| Mittermayr|Stefan|S| Farrell|Amy|A| Albrecht|Simone|S| Bones|Jonathan|J|

CHO cells
Mass spectrometry
Glycan analysis
Liquid chromatography
Monoclonal antibodies


The Frequency Response of Outer Hair Cell Voltage-Dependent Motility Is Limited by Kinetics of Prestin.

Abstract: The voltage-dependent protein SLC26a5 (prestin) underlies outer hair cell electromotility (eM), which is responsible for cochlear amplification in mammals. The electrical signature of eM is a bell-shaped nonlinear capacitance (NLC), deriving from prestin sensor-charge (Qp) movements, which peaks at the membrane voltage, Vh, where charge is distributed equally on either side of the membrane. Voltage dependencies of NLC and eM differ depending on interrogation frequency and intracellular chloride, revealing slow intermediate conformational transitions between anion binding and voltage-driven Qp movements. Consequently, NLC exhibits low-pass characteristics, substantially below prevailing estimates of eM frequency response. Here we study in guinea pig and mouse of either sex synchronous prestin electrical (NLC, Qp) and mechanical (eM) activity across frequencies under voltage clamp (whole cell and microchamber). We find that eM and Qp magnitude and phase correspond, indicating tight piezoelectric coupling. Electromechanical measures (both NLC and eM) show dual-Lorentzian, low-pass behavior, with a limiting (τ2) time constant at Vh of 32.6 and 24.8 μs, respectively. As expected for voltage-dependent kinetics, voltage excitation away from Vh has a faster, flatter frequency response, with our fastest measured τ2 for eM of 18.2 μs. Previous observations of ultrafast eM (τ ≈ 2 μs) were obtained at offsets far removed from Vh We hypothesize that trade-offs in eM gain-bandwith arising from voltage excitation at membrane potentials offset from Vh influence the effectiveness of cochlear amplification across frequencies.SIGNIFICANCE STATEMENT Of two types of hair cells within the organ of Corti, inner hair cells and outer hair cells, the latter evolved to boost sensitivity to sounds. Damage results in hearing loss of 40-60 dB, revealing amplification gains of 100-1000× that arise from voltage-dependent mechanical responses [electromotility (eM)]. eM, driven by the membrane protein prestin, may work beyond 70 kHz. However, this speed exceeds, by over an order of magnitude, kinetics of typical voltage-dependent membrane proteins. We find eM is actually low pass in nature, indicating that prestin bears kinetics typical of other membrane proteins. These observations highlight potential difficulties in providing sufficient amplification beyond a cutoff frequency near 20 kHz. Nevertheless, observed trade-offs in eM gain-bandwith may sustain cochlear amplification across frequency.

outer hair cell
electromotility
cochlear amplification
capacitance
membrane proteins
sensor charge


Maternal Perinatal Outcomes Related to Advanced Maternal Age in Preeclampsia Pregnant Women.

Abstract: Objective: This study aims to analyze the effect of advanced maternal age (>35 years old) in maternal and perinatal outcomes of preeclampsia women. Materials and methods: This is a retrospective cross-sectional study involved all women who were diagnosed with preeclampsia at Universitas Airlangga Hospital (Surabaya, Indonesia) between January 2016 until May 2017. The participant was divided into two groups based on maternal ages: the first group was women older than 35 years old (advanced maternal age - AMA), and the other group was 20-34 years old (reproductive age - RA). The primary outcomes of this study were the maternal and perinatal outcome. Results: There were a total of 43 AMA preeclampsia women and 105 RA preeclampsia women. The AMA preeclampsia group had a higher proportion of poor maternal outcome (the occurence of any complication: pulmonary edema, HELLP syndrome, visual impairment, post partum hemorrhage, and eclampsia) compared to RA preeclampsia group (60,5% vs 33,3%, p = 0,002; OR 3,059, CI 1,469-6,371). There was no significant difference in the other maternal complications such as HELLP syndrome, pulmonary oedema, and eclampsia. The only difference was the occurrence of postpartum haemorrhage which was higher in the AMA group (16,3% vs 4,8%, p = 0,02; OR 3,889, CI 1,161-13,031). The prevalence of cesarean delivery was more common in AMA group (53,3% vs 28,6%, p = 0,004; OR 2.825, CI 1.380-5.988). The AMA preeclampsia women also had poorer perinatal outcomes compared to the RA group (81,4% vs 59%, p = 0,009; OR 3.034 CI 1.283-7.177). AMA women had a higher risk of perinatal complication such as prematurity (OR 3.266 CI 1.269-8.406), IUGR (OR 4.474 CI 1.019-19.634), asphyxia (OR 4.263 CI 2.004-9.069), and infection (OR 2.138 CI 1.040-4.393). Conclusion: Advanced maternal age increases the risk of poorer maternal and neonatal outcomes in preeclampsia patients. The addition of advanced maternal ages in preeclampsia should raise the awareness of the health provider, tighter monitoring, complete screening and early intervention if needed to minimize the risk of complications.

Tyas|Bestari Dianing|BD|
Lestari|Pudji|P|
Aldika Akbar|Muhammad Ilham|MI|

Perinatal Outcomes
Advanced Maternal Age
Preeclampsia
Maternal Outcomes


The effects of prone bridge exercise on the Oswestry disability index and proprioception of patients with chronic low back pain.

Abstract: [Purpose] The purpose of this study was to investigate the effect of bridge exercises on the Oswestry disability index (ODI) scores and proprioception among patients with chronic low back pain (CLBP). [Subjects and Methods] A total of 38 patients participated in this study. After eight weeks of bridge exercise, the joint position angle of the body trunk was measured and the ODI was used in survey form to investigate the intensity of the patients' low back pain. [Results] After eight weeks of exercise, the ODI showed significant differences in all three groups. Subjects' joint position sense of the trunk in both lumbar flexion and extension was also significantly different after completing the exercise program; this was true for all three groups. [Conclusion] Performing the prone bridge exercise for eight weeks improved proprioceptive function and reduced pain and impediment of activity, showing it a more effective exercise than other bridge exercises.

Bridge exercise
Proprioception
Chronic low back pain


Inter- and intra-observer variability of the AO/OTA classification for sternal fractures: a validation study.

Abstract:
INTRODUCTION
Recently, a new classification system for sternal fractures has been published in the Journal of Orthopedic trauma by the Arbeitsgemeinschaft für Osteosynthesefragen (AO) foundation and the Orthopaedic Trauma Association (OTA). The aim of this study was to evaluate inter- and intra-observer variability of the AO/OTA classification for sternal fractures.

MATERIALS AND METHODS
Twenty multidetector computed tomography (CT) scans of patients with sternal fractures were classified independently by six senior and six junior orthopedic trauma surgeons of two level-1 trauma centers. Assessment was done on two occasions with an interval of 6 weeks. The kappa value was calculated to determine variability.

RESULTS
The inter-observer variability of the AO/OTA classification for sternal fractures showed fair-to-moderate agreement (kappa = 0.364). There was no significant difference between junior and senior surgeons. Analyses of the separate components of the classification demonstrated that agreement was lowest for classifying fracture type within the sternal body (kappa = 0.319) followed by manubrium (kappa = 0.525). The intra-observer variability showed moderate agreement with a mean kappa of 0.414.

CONCLUSION
The inter- and intra-observer variability of the AO/OTA classification for sternal fractures shows fair-to-moderate agreement. The overall performance of the classification might be improved with minor modifications.

LEVEL OF EVIDENCE
Diagnostic cross-sectional study (level I).

van de Wall|B J M|BJM|
Beeres|F J P|FJP|
Link|B|B|
Michelitsch|C|C|
Houwert|R M|RM|
Babst|R|R|
Sommer|C|C|
Frima|H|H|
|||


Type 2 diabetes and the risk of incident hearing loss.

Abstract:
AIMS/HYPOTHESIS
Type 2 diabetes mellitus has been implicated as a risk factor for hearing loss, with possible mechanisms including microvascular disease, acoustic neuropathy or oxidative stress. A few small studies have examined the longitudinal association between type 2 diabetes and hearing loss, but larger studies are needed. Our objective was to examine whether type 2 diabetes (including diabetes duration) is associated with incident hearing loss in two prospective cohorts: Nurses' Health Studies (NHS) I and II.

METHODS
We conducted a longitudinal study of 139,909 women to examine the relationship between type 2 diabetes and the risk of self-reported incident hearing loss. A physician-diagnosis of diabetes was ascertained from biennial questionnaires. The primary outcome was hearing loss reported as moderate or worse in severity (categorised as a 'moderate or severe' hearing problem, or 'moderate hearing trouble or deaf') on questionnaires administered in 2012 in NHS I and 2009 or 2013 in NHS II. Cox proportional hazards regression was used to adjust for potential confounders.

RESULTS
During >2.4 million person-years of follow-up, 664 cases of moderate or worse hearing loss were reported among those with type 2 diabetes and 10,022 cases among those without type 2 diabetes. Compared with women who did not have type 2 diabetes, those with type 2 diabetes were at higher risk for incident moderate or worse hearing loss (pooled multivariable-adjusted HR 1.16 [95% CI 1.07, 1.27]). Participants who had type 2 diabetes for ≥8 years had a higher risk of moderate or worse hearing loss compared with those without type 2 diabetes (pooled multivariable-adjusted HR 1.24 [95% CI 1.10, 1.40]).

CONCLUSIONS/INTERPRETATION
In this large longitudinal study, type 2 diabetes was associated with a modestly higher risk of moderate or worse hearing loss. Furthermore, longer duration diabetes was associated with a higher risk of moderate or worse hearing loss.

Gupta|Shruti|S|0000-0002-5747-2151
Eavey|Roland D|RD|
Wang|Molin|M|
Curhan|Sharon G|SG|
Curhan|Gary C|GC|

Type 2 diabetes
Hearing loss
Longitudinal
Nurses’ Health Study


gem-Dinitroalkyl Benzenes: A Novel Class of IOP-Lowering Agents for the Treatment of Ocular Hypertension.

Abstract: Primary open angle glaucoma is the second most common cause of blindness worldwide. Nitric oxide has recently received particular attention as a potential antiglaucoma agent. In this work, gem-dinitroalkyl benzenes are evaluated for their capability to act as a new class of IOP lowering agents. These derivatives have been endowed with a variety of NO-release capacities and found to relax contracted rat aorta strips in a concentration-dependent manner. They have been studied for their IOP-lowering activity in a transient ocular hypertensive rabbit model at 1% dose. The most effective IOP-lowering products were compounds 9-11 and 13, whose activity was similar to that of Molsidomine 120 min after administration. Compounds 9 and 13 were selected for evaluation using carbomer-induced glaucoma as the chronic model of IOP. They cause a significant reduction in IOP in the first 24 h, and their activity is maintained over 5 days, displaying a Molsidomine-like profile.

Blangetti|Marco|M| Rolando|Barbara|B| Marini|Elisabetta|E| Chegaev|Konstantin|K| Guglielmo|Stefano|S| Lazzarato|Loretta|L| Lucarini|Laura|L| Masini|Emanuela|E| Fruttero|Roberta|R|

gem-Dinitroalkyl benzenes
ocular hypertension
glaucoma
nitric oxide


Effect of Calcium Hydroxide on the Push-out Bond Strength of Endodontic Biomaterials in Simulated Furcation Perforations.

Abstract:
INTRODUCTION
The aim of this in vitro study was to evaluate the effect of calcium hydroxide (CH) on push-out bond strength of white mineral trioxide aggregate (WMTA) and calcium-enriched mixture (CEM) cement in simulated furcation perforations.

METHODS AND MATERIALS
Furcation perforations, measuring 1.3 mm in diameter and 2 mm in height, were created in 80 human mandibular first molars. The teeth were then divided into 4 groups (n=20). In groups 1 and 3 CH was placed in the perforation for one week, before placement of WMTA and CEM. In groups 2 and 4 perforations were repaired without placement of CH. In groups 1 and 2 the perforation sites were repaired with WMTA and CEM cement was used in groups 3 and 4. After 7 days, the push-out test was carried out using a universal testing machine. Data were analyzed with two-way ANOVA. The level of significance was set at 0.05.

RESULTS
The maximum and minimum bond strength values were recorded in the WMTA/CH (13.08±1.8 MPa) and CEM cement groups (8.03±0.98 MPa), respectively. There were significant differences in resistance to dislodgement between the WMTA/CH and other groups (P<0.05).

CONCLUSION
Placement of CH before placement of WMTA in furcation perforation improves the push-out bond strength of this material.

Ghasemi|Negin|N|
Reyhani|Mohammad Forough|MF|
Salem Milani|Amin|A|
Mokhtari|Hadi|H|
Khoshmanzar|Faezeh|F|

Calcium Hydroxide
Push-Out
Furcation Perforation
Mineral Trioxide Aggregate
Calcium-Enriched Mixture


A novel RARα/CAR-mediated mechanism for regulation of human organic solute transporter-β gene expression.

Abstract: The organic solute transporter-α/β (OSTα/β) is a heteromeric transporter that is essential for bile acid and sterol disposition and for the enterohepatic circulation. To better understand the mechanism underlying OST gene regulation, the effects of retinoic acid (RA) on OSTα/β gene expression were investigated. The results show a dose-dependent induction of OSTβ but not OSTα expression in both Huh7 and HepG2 cells by RA treatment. A novel functional RA receptor response element (RARE; so-called DR5) in the promoter of OSTβ gene was identified. The interaction of RARα/RXRα with the RARE was verified by electrophoretic mobility shift and chromatin immunoprecipitation assays and its functional importance by hOSTβ promoter activation in luciferase reporter assays. The studies demonstrated that the RARE is also a constitutive androstane receptor (CAR) binding site for OSTβ gene regulation. These results suggest that OSTβ is a target of both FXR-mediated (by binding to IR-1 element) and RARα- and CAR-mediated (by binding to DR5 element) gene regulation pathways. In summary, this study has uncovered a novel RARE (DR5) element in the promoter of OSTβ that binds RARα or CAR heterodimerized with RXRα and appears to function synergistically with the IR-1 element to provide maximal induction of OSTβ in response to RA. These findings demonstrate a role for RARα and CAR in controlling OSTβ expression levels.

Xu|Shuhua|S|
Sun|An-Qiang|AQ|
Suchy|Frederick J|FJ|

D024202:Electrophoretic Mobility Shift Assay

D060888:Real-Time Polymerase Chain Reaction

D018160:Receptors, Cytoplasmic and Nuclear

organic solute transporter-β
DR5
constitutive androstane receptor
retinoic acid receptor-α


Effect of pretreatment with ketorolac tromethamine on operative pain during periodontal surgery: A case-control study.

Abstract:
BACKGROUND
The efficacy of a nonsteroidal anti-inflammatory agent, ketorolac tromethamine, was evaluated in pain control after periodontal surgery. This type of agent acts peripherally by inhibiting the release of prostaglandins and minimizing the local inflammatory response. Thus, there may be an advantage in pretreatment administration of ketorolac tromethamine, 10 mg, compared with placebo on operative pain during periodontal surgery.

MATERIALS AND METHODS
Two groups of 40 outpatients from the Department of Periodontology, Darshan Dental College and Hospital, Udaipur, were selected for this study. Patients who were to undergo periodontal surgery were randomly given either one group 10 mg ketorolac immediately before surgery or the other group placebo tablets at least 30 minutes before administration of local anesthesia (LA). All procedures were performed under LA, and the total volume of anesthetic used was recorded. The duration of surgery from the time of incision to the placement of the last suture was recorded. At the completion of the surgery, patients were supplied with printed record forms and were asked to rate their subjective operative pain intensity using a visual analog scale.

STATISTICAL ANALYSIS
The data were analyzed using the student t test.

RESULTS
Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity of operative pain as compared with placebo. No adverse reactions related to preoperative medication were observed.

CONCLUSIONS
The results of this study showed that 10-mg ketorolac administered immediately before periodontal surgery was effective for alleviating the operative painful sequelae.

Ketorolac
operative pain
periodontal surgery
pain/prevention and control


The Declining Scope of Practice of Family Physicians Is Limited to Urban Areas.

Abstract:
PURPOSE
Scope of practice of family physicians (FPs) has been decreasing overall. Our objective was to determine if the distribution of declining scope occurs across urban and rural settings.

METHODS
We used secondary data from practicing FPs collected on the American Board of Family Medicine examination registration demographic questionnaire from 2014 to 2016 on scope of practice merged with county-level data from the Area Health Resources File. Rurality was assigned using 4 population-based groupings from the Rural Urban Continuum Codes. Outcome measures were scope of practice score (0-30, higher score reflecting broader scope) and provision of specific types of care/procedures. Bivariate statistics assessed changes in scope of practice over time. Adjusted regression models tested associations between time, physician, practice, and county characteristics with scope of practice score.

FINDINGS
Our sample was 27,343 practicing FPs. Overall, the scope score decreased from 15.5 to 15.0 (P value < .05) but was significant only for urban settings. Regression analysis found that scope decreased each year (β = -0.15), broader scope for rural FPs, and no interaction between year and rural.

CONCLUSIONS
The decrease in FP scope of practice is largely an urban phenomenon. FPs in rural areas have a broad scope of practice, which may ensure access to care in rural areas that rely on FPs to provide a large portion of health care services. However, county characteristics like persistent poverty and the presence of nurse practitioners, physician assistants, and other physicians were associated with changes in scope that may modify the gains associated with rurality.

Nasim|Urooj|U|0000-0002-1196-0328
Morgan|Zachary J|ZJ|
Peterson|Lars E|LE|

D005194:Family Practice
D006801:Humans
D010823:Physician Assistants
D010821:Physicians, Family
D010818:Practice Patterns, Physicians'
D019035:Rural Health Services
D000079103:Scope of Practice
D014481:United States

scope of practice
family physicians
rural health


Small RNA profiles in soybean primary root tips under water deficit.

Abstract:
BACKGROUND
Soybean (Glycine max) production is significantly hampered by frequent droughts in many regions of the world including the United States. Identifying microRNA (miRNA)-controlled posttranscriptional gene regulation under drought will enhance our understanding of molecular basis of drought tolerance in this important cash crop. Indeed, miRNA profiles in soybean exposed to drought were studied but not from the primary root tips, which is not only a main zone of water uptake but also critical for water stress sensing and signaling.

METHODS
Here we report miRNA profiles specifically from well-watered and water-stressed primary root tips (0 to 8 mm from the root apex) of soybean. Small RNA sequencing confirmed the expression of vastly diverse miRNA (303 individual miRNAs) population, and, importantly several conserved miRNAs were abundantly expressed in primary root tips.

RESULTS
Notably, 12 highly conserved miRNA families were differentially regulated in response to water-deficit; six were upregulated while six others were downregulated at least by one fold (log2) change. Differentially regulated soybean miRNAs are targeting genes include auxin response factors, Cu/Zn Superoxide dismutases, laccases and plantacyanin and several others.

CONCLUSIONS
These results highlighted the importance of miRNAs in primary root tips both under control and water-deficit conditions; under control conditions, miRNAs could be important for cell division, cell elongation and maintenance of the root apical meristem activity including quiescent centre whereas under water stress differentially regulated miRNAs could decrease auxin signaling and oxidative stress as well as other metabolic processes that save energy and water.

Zheng|Yun|Y|
Hivrale|Vandana|V|
Zhang|Xiaotuo|X|
Valliyodan|Babu|B|
Lelandais-Brière|Christine|C|
Farmer|Andrew D|AD|
May|Gregory D|GD|
Crespi|Martin|M|
Nguyen|Henry T|HT|
Sunkar|Ramanjulu|R|

D018506:Gene Expression Regulation, Plant

Soybean
Primary root tips
Drought
miRNAs
Post-transcriptional gene regulation


Circulating fetal and total cell-free DNA, and sHLA-G in black South African women with gestational hypertension and pre-eclampsia.

Abstract:
OBJECTIVE
Quantification of circulating fetal and total cell-free DNA (cfDNA) and soluble human leucocyte antigen (HLAG) in gestational hypertension and pre-eclampsia.

METHODS
Serum cfDNA were quantified in controls, pre-eclamptics, and gestational hypertensive patients using real-time qPCR. Soluble HLAG was measured by enzyme-linked immune-sorbent assay.

RESULTS
Serum fetal and total cfDNA levels were higher in pre-eclampsia compared with the controls and gestational hypertensives (p < 0.001), more so in severe compared with mild-to-moderate pre-eclampsia (p < 0.05). Soluble HLAG levels were lower in pre-eclamptics than controls and gestational hypertension (p < 0.05).

CONCLUSION
Circulating fetal and total cfDNA were increased, while soluble HLAG was decreased in pre-eclampsia.

total cell-free DNA
gestational hypertension
pre-eclampsia
soluble human leucocyte antigen
Fetal cell-free DNA


Past Care Predicts Future Care in Out-of-Care People Living with HIV: Results of a Clinic-Based Retention-in-Care Intervention in North Carolina.

Abstract: Poor retention in care is associated with higher viral load (VL) results and decreased rates of viral load suppression (VS) in people living with HIV (PLWH). Therefore, improving retention in HIV care is a priority of national significance. The NC-LINK Retention Project utilized a systematic approach to identify, locate, and attempt to return to care patients who did not attend a clinic appointment for 6-9 months. Clinical and surveillance data were used to evaluate associations between patient characteristics and VL outcomes. Between January 1, 2013 and December 31, 2014, 1118 patients at participating clinics were identified as out-of-care and referred to retention staff. Of these, 712 (64%) were located in North Carolina. Patients with recent prior medical care (aPR 1.43, 95% CI 1.25, 1.66) and recent VS (aPR 1.28, 95% CI 1.16, 1.41) were more likely to be located. Of located patients, 58% re-engaged in care within 90 days of retention referral. Patients who achieved VS within 180 days were more likely to be 40-49 years (aPR 1.19 95% CI 1.01-1.40; compared with 18-29 age group), had insurance at their last visit (aPR 1.19 95% CI 1.01-1.77), had a care visit in the prior year (aPR 1.37 95% CI 1.05-1.77), and had VS at the prior care visit (aPR 2.54 95% CI 1.98-3.25). Clinic-based retention efforts may be effective at helping PLWH decrease out-of-care periods, but prior patterns of care usage persist.

D000293:Adolescent
D000328:Adult
D000554:Ambulatory Care Facilities
D001071:Appointments and Schedules
D019090:Case Management
D005260:Female
D015658:HIV Infections
D006801:Humans
D008297:Male
D008875:Middle Aged
D009657:North Carolina
D062526:Patient Navigation
D010358:Patient Participation
D012017:Referral and Consultation
D000076522:Retention in Care
D013689:Telephone
D019562:Viral Load
D055815:Young Adult


Measuring Micro-Level Effects of a New Supermarket: Do Residents Within 0.5 Mile Have Improved Dietary Behaviors?

Abstract:
BACKGROUND
Local and national policies to encourage supermarket opening or expansion are popular strategies for improving access to healthy food for residents in neighborhoods lacking these types of stores, yet few evaluations of such initiatives exist.

OBJECTIVE
Our aim was to test whether a newly opened supermarket in the Bronx, NY, changed household availability of healthy and unhealthy food items and reported daily consumption of these items among respondents residing in close proximity (≤0.5 mile) to the new supermarket.

DESIGN
This quasi-experimental study evaluated changes in purchasing and consumption habits of residents within 0.5 mile of the new supermarket as compared to residents living more than 0.5 mile from the supermarket. Data were collected through street intercept surveys at three different times: once before the store opened (March to August 2011) and in two follow-up periods (1 to 5 months and 13 to 17 months after the store opened). This study analyzed a subset of successfully geocoded resident intersections from the larger study.

PARTICIPANTS/SETTING
We surveyed 3,998 residents older than the age of 18 years in two Bronx neighborhoods about their food-purchasing behaviors before the store opened and in two follow-up periods. Responses from residents whose intersections were successfully geocoded (N=3,378) were analyzed to examine the consumption and purchasing behaviors of those in close proximity to the new store.

INTERVENTION
A new supermarket opened in a low-access neighborhood in the Bronx with the help of financial incentives through New York City's Food Retail Expansion to Support Health (FRESH) program.

MAIN OUTCOME MEASURES
The primary outcome evaluated was the change in percent of respondents reporting that the following food items were "always available" in the home: milk, fruit juice, soda, pastries, packaged snacks, fruits, and vegetables. As a secondary outcome, we explored changes in self-reported daily servings of these items.

STATISTICAL ANALYSIS PERFORMED
A difference-in-difference analysis was performed, controlling for age, education, marital status, income, sex, race, and ethnicity.

RESULTS
Residents within 0.5 mile of the store had increased household availability of both healthy and unhealthy foods. After the introduction of the supermarket, the percent of residents in close proximity to the store who reported always having produce available in the home increased by 8.8% compared to those living >0.5 mile from the store in the first post-period and by 10.6% compared to those living >0.5 mile from the store in the second post-period. A similar positive increase in household availability of salty snacks and pastries was observed. Residents living in close proximity also reported greater consumption of healthy foods like produce and water, and lower intake of soft drinks and pastries.

CONCLUSIONS
Given the financial support at the national and local levels to encourage supermarket development and expansion in high-need communities, it is imperative to evaluate the impact of such initiatives. Although the findings have so far been equivocal, our findings give weight to the argument that, at a micro-level, the siting of a new supermarket can indeed impact local purchasing and consumption behavior. Although purchasing for both healthy and unhealthy food items increased, reported consumption showed an increase in servings of healthy items (water, vegetables, and fruit) and a decrease in servings of unhealthy foods (soft drinks, salty snacks, and pastries).

Rogus|Stephanie|S| Athens|Jessica|J| Cantor|Jonathan|J| Elbel|Brian|B|

D065228:Non-Randomized Controlled Trials as Topic

Supermarkets
Diet quality
Food access
Food purchasing patterns


Continuous control of tracheal cuff pressure for VAP prevention: a collaborative meta-analysis of individual participant data.

Abstract:
BACKGROUND
Underinflation of tracheal cuff is a risk factor for microaspiration of contaminated secretions and subsequent ventilator-associated pneumonia (VAP). The aim of this collaborative meta-analysis of individual participant data is to determine the impact of continuous control of P cuff on the incidence of VAP.

METHODS
Studies were identified by searching PubMed and references of relevant articles. Data from 3 prospective controlled trials (two randomized and one quasi-randomized), which evaluated the impact of continuous control of P cuff on the incidence of VAP, were obtained and pooled together. Three different devices were used to continuously control P cuff. VAP was diagnosed using clinical, radiologic, and quantitative microbiological criteria. The impact of continuous control of P cuff on VAP was assessed by Cox regression analysis, stratified on trial.

RESULTS
263 (48.4 %) patients received continuous control of P cuff, and 280 (51.5 %) patients received routine control of P cuff using a manometer. 36 (13.6 %) VAP were diagnosed in continuous control group, and 72 (25.7 %) in routine care group (HR 0.47, 95 % CI 0.31-0.71, p < 0.001). However, heterogeneity was apparent in continuous control effect size across trials (I (2) = 58 %, p = 0.085). The number of patients needed to treat to prevent one VAP episode was 8. No significant impact of continuous control of P cuff was found on duration of mechanical ventilation, ICU length of stay, or mortality.

CONCLUSION
Continuous control of P cuff might be beneficial in reducing the risk for VAP. However, no significant impact of continuous control of P cuff was found on duration of mechanical ventilation, ICU length of stay, or mortality.

Nseir|Saad|S|
Lorente|Leonardo|L|
Ferrer|Miquel|M|
Rouzé|Anahita|A|
Gonzalez|Oswaldo|O|
Bassi|Gianluigi Li|GL|
Duhamel|Alain|A|
Torres|Antoni|A|

Cuff pressure
Meta-analysis
Microaspiration
Pneumonia
Mechanical ventilation
Critical care


Rapid induction of edible lipids in Chlorella by mild electric stimulation.

Abstract: In this work, a new stress-based method for rapid induction of triacylglycerol (TAG) and total and polyunsaturated fatty acid accumulations in Chlorella sp. by mild electric stimulation is presented. When a cathodic current of 31 mA (voltage: 4 V) was applied to the algal cells for 4 h, the TAG content of the electro-treated cells was sharply increased to a level 2.1 times that of the untreated control. The contents of the polyunsaturated linoleic (C18:2n6) and linolenic (C18:3n3) acids in the electro-treated cells were also 36 and 57% higher than those in the untreated cells, respectively. Cyclic voltammetry and various biochemical analyses indicate that TAG and fatty acid formations are electro-stimulated via de novo fatty acid biosynthesis and metabolic transformation in the Chlorella cells.

Choi|Sun-A|SA|
Lee|Soo Youn|SY|
Lee|Jiye|J|
Cho|Jun Muk|JM|
Lee|Jin-Suk|JS|
Kim|Seung Wook|SW|
Kim|Dong-Yeon|DY|
Park|Se-Kook|SK|
Jin|Chang-Soo|CS|
Oh|You-Kwan|YK|

Chlorella
Electric stimulation
Triacylglycerol
Essential polyunsaturated fatty acids
Lipid induction


Mineral Homeostasis and Effects on Bone Mineralization in the Preterm Neonate.

Abstract: Most bone formation and mineralization occurs late in gestation. Accretion of adequate minerals is a key element of this process and is often interrupted through preterm birth. In utero, mineral transport is accomplished via active transport across the placenta and does not require fetal hormone input. Postnatal mineral homeostasis requires a balance of actions of parathyroid hormone, calcitonin, and vitamin D on target organs. Preterm birth, asphyxia, acidosis, and prolonged parenteral nutrition increase the risk of mineral imbalance and metabolic bone disease (MBD). Aggressive postnatal nutrition is key to preventing and treating MBD in preterm infants.

Bone mineralization
Parathyroid hormone
Nutrition
Bone density
Calcium
Phosphorus
Rickets of prematurity


Braun enteroenterostomy reduces delayed gastric emptying: A systematic review and meta-analysis.

Abstract:
BACKGROUND
It remains controversial whether the additional Braun enteroenterostomy (BEE) is necessary in decreasing delayed gastric emptying (DGE) following pancreaticoduodenectomy (PD). This meta-analysis aims to assess the efficacy of the additional BEE in reducing DGE after PD.

METHODS
PubMed, EMBASE, Science Citation Index and The Cochrane Library were searched to identify relevant studies. Articles published before May 15, 2015 comparing BEE with traditional gastrojejunostomy during PD were selected. The evaluated end points consist of intro-operative outcomes as well as postoperative complications.

RESULTS
Seven observational clinical studies that recruited 1401 patients were included. This meta-analysis indicated that the occurrence of DGE was lower in Braun group (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15 to 0.60; P = 0.0007). Overall morbidity (OR, 0.61; 95%CI, 0.47 to 0.80; P = 0.0003) and the length of hospital stay (LOS) (weighted mean difference [WMD], -1.80; 95%CI, -3.4 to -0.18; p = 0.03) were also in favor of the Braun group. However, Braun group had no advantage over Non-Braun group in terms of intra-operative blood loss, mortality, pancreatic fistula, bile Leakage and intra-abdominal abscess.

CONCLUSION
The additional of BEE plays an important role in reducing DGE, overall morbidity and LOS.

Huang|Ming-quan|MQ| Li|Mou|M| Mao|Jing-yu|JY| Tian|Bo-le|BL|

Braun enteroenterostomy
Delayed gastric emptying
Meta-analysis
Pancreaticoduodenectomy


History and Perspectives on Nutrition and Hydration at the End of Life.

Abstract: The question of whether to provide artificial nutrition and hydration (ANH) to a patient with terminal illness or at end of life has been debated over many years. Due to the nature of the question and the setting in which it presents, prospective trials are not feasible, and the health care professional is left to work with the patient and family to make decisions. This perspectives piece addresses the issue in a format designed to inform the reader as to the pertinent considerations around ANH. We briefly review significant historic, religious, ethical, and legal contributions to this discussion and physiologic underpinnings. We address the beliefs of patient, family, and health care providers surrounding this issue. Our goal is to provide a review of the considerations for health care providers as they address this issue with patients and families in the course of compassionate care.

Marcolini|Evie G|EG|
Putnam|Andrew T|AT|
Aydin|Ani|A|

D003657:Decision Making
D003681:Dehydration
D006801:Humans
D018673:Nutrition Policy
D011446:Prospective Studies
D013727:Terminal Care

hydration
end of life
artificial nutrition
terminal illness
ethics


RICE: A method for quantitative mammographic image enhancement.

Abstract: We introduce Region of Interest Contrast Enhancement (RICE) to identify focal densities in mammograms. It aims to help radiologists: 1) enhancing the contrast of mammographic images; and 2) detecting regions of interest (such as focal densities) that are candidate masses potentially masked behind dense parenchyma. Cancer masking is an unsolved issue, particularly in breast density categories BI-RADS C and D. RICE suppresses normal breast parenchyma in order to highlight focal densities. Unlike methods that enhance mammograms by modifying the dynamic range of an image; RICE relies on the actual tissue composition of the breast. It segments Volumetric Breast Density (VBD) maps into smaller regions and then applies a recursive mechanism to estimate the 'neighbourhood' for each segment. The method then subtracts and updates the neighbourhood, or the encompassing tissue, from each piecewise constant component of the breast image. This not only enhances the appearance of a candidate mass but also helps in estimating the mass density. In extensive experiments, RICE enhances focal densities in all breast density types including the most challenging category BI-RADS D. Suitably adapted, RICE can be used as a precursor to any computer-aided diagnostics and detection system.

D011857:Radiographic Image Interpretation, Computer-Assisted

Image Enhancement
Contrast Enhancement
Focal Density
Cancer Masking
Breast Density
Breast Cancer


Effectiveness of using wearable vibration therapy to alleviate muscle soreness.

Abstract:
PURPOSE
To examine the acute and short-term effect of a wearable vibration device following strenuous eccentric exercise of the elbow flexors.

METHODS
Physically active males (n = 13) performed vibration therapy (VT) and control following eccentric exercise. The arms were randomised and counterbalanced, separated by 14 days. 15 min of VT (120 Hz) was applied immediately and 24, 48, and 72 h after eccentric exercise while the contralateral arm performed no VT (control). Muscle (isometric and concentric) strength, range of motion, electromyography (EMG), muscle soreness and creatine kinase were taken pre-exercise, immediately and 24, 48, and 72 h post-eccentric exercise. Additionally, the acute effect of VT of muscle strength, range of motion, EMG, muscle soreness was also investigated immediately after VT.

RESULTS
In the short-term VT was able to significantly reduce the level of biceps brachii pain at 24 h (p < 0.05) and 72 h (p < 0.01), enhance pain threshold at 48 h (p < 0.01) and 72 h (p < 0.01), improve range of motion at 24 h (p < 0.05), 48 h (p < 0.01) and 72 h (p < 0.01) and significantly (p < 0.05) reduced creatine kinase at 72 h compared to control. Acutely, following VT treatment muscle pain and range of motion significantly improved (p < 0.05) at 24 h post, 48 h post, and 72 h post but no significant changes in muscle strength and EMG were reported acutely or short-term.

CONCLUSIONS
Acute and short-term VT attenuated muscle soreness, creatine kinase and improved range of motion; however, there was no improvement of muscle strength recovery compared to control following eccentric exercise of the elbow flexors.

Creatine kinase
Recovery
Concentric torque
Muscle damage


Valorization of Cork Using Subcritical Water.

Abstract: Granulated cork was submitted to subcritical water extraction/hydrolysis in a semi-continuous reactor at temperatures in the range of 120-200 °C and with a constant pressure of 100 bar. The influence of temperature on the composition of the cork extracts obtained was assessed-namely, their content of carbohydrates and phenolics. The extraction yield increased with the temperature, and this was associated with the decrease in the dielectric constant of water and the increase in its ionic product. Extracts composed of up to 36% phenolics were obtained at temperatures of up to 120 °C, with an antioxidant activity only two times lower than that of pure gallic acid, but in low amounts. Assays at higher temperatures generated extracts richer in carbohydrates and with a phenolics content of ca. 20 wt.% in comparatively far higher amounts. Neither the amount of suberin nor its structure were affected by the subcritical water treatment.

D002851:Chromatography, High Pressure Liquid

D017550:Spectroscopy, Fourier Transform Infrared

cork
subcritical water
carbohydrates
phenolics
antioxidant activity
Quercus suber L.


New Concepts, Concerns, and Creations in Acne.

Abstract: Laboratory monitoring for patients on isotretinoin should include creatinine kinase in athletic males and the more liver-specific gamma glutamyltransferase. There is mounting evidence that acne pathophysiology includes a barrier defect and subsequent microbiome disruption. Avoidance of acne scars with early and aggressive treatment is a more efficient and cost-effective option than subsequent treatment. Laser and light treatments for acne and acne scars are plentiful but poorly supported by evidence-based medicine. The acne pipeline is rich with new chemical entities, new formulations, and combinations of older agents. The gold standard for acne therapy may be changing its face.

Marson|Justin W|JW|
Baldwin|Hilary E|HE|

Acne
Gamma glutamyltransferase
Microbiome
Acne scarring
Acne pipeline
Creatine kinase


Surgical treatment for posteromedial talar process fractures.

Abstract:
PURPOSE
The first descriptions on medial talar tubercle fractures are attributed to Cedell. He described avulsion fractures of the insertion of the posterior talotibial ligament. However the true etiology has not been established. Since little is known about these fractures, they are easily misdiagnosed as simple ankle sprains. Untreated, these fractures may lead to chronic ankle pain. To improve the understanding of the etiology and outcome of these fractures a systematic review was conducted of all cases of isolated fractures of the medial tubercle of the posterior talar process. In addition we present the first series of competitive athletes treated by means of the two-portal hindfoot approach for isolated medial talar tubercle fractures.

METHODS
A systematic search was performed to identify all cases of medial tubercle fractures. Data on trauma mechanism, clinical presentation, imaging and treatment were extracted. In addition we retrospectively report on the results of endoscopically treated patients in our institution over the last fifteen years. Of all patients Numeric Rating Scores (NRS) for Satisfaction, Pain and Function, Foot Ankle Outcome Scores (FAOS), return to sport and complications were reported.

RESULTS
Eightteen articles were included reporting on 33 patients with an isolated fracture or avulsion of the posteromedial talar process. Most of the fractures occurred during sport activities (58%), followed by motor vehicle accidents (21%) and fall from height (12%). Of the activities during sport, 73% resulted following an ankle sprain. Reasonable to good outcomes are described in cases treated with immobilization, open reduction internal fixation or open excision. Of the nine patients treated in our institution, five were male and the median age was 29. All were participating in sports at a competitive level, with four of them being a professional athlete. In most patients the diagnosis was made more than a year after initial trauma. Ankle sprain was most common trauma mechanism. In some patients it was evident the avulsion was part or the deep portion of the deltoid ligament, however in two cases it was more likely an avulsion of the flexor hallucis longus (FHL) retinaculum. The median follow-up was 69 months (IQR 12.0-94.3). At final follow-up patients had little pain, NRS 1. Median NRS for satisfaction and function were 7 and 8, respectively. All patients did resume sport activities, however only four reached the preinjury level. Of the five patients that did not return to their pre-injury level of activity, two were professional athletes at the end of their career, and retired not due to ankle complaints. One complication was reported.

CONCLUSION
Fractures of the medial tubercle are rare and based on the available literature there is not one distinct trauma mechanism. Based on literature no recommendation for treatment can be made. Our results show endoscopic excision of the fragment as a save alternative for open surgical treatment.

Zwiers|Ruben|R|
de Leeuw|Peter A J|PAJ|
Wiegerinck|Esther M A|EMA|
van Dijk|C Niek|CN|


Femoral neck fractures: Key points to consider for fixation or replacement a narrative review of recent literature.

Abstract:
INTRODUCTION
Femoral neck fractures (FNF) are frequent injuries and not rarely complicated by non-union, implant failure, and avascular necrosis. Some of these fractures represent a dilemma for trauma surgeons. Which fracture should be fixed? Which replaced with a prosthesis? How? The aim of this narrative review is to investigate the literature in order to provide the most updated and evidence-based knowledge about FNF' treatment.

MATERIALS AND METHODS
A literature research has been performed to find the essential key points to consider when dealing with FNF and their treatment. The most representative papers and the new meta-analysis were matched with authors' experience to give a concise but comprehensive view of the problem. Timing, age, comorbidities, vascularization of the femoral head, displacement, instability, comminution of the fracture, bone quality, and surgeon experience seem to be the major topics to consider in the decision making. We then focus on the optimal fixation or replacement as suggested by the literature.

RESULTS
Age is the main independent factor to consider. Timing seems essential in the elderly population to reduce mortality and important in the younger patients to reduce complications. Vascular supply should be always considered. Displacement, instability, and comminution of the fracture are negative prognostic factors for fixation as well as, theoretically, bone quality. In the elderly hip replacement is mostly indicated. A stable and solid fixation is mandatory to allow early mobilization. Sliding Hip Screws (SHS) seem preferable to cannulated screws for displaced/unstable (Pauwels II-III, posterior comminution) and basicervical fracture patterns or in smokers. There is a tendency toward Total Hip Arthroplasty (THA) also in the elderly if the patient is an indipendent ambulator without severe comorbidities. Dual mobility cups are gaining popularity in THA for FNF.

CONCLUSIONS
FNF are frequent injuries and represent, in some cases, a dilemma for the trauma surgeon. Age, timing, comorbidities, bone quality, femoral head vascularization, fracture displacement, intrinsic instability, and comminution as surgeon experience should be carefully evaluated before surgery. A case-to-case analysis of the patient-related factors helps the surgeon to make the right choice and reduce the well-known complications.

Randelli|Filippo|F|
Viganò|Martino|M|
Liccardi|Alfonso|A|
Mazzoleni|Manuel Giovanni|MG|
Basile|Giuseppe|G|
Menon|Alessandra|A|
Cosmelli|Nicolò|N|

Femoral neck fractures
Osteosynthesis
Partial hip replacement
Total hip replacement


Adolescents and young adults' (AYA) views on their cancer knowledge prior to diagnosis: Findings from a qualitative study involving AYA receiving cancer care.

Abstract:
BACKGROUND
Cancer is rare amongst adolescents and young adults (AYA). Previous research has reported (healthy) AYA's knowledge of risk factors and symptoms as limited, with this potentially leading to delays in help-seeking and diagnosis.

OBJECTIVES
We explored AYA's views on their cancer knowledge prior to diagnosis and if/how they perceived this as having affected their experiences of diagnosis and care.

METHODS
We interviewed 18 AYA diagnosed with cancer (aged 16-24 years). Interviews were recorded and transcribed verbatim. We undertook qualitative descriptive analysis, exploring both a priori topics and emergent themes, including cancer knowledge prior to diagnosis.

RESULTS
Adolescents and young adults characterized their knowledge of cancer and treatment prior to diagnosis and treatment initiation as limited and superficial. AYA perceived gaps in their knowledge as having profound consequences throughout their cancer journey. These included: hindering recognition of symptoms, thereby delaying help-seeking; impeding understanding of the significance of tests and referrals; amplifying uncertainty on diagnosis; and affording poor preparation for the harsh realities of treatment.

CONCLUSIONS
Adolescents and young adults perceived their limited cancer knowledge prior to diagnosis as affecting experiences of diagnosis and initial/front-line care. These findings prompt consideration of whether, when and how, AYA's knowledge of cancer might be improved. Two broad approaches are discussed: universal education on AYA cancer and/or health; and targeted education (enhanced information and counselling) at and after diagnosis.

PATIENT OR PUBLIC CONTRIBUTION
Our work was informed throughout by discussions with an advisory group, whose membership included AYA treated for cancer.

adolescents
young adults
cancer
knowledge
information
patient care
qualitative research


Effects of loss aversion on neural responses to loss outcomes: An event-related potential study.

Abstract: Loss aversion is the tendency to prefer avoiding losses over acquiring gains of the same amount. To shed light on the spatio-temporal processes underlying loss aversion, we analysed the associations between individual loss aversion and electrophysiological responses to loss and gain outcomes in a monetary gamble task. Electroencephalographic feedback-related negativity (FRN) was computed in 29 healthy participants as the difference in electrical potentials between losses and gains. Loss aversion was evaluated using non-linear parametric fitting of choices in a separate gamble task. Loss aversion correlated positively with FRN amplitude (233-263ms) at electrodes covering the lower face. Feedback related potentials were modelled by five equivalent source dipoles. From these dipoles, stronger activity in a source located in the orbitofrontal cortex was associated with loss aversion. The results suggest that loss aversion implemented during risky decision making is related to a valuation process in the orbitofrontal cortex, which manifests during learning choice outcomes.

Kokmotou|Katerina|K| Cook|Stephanie|S| Xie|Yuxin|Y| Wright|Hazel|H| Soto|Vicente|V| Fallon|Nicholas|N| Giesbrecht|Timo|T| Pantelous|Athanasios|A| Stancak|Andrej|A|

Loss aversion
Feedback-related negativity
Orbitofrontal cortex
Decision making
Reward and punishment


Promotion of Advance Care Planning Among Young Adults: A Pilot Study of Health Engagement Workshop Feasibility, Implementation, and Efficacy.

Abstract:
OBJECTIVE
This pilot study set out to evaluate the feasibility and efficacy of an interactive, peer-led, health engagement workshop to improve confidence and comprehension related to advance care planning (ACP) among young adults. Secondarily, this study evaluated if such workshops could promote ACP related behavior changes within this population.

METHODS
This observational cohort study utilized a repeated measures, mixed-method design. Six hour-long, in-person workshops were conducted with undergraduate students during meetings of university student organizations. Participants were evaluated across 3 mixed-method surveys, evaluating confidence, knowledge, and behaviors related to ACP prior to participation, directly after, and during a 2-week follow-up.

RESULTS
Workshop participation improved the average participant confidence and knowledge related to ACP as well as encouraged some participants to engage in discussions related to end-of-life care with friends and family. Alongside the impact of the workshops on knowledge and confidence, participants positively evaluated the design of the workshops through collected qualitative feedback.

CONCLUSION
These results are encouraging in assessing this population's willingness to learn about end-of-life care planning. The tools developed and the corresponding results should be used for further exploration of engaging the young adult population in ACP to promote improved healthcare outcomes.

D032722:Advance Care Planning
D005240:Feasibility Studies
D006801:Humans
D010865:Pilot Projects
D011795:Surveys and Questionnaires
D013727:Terminal Care
D055815:Young Adult

advance care planning
young adults
pilot study
health engagement workshops
observational cohort study
health education


Modified Biosensor for Cholinesterase Inhibitors with Guinea Green B as the Color Indicator.

Abstract: Colorimetric biosensors of cholinesterase inhibitors are ideal for fast, reliable, and very simple detection of agents in air, in water, and on surfaces. This paper describes an innovation of the Czech Detehit biosensor, which is based on a biochemical enzymatic reaction visualized by using Ellman's reagent as a chromogenic indicator. The modification basically consists of a much more distinct color response of the biosensor, attained through optimization of the reaction system by using Guinea Green B as the indicator. The performance of the modified biosensor was verified on the chemical warfare agents (sarin, soman, cyclosarin, and VX) in water. The detection limits ascertained visually (with the naked eye) were about 0.001 µg/mL in water (exposure time 60 s, inhibition efficiency 25%).

Pitschmann|Vladimír|V| Matějovský|Lukáš|L|0000-0002-0248-4809 Lobotka|Martin|M| Dědič|Jan|J| Urban|Martin|M| Dymák|Michal|M|

D015374:Biosensing Techniques
D002619:Chemical Warfare Agents
D002800:Cholinesterase Inhibitors
D003124:Colorimetry
D008086:Lissamine Green Dyes

Guinea Green B
biosensor of cholinesterase inhibitors
enzymatic reaction
chemical warfare agents
visual evaluation


Biocidal effects of volatile organic compounds produced by the myxobacterium Corrallococcus sp. EGB against fungal phytopathogens.

Abstract: Myxobacteria have excellent biocontrol activity against various phytopathogens due to their rich spectrum of secondary metabolites and active predatory characteristics. In this study, the mycelial growth of Fusarium oxysporum f. sp. cucumerinum (FOC) was found to be significantly inhibited by volatile compounds (VOCs) produced by Corallococcus sp. EGB. A total of 32 compounds were identified among the VOCs produced by strain EGB, of which isooctanol exhibited the highest antifungal activity, with dosages of 3.75 and 4.0 μL/plate being sufficient to suppress FOC and Penicillum digitatum, respectively. Isooctanol was found to damage the cell wall and cell membranes of FOC and P. digitatum. Apoptosis-like cell death of FOC and P. digitatum induced by isooctanol was observed subsequently due to the accumulation of reactive oxygen species (ROS). The transcription level of genes related to cell wall integrity (CWI) pathway and redox reactions were significantly upregulated by 15- to 40-fold, indicating the stress caused by isooctanol. Postharvest storage experiments showed that the disease severity of post-harvest oranges infected with P. digitatum could be significantly reduced by isooctanol at 114.2 μL/L.

Ye|Xianfeng|X| Chen|Yang|Y| Ma|Shiyun|S| Yuan|Tian|T| Wu|Yaxuan|Y| Li|Yingxuan|Y| Zhao|Yuqiang|Y| Chen|Shuying|S| Zhang|Yiwen|Y| Li|Liuyan|L| Li|Zhoukun|Z| Huang|Yan|Y| Cao|Hui|H| Cui|Zhongli|Z|

D000935:Antifungal Agents
D002473:Cell Wall
D032084:Citrus sinensis
D061353:Food Storage
D005670:Fusarium
D050296:Microbial Viability
D025282:Mycelium
D009231:Myxococcales
D000442:Octanols
D010935:Plant Diseases
D017382:Reactive Oxygen Species
D055549:Volatile Organic Compounds

Fusarium oxysporum f. sp. cucumerinum
Volatile compounds
Penicillum digitatum
Cell wall integrity
Postharvest storage
Apoptosis-like death


Frailty and long-term postoperative disability trajectories: a prospective multicentre cohort study.

Abstract:
BACKGROUND
Frailty is associated with early postoperative outcomes. How frailty influences long-term postoperative recovery is poorly described. Our objective was to evaluate the association of frailty with postoperative disability trajectories in the year after surgery.

METHODS
Prespecified 1-yr follow-up of a prospective multicentre cohort study. Patients ≥65 yr were assessed for frailty before major elective noncardiac surgery (Clinical Frailty Scale [CFS] and Fried Phenotype [FP]). The primary outcome was patient-reported disability score (using the WHO Disability Assessment Schedule 2.0) at baseline, 30, 90, and 365 days after surgery. Repeated measures linear regression estimated the association of preoperative frailty with changes in disability scores over time, adjusted for procedure. Group-based trajectory modelling was used to identify subgroup trajectories of people with frailty.

RESULTS
One-year follow-up was complete for 687/702 (97.9%) participants. Frailty was associated with a significant difference in disability trajectory (P<0.0001). Compared with baseline, people with frailty experienced a decrease in disability score at 365 days (CFS frailty: -7.3 points, 95% confidence interval [CI] -10.2 to -4.5); (FP frailty: -5.4 points, 95% CI -8.5 to -2.3); people without frailty had no significant change in their disability score from baseline (no CFS frailty: +0.8 points, 95% CI -1.7 to 3.2; no FP frailty: +1.1 points, 95% CI -3.5 to 1.3). More than one-third of people with frailty experienced an early increase in disability before achieving a net decrease in disability.

CONCLUSIONS
Decision-making and care planning should integrate the possible trade-offs between early adverse outcomes with longer-term benefit when frailty is present in older surgical patients.

McIsaac|Daniel I|DI|
Taljaard|Monica|M|
Bryson|Gregory L|GL|
Beaulé|Paul E|PE|
Gagne|Sylvain|S|
Hamilton|Gavin|G|
Hladkowicz|Emily|E|
Huang|Allen|A|
Joanisse|John|J|
Lavallée|Luke T|LT|
MacDonald|David|D|
Moloo|Husein|H|
Thavorn|Kednapa|K|
van Walraven|Carl|C|
Yang|Homer|H|
Forster|Alan J|AJ|

D000368:Aged
D000369:Aged, 80 and over
D015331:Cohort Studies
D004185:Disability Evaluation
D005260:Female
D005500:Follow-Up Studies
D016330:Frail Elderly
D000073496:Frailty
D015577:Geriatric Assessment
D006801:Humans
D008297:Male
D011183:Postoperative Complications
D011446:Prospective Studies
D020127:Recovery of Function
D012307:Risk Factors
D016896:Treatment Outcome

frailty
disability
postoperative outcome
recovery
surgery
epidemiology


Magnetoencephalography in pediatric epilepsy.

Abstract: Magnetoencephalography (MEG) records the magnetic field generated by electrical activity of cortical neurons. The signal is not distorted or attenuated, and it is contactless recording that can be performed comfortably even for longer than an hour. It has excellent and decent temporal resolution, especially when it is combined with the patient's own brain magnetic resonance imaging (magnetic source imaging). Data of MEG and electroencephalography are not mutually exclusive and it is recorded simultaneously and interpreted together. MEG has been shown to be useful in detecting the irritative zone in both lesional and nonlesional epilepsy surgery. It has provided valuable and additive information regarding the lesion that should be resected in epilepsy surgery. Better outcomes in epilepsy surgery were related to the localization of the irritative zone with MEG. The value of MEG in epilepsy surgery is recruiting more patients to epilepsy surgery and providing critical information for surgical planning. MEG cortical mapping is helpful in younger pediatric patients, especially when the epileptogenic zone is close to the eloquent cortex. MEG is also used in both basic and clinical research of epilepsy other than surgery. MEG is a valuable diagnostic modality for diagnosis and treatment, as well as research in epilepsy.

Kim|Hunmin|H|
Chung|Chun Kee|CK|
Hwang|Hee|H|