Dipeptidylpeptidase 4 (DPP4, CD26) activity in the blood serum of term and preterm neonates with cerebral ischemia.

Abstract:
BACKGROUND
To investigate the mechanisms of inflammation in neonates after cerebral ischemia (CI), we evaluated the DPP4 activity in their blood sera and compared these values with clinical indicators.

METHODS
The activity of DPP4 was determined in blood serum by a fluorescent method. We studied the correlation between the blood serum DPP4 activity and clinical, neurological and biochemical parameters in neonates with CI.

RESULTS
No correlation between the DPP4 activity in umbilical blood and the venous blood of mothers was discovered. Increased blood serum DPP4 activity in full-term and pre-term newborns with CI is demonstrated. The interrelation between serum DPP4 activity and the functional disturbances of CNS (such as depression or excitement) was found in mature but not in premature newborns. Enzyme activity was still elevated at 2-3weeks after birth.

CONCLUSION
It is possible that in neonates this enzymatic system operates independently from mothers. It is assumed that increased DPP4 activity in newborns with CI is apparently connected with immune system activation in response to hypoxic stress. The obtained data support the participation of DPP4 in adaptive reactions of newborns and its regulating influence during hypoxemic damage of the CNS due to inflammation and neurodegeneration.

Yakovleva|A A|AA|
Zolotov|N N|NN|
Sokolov|O Yu|OY|
Kost|N V|NV|
Kolyasnikova|K N|KN|
Micheeva|I G|IG|

Dipeptidylpeptidase 4
Neonates
Cerebral ischemia


The person-centred care of older people with cognitive impairment in acute care (POPAC) scale - psychometric evaluation.

Abstract:
AIM
To test the reliability and validity of the Person-centred care of Older People with cognitive impairment in Acute Care scale to determine nurses' perceptions of person-centred care.

BACKGROUND
One-third of older adults admitted to hospital are at risk of serious hospital-acquired complications such as falls, infections and pressure injuries because of cognitive impairment. These risks can be reduced through person-centred practices. The Person-centred care of Older People with cognitive impairment in Acute Care scale is a self-report staff instrument to explore the extent to which person-centred practices are undertaken; however psychometric testing is limited.

METHODS
A cross-sectional sample of acute care nurses (n = 240) in Queensland, Australia completing self-report questionnaires. Psychometric analyses of item performance, reliability and validity were conducted.

RESULTS
Item analysis revealed independent items. One item was removed due to negatively associating with the scale, improving total Cronbach's alpha from 0.76 to 0.84. The three original factors were maintained with regrouping of items. Confirmatory factor analysis confirmed the revised model.

CONCLUSIONS
The revised Person-centred care of Older People with cognitive impairment in Acute Care scale had satisfactory psychometric properties when used as a total scale.

IMPLICATIONS FOR NURSING MANAGEMENT
Scale brevity and simplicity together with rigorous development and testing indicates that the revised Person-centred care of Older People with cognitive impairment in Acute Care may be useful for quality improvement programmes into the care of older people in hospitals.

person-centred care
cognitive impairment
POPAC
nurse
older person


Hippocampal sleep features: relations to human memory function.

Abstract: The recent spread of intracranial electroencephalographic (EEG) recording techniques for presurgical evaluation of drug-resistant epileptic patients is providing new information on the activity of different brain structures during both wakefulness and sleep. The interest has been mainly focused on the medial temporal lobe, and in particular the hippocampal formation, whose peculiar local sleep features have been recently described, providing support to the idea that sleep is not a spatially global phenomenon. The study of the hippocampal sleep electrophysiology is particularly interesting because of its central role in the declarative memory formation. Recent data indicate that sleep contributes to memory formation. Therefore, it is relevant to understand whether specific patterns of activity taking place during sleep are related to memory consolidation processes. Fascinating similarities between different states of consciousness (wakefulness, REM sleep, non-REM sleep) in some electrophysiological mechanisms underlying cognitive processes have been reported. For instance, large-scale synchrony in gamma activity is important for waking memory and perception processes, and its changes during sleep may be the neurophysiological substrate of sleep-related deficits of declarative memory. Hippocampal activity seems to specifically support memory consolidation during sleep, through specific coordinated neurophysiological events (slow waves, spindles, ripples) that would facilitate the integration of new information into the pre-existing cortical networks. A few studies indeed provided direct evidence that rhinal ripples as well as slow hippocampal oscillations are correlated with memory consolidation in humans. More detailed electrophysiological investigations assessing the specific relations between different types of memory consolidation and hippocampal EEG features are in order. These studies will add an important piece of knowledge to the elucidation of the ultimate sleep function.

Ferrara|Michele|M|
Moroni|Fabio|F|
De Gennaro|Luigi|L|
Nobili|Lino|L|

local sleep
memory consolidation
oscillations
brain rhythms
hippocampus
stereo-EEG


Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting.

Abstract: The optimal revascularization for in-stent occlusion (ISO) lesions after femoropopliteal (FP) bare-nitinol stenting has not been established. We, therefore, investigated the comparison between drug-coated stent (DCS) implantation and bypass surgery (BSX) for ISO lesions after FP bare-nitinol stenting. This study was a dual-center, observational study from January 2004 to December 2015. A total of 172 ISO lesions were observed, and after excluding 120 ISO lesions, 52 ISO lesions (50 patients; mean age, 71.0 ± 9.2 years; male, 59.6%) after FP bare-nitinol stenting were enrolled. The included patients with clinical symptoms underwent either DCS implantation (n = 28) or BSX (n = 22). The primary endpoint was recurrent in-stent restenosis (ReISR); secondary endpoints were recurrent target lesion revascularization (ReTLR), recurrent occlusion (reocclusion) and major adverse limb events (MALE), and perioperative complications (POCs), respectively. ReISR or reocclusion was defined as ISR or occlusion after TLR. Stent restenosis was defined as a peak systolic velocity ratio (PSVR) > 2.4 on a duplex scan or ≥ 50% stenosis on angiography. Graft restenosis was defined as a PSV > 300 cm/s and velocity ratio 3.5 or uniformly low PSV < 45 cm/s throughout the entire graft based on graft surveillance. The mean follow-up period was 36.6 ± 25.5 months. At 2 years, the rates of freedom from ReISR, ReTLR, and MALE were not significantly different between the DCS implantation and BSX groups (68.9% vs. 73.7%, p = 0.81; 84.7% vs. 73.7%, p = 0.45; 84.7% vs. 78.6%, p = 0.60, respectively). However, the freedom from reocclusion rate was significantly lower in the DCS implantation group (81.6% vs. 100%, p = 0.04). The occurrence of POCs was not significantly different between the DCS implantation and BSX groups (7.1% vs 4.2%, p = 1.0). Although BSX was the gold-standard therapy for ISO lesions after FP bare-nitinol stenting, DCS implantation might be a good option because the rates of freedom from ReISR, ReTLR, and MALE were similar.

D000368:Aged
D000792:Angiography
D054855:Drug-Eluting Stents
D057510:Endovascular Procedures
D005260:Female
D005263:Femoral Artery
D005500:Follow-Up Studies
D006801:Humans
D008297:Male
D058729:Peripheral Arterial Disease
D011150:Popliteal Artery
D011474:Prosthesis Design
D012189:Retrospective Studies
D016896:Treatment Outcome
D014654:Vascular Patency

Drug-coated stent
Bypass surgery
In-stent occlusion
Endovascular therapy


Functional neuroanatomy of tics.

Abstract: The therapeutic success of haloperidol in the treatment of Tourette syndrome (TS) put an end to the discussion about a "hysteric" or "neurotic" origin of TS. The cortico-striato-thalamo-cortical circuit has been identified as an underlying neurobiological correlate of TS. In this review we explore the main findings of structural alterations in TS including cortical areas, basal ganglia, hippocampus, amygdala, midbrain, and cerebellum. Based on the structural changes we examine the functional pattern described by the findings of fMRI and (15)O-PET/(18)FDG PET investigations. From the neuroimaging findings a cortical origin of the generation of tics is indicated. Future research on the neuronal footprint of TS should be directed towards addressing the question of which patterns of connectivity distinguish individuals in whom tics disappear during early adulthood from those in whom the tics persist. The understanding of this pathomechanism could provide a key on how to influence dysconnectivity in TS, for example, by more specific pharmaceutical intervention or by individually adopted EEG and/or fMRI neurofeedback.

Neuner|Irene|I|
Schneider|Frank|F|
Shah|N Jon|NJ|


Embryonic cell-cell adhesion: a key player in collective neural crest migration.

Abstract: Cell migration is essential for morphogenesis, adult tissue remodeling, wound healing, and cancer cell migration. Cells can migrate as individuals or groups. When cells migrate in groups, cell-cell interactions are crucial in order to promote the coordinated behavior, essential for collective migration. Interestingly, recent evidence has shown that cell-cell interactions are also important for establishing and maintaining the directionality of these migratory events. We focus on neural crest cells, as they possess extraordinary migratory capabilities that allow them to migrate and colonize tissues all over the embryo. Neural crest cells undergo an epithelial-to-mesenchymal transition at the same time than perform directional collective migration. Cell-cell adhesion has been shown to be an important source of planar cell polarity and cell coordination during collective movement. We also review molecular mechanisms underlying cadherin turnover, showing how the modulation and dynamics of cell-cell adhesions are crucial in order to maintain tissue integrity and collective migration in vivo. We conclude that cell-cell adhesion during embryo development cannot be considered as simple passive resistance to force, but rather participates in signaling events that determine important cell behaviors required for cell migration.

D000818:Animals
D015820:Cadherins
D002448:Cell Adhesion
D002450:Cell Communication
D002465:Cell Movement
D047108:Embryonic Development
D006801:Humans
D009420:Nervous System
D009432:Neural Crest
D015398:Signal Transduction

Neural crest
Cell migration
Cell polarity
Cadherin
Cell–cell adhesion


Cardiometabolic risk factors in treatment-seeking youth versus population youth with obesity.

Abstract:
Background
Although obesity affects approximately one in five youths, only a fraction is treated in pediatric weight management clinics. Characteristics distinguishing youth with obesity who seek weight management treatment from those who do not are largely unknown. Yet identification of specific health characteristics which differentiate treatment-seeking from non-treatment seeking youth with obesity may shed light on underlying motivations for pursuing treatment.

Objectives
Compare the cardiometabolic profiles of an obesity treatment-seeking sample of youth to a population-based sample of youth with obesity, while controlling for body mass index (BMI).

Methods
This cross-sectional study included participants, ages 12-17 years, with obesity from the Pediatric Obesity and Weight Evaluation Registry (POWER) and National Health and Nutrition Examination Survey, representing the treatment-seeking and population samples, respectively. Mean differences were calculated for systolic and diastolic blood pressure percentiles, total cholesterol, low-density and high-density lipoprotein-cholesterol, triglycerides, fasting glucose, glycated hemoglobin and alanine aminotransferase, while adjusting for age, sex, race/ethnicity, insurance status, and multiple of the 95th BMI percentile.

Results
The POWER and National Health and Nutrition Examination Survey cohorts included 1,823 and 617 participants, respectively. The POWER cohort had higher systolic blood pressure percentile (mean difference 17.4, 95% confidence interval [14.6, 20.1], p < 0.001), diastolic blood pressure percentile (21.8 [19, 24.5], p < 0.001), triglycerides (42.3 [28, 56.5], p < 0.001) and alanine aminotransferase (7.5 [5.1, 9.8], p < 0.001) and lower fasting glucose (-6.9 [-8.2, -5.6], p < 0.001) and high-density lipoprotein-cholesterol (-2.3 [-3.8, -0.9], p < 0.002). There were no differences in total cholesterol or low-density lipoprotein-cholesterol or clinical differences in glycated hemoglobin.

Conclusion
For a given BMI, obesity treatment-seeking youth are more adversely affected by cardiometabolic risk factors than the general population of youth with obesity. This suggests that treatment-seeking youth may represent a distinct group that is at particularly high risk for the development of future cardiometabolic disease.

Cardiometabolic risk factor
population
treatment seeking


Changes in symptom intensity among cancer patients receiving outpatient palliative care.

Abstract:
CONTEXT
Symptom changes are usually reported using summary statistics such as mean and/or median, which may obscure the treatment effect.

OBJECTIVES
The main objective of this retrospective study was to determine the magnitude of symptom changes as assessed by the Edmonton Symptom Assessment System (ESAS) after outpatient palliative care at the first follow-up visit.

METHODS
We reviewed 1612 consecutive patients with cancer who were referred to the outpatient Supportive Care Center and who completed the ESAS at the initial and first follow-up visits between January 2003 and December 2010. All patients received interdisciplinary care led by the palliative care specialists following an institutional protocol.

RESULTS
The distribution of the magnitude of symptom changes was stratified by baseline intensities. Patterns were similar for different ESAS items. At the follow-up visit (median: 15 days later), 52-74% of patients showed a decrease of one or more points in the ESAS score. However, 48-80% of patients with moderate/severe intensity at baseline complained of symptoms with an ESAS score of four or more after outpatient palliative care. Symptoms with absent/mild intensity worsened, ranging from a mean of -3.04 to 0.12 at the first follow-up visit, whereas symptoms with moderate/severe intensity improved from -0.2 to 3.86 (P<0.001).

CONCLUSION
A considerable proportion of patients with moderate or severe intensity at baseline still had symptoms with an ESAS score of four or more. Patients with absent/mild intensities at baseline complained of symptom exacerbation at the first follow-up visit. Various strategies are needed to optimize symptom control in advanced cancer.

Kang|Jung Hun|JH|
Kwon|Jung Hye|JH|
Hui|David|D|
Yennurajalingam|Sriram|S|
Bruera|Eduardo|E|

Symptom
symptom intensity
outpatient
palliative care
assessment


The Atrioventricular Junction: A Potential Niche Region for Progenitor Cells in the Adult Human Heart.

Abstract: A stem cell niche is a microenvironment where stem cells reside in a quiescent state, until activated. In a previous rat model, we combined 5-bromo-2-deoxy-uridine labeling with activation of endogenous stem cells by physical exercise and revealed a distinct region, in the atrioventricular junction (AVj), with features of a stem cell niche. In this study, we aim to investigate whether a similar niche exists in the human heart. Paired biopsies from AVj and left ventricle (LV) were collected both from explanted hearts of organ donors, not used for transplantation (N = 7) and from severely failing hearts from patients undergoing heart transplantation (N = 7). Using antibodies, we investigated the expression of stem cell, hypoxia, proliferation and migration biomarkers. In the collagen-dense region of the AVj in donor hearts, progenitor markers, MDR1, SSEA4, ISL1, WT1, and hypoxia marker, HIF1-α, were clearly detected. The expression gradually decreased with distance from the valve. At the myocardium border in the AVj costaining of the proliferation marker Ki67 with cardiomyocyte nuclei marker PCM1 and cardiac Troponin-T (cTnT) indicated proliferation of small cardiomyocytes. In the same site we also detected ISL1+/WT1+/cTnT cells. In addition, heterogeneity in cardiomyocyte sizes was noted. Altogether, these findings indicate different developmental stages of cardiomyocytes below the region dense in stem cell marker expression. In patients suffering from heart failure the AVj region showed signs of impairment generally displaying much weaker or no expression of progenitor markers. We describe an anatomic structure in the human hearts, with features of a progenitor niche that coincided with the same region previously identified in rats with densely packed cells expressing progenitor and hypoxia markers. The data provided in this study indicate that the adult heart contains progenitor cells and that AVj might be a specific niche region from which the progenitors migrate at the time of regeneration.

Vukusic|Kristina|K| Sandstedt|Mikael|M| Jonsson|Marianne|M| Jansson|Märta|M| Oldfors|Anders|A| Jeppsson|Anders|A| Dellgren|Göran|G| Lindahl|Anders|A| Sandstedt|Joakim|J|

atrioventricular junction
heart
stem cell niche
hypoxia
cardiomyocyte proliferation


Mother-to-infant transmission of the carcinogenic colibactin-producing bacteria.

Abstract:
BACKGROUND
The Escherichia coli strain that is known to produce the genotoxic secondary metabolite colibactin is linked to colorectal oncogenesis. Therefore, understanding the properties of such colibactin-positive E. coli and the molecular mechanism of oncogenesis by colibactin may provide us with opportunities for early diagnosis or prevention of colorectal oncogenesis. While there have been major advances in the characterization of colibactin-positive E. coli and the toxin it produces, the infection route of the clb + strain remains poorly characterized.

RESULTS
We examined infants and their treatments during and post-birth periods to examine potential transmission of colibactin-positive E. coli to infants. Here, analysis of fecal samples of infants over the first month of birth for the presence of a colibactin biosynthetic gene revealed that the bacterium may be transmitted from mother to infant through intimate contacts, such as natural childbirth and breastfeeding, but not through food intake.

CONCLUSIONS
Our finding suggests that transmission of colibactin-positive E. coli appears to be occurring at the very early stage of life of the newborn and hints at the possibility of developing early preventive measures against colorectal cancer.

Tsunematsu|Yuta|Y| Hosomi|Koji|K| Kunisawa|Jun|J| Sato|Michio|M| Shibuya|Noriko|N| Saito|Emiko|E| Murakami|Haruka|H| Yoshikawa|Yuko|Y| Iwashita|Yuji|Y| Miyoshi|Noriyuki|N| Mutoh|Michihiro|M| Ishikawa|Hideki|H| Sugimura|Haruhiko|H| Miyachi|Motohiko|M| Wakabayashi|Keiji|K| Watanabe|Kenji|K|0000-0002-0463-4831

Escherichia coli
Colibactin
Colorectal cancer
Natural product
Perinatal transmission


Metabolic and genetic assessments interpret unexplained aggressive pulmonary hypertension induced by methylmalonic acidemia: A case report.

Abstract:
BACKGROUND
Pulmonary hypertension (PH) causes significant morbidity and mortality in diverse childhood diseases. However, limited information has been reported to obtain a good understanding of pediatric PH. Gaps exist between genome sequencing and metabolic assessments and lead to misinterpretations of the complicated symptoms of PH. Here, we report a rare case of a patient who presented with severe PH as the first manifestation without significant cardiovascular malformation and was finally diagnosed with methylmalonic aciduria (MMA) after metabolic and genomic assessments.

CASE SUMMARY
An 11-year-old female presented with an aggressive reduction in activity capability and shortness of breath for only 4 mo and suffered from unexplained PH. A series of examinations was performed to evaluate any possible malformations or abnormalities of the cardiovascular system and lungs, but negative results were obtained. The blood tests were normal except for manifestations of microcytic anemia and elevated total homocysteine. Computed tomography and magnetic resonance imaging failed to identify any pulmonary diseases. Cardiac catheterization examination identified a small right coronary artery to pulmonary artery shunt and severe PH. During the follow-up, PH progressed rapidly. Then, genome sequencing and metabolic disorder screening were performed, which confirmed a diagnosis of MMA with MMACHC c.80A > G/c and 609G > A mutations. Vitamin B12, betaine and bosentan were then administered as the main treatments. During the 6-mo follow-up, the pulmonary artery pressure dropped to 45 mmHg, while the right ventricle structure recovered. The patient's heart function recovered to NYHA class II. Metabolic disorder analysis failed to identify significant abnormalities.

CONCLUSION
As emerging types of metabolic dysfunction have been shown to present as the first manifestation of PH, and taking advantage of next generation sequencing technology, genome sequencing and metabolic disorder screening are recommended to have a more superior role when attempting to understand unclear or aggressive PH.

Pulmonary hypertension
Methylmalonic acidemia
Case report
Genomic sequence
Metabolic disorder


Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study.

Abstract:
Background
Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar.

Methods
A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter's classification, Pell and Gregory's classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar.

Results
The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups.

Conclusion
Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

Tojyo|Itaru|I|0000-0003-0528-3313 Nakanishi|Takashi|T| Shintani|Yukari|Y| Okamoto|Kenjiro|K| Hiraishi|Yukihiro|Y| Fujita|Shigeyuki|S|

Lingual nerve injury
Mandibular third molar
Extraction
Orthopantomograph


Measuring drinking motives in undergraduates: an exploration of the Drinking Motives Questionnaire-Revised in Swedish students.

Abstract:
BACKGROUND
Alcohol consumption is generally high among undergraduate students and may lead to adverse consequences. Drinking motives play a vital role in the development of alcohol-related problems. The Drinking Motives Questionnaire-Revised (DMQ-R) and the short form of DMQ-R, DMQ-R SF, are widely used tools to identify drinking motives. Still, there is a need for further exploration of the instruments in different cultures and settings. The aims of this study were 1) to explore the four-factor structure of the DMQ-R and DMQ-R SF in Swedish undergraduate students 2) to investigate if extracting the SF responses from the DMQ-R is equivalent to the factor structure of the DMQ-R SF 3) to study the association between drinking motives and hazardous drinking.

METHODS
Data were collected among 536 Swedish undergraduate students and were analyzed by confirmatory factor analyses, Mann-Whitney, chi-square tests and logistic regressions.

RESULTS
We could confirm the four-dimensional structure of both versions of the DMQ. There was a similar (or in fact even slightly better) model fit of the short form and when drawing the SF items. Emotionally oriented motives (enhancement and coping), together with social motives, were strongly associated with hazardous or harmful drinking levels, whereas conformity motives were not. The enhancement motive showed the highest group mean value and was also the most common main motive. Students with hazardous drinking endorsed their motives more strongly than those without hazardous drinking, which is a finding worthy of further investigation.

CONCLUSIONS
The DMQ-R SF is suitable and preferable for Swedish student populations and extracting the SF responses from the DMQ-R is equivalent to the factor structure of the DMQ-R SF. In future research, effects of including the DMQ-R SF in preventive strategies and in interventions with risk drinking students would be of particular interest.

Drinking motives
Students
Questionnaires
Validation


Macrophage Activation Syndrome in Patients with Systemic Juvenile Idiopathic Arthritis under Treatment with Tocilizumab.

Abstract:
OBJECTIVE
To identify macrophage activation syndrome (MAS) in patients with systemic juvenile idiopathic arthritis (sJIA) undergoing tocilizumab (TCZ) treatment, and to confirm laboratory marker changes and responses to treatment in patients with MAS receiving TCZ.

METHODS
In Japan, 394 patients with sJIA were registered in an all-patient registry surveillance of TCZ as of January 15, 2012. TCZ (8 mg/kg) was administered every 2 weeks to patients with sJIA. MAS, hemophagocytic lymphohistiocytosis, or Epstein-Barr virus-associated hemophagocytic syndrome (EB-VAHS) was reported in 23 of these patients (25 events). The Safety Evaluation Committee of Tocilizumab for JIA reviewed these cases and clinically evaluated the data and laboratory findings using their own therapeutic experience. Events were categorized into 4 groups: definitive MAS, probable MAS, EB-VAHS, and non-MAS.

RESULTS
The committee's review revealed 3 events of definitive MAS in 3 patients, 12 events of probable MAS in 11 patients, 2 events of EB-VAHS in 2 patients, and 8 events of non-MAS in 8 patients. There were 2 patients who developed 2 events: 2 events in 1 patient were classified into definitive MAS and probable MAS, and 2 events in another patient were classified into probable MAS. In patients with definitive or probable MAS, common clinical manifestations and laboratory findings of MAS were observed. Changes in laboratory data observed in patients with EB-VAHS were similar to those observed in patients with MAS.

CONCLUSION
These results suggest that the clinical/laboratory features in the course of MAS appear to be similar among patients regardless of whether TCZ is administered. Similarities in the pathophysiological background of MAS and EB-VAHS were also suggested.

Yokota|Shumpei|S| Itoh|Yasuhiko|Y| Morio|Tomohiro|T| Sumitomo|Naokata|N| Daimaru|Kaori|K| Minota|Seiji|S|


A Decade of Counseling Services in One College of Veterinary Medicine: Veterinary Medical Students' Psychological Distress and Help-Seeking Trends.

Abstract: Much has been discussed about the high prevalence of psychological distress among veterinary medical students. Studies investigating general samples of veterinary medical students indicate that, on average, depression and anxiety symptoms are present at higher rates than in comparison samples. However, little is known about veterinary medical students who seek counseling. This study intends to expand the literature on veterinary student well-being, as the first to examine a sample of veterinary medical students seeking counseling services. It offers an overview of student distress and help-seeking trends from a decade of counseling services provided in one College of Veterinary Medicine (CVM) in the US. The sample includes data from 279 participants. Results indicate a steady increase in students seeking counseling over the last decade. First-year students sought services at higher rates but second-year students experienced the greatest distress when compared to other cohorts. Students seeking counseling services experienced levels of overall distress, symptoms of anxiety and depression, and social role concerns that were, on average, above cut-off scores. Physical health was significantly associated with student distress, suggesting opportunities for intervention.

Drake|Adryanna A S|AA|
Hafen|McArthur|M|
Rush|Bonnie R|BR|

counseling
depression
anxiety
help seeking
student mental health


Anatomical variations of the ethmoidal roof: differences between men and women.

Abstract:
AIM
During the paranasal sinuses surgery different complications may occur, both vascular and bony. The objective of the present study was to evaluate the ethmoidal roof configuration through the Keros and Yenigun classifications, analyzing results stratified by gender and side.

MATERIALS AND METHODS
We retrospectively analyzed 120 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in a coronal view and the anterior-posterior length in a cross section.

RESULTS
The Keros Type II was the most frequent and no statistically significant difference was found when comparing by gender. Yenigun type I was more prevalent, and a statistically significant difference was found between men and women in types I and II (p = 0.010 and p = 0.049, respectively). Statistical difference was observed in anterior-posterior means in the comparison between both classifications. In both, right and left side for men (p = 0.003 and p = 0.05) and women (p = 0.029 and p = 0.039).

CONCLUSION
We demonstrate the morphological variability that exists in this region. Gender differences that must be considered by the surgeon to avoid complications. Further studies are needed to evaluate the value of these findings when predicting surgical complications. A CT before PNS surgery is already widely accepted.

Muñoz-Leija|Milton Alberto|MA|
Yamamoto-Ramos|Masao|M|
Barrera-Flores|Francisco Jesús|FJ|
Treviño-González|José Luis|JL|
Quiroga-Garza|Alejandro|A|
Méndez-Sáenz|Marco Antonio|MA|
Campos-Coy|Mario Alberto|MA|
Elizondo-Rojas|Guillermo|G|
Guzmán-López|Santos|S|
Elizondo-Omaña|Rodrigo Enrique|RE|

Ethmoidal roof
Keros
Yenigun
Computed tomography
Morphology
Anterior ethmoidal artery


Re Facial aesthetic injections in clinical practice: Pretreatment and post-treatment consensus recommendations to minimise adverse outcome Region-specific changes in line with the Covid-19 pandemic.

Abstract: Despite the recent publication in March 2020 of guidelines for facial injectable treatments, the speed of the COVID-19 pandemic and its safety implications necessitate changes to these guidelines The authors described what would constitute safest practice in the provision of facial injectable treatments and summarised these in table form. Adherence to a high standard of asepsis and infectious disease precautions remain a key patient safety requirement when performing facial aesthetic injections. A revision and update of these guideline summary tables follows. Changes made should enhance both patient and staff safety regarding COVID-19/SARS-CoV-2, a highly infective respiratory pathogen transmitted by respiratory droplets, respiratory/mucosal secretions and contaminated fomites. Some of the additions are COVID-19 specific and are likely to evolve and change, particularly should serological tests determining acquired immunity become available. Other additions represent further tightening of our infection control precautions.

COVID-19
botulinum toxin
hyaluronic acid
tissue fillers


Italian Society for the Study of Diabetes (SID)/Italian Endocrinological Society (SIE) guidelines on the treatment of hyperglycemia in Cushing's syndrome and acromegaly.

Abstract:
BACKGROUND
Hyperglycemia is a common feature associated with states of increased growth hormone secretion and glucocorticoid levels.

AIMS
The purpose of these guidelines is to assist clinicians and other health care providers to take evidence-based therapeutic decisions for the treatment of hyperglycemia in patients with growth hormone and corticosteroid excess.

METHODOLOGY
Both the SID and SIE appointed members to represent each society and to collaborate in Guidelines writing. Members were chosen for their specific knowledge in the field. Each member agreed to produce--and regularly update--conflicts of interest. The Authors of these guidelines prepared their contributions following the recommendations for the development of Guidelines, using the standard classes of recommendation shown below. All members of the writing committee provided editing and systematic review of each part of the manuscript, and discussed the grading of evidence. Consensus was guided by a systematic review of all available trials and by interactive discussions.

Baroni|M G|MG|
Giorgino|F|F|
Pezzino|V|V|
Scaroni|C|C|
Avogaro|A|A|
|||
|||

Diabetes
Antidiabetic treatment
Dopamine agonists
GH hypersecretion
Glucocorticoid excess
Pegvisomant
Somatostatin agonists
Steroid treatment


A performance analysis of prediction techniques for impacting vehicles in hit-and-run road accidents.

Abstract: Road accidents are globally accepted challenges. They are one of the significant causes of deaths and injuries besides other direct and indirect losses. Countries and international organizations have designed technologies, systems, and policies to prevent accidents. However, hit-and-run accidents remain one of the most dangerous types of road accidents as the information about the vehicle responsible for the accident remain unknown. Therefore, any mechanism which can provide information about the impacting vehicle in hit-and-run accidents will be useful in planning and executing preventive measures to address this road menace. Since there exist several models to predict the impacting unknown vehicle, it becomes important to find which is the most accurate amongst those available. This research applies a process-based approach that identifies the most accurate model out of six supervised learning classification models viz. Logistic Reasoning, Linear Discriminant Analysis, Naïve Bayes, Classification and Regression Trees, k-Nearest Neighbor and Support Vector Machine. These models are implemented using five-fold and ten-fold cross validation, on road accident data collected from five mid-sized Indian cities: Agra, Amritsar, Bhopal, Ludhiana, and Vizag (Vishakhapatnam).This study investigates the possible input factors that may have effect on the performance of applied models. Based on the results of the experiment conducted in this study, Support Vector Machine has been found to have the maximum potentiality to predict unknown impacting vehicle type in hit-and-run accidents for all the cities except Amritsar. The result indicates that, Classification and Regression Trees have maximum accuracy, for Amritsar. Naïve Bayes performed very poorly for the five cities. These recommendations will help in predicting unknown impacting vehicles in hit-and-run accidents. The outcome is useful for transportation authorities and policymakers to implement effective road safety measures for the safety of road users.

Jha|Alok Nikhil|AN|
Chatterjee|Niladri|N|
Tiwari|Geetam|G|

Hit-and-run
Road accident
Linear discriminant analysis
Naïve Bayes
Classification and regression tree
k-Nearest neighbor
Support vector machine
Cross validation
Road user safety
Vehicle type prediction


Detection of localized changes in the metabolism of hyperpolarized gluconeogenic precursors 13 C-lactate and 13 C-pyruvate in kidney and liver.

Abstract:
PURPOSE
The purpose of this study was to characterize tissue-specific alterations in metabolism of hyperpolarized (HP) gluconeogenic precursors 13 C-lactate and 13 C-pyruvate by rat liver and kidneys under conditions of fasting or insulin-deprived diabetes.

METHODS
Seven normal rats were studied by MR spectroscopic imaging of both HP 13 C-lactate and 13 C-pyruvate in both normal fed and 24 h fasting states, and seven additional rats were scanned after induction of diabetes by streptozotocin (STZ) with insulin withdrawal. Phosphoenolpyruvate carboxykinase (PEPCK) expression levels were also measured in liver and kidney tissues of the STZ-treated rats.

RESULTS
Multiple sets of significant signal modulations were detected, with graded intensity in general between fasting and diabetic states. An approximate two-fold reduction in the ratio of 13 C-bicarbonate to total 13 C signal was observed in both organs in fasting. The ratio of HP lactate-to-alanine was markedly altered, ranging from a liver-specific 54% increase in fasting, to increases of 69% and 92% in liver and kidney, respectively, in diabetes. Diabetes resulted in a 40% increase in renal lactate signal. STZ resulted in 5.86-fold and 2.73-fold increases in PEPCK expression in liver and kidney, respectively.

CONCLUSION
MRI of HP 13 C gluconeogenic precursors may advance diabetes research by clarifying organ-specific roles in abnormal diabetic metabolism. Magn Reson Med 77:1429-1437, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

von Morze|Cornelius|C|
Chang|Gene-Yuan|GY|
Larson|Peder E Z|PE|0000-0003-4183-3634
Shang|Hong|H|
Allu|Prasanna K R|PK|
Bok|Robert A|RA|
Crane|Jason C|JC|
Olson|Marram P|MP|
Tan|Chou T|CT|
Marco-Rius|Irene|I|
Nelson|Sarah J|SJ|
Kurhanewicz|John|J|
Pearce|David|D|
Vigneron|Daniel B|DB|

D066241:Carbon-13 Magnetic Resonance Spectroscopy

fasting
diabetes
streptozotocin
dynamic nuclear polarization
gluconeogenesis


Acetone Ingestion Resulting in Cardiac Arrest and Death.

Abstract: Acetone is a chemical found naturally in the environment, and acetone poisoning can occur through contact with household products that contain acetone, including nail polish removers, paint removers, some polishes, as well as certain detergents and cleaners. Acetone toxicity affects almost all body systems, including the nervous, respiratory, cardiovascular, and endocrine systems. The incidence of life-threatening medical problems from acetone exposure is very rare. However, in this report, we present a case of acetone toxicity resulting in death. Our patient presented with cardiopulmonary arrest, hypotension, tachycardia, hyperglycemia, acute kidney injury (AKI), thrombocytopenia, elevated liver enzymes, and extensive esophageal and gastric erosion with associated upper gastrointestinal bleeding.

Umeh|Chukwuemeka|C|
Gupta|Rakesh C|RC|
Gupta|Rahul|R|
Kaur|Harpreet|H|
Kazourra|Shadi|S|
Maguwudze|Stella|S|
Torbela|Adrian|A|
Saigal|Shipra|S|

acetone
cardiac arrest
death
nail polish cleaner ingestion
respiratory arrest


Assessing Individual Differences in the Affective Experience of Dreams: The Jena Dream Inventory-Affect Scales (JeDI-A).

Abstract: The study reports on the validation of a new instrument for the assessment of emotional experiences in dreams. The Jena Dream Inventory-Affect (JeDI-A) contains 21 items and 3 scales, positive dream affect, negative dream affect, and dream intensity, providing a differentiated yet economic assessment of dream affect. Cross-sectional and longitudinal analyses in a sample of university students (N = 426) and a clinical sample of patients with sleep disorders (N = 149) supported factorial validity and measurement invariance, high temporal stability (over 1 year and 9 months in the students and patients, respectively), convergent and discriminant validity regarding established measures of dream affect and the Big Five, and criterion validity regarding subjective well-being. Cross-lagged panel models showed reciprocal longitudinal effects between dream affect and waking affect. We conclude that the JeDI-A is a valid instrument for differentiated investigations of individual differences in dream affect in clinical and nonclinical populations.

Hagemeyer|Birk|B|0000-0003-4833-1370
Salomo|Sarah|S|
Engelhardt|Cordelia|C|
Neyer|Franz J|FJ|
Rupprecht|Sven|S|

individual differences
dreaming
dream affect
subjective well-being
negative affect
positive affect
subjective dream experience


Decreasing skeletal muscle as a risk factor for mortality in elderly patients with sepsis: a retrospective cohort study.

Abstract:
BACKGROUND
Older patients account for the majority of patients with sepsis. The objective of this study was to determine if decreased skeletal muscle mass is associated with outcomes in elderly patients with sepsis.

METHODS
Patients (60 years and older) who were admitted to a tertiary medical center intensive care unit with a primary diagnosis of sepsis between January 2012 and February 2016 were included. Patients who had not undergone abdominal computed tomography on the day of admission, had cardiopulmonary arrest on arrival, or had iliopsoas abscess were excluded from the analyses. Cross-sectional muscle area at the 3rd lumber vertebra was quantified, and the relation to in-hospital mortality was analyzed. Multivariable logistic regression analysis that included sex and APACHE II score as explanatory variables was performed. The optimal cutoff value to define decreased muscle mass (sarcopenia) was calculated using receiver operating characteristic curve analysis, and the odds ratio for in-hospital mortality was determined.

RESULTS
There were 150 elderly patients with sepsis (median age, 75 years) enrolled; in-hospital mortality and median APACHE II score were 38.7 and 24%, respectively. The skeletal muscle area of deceased patients was significantly lower than that of the survival group (P < 0.001). The multivariable logistic regression analysis demonstrated that decreased muscle mass was significantly associated with increased mortality (odds ratio = 0.94, 95% confidence interval = 0.90 to 0.97, P < 0.001). The optimal cutoff value of skeletal muscle area to predict in-hospital mortality was 45.2 cm2 for men and 39.0 cm2 for women. With these cutoff values, the adjusted odds ratio for decreased muscle area was 3.27 (95% CI, 1.61 to 6.63, P = 0.001).

CONCLUSIONS
Less skeletal muscle mass is associated with higher in-hospital mortality in elderly patients with sepsis. The results of this study suggest that identifying patients with low muscularity contributes to better stratification in this population.

Shibahashi|Keita|K| Sugiyama|Kazuhiro|K| Kashiura|Masahiro|M| Hamabe|Yuichi|Y|

Mortality
Sepsis
Intensive care
Sarcopenia


Construction, renovation and demolition (CRD) wastes contaminated by gypsum residues: Characterization, treatment and valorization.

Abstract: Management of wastes resulting from construction, renovation and demolition (CRD) activities has become an important challenge for scientists. The recovery of gypsum residues from CRD waste is one of the solutions to minimize the impact of CRD operations on the environment. This review discusses the characteristics of CRD waste, different treatment and valorization methods for both CRD waste and extracted gypsum residues. Pre-treatment based on particle size separation is the most fundamental step in the process of extracting gypsum residues from CRD fine tailings. The subsequent application of a physical, chemical or biological decontamination approach on the gypsum residues could significantly improve its quality as compared to natural gypsum. The quality of the gypsum obtained affects its valorization potential in different sectors such as cement manufacturing, the sequestration of carbon dioxide and nutrients. The valorization strategy could help reducing emissions of greenhouse gases while producing by-products that can be reused in agriculture. As such, this review may provide guidance for more sustainable management of CRD and gypsum residues in the future.

Amine Laadila|Mohamed|M|
LeBihan|Yann|Y|
Caron|Richard-Francois|RF|
Vaneeckhaute|Céline|C|

D002133:Calcium Sulfate
D003252:Construction Materials
D007220:Industrial Waste
D059027:Recycling
D018505:Waste Management

Gypsum
Valorization
CRD waste
Particle size separation
Decontamination
Recycling


Imaging Accuracy in Diagnosis of Different Focal Liver Lesions: A Retrospective Study in North of Iran.

Abstract:
INTRODUCTION
Focal liver lesions (FLLs) are incidentally detected masses found in daily abdominal imaging which are necessary to be characterized, because of the potential of being malignant. There are several imaging methods, such as ultrasonography (US), computed tomography (CT scan), and contrast enhanced magnetic resonance imaging (MRI). Here, we evaluate and compare the diagnostic accuracy (i.e., sensitivity and specificity) of these imaging methods for the diagnosis of FLLs.

MATERIAL AND METHODS
In this retrospective study, patients with focal liver lesions included and based on the gastroenterologist decision, in 79 patients different imaging methods were used to determine the nature of FLLs: the US, CT scan, and MRI. At the next step, fine-needle aspiration biopsy (FNA) was performed in all cases, and the results about the true nature of FLLs compared with different imaging results. The chi-square test and McNemar test were used.

RESULTS
Ultrasound diagnosis of benign and malignant was obtained with 82% diagnosis accuracy, 100% sensitivity, 71.4% specificity, 100% negative predictive value, and 69.2% positive predictive value (PPV) compared with the biopsy. Also, the results of benign and malignant masses in CT scan were obtained with diagnostic accuracy of 95%, 100% sensitivity, 80% specificity, 93.9% positive predictive value, and 100% negative predictive value. MRI performed only in 2 cases with similar results to pathology.

CONCLUSION
It seems that CT scan is more appropriate and useful in the diagnosis of hepatic masses due to its higher diagnostic accuracy than the ultrasound.

Alizadeh|Ahmad|A|
Mansour-Ghanaei|Fariborz|F|
Bagheri|Faezeh Berengi|FB|
Froutan|Hossein|H|
Froutan|Yaser|Y|
Joukar|Farahnaz|F|
Atrkar-Roushan|Zahra|Z|
Chavoshi|Seyed Ali|SA|
Hassanipour|Soheil|S|

Focal liver lesions
CT scan
Sensitivity
Specificity
Biopsy
Ultrasound


Detection of pronator muscle overactivity in children with unilateral spastic cerebral palsy: Development of a semi-automatic method using EMG data.

Abstract:
BACKGROUND
The pronator teres and pronator quadratus muscles are frequently injected with neuromuscular blocking agents to improve supination in children with spastic cerebral palsy and limited active elbow supination. However, determining by simple clinical examination whether these muscles are overactive during active movement is difficult.

OBJECTIVE
This study aimed to develop a semi-automatic method to detect pronator muscle overactivity by using surface electromyography (EMG) during active supination movements in children with cerebral palsy.

METHODS
In total, 25 children with unilateral spastic cerebral palsy (10 males; mean [SD] age 10.6 [3.0] years) and 12 typically developing children (7 males; mean age 11.0 [3.0] years) performed pronation-supination movements at 0.50Hz. Kinematic parameters and surface EMG signals were recorded for both pronator muscles. Three experts visually assessed muscle overactivity in the EMG signals of the children with cerebral palsy, in comparison with the reference group. The reliability and discrimination ability of the visual assessments were analysed. Overactivity detection thresholds for the semi-automatic method were adjusted by using the visual assessment by the EMG experts. The positive and negative predictive values of the semi-automatic detection method were calculated.

RESULTS
Intra-rater reliability of visual assessment by EMG experts was excellent and inter-rater reliability was moderate. For the 25 children with unilateral spastic cerebral palsy, EMG experts could discriminate different profiles of pronator overactivity during active supination: no pronator overactivity, one overactive pronator, or overactivity of both pronators. The positive and negative predictive values were 96% and 91%, respectively, for this semi-automatic detection method.

CONCLUSIONS
Detection of pronator overactivity by using surface EMG provides an important complement to the clinical examination. This method can be used clinically, with the condition that clinicians be aware of surface EMG limitations. We believe use of this method can increase the accuracy of treatment for muscle overactivity, resulting in improved motor function and no worsening of paresis.

Sarcher|Aurélie|A| Brochard|Sylvain|S| Perrouin-Verbe|Brigitte|B| Raison|Maxime|M| Letellier|Guy|G| Leboeuf|Fabien|F| Gross|Raphaël|R|

Pronators
Overactivity
Children
Cerebral palsy
Electromyography
Forearm supination


Comparative proteomic profiling of pancreatic ductal adenocarcinoma cell lines.

Abstract: Pancreatic cancer is one of the most fatal cancers and is associated with limited diagnostic and therapeutic modalities. Currently, gemcitabine is the only effective drug and represents the preferred first-line treatment for chemotherapy. However, a high level of intrinsic or acquired resistance of pancreatic cancer to gemcitabine can contribute to the failure of gemcitabine treatment. To investigate the underlying molecular mechanisms for gemcitabine resistance in pancreatic cancer, we performed label-free quantification of protein expression in intrinsic gemcitabine-resistant and - sensitive human pancreatic adenocarcinoma cell lines using our improved proteomic strategy, combined with filter-aided sample preparation, single-shot liquid chromatography-mass spectrometry, enhanced spectral counting, and a statistical method based on a power law global error model. We identified 1931 proteins and quantified 787 differentially expressed proteins in the BxPC3, PANC-1, and HPDE cell lines. Bioinformatics analysis identified 15 epithelial to mesenchymal transition (EMT) markers and 13 EMT-related proteins that were closely associated with drug resistance were differentially expressed. Interestingly, 8 of these proteins were involved in glutathione and cysteine/methionine metabolism. These results suggest that proteins related to the EMT and glutathione metabolism play important roles in the development of intrinsic gemcitabine resistance by pancreatic cancer cell lines.

Kim|Yikwon|Y|
Han|Dohyun|D|
Min|Hophil|H|
Jin|Jonghwa|J|
Yi|Eugene C|EC|
Kim|Youngsoo|Y|

D015972:Gene Expression Regulation, Neoplastic

pancreatic cancer
gemcitabine
LC-MS/MS
chemoresistance
quantitative Proteomics


Review of the Indian Ocean spikefish genus Mephisto (Tetraodontiformes: Triacanthodidae).

Abstract: We redescribe the triacanthodid spikefish Mephisto fraserbrunneri Tyler 1966 based upon eight specimens (five newly reported herein) and the first color photographs of freshly collected specimens; these data are compared with that of the single specimen of the recently described M. albomaculosus Matsuura, Psomadakis, and Mya Than Tun 2018. Both species are found in the Indian Ocean, with M. fraserbrunneri known from the Arabian Sea off the east coast of Africa to the eastern Bay of Bengal, and M. albomaculosus confirmed only from the type locality in the Andaman Sea (a color photograph of an individual M. cf. albomaculosus from the Bay of Bengal that was not retained is also presented). We describe and diagnose the genus Mephisto and provide a key to the two species based upon all available specimens. We also provide a distribution map for both species and summarize literature records. Using micro-CT data, we show that Mephisto fraserbrunneri replaces teeth intraosseously, which suggests this tooth replacement pattern is plesiomorphic for Tetraodontiformes.

Bemis|Katherine E|KE|
Tyler|James C|JC|
Psomadakis|Peter N|PN|
Ferris|Lauren Newell|LN|
Kumar|Appukuttannair Biju|AB|


Surviving Violence in Everyday Life: A Communicative Approach to Homelessness.

Abstract: In this narrative review, the author synthesizes the literature on homelessness across various disciplines (e.g., public health, social work, sociology, and communication) to demonstrate how the experiences of homelessness can be created, maintained, and reinforced through communication, including interpersonal interactions and public discourse. By conceptualizing homelessness as a culturally constructed and socially situated phenomenon, the author examines (a) the complex conceptualization of homelessness, (b) everyday violence faced by people who are homeless, and (c) coping strategies of people who are homeless. In summary, homelessness is a complex social phenomenon, involving tensions between individuals, families, and social systems, all of which are situated in the larger sociocultural and sociopolitical contexts of a specific time and place.

violence
everyday life
homelessness
review


Enteropathogenic Escherichia coli Outbreak and its Incubation Period: Is it Short or Long?

Abstract:
OBJECTIVES
The aim of this study is to determine the incubation period of enteropathogenic Escherichia coli (EPEC), which creates several outbreaks in a year in South Korea.

METHODS
We reviewed all water and food-borne outbreaks data reported to the Korea Centers for Disease Control and Prevention (KCDC) from 2009 to 2010 and determined their characteristics. Through this process, we can presume the incubation period of EPEC among outbreaks in South Korea.

RESULTS
A total of 497 water and food-borne outbreaks were reported to KCDC and 66 (13.28%) are defined as E coli-origin outbreaks. EPEC was the most common subtype of E coli, being confirmed as a causative organism in 26 outbreaks. Overall attack rate was 15.85% (range 0.9-100). The subjects were eight outbreaks that have a clear history of single exposure and we can estimate the incubation time of EPEC as minimum 0.5 hours to maximum 34.0 hours with a mean 12.9 hours (range 4.5-24.0). The cases of those cannot completely rule out the chance of multiple exposure from same source or place have minimum 1.0 hour, to a maximum of 195.5 hours and a mean 30.5 (range 22.7-61.0) hours of incubation period.

CONCLUSIONS
This serial analysis suggests that EPEC has actually shorter mean incubation period as much as 12 hours. When this period is longer than 1 day or over, then the epidemiologic investigator should consider the chance of repeated or continuous exposure by making it clear whether there is any chance of any other exposure in common.

outbreak
incubation period
EPEC
single exposure
enteropathogenic E coli


Standards for Interprofessional Collaboration in the Treatment of Individuals With Autism.

Abstract: Interprofessional collaboration has become an essential component in the treatment of individuals with autism spectrum disorder, as practitioners from a range of disciplines are often necessary to address the core features and co-occurring conditions. Theoretically, such cross-disciplinary collaboration results in superior client care and maximal outcomes by capitalizing on the unique expertise of each collaborating team member. However, conflict in collaborative practice is not uncommon given that the treatment providers come from varying educational backgrounds and may have opposing core values, fundamental goals, and overall approaches. Although the overarching interest of each of these professionals is to improve client outcomes and quality of life, they may be unequipped to effectively navigate the barriers to collaboration. This article reviews the potential benefits and misconceptions surrounding interprofessional collaboration and highlights common sources of conflict. As a proposed solution to many of the identified issues, we offer a set of standards for effective collaborative practice in the interprofessional treatment of autism spectrum disorder. These standards prioritize client care and value each discipline's education and unique contributions. They are intended to function as core standards for all treatment team members, promote unity, prevent conflict, and ultimately help practitioners achieve the most integrated collaborative practice among professionals of varying disciplines.

Bowman|Kristin S|KS|0000-0002-7693-565X
Suarez|Victoria D|VD|
Weiss|Mary Jane|MJ|

collaboration autism interdisciplinary multidisciplinary transdisciplinary


Humidity-Tolerant Ultrathin NiO Gas-Sensing Films.

Abstract: When the gas sensor active layer film thickness is decreased, increased sensitivity to changes in the adsorbate concentration is expected when measuring the resistance of the layer, in particular when this thickness is on the order of the Debye length of the material (one-tens of nanometers); however, this is demonstrated only for a limited number of materials. Herein, ultrathin NiO films of different thicknesses (8-21 nm) have been deposited via chemical vapor deposition to fabricate gas sensor devices. Sensor performance for a range of NO2 concentrations (800 part-per-billion to 7 part-per-million) was evaluated and an optimum operating temperature of 125 °C determined. The dependence of the potential relative changes with respect to the NO2 concentration and of the sensor signal with respect to the geometrical parameters was qualitatively evaluated to derive a transduction model capable of fitting the experimental results. The selective sensitivity toward NO2 was confirmed by the limited response for different reducing gases, CO, CH4, NH3, and SO2, under optimum operating conditions, and the sensor signal toward NO2 increased with decreasing thickness, demonstrating that the concept of a Debye length dependence of sensitivity is applicable for the p-type semiconductor NiO. In addition, these NiO sensors were exposed to different relative levels of humidity over a wide range of operating temperatures and were found to display humidity tolerance far superior to those in previous reports on SnO2 materials.

Wilson|Rachel L|RL|
Simion|Cristian Eugen|CE|
Stanoiu|Adelina|A|
Taylor|Alaric|A|0000-0001-6494-8309
Guldin|Stefan|S|0000-0002-4413-5527
Covington|James A|JA|
Carmalt|Claire J|CJ|0000-0003-1788-6971
Blackman|Chris S|CS|0000-0003-0700-5843

humidity
NO2 sensing
low temperature
nickel oxide
thickness dependence


Extracellular vesicles from MDA-MB-231 breast cancer cells stimulated with insulin-like growth factor 1 mediate an epithelial-mesenchymal transition process in MCF10A mammary epithelial cells.

Abstract: Insulin-like growth factor-1 (IGF-1) plays an important role in function and development of the mammary gland. However, high levels of IGF-1 has been associated with an increased risk of breast cancer development. Epithelial-mesenchymal transition (EMT) is a process where epithelial cells lose their epithelial characteristics and acquire a mesenchymal phenotype, which is considered one of the most important mechanisms in cancer initiation and promotion of metastasis. Extracellular vesicles (EVs) are released into the extracellular space by different cell types, which mediate intercellular communication and play an important role in different physiological and pathological processes, such as cancer. In this study, we demonstrate that EVs from MDA-MB-231 breast cancer cells stimulated with IGF-1 (IGF-1 EVs) decrease the levels of E-cadherin, increase the expression of vimentin and N-cadherin and stimulate the secretion of metalloproteinase-9 in mammary non-tumorigenic epithelial cells MCF10A. IGF-1 EVs also induce the expression of Snail1, Twist1 and Sip1, which are transcription factors involved in EMT. Moreover, IGF-1 EVs induce activation of ERK1/2, Akt1 and Akt2, migration and invasion. In summary, we demonstrate, for the first time, that IGF-1 EVs induce an EMT process in mammary non-tumorigenic epithelial cells MCF10A.


A transcriptional response of Clostridium beijerinckii NRRL B-598 to a butanol shock.

Abstract:
Background
One of the main obstacles preventing solventogenic clostridia from achieving higher yields in biofuel production is the toxicity of produced solvents. Unfortunately, regulatory mechanisms responsible for the shock response are poorly described on the transcriptomic level. Although the strain Clostridium beijerinckii NRRL B-598, a promising butanol producer, has been studied under different conditions in the past, its transcriptional response to a shock caused by butanol in the cultivation medium remains unknown.

Results
In this paper, we present a transcriptional response of the strain during a butanol challenge, caused by the addition of butanol to the cultivation medium at the very end of the acidogenic phase, using RNA-Seq. We resequenced and reassembled the genome sequence of the strain and prepared novel genome and gene ontology annotation to provide the most accurate results. When compared to samples under standard cultivation conditions, samples gathered during butanol shock represented a well-distinguished group. Using reference samples gathered directly before the addition of butanol, we identified genes that were differentially expressed in butanol challenge samples. We determined clusters of 293 down-regulated and 301 up-regulated genes whose expression was affected by the cultivation conditions. Enriched term "RNA binding" among down-regulated genes corresponded to the downturn of translation and the cluster contained a group of small acid-soluble spore proteins. This explained phenotype of the culture that had not sporulated. On the other hand, up-regulated genes were characterized by the term "protein binding" which corresponded to activation of heat-shock proteins that were identified within this cluster.

Conclusions
We provided an overall transcriptional response of the strain C. beijerinckii NRRL B-598 to butanol shock, supplemented by auxiliary technologies, including high-pressure liquid chromatography and flow cytometry, to capture the corresponding phenotypic response. We identified genes whose regulation was affected by the addition of butanol to the cultivation medium and inferred related molecular functions that were significantly influenced. Additionally, using high-quality genome assembly and custom-made gene ontology annotation, we demonstrated that this settled terminology, widely used for the analysis of model organisms, could also be applied to non-model organisms and for research in the field of biofuels.

Sedlar|Karel|K|0000-0002-8269-4020 Kolek|Jan|J| Gruber|Markus|M| Jureckova|Katerina|K| Branska|Barbora|B| Csaba|Gergely|G| Vasylkivska|Maryna|M| Zimmer|Ralf|R| Patakova|Petra|P| Provaznik|Ivo|I|

Clostridium beijerinckii NRRL B-598
Butanol shock
ABE fermentation
RNA-Seq transcriptome


Are green cities healthy and equitable? Unpacking the relationship between health, green space and gentrification.

Abstract: While access and exposure to green spaces has been shown to be beneficial for the health of urban residents, interventions focused on augmenting such access may also catalyse gentrification processes, also known as green gentrification. Drawing from the fields of public health, urban planning and environmental justice, we argue that public health and epidemiology researchers should rely on a more dynamic model of community that accounts for the potential unintended social consequences of upstream health interventions. In our example of green gentrification, the health benefits of greening can only be fully understood relative to the social and political environments in which inequities persist. We point to two key questions regarding the health benefits of newly added green space: Who benefits in the short and long term from greening interventions in lower income or minority neighbourhoods undergoing processes of revitalisation? And, can green cities be both healthy and just? We propose the Green Gentrification and Health Equity model which provides a framework for understanding and testing whether gentrification associated with green space may modify the effect of exposure to green space on health.

D002947:Cities
D002958:City Planning
D004782:Environmental Health
D006293:Health Promotion
D006801:Humans
D011634:Public Health
D012111:Residence Characteristics
D014481:United States
D014504:Urban Health

environmental health
health inequalities
health promotion


Interaction effects of salinity, sewage sludge, and earthworms on the fractionations of Zn and Cu, and the metals uptake by the earthworms in a Zn- and Cu-contaminated calcareous soil.

Abstract: This study assessed the effects of salinity and sewage sludge on the fractionation of Zn and Cu in a soil around a lead-zinc mine as well as their uptake by earthworms (Eisenia fetida) in order to identify novel methods for employing the earthworms in waste management techniques. Eisenia fetida specimens were kept under laboratory conditions for 42 days. The first treatment involved the addition of 0%, 2%, 4%, and 8% (w/w) sewage sludge to contaminated soil. In the second treatment, NaCl was added to the soil at concentrations of 0, 1170, 2340, 3510, and 4680 mg L-1. The results indicated that the combined application of high salinity and sewage sludge had adverse effects on the survival of the earthworms. The presence of the earthworms increased the amount of Zn and Cu bound to organic matter. The organic fraction of Zn and Cu also significantly aggregated with increasing salinity levels. The interaction of salinity and earthworm showed that the residual Cu fraction increased with the presence of earthworm and decreased with increasing salinity. The residual fraction of Cu was significantly affected by the interactions of salinity and sewage sludge, where the highest amount was seen in the EC0 (distilled water) × SS8 (8% sewage sludge) treatment. The Zn and Cu contents increased with the earthworms when exposed to higher levels of salinity and sewage sludge.

Fractionation
Metal
Eisenia fetida
Survival
Bioavailability
Environment


A β-glucuronosyltransferase from Arabidopsis thaliana involved in biosynthesis of type II arabinogalactan has a role in cell elongation during seedling growth.

Abstract: We have characterized a β-glucuronosyltransferase (AtGlcAT14A) from Arabidopsis thaliana that is involved in the biosynthesis of type II arabinogalactan (AG). This enzyme belongs to the Carbohydrate Active Enzyme database glycosyltransferase family 14 (GT14). The protein was localized to the Golgi apparatus when transiently expressed in Nicotiana benthamiana. The soluble catalytic domain expressed in Pichia pastoris transferred glucuronic acid (GlcA) to β-1,6-galactooligosaccharides with degrees of polymerization (DP) ranging from 3-11, and to β-1,3-galactooligosaccharides of DP5 and 7, indicating that the enzyme is a glucuronosyltransferase that modifies both the β-1,6- and β-1,3-galactan present in type II AG. Two allelic T-DNA insertion mutant lines showed 20-35% enhanced cell elongation during seedling growth compared to wild-type. Analyses of AG isolated from the mutants revealed a reduction of GlcA substitution on Gal-β-1,6-Gal and β-1,3-Gal, indicating an in vivo role of AtGlcAT14A in synthesis of those structures in type II AG. Moreover, a relative increase in the levels of 3-, 6- and 3,6-linked galactose (Gal) and reduced levels of 3-, 2- and 2,5-linked arabinose (Ara) were seen, suggesting that the mutation in AtGlcAT14A results in a relative increase of the longer and branched β-1,3- and β-1,6-galactans. This increase of galactosylation in the mutants is most likely caused by increased availability of the O6 position of Gal, which is a shared acceptor site for AtGlcAT14A and galactosyltransferases in synthesis of type II AG, and thus addition of GlcA may terminate Gal chain extension. We discuss a role for the glucuronosyltransferase in the biosynthesis of type II AG, with a biological role during seedling growth.

Knoch|Eva|E|
Dilokpimol|Adiphol|A|
Tryfona|Theodora|T|
Poulsen|Christian P|CP|
Xiong|Guangyan|G|
Harholt|Jesper|J|
Petersen|Bent L|BL|
Ulvskov|Peter|P|
Hadi|Masood Z|MZ|
Kotake|Toshihisa|T|
Tsumuraya|Yoichi|Y|
Pauly|Markus|M|
Dupree|Paul|P|
Geshi|Naomi|N|

Arabidopsis thaliana
type II arabinogalactan
glycosyltransferase family 14
Golgi apparatus
glucuronosyltransferase
arabinogalactan protein
plant cell wall


Neutrophil to lymphocyte ratio as prognostic and predictive factor in patients with coronavirus disease 2019: A retrospective cross-sectional study.

Abstract: This retrospective study was designed to explore whether neutrophil to lymphocyte ratio (NLR) is a prognostic factor in patients with coronavirus disease 2019 (COVID-19). A cohort of patients with COVID-19 admitted to the Tongren Hospital of Wuhan University from 11 January 2020 to 3 March 2020 was retrospectively analyzed. Patients with hematologic malignancy were excluded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count. NLR values were measured at the time of admission. The primary outcome was all-cause in-hospital mortality. A multivariate logistic analysis was performed. A total of 1004 patients with COVID-19 were included in this study. The mortality rate was 4.0% (40 cases). The median age of nonsurvivors (68 years) was significantly older than survivors (62 years). Male sex was more predominant in nonsurvival group (27; 67.5%) than in the survival group (466; 48.3%). NLR value of nonsurvival group (median: 49.06; interquartile range [IQR]: 25.71-69.70) was higher than that of survival group (median: 4.11; IQR: 2.44-8.12; P < .001). In multivariate logistic regression analysis, after adjusting for confounding factors, NLR  more than 11.75 was significantly correlated with all-cause in-hospital mortality (odds ratio = 44.351; 95% confidence interval = 4.627-425.088). These results suggest that the NLR at hospital admission is associated with in-hospital mortality among patients with COVID-19. Therefore, the NLR appears to be a significant prognostic biomarker of outcomes in critically ill patients with COVID-19. However, further investigation is needed to validate this relationship with data collected prospectively.

Yan|Xisheng|X| Li|Fen|F| Wang|Xiao|X| Yan|Jie|J| Zhu|Fen|F| Tang|Shifan|S| Deng|Yingzhong|Y| Wang|Hua|H| Chen|Rui|R| Yu|Zhili|Z| Li|Yaping|Y| Shang|Jingzhou|J| Zeng|Lingjun|L| Zhao|Jie|J| Guan|Chaokun|C| Liu|Qiaomei|Q| Chen|Haifeng|H| Gong|Wei|W| Huang|Xin|X| Zhang|Yu-Jiao|YJ| Liu|Jianguang|J| Dong|Xiaoyan|X| Zheng|Wen|W| Nie|Shaoping|S| Li|Dongsheng|D|0000-0001-6110-9630

neutrophils prognostic SARS-CoV-2 lymphopenia pneumonia


When Using a Negative Gender Stereotype as an Excuse Increases Gender Stereotyping in Others.

Abstract: Prior work has shown that women use gender stereotypes to excuse their stereotypic failures, and doing so incurs negative costs. This study examined if the audience who witnesses a woman using such a stereotypic excuse also incurs costs in the form of increased gender stereotype endorsement. Male and female participants reviewed a survey supposedly completed by a female target who recently took a math exam. In this survey, the female target either performed well or poorly on the exam, and when asked to explain her performance, either invoked a gender stereotype as an excuse (e.g., women are worse at math than men) or not. The results indicated that men (but not women) showed greater gender stereotype endorsement after reading about a female target that invoked a stereotypic excuse. These results suggest that when women use a gender stereotype as an excuse, they may unintentionally cause some observers to increase their endorsement of gender stereotypes.

gender stereotypes
excuses
gender differences
sexism


Phytoplankton biomass and composition in a well-flushed, sub-tropical estuary: The contrasting effects of hydrology, nutrient loads and allochthonous influences.

Abstract: The primary objective of this study was to examine trends in phytoplankton biomass and species composition under varying nutrient load and hydrologic regimes in the Guana Tolomato Matanzas estuary (GTM), a well-flushed sub-tropical estuary located on the northeast coast of Florida. The GTM contains both regions of significant human influence and pristine areas with only modest development, providing a test case for comparing and contrasting phytoplankton community dynamics under varying degrees of nutrient load. Water temperature, salinity, Secchi disk depth, nutrient concentrations and chlorophyll concentrations were determined on a monthly basis from 2002 to 2012 at three representative sampling sites in the GTM. In addition, microscopic analyses of phytoplankton assemblages were carried out monthly for a five year period from 2005 through 2009 at all three sites. Results of this study indicate that phytoplankton biomass and composition in the GTM are strongly influenced by hydrologic factors, such as water residence times and tidal exchanges of coastal waters, which in turn are affected by shifts in climatic conditions, most prominently rainfall levels. These influences are exemplified by the observation that the region of the GTM with the longest water residence times but lowest nutrient loads exhibited the highest phytoplankton peaks of autochthonous origin. The incursion of a coastal bloom of the toxic dinoflagellate Karenia brevis into the GTM in 2007 demonstrates the potential importance of allochthonous influences on the ecosystem.

Hart|J A|JA|
Phlips|E J|EJ|
Badylak|S|S|
Dix|N|N|
Petrinec|K|K|
Mathews|A L|AL|
Green|W|W|
Srifa|A|A|

Guana Tolomato Matanzas estuary
Water residence time
Karenia brevis
Climate change
Eutrophication
Red tides


Adjunct Histamine Blockers as Premedications to Prevent Carboplatin Hypersensitivity Reactions.

Abstract:
OBJECTIVE
The objective of this study was to evaluate the impact of premedications given as an adjunct to carboplatin on the incidence of hypersensitivity reactions in women with ovarian cancer. Medications of interest include a histamine1 (H1 ) and histamine2 (H2 ) blocker in addition to dexamethasone.

METHODS
This was a retrospective chart review evaluating the addition of an H1 and H2 blocker in addition to dexamethasone as standard premedications on the incidence of carboplatin hypersensitivity reactions (CHRs) in women with ovarian cancer.

MAIN RESULTS
The odds ratio for premedication use was 0.46 with a 95% confidence interval (0.17-1.27), suggesting that patients with premedication use had approximately half the risk of CHR compared with patients without premedication. The overall incidence of CHRs decreased from 7.9% at baseline to 3.2% after the addition of premedications. The incidence of CHRs was 5.2% in 58 patients with recurrent or progressive disease compared with 2.1% in 96 newly diagnosed patients. Lifetime dose greater than 3377 mg, number of cycles more than six, and progressive or recurrent disease were predictive factors of CHR in women with ovarian cancer.

PRINCIPAL CONCLUSIONS
Total lifetime exposure to carboplatin remains the greatest predictive factor of CHR in women with ovarian cancer. Although data analysis indicates the addition of premedications for all ovarian cancer patients receiving carboplatin did not result in a statistically significant reduction in CHRs, a patient benefit in CHR reduction was observed. A prospective study is needed to confirm these findings.

Mach|Claire M|CM|
Lapp|Elisabeth A|EA|
Weddle|Kellie J|KJ|
Hunter|Rodney J|RJ|
Burns|Kimberly A|KA|
Parker|Crystal|C|
Brown|Jubilee|J|
Smith|Judith A|JA|

premedication
carboplatin
hypersensitivity
ovarian cancer
allergy


Social and structural determinants of youth alcohol use in Tanzania: The role of gender, social vulnerability and stigma.

Abstract: Adolescent alcohol use remains an under-addressed population health issue across Africa. Although the literature explores the intersection of alcohol use and vulnerability to HIV and AIDS, there is limited evidence on the gendered uptake and use of alcohol among adolescents. Capturing adolescents' voiced experiences about the societal influences shaping their alcohol usage is essential for identifying contextually relevant interventions to reduce their vulnerability to alcohol and related risky behaviours, such as unsafe sex. We conducted qualitative research in urban Tanzania, including key informant interviews, systematic mapping of alcohol availability, in-depth interviews with adolescents in and out of school and adults, and participatory methodologies with adolescents ages 15-19. The findings described here were drawn from the participatory methodologies (n = 177); and in-depth interviews with adolescents (n = 24) and adults (n = 24). Three key themes emerged: (1) boys' increased social vulnerability to alcohol consumption; (2) the ways in which stigma shapes girls' alcohol usage; and (3) how gendered perceptions of alcohol use reinforce societal inequalities. There exists an urgent need to address the social and gendered vulnerabilities of youth in Africa to the uptake and use of alcohol, and identify interventions that reshape notions of masculinity increasing boy's vulnerability to use.

Sommer|Marni|M| Kaaya|Sylvia|S| Kajula|Lusajo|L| Marwerwe|Graca|G| Hamisi|Hassan|H| Parker|Richard|R|0000-0003-3796-0198

AIDS – Acquired Immunodeficiency Syndrome


Stability of African swine fever virus on heat-treated field crops.

Abstract: African swine fever (ASF) is an infectious disease of pigs and represents a massive threat to animal health and the pig industry worldwide. The ASF virus (ASFV) is efficiently transmitted via blood and meat from infected animals and can be highly stable in the environment. There is therefore great concern about the potential role of contaminated raw materials used for feed or bedding in the spread of ASFV. Especially crops and derived products originating from areas with ASF in wild boar and thus with high environmental ASFV contamination may be a risk for virus introduction into domestic pig herds. However, little is known about the stability of ASFV on contaminated crops and possible inactivation methods. In this study, we tested the effect of drying and heat treatment on the inactivation of ASFV on six different types of field crops, namely wheat, barley, rye, triticale, corn, and peas, contaminated with infectious blood. Samples were analysed for the presence of viral DNA and infectious virus after 2 hr drying at room temperature or after drying and 1 hr exposure to moderate heat at a specific temperature between 40°C and 75°C. ASFV genome was detected in all samples by real-time polymerase chain reaction (PCR), including samples that had been dried for 2 hr and incubated for 1 hr at 75°C. On the other hand, no infectious virus could be detected after 2 hr drying using virus isolation in porcine macrophages in combination with the detection of ASFV by the haemadsorption test (HAT). We therefore conclude that the risk of ASFV transmission via contaminated crops is most likely low, if they are incubated for at least 2 hr minimum at room temperature. Nonetheless, to minimize the risk of transmission as much as possible crops from ASF-affected zones should not be used for pig feed.

D060888:Real-Time Polymerase Chain Reaction

African swine fever virus
contamination of field crops
disease introduction
risk factor
virus stability
wild boar carcass


Patient delay in presenting symptoms of breast cancer in women in the Czech Republic.

Abstract:
BACKGROUND
Presenting breast cancer symptoms and seeking medical help is a key element in the dia-gnosis and treatment of this disease. Early presentation of symptoms increases the likelihood of recovery. However, some women do not seek medical attention as soon as they find a symptom and delay a visit to the physician.

MATERIAL AND METHODS
This study is part of a project based on DIPEx qualitative methodology focused on experience of women with breast cancer. The aim of this article is to explore reasons for the delay of the presentation of breast cancer symptoms to a physician. Fifty-three interviews with women were collected across the Czech Republic. Aiming for maximum variation of the sample, the women represent different age groups, education level, marital status, stages of illness and types of treatment. The DIPEx qualitative methodology was used. The first part of the interview is narrative, followed by a semi-structured part. The interviews were verbatim transcribed for the analysis. The data were analysed using NVivo10 software. Open coding was applied from which the categories were constructed and the themes emerged. We used the OSOP (one sheet of paper) method for a thematic analysis.

RESULTS
Delay in presenting symptoms to a physician is mainly caused by wrong symptom interpretation, and not considering symptom as serious. In some cases, defence mechanisms are activated and women tend to downplay the symptom. Cognitive distortion is triggered in some women who have experience with such a symptom. Other women tend to prioritize various life events over seeing a physician. Screening tests were perceived positively.

CONCLUSIONS
Bearing the results in mind, we recommend aiming educational campaigns not only at symptom recognition and the importance of seeking medical help, but also the subsequent steps that need to be taken.

Černíková Anna|Kristýna|K|
Kráčmarová Klůzová|Lucie|L|
Pešoutová|Markéta|M|
Tavel|Peter|P|

D007722:Health Knowledge, Attitudes, Practice

D010342:Patient Acceptance of Health Care

patient
patient delay
breast cancer
health care
health psychology –psycho-oncology
psycho-oncology


Role of GLP-1 Receptor Agonists in Pediatric Obesity: Benefits, Risks, and Approaches to Patient Selection.

Abstract:
PURPOSE OF REVIEW
Effective treatments for pediatric obesity are limited. Glucagon-like peptide-1 receptor (GLP-1R) agonists have emerged as therapeutic agents for obesity in adults and have shown benefits outside of weight loss. Here we explore the evidence for GLP-1R agonist use in pediatric obesity.

RECENT FINDINGS
Emerging evidence suggests that GLP-1R agonists have a role in pediatric obesity treatment. A recently published, randomized, placebo-controlled trial found a greater reduction in BMI z-score (- 0.22 SDs) in adolescents receiving liraglutide compared with placebo. As in adults, gastrointestinal adverse effects were commonly seen. GLP-1R agonists appear to perform favorably compared with other approved pharmacological agents for pediatric obesity. However, heterogeneity in weight loss response, cost, side effects, and need for injections may limit their use in many pediatric patients. Rather than broadly applying this therapy if it is approved, we suggest careful patient selection and monitoring by clinicians pending further studies.

D016032:Randomized Controlled Trials as Topic

Pediatric obesity
GLP-1R agonist
Liraglutide
Metformin
Orlistat
Phentermine


White matter damage disorganizes brain functional networks in amnestic mild cognitive impairment.

Abstract: Although progressive functional brain network disruption has been one of the hallmarks of Alzheimer's Disease, little is known about the origin of this functional impairment that underlies cognitive symptoms. We investigated how the loss of white matter (WM) integrity disrupts the organization of the functional networks at different frequency bands. The analyses were performed in a sample of healthy elders and mild cognitive impairment (MCI) subjects. Spontaneous brain magnetic activity (measured with magnetoencephalography) was characterized with phase synchronization analysis, and graph theory was applied to the functional networks. We identified WM areas (using diffusion weighted magnetic resonance imaging) that showed a statistical dependence between the fractional anisotropy and the graph metrics. These regions are part of an episodic memory network and were also related to cognitive functions. Our data support the hypothesis that disruption of the anatomical networks influences the organization at the functional level resulting in the prodromal dementia syndrome of MCI.

Pineda-Pardo|José Angel|JA|
Garcés|Pilar|P|
López|María Eugenia|ME|
Aurtenetxe|Sara|S|
Cuesta|Pablo|P|
Marcos|Alberto|A|
Montejo|Pedro|P|
Yus|Miguel|M|
Hernández-Tamames|Juan Antonio|JA|
del Pozo|Francisco|F|
Becker|James T|JT|
Maestú|Fernando|F|

D038524:Diffusion Magnetic Resonance Imaging

mild cognitive impairment
magnetoencephalography
phase synchronization
graph theory
diffusion tensor image
multimodal integration


Epidemiological investigation of bovine tuberculosis outbreaks in Uruguay (2011-2013).

Abstract: Bovine tuberculosis (bTB) is a chronic disease of cattle caused by infection with the Mycobacterium bovis. While bTB prevalence in Uruguay has been low (<11 outbreaks/year) for the past 50 years as a consequence of a national control program, annual incidence increased in 2011 through 2013-15, 26 and 16 infected herds each year, raising concerns from livestock stakeholders and the government. The goal of this study was to assess the spatial dynamics of bTB in Uruguay from 2011 to 2013 and the association between bTB and potential demographic and movement risk factors at the herd level using data provided by the Uruguayan Ministry of Livestock, Agriculture, and Fisheries. Clustering of incident outbreaks was assessed using the Cuzick-Edwards' test and the Bernoulli model of the spatial scan statistic, and a conditional multivariable logistic regression model was used to assess risk factors associated with bTB in a subset of Uruguayan dairy farms. Significant (P<0.05) global clustering was detected in 2012, while high-risk local clusters were detected in southwestern (2011, 2012, 2013), northwestern (2012), and southeastern (2012) Uruguay. Increased risk of bTB in different regions of Uruguay suggests a potential role of animal movements in disease dissemination. Larger herds, higher numbers of animals purchased, and incoming steers to the farm were associated with increased odds of breaking with bTB, in agreement with previous studies but also suggesting other additional sources of risk. These results will contribute to enhanced effectiveness of bTB control programs in Uruguay with the ultimate objective of preventing or mitigating the impact of the disease in the human and animal populations of the country.

Picasso|Catalina|C|
Alvarez|Julio|J|
VanderWaal|Kimberly L|KL|
Fernandez|Federico|F|
Gil|Andres|A|
Wells|Scott J|SJ|
Perez|Andres|A|

D000822:Animal Husbandry
D000818:Animals
D002417:Cattle
D004196:Disease Outbreaks
D016015:Logistic Models
D009163:Mycobacterium bovis
D012307:Risk Factors
D062206:Spatial Analysis
D014380:Tuberculosis, Bovine
D014583:Uruguay

Bovine tuberculosis
Uruguay
Risk factors
Spatial cluster analysis


Survey of cases of tick-paralysis and the presence of the eastern paralysis tick, Ixodes holocyclus, and the southern paralysis tick, Ixodes cornuatus, in the Greater Melbourne Area.

Abstract:
OBJECTIVE
The objective of this study was to test the hypothesis that the paralysis ticks, Ixodes holocyclus and Ixodes cornuatus, are epizootic and/or enzootic in the Greater Melbourne Area (GMA).

METHODS
We examined the ticks in the museum collections of Australia, wrote to, phoned and visited veterinarians and other colleagues in the GMA to gather information about the cases of tick paralysis and to request the ticks for identification.

RESULTS
We present evidence of I. holocyclus at 24 postcodes and I. cornuatus at 28 postcodes in the GMA.

CONCLUSIONS
We found evidence that I. holocyclus is epizootic at four postcodes in the GMA: at East Melbourne, Williamstown, Moonee Ponds and Hoppers Crossing. We did not find evidence that I. holocyclus is enzootic in the GMA. I. cornuatus is apparently enzootic in the GMA at Bullengarook, Kinglake, Chum Creek and Healesville. Our hypothesis is that I. cornuatus is also enzootic at Mt Macedon, Gisborne and at other bushy postcodes in the GMA. Since this tick is apparently enzootic in the GMA, it may also be epizootic at postcodes adjacent to busy postcodes such as Bullengarook, Kinglake, Chum Creek and Healesville. The concept of hitch-hiker larvae, nymphs and adult female ticks may explain many of the cases of tick paralysis due to I. holocyclus in the GMA. The accurate assessment of the risk of tick paralysis in dogs and cats in the GMA requires a more detailed map of the distribution of I. holocyclus and I. cornuatus in Victoria.

tick
dogs
cats
ectoparasites
external parasites
ixodidae


Association between sleep difficulties as well as duration and hypertension: is BMI a mediator?

Abstract: Sleep difficulties and short sleep duration have been associated with hypertension. Though body mass index (BMI) may be a mediator variable, the mediation effect has not been defined. We aimed to assess the association between sleep duration and sleep difficulties with hypertension, to determine if BMI is a mediator variable, and to quantify the mediation effect. We conducted a mediation analysis and calculated prevalence ratios with 95% confidence intervals. The exposure variables were sleep duration and sleep difficulties, and the outcome was hypertension. Sleep difficulties were statistically significantly associated with a 43% higher prevalence of hypertension in multivariable analyses; results were not statistically significant for sleep duration. In these analyses, and in sex-specific subgroup analyses, we found no strong evidence that BMI mediated the association between sleep indices and risk of hypertension. Our findings suggest that BMI does not appear to mediate the association between sleep patterns and hypertension. These results highlight the need to further study the mechanisms underlying the relationship between sleep patterns and cardiovascular risk factors.

Carrillo-Larco|R M|RM|
Bernabe-Ortiz|A|A|
Sacksteder|K A|KA|
Diez-Canseco|F|F|
Cárdenas|M K|MK|
Gilman|R H|RH|
Miranda|J J|JJ|0000-0002-4738-5468

hypertension
Body mass index
obesity
sleep apnea
sleep disorders


Application of a Systematic Protocol in the Treatment of TMDs With Occlusal Appliances: Effectiveness and Efficiency in a Longitudinal Retrospective Study With Medium-Term Follow-Up.

Abstract:
Objectives
This study aimed to assess effectiveness, efficiency, and feasibility of a systematic protocol for the choice and management of occlusal splints (OA) in the treatment of temporomandibular disorders (TMDs).

Materials and Methods
A longitudinal retrospective study was conducted. Two different samples, G1 + G2 (337 patients), between January 2011 and January 2014, were selected according to inclusion and exclusion criteria. G1 was composed of patients visited at Policlinico Umberto I, Head-Neck Department, Sapienza University of Rome, Italy, and patients in G2 visited at a private structure in Rome. Pain records and functionality were compared before (T0) and at the end of therapy (T1). A follow-up group, composed of 100 patients randomly selected among those who completed treatment for at least 1 year (T2), was analyzed and symptomatology records were compared. Descriptive statistical analysis was performed.

Results
In the entire sample, joint and muscular pain, joint noises and mandibular functionality, headache, and neck pain improved from T0 to T2. The average time for articular and muscular recovery was 6.4 months. Comparing treatment outcomes, there were not statistically significant differences between the two groups.

Conclusions
Treatment outcomes using this setting of protocol showed a positive trend also in the medium term. The use of a systematic protocol seems to reduce operator-dependent factors.

Tolevski Meshkova|Doria|D|
Di Giacomo|Paola|P|
Panti|Fabrizio|F|
D'Urso|Anna|A|
Serritella|Emanuela|E|
Di Paolo|Carlo|C|

systematic protocol
Occlusal appliances
temporomandibular disorders


Virtual Fracture Clinics in Orthopaedic Surgery - A Systematic Review of Current Evidence.

Abstract:
AIMS
Approximately 75% of fractures are simple, stable injuries which are often unnecessarily immobilised with subsequent repeated radiographs at numerous fracture clinic visits. In 2014, the Glasgow Fracture Pathway offered an alternative virtual fracture clinic (VFC) pathway with the potential to reduce traditional fracture clinic visits, waiting times and overall costs. Many units have implemented this style of pathway in the non-operative management of simple, undisplaced fractures. This study aims to systematically review the clinical outcomes, patient reported outcomes and cost analyses for VFCs.

MATERIALS AND METHODS
Two independent reviewers performed the literature search based on PRISMA guidelines, utilizing the MEDLINE, EMBASE and COCHRANE Library databases. Studies reporting outcomes following the use of VFC were included. Outcomes analysed were: 1) clinical outcomes, 2) patient reported outcomes, and 3) cost analysis.

RESULTS
Overall, 15 studies involving 11,921 patients with a mean age of 41.1 years and mean follow-up of 12.6 months were included. In total, 65.7% of patients were directly virtually discharged with protocol derived conservative management, with 9.1% using the Helpline and 15.6% contacting their general practitioner for advice or reassurance. A total of 1.2% of patients experienced fracture non-unions and 0.4% required surgical intervention. The overall patient satisfaction rate was 81.0%, with only 1.3% experiencing residual pain at the fracture site. Additionally, the mean cost per patient for VFC was £71, with a mean saving of £53 when compared to traditional clinic models. Subgroup analysis found that for undisplaced fifth metatarsal or radial head/neck fractures, the rates of discharge from VFC to physiotherapy or general practitioners were 81.2% and 93.7% respectively.

DISCUSSION AND CONCLUSION
This study established that there is excellent evidence to support virtual fracture clinic for non-operative management of fifth metatarsal fractures, with moderate evidence for radial head and neck fractures. However, the routine use of virtual fracture clinics is presently not validated for all stable, undisplaced fracture patterns.

LEVEL OF EVIDENCE
IV; Systematic Review of all Levels of Evidence.

Davey|Martin S|MS|
Coveney|Eamonn|E|
Rowan|Fiachra|F|
Cassidy|J Tristan|JT|
Cleary|May S|MS|

D000086382:COVID-19
D003140:Communicable Disease Control
D003362:Cost-Benefit Analysis
D019317:Evidence-Based Medicine
D050723:Fractures, Bone
D006801:Humans
D009985:Orthopedics
D017060:Patient Satisfaction
D019114:Remote Consultation
D016896:Treatment Outcome

Virtual Fracture Clinic
VFC
COVID-19
TAC
Trauma
Trauma Assessment Clinic


Ultrasonographic caval indices do not significantly contribute to predicting fluid responsiveness immediately after coronary artery bypass grafting when compared to passive leg raising.

Abstract:
BACKGROUND
Appropriate fluid management is one of the most important elements of early goal-directed therapy after cardiothoracic surgery. Reliable determination of fluid responsivenss remains the fundamental issue in volume therapy. The purpose of the study was to assess the usefulness of dynamic IVC-derived parameters (collapsibility index, distensibility index) in comparison to passive leg raising, in postoperative fluid management in mechanically ventilated patients with left ventricular ejection fraction ≥ 30 %, immediately after elective coronary artery bypass grafting.

METHODS
Prospective observational case series study including 35 patients with LVEF ≥ 30 %, undergoingelective coronary artery bypass grafting was conducted. Transthoracic echocardiography, passive leg raising and intravenous administration of saline were performed in all study subjects. Dynamic parameters derived from ultrasonographic assessment of the IVC diameter (collapsibility index-CI and distensibility index-DI), cardiac output

RESULTS
There were 24 (68.57 %) responders in the study population. There were no statistical differences between the groups in relation to: clinical parameters, pre- and postoperative LVEF, fluid balance and CVP. Change in cardiac output after passive leg raising correlated significantly with that after the volume expansion (p=0.000, r=0.822). Dynamic IVC derivatives were slightly higher in fluid responders, however this trend did not reach statistical significance. None of the caval indices correlated with fluid responsiveness.

CONCLUSION
Dynamic IVC-derived parameters do not predict fluid responsiveness in mechanically ventilated patients with preserved ejection fraction immediately after elective coronary artery bypass grafting. Passive leg raising is not inferior to volume expansion in differentiating between fluid responders and nonresponders. Immediate fluid challenge after CABG is safe and well tolerated.

Sobczyk|Dorota|D| Nycz|Krzysztof|K| Andruszkiewicz|Pawel|P| Wierzbicki|Karol|K| Stapor|Maciej|M|

Fluid responsiveness
Coronary artery bypass grafting
Passive leg raising
Fluid challenge
Caval index
Inferior vena cava
Ultrasound-guided fluid therapy