Παρασκευή 30 Νοεμβρίου 2018

Football Compared with Usual Care in Men with Prostate Cancer (FC Prostate Community Trial): A Pragmatic Multicentre Randomized Controlled Trial

Abstract

Background

Physical activity has been shown to mitigate the unwanted psychological and physiological side effects of prostate cancer treatments, but sustainable exercise possibilities are limited.

Objective

Our objective was to examine whether football in a real-world setting (i.e., local football clubs) was safe and feasible in practice and could improve quality of life, mitigate decline in muscle mass and bone density, and increase fat mass in patients with prostate cancer.

Methods

In this pragmatic, multicentre, parallel randomized controlled trial, men diagnosed with prostate cancer were recruited from five Danish urological departments. Men (N = 214) diagnosed with prostate cancer were randomly allocated, using random generated lists (block size 4–8) stratified for center and androgen-deprivation therapy status, to either 1 h of football twice weekly in a local football club or to usual care, which was a 15- to 30-min telephone session covering their options for physical activity or free-of-charge rehabilitation delivered as standard in Denmark. Allocation was concealed from the trial investigator performing the randomization, but—given the nature of the intervention—this was not possible for personnel and participants. Assessments were performed at baseline, 12 weeks, and 6 months. The primary outcome was mean change difference in prostate cancer-specific quality of life at 12 weeks. Secondary outcomes were body composition, 12-Item Short Form Health Survey (SF-12) physical and mental health, and safety—reported as fractures, falls, and serious adverse events.

Results

Attrition was 1 and 3% at 12 weeks, and 5% and 5% at 6 months for the usual care and football groups, respectively. Prostate cancer-specific quality of life was equal between groups at 12 weeks (mean difference + 1.9 points, 95% confidence interval [CI] –1.0–4.8; P = 0.20) and at 6 months (+ 0.5 points, 95% CI –2.8–3.8; P = 0.76). Fractures were equally distributed, with two fractures in the usual care group and one in the football group. Likewise, body composition outcomes were equal. Mental health improved after 6 months of football (mean difference + 2.7 points, 95% CI 0.8–4.6; P = 0.006).

Conclusions

In this trial, community-based football was a feasible exercise strategy for men with prostate cancer. Football did not improve prostate cancer-specific quality of life but did improve mental health; the clinical significance of this is unclear.

Trial registration

ClinicalTrials.gov: NCT02430792.



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Genetic Diversity Analysis of Mupirocin-Resistant Staphylococcus aureus Clinical Isolates in Tehran Hospitals, Iran

Microbial Drug Resistance, Ahead of Print.


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Efficient Homologous Recombination in Mice Using Long Single Stranded DNA and CRISPR Cas9 Nickase

The CRISPR/Cas9 nickase mutant is less prone to off-target double-strand (ds)DNA breaks than wild-type Cas9 because to produce dsDNA cleavage it requires two guide RNAs to target the nickase to nearby opposing strands. Like wild-type Cas9 lesions, these staggered lesions are repaired by either non-homologous end joining or, if a repair template is provided, by homologous recombination (HR). Here, we report very efficient (up to 100%) recovery of heterozygous insertions in Mus musculus produced by long (>300 nt), single-stranded DNA donor template-guided repair of paired-nickase lesions.



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Effects of deep brain stimulation on the primary motor cortex: Insights from transcranial magnetic stimulation studies

Movement disorders are characterized by hyperkinetic or hypokinetic movements. Abnormal neuronal activities in the cortex and other regions related to disturbances in the basal ganglia nuclei is a major cause of many movement disorders (Lang and Lozano, 1998a; Lozano and Lipsman, 2013). Modulation of disordered circuits within basal ganglia-thalamo-cortical pathways is a critical therapeutic strategy in various movement disorders. Although a pharmacological approach to correct disordered circuits is useful, potential exposure of all neurons in the brain to a drug may make the therapy less attractive in some patient populations (Lang and Lozano, 1998b).

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Development of a collaborative model of low back pain: report from the 2017 NASS consensus meeting

Low back pain (LBP) is a multifactorial problem with complex interactions among many biological, psychological and social factors. It is difficult to fully appreciate this complexity because the knowledge necessary to do so is distributed over many areas of expertise that span the biopsychosocial domains.

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PREDICTION OF MECHANICAL COMPLICATIONS IN ADULT SPINAL DEFORMITY SURGERY – THE GAP SCORE VERSUS THE SCHWAB CLASSIFICATION

– Surgery for adult spinal deformity (ASD) is a challenging and complex procedure with high reported complication (8.4-42%) and revision rates (9-17.6%). Failure to achieve or maintain adequate postoperative sagittal alignment has been reported to be the main cause of mechanical complications. In order to define appropriate surgical targets, the Scoliosis Research Society (SRS)-Schwab classification and the Global Alignment and Proportion (GAP) score were established. In the literature, no study has yet compared these classification systems with respect to the risk of developing mechanical complications.

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Editorial announcement

Publication date: December 2018

Source: Journal of Human Evolution, Volume 125

Author(s): Mike Plavcan, David M. Alba, Sarah Elton



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Scapular anatomy of Paranthropus boisei from Ileret, Kenya

Publication date: December 2018

Source: Journal of Human Evolution, Volume 125

Author(s): David J. Green, Habiba Chirchir, Emma Mbua, John W.K. Harris, David R. Braun, Nicole L. Griffin, Brian G. Richmond

Abstract

KNM-ER 47000A is a new 1.52 Ma hominin scapular fossil belonging to an associated partial skeleton from the Koobi Fora Formation, Kenya (FwJj14E, Area 1A). This fossil effectively doubles the record of Early Pleistocene scapulae from East Africa, with KNM-WT 15000 (early African Homo erectus) preserving the only other known scapula to date. KNM-ER 47000A consists of a complete glenoid cavity preserving a portion of the scapular spine and neck, the proximal half of the acromion, and a majority of the axillary border. A sufficient amount of anatomy is preserved to compare KNM-ER 47000A with scapulae of several Australopithecus species, extinct Homo, and living hominoids. The glenohumeral joint of KNM-ER 47000A is more laterally oriented than those of great apes and Australopithecus, aligning it closely with KNM-WT 15000 and modern humans. While this morphology does not imply a strong commitment to arboreality, its scapular spine is obliquely oriented—as in gorillas and some Australopithecus fossils—particularly when compared to the more horizontal orientation seen in KNM-WT 15000 and modern humans. Such a spine orientation suggests a narrow yet long infraspinous region, a feature that has been attributed to suspensory taxa. Accordingly, the morphology of KNM-ER 47000A presents conflicting behavioral implications. Nonetheless, a multivariate consideration of the available scapular traits aligns KNM-ER 47000A and Australopithecus with great apes, whereas KNM-WT 15000 resembles modern humans. The scapular morphology of KNM-ER 47000A is unique among fossil and extant hominoids and its morphological differences from KNM-WT 15000 strengthen the attribution of KNM-ER 47000 to Paranthropus boisei as opposed to early Homo. As the first evidence of scapular morphology in P. boisei, KNM-ER 47000A provides important new information on variation in hominin shoulder and upper limb anatomy from this critical period of hominin evolutionary history.



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Editorial Board

Publication date: December 2018

Source: Journal of Human Evolution, Volume 125

Author(s):



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EEG analysis in anti-NMDA receptor encephalitis: description of typical patterns

Publication date: Available online 29 November 2018

Source: Clinical Neurophysiology

Author(s): S. Jeannin-Mayer, N. André-Obadia, S. Rosenberg, C. Boutet, J. Honnorat, J.C. Antoine, L. Mazzola

Abstract
Objective

To describe different electroencephalogram (EEG) patterns and epileptic features in patients with anti- N-methyl-D-aspartate receptor encephalitis (anti-NMDARE), their timeline in the course of the disease, their correlation with clinical data and outcome.

Methods

We retrospectively analyzed EEG recordings between November 2007 and June 2016 in 24 consecutive patients.

Results

Three EEG patterns were described: Excessive Beta Activity range 14-20 Hz (EBA) in 71% of patients, Extreme Delta Brush (EDB) in 58% and Generalized Rhythmic Delta Activity (GRDA) in 50%. They followed a chronological organization in the course of the disease: EBA appeared first, followed by EDB and then GRDA, as the median time of appearance for EBA, EDB and GRDA was respectively 10, 16.5 and 21.5 days. The presence of GRDA was strongly associated with concomitant abnormal movements (p<0.001).

Conclusion

This study focuses on EEG and epileptic abnormalities in anti-NMDARE. Beyond EDB that were already reported (Schmitt et al., 2012), GRDA seems to be a very frequent pattern. Its rhythmic aspect should not be misinterpreted as seizure or status epilepticus, to avoid antiepileptic treatments intensification.

Significance

This study comforts the importance of EEG in anti-NMDARE, with a better description of EEG abnormalities for a better treatment management.



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Behavioural and electrophysiological effects of tDCS to prefrontal cortex in patients with disorders of consciousness

Publication date: Available online 29 November 2018

Source: Clinical Neurophysiology

Author(s): Marianna Cavinato, Clara Genna, Emanuela Formaggio, Caterina Gregorio, Silvia F. Storti, Paolo Manganotti, Emanuela Casanova, Roberto Piperno, Francesco Piccione

Abstract
Objectives

Left dorsolateral prefrontal cortex anodal transcranial direct current stimulation (tDCS) was applied in a group of patients with disorders of consciousness to determine the effects of modulation of spontaneous oscillatory brain activity.

Methods

12 patients in an unresponsive wakefulness syndrome (UWS) and 12 in a minimally conscious state (MCS) underwent 2-weeks active and 2-weeks sham tDCS. Neurophysiological assessment was performed with EEG power spectra and coherence analysis directly before and after each session

Results

An increase of power and coherence of the frontal and parietal alpha and beta frequency bands and significant clinical improvements were seen after the active tDCS in MCS patients. In contrast, UWS patients showed some local frontal changes in the slow frequencies. No treatment effect was observed after sham.

Conclusions

tDCS could induce changes in cortical EEG oscillations, modulating the travel of alpha and beta waves between anterior and posterior brain areas when some cognitive functions were preserved. This plays an important role in consciousness by integrating cognitive-emotional processing with the state of arousal. In unresponsive people, brain integration seems to be lost.

Significance

Our results further support the critical role of long-range fronto-parietal connections in consciousness and show the potential therapeutic utility of tDCS.



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Coregulatory long non-coding RNA and protein-coding genes in serum starved cells

Publication date: Available online 29 November 2018

Source: Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms

Author(s): Fan Wang, Rui Liang, Benjamin Soibam, Jin Yang, Yu Liu

Abstract

Serum starvation is widely used in cell biology to trigger cell cycle arrest, apoptosis, autophagy, and metabolic adaptations. Serum starvation-related molecular events have been well characterized at protein level but not at transcript level: how long non-coding RNAs contribute to the regulation of protein-coding genes is largely unknown. Here, we captured the lncRNA transcriptome in serum starved mouse embryonic fibroblasts and identified three main modes of action: cis-acting/coregulatory, trans-acting, and "miRNA-carrier". Whole-genome and individual gene level analyses support that our annotation provides an important platform for understanding lncRNA/protein-coding gene coregulatory mechanisms in serum starvation.



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Severe vitamin D deficiency is a prognostic biomarker in autoimmune hepatitis

Alimentary Pharmacology and Therapeutics

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Depression in cirrhosis – A prospective evaluation of the prevalence, predictors and development of a screening nomogram

Alimentary Pharmacology and Therapeutics

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Hepatitis B virus relapse rates in chronic hepatitis B patients who discontinue either entecavir or tenofovir

Alimentary Pharmacology and Therapeutics

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Comprehensive study on the technical aspects of sampling, transporting and measuring radon-in-water

Publication date: February 2019

Source: Journal of Environmental Radioactivity, Volume 197

Author(s): Viktor Jobbágy, Heiko Stroh, Gerd Marissens, Mikael Hult

Abstract

The European Commission's Joint Research Centre organizes proficiency tests (PT) on radon-in-water measurements. In order to optimize sampling, transport and measurement methods many tests and small scale proficiency tests have been performed. The waters from natural springs, wells were sampled on-site in glass bottles then transported cooled to the JRC and collaborating laboratories. For the material characterization standard measurement methods based on gamma-ray spectrometry, emanometry and liquid scintillation counting were used. The influence of sampling, transport and sample handling on radon-loss was tested and quantified. It was observed that parameters like container material, filling height, storage temperature and handling can lead to substantial measurement bias due to radon-loss. This high risk for radon-loss from samples can potentially be a general radioprotection problem as doses to the public may be underestimated. Regular air and road transport can be considered adequate means of transport as they have little influence on radon-loss if a suitable glass sample container with flexible cap is used and that it is completely filled. On the basis of this work, modifications to the related standard as best practices are also proposed.



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Correction to: Inequality and Innovation: Barriers and Facilitators to 17P Administration to Prevent Preterm Birth among Medicaid Participants

The original version of this article unfortunately contained a mistake in the order of authors. The co-author "Sarah Benatar" should be the second author and "Brigette Courtot" should be the third author of the article.



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Micronutrient status of populations and preventive nutrition interventions in South East Asia

Abstract

Objectives Since the 1990s, programs for the control of micronutrient deficiencies became a public health priority for many governments, including the countries partnering the project "Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia" (SMILING): Cambodia, Indonesia, Laos-PDR, Thailand and Vietnam. The aim of this study was to map which micronutrient deficiencies have been addressed and which interventions were in place in the SMILING countries. Methods The mapping covered the period up to 2012. Updated information from relevant surveys after 2012 is included in this paper after the completion of the SMILING project. The mapping of micronutrient status was limited to either national or at least large-scale surveys. Information on nutrition interventions obtained through a systematic mapping of national programs combined with a snowball collection from various sources. Results Among the five SMILING countries, Thailand differed historically by an early implementation of a nationwide community-based nutrition program, contributing to reductions in undernutrition and micronutrient deficiencies. For Cambodia, Indonesia, Laos PDR, and Vietnam, some national programs addressing micronutrients have been implemented following adjusted international recommendations. National surveys on micronutrient status were scattered and inconsistent across the countries in design and frequency. Conclusion for practice In conclusion, some micronutrient deficiencies were addressed in national interventions but the evidence of effects was generally lacking because of limited nationally representative data collected. Improvement of intervention programs to efficiently reduce or eliminate micronutrient deficiencies requires more systematic monitoring and evaluation of effects of interventions in order to identify best practices.



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The Gut Microbiome: A Difficult Target for Translational Studies of Clostridium Difficile Colonization

No abstract available

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Conceptual Model of Lean Body Mass in Pediatric Inflammatory Bowel Disease

Youth with Inflammatory Bowel Disease (IBD) demonstrate deficits in lean body mass (LM) placing them at increased risk for future health problems, including reduction of bone mass and impaired bone architecture. Research suggests that deficits in LM are multifactorial, including influences from the disease and its treatment, as well as health behaviors such as diet and physical activity. Based on a systematic literature review examining factors related to LM deficits in IBD, this paper presents a conceptual model to explain the development of LM in youth with IBD. The model considers predictors of LM across four domains: (1) demographic; (2) medical; (3) diet; and (4) physical activity. Much existing research is cross-sectional, but suggests multiple factors work together to promote or inhibit LM accrual in youth with IBD. The conceptual model, developed based on empirical findings to date, can be used to understand and further elucidate the process through which LM is developed and maintained, to inform the development of empirically-supported clinical interventions, and to guide future research objectives and priorities. Address correspondence and reprint requests to Margaux J. Barnes, Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue South, McWane Suite 5604, Birmingham, AL 35294 (e-mail: mbarnes@peds.uab.edu). Received 11 June, 2018 Accepted 14 October, 2018 This work has been supported in part by the Nutrition and Obesity Research Center Pilot and Feasibility Program as well as the Kaul Pediatric Research Institute. No competing interests, personal or financial, exist for any authors. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Abnormal Liver Enzymes in Fat or Lean Children Should Always Be a Cautionary Tale

No abstract available

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Lean NAFLD: Should it be considered in Lean Adolescents with Elevated Liver Enzymes?

No abstract available

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Colombian school children with functional GI disorders respond differently to family stress than healthy children

Our objective is to compare coping methods, stress responses, and resilience in children with and without functional gastrointestinal disorders (FGIDs) in response to common sources of stress. We performed a case-control study. Children meeting criteria for FGIDs and matched controls completed measures of response to stress (Peer Stress, Family Stress, Academic Problems, and Recurrent Abdominal Pain versions of the Response to Stress Questionnaire) and resilience (Connor-Davidson Resilience Scale 10). We included 134 children with a FGID (57 with functional constipation and 74 with an abdominal pain-predominant FGID) and 135 controls. Children with FGIDs were more likely to take action (p 

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Complementary and alternative medicine use in children with inflammatory bowel disease

Complementary and Alternative Medicine (CAM) consists of products and practices that are not considered to be a part of conventional medicine. This article reviews pediatric studies on CAM in Inflammatory Bowel Disease (IBD) along with relevant adult studies. Prevalence of CAM use ranges from 22 to 84% in children with IBD all over the world. CAM use in IBD includes diet changes, supplements, herbals, botanicals and mind-body therapies. Common reasons for using CAM include severe disease and concern for adverse effects of conventional medicines. Despite widespread use, there are limited studies on efficacy and safety of CAM in children. Small studies suggest a favorable evidence for use of probiotics, fish oil, marijuana and mind-body therapy in IBD. Adverse effects of CAM are reported but are rare. The article provides current state of knowledge on the topic and provides guidance to physicians to address CAM use in pediatric patients with IBD. Address correspondence and reprint requests to Dinesh S. Pashankar, MD, MRCP, Department of Pediatrics, Yale University, School of Medicine, 333 Cedar Street, PO Box 208064, LMP 4091A, New Haven, CT 06520 (e-mail: dinesh.pashankar@yale.edu). Received 7 August, 2018 Accepted 6 November, 2018 Financial Disclosure Statement: The authors have no financial relationship relevant to this article to disclose. Funding Source: None Conflict of interest Statement: The authors have no conflicts of interest relevant to this article to disc. Abbreviations: CAM-complementary and alternative medicine, IBD-Inflammatory bowel disease, CD – Crohn's disease, UC – Ulcerative colitis Author role: Dr Phatak conceptualized the review, drafted the initial manuscript, reviewed and revised the manuscript and approved the final manuscript as submitted. Dr Alper reviewed and revised the manuscript, and approved the final manuscript as submitted Dr Pashankar conceptualized the review, reviewed and revised the manuscript, and approved the final manuscript as submitted. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Giant Portomesenteric Venous Thrombosis Associated With Rectal Bleeding In A Child

No abstract available

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Changing Epidemiology of Liver Involvement in Children with Celiac Disease

Objectives: Available data indicate that liver involvement is present in a significant proportion of children with celiac disease (CD) at the diagnosis (elevated transaminases 15–57%, autoimmune liver disease 1–2%). We sought to evaluate prevalence, clinical course, and risk factors for liver involvement in a large cohort of children with CD. Methods: Children (age 0–18 years) diagnosed with CD from March 2010 to April 2016 were enrolled. Liver involvement was considered to be present when ALT levels were >40 U/L (hypertransaminasemia, HTS). Patients with HTS were re-evaluated after at least 12 months of a gluten-free diet (GFD). Results: CD was diagnosed in 806 patients during the study period; of these, ALT levels were available for 700 patients (86.9%), and were elevated in 27 (3.9%, HTS group); median ALT and AST levels in the HTS group were 57 U/L (IQR 49–80 U/L) and 67 U/L (IQR 53–85 U/L), respectively. Younger age, malabsorption symptoms, and low hemoglobin or ferritin were significantly more common in the HTS group at univariate analysis. At multivariate analysis, only age ≤4.27 years correlated with risk of liver involvement (OR 3.73; 95% CI: 1.61 - 8.66). When retested on a GFD, all but three patients normalized ALT levels; of these, one was diagnosed with sclerosing cholangitis. Conclusions: Liver involvement in celiac children is now less frequent than previously reported, possibly due to changing CD epidemiology. Younger age is the only risk factor. Associated autoimmune liver disease is rare. Address correspondence and reprint requests to Samuele Naviglio, MD, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy (e-mail: samuele.naviglio@gmail.com). Received 18 August, 2018 Accepted 5 November, 2018 Elisa Benelli and Samuele Naviglio contributed equally to this work. Conflicts of Interest and Source of Funding: This study was supported by the European Union - European Regional Development Fund (Interreg Central Europe "Focus in CD" project N° CE11). All Authors declare no conflict of interests. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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