Σάββατο 8 Ιουλίου 2017

Vinpocetine Inhibits NF-κB-Dependent Inflammation in Acute Ischemic Stroke Patients

Abstract

Immunity and inflammation play critical roles in the pathogenesis of acute ischemic stroke. Therefore, immune intervention, as a new therapeutic strategy, is worthy of exploration. Here, we tested the inflammation modulator, vinpocetine, for its effect on the outcomes of stroke. For this multi-center study, we recruited 60 patients with anterior cerebral circulation occlusion and onset of stroke that had exceeded 4.5 h but lasted less than 48 h. These patients, after random division into two groups, received either standard management alone (controls) or standard management plus vinpocetine (30 mg per day intravenously for 14 consecutive days, Gedeon Richter Plc., Hungary). Vinpocetine treatment did not change the lymphocyte count; however, nuclear factor kappa-light-chain-enhancer of activated B cell activation was inhibited as seen not only by the increased transcription of IκBα mRNA but also by the impeded phosphorylation and degradation of IκBα and subsequent induction of pro-inflammatory mediators. These effects led to significantly reduced secondary lesion enlargement and an attenuated inflammation reaction. Compared to controls, patients treated with vinpocetine had a better recovery of neurological function and improved clinical outcomes during the acute phase and at 3-month follow-up. These findings identify vinpocetine as an inflammation modulator that could improve clinical outcomes after acute ischemic stroke. This study also indicated the important role of immunity and inflammation in the pathogenesis of acute ischemic stroke and the significance of immunomodulatory treatment. Clinical Trial Registration Information: http://ift.tt/PmpYKN. Identifier: NCT02878772



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Now, -when the G.19 meeting in Hamburg is a done deal. ...

It`s time to plan for Worlds Overdose Day -31. August. First aid training is a given, CPR, Nalaxone etc. -Info on rehab. If you`r politicians are not all B.S. they will ofcource be there... It`s most importent to "see them" -the users. Sponsors! Ask you`r Laerdal dealer about free CPR face-shields? Free coffe, tea, hot-dogs..? Twist the arm on local bizz. Ask the mayor about using Town-hall? EMT station, Police ? What they want, and need is some respect, be treated like humans... It will make life better, and safer for all innvolved. ExEMTNor

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Now, -when the G.19 meeting in Hamburg is a done deal. ...

It`s time to plan for Worlds Overdose Day -31. August. First aid training is a given, CPR, Nalaxone etc. -Info on rehab. If you`r politicians are not all B.S. they will ofcource be there... It`s most importent to "see them" -the users. Sponsors! Ask you`r Laerdal dealer about free CPR face-shields? Free coffe, tea, hot-dogs..? Twist the arm on local bizz. Ask the mayor about using Town-hall? EMT station, Police ? What they want, and need is some respect, be treated like humans... It will make life better, and safer for all innvolved. ExEMTNor

from EMS via xlomafota13 on Inoreader http://ift.tt/2tZfxqD
via IFTTT

Now, -when the G.19 meeting in Hamburg is a done deal. ...

It`s time to plan for Worlds Overdose Day -31. August. First aid training is a given, CPR, Nalaxone etc. -Info on rehab. If you`r politicians are not all B.S. they will ofcource be there... It`s most importent to "see them" -the users. Sponsors! Ask you`r Laerdal dealer about free CPR face-shields? Free coffe, tea, hot-dogs..? Twist the arm on local bizz. Ask the mayor about using Town-hall? EMT station, Police ? What they want, and need is some respect, be treated like humans... It will make life better, and safer for all innvolved. ExEMTNor

from EMS via xlomafota13 on Inoreader http://ift.tt/2tZfxqD
via IFTTT

Now, -when the G.19 meeting in Hamburg is a done deal. ...

It`s time to plan for Worlds Overdose Day -31. August. First aid training is a given, CPR, Nalaxone etc. -Info on rehab. If you`r politicians are not all B.S. they will ofcource be there... It`s most importent to "see them" -the users. Sponsors! Ask you`r Laerdal dealer about free CPR face-shields? Free coffe, tea, hot-dogs..? Twist the arm on local bizz. Ask the mayor about using Town-hall? EMT station, Police ? What they want, and need is some respect, be treated like humans... It will make life better, and safer for all innvolved. ExEMTNor

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Preclinical and Clinical Evidence on Ipsilateral Corticospinal Projections: Implication for Motor Recovery

Abstract

Motor impairment is the most common complication after stroke, and recovery of motor function has been shown to be dependent on the extent of lesion in the ipsilesional corticospinal tract (iCST) and activity within ipsilesional primary and secondary motor cortices. However, work from neuroimaging research has suggested a role of the contralesional hemisphere in promoting recovery after stroke potentially through the ipsilateral uncrossed CST fibers descending to ipsilateral spinal segments. These ipsilateral fibers, sometimes referred to as “latent” projections, are thought to contribute to motor recovery independent of the crossed CST. The aim of this paper is to evaluate using cumulative evidence from animal models and human patients on whether an uncrossed CST component is present in mammals and conserved through primates and humans, and whether iCST fibers have a functional role in hemiparetic/hemiplegic human conditions. This review highlights that an ipsilateral uncrossed CST exists in human during development, but the evidence on a functionally relevant iCST component in adult humans is still elusive. In addition, this review argues that whereas activity within the ipsilesional cortex is essential for enhancing motor recovery after stroke, the role of iCST projections specifically is still controversial. Finally, conclusions from current literature emphasize the importance of activity in the ipsilesional cortex and the integrity of crossed CST fibers as major determinants of motor recovery after brain injury.



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Intra-Target Microdosing – A Novel Drug Development Approach: Proof of Concept, Safety, and Feasibility Study in Humans

Intra-target microdosing (ITM) is a novel drug development approach aimed at increasing the efficiency of first-in-human (FIH) testing of new molecular entities (NMEs). ITM combines intra-target drug delivery and “microdosing,” the subpharmacological systemic exposure. We hypothesized that when the target tissue is small (about 1/100th of total body mass), ITM can lead to target therapeutic-level exposure with minimal (microdose) systemic exposure. Each of five healthy male volunteers received insulin microdose into the radial artery or full therapeutic dose intravenously in separate visits. Insulin and glucose levels were similar between systemic administration and ITM administration in the ipsilateral hand, and glucose levels demonstrated a reduction in the ipsilateral hand but not in the contralateral hand. Positron emission tomography (PET) imaging of 18F-fluorodeoxyglucose (FDG) uptake demonstrated differences between the ipsilateral and contralateral arms. The procedures were safe and well-tolerated. Results are consistent with ITM proof-of-concept (POC) and demonstrate the ethical, regulatory, and logistical feasibility of the approach.



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Identification of OAT1/OAT3 as Contributors to Cisplatin Toxicity

Cisplatin is among the most widely used anticancer drugs and known to cause a dose-limiting nephrotoxicity, which is partially dependent on the renal uptake carrier OCT2. We here report a previously unrecognized, OCT2-independent pathway of cisplatin-induced renal injury that is mediated by the organic anion transporters OAT1 and OAT3. Using transporter-deficient mouse models, we found that this mechanism regulates renal uptake of a mercapturic acid metabolite of cisplatin that acts as a precursor of a potent nephrotoxin. The function of these two transport systems can be simultaneously inhibited by the tyrosine kinase inhibitor nilotinib through noncompetitive mechanisms, without compromising the anticancer properties of cisplatin. Collectively, our findings reveal a novel pathway that explains the fundamental basis of cisplatin-induced nephrotoxicity, with potential implications for its therapeutic management.



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Tensins: Bridging AMP-Activated Protein Kinase with Integrin Activation

Publication date: Available online 8 July 2017
Source:Trends in Cell Biology
Author(s): Maria Georgiadou, Johanna Ivaska
Integrin activation is essential for cell adhesion and for connecting the extracellular matrix to the actin cytoskeleton. Thus, inappropriate integrin activation has been linked to several diseases, including cancer. Recent insights demonstrate that the main fibrillar adhesion component tensin maintains β1-integrin active in these mature adhesions. Depletion or silencing of AMP-activated protein kinase (AMPK), the energy sensor involved in maintaining the energy balance of the cell, enhances integrin activity by increasing the expression of tensin and thereby promoting cell adhesion, matrix formation, and mechanotransduction. Here, we discuss the role of tensin and AMPK in the regulation of integrin activity and integrin-dependent processes and their implication in diseases such as cancer and tissue fibrosis.



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Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus

Abstract

Objective

The underlying causes of type 2 diabetes (T2DM) remain poorly understood. Adipose tissue dysfunction with high leptin, inflammation, and increased oxidative stress may play a pivotal role in T2DM development in obese patients. Little is known about the changes in the adipose tissue after Roux-Y gastric bypass (RYGB) in non-severely obese patients (BMI < 35 kg/m2) and since these patients have more T2DM-associated complications than obese patients (“obesity paradox”), we investigated changes in adipose tissue function in a cohort of BMI <35 kg/m2 with insulin-dependent T2DM after RYGB surgery which resolves T2DM.

Methods

Twenty patients with insulin-dependent T2DM and BMI <35 kg/m2 underwent RYGB. Insulin-resistance, leptin, oxidative stress, and cytokines were determined over 24 months. Expression of cytokines and NF-kappaB pathway genes were measured in leukocytes (PBMC). Adipose tissue inflammation was examined histologically preoperatively and 24 months after RGYB in subcutaneous adipose tissue.

Results

Insulin-resistance, leptin, oxidative stress as well as adipose tissue inflammation decreased significantly after RYGB. Similarly, systemic inflammation was reduced and peripheral blood mononuclear cells (PBMCs) were reprogrammed towards an M2-type inflammation. Loss of BMI correlated with leptin levels (r = 0.891, p < 0.0001), insulin resistance (r = 0.527, p = 0.003), and oxidative stress (r = 0.592, p = 0.016). Leptin correlated with improved insulin resistance (r = 0.449, p = 0.032) while reduced leptin showed a strong association with improved oxidative stress (r = 0.809, p = 0.001). Lastly, reduced oxidative stress correlated strongly with improved insulin-resistance (r = 0.776, p = 0.001).

Conclusions

RYGB improves adipose tissue function and inflammation. Leptin as marker for adipose tissue dysfunction may be the mediating factor between insulin resistance and oxidative stress and thereby likely improving T2DM.



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Cost-effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) in older Australians

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Publication date: Available online 8 July 2017
Source:Vaccine
Author(s): S. Dirmesropian, J.G. Wood, C.R. MacIntyre, P. Beutels, P. McIntyre, R. Menzies, J.F. Reyes, C. Chen, A.T. Newall
BackgroundThe 23-valent pneumococcal polysaccharide vaccine (PPV23) has been funded under the Australia National Immunisation Program (NIP) since January 2005 for those aged >65years and other risk groups. In 2016, PCV13 was accepted by the Pharmaceutical Benefits Advisory Committee (PBAC) as a replacement for a single dose of PPV23 in older Australian adults.MethodsA single-cohort deterministic multi-compartment (Markov) model was developed describing the transition of the population between different invasive and non-invasive pneumococcal disease related health states. We applied a healthcare system perspective with costs (Australian dollars, A$) and health effects (measured in quality adjusted life-years, QALYs) attached to model states and discounted at 5% annually. We explored replacement of PPV23 with PCV13 at 65years as well as other age based vaccination strategies. Parameter uncertainty was explored using deterministic and probabilistic sensitivity analysis.ResultsIn a single cohort, we estimated PCV13 vaccination at the age of 65years to cost ∼A$11,120,000 and prevent 39 hospitalisations and 6 deaths from invasive pneumococcal disease and 180 hospitalisations and 10 deaths from community acquired pneumonia. The PCV13 program had an incremental cost-effectiveness ratio of ∼A$88,100 per QALY gained when compared to a no-vaccination, whereas PPV23 was ∼A$297,200 per QALY gained. To fall under a cost-effectiveness threshold of A$60,000 per QALY, PCV13 would have to be priced below ∼A$46 per dose. The cost-effectiveness of PCV13 in comparison to PPV23 was ∼A$35,300 per QALY gained.ConclusionIn comparison to no-vaccination, we found PCV13 use in those aged 65years was unlikely to be cost-effective unless the vaccine price was below A$46 or a longer duration of protection can be established. However, we found that in comparison to the PPV23, vaccination with PCV13 was cost-effective. This partly reflects the poor value for money estimated for PPV23 use in Australia.



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Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus

Abstract

Objective

The underlying causes of type 2 diabetes (T2DM) remain poorly understood. Adipose tissue dysfunction with high leptin, inflammation, and increased oxidative stress may play a pivotal role in T2DM development in obese patients. Little is known about the changes in the adipose tissue after Roux-Y gastric bypass (RYGB) in non-severely obese patients (BMI < 35 kg/m2) and since these patients have more T2DM-associated complications than obese patients (“obesity paradox”), we investigated changes in adipose tissue function in a cohort of BMI <35 kg/m2 with insulin-dependent T2DM after RYGB surgery which resolves T2DM.

Methods

Twenty patients with insulin-dependent T2DM and BMI <35 kg/m2 underwent RYGB. Insulin-resistance, leptin, oxidative stress, and cytokines were determined over 24 months. Expression of cytokines and NF-kappaB pathway genes were measured in leukocytes (PBMC). Adipose tissue inflammation was examined histologically preoperatively and 24 months after RGYB in subcutaneous adipose tissue.

Results

Insulin-resistance, leptin, oxidative stress as well as adipose tissue inflammation decreased significantly after RYGB. Similarly, systemic inflammation was reduced and peripheral blood mononuclear cells (PBMCs) were reprogrammed towards an M2-type inflammation. Loss of BMI correlated with leptin levels (r = 0.891, p < 0.0001), insulin resistance (r = 0.527, p = 0.003), and oxidative stress (r = 0.592, p = 0.016). Leptin correlated with improved insulin resistance (r = 0.449, p = 0.032) while reduced leptin showed a strong association with improved oxidative stress (r = 0.809, p = 0.001). Lastly, reduced oxidative stress correlated strongly with improved insulin-resistance (r = 0.776, p = 0.001).

Conclusions

RYGB improves adipose tissue function and inflammation. Leptin as marker for adipose tissue dysfunction may be the mediating factor between insulin resistance and oxidative stress and thereby likely improving T2DM.



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Gut microbiome, metabolome, and allergic diseases

Publication date: Available online 8 July 2017
Source:Allergology International
Author(s): So-ichiro Hirata, Jun Kunisawa
The number of patients with allergic and inflammatory disorders has been increasing during the past several decades. Accumulating evidence has refined our understanding of the relationship between allergic diseases and the gut microbiome. In addition, the gut microbiome is now known to produce both useful and harmful metabolites from dietary materials. These metabolites and bacterial components help to regulate host immune responses and potentially affect the development of allergic diseases. Here, we describe recent findings regarding the immunologic crosstalk between commensal bacteria and dietary components in the regulation of host immunity and the influence of this relationship on the development of allergic diseases.



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Survey on the proper use of an adrenaline auto-injector in 551 Japanese outdoor workers after Hymenoptera stings

Publication date: Available online 8 July 2017
Source:Allergology International
Author(s): Hirokuni Hirata, Naruo Yoshida, Masamitsu Tatewaki, Sadaaki Shiromori, Kozo Sato, Tomoshige Wakayama, Shingo Tokita, Kumiya Sugiyama, Masafumi Arima, Kazuhiro Kurasawa, Takeshi Fukuda, Daisuke Shima, Yasutsugu Fukushima




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A Temporal and Spatial Analysis Approach to Automated Segmentation of Microbubble Signals in Contrast-Enhanced Ultrasound Images: Application to Quantification of Active Vascular Density in Human Lower Limbs

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Publication date: Available online 8 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Wing Keung Cheung, Katherine J. Williams, Kirsten Christensen-Jeffries, Brahman Dharmarajah, Robert J. Eckersley, Alun H. Davies, Meng-Xing Tang
Contrast-enhanced ultrasound (CEUS) using microbubble contrast agents has shown great promise in visualising and quantifying active vascular density. Most existing approaches for vascular density quantification using CEUS are calculated based on image intensity and are susceptible to confounding factors and imaging artefact. Poor reproducibility is a key challenge to clinical translation. In this study, a new automated temporal and spatial signal analysis approach is developed for reproducible microbubble segmentation and quantification of contrast enhancement in human lower limbs. The approach is evaluated in vitro on phantoms and in vivo in lower limbs of healthy volunteers before and after physical exercise. In this approach, vascular density is quantified based on the relative areas microbubbles occupy instead of their image intensity. Temporal features of the CEUS image sequences are used to identify pixels that contain microbubble signals. A microbubble track density (MTD) measure, the ratio of the segmented microbubble area to the whole tissue area, is calculated as a surrogate for active capillary density. In vitro results reveal a good correlation (r2 = 0.89) between the calculated MTD measure and the known bubble concentration. For in vivo results, a significant increase (129% in average) in the MTD measure is found in lower limbs of healthy volunteers after exercise, with excellent repeatability over a series of days (intra-class correlation coefficient = 0.96). This compares to the existing state-of-the-art approach of destruction and replenishment analysis on the same patients (intra-class correlation coefficient ≤0.78). The proposed new approach shows great potential as an accurate and highly reproducible clinical tool for quantification of active vascular density.



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Reproducible Computer-Assisted Quantification of Myocardial Perfusion with Contrast-Enhanced Ultrasound

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Publication date: Available online 8 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Yuanwei Li, Navtej Chahal, Roxy Senior, Meng-Xing Tang
Myocardial perfusion can be quantified by myocardial contrast echocardiography (MCE) and is used for the diagnosis of coronary artery disease (CAD). However, existing MCE quantification software is highly operator dependent and has poor reproducibility and ease of usage. The aim of this study was to develop robust and easy-to-use software that can perform MCE quantification accurately, reproducibly and rapidly. The developed software has the following features: (i) semi-automatic segmentation of the myocardium; (ii) automatic rejection of MCE data with poor image quality; (iii) automatic computation of perfusion parameters such as myocardial blood flow (MBF). MCE sequences of 18 individuals (9 normal, 9 with CAD) undergoing vasodilator stress with dipyridamole were analysed quantitatively using the software. When evaluated against coronary angiography, the software achieved a sensitivity of 71% and a specificity of 91% for hyperemic MBF. With the automatic rejection algorithm, the sensitivity and specificity further improved to 77% and 94%, respectively. For MBF reproducibility, the percentage agreement is 85% (κ = 0.65) for inter-observer variability and 88% (κ = 0.72) for intra-observer variability. The intra-class correlation coefficients are 0.94 (inter-observer) and 0.96 (intra-observer). The time taken to analyse one MCE sequence using the software is about 3 min on a PC. The software has exhibited good diagnostic performance and reproducibility for CAD detection and is rapid and user-friendly.



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Gut microbiome, metabolome, and allergic diseases

Publication date: Available online 8 July 2017
Source:Allergology International
Author(s): So-ichiro Hirata, Jun Kunisawa
The number of patients with allergic and inflammatory disorders has been increasing during the past several decades. Accumulating evidence has refined our understanding of the relationship between allergic diseases and the gut microbiome. In addition, the gut microbiome is now known to produce both useful and harmful metabolites from dietary materials. These metabolites and bacterial components help to regulate host immune responses and potentially affect the development of allergic diseases. Here, we describe recent findings regarding the immunologic crosstalk between commensal bacteria and dietary components in the regulation of host immunity and the influence of this relationship on the development of allergic diseases.



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Survey on the proper use of an adrenaline auto-injector in 551 Japanese outdoor workers after Hymenoptera stings

Publication date: Available online 8 July 2017
Source:Allergology International
Author(s): Hirokuni Hirata, Naruo Yoshida, Masamitsu Tatewaki, Sadaaki Shiromori, Kozo Sato, Tomoshige Wakayama, Shingo Tokita, Kumiya Sugiyama, Masafumi Arima, Kazuhiro Kurasawa, Takeshi Fukuda, Daisuke Shima, Yasutsugu Fukushima




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Sialoendoscopy combined with an internal stent and postoperative massage as a comprehensive treatment of delayed I131-induced parotitis

Publication date: Available online 8 July 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Q. Meng, W. Fang, X. Long, M. Deng, J. Li, J. Ke
A common complication of radioiodine (I131) treatment of thyroid cancer is parotitis. Here we describe our clinical experience in treating delayed I131-induced parotitis using sialoendoscopy together with an internal stent and postoperative massage. In this retrospective cohort study we reviewed 32 patients who were treated in that way under general anaesthesia between July 2010 and March 2015. Their age, sex, and the time to development of the parotitis were collected from the hospital’s database. All patients were evaluated using a visual analogue scale (VAS), sialography, and computed tomography preoperatively. The analyses of VAS scores were made during postoperative follow-up visits. We used the paired Student’s t test and one-way ANOVA to assess the significance of differences, and probabilities of < 0.05 were accepted as significant. The mean (SD) age of the 32 patients was 50 (11) years, and they developed symptoms of delayed parotitis after a mean (SD) of 12 (11) months. The mean time between treatment with I131 and sialoendoscopy was 26 (10) months. Ductal stenosis was the most common sialoendoscopic feature, together with mucous plugs and fibrosis. Fifty of the 56 ducts were successfully dilated by sialoendoscopy, and VAS scores significantly decreased from a preoperative 7.3 (1.1) to a postoperative 3.3 (2.1) (p=0.000) during follow-up of 3 - 41 months. Sialoendoscopic interventions combined with an internal stent and postoperative massage may be optimal comprehensive treatment for delayed I131-induced parotitis.



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Audio-visual synchronization in reading while listening to texts: Effects on visual behavior and verbal learning.

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Publication date: Available online 8 July 2017
Source:Computer Speech & Language
Author(s): Gerbier Emilie, Bailly Gérard, Bosse Marie Line
Reading while listening to texts (RWL) is a promising way to improve the learning benefits provided by a reading experience. In an exploratory study, we investigated the effect of synchronizing the highlighting of words (visual) with their auditory (speech) counterpart during a RWL task. Forty French children from 3rd to 5th grade read short stories in their native language while hearing the story spoken by a narrator. In the non-synchronized (S-) condition the text was written in black on a white background, whereas in the synchronized (S+) RWL, the text was written in grey and the words were dynamically written in black when they were aurally displayed, in a karaoke-like fashion. The children were then unexpectedly tested on their memory for the orthographic form and semantic category of pseudowords that were included in the stories. The effect of synchronizing was null in the orthographic task and negative in the semantic task. Children's preference was mainly for the S- condition, except for the poorest readers who tended to prefer the S+ condition. In addition, the children's eye movements were recorded during reading. Gaze was affected by synchronization, with fewer but longer fixations on words, and fewer regressive saccades in the S+ condition compared to the S- condition. Thus, the S+ condition presumably captured the children's attention toward the currently heard word, which forced the children to be strictly aligned with the oral modality.



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In Reply

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Publication date: Available online 8 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Douglas J. Courtemanche




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Desai et al on Multiple Calcifying Hyperplastic Dental Follicles: A Critique

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Publication date: Available online 8 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Fumio Ide, Naoyuki Matsumoto, Kentaro Kikuchi, Kaoru Kusama




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Now, -when the G.19 meeting in Hamburg is a done deal. ...

It`s time to plan what, -and how you and you`r EMS service will deal with World overdoseday! 31. august. Ofcource you will interact with the "customers", first aid training is a given, CPR, Nalaxone, etc. -Info on rehab too. And, if you`r politicians are not all B.S. they would offcource be there to! Sponsors? ( Ask you`r local Laerdal dealer for face-shields -CPR ?) Free coffe, tea, hot-dogs..? Twist the arm on you`r lokal dealers. Ask you`r mayor to use the town-hall? EMT station, Police..? Make it clear that you see "them" ( Users ). It will make life better, -and safer for all off you ! Kim Larsen-This is My Life Lyrics.flvExEMTNor

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Sialoendoscopy combined with an internal stent and postoperative massage as a comprehensive treatment of delayed I131-induced parotitis

Publication date: Available online 8 July 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Q. Meng, W. Fang, X. Long, M. Deng, J. Li, J. Ke
A common complication of radioiodine (I131) treatment of thyroid cancer is parotitis. Here we describe our clinical experience in treating delayed I131-induced parotitis using sialoendoscopy together with an internal stent and postoperative massage. In this retrospective cohort study we reviewed 32 patients who were treated in that way under general anaesthesia between July 2010 and March 2015. Their age, sex, and the time to development of the parotitis were collected from the hospital’s database. All patients were evaluated using a visual analogue scale (VAS), sialography, and computed tomography preoperatively. The analyses of VAS scores were made during postoperative follow-up visits. We used the paired Student’s t test and one-way ANOVA to assess the significance of differences, and probabilities of < 0.05 were accepted as significant. The mean (SD) age of the 32 patients was 50 (11) years, and they developed symptoms of delayed parotitis after a mean (SD) of 12 (11) months. The mean time between treatment with I131 and sialoendoscopy was 26 (10) months. Ductal stenosis was the most common sialoendoscopic feature, together with mucous plugs and fibrosis. Fifty of the 56 ducts were successfully dilated by sialoendoscopy, and VAS scores significantly decreased from a preoperative 7.3 (1.1) to a postoperative 3.3 (2.1) (p=0.000) during follow-up of 3 - 41 months. Sialoendoscopic interventions combined with an internal stent and postoperative massage may be optimal comprehensive treatment for delayed I131-induced parotitis.



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Audio-visual synchronization in reading while listening to texts: Effects on visual behavior and verbal learning.

1-s2.0-S0885230816300596-fx1.jpg

Publication date: Available online 8 July 2017
Source:Computer Speech & Language
Author(s): Gerbier Emilie, Bailly Gérard, Bosse Marie Line
Reading while listening to texts (RWL) is a promising way to improve the learning benefits provided by a reading experience. In an exploratory study, we investigated the effect of synchronizing the highlighting of words (visual) with their auditory (speech) counterpart during a RWL task. Forty French children from 3rd to 5th grade read short stories in their native language while hearing the story spoken by a narrator. In the non-synchronized (S-) condition the text was written in black on a white background, whereas in the synchronized (S+) RWL, the text was written in grey and the words were dynamically written in black when they were aurally displayed, in a karaoke-like fashion. The children were then unexpectedly tested on their memory for the orthographic form and semantic category of pseudowords that were included in the stories. The effect of synchronizing was null in the orthographic task and negative in the semantic task. Children's preference was mainly for the S- condition, except for the poorest readers who tended to prefer the S+ condition. In addition, the children's eye movements were recorded during reading. Gaze was affected by synchronization, with fewer but longer fixations on words, and fewer regressive saccades in the S+ condition compared to the S- condition. Thus, the S+ condition presumably captured the children's attention toward the currently heard word, which forced the children to be strictly aligned with the oral modality.



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The tumor suppressor CYLD controls epithelial morphogenesis and homeostasis by regulating mitotic spindle behavior and adherens junction assembly

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Publication date: Available online 8 July 2017
Source:Journal of Genetics and Genomics
Author(s): Wei Xie, Yunfan Yang, Siqi Gao, Ting Song, Yuhan Wu, Dengwen Li, Min Liu, Jun Zhou
Epithelial morphogenesis and homeostasis are essential for animal development and tissue regeneration, and epithelial disorganization is associated with developmental disorders and tumorigenesis. However, the molecular mechanisms that contribute to the morphogenesis and homeostasis of the epithelium remain elusive. Herein, we report a novel role for the cylindromatosis (CYLD) tumor suppressor in these events. Our results show that CYLD depletion disrupts epithelial organization in both Drosophila egg chambers and mouse skin and intestinal epithelia. Microscopic analysis of proliferating cells in mouse epithelial tissues and cultured organoids reveals that loss of CYLD synergizes with tumor-promoting agents to cause the misorientation of the mitotic spindle. Mechanistic studies show that CYLD accumulates at the cell cortex in epithelial tissues and cultured cells, where it promotes the formation of epithelial adherens junctions through the modulation of microtubule dynamics. These data suggest that CYLD controls epithelial morphogenesis and homeostasis by modulating the assembly of adherens junctions and ensuring proper orientation of the mitotic spindle. Our findings thus provide novel insight into the role of CYLD in development, tissue homeostasis, and tumorigenesis.



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In Reply

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Publication date: Available online 8 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Douglas J. Courtemanche




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In Response to “Routine Postoperative Imaging Is Not Indicated in the Management of Mandibular Fractures”

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Publication date: Available online 8 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): David B. Powers




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Desai et al on Multiple Calcifying Hyperplastic Dental Follicles: A Critique

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Publication date: Available online 8 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Fumio Ide, Naoyuki Matsumoto, Kentaro Kikuchi, Kaoru Kusama




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In Response to “Routine Postoperative Imaging Is Not Indicated in the Management of Mandibular Fractures”

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Publication date: Available online 8 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): David B. Powers




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Identification of a prototypical single-stranded uracil DNA glycosylase from Listeria innocua

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Publication date: Available online 8 July 2017
Source:DNA Repair
Author(s): Jing Li, Ye Yang, Jose Guevara, Liangjiang Wang, Weiguo Cao
A recent phylogenetic study on UDG superfamily estimated a new clade of family 3 enzymes (SMUG1-like), which shares a lower homology with canonic SMUG1 enzymes. The enzymatic properties of the newly found putative DNA glycosylase are unknown. To test the potential UDG activity and evaluate phylogenetic classification, we isolated one SMUG1-like glycosylase representative from Listeria innocua (Lin). A biochemical screening of DNA glycosylase activity in vitro indicates that Lin SMUG1-like glycosylase is a single-strand selective uracil DNA glycosylase. The UDG activity on DNA bubble structures provides clue to its physiological significance in vivo. Mutagenesis and molecular modeling analyses reveal that Lin SMUG1-like glycosylase has similar functional motifs with SMUG1 enzymes; however, it contains a distinct catalytic doublet S67-S68 in motif 1 that is not found in any families in the UDG superfamily. Experimental investigation shows that the S67M-S68N double mutant is catalytically more active than either S67M or S68N single mutant. Coupled with mutual information analysis, the results indicate a high degree of correlation in the evolution of SMUG1-like enzymes. This study underscores the functional and catalytic diversity in the evolution of enzymes in UDG superfamily.



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Profunda artery perforator flap : quelle place dans la reconstruction mammaire par lambeau autologue ?

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Publication date: Available online 8 July 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): P. Fosseprez, A. Gerdom, M. Servaes, C. Deconinck, G. Pirson, A. Berners
ContexteAu cours des dernières années, le DIEP flap est devenu le premier choix pour les reconstructions mammaires autologues. Cependant, lorsque le site donneur abdominal n’est pas disponible, les options secondaires sont diverses. Notre second choix s’est porté sur le PAP flap. Ce rapport documente notre expérience de l’utilisation du PAP flap dans la reconstruction mammaire.MéthodeÉtude rétrospective des patientes ayant bénéficié d’une reconstruction mammaire par PAP flap dans notre institution depuis 2014.RésultatsDix-sept reconstructions ont été réalisées auprès de 15 patientes. L’indication de PAP était l’absence de laxité abdominale chez 8 patientes, un antécédent d’abdominoplastie chez 6 patientes et un angioscanner défavorable en vue de la réalisation d’un DIEP flap. Nous déplorons deux cas de nécrose complète de lambeau. Les autres complications observées furent des déhiscences mineures du site donneur dans six cas (35,3 %), une déhiscence du lambeau dans un cas (5,8 %) et un hématome du site receveur (5,8 %).DiscussionLes auteurs analysent leur série quant au taux important de complications et des résultats obtenus.ConclusionL’auteur est d’avis que le PAP-Flap est une option fiable en tant que second choix pour les reconstructions mammaires chez des patientes ne pouvant bénéficier d’un DIEP en raison de la constance de son pédicule vasculaire et de sa fiabilité. Les complications décrites portent essentiellement sur le site donneur et bien qu’étant fréquentes, elles sont de gestion aisée et aux conséquences minimes. Le volume du PAP étant limité, une autre alternative devra être envisagée pour reconstruire un volume mammaire important.BackgroundIn recent years, the DIEP-flap has become the standard for autologous breast reconstruction. However, when abdominal donor site is unavailable, secondary options are numerous. This report documents our experience with PAP-flap breast reconstruction.MethodWe carried out a retrospective study of patients who underwent reconstructive breast surgery by PAP-flaps in our institution since 2014.ResultsSeventeen PAP-flaps were carried out in 15 patients, two of which received consecutive reconstruction of each breast at distinct intervals. Indication was lack of abdominal excess in 8 patients and history of abdominoplasty in 6 patients. These six patients and one more had bad or absence of perforator for DIEP flap. There were 2 flap losses (11.8%). Other complications included minor dehiscences from seroma at donor site in 6 cases (35.3%), flap dehiscence in one case (5.8%), and receiver site hematoma in 1 patient (5.8%).DiscussionThe authors analyze their series when the high rate of complications and the results obtained compared to the second alternative choices of other teams.ConclusionThe author is of the opinion that the PAP-Flap is a reliable option as a second choice for breast reconstruction in patients whose DIEP can not be retained. It is limited in terms of volume and a third choice should be considered when the indication is to reconstruct a breast of large volume.



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Jean-Pierre Lalardrie (1931–2016)

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Publication date: Available online 8 July 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): M. Prevot




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Influence of (p)ppGpp on biofilm regulation in Pseudomonas putida KT2440

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Publication date: Available online 8 July 2017
Source:Microbiological Research
Author(s): Huizhong Liu, Yujie Xiao, Hailing Nie, Qiaoyun Huang, Wenli Chen
The global regulatory molecule (p)ppGpp is synthesized under limited nutrition conditions and involves in many cellular processes in bacteria. (p)ppGpp has been reported to affect biofilm formation in several bacterial species. Here, we found that deletion of (p)ppGpp synthase genes of Pseudomonas putida KT2440 led to enhanced biofilm formation in polystyrene microtitre plates. Besides, the pellicle of this mutant formed at the air-liquid interface lost the robust structure and became frail. The biofilm formation and its structure are mainly determined by exopolysaccharides (EPSs) and adhesins. Transcriptional analysis of four EPS operons designated as pea, peb, alg and bcs and two adhesin genes nominated as lapA and lapF showed that the deletion of (p)ppGpp synthase genes increased the expression of peb, bcs and lapA but repressed the expression of pea and lapF. Furthermore, expression of the regulation factor FleQ was significantly augmented in (p)ppGpp-synthase mutants while the expression of sigma factor RpoS was reduced. Since FleQ and RpoS play important roles in regulating expression of EPS and adhesin genes, (p)ppGpp may mediate the synthesis of biofilm matrix via influencing these regulators to control the biofilm formation and pellicle structure.



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Profunda artery perforator flap : quelle place dans la reconstruction mammaire par lambeau autologue ?

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Publication date: Available online 8 July 2017
Source:Annales de Chirurgie Plastique Esthétique
Author(s): P. Fosseprez, A. Gerdom, M. Servaes, C. Deconinck, G. Pirson, A. Berners
ContexteAu cours des dernières années, le DIEP flap est devenu le premier choix pour les reconstructions mammaires autologues. Cependant, lorsque le site donneur abdominal n’est pas disponible, les options secondaires sont diverses. Notre second choix s’est porté sur le PAP flap. Ce rapport documente notre expérience de l’utilisation du PAP flap dans la reconstruction mammaire.MéthodeÉtude rétrospective des patientes ayant bénéficié d’une reconstruction mammaire par PAP flap dans notre institution depuis 2014.RésultatsDix-sept reconstructions ont été réalisées auprès de 15 patientes. L’indication de PAP était l’absence de laxité abdominale chez 8 patientes, un antécédent d’abdominoplastie chez 6 patientes et un angioscanner défavorable en vue de la réalisation d’un DIEP flap. Nous déplorons deux cas de nécrose complète de lambeau. Les autres complications observées furent des déhiscences mineures du site donneur dans six cas (35,3 %), une déhiscence du lambeau dans un cas (5,8 %) et un hématome du site receveur (5,8 %).DiscussionLes auteurs analysent leur série quant au taux important de complications et des résultats obtenus.ConclusionL’auteur est d’avis que le PAP-Flap est une option fiable en tant que second choix pour les reconstructions mammaires chez des patientes ne pouvant bénéficier d’un DIEP en raison de la constance de son pédicule vasculaire et de sa fiabilité. Les complications décrites portent essentiellement sur le site donneur et bien qu’étant fréquentes, elles sont de gestion aisée et aux conséquences minimes. Le volume du PAP étant limité, une autre alternative devra être envisagée pour reconstruire un volume mammaire important.BackgroundIn recent years, the DIEP-flap has become the standard for autologous breast reconstruction. However, when abdominal donor site is unavailable, secondary options are numerous. This report documents our experience with PAP-flap breast reconstruction.MethodWe carried out a retrospective study of patients who underwent reconstructive breast surgery by PAP-flaps in our institution since 2014.ResultsSeventeen PAP-flaps were carried out in 15 patients, two of which received consecutive reconstruction of each breast at distinct intervals. Indication was lack of abdominal excess in 8 patients and history of abdominoplasty in 6 patients. These six patients and one more had bad or absence of perforator for DIEP flap. There were 2 flap losses (11.8%). Other complications included minor dehiscences from seroma at donor site in 6 cases (35.3%), flap dehiscence in one case (5.8%), and receiver site hematoma in 1 patient (5.8%).DiscussionThe authors analyze their series when the high rate of complications and the results obtained compared to the second alternative choices of other teams.ConclusionThe author is of the opinion that the PAP-Flap is a reliable option as a second choice for breast reconstruction in patients whose DIEP can not be retained. It is limited in terms of volume and a third choice should be considered when the indication is to reconstruct a breast of large volume.



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Inhibition of ataxia telangiectasia related-3 (ATR) improves therapeutic index in preclinical models of non-small cell lung cancer (NSCLC) radiotherapy

To evaluate the impact of ATR inhibition using AZD6738 in combination with radiotherapy on the response of non-small cell lung cancer (NSCLC) tumour models and a murine model of radiation induced fibrosis.

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A prospective study of proton reirradiation for recurrent and secondary soft tissue sarcoma

Proton reirradiation for sarcoma has not been previously described. We hypothesized that this strategy would provide favorable toxicity and survival outcomes.

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Loop-mediated isothermal amplification as a reliable assay for Toxocara canis infection in pet dogs

Abstract

Keeping of infected dogs as pet results in the potential transmission risk factors for shedding helminthic infections such as toxocariasis. Lack of accurate identification of Toxocara canis eggs in non-dewormed infected pet dogs remains a diagnostic concern among researchers. In this study, dog owners were asked to fill up a questionnaire regarding their pets and their attitude towards the deworming regimen. One hundred faecal samples were collected from pet dogs (Northwest Iran) and were subsequently identified by the ZnSo4 flotation technique, PCR and loop-mediated isothermal amplification (LAMP) assays. The DNA of the recovered T. canis eggs was then extracted and amplified by LAMP and PCR. Furthermore, ITS2 amplicons were sequenced for appraisal of the phylogenetic analysis. Nine, 5 and 11% of T. canis infections were identified by microscopy, PCR and LAMP, respectively. It was detected that LAMP was 10 times (10−10to 10−13 g/μl) more sensitive than PCR (10−10to 10−12 g/μl). The kappa value between LAMP and PCR indicated a faint concurrence (0.463). The kappa coefficient between LAMP and flotation technique indicated a strong agreement (0.667). The highest infection rate (n = 11) was detected in non-dewormed pet dogs, particularly those less than 3 months old (P < 0.05). None of the infected dogs had a history of walking and kennelled behaviours in public places. The LAMP assay can address as a simple, rapid and highly sensitive technique for detecting low burden of T. canis eggs in infected pet dogs. It was proposed that the dog holder’s awareness is insufficient to implement regular deworming schedules. Additionally, regional policymakers should broadly revise anthelmintic treatment guidelines.



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Total lower lip and chin reconstruction with radial forearm free flap: A novel approach

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Publication date: Available online 8 July 2017
Source:American Journal of Otolaryngology
Author(s): Eliza H. Dewey, Ansley M. Roche, Cathy L. Lazarus, Mark L. Urken
BackgroundThe management of large chin and lower lip defects is challenging due to this facial subunit's tremendous functional and aesthetic importance. Specific methods for total lower lip and mentum reconstruction are not well chronicled. Aesthetic and functional goals of this reconstruction include restoration of oral competence by maintaining lower lip height, vermilion reestablishment, color-matched skin introduction to the chin, sensation restoration, and ideally restoration of dynamic activity to the lower lip.MethodsLiterature review performed.ResultsPresentation of novel, two-stage technique for lower lip and chin reconstruction with a submental flap and a radial forearm free flap, suspension of the lower lip and chin with a tensor fascia lata graft, and vermilion reconstruction with a buccal mucosal flap.ConclusionsThis procedure meets all goals of total lower lip reconstruction with the exception of the introduction of dynamic tissue and represents a novel solution to a challenging reconstructive problem.



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Curcumin Induces p53-Null Hepatoma Cell Line Hep3B Apoptosis through the AKT-PTEN-FOXO4 Pathway

Objective. Curcumin (diferuloylmethane) is a yellow-colored polyphenol with antiproliferative and proapoptotic activities to various types of cancer cells. This study explored the mechanism by which curcumin induces p53-null hepatoma cell apoptosis. Results. AKT, FOXO1, and FOXO3 proteins were downregulated after curcumin treatment. Conversely, PTEN was upregulated. Subcellular fractionations revealed that the FOXO4 protein translocated from cytosol into the nucleus after curcumin treatment. Overexpression of FOXO4 increases the sensitivity of Hep3B cells to curcumin. Knockdown of the FOXO4 gene by siRNA inhibits the proapoptotic effects of curcumin on Hep3B cell. Conclusions. This study revealed the AKT/PTEN/FOXO4 pathway as a potential candidate of target for treatment of p53-null liver cancers.

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Current Challenges in the Management of Breast Cancer Brain Metastases

Publication date: Available online 8 July 2017
Source:Seminars in Oncology
Author(s): Ciara C. O’Sullivan, Nicole N. Davarpanah, Jame Abraham, Susan E. Bates
Approximately 50% of patients with advanced human epidermal growth factor 2 (HER2)-positive breast cancer and triple negative breast cancer (TNBC) ultimately develop breast cancer brain metastases (BCBM), which are associated with significant morbidity and mortality. The advent of HER2-directed therapy resulted in greatly improved survival outcomes, but unfortunately at the price of an increased cumulative incidence of BCBM. We review challenges in the management of BCBM, and potential treatment strategies, including novel agents such as poly-ADP ribose polymerase (PARP) inhibitors (olaparib, veliparib), cyclin dependent kinase 4/6 (CDK4/6) inhibitors (palbociclib, abemaciclib) and taxane derivatives (e.g. ANG1005 and TPI-287). The utility of human epidermal growth factor 2 (HER2)-directed therapies − lapatinib, ado-trastuzumab emtansine (T-DM1), neratinib and tucatinib − is also being studied in this setting. We address the need for improved imaging techniques and innovation in clinical trial design. For example, the current practice is to initially administer whole brain radiotherapy (WBRT) as treatment for patients with multiple BCBM. However, in selected circumstances, first line systemic treatment may be more appropriate in order to avoid neurocognitive toxicities and potential options should be evaluated in window of opportunity trials. Other strategies that may aid development of more effective clinical trials and expedite the development of promising agents include the use of different clinical endpoints and different imaging tools.



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Sialoendoscopy combined with an internal stent and postoperative massage as a comprehensive treatment of delayed I131-induced parotitis

A common complication of radioiodine (I131) treatment of thyroid cancer is parotitis. Here we describe our clinical experience in treating delayed I131-induced parotitis using sialoendoscopy together with an internal stent and postoperative massage. In this retrospective cohort study we reviewed 32 patients who were treated in that way under general anaesthesia between July 2010 and March 2015. Their age, sex, and the time to development of the parotitis were collected from the hospital’s database.

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Nanoparticle doubles-up tumor targeting

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Publication date: Available online 8 July 2017
Source:Nano Today





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Nanocomposite makes printing glass a synch

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Publication date: Available online 8 July 2017
Source:Nano Today





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Correlation between air pollution and weather data in urban areas: Assessment of the city of Rome (Italy) as spatially and temporally independent regarding pollutants

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Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Gabriele Battista, Roberto de Lieto Vollaro
Air pollution represents the biggest environmental risk for health. It is so widespread and it represents one of the main problems of the worldwide, especially because it is emitted by so many different types of sources. The pollutants can originate directly by exhausted or they can be formed because of the reaction with the atmosphere. The first one includes particulate matter and gaseous pollutants such as sulfur oxides, nitrogen oxides, and carbon oxides. The second one includes the ozone formed from nitrogen oxides and hydrocarbons, and particulate sulfate and nitrate aerosols created in the atmosphere from sulfur and nitrogen oxide gases. During the entire life course, people are exposed to the pollutants and suffer from different consequences depending on the age. The first nine month of life are generally recognized as more critical than latter time periods. The mortality associated to air pollutant exposure is main related to the concentrations of NOx, ozone, carbon monoxide, sulfur dioxides and particular matter. More than 92% of the world's population lives in places where air quality levels exceed the standards. In 2012, one out of every nine deaths was the result of air pollution-related conditions. In 2016 about 3 million deaths a year were linked to exposure to outdoor air pollution. In the last few years many epidemiological studies have shown associations between air pollutant concentrations and human health. Apart from people, even monuments and artworks can be damaged by pollution, especially in city centres. Furthermore, urbanization modified microclimate conditions of the cities, and, together with traffic and domestic heating, led to a discomfort of living conditions. For these reasons, there is the necessity to improve the research on the impact of pollutant and microclimate conditions inside urban areas. In this work different kinds of pollutants in Rome from 2006 to 2015 were analysed, and different techniques of post elaboration were used. In particular, the attention was focused on statistic and cross statistic techniques in time and space. The results led to describe Rome as spatially and temporally independence regarding pollutant. Even weather changes were studied in relation with pollution. In particular, cross-correlation analysis were done with air temperature, solar radiation, wind direction and velocity, highlighting a strong coupling for the most of cases except for particular matter.



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Short-term aerosol radiative effects and their regional difference during heavy haze episodes in January 2013 in China

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Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Xinghong Cheng, Zhian Sun, Deping Li, Xiangde Xu, Mengwei Jia, Siyang Cheng
Short-term direct effects of aerosols on surface shortwave radiation and its regional difference during heavy haze episodes in January 2013 in China are investigated using the offline Weather Research and Forecasting (WRF) - the Community Multiscale Air Quality (CMAQ)- second Sun-Edward-Slingo radiative transfer (SES2) model system. The aerosol concentrations are first generated using the WRF-CMAQ model simulations and then corrected based on the observed concentrations of PM10 and PM2.5. The atmospheric profile data produced by the WRF model and the corrected aerosol concentrations are used as inputs to the SES2 model to calculate the global horizontal irradiance (GHI) and direct solar irradiance (DIR) at the surface for a period of heavy haze episodes in January 2013 in China. The effects of aerosol on the GHI and DIR at the surface are then analyzed. The modeled radiation is evaluated against the observations first and the results show some improvement due to the correction for the aerosol concentrations. The aerosol shortwave radiative effects are determined by the difference between the model calculations with and without the inclusion of aerosols. It is found that the short-term aerosol radiative impacts during heavy haze days are very large, range between 100 and 500 W m-2. The aerosol concentrations have a large spatial variation with the highest concentration occurring in the areas of Beijing-Tianjin-Hebei, which causes a large difference in the radiative effect nation wide. In addition to the total concentration, the aerosol vertical distributions s also vary from the north to south in China and this leads to a significant difference in radiative effect even when the PM10 concentration is similar at three regions.



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How private vehicle use increases ambient air pollution concentrations at schools during the morning drop-off of children

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Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Matthew D. Adams, Weeberb J. Requia
A child's exposure to environmental pollutants can have life-long health effects. Thus it is critical to understand the potential exposure pathways. In this paper, we examine the increase in ambient PM2.5 concentrations at schools from private vehicle use for dropping children off at school. In North America, students are commonly driven to school in a private vehicle. Additionally, students walk or cycle, or take a school bus. Our vehicle surveys recorded between 23 and 116 personal vehicles at 25 schools, where enrolment ranged from 160 to 765 students. We fit a linear regression model to predict the number of vehicles at schools we did not observe within our study area, which explained 57% of the variation in our surveys. A microsimulation traffic model was created for each of the 86 schools we studied. Outputs from the traffic model were used to determine the emissions generated at each school. PM2.5 emissions varied from 0.14 to 6.38 g. Lastly, we dispersed the emissions produced by private vehicles dropping off students, which are emissions generated by unnecessary trips because students further than walking distance are provided transportation by the school board. At the drop-off location in front of the school, we found ambient concentration increases of at least 5 μg/m3, 10 μg/m3, 25 μg/m3 and 50 μg/m3 during 16.8%, 7.6%, 2.0% and 0.5% of the mornings, respectively. This research was conducted in a medium-sized North American city and should allow transferability to similar cities. We conclude that the use of private vehicles can significantly increase local concentrations, regardless of background conditions.



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Temporal characteristics of columnar aerosol optical properties and radiative forcing (2011–2015) measured at AERONET’s Pretoria_CSIR_DPSS site in South Africa

Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): K. Raghavendra Kumar, Na Kang, V. Sivakumar, Derek Griffith
Ground-based observations of the spectral aerosol optical depths (AODs) revealed that the northwest of South Africa (SA) possessed large aerosol loading and still remained unexplored as none of the authors have been extensively studied. The characteristics of aerosol optical, physical, and radiative properties, as well as their relationships presented in this paper, were derived from the direct sun and sky radiances measured at Pretoria during August 2011–December 2015 using the AERONET's (CE-318) automatic sun/sky radiometer. The annual mean AOD440, AE440-870, and SSA-T440 estimated at Pretoria during the study period were 0.23 ± 0.13, 1.50 ± 0.26, and 0.91 ± 0.04, respectively. The mean AOD440 (AE440-870) for the study period appeared higher during the spring and summer seasons (summer), suggest dominance of fine mode particles attributed to biomass burning activities and seasonal influence of meteorology. Analysis of frequency occurrences of AOD and AE also indicate that this region is richly populated with fine mode particles. Further, the AOD-AE relationship was studied at Pretoria and the result concluded that the mixed type aerosols contributed more among the others followed by the urban/industrial-biomass burning and clean continental (background) aerosols. The high summertime SSA-T440 and fine mode radius of AVSD could be associated with the hygroscopic growth of water-soluble aerosols under high water vapor (absorbing aerosols). The positive (negative) values of aerosol radiative forcing (ARF) were observed in all the months, an indication of significant heating (cooling) within the atmosphere (top of the atmosphere (TOA) and bottom of the atmosphere (BOA)) were due to strong absorption (scattering) of radiation. Further, the efficiency derived between ARF and AOD440 indicated that ARF is a strong function of AOD at the BOA noted with a high degree of correlation coefficient (r = 0.93).

Graphical abstract

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Mycoplasma pneumoniae as a cause of vulvar ulcers in a non-sexually active girl: a case report

Non-sexually active young females very rarely develop genital ulcers. Such ulcers pose a diagnostic challenge as well as physical and emotional distress for patients and family; therefore, the search for their...

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Techniques d’irradiation mammaire complexe : radiothérapie conformationelle tridimensionnelle mono-isocentrique et nomothérapie hélicoïdale

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Publication date: Available online 8 July 2017
Source:Cancer/Radiothérapie
Author(s): B. Vandendorpe, P. Guilbert, C. Champagne, T. Antoni, T.D. Nguyen, N. Gaillot-Petit, S. Servagi Vernat
Objectif de l’étudeÉvaluer l’apport dosimétrique de la tomothérapie hélicoïdale pour les cancers du sein par rapport à une radiothérapie conformationelle en technique mono-isocentrique.Patientes et méthodePour 23 patientes, les résultats dosimétriques obtenus avec la radiothérapie conformationelle en technique mono-isocentrique ne permettaient pas de satisfaire les contraintes soit des volumes prévisionnels soit des organes à risque. Une comparaison dosimétrique prospective entre radiothérapie conformationelle en technique mono-isocentrique et tomothérapie hélicoïdale a donc été réalisée.RésultatsL’utilisation de la tomothérapie hélicoïdale a montré chez ces 23 patientes, un intérêt avec une amélioration soit de l’indice de conformité, soit de celui d’homogénéité, avec cependant une augmentation des doses faibles. Sur les 23 patientes, deux avaient un pectus excavatum, cinq un antécédent d’irradiation et deux nécessitaient une irradiation bilatérale. Pour les 14 autres patientes, il s’agissait d’une association de la morphologie et/ou de l’indication d’irradiation ganglionnaire. La tomothérapie hélicoïdale a donc été préférée pour ces patientes par rapport à la radiothérapie conformationelle en technique mono-isocentrique.ConclusionLa tomothérapie semble apporter une meilleure homogénéité et couverture tumorale. Cette technique d’irradiation peut se justifier en cas de situation morphologique comme le pectus excavatum ou de situation clinique complexe. Dans les autres cas, la radiothérapie conformationelle en technique mono-isocentrique reste à privilégier.PurposeTo evaluate the dosimetric contribution of helical tomotherapy for breast cancers compared with conformal radiotherapy in mono-isocentric technique.Patients and methodFor 23 patients, the dosimetric results in mono-isocentric 3D conformational radiotherapy did not satisfy the constraints either of target volumes nor organs at risk. A prospective dosimetric comparison between mono-isocentric 3D conformational radiotherapy and helical tomotherapy was therefore carried out.ResultsThe use of helical tomotherapy showed a benefit in these 23 patients, with either an improvement in the conformity index or homogeneity, but with an increase in low doses. Of the 23 patients, two had pectus excavatum, five had past thoracic irradiation and two required bilateral irradiation. The other 14 patients had a combination of morphology and/or indication of lymph node irradiation. For these patients, helical tomotherapy was therefore preferred to mono-isocentric 3D conformational radiotherapy.ConclusionsTomotherapy appears to provide better homogeneity and tumour coverage. This technique of irradiation may be justified in the case of morphological situations such as pectus exavatum and in complex clinical situations. In other cases, conformal radiotherapy in mono-isocentric technique remains to be favoured.



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Vermi-modification of ruminant excreta using Eisenia fetida

Abstract

Present investigation aims on the vermicomposting of the excreta of different ruminants to convert it into manure employing earthworm species, Eisenia fetida. A total of 11 feedstocks (FS1–FS11) with different ratios were prepared from the excreta of different ruminants, viz., sheep, cow, buffalo, and goat. Semi-composted feedstocks were fed to E. fetida for 90 days under laboratory conditions. Vermicomposting enhanced the nutrient contents of ruminant excreta and converted it into odor-free and homogenous vermicompost. The growth of E. fetida was significant in all the feedstocks, but largest biomass gain was achieved in buffalo excreta followed by [sheep + buffalo] > [goat + buffalo] and [cow + buffalo] feedstocks. Highest fecundity (782 ± 23.3) was also recorded in buffalo excreta followed by [goat + buffalo] excreta feedstock (484.6 ± 15.7). In vermicomposted feedstocks, total organic carbon and organic matter was lesser, while NPK and heavy metals were higher as compared to raw feedstocks. C/N ratios of vermicomposts ranged from 15.37 to 38.56, which indicate a good level of maturity and stabilization of feedstocks.



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Optimal scale of China’s cities under the maximization of economic benefits and environmental benefits

Abstract

The cities are the consumption concentration of energy, resources, and the concentration of CO2 emissions. The cities’ area only accounted for 2% in the world’s surface; however, their population accounted for about 50% of the total population, and CO2 emissions accounted for about 80% of the total emissions. The cities lie in a key position in solving the global climate change. China’s urbanization level was just exceeding by 50%, which was in the intermediate stage of urbanization. The rapid development of the urbanization process and the expansion of city scale have brought economic growth and all kinds of environmental issues. Therefore, is there an optimal city scale which can make cities maintain economic growth and can also reduce or even avoid the environmental problems in the meantime? The question deserves deep research. Based on the background, the data from 1998 to 2014, and the goals of the cities’ economic and environmental benefits, this paper builds the optimal scale model for the cities, and obtain two conclusions: (1) in a certain period and range, the cities have the optimal scale; (2) for the cities in China, the optimal scale is about 1.78 million people.



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Temporal characteristics of columnar aerosol optical properties and radiative forcing (2011–2015) measured at AERONET’s Pretoria_CSIR_DPSS site in South Africa

Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): K. Raghavendra Kumar, Na Kang, V. Sivakumar, Derek Griffith
Ground-based observations of the spectral aerosol optical depths (AODs) revealed that the northwest of South Africa (SA) possessed large aerosol loading and still remained unexplored as none of the authors have been extensively studied. The characteristics of aerosol optical, physical, and radiative properties, as well as their relationships presented in this paper, were derived from the direct sun and sky radiances measured at Pretoria during August 2011–December 2015 using the AERONET's (CE-318) automatic sun/sky radiometer. The annual mean AOD440, AE440-870, and SSA-T440 estimated at Pretoria during the study period were 0.23 ± 0.13, 1.50 ± 0.26, and 0.91 ± 0.04, respectively. The mean AOD440 (AE440-870) for the study period appeared higher during the spring and summer seasons (summer), suggest dominance of fine mode particles attributed to biomass burning activities and seasonal influence of meteorology. Analysis of frequency occurrences of AOD and AE also indicate that this region is richly populated with fine mode particles. Further, the AOD-AE relationship was studied at Pretoria and the result concluded that the mixed type aerosols contributed more among the others followed by the urban/industrial-biomass burning and clean continental (background) aerosols. The high summertime SSA-T440 and fine mode radius of AVSD could be associated with the hygroscopic growth of water-soluble aerosols under high water vapor (absorbing aerosols). The positive (negative) values of aerosol radiative forcing (ARF) were observed in all the months, an indication of significant heating (cooling) within the atmosphere (top of the atmosphere (TOA) and bottom of the atmosphere (BOA)) were due to strong absorption (scattering) of radiation. Further, the efficiency derived between ARF and AOD440 indicated that ARF is a strong function of AOD at the BOA noted with a high degree of correlation coefficient (r = 0.93).

Graphical abstract

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Ricinus communis L . (castor bean) as a potential candidate for revegetating industrial waste contaminated sites in peri-urban Greater Hyderabad: remarks on seed oil

Abstract

Ricinus communis L. (castor bean or castor oil plant) was found growing on metal-contaminated sites (4) of peri-urban Greater Hyderabad comprises of erstwhile industrial areas viz Bollaram, Patancheru, Bharatnagar, and Kattedan industrial areas. During 2013–2017, about 60 research papers have appeared focusing the role of castor bean in phytoremediation of co-contaminated soils, co-generation of biomaterials, and environmental cleanup, as bioenergy crop and sustainable development. The present study is focused on its use as a multipurpose phytoremediation crop for phytostabilization and revegetation of waste disposed peri-urban contaminated soils. To determine the plant tolerance level, metal accumulation, chlorophyll, protein, proline, lipid peroxidation, oil content, and soil properties were characterized. It was noticed that the castor plant and soils have high concentration of metals such as cadmium (Cd), lead (Pb), iron (Fe), manganese (Mn), and zinc (Zn). The soils have high phosphorous (P), adequate nitrogen (N), and low concentration of potassium (K). Iron (Fe) concentrations ranged from1672±50.91 to 2166±155.78 mg kg−1 in the soil. The trend of metal accumulation Fe>Zn>Mn>Pb>Cd was found in different plant parts at polluted sites. The translocation of Cd and Pb showed values more than one in industrial areas viz Bollaram, Kattedan, and Bharatnagar indicating the plants resistance to metal toxicity. Chlorophyll and protein content reduced while proline and malondialdehyde increased due to its tolerance level under metal exposure. The content of ricinoleic acid was higher, and the fatty acids composition of polluted areas was almost similar to that of the control area. Thus, R. communis L. can be employed for reclamation of heavy metal contaminated soils.



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TiO 2 -SnS 2 nanocomposites: solar-active photocatalytic materials for water treatment

Abstract

The study is aimed at evaluating TiO2-SnS2 composites as effective solar-active photocatalysts for water treatment. Two strategies for the preparation of TiO2-SnS2 composites were examined: (i) in-situ chemical synthesis followed by immobilization on glass plates and (ii) binding of two components (TiO2 and SnS2) within the immobilization step. The as-prepared TiO2-SnS2 composites and their sole components (TiO2 or SnS2) were inspected for composition, crystallinity, and morphology using Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), X-ray diffraction (XRD), and scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDX) analyses. Diffuse reflectance spectroscopy (DRS) was used to determine band gaps of immobilized TiO2-SnS2 and to establish the changes in comparison to respective sole components. The activity of immobilized TiO2-SnS2 composites was tested for the removal of diclofenac (DCF) in aqueous solution under simulated solar irradiation and compared with that of single component photocatalysts. In situ chemical synthesis yielded materials of high crystallinity, while their morphology and composition strongly depended on synthesis conditions applied. TiO2-SnS2 composites exhibited higher activity toward DCF removal and conversion in comparison to their sole components at acidic pH, while only in situ synthesized TiO2-SnS2 composites showed higher activity at neutral pH.



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Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016

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Publication date: Available online 8 July 2017
Source:Brain Stimulation
Author(s): Mariane M. Godinho, Daniela R. Junqueira, Mariana L. Castro, Yoon Loke, Su Golder, Hugo P. Neto




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Dynamic expression of nectins in enamel organs of mouse incisors

Publication date: Available online 8 July 2017
Source:Journal of Oral Biosciences
Author(s): Tsubasa Kawashima, Jiro Takito, Yukie Shimada, Masashi Sato, Mitsuko Inoue, Takashi Miyazaki, Muneaki Miyata, Yoshiyuki Rikitake, Yoshimi Takai, Masanori Nakamura
ObjectivesNectins are immunoglobulin-like cell–cell adhesion molecules and are of four types, namely, nectin-1, nectin-2, nectin-3, and nectin-4. Cleft lip/palate-ectodermal dysplasia is caused by a mutation in the nectin-1 gene locus. However, nectin-1-deficient (KO) mice only show mild tooth defects. This study determined the intracellular localization of nectins in mouse mandibular incisors to identify their heterophilic interactions during amelogenesis.MethodsNectin localization was determined by performing immunohistochemical analysis with confocal microscopy. Nectin gene expression was determined by performing quantitative reverse transcription-PCR. Phenotypes of nectin-2-KO mice were examined by performing micro-computed tomography, histological analysis, and organ culture.ResultsWe found that mRNA levels of nectin-1 and nectin-3 genes were higher than those of nectin-2 and nectin-4 genes in mouse enamel organs. Nectin-2 and nectin-4 were strongly expressed at the apical adherens junctions of secretory-stage ameloblasts, whereas nectin-1 and nectin-3 were distributed between the basal adherens junction of maturation-stage ameloblasts and the stratum intermedium and papillary layers. Nectin-2-KO mice showed normal mandibular tooth shape, incisor surface pigmentation, and histology. Moreover, organ cultures of the tooth organs of nectin-2-KO mice proceeded normally.ConclusionThese results indicate that nectins show graded and overlapping distribution in mouse incisors.



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Structural characterization of endogenous peroxidase activity in human, rat, hamster, and Suncus murinus salivary glands

Publication date: Available online 8 July 2017
Source:Journal of Oral Biosciences
Author(s): Keiichi Moriguchi, Michiya Utsumi, Takamichi Jogahara, Senichi Oda, Masaki Honda
Background3,3’-diaminobenzidine tetrazolium (DAB)-based methods have been developed to detect the localization of peroxidase (PO) activity. Histochemically, endogenous PO activity has been localized to acini of human and rodent salivary glands. This suggests that the enzyme may be used as a convenient marker of differentiated acinar cells to study factors that influence the development of the rat submandibular gland. We also investigated endogenous PO localization differences between rodent and insectivora (Suncus murinus) major salivary glands by light and electron microscopy. Moreover, ectopic sublingual gland-like tissue was found in the resin-embedded semi-thin sections of DAB-reacted hamster submandibular gland by confocal laser scanning microscopy.HighlightReflectance-mode confocal laser scanning microscopy was employed to visualize sites of PO activity in ectopic sublingual gland-like tissue of the hamster submandibular gland.ConclusionThe technique proposed here may result in novel applications for DAB-based histochemistry.



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Multi-frequency interpolation in spiral magnetic resonance fingerprinting for correction of off-resonance blurring

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Publication date: Available online 8 July 2017
Source:Magnetic Resonance Imaging
Author(s): Jason Ostenson, Ryan K. Robison, Nicholas R. Zwart, E. Brian Welch
Magnetic resonance fingerprinting (MRF) pulse sequences often employ spiral trajectories for data readout. Spiral k-space acquisitions are vulnerable to blurring in the spatial domain in the presence of static field off-resonance. This work describes a blurring correction algorithm for use in spiral MRF and demonstrates its effectiveness in phantom and in vivo experiments. Results show that image quality of T1 and T2 parametric maps is improved by application of this correction. This MRF correction has negligible effect on the concordance correlation coefficient and improves coefficient of variation in regions of off-resonance relative to uncorrected measurements.



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The effect of radiotherapy on fat content and fatty acids in myxoid liposarcomas quantified by MRI

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Publication date: Available online 8 July 2017
Source:Magnetic Resonance Imaging
Author(s): Skorpil Mikael, Rydén Henric, Wejde Johan, Lidbrink Elisabet, Brosjö Otte, Berglund Johan
BackgroundMyxoid liposarcomas are highly radiosensitive. Consequently radiotherapy is often used pre-operatively to reduce tumor volume and lessen the post-operative deficit. In soft-tissue sarcomas therapy response is mainly evaluated using magnetic resonance imaging (MRI) and the fundamental criterion for a positive response is decreased tumor size. In myxoid liposarcomas an increased fat content is also known to occur as a response to radiotherapy.ObjectiveTo highlight the difficulties of MRI for therapy response evaluation in irradiated myxoid liposarcomas, by using MRI Dixon techniques enabling objective quantification of proton density fat fraction (%) and the number of double bonds (ndb; unsaturation degree) of fatty acids. Secondly, to compare quantitative fat fraction measurements versus visual grading of fat content on T1-weighted images.Case descriptionsPrior to surgery, two patients with myxoid liposarcoma were treated with 50Gy. Following radiotherapy, both tumors on MRI showed reduced size, elevated fat fraction and transformed fat fraction histograms with diverse changes of ndb, while histopathological specimens showed discordant treatment effects; one case having good response and the other having poor response.ConclusionsA decrease in tumor size and increase in fat content on MRI cannot be interpreted as positive therapy response in radiotherapy of myxoid liposarcomas. Our data also give further supporting evidence that differentiation and maturation of tumor cells is the cause for the lipoma-like areas seen after radiotherapy. Finally, quantitative MRI Dixon techniques are preferable to visual grading for estimating the fat content in lipomatous tumors.



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Pediatric Skeletal Scintigraphy: What a General Radiologist Needs to Know

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Publication date: Available online 8 July 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Fathima Fijula Palot Manzil, John Baldwin, Asim Kumar Bag




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Techniques d’irradiation mammaire complexe : radiothérapie conformationelle tridimensionnelle mono-isocentrique et nomothérapie hélicoïdale

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Publication date: Available online 8 July 2017
Source:Cancer/Radiothérapie
Author(s): B. Vandendorpe, P. Guilbert, C. Champagne, T. Antoni, T.D. Nguyen, N. Gaillot-Petit, S. Servagi Vernat
Objectif de l’étudeÉvaluer l’apport dosimétrique de la tomothérapie hélicoïdale pour les cancers du sein par rapport à une radiothérapie conformationelle en technique mono-isocentrique.Patientes et méthodePour 23 patientes, les résultats dosimétriques obtenus avec la radiothérapie conformationelle en technique mono-isocentrique ne permettaient pas de satisfaire les contraintes soit des volumes prévisionnels soit des organes à risque. Une comparaison dosimétrique prospective entre radiothérapie conformationelle en technique mono-isocentrique et tomothérapie hélicoïdale a donc été réalisée.RésultatsL’utilisation de la tomothérapie hélicoïdale a montré chez ces 23 patientes, un intérêt avec une amélioration soit de l’indice de conformité, soit de celui d’homogénéité, avec cependant une augmentation des doses faibles. Sur les 23 patientes, deux avaient un pectus excavatum, cinq un antécédent d’irradiation et deux nécessitaient une irradiation bilatérale. Pour les 14 autres patientes, il s’agissait d’une association de la morphologie et/ou de l’indication d’irradiation ganglionnaire. La tomothérapie hélicoïdale a donc été préférée pour ces patientes par rapport à la radiothérapie conformationelle en technique mono-isocentrique.ConclusionLa tomothérapie semble apporter une meilleure homogénéité et couverture tumorale. Cette technique d’irradiation peut se justifier en cas de situation morphologique comme le pectus excavatum ou de situation clinique complexe. Dans les autres cas, la radiothérapie conformationelle en technique mono-isocentrique reste à privilégier.PurposeTo evaluate the dosimetric contribution of helical tomotherapy for breast cancers compared with conformal radiotherapy in mono-isocentric technique.Patients and methodFor 23 patients, the dosimetric results in mono-isocentric 3D conformational radiotherapy did not satisfy the constraints either of target volumes nor organs at risk. A prospective dosimetric comparison between mono-isocentric 3D conformational radiotherapy and helical tomotherapy was therefore carried out.ResultsThe use of helical tomotherapy showed a benefit in these 23 patients, with either an improvement in the conformity index or homogeneity, but with an increase in low doses. Of the 23 patients, two had pectus excavatum, five had past thoracic irradiation and two required bilateral irradiation. The other 14 patients had a combination of morphology and/or indication of lymph node irradiation. For these patients, helical tomotherapy was therefore preferred to mono-isocentric 3D conformational radiotherapy.ConclusionsTomotherapy appears to provide better homogeneity and tumour coverage. This technique of irradiation may be justified in the case of morphological situations such as pectus exavatum and in complex clinical situations. In other cases, conformal radiotherapy in mono-isocentric technique remains to be favoured.



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Radiology Trainee Versus Faculty Radiologist Fluoroscopy Time for Imaging-Guided Procedures: A Retrospective Study of 17,966 Reports Over a 5.5-Year Period

Publication date: Available online 8 July 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Ariadne K. DeSimone, Andrew Post, Richard Duszak, Phuong-Anh T. Duong
Rationale and ObjectivesTo evaluate differences in fluoroscopy time (FT) for common vascular access and gastrointestinal procedures performed by radiology trainees versus faculty radiologists.Materials and MethodsReport information was extracted for all 17,966 index fluoroscopy services performed by trainees and/or faculty from two university hospitals over 66 months. Various vascular access procedures (e.g., peripherally-inserted central catheters [PICCs] and ports) and gastrointestinal fluoroscopy procedures (e.g., upper gastrointestinal and contrast enema studies) were specifically targeted. Statistical analysis was performed.ResultsFT was recorded in 17,549/17,966 reports (98%) The 1393 procedures performed by non-physician providers or transitional year interns were excluded. Residents, fellows, and faculty were primary operators in 5,066, 6,489, and 4,601 procedures, respectively. Average FT (in seconds) for resident and fellow services, respectively, was less than that of faculty only for PICCs (75 and 101 vs. 148, p < 0.01). For all other procedures, average FT of trainee services was greater than that for faculty. This was statistically significant (P < 0.05) for fellows vs. faculty port placement (121 vs. 87), resident vs. faculty small bowel series (130 vs. 96), and both resident and fellow vs. faculty esophagram procedures (143 and 183 vs. 126 ). FT for residents was significantly less than that for fellows only for PICCs (75 vs. 101, p < 0.01).ConclusionFor most, but not all, fluoroscopy procedures commonly performed by radiology trainees, FT is greater than that for procedures performed by faculty radiologists. Better awareness and understanding of such differences may aid training programs in developing benchmarks, protocols, and focused teaching in the safe use of fluoroscopy for patients and operators.



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Current Techniques and Clinical Applications of CT Urography

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Publication date: Available online 8 July 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Vijay Krishnan, Ashish Chawla, Kedar G. Sharbidre, Wilfred Peh
From conventional radiograph to MR urography, imaging of urinary system has evolved with variety of investigations over the past several decades with each of them having advantages and limitations of their own. In the current era, Computed tomography (CT) has emerged as a preferred investigations for evaluation of the urinary tract. There are various techniques involved in performing CT urography (CTU) with triple bolus technique (TB-CTU) currently drawing a special attention because of its low radiation exposure. This article aims to discuss the current techniques, indications and clinical applications of CTU with illustrations.



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Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016

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Publication date: Available online 8 July 2017
Source:Brain Stimulation
Author(s): Mariane M. Godinho, Daniela R. Junqueira, Mariana L. Castro, Yoon Loke, Su Golder, Hugo P. Neto




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Linear stapled gastrojejunostomy results in fewer strictures compared to circular stapled gastrojejunostomy in laparoscopic gastric bypass surgery

Abstract

Purpose

Currently, there are two laparoscopic stapling techniques to perform the gastrojejunostomy in gastric bypass surgery: the linear stapling and circular stapling techniques. The aim of the study was to compare the two techniques regarding postoperative morbidity and weight loss at an accredited bariatric reference center in Switzerland.

Methods

We compared two consecutive cohorts at a single institution between November 2012 and June 2014 undergoing laparoscopic gastric bypass surgery. The frequency of complications and weight loss at 1 year was assessed in 109 patients with the 21-mm circular stapling technique (CSA) and 134 patients with the linear stapling technique (LSA).

Results

Postoperative complications were more frequent in the CSA group with 23.9 versus 4.5% in the LSA group (p = <0.0001). The main difference was the frequency of strictures, which occurred in 15.6% in the CSA group versus 0% in the LSA group. As a result, endoscopic dilation was required at least once in 15 patients. There was no statistically significant difference in percentage of excessive weight loss (EWL) in both groups; EWL was 74% in the CSA group and 73% in the LSA group (p = 0.68).

Conclusion

Linear stapled laparoscopic gastric bypass had fewer stenotic strictures with similar weight loss at 1 year compared to circular stapling technique.



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PD-L1 and immune escape - insights from melanoma and other lineage-unrelated malignancies

Publication date: Available online 8 July 2017
Source:Human Pathology
Author(s): Noah Frydenlund, Meera Mahalingam
One of the major breakthroughs in oncology in the past decade has been the research and development of immune checkpoint inhibitors. Since the discovery of the PD-1/PD-L1 axis as a key mediator in peripheral self-tolerance and the subsequent discovery of its role promoting immune escape in cancers, the PD-1/PD-L1 pathway has produced considerable excitement from both a scientific and therapeutic stand point. The past decade has seen an explosion in the number of clinical trials utilizing antI-PD-1/PD-L1 therapy. Notably, pathologists have played a critical role in the development of these trials, and in guiding the use of anti-PD-1/PD-L1 therapies in FDA approved clinical settings. Analysis of tissue biopsies has been increasingly used to predict patients with which cancers are most likely to benefit from these new therapies. However, many open questions remain in a rapidly changing therapeutic and scientific landscape.In this review, we describe the basic functioning of the PD-1/PD-L1 axis in normal biology, how it is coopted by cancers to promote immune escape, and then review the literature regarding the prognostic value of tumoral PD-L1 expression on its own before discussing recent therapeutic advances, and the emerging role for pathologists in predicting response to anti-PD-1/PD-L1 therapies. Special attention is given to melanoma and non-small cell lung cancer, malignancies which have the seen the broadest applications of anti-PD-L1/PD-1 therapies.



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Assessing and Promoting the Wellness of United States Ophthalmology Residents: A Survey of Program Directors

Publication date: Available online 8 July 2017
Source:Journal of Surgical Education
Author(s): Elaine M. Tran, Ingrid U. Scott, Melissa A. Clark, Paul B. Greenberg
ObjectiveTo report on the status of residency-based wellness initiatives in ophthalmic graduate medical education and identify strategies for promoting ophthalmology resident wellness by surveying US ophthalmology program directors (PDs).DesignThe PDs were each sent an e-mail containing a link to an anonymous online 15-question survey. The PDs also received a letter with the survey link and a $1 incentive. After 2 weeks, nonresponders received 2 weekly reminder e-mails and phone calls. Descriptive statistics were used to analyze the multiple choice responses and categorize the free response answers.SettingNational survey.ParticipantsAll 111 US ophthalmology PDs were invited to participate.ResultsOf 111 PDs, 56 (50%) responded; 14 (26%) of 53 respondents reported that their programs faced an issue involving resident depression, burnout, or suicide within the last year; 25 (45%) of 56 reported that their department had a resident wellness program. Respondents without wellness programs reported a shortage of time (19/30; 63%) and lack of training and resources (19/30; 63%) as barriers to instituting these programs. Respondents reported that the Accreditation Council for Graduate Medical Education could better promote resident wellness by providing training resources for burnout and depression screening (35/53; 66%), resilience skills building (38/53; 72%), and wellness program development (36/53; 68%).ConclusionsThis survey suggests that there is a substantial burden of burnout and depression among residents in ophthalmic graduate medical education and that this burden can be addressed by promoting the training of educators to recognize the signs of burnout and depression, and providing resources to develop and expand formal wellness programs.



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Parenting children with down syndrome: An analysis of parenting styles, parenting dimensions, and parental stress

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Publication date: September 2017
Source:Research in Developmental Disabilities, Volume 68
Author(s): B. Allyson Phillips, Frances Conners, Mary Elizabeth Curtner-Smith
BackgroundEffective parenting is vital for a child’s development. Although much work has been conducted on parenting typically developing children, little work has examined parenting children with Down syndrome.AimsThe purpose of the current study was to compare the parenting styles and dimensions in mothers of children with DS and mothers of TD children.Methods and proceduresThirty-five mothers of children with DS and 47 mothers of TD children completed questionnaires about parenting, parental stress, child behavior problems, and child executive function.Outcomes and resultsWe found that mothers of children with DS use an authoritative parenting style less and a permissive parenting style more than mothers of TD children. Additionally, we found that mothers of children with DS use reasoning/induction and verbal hostility less and ignoring misbehavior more than mothers of TD children. All of these differences, except for those of reasoning/induction, were at least partially accounted for by the higher levels of parental stress in the DS group.Conclusions and implicationsParenting interventions should be focused on reducing parental stress and training mothers to parent under stress in an effort to improve parenting techniques, which would, in theory, improve long-term child outcomes for children with DS.



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How services for children with disabilities in Serbia affect the quality of life of their families

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Publication date: September 2017
Source:Research in Developmental Disabilities, Volume 68
Author(s): Tamara Dzamonja Ignjatovic, Marko Milanovic, Nevenka Zegarac
BackgroundFamilies that have children with disabilities face numerous difficulties related to the lack of services support, social isolation and poverty in Serbia. Mostly due to the prolonged effect of social and economic crisis, there are insufficient adequate and diverse community-based services for those families.AimsThe aim of the study was to examine the effect of newly introduced services on the quality of families’ life.MethodsA pretest/posttest study was conducted at the beginning of service and one year later to evaluate the effect of services measured by Family Quality of Life Scale (Hoffman et al., 2006). The sample consists of 153 families of children with disabilities from 35 different places in Serbia.ResultsThe results show that the services generally improved the families' quality of life, particularly in the aspects targeted by services, but also had significant positive effect on family interaction and parenting. The services had the highest impact on the families that perceived the lowest life quality before using them. The life quality was improved, regardless of the type of services, but the effectiveness is affected by the severity of child disability.ImplicationsThe results might be useful for further steps in developing and evaluating individually and flexible tailored service that support families’ needs and suits them the best.



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