Δευτέρα, 11 Δεκεμβρίου 2017

Simple classifiers for molecular subtypes of colorectal cancer

Publication date: Available online 11 December 2017
Source:Arab Journal of Gastroenterology
Author(s): Woo Gyeong Kim, Joo Yeon Kim, Do Youn Park
Background and study aimColorectal cancer (CRC) is a heterogeneous disease entity with a diverse biological pathogenesis. This study aims to validate the two studies published in 2013 which established a separate CRC molecular subtype classification by utilizing a rapidly accessible miniclassifier, and verify a simplified version thereof.Patients and methodsParticipants diagnosed with CRC (n = 568) were subtyped in three classifications for characteristic, and prognostic purposes. Colorectal cancer subtypes (CCS) were classified as: i) CCS1 (CDX2+, microsatellite stable (MSS)/microsatellite instability (MSI)-low), ii) CCS2 (MSI-high), and iii) CCS3 (FRMD6/ZEB1/HTR2B +, CDX2-, MSS/MSI-low]. Simplified CCS (SiCCS) subtypes were grouped as: i) CDX2 (CDX2+, MSS/MSI-low, ZEB1 ≤ 2), ii) MSI-H (MSI-high, CDX2/FRMD6/ZEB1/HTR2B +/-), and iii) ZEB1 (ZEB1 ≥ 2, CDX2-, MSS/MSI-low). New molecular classification (NMC) subtypes were defined as: i) enterocyte (E-C) (MUC2 +), ii) goblet-like (G-L) (MUC2 + and TFF3 +), iii) transit-amplifying (T-A) (CFTR +), and iv) stem-like (S-L) (ZEB1 +).ResultsIn total, 53.5% (n = 304) CCS, 58.3% (n = 331) SiCCS, and 37.7% (n = 214) NMC tumours could be evaluated. CCS2 and MSI-H CRCs had the most favourable survival outcome, whereas the CCS3, ZEB1 and S-L subtypes showed the poorest prognosis. A significant overlap between CCS3, ZEB1, and S-L tumours was demonstrated.ConclusionThere is still a need for a consensus gene expression-based subtyping classification system for CRCs, thereby allowing the categorization of most CRC tumours. This study reveals that a simple and rapidly accessible process could replace the complicated, costly and mostly inapproachable methods clinical practices that have been introduced in the majority of previous studies.



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Prevalence and risk factors of hepatitis D virus infection in patients with chronic hepatitis B infection attending the three main tertiary hospitals in Libya

Publication date: Available online 11 December 2017
Source:Arab Journal of Gastroenterology
Author(s): Abdel-Naser Elzouki, Saleh M. Bashir, Omar Elahmer, Islam Elzouki, Fathi Alkhattali
Background and study aimsGlobally, More than 350 million individuals are chronically infected with hepatitis B virus (HBV), and >20 million of them are co-infected with hepatitis D virus (HDV). The aim of this study was to determine the pattern of HDV infection in patients with chronic hepatitis B in three main tertiary hospitals in Tripoli and Benghazi, Libya.Patients and methodsThis cross sectional and descriptive study was conducted on 162 patients with chronic hepatitis B positive for more than six months) who were followed up at hepatitis clinics of the three main tertiary hospitals in Tripoli city (88 patients from Tripoli Medical Centre and Tripoli Central Hospital) and Benghazi city (74 patients from Aljomhoria Hospital) during the period from January 2010 to June 2012. HBV and HDV markers were detected by enzyme linked fluorescent assay (ELFA) or enzyme-linked immunosorbent assay and HBV-DNA was quantified by real-time PCR techniques.ResultsThe mean age of patients was 36,92 ± 15,35. One hundred and three (63.6%) of them were males and 59 (36,4%) were females. Four patients (2,5%) were tested positive for anti-HD antibodies, all of them have had clinical and/or histological diagnosis of cirrhosis. In multivariable regression analysis, age (p = .04), elevation of serum ALT (p = .03), elevation of serum AST (p = .04), and presence of cirrhosis (p = .003) were significantly related to HDV seropositivity.ConclusionAlthough the study demonstrated that Libya has low to moderate prevalence of HDV (2,5%), it is important for policy makers and health care providers to continue the preventive measures for HDV spread, and HBV prevention program including utilization of HBV vaccine. Furthermore, it is imperative to screen chronic HBV patients for HDV for close observation for early diagnosis of subsequent development of liver cirrhosis. Moreover, further epidemiologic and genetic studies are needed to explore the trend for HDV infection in Libya.



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Value of water enema computed tomography in elderly symptomatic patients

Publication date: Available online 11 December 2017
Source:Arab Journal of Gastroenterology
Author(s): Heyfa Romdhane, Imen Marzouk, Zeineb Mzoughi, Meriem Cheikh, Meriem Dridi, Houcem Fadhl, Rym Ennaifer, Najet Belhadj
Background and study aimsColonoscopy remains the gold standard for the examination of the colon. However, its use in the elderly is not well tolerated, and there is often a need for general anaesthesia, thus increasing the risk, especially if there are co-morbidities. Water enema computed tomography has been suggested to be a satisfactory alternative as a non-invasive, fast and effective means for the diagnosis of colorectal supra-centimetric lesions.The aim of our study was to assess the performance of water enema computed tomography as first-line examination by calculating its negative predictive value (NPV) for the diagnosis of supra-centimetric lesions in symptomatic elderly referred to colonoscopy.Patients and methodsThis was a prospective study including 57 symptomatic patients older than 65 years. All patients were explored by water enema computed tomography at first, followed by colonoscopy, and responded to a questionnaire on the tolerance to the preparation and both procedures.ResultsThe mean age of patients was 73 years. The M:F sex ratio was 1.59. The most frequent indication for colonoscopy was bowel disorders associated with abdominal pain (30%). Water enema computed tomography allowed the diagnosis of tumours (n = 2), polyps (n = 6), diverticulosis (n = 7), inflammatory wall thickening (n = 1) and extra-colic lesions (n = 28). NPV of water enema computed tomography for supra-centimetric lesions was 96.5%. Sensitivity and specificity were 87.3% and 98%, respectively. However, for sub-centimetric lesions, water enema computed tomography had a low sensitivity estimated at 6%, specificity at 89.9%, positive predictive value at 91.9% and NPV at 27.7%.ConclusionWater enema computed tomography has proven to be a valuable and non-invasive method indicated as a first-line examination in case of colonic symptoms in the elderly to diagnose supra-centimetric lesions.



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Beneficial Effects of Exercise Pretreatment in a Sporadic Alzheimer's Rat Model

PURPOSE This study aimed to examine the effects of swimming exercise pretreatment on a streptozotocin (STZ)-induced sporadic Alzheimer's disease rat model and provide an initial understanding of related molecular mechanisms. METHODS Male 2.5-month-old Sprague-Dawley rats were divided into the following 4 groups: a) control, b) swim + vehicle, c) STZ without swim, and d) swim + STZ. The Barnes Maze task and Novel Object Recognition test were used to measure hippocampus-dependent spatial learning and working memory, respectively. Immunofluorescence staining, Western blot analysis, ELISA analysis and related assay kits were used to assess synaptic proteins, inflammatory cytokines, total antioxidant capacity, antioxidant enzymes, amyloid-beta (Aβ) production and tau hyperphosphorylation. RESULTS Behavioral tests revealed that exercise pretreatment could significantly inhibit STZ-induced cognitive dysfunction (p

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PRIME: A Novel Low-Mass, High-Repetition Approach to Improve Function in Older Adults

ABSTRACT Introduction The ability to maintain functional independence in a rapidly aging population results in an increased life expectancy without corresponding increases in health care costs. The accelerated decline in VO2peak after the age of 65 is primarily due to peripheral tissue changes rather than centrally mediated factors. The purpose of this study was to determine if the PRIME (Peripheral Remodeling through Intermittent Muscular Exercise) approach, consisting of a low mass, high repetition/duration skeletal muscle focused training regimen would provide superior functional benefits in participants above 70 years old and at risk for losing functional independence. Methods In this clinical trial, 107 participants were randomized to four weeks of either standard aerobic exercise training (AT) or PRIME [Phase 1]. This was followed by eight weeks of a progressive whole-body aerobic and resistance training (AT+RT) for all participants [Phase 2]. The major outcome measures were cardiorespiratory fitness (peak oxygen consumption-VO2peak), muscular fitness (1 repetition maximal strength -1RM) and physical function (Senior Fitness Test scores-SFT). Results were analyzed under a pro-protocol criterion. Results Thirty-eight PRIME and 38 AT participants completed the 3-month protocols. VO2peak, 1RM, and SFT scores all increased significantly after 12 weeks for both treatment groups (p

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Postexercise Fructose-Maltodextrin Ingestion Enhances Subsequent Endurance Capacity

ABSTRACT Purpose Restoring skeletal muscle and hepatic glycogen content during short-term (

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Putting gene essentiality into context



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Postoperative nausea and vomiting after unrestricted clear fluids before day surgery: A retrospective analysis

BACKGROUND Guidance on pre-operative fluids fasting policy continues to evolve. Current European guidelines encourage the intake of oral fluids up to 2 h before the induction of general anaesthesia. From October 2014, Torbay Hospital Day Surgery Unit commenced an unrestricted fluid policy, encouraging patients to drink clear fluids up until the time of transfer to theatre. OBJECTIVE The aim of this study was to assess the incidence of postoperative nausea and vomiting before and after the change to the unrestricted pre-operative clear oral fluids. DESIGN Retrospective, before and after study. SETTING Single district general hospital between November 2013 and February 2016. PATIENTS A total of 11 500 patients on the day case pathway who were receiving either sedation, general anaesthesia, regional anaesthesia or their combination. The data from these patients were collected routinely. This number of patients represents approximately 78% of all patients before the change in fluids policy and 74% after the change. Exclusions were patients undergoing a termination of pregnancy, or patients undergoing community dental procedures, from whom patient experience data are not collected. INTERVENTION Introduction of a change to the day surgery pathway policy permitting unrestricted clear oral fluids preoperatively until transfer to theatre (from October 2014). MAIN OUTCOME MEASURES Incidence of postoperative nausea and vomiting. RESULTS The rates of nausea within 24 h postoperatively were 270/5192 (5.2%) when patients could not drink within 2 h of surgery, and 179/4724 (3.8%) when patients could drink up until surgery, a relative rate (95% confidence interval) of 0.73 (0.61 to 0.88), P = 0.00074. The corresponding rates of vomiting were 146/5186 (2.8%) and 104/4716 (2.2%), a relative rate (95% confidence interval) of 0.78 (0.61 to 1.00), P = 0.053. CONCLUSION Our data suggest that the liberal consumption of clear fluids before the induction of scheduled day case anaesthesia reduced the rates of postoperative nausea and vomiting. Correspondence to Dr Graham C. McCracken, MB, BCh, BAO, Department of Anaesthetics, Torbay and South Devon NHS Foundation Trust, Lowes Bridge, Torquay TQ2 7AA, Devon, UK E-mail: gmccracken@nhs.net © 2017 European Society of Anaesthesiology

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Knowledge Translation: the bridging function of Cochrane Rehabilitation

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Publication date: Available online 12 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Stefano Negrini, Francesca Gimigliano, Chiara Arienti, Carlotte Kiekens
Cochrane Rehabilitation is aimed to ensure that all rehabilitation professionals can apply Evidence Based Clinical Practice and take decisions according to the best and most appropriate evidence in this specific field, combining the best available evidence as gathered by high quality Cochrane systematic reviews, with their own clinical expertise and the values of patients. This mission can be pursued through Knowledge Translation. The aim of this paper is to shortly present what Knowledge Translation is, how and why Cochrane (previously known as Cochrane Collaboration) is trying to reorganize itself in light of Knowledge Translation, and the relevance that this process has for Cochrane Rehabilitation and in the end for the whole world of Rehabilitation.It is well known how it is difficult to effectively apply in everyday life what we would like to do and to apply the scientific knowledge in the clinical field: this is called the "know-do gap". In the field of Evidence Based Medicine, where Cochrane belongs, it has been proven that high quality evidence is not consistently applied in practice. A solution to these problems is the so-called "Knowledge Translation". In this context, Cochrane Rehabilitation is organized to provide the best possible Knowledge Translation in both directions (bridging function), obviously toward the world of rehabilitation (spreading reviews), but also to the Cochrane community (production of reviews significant for rehabilitation). Cochrane is now strongly pushing to improve its KT activities, and this creates a strong base for Cochrane Rehabilitation work, focused not only on spreading the evidence, but also on improving its production to make it more meaningful for the world of rehabilitation.



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Molecular Epidemiology of Klebsiella pneumoniae Strains Causing Bloodstream Infections in Adults

Microbial Drug Resistance , Vol. 0, No. 0.


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Antibiotic Resistance of Helicobacter pylori in Iranian Children: A Systematic Review and Meta-Analysis

Microbial Drug Resistance , Vol. 0, No. 0.


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New Subclass B1 Metallo-β-Lactamase Gene from a Clinical Pathogenic Myroides odoratus Strain

Microbial Drug Resistance , Vol. 0, No. 0.


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Clinical Strains of Chryseobacterium and Elizabethkingia spp. Isolated from Pediatric Patients in a University Hospital: Performance of MALDI-TOF MS-Based Identification, Antimicrobial Susceptibilities, and Baseline Patient Characteristics

Microbial Drug Resistance , Vol. 0, No. 0.


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Diversity of CTX-M Extended-Spectrum β-Lactamases in Escherichia coli Isolates from Retail Raw Ground Beef: First Report of CTX-M-24 and CTX-M-32 in Algeria

Microbial Drug Resistance , Vol. 0, No. 0.


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First Report of the Plasmid-Mediated Colistin Resistance Gene mcr-1 in Escherichia coli ST405 Isolated from Wildlife in Bejaia, Algeria

Microbial Drug Resistance , Vol. 0, No. 0.


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Editorial Board



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Table of Contents



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Reply to Saeid Safiri's Letter to the Editor: Risk factors for laryngeal penetration-aspiration in patients with acute traumatic cervical spinal cord injury

We would like to thank you for the opportunity to respond to the issues raised in Dr Saeid Safiri's letter.

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Meetings Calendar



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Risk factors for laryngeal penetration-aspiration in patients with acute traumatic cervical spinal cord injury: methodological issues

We were interested to read the paper by Ihalainen et al. that was published in the The Spine Journal [1]. The authors aimed to evaluate the effect of a wide range of potential pre-, peri- and postinjury risk factors on laryngeal penetration-aspiration on videofluoroscopic swallowing study. The results have demonstrated that coughing, throat clearing, choking, and changes in voice quality related to swallowing can be considered as independent risk factors of penetration-aspiration.

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Selecting passive dosimetry technologies for measuring the external dose of terrestrial wildlife

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Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Phakphum Aramrun, Nicholas A. Beresford, Michael D. Wood
Dosimeters attached to wild animals can be used to validate regulatory assessment approaches and models for estimating radiation exposure of wild animals. Such measurements are also necessary to ensure that robust dose-effect relationships can be developed from the results of field research programmes. This paper presents the first comprehensive evaluation of the different dosimetry technologies available for specifically measuring the external exposure of wildlife. Guidance is provided on the selection of appropriate passive dosimetry approaches for directly measuring external exposure of terrestrial wildlife under field conditions. The characteristics and performance of four available dosimetry technologies (thermoluminescent dosimeter (TLD), optically stimulated luminescent dosimeter (OSLD), radiophotoluminescent dosimeter (RPLD) and direct ion storage, (DIS)) are reviewed. Dosimeter properties, detection limit and dose range, study organisms and the intended application are variables that need to be considered when selecting a suitable dosimetry technology. Evaluated against these criteria, it is suggested that LiF based and Al2O3:C TLDs, OSLD and RPLD could all be used to estimate doses to wildlife. However, only LiF based TLDs have been used to directly measure wildlife doses in field studies to date. DIS is only suitable for comparatively large species (e.g. medium to large mammals), but has the advantage that temporal variation in dose can be recorded. In all cases, dosimeter calibration is required to ensure that the dose measurements reported can be interpreted appropriately for the organisms of interest.



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A review of numerical models to predict the atmospheric dispersion of radionuclides

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Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Ádám Leelőssy, István Lagzi, Attila Kovács, Róbert Mészáros
The field of atmospheric dispersion modeling has evolved together with nuclear risk assessment and emergency response systems. Atmospheric concentration and deposition of radionuclides originating from an unintended release provide the basis of dose estimations and countermeasure strategies. To predict the atmospheric dispersion and deposition of radionuclides several numerical models are available coupled with numerical weather prediction (NWP) systems. This work provides a review of the main concepts and different approaches of atmospheric dispersion modeling. Key processes of the atmospheric transport of radionuclides are emission, advection, turbulent diffusion, dry and wet deposition, radioactive decay and other physical and chemical transformations. A wide range of modeling software are available to simulate these processes with different physical assumptions, numerical approaches and implementation. The most appropriate modeling tool for a specific purpose can be selected based on the spatial scale, the complexity of meteorology, land surface and physical and chemical transformations, also considering the available data and computational resource. For most regulatory and operational applications, offline coupled NWP-dispersion systems are used, either with a local scale Gaussian, or a regional to global scale Eulerian or Lagrangian approach. The dispersion model results show large sensitivity on the accuracy of the coupled NWP model, especially through the description of planetary boundary layer turbulence, deep convection and wet deposition. Improvement of dispersion predictions can be achieved by online coupling of mesoscale meteorology and atmospheric transport models. The 2011 Fukushima event was the first large-scale nuclear accident where real-time prognostic dispersion modeling provided decision support. Dozens of dispersion models with different approaches were used for prognostic and retrospective simulations of the Fukushima release. An unknown release rate proved to be the largest factor of uncertainty, underlining the importance of inverse modeling and data assimilation in future developments.



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Radiocesium uptake through leaf surfaces of tea plants (Camellia sinensis L.)

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Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Takashi Ikka, Yoshifumi Nishina, Mizuho Kamoshita, Yasuhisa Oya, Kenji Okuno, Akio Morita
To clarify the source of radiocesium detected in newly emerged tea leaves contaminated just before the time of bud opening by fallout of radionuclides from Fukushima Dai-ichi Nuclear Power Plant, 137CsCl solution (0.185 M Bq mL−1) was applied to the front or the backside surfaces of mature leaves of tea plant (Camellia sinensis L. cv. Yabukita) at the time of bud opening. A 21 days after foliar application, the buds had grown and developed to the three- or four-leaf stage. In the front treatment, almost all (95%) of the applied 137Cs was present in the mature leaves (hot mother leaves). In the backside treatment, 68% of applied 137Cs also remained in hot mother leaves, but 22% and 10% was found in the new shoots attached to hot mother leaves and the other parts (non-applied mature leaves, stems and roots), respectively. The images of a hot leaf and its attached new shoots by imaging plate analysis revealed that the results coincided with those of the 137Cs distribution above. These suggested that radiocesium was primarily absorbed from the backside surface of tea leaves through the stoma, and then the greater part was transported to newly emerged tea organs during the new shoot growth period.



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Soil-to-cassava transfer of naturally occurring radionuclides from communities along Ghana's oil and gas rich Tano Basin

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Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Israel Nutifafa Yawo Doyi, David Kofi Essumang, Asare Kwaku Agyapong, Samuel Asumadu-Sarkodie
Soil-to-plant transfer factor (TF) is widely used to assess the impact of soil radioactivity on agricultural crops. The root crop cassava (Manihot esculenta) provides 30%–50% of the calories consumed in Sub-Saharan Africa and is widely used in South America. γ-ray analysis was used to measure activity concentrations of 238U, 232Th, and 40K in cassava root and soil. The TF values for 238U, 232Th, and 40K were in the range 0.06–0.12, 0.01–0.10 and 0.04–0.28 respectively. The median transfer factors were 0.10 (238U), 0.04 (232Th) and 0.08 (40K). For 238U and 232Th, the highest TF values were 0.12 and 0.10 respectively.



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Postoperative thrombocytopenia: why you should consider antiplatelet therapy?

Purpose of review This review addresses the role of platelets in perioperative ischemic complications involving the brain, kidneys, and gastrointestinal tract, and long-term survival in patients undergoing coronary artery bypass grafting surgery. Importantly, findings of several recent clinical studies will be discussed with emphasis on platelet activation and leukocyte inflammatory responses as important mediators of vascular microthrombosis and ischemic injury. Recent findings Our recent findings suggest that in some patients, the hemostatic balance during and after surgery may shift toward a hypercoagulable state and contribute to acute organ failure. Summary For over 6 decades, major postoperative complications after cardiac surgery have remained unchanged. The potential influence of microthrombosis involving platelets has been underappreciated and use of perioperative antiplatelet therapy remains very limited – primarily because of a culture of fear of bleeding. Correspondence to Manuel L. Fontes, MD, Professor of Anesthesiology and Critical Care, Yale University School of Medicine, 333 Cedar Street, TMP-3, P.O. Box 208051, New Haven, CT 06520, USA. Tel: +1 203 785 2802; e-mail: manuel.fontes@yale.edu Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Perioperative steroid therapy: where's the evidence?

Purpose of review Review of historical and current evidence of adrenal suppression in patients on chronic glucocorticoid therapy during perioperative period, and discussion of current recommendations for perioperative stress dose steroid administration. Recent findings Evidence suggests low incidence of perioperative adrenal insufficiency in patients receiving chronic glucocorticoid therapy. Recent studies show no difference in survival or hemodynamic sequella by withholding perioperative stress steroids; however, these studies are limited in size and universal applicability. Summary Current recommendations for perioperative stress dose steroids for patients on chronic glucocorticoid therapy are based on duration and dose of maintenance steroids. All patients should take their regular daily dose of steroid preoperatively regardless of dose or chronicity of prior treatment. Additional, stress dose steroid dosing is based on patient risk of adrenal suppression and surgical complexity and stress. Correspondence to Leon Freudzon, MD, 333 Cedar Street, TMP 3, P.O. Box 208051, New Haven, CT 06520-8051, USA. Tel: +1 203 785 2802; e-mail: leon.freudzon@yale.edu Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Impact of pectoral nerve block on postoperative pain and quality of recovery in patients undergoing breast cancer surgery: A randomised controlled trial

BACKGROUND In recent years, thoracic wall nerve blocks, such as the pectoral nerve (PECS) block and the serratus plane block have become popular for peri-operative pain control in patients undergoing breast cancer surgery. The effect of PECS block on quality of recovery (QoR) after breast cancer surgery has not been evaluated. OBJECTIVES To evaluate the ability of PECS block to decrease postoperative pain and anaesthesia and analgesia requirements and to improve postoperative QoR in patients undergoing breast cancer surgery. DESIGN Randomised controlled study. SETTING A tertiary hospital. PATIENTS Sixty women undergoing breast cancer surgery between April 2014 and February 2015. INTERVENTIONS The patients were randomised to receive a PECS block consisting of 30 ml of levobupivacaine 0.25% after induction of anaesthesia (PECS group) or a saline mock block (control group). The patients answered a 40-item QoR questionnaire (QoR-40) before and 1 day after breast cancer surgery. MAIN OUTCOME MEASURES Numeric Rating Scale score for postoperative pain, requirement for intra-operative propofol and remifentanil, and QoR-40 score on postoperative day 1. RESULTS PECS block combined with propofol–remifentanil anaesthesia significantly improved the median [interquartile range] pain score at 6 h postoperatively (PECS group 1 [0 to 2] vs. Control group 1 [0.25 to 2.75]; P = 0.018]. PECS block also reduced propofol mean (± SD) estimated target blood concentration to maintain bispectral index (BIS) between 40 and 50 (PECS group 2.65 (± 0.52) vs. Control group 3.08 (± 0.41) μg ml−1; P 

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Teacher who helped special needs woman fulfill EMT dream 'forever' changed

By Charles Avery, EMS1 Contributor I remember the day that Blair Williams changed my life forever. I have served as the EMS programs director at Bainbridge State College for the past five years. I entered my office one morning and turned on my computer to find an email from Jason Rubenbauer, the dean of Health Sciences and Professional Studies. In a very short email, he requested an immediate meeting ...

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Top 10 viral EMS videos of 2017

By EMS1 Staff Whether it was a creatively humorous way to teach a lesson, a contribution to a viral trend or a tear-jerking reunion, the EMS videos were pretty great this year. We collected 10 of our personal favorites to give you a chance to look back on 2017 and remember what everyone was watching. If we missed your favorite, let us know in the comment section below. 10. Responders make lip dub video ...

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Detection of deception: Event-related potential markers of attention and cognitive control during intentional false responses

Abstract

Successful deception requires the coordination of multiple mental processes, such as attention, conflict monitoring, and the regulation of emotion. We employed a simple classification task, assessing ERPs to further investigate the attentional and cognitive control components of (instructed) deception. In Experiment 1, 20 participants repeatedly categorized visually presented names of five animals and five plants. Prior to the experiment, however, each participant covertly selected one animal and one plant for deliberate misclassification. For these critical items, we observed significantly increased response times (RTs), error rates, and amplitudes of three ERP components: anterior P3a indicating the processing of task relevance, medial-frontal negativity reflecting conflict monitoring, and posterior P3b indicating sustained visual attention. In a blind identification of the individual critical words based on a priori defined criteria, an algorithm using two behavioral and two ERP measures combined showed a sensitivity of 0.73 and a specificity of 0.95, thus performing far above chance (0.2/0.2). Experiment 2 used five clothing and five furniture names and successfully replicated the findings of Experiment 1 in 25 new participants. For detection of the critical words, the algorithm from Experiment 1 was reused with only slight adjustments of the ERP time windows. This resulted in a very high detection performance (sensitivity 0.88, specificity 0.94) and significantly outperformed an algorithm based on RT alone. Thus, at least under controlled laboratory conditions, a highly accurate detection of instructed lies via the attentional and cognitive control components is feasible, and benefits strongly from combined behavioral and ERP measures.



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Masking exposure to phobic stimuli reduces fear without inducing electrodermal activity

Abstract

A series of experiments has shown that limiting awareness of exposure to feared stimuli through visual masking—or very brief exposure (VBE)—reduces avoidance of a live tarantula by spider-phobic participants. We investigated this process of fear reduction by directly relating the effects of VBE on electrodermal activity to its ensuing effects on phobic behavior. Sixty spider-phobic participants, identified by approaching a live tarantula and a questionnaire, were administered either VBE to masked spiders or control exposure to masked flowers. Skin conductance levels (SCLs) were continuously recorded during exposure. The participants approached the tarantula again immediately thereafter. VBE reduced avoidance of the tarantula and did not increase SCLs or cause subjective distress relative to control exposure. SCL increases during VBE were strongly negatively correlated with the reduction of self-reported fear of the tarantula: the less that SCLs increased during VBE, the more it reduced fear. VBE only increased SCLs in participants whose fear was not reduced; it did not increase SCLs in participants whose fear of the tarantula was reduced. Awareness of the stimuli did not mediate these effects. Control exposure did not yield any of these effects. In a second experiment, clearly visible exposure to spider images increased SCLs and subjective distress more than both VBE and control exposure, whereas VBE did not increase SCLs or subjective distress relative to control exposure within the same spider-phobic participants. These findings suggest that exposure to phobic images can reduce fear even when it bypasses the induction of electrodermal activity.



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Using trial-level data and multilevel modeling to investigate within-task change in event-related potentials

Abstract

EEG data, and specifically the ERP, provide psychologists with the power to examine quickly occurring cognitive processes at the native temporal resolution at which they occur. Despite the advantages conferred by ERPs to examine processes at different points in time, ERP researchers commonly ignore the trial-to-trial temporal dimension by collapsing across trials of similar types (i.e., the signal averaging approach) because of constraints imposed by repeated measures ANOVA. Here, we present the advantages of using multilevel modeling (MLM) to examine trial-level data to investigate change in neurocognitive processes across the course of an experiment. Two examples are presented to illustrate the usefulness of this technique. The first demonstrates decreasing differentiation in N170 amplitude to faces of different races across the course of a race categorization task. The second demonstrates attenuation of the ERN as participants commit more errors within a task designed to measure implicit racial bias. Although the examples presented here are within the realm of social psychology, the use of MLM to analyze trial-level EEG data has the potential to contribute to a number of different theoretical domains within psychology.



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EEG frequency PCA in EEG-ERP dynamics

Abstract

Principal components analysis (PCA) has long been used to decompose the ERP into components, and these mathematical entities are increasingly accepted as meaningful and useful representatives of the electrophysiological components constituting the ERP. A similar expansion appears to be beginning in regard to decomposition of the EEG amplitude spectrum into frequency components via frequency PCA. However, to date, there has been no exploration of the brain's dynamic EEG-ERP linkages using PCA decomposition to assess components in each measure. Here, we recorded intrinsic EEG in both eyes-closed and eyes-open resting conditions, followed by an equiprobable go/no-go task. Frequency PCA of the EEG, including the nontask resting and within-task prestimulus periods, found seven frequency components within the delta to beta range. These differentially predicted PCA-derived go and no-go N1 and P3 ERP components. This demonstration suggests that it may be beneficial in future brain dynamics studies to implement PCA for the derivation of data-driven components from both the ERP and EEG.



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An adaptive orienting theory of error processing

Abstract

The ability to detect and correct action errors is paramount to safe and efficient goal-directed behaviors. Existing work on the neural underpinnings of error processing and post-error behavioral adaptations has led to the development of several mechanistic theories of error processing. These theories can be roughly grouped into adaptive and maladaptive theories. While adaptive theories propose that errors trigger a cascade of processes that will result in improved behavior after error commission, maladaptive theories hold that error commission momentarily impairs behavior. Neither group of theories can account for all available data, as different empirical studies find both impaired and improved post-error behavior. This article attempts a synthesis between the predictions made by prominent adaptive and maladaptive theories. Specifically, it is proposed that errors invoke a nonspecific cascade of processing that will rapidly interrupt and inhibit ongoing behavior and cognition, as well as orient attention toward the source of the error. It is proposed that this cascade follows all unexpected action outcomes, not just errors. In the case of errors, this cascade is followed by error-specific, controlled processing, which is specifically aimed at (re)tuning the existing task set. This theory combines existing predictions from maladaptive orienting and bottleneck theories with specific neural mechanisms from the wider field of cognitive control, including from error-specific theories of adaptive post-error processing. The article aims to describe the proposed framework and its implications for post-error slowing and post-error accuracy, propose mechanistic neural circuitry for post-error processing, and derive specific hypotheses for future empirical investigations.



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Brain reflections: A circuit-based framework for understanding information processing and cognitive control

Abstract

Here, I propose a view of the architecture of the human information processing system, and of how it can be adapted to changing task demands (which is the hallmark of cognitive control). This view is informed by an interpretation of brain activity as reflecting the excitability level of neural representations, encoding not only stimuli and temporal contexts, but also action plans and task goals. The proposed cognitive architecture includes three types of circuits: open circuits, involved in feed-forward processing such as that connecting stimuli with responses and characterized by brief, transient brain activity; and two types of closed circuits, positive feedback circuits (characterized by sustained, high-frequency oscillatory activity), which help select and maintain representations, and negative feedback circuits (characterized by brief, low-frequency oscillatory bursts), which are instead associated with changes in representations. Feed-forward activity is primarily responsible for the spread of activation along the information processing system. Oscillatory activity, instead, controls this spread. Sustained oscillatory activity due to both local cortical circuits (gamma) and longer corticothalamic circuits (alpha and beta) allows for the selection of individuated representations. Through the interaction of these circuits, it also allows for the preservation of representations across different temporal spans (sensory and working memory) and their spread across the brain. In contrast, brief bursts of oscillatory activity, generated by novel and/or conflicting information, lead to the interruption of sustained oscillatory activity and promote the generation of new representations. I discuss how this framework can account for a number of psychological and behavioral phenomena.



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Autopsy findings in EPG5-related Vici syndrome with antenatal onset: Additional report of Focal cortical microdysgenesis in a second trimester fetus



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Holiday gift guide: 10 gifts under $25 for new paramedics, EMTs

Here's a roundup of gift ideas to help your newest colleague feel prepared and, in some cases, entertained

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Phenotype expansion and development in Kosaki Overgrowth Syndrome

Abstract

We expand the KOGS phenotype by over 70% to include 24 unreported KOGS symptoms, in a first male patient, the third overall associated with the PDGFRB c.1751C>G, p.(Pro584Arg) mutation. 18 of these symptoms are unique to our patient, the remaining 6 are shared with other patients. Of the 24 unreported features overall, 6 show marked phenotype evolution and varying time of onset. The triangular face detected at 14 months and long palpebral fissures with lateral ectropion at 4 years are present in other members of the cohort. The remaining 4 are unique to Patient 5: pronounced macrocephaly from birth, increasingly triangular anterior skull from 14 months, camptodactyly, emerging at 4 years and worsening joint contractures from 6 years. Compilation of all new symptoms reported here with published clinical data further identifies at least 18 clinical parameters common to all cases to date, encompassing both known KOGS-associated PDGFRB mutations. We therefore propose a set of 18 core KOGS symptoms, with 16 present in early childhood. These results should also impact diagnostic/prognostic scope, intervention and outcome potential for KOGS patients, particularly for developmentally progressive conditions such as scoliosis and myofibroma.

Thumbnail image of graphical abstract

We expand the Kosaki Overgrowth Syndrome by over 70% to include 24 unreported symptoms, in a first male patient, the third overalll associated with the PDGFRB c.1751C>G, p.(Pro584Arg) mutation



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A case of a protruded lesion formed by a poorly differentiated intramucosal adenocarcinoma of the stomach: an immunohistochemical analysis

Abstract

A 70-year-old woman underwent upper gastrointestinal endoscopy and was found to have a 25-mm protruded lesion in the gastric body. A biopsy revealed malignant cells. Endoscopic submucosal dissection was performed. Histopathologically, the tumor was mainly composed of poorly differentiated adenocarcinoma (PDA), while moderately differentiated adenocarcinoma was observed on its superficial layer. The tumor was located within the mucosal layer. PDAs rarely form a protruded lesion. Here, the presence of a moderately differentiated adenocarcinoma element in the superficial layer of the tumor might have protected the tumor cells from erosion, and solid proliferation of the PDA also contributed to its outward growth.



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The metagenomic approach to characterization of the microbial community shift during the long-term cultivation of anammox-enriched granular sludge

Abstract

A metagenomic approach was used to investigate how the microbial community composition changes when an anammox-based granular sludge reactor is seeded with nitritation-anammox biomass from a wastewater treatment plant. In the seed sample, the abundance of Candidatus Kuenenia stuttgartiensis was similar to Candidatus Jettenia caeni (12.63 vs. 11.68%). This biomass was typical in terms of microbial nitrogen conversion; both ammonia (Nitrosomonas sp.) and nitrite (Nitrospira sp.) oxidizing bacteria were detected. In the lab-scale reactor, Candidatus Kuenenia stuttgartiensis and Candidatus Jettenia caeni bacteria were also present in equal proportions (18.57 vs. 20.89%). On the contrary, Candidatus Nitrospira defluvii bacteria were highly abundant in this reactor, but no known ammonia-oxidizing bacteria were detected. In light of recent studies showing that Nitrospira sp. are capable of complete nitrification, the results presented here may well indicate that both stages of nitrification in the anammox-based granular sludge reactor were performed by this bacteria.



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Genetic architecture: the shape of the genetic contribution to human traits and disease

Genetic architecture: the shape of the genetic contribution to human traits and disease

Genetic architecture: the shape of the genetic contribution to human traits and disease, Published online: 11 December 2017; doi:10.1038/nrg.2017.101

Genetic architecture describes the characteristics of genetic variation that are responsible for phenotypic variability. This Review discusses the types of genetic architecture that have been observed, how they can be measured and how genetic architecture informs the scientific and clinical goals of human genetics.

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A change of view: homologous recombination at single-molecule resolution

A change of view: homologous recombination at single-molecule resolution

A change of view: homologous recombination at single-molecule resolution, Published online: 11 December 2017; doi:10.1038/nrg.2017.92

In this Review, Kaniecki et al. discuss how the use of single-molecule optical microscopy and super-resolution optical microscopy methods has benefited our understanding of homologous recombination by generating detailed insights into the molecules and processes involved.

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Technique: A miniature living recording device

Technique: A miniature living recording device

Technique: A miniature living recording device, Published online: 11 December 2017; doi:10.1038/nrg.2017.110

Technique: A miniature living recording device

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Size discrimination in barn owls as compared to humans

Abstract

We tested how well barn owls can discriminate objects of different sizes. This ability may be important for the owls when catching prey. We performed a quantitative experiment in the laboratory and trained owls in a task in which the owls had to discriminate whether two rhombi presented simultaneously on a computer monitor were of the same or of different sizes. We obtained full data sets with two experienced owls and one data point with a third owl. For objects being sufficiently larger than the spatial resolution of the barn owl, the angular threshold was related to object size, implying that the discrimination followed Weber's law. The range of Weber fractions we determined was between 0.026 and 0.09. For object sizes close to the spatial resolution, performance degraded. We conducted similar experiments with human subjects. Human thresholds showed the same dependence on object size, albeit down to smaller object sizes. Human performance resulted in a range of Weber fractions extending from 0.025 to 0.036. The differences between owls and humans could be explained by the much higher spatial acuity of humans compared with owls.



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Mid-term results of bariatric surgery in morbidly obese Japanese patients with slow progressive autoimmune diabetes

Abstract

Introduction

Bariatric surgery is recognized as an effective treatment for type 2 diabetes mellitus, but data on its efficacy for type 1 diabetes mellitus, especially slowly progressive insulin-dependent diabetes mellitus, are limited.

Methods

We investigated five Japanese patients with slowly progressive insulin-dependent diabetes mellitus who underwent bariatric surgery at our center.

Results

Five morbidly obese glutamic acid decarboxylase antibody-positive diabetic patients underwent two different types of bariatric surgery. The mean titer of anti-glutamic acid decarboxylase antibody was 4.6 U/mL, and the mean preoperative bodyweight and BMI were 113 kg and 39.6 kg/m2, respectively. The mean hemoglobin A1c was 8.4%. The mean fasting serum C-peptide was 5.0 ng/mL. Laparoscopic sleeve gastrectomy was performed in two patients, while laparoscopic sleeve gastrectomy with duodenojejunal bypass was performed in three patients. At one year after surgery, the mean bodyweight and BMI significantly dropped, and the mean percentage of excess weight loss was 96.4%. The mean hemoglobin A1c was 5.7%. This favorable trend was maintained at mid-term.

Conclusion

Bariatric surgery for morbidly obese patients with anti-glutamic acid decarboxylase antibody–positive type 1 diabetes mellitus, especially slow progressive autoimmune diabetes, seemed effective in achieving mid-term glycemic control. Longer follow-up with a larger number of patients, as well as validation with more advanced patients with slowly progressive insulin-dependent diabetes mellitus, will be needed.



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Issue Information



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Agreement and Discrepancy Between Supervisor and Clinician Alliance: Associations with Clinicians’ Perceptions of Psychological Climate and Emotional Exhaustion

Abstract

Despite increasing interest in supervision as a leverage point for bolstering public mental health services, the potential influence of supervisory alliance on organizations and direct service providers remains understudied, particularly in the context of supporting evidence-based treatment (EBT) use. This study examined agreement and discrepancy between supervisor and clinician ratings of alliance associated with clinicians' perceptions of psychological climate and emotional exhaustion. Results indicated that discrepancies in alliance ratings were common and associated with clinicians' perceptions of psychological climate. These findings have important implications for collaboration among supervisors and clinicians within a community mental health organizational context and the provision of EBTs.



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