Gastric submucosal haematoma caused by an amyloidoma in the setting of multiple myeloma

Publication date: Available online 15 December 2017
Source:Arab Journal of Gastroenterology
Author(s): Stella C. Pak, John-Phillip T. Markovic
This is a case of a 67-year-old woman with a history of multiple myeloma with amyloidosis who presented with massive hematemesis. Emergent upper endoscopy revealed a mass on the greater curvature of the stomach, which measured approximately 3 cm in width and 7 cm in length. The patient underwent a wedge resection of the gastric mass without complication. Microscopic examination of the gastric mass revealed amorphous deposits that were congophilic in nature and stained positive with Alcian blue. These findings are consistent with amyloidosis. The patient had a favourable postoperative recovery and was discharged from the hospital. This case highlights the need for clinicians to be aware of the possibility of spontaneous gastric haemorrhage secondary to light chain (AL) amyloidosis, especially in patients with a known bone marrow disorder.



from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2AKUDQE
via IFTTT

Issue Information

from Physiology via xlomafota13 on Inoreader http://ift.tt/2CnsFri
via IFTTT

Differential Regulation of Zfp30 Expression in Murine Airway Epithelia Through Altered Binding of ZFP148 to rs51434084

Neutrophil chemotaxis to the airways is a key aspect of host response to microbes and a feature of multiple pulmonary diseases including asthma. Tight regulation of this recruitment is critical to prevent unwanted host tissue damage and inflammation. Using a mouse (Mus musculus) model of asthma applied to the Collaborative Cross (CC), we previously identified a lung gene expression quantitative trait locus (eQTL) for Zinc finger protein 30 (Zfp30) that was also a QTL for neutrophil recruitment and the hallmark neutrophil chemokine CXCL1. The Zfp30 eQTL is defined by three functionally distinct haplotypes. In this study, we searched for causal genetic variants that underlie the Zfp30 eQTL to gain a better understanding of this candidate repressor's regulation. First, we identified a putative regulatory region spanning 500 bp upstream of Zfp30, which contains 10 SNPs that form five haplotypes. In reporter gene assays in vitro, these haplotypes recapitulated the three previously identified in vivo expression patterns. Second, using site directed mutagenesis followed by reporter gene assays, we identified a single variant, rs51434084, that explained the majority of variation in expression between two out of three haplotype groups. Finally, using a combination of in silico predictions and electrophoretic mobility shift assays, we identified ZFP148 as a transcription factor that differentially binds to the Zfp30 promoter region harboring rs51434084. In conclusion, we provide evidence in support of rs51434084 being a causal variant for the Zfp30 eQTL and have identified a mechanism by which this variant alters Zfp30 expression, namely differential binding of ZFP148.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2j7OZwp
via IFTTT

Corrigendum to the plant heat stress transcription factor (Hsf) family: Structure, function and evolution. [BBAGRM 1819 (2) 104–119]

Publication date: Available online 14 December 2017
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Klaus-Dieter Scharf, Thomas Berberich, Ingo Ebersberger, Lutz Nover




from Genetics via xlomafota13 on Inoreader http://ift.tt/2C8Eil5
via IFTTT

Hepatic arterial infusion in the management of colorectal cancer liver metastasis: current and future perspectives

The technique of hepatic arterial infusion (HAI) for the treatment of liver metastases from colorectal cancer has been developed over more than 30 years. Although the indications and protocols for this technique have evolved with time, HAI is not routinely performed in clinical practice. Studies have been heterogeneous, with different regimens of intra-arterial drugs, associated or not with systemic chemotherapy, and with unconvincing outcomes. Technical difficulties for catheter placement have limited the implementation of this method in routine practice.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2BoZsOY
via IFTTT

A case of duodenal bulb involvement of Immunoglobulin G4 related disease complicated by ulcerative colitis

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2Aqi7WK
via IFTTT

ESO to market TrackEMS® System to alert hospitals of incoming critical EMS patients

EMS-to-Hospital Notification System Will Integrate with ESO EHR ePCR Software for EMS

from EMS via xlomafota13 on Inoreader http://ift.tt/2j2yEJz
via IFTTT

A randomized phase II study of S-1 versus capecitabine as first-line chemotherapy in elderly metastatic gastric cancer patients with or without poor performance status: clinical and pharmacogenetic results

Objective This study investigated the efficacy and safety of S-1 versus capecitabine in elderly patients with metastatic gastric cancer (MGC), and examined the association between cytochrome P450 2A6 (CYP2A6) polymorphisms and treatment outcomes. Materials and methods MGC patients 70–85 years old with Eastern Cooperative Oncology Group (ECOG) performance status 0–2 or 65–70 years old with ECOG PS 2 were randomized to receive S-1 40 mg/m2, twice daily, or capecitabine 1250 mg/m2, twice daily, on days 1–14 every 3 weeks. Results From May 2007 up to July 2010, 107 patients were enrolled. G3/4 neutropenia developed in 3.8% of each arm, and the most common G3/4 nonhematological toxicities were anorexia and fatigue. Vomiting and tearing were more frequent with S-1 and hand–foot syndrome with capecitabine. The primary endpoint, the overall response rate, was 26.4% (14/53, 95% confidence interval: 14.5–38.3%) in S-1 and 24.1% (13/54, 95% confidence interval: 12.7–35.5%) in capecitabine, both of which exceeded the null hypothesis response rate of 10%. The median time to progression (TTP; 3.2 vs. 3.4 months, P=0.813) and overall survival (OS; 8.5 vs. 10.3 months, P=0.691) were similar in both arms. CYP2A6 polymorphisms were associated with S-1 efficacy. In the S-1 arm only, patients with CYP2A6 variant/variant alleles had worse TTP and OS than those with wild/wild or wild/variant alleles, and in multivariate analysis, the CYP2A6 genotype was predictive for TTP and OS. Conclusion Both S-1 and capecitabine were active and tolerable for elderly MGC patients. The CYP2A6 genotyping might guide treatment selection.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2Bmihm3
via IFTTT

Novel CYP2A6 diplotypes identified through next-generation sequencing are associated with in-vitro and in-vivo nicotine metabolism

Objectives Smoking patterns and cessation rates vary widely across smokers and can be influenced by variation in rates of nicotine metabolism [i.e. cytochrome P450 2A6 (CYP2A6), enzyme activity]. There is high heritability of CYP2A6-mediated nicotine metabolism (60–80%) owing to known and unidentified genetic variation in the CYP2A6 gene. We aimed to identify and characterize additional genetic variants at the CYP2A6 gene locus. Methods A new CYP2A6-specific sequencing method was used to investigate genetic variation in CYP2A6. Novel variants were characterized in a White human liver bank that has been extensively phenotyped for CYP2A6. Linkage and haplotype structure for the novel single nucleotide polymorphisms (SNPs) were assessed. The association between novel five-SNP diplotypes and nicotine metabolism rate was investigated. Results Seven high-frequency (minor allele frequencies ≥6%) noncoding SNPs were identified as important contributors to CYP2A6 phenotypes in a White human liver bank (rs57837628, rs7260629, rs7259706, rs150298687 (also denoted rs4803381), rs56113850, rs28399453, and rs8192733), accounting for two times more variation in in-vitro CYP2A6 activity relative to the four established functional CYP2A6 variants that are frequently tested in Whites (CYP2A6*2, *4, *9, and *12). Two pairs of novel SNPs were in high linkage disequilibrium, allowing us to establish five-SNP diplotypes that were associated with CYP2A6 enzyme activity (rate of nicotine metabolism) in-vitro in the liver bank and in-vivo among smokers. Conclusion The novel five-SNP diplotype may be useful to incorporate into CYP2A6 genotype models for personalized prediction of nicotine metabolism rate, cessation success, and response to pharmacotherapies.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2Bqpbqm
via IFTTT

Race/ethnicity difference in the pharmacogenetics of bilirubin-related atazanavir discontinuation

Background Atazanavir causes plasma indirect bilirubin to increase. We evaluated associations between Gilbert's polymorphism and bilirubin-related atazanavir discontinuation stratified by race/ethnicity. Patients and methods Patients had initiated atazanavir/ritonavir-containing regimens at an HIV primary care clinic in the southeastern USA, and had at least 12 months of follow-up data. Metabolizer group was defined by UGT1A1 rs887829 C→T. Genome-wide genotype data were used to adjust for genetic ancestry in combined population analyses. Results Among 321 evaluable patients, 15 (4.6%) had bilirubin-related atazanavir discontinuation within 12 months. Homozygosity for rs887829 T/T was present in 28.1% of Black, 21.4% of Hispanic, and 8.6% of White patients. Among all patients the hazard ratio (HR) for bilirubin-related discontinuation with T/T versus C/C genotype was 7.3 [95% confidence interval (CI): 1.7–31.5; P=0.007]. Among 152 White patients the HR was 14.4 (95% CI: 2.6–78.7; P=0.002), but among 153 Black patients the HR was 0.8 (95% CI: 0.05–12.7; P=0.87). Conclusion Among patients who initiated atazanavir/ritonavir-containing regimens, UGT1A1 slow metabolizer genotype rs887829 T/T was associated with increased bilirubin-related discontinuation of atazanavir in White but not in Black patients, this despite T/T genotype being more frequent in Black patients.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2BnQMIv
via IFTTT

Effect of pharmacogenetic markers of vitamin D pathway on deferasirox pharmacokinetics in children

Objectives Patients with β-thalassemia major have extremely low vitamin D levels, owing to reduced intestinal absorption, subicteric tint, and/or iron-induced higher pigmentation. We investigated whether some polymorphisms within the VDR, CYP24A1, CYP27B1, and GC genes could play a role in deferasirox pharmacokinetics in a cohort of pediatric patients. Patients and methods Eighteen children with β-thalassemia were enrolled. Drug plasma concentrations at the end of dosing interval (Ctrough) and after 0, 2, 4, 6, and 24 h of drug administration were measured by a HPLC-UV method. Allelic discrimination for VDR (TaqI, FokI, BsmI, Cdx2, and ApaI), CYP24A1 (22776, 3999 and 8620), CYP27B1 (2838 and −1260), and GC (1296) single nucleotide polymorphisms was performed by real-time PCR. Results CYP24A1 8620 AG/GG group negatively predicted Ctrough in regression analysis (P=0.012). ApaI AA genotype resulted as a negative predictor of Ctrough (P=0.025) and area under the concentration curve (P=0.007); FoKI CC genotype remained as area under the concentration curve positive predictor (P=0.008) and TC/CC group as half-life (t1/2) (P=0.003) and volume of distribution (Vd) (P=0.011) negative one; TaqI TC/CC was retained as a negative predictor of drug maximum concentration (Cmax) (P=0.004). Moreover, GC 1296 TG/GG seemed able to predict lower time to reach drug maximum concentration (Tmax) (P=0.033). Conclusion Our preliminary experience suggested the potential usefulness of vitamin D pharmacogenetic to better understand deferasirox interindividual variability, also in pediatric patients.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2BqhYGC
via IFTTT

Gene–gene interaction between DRD4 and COMT modulates clinical response to clozapine in treatment-resistant schizophrenia

Clozapine is the drug of choice for treatment-resistant schizophrenia. However, its use is associated with variable clinical responses and serious adverse effects. Polymorphisms in genes encoding proteins involved in synaptic neurotransmission may account for such variability. Here, we studied independent and epistatic genetic associations of polymorphisms in DRD4 (120-bp duplication) and COMT (Val158Met) with clinical response to clozapine in people with treatment-resistant schizophrenia. We studied 93 participants who were on stable doses of clozapine for at least 12 weeks. A total score of less than or equal to 35 on the Brief Psychiatric Rating Scale was defined as a clinical response. The genetic associations were tested using logistic regression analyses. Neither polymorphism studied was found to be independently associated with response to clozapine. However, a statistically significant gene–gene interaction was observed between the polymorphisms. Participants with the COMT Val/Met or Met/Met genotype, who also had one or two DRD4 120-bp alleles (120/240 and 120/120), showed significantly better clinical response to clozapine. Our results highlight the importance of investigating gene–gene interactions, while studying the pharmacogenetics of clozapine.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2BpZWV6
via IFTTT

eCore employee scheduling software offers enterprise solutions for enterprise operations

By eCore Software There is nothing more difficult to manage than large, distributed operations in a nationwide or worldwide company. The hierarchy usually starts at the top with the HR department and company-wide IT departments headed by a CTO (Chief Technology Officer). Next level is regions, then divisions within a region, then each operation within a division. Each level of the hierarchy has different ...

from EMS via xlomafota13 on Inoreader http://ift.tt/2AZU6Hd
via IFTTT

Interindividual Responses of Appetite to Acute Exercise: A Replicated Crossover Study

AbstractPurposeAcute exercise transiently suppresses appetite, which coincides with alterations in appetite-regulatory hormone concentrations. Individual variability in these responses is suspected, but replicated trials are needed to quantify them robustly. We examined the reproducibility of appetite and appetite-regulatory hormone responses to acute exercise and quantified the individual differences in responses.MethodsFifteen healthy, recreationally-active men completed two control (60-min resting) and two exercise (60-min fasted treadmill running at 70% peak oxygen uptake) conditions in randomised sequences. Perceived appetite and circulating concentrations of acylated ghrelin and total peptide YY (PYY) were measured immediately before and after the interventions. Inter-individual differences were explored by correlating the two sets of response differences between exercise and control conditions. Within-participant covariate-adjusted linear mixed models were used to quantify participant-by-condition interactions.ResultsCompared with control, exercise suppressed mean acylated ghrelin concentrations and appetite perceptions (all ES = 0.62 to 1.47, P

from Sports Medicine via xlomafota13 on Inoreader http://ift.tt/2jVi8vA
via IFTTT

Acute Impact of Different Exercise Modalities on Arterial and Platelet Function

AbstractPurposeAcute coronary syndromes and ischemic stroke are associated with arterial events involving platelets, the endothelium and atherosclerosis. Whilst regular physical activity is associated with lower risk of cardiovascular events and mortality, risk is transiently increased during and immediately following participation in an acute bout of exercise. No previous study has investigated the acute impact of exercise on platelet activation and arterial function in the same participants; it is also unknown if responses are dependent on exercise modality. We hypothesised that commonly adopted, yet physiologically distinct, modalities of exercise ("aerobic" versus "resistance") have differing effects on in vivo platelet activation and conduit artery diameter.MethodsEight apparently healthy middle-aged (53.5±1.6yrs) male subjects took part in four, 30 min experimental interventions (aerobic AE, resistance RE, combined aerobic/resistance exercise CARE or no-exercise), in random order. Blood samples were collected and the measurement of brachial artery diameter by ultrasound was performed before, immediately after, and one hour after each intervention. Platelet activation was determined by the positive binding of antibodies to surface receptors exposed on activated platelets (anti-CD62P and PAC-1).ResultsBrachial artery diameter increased immediately following all three exercise modalities (P

from Sports Medicine via xlomafota13 on Inoreader http://ift.tt/2kwi45k
via IFTTT

Functional limitation of the masticatory system in patients with bulbar involvement in amyotrophic lateral sclerosis

Abstract

Amyotrophic lateral sclerosis (ALS) with bulbar dysfunction affects the motor neurons responsible for controlling the muscles in the jaw, face, soft palate, pharynx, larynx, and tongue. This cross-sectional study aimed to determine the functional limitation of the jaw in patients with ALS and bulbar dysfunction who had upper motor neurons (UMN), lower motor neurons (LMN) or balanced involvement. One hundred and fifty three patients with ALS and 23 controls were included. All participants answered using the eight-item Jaw Functional Limitation Scale (JFLS-8). Patients with ALS were grouped by neurologic examination as follows: non-bulbar ALS, bulbar UMN-predominant ALS; bulbar LMN-predominant ALS; and bulbar balanced (UMN + LMN) ALS. Jaw limitation between the different groups was compared using the Kruskal–Wallis test. Patients with non-bulbar ALS had similar mandibular limitations to healthy participants. Only patients with balanced UMN and LMN bulbar manifestations reported greater difficulties in chewing soft food or in jaw mobility compared to the non-bulbar ALS group. Patients with bulbar involvement also had greater difficulties in chewing tough food or chicken and in swallowing and talking compared to the non-bulbar group, regardless of whether UMN or LMN predominant. No significant differences were found between the groups in smiling and yawning difficulties. Bulbar involvement in patients with ALS is associated with functional limitation of the masticatory system. However, balanced bulbar UMN and LMN involvement is associated with the worst impairments in chewing soft food and in opening the jaw widely.

This article is protected by copyright. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2o6dz6m
via IFTTT

Okur-Chung neurodevelopmental syndrome: Eight additional cases with implications on phenotype and genotype expansion

Abstract

Okur-Chung syndrome is a neurodevelopmental condition attributed to germline CSNK2A1 pathogenic missense variants. We present eight unreported subjects with the above syndrome, who have recognizable dysmorphism, varying degrees of developmental delay and multisystem involvement. Together with six previously reported cases, we present a case series of seven female and seven male subjects, highlighting the recognizable facial features of the syndrome (microcephaly, hypertelorism, epicanthic fold, ptosis, arched eyebrows, low set ears, ear fold abnormality, broad nasal bridge and round face) as well as frequently occurring clinical features including neurodevelopmental delay (93%), gastrointestinal (57%), musculoskeletal (57%) and immunological (43%) abnormalities. The variants reported in this study are evolutionary conserved and absent in the normal population. We observed that the CSNK2A1 gene is relatively intolerant to missense genetic changes, and most variants are within the protein kinase domain. All except one variant reported in this cohort are spatially located on the binding pocket of the holoenzyme. We further provide key recommendations on the management of Okur-Chung syndrome. To conclude, this is the second case series on Okur-Chung syndrome, and an in-depth review of the phenotypic features and genomic findings of the condition with suggestions on clinical management.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2BkRzu1
via IFTTT

CertaDose wins Johnson & Johnson Innovation Award For Advancing Safety in Healthcare

Company's color-coded pediatric syringe could significantly reduce critical dosing errors in children. DENVER — One of the most common mistakes made in emergency rooms is giving children the wrong dose of medicine. Emerging medical device start-up CertaDoseTM, Inc. was recognized by Johnson & Johnson Innovation LLC as having a potential solution for this problem and named the winner ...

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

FirstNet debuts ruthless preemption for first responders

The mission-critical feature allows responders to communicate in situations where networks could become congested

from EMS via xlomafota13 on Inoreader http://ift.tt/2j5y11U
via IFTTT

Low-Frequency Pulsed Current Versus Kilohertz-Frequency Alternating Current: A Scoping Literature Review

Publication date: Available online 14 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Marco Aurélio Vaz, Viviane Bortoluzzi Frasson
ObjectiveTo compare the effectiveness of low-frequency pulsed current versus kilohertz-frequency alternating current in terms of evoked-force, discomfort level, current intensity, and muscle fatigability, to discuss the physiological mechanisms of each Neuromuscular Electrical Stimulation type, and to determine if kilohertz-frequency alternating current is better than low-frequency pulsed current for clinical treatment.Data SourcesManuscripts were obtained from PUBMED, SCOPUS, CENTRAL, CINAHL and SPORTSDISCUS databases using the terms "Russian current" OR "Kilohertz current" OR "Alternating current" OR "Pulsed current" OR "Aussie current" AND torque OR discomfort OR fatigue OR "current intensity", and through citation tracking up to July 2017.Study SelectionTwo independent reviewers selected studies comparing the use of the two neuromuscular electrical stimulation currents. Studies describing maximal current intensity tolerated and the main effects of the two different current types on discomfort, muscle force and fatigability were independently reviewed.Data ExtractionData was systematized according to (1) the methodology, (2) electrical current characteristics, (3) the outcomes on discomfort level, evoked force, current intensity and muscle fatigability.Data SynthesisThe search revealed 15 manuscripts comparing the two current types. Kilohertz-frequency alternated current generated equal or less force, similar discomfort, similar current intensity for maximal tolerated neuromuscular electrical stimulation and more fatigue compared to low-frequency pulsed current. Similar submaximal levels of evoked force revealed higher discomfort and current intensity for kilohertz-frequency alternated current compared to low-frequency pulsed current.ConclusionsAvailable evidence does not support the idea that Kilohertz-frequency alternated current is better than low-frequency pulsed current for strength training and rehabilitation.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2o3WOZE
via IFTTT

Racial Differences in Weight Gain: a 5-year Longitudinal Study of Persons with Spinal Cord Injury

Publication date: Available online 14 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Huacong Wen, Yuying Chen, Yin He, C. Scott Bickel, Susan Robinson-Whelen, Allen W. Heinemann
ObjectiveTo investigate racial differences in body mass index (BMI) change over 5 years among people with spinal cord injury (SCI).DesignMulticenter longitudinal studySetting11 SCI Model Systems centers in the United StatesParticipants437 individuals (313 non-Hispanic white, 81 non-Hispanic black and 43 Hispanic), who incurred a SCI 1974 to 2010 and completed 2 follow-up assessments within 5 years between October 2006 and September 2015. Of these 335 men and 102 women, the average age was 41 years (range: 18-78 years), and duration of injury was 9 years (range: 1-35 years) at the start of the 5-year follow-up.InterventionNot applicable.Main Outcome MeasuresBMI (kg/m²)ResultsThe average BMI of 437 participants increased from 26.4±6.3 kg/m² to 27.0±6.4 kg/m² over 5 years (P=.002). The greatest increase was noted for Hispanics (2.0±5.7 kg/m², P=.02), followed by non-Hispanic whites (0.6±3.9 kg/m², P=.01) and non-Hispanic blacks (0.01±3.7 kg/m², P=1.00). The differences in BMI increase across racial groups were significant (P=.03) among those with severe injuries, those who were underweight or of normal weight at baseline, and those within 10 years of their injury. Such racial differences remained significant after taking into account of demographic and injury characteristics.ConclusionsOur study findings provide a foundation for future research to explore risk and protective factors that contribute to racial differences in weight gain after SCI, which help alert health professionals to a high-risk group for obesity prevention and management.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2CkhhfG
via IFTTT

Evaluation of Cognitive Behavioral Interventions and Psychoeducation Implemented by Rehabilitation Specialists to Treat Fear-Avoidance Beliefs in Patients with Low Back Pain: A Systematic Review

Publication date: Available online 14 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Shelby Baez, Matthew C. Hoch, Johanna M. Hoch
ObjectiveTo systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBT) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, sub-acute, and chronic low back pain.Data SourcesElectronic databases (CINAHL, PUBMED, PSYCHOLOGY AND BEHAVIOR SCIENCES COLLECTION, SPORTDISCUS, and PSYCH INFO) were searched from inception to September 2017.Study SelectionAssessment of methodological quality was completed utilizing the Physiotherapy Evidence Database (PEDro) scale. The Strength-of-Recommendation Taxonomy was used to evaluate the quality of evidence.Data ExtractionStudy sample, subject demographics, CBT and/or psychoeducation intervention details, data collection time points, outcome assessments, statistical analysis, results, and conclusions were extracted from each study. In addition, effect sizes were calculated.Data SynthesisFive high quality studies (PEDro >6) were included. All included studies evaluated fear-avoidance beliefs. Cognitive behavioral therapies and psychoeducation strategies designed to target patient-specific fears demonstrated clinically meaningful results, while psychoeducation methodologies were not as effective.ConclusionThere is inconsistent, patient-oriented evidence (grade B), to support the use of CBTs and/or psychoeducation strategies by rehabilitation specialists to treat fear-avoidance beliefs. Patient-centered and personalized CBTs were most effective to treat these psychosocial factors in patients with LBP when compared to a control treatment.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2Ck4JFg
via IFTTT

Preliminary psychometric evaluation of the Brachial Assessment Tool Part 2: Construct validity and Responsiveness

Publication date: Available online 14 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Bridget Hill, Gavin Williams, John Olver, Scott Ferris, Andrea Bialocerkowski
ObjectiveTo evaluate construct validity and responsiveness of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for people with traumatic Brachial Plexus Injury (BPI) and to compare it to the Disability of the Arm, Shoulder and Hand (DASH) and the Upper Extremity Functional Index (UEFI)DesignCross sectional studySettingOutpatient clinicsParticipantsAdults with confirmed traumatic BPIIntervention29 people (aged 20 – 69 years) with BPI completed the BrAT three times over an 18-month period together with sixteen DASH activity items and the UEFI. Evaluations were undertaken of construct validity, known groups validity, one-way repeated ANOVA and effect size.Main outcome measuresThe BrAT, DASH, UEFIResultsThe BrAT demonstrated a moderate to low correlation with the DASH activity items (< 0.7) and a large correlation with the UEFI (> 0.7). According to known groups validity only the BrAT was able to discriminate between people who stated they could use their hand versus those who were unable to use their hand to perform activities. All measures indicated a significant effect for time with the exception of BrAT subscale 1. The effect size was highest for the BrAT but lower than expected (BrAT 0.52 – 0.40. DASH 0.15. UEFI 0.36).ConclusionThese preliminary findings support the BrAT as a valid and responsive patient-reported outcome measure for adults with traumatic BPI. The BrAT activity items appear to be more targeted than the DASH or UEFI particularly for people with more severe BPI. The BrAT also appears to be measuring a different activity construct to the DASH and the UEFI. Further work is required to confirm these results with larger sample sizes.



from Rehabilitation via xlomafota13 on Inoreader http://ift.tt/2o3Wwlw
via IFTTT

Downward migration of radiocesium in an abandoned paddy soil after the Fukushima Dai-ichi Nuclear Power Plant accident

Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Junko Takahashi, Shokichi Wakabayashi, Kenji Tamura, Yuichi Onda
After the Fukushima Dai-ichi Nuclear Power Plant accident on March 2011, continuous monitoring of the detailed vertical distribution of radiocesium in soil is required to evaluate the fate of radiocesium and establish strategies for remediation and management of the contaminated land. It is especially important to investigate paddy soil because little knowledge has been accumulated for paddy soil and wetland rice is a major staple in Japan. Therefore, we monitored the vertical distribution of ¹³⁷Cs in abandoned paddy soil in a planned evacuation zone from June 2011 to March 2016. The decontamination works (i.e., 5 cm of surface soil removal and re-covering with uncontaminated soil) were conducted by the government in 2015. As a result of monitoring, the ¹³⁷Cs gradually migrated downward with time and the ¹³⁷Cs concentration in the 0–10 cm soil was almost homogenous in October 2014, although it was non-cultivated. The liner relationship was obtained between the median depth, which is the thickness of a soil layer containing half of the total ¹³⁷Cs inventory, and the time after the accident, indicating the migration rate was constant (1.3 cm y⁻¹) before the decontamination works. After the decontamination works, the ¹³⁷Cs concentration in the uppermost surface layer was reduced by 90%, however the total ¹³⁷Cs inventory was reduced by only 50–70%. It was shown that the efficiency of ¹³⁷Cs removal by the decontamination works decrease linearly over time in fields like the studied paddy, in which the homogenization of ¹³⁷Cs concentration occurred. Conversely, the downward migration of ¹³⁷Cs to subsurface layers deeper than 10 cm (i.e., plowpan layer) with low permeability rarely occurred. It is expected that these unique trends in distribution and migration of ¹³⁷Cs would be found in abandoned paddy soils with properties similar to the studied soil, sandy loam but poorly drained because of the low permeable plowpan layer, although further validation is necessary.

Graphical abstract

from Radiology via xlomafota13 on Inoreader http://ift.tt/2zcJDsC
via IFTTT

Selective effects of different fatigue protocols on the function of upper body muscles assessed through the force–velocity relationship

Abstract

Purpose

This study explored the feasibility of the force–velocity relationship (F–V) to detect the acute effects of different fatigue protocols on the selective changes of the maximal capacities of upper body muscles to produce force, velocity, and power.

Methods

After determining the bench press one-repetition maximum (1RM), participants' F–V relationships were assessed during the bench press throw exercise on five separate sessions after performing one of the following fatiguing protocols: 60%1RM failure, 60%1RM non-failure, 80%1RM failure, 80%1RM non-failure, and no-fatigue. In the non-failure protocols, participants performed half the maximum number of repetitions than in their respective failure protocols.

Results

The main findings revealed that (1) all F–V relationships were highly linear (median r = 0.997 and r = 0.982 for averaged across participants and individual data, respectively), (2) the fatiguing protocols were ranked based on the magnitude of power loss as follows: 60%1RM failure > 80%1RM failure > 60%1RM non-failure > 80%1RM non-failure, while (3) the assessed maximum force and velocity outputs showed a particularly prominent reduction in the protocols based on the lowest and highest levels of fatigue (i.e., 80%1RM non-failure and 60%1RM failure), respectively.

Conclusions

The results support the use of F–V to assess the effects of fatigue on the distinctive capacities of the muscles to produce force, velocity, and power output while performing multi-joint tasks, while the assessed maximum force and velocity capacities showed a particularly prominent reduction in the protocols based on the lowest and highest levels of fatigue (i.e., 80%1RM non-failure and 60%1RM failure), respectively.

from Physiology via xlomafota13 on Inoreader http://ift.tt/2BmMjpD
via IFTTT

Comparative Effectiveness of Infliximab Versus Adalimumab in Patients with Biologic-Naïve Crohn’s Disease

Abstract

Background

Direct head-to-head studies comparing the long-term outcomes of infliximab (IFX) to adalimumab (ADA) in Crohn's disease (CD) are sparse.

Aims

We compared the short-term and long-term efficacy and safety of IFX and ADA in CD.

Methods

We performed a single-center retrospective study including biologic-naïve adult patients with CD who were started on IFX or ADA at the McGill University Health Center. The primary end points were clinical response and remission at 12 months. Secondary end points included corticosteroid-free remission at 12 months, durable remission, and treatment failure with need for steroids, hospitalization or surgery. Safety was also assessed.

Results

Two hundred and twenty patients were included (143 IFX, 77 ADA). Patients on IFX had a higher prevalence of fistulizing or perianal disease and corticosteroid treatment at baseline. Rates of clinical remission and corticosteroid-free remission at 12 months were similar between both groups: 63.8 versus 76.3% (p = 0.139) and 54.1 versus 44.7% (p = 0.354), respectively, for IFX and ADA. Combination therapy led to significantly higher remission rates at 12 months compared to monotherapy for patients on IFX (81.2 vs. 52.1%, p = 0.008), but not for those on ADA. Higher rates of adverse events were reported with IFX compared to ADA (p = 0.006).

Conclusions

Our real-life experience in biologic-naïve CD patients demonstrated that patients started on IFX were more likely to have a harder-to-treat phenotype. Despite that, efficacy end points were similar between both groups. Clinical remission was higher in patients with combination therapy for IFX, but not for those on ADA. This warrants further investigation.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2ks9t3n
via IFTTT

What Performance Analysts Need to Know About Research Trends in Association Football (2012–2016): A Systematic Review

Abstract

Background

Evolving patterns of match analysis research need to be systematically reviewed regularly since this area of work is burgeoning rapidly and studies can offer new insights to performance analysts if theoretically and coherently organized.

Objective

The purpose of this paper was to conduct a systematic review of published articles on match analysis in adult male football, identify and organize common research topics, and synthesize the emerging patterns of work between 2012 and 2016, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Methods

The Web of Science database was searched for relevant published studies using the following keywords: 'football' and 'soccer', each one associated with the terms 'match analysis', 'performance analysis', 'notational analysis', 'game analysis', 'tactical analysis' and 'patterns of play'.

Results

Of 483 studies initially identified, 77 were fully reviewed and their outcome measures extracted and analyzed. Results showed that research mainly focused on (1) performance at set pieces, i.e. corner kicks, free kicks, penalty kicks; (2) collective system behaviours, captured by established variables such as team centroid (geometrical centre of a set of players) and team dispersion (quantification of how far players are apart), as well as tendencies for team communication (establishing networks based on passing sequences), sequential patterns (predicting future passing sequences), and group outcomes (relationships between match-related statistics and final match scores); and (3) activity profile of players, i.e. playing roles, effects of fatigue, substitutions during matches, and the effects of environmental constraints on performance, such as heat and altitude.

Conclusion

From the previous review, novel variables were identified that require new measurement techniques. It is evident that the complexity engendered during performance in competitive soccer requires an integrated approach that considers multiple aspects. A challenge for researchers is to align these new measures with the needs of the coaches through a more integrated relationship between coaches and researchers, to produce practical and usable information that improves player performance and coach activity.

from Sports Medicine via xlomafota13 on Inoreader http://ift.tt/2ADYui5
via IFTTT

The effect of emotionally valenced eye region images on visuocortical processing of surprised faces

Abstract

In this study, we presented pictorial representations of happy, neutral, and fearful expressions projected in the eye regions to determine whether the eye region alone is sufficient to produce a context effect. Participants were asked to judge the valence of surprised faces that had been preceded by a picture of an eye region. Behavioral results showed that affective ratings of surprised faces were context dependent. Prime-related ERPs with presentation of happy eyes elicited a larger P1 than those for neutral and fearful eyes, likely due to the recognition advantage provided by a happy expression. Target-related ERPs showed that surprised faces in the context of fearful and happy eyes elicited dramatically larger C1 than those in the neutral context, which reflected the modulation by predictions during the earliest stages of face processing. There were larger N170 with neutral and fearful eye contexts compared to the happy context, suggesting faces were being integrated with contextual threat information. The P3 component exhibited enhanced brain activity in response to faces preceded by happy and fearful eyes compared with neutral eyes, indicating motivated attention processing may be involved at this stage. Altogether, these results indicate for the first time that the influence of isolated eye regions on the perception of surprised faces involves preferential processing at the early stages and elaborate processing at the late stages. Moreover, higher cognitive processes such as predictions and attention can modulate face processing from the earliest stages in a top-down manner.

from Physiology via xlomafota13 on Inoreader http://ift.tt/2AFz1oP
via IFTTT

Transcriptome analysis of Δ mig1 Δ mig2 mutant reveals their roles in methanol catabolism, peroxisome biogenesis and autophagy in methylotrophic yeast Pichia pastoris

Abstract

Two catabolite repressor genes (MIG1 and MIG2) were previously identified in Pichia pastoris, and the derepression of alcohol oxidase (AOX) expression was realized in Δmig1 or Δmig1Δmig2 mutants grown in glycerol, but not in glucose. In this study, genome-wide RNA-seq analysis of Δmig1Δmig2 and the wild-type strain grown in glycerol revealed that the expression of numerous genes was greatly altered. Nearly 7% (357 genes) of approximately 5276 genes annotated in P. pastoris were significantly upregulated, with at least a two-fold differential expression in Δmig1Δmig2; the genes were mainly related to cell metabolism. Approximately 23% (1197 genes) were significantly downregulated; these were mainly correlated with the physiological characteristics of the cell. The methanol catabolism and peroxisome biogenesis pathways were remarkably enhanced, and the genes AOX1 and AOX2 were upregulated higher than 30-fold, which was consistent with the experimental results of AOX expression. The Mig proteins had a slight effect on autophagy when cells were grown in glycerol. The expression analysis of transcription factors showed that deletion of MIG1 and MIG2 significantly upregulated the binding of an essential transcription activator, Mit1p, with the AOX1 promoter, which suggested that Mig proteins might regulate the AOX1 promoter through the regulation of Mit1p. This work provides a reference for the further exploration of the methanol induction and catabolite repression mechanisms of AOX expression in methylotrophic yeasts.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2AWCDiS
via IFTTT

Selected microRNA-192 mutant indicates association with several function genes in bovine cells

Abstract

MicroRNAs are implicated in many cellular processes such as cell differentiation and development, tumorigenesis, and immune regulation. In this study, miR192 was detected using quantitative real-time polymerase chain reaction (qRT-PCR) when MDBK cells were exposed to Escherichia coli. Cells with malfunction of bta-miR-192 were established using transcription activator-like effector nuclease (TALEN) technology. Finally, bta-miR-192 mutant cells were screened for differentially expressed genes using RNA-sequencing (RNA-seq). The results showed that miR192 significantly decreased in cells exposed to E. coli F18ac and E. coli K88ac. The RNA-seq results showed that 1673 differentially expressed transcripts were identified; 890 genes were upregulated and 775 genes were downregulated. With the gene ontology enrichment analysis, 431 differentially expressed genes (DEGs) were classified into 937 gene ontology terms. The pathway enrichment analysis showed that 535 genes were involved in 254 pathway terms. Interestingly, most of these DEGs were associated with the pathways in cancers or infectious diseases. When the selected DEGs (n = 162) in these pathways were intersected with 120 differential transcripts, 11 DEGs were identified. Subsequently, several genes associated with regulation, cancers, or viral infections, such as LEF1, AXIN2, MX1, and FCGR2B, were identified among the DEGs using functional analysis. Furthermore, associations between bta-miR-192 and DEGs were detected by intersecting the bta-miR-192's target genes with the DEGs, indicating that three genes including CBL, DICER1 and TRERF1 were involved in this relationship. These findings provided useful guidance for investigating the role played by bta-miR-192 in cellular functionality in bovine cells.

from Genetics via xlomafota13 on Inoreader http://ift.tt/2C4yZTE
via IFTTT

Health Status and Experience of the Migrant Workers Returned from Spain to Colombia: A Qualitative Approach

Abstract

This study aims to understand the migratory experience and the employment, work and health conditions of the returned migrants from Spain to Colombia. A qualitative study was conducted by means of 23 semi-structured interviews with Colombian returned migrant workers. Qualitative narrative content analysis was performed using Atlas.Ti software. Main findings are represented by nine categories emerged from the participants' discourses: (1) impact of the economic crisis on work and employment conditions in Spain, (2) economic crisis and return, (3) characteristics of returnees, (4) perception of the returnees about Colombia, (5) the role of social support networks, (6) employment and working conditions in Colombia, (7) health and wellbeing, (8) future plans and expectations, (9) the experience of being immigrant. Adjustment difficulties in participants are evidenced by the return migration process and the conditions of the social, political and economic system in Colombia. Return migration represents the reconfiguration of personal and working lives of this population. This situation requires the development of global policies and strategies in public health to facilitate the adaptation of these people.

from Health via xlomafota13 on Inoreader http://ift.tt/2j1v16L
via IFTTT

Diabetes Self-Care Behaviors Among Marshallese Adults Living in the United States

Abstract

Marshallese experience high rates of type 2 diabetes. Proper management of diabetes requires multiple self-care behaviors, yet little is known about Marshallese's diabetes-related self-care behaviors. Survey data from 111 Marshallese adults with diabetes were used to examine relationships between self-care behaviors and socio-demographic characteristics. The most common self-care behavior was attending annual doctor visits, while the least common was maintaining a normal weight. Age group, education level, and having a regular doctor were significantly associated with engaging in self-care behaviors. Having a regular doctor had the most effect on performing self-care behaviors (p = 0.006); although, only 38.7% reported having a regular doctor. To minimize diabetes-related complications, efforts to improve self-care behaviors among the Marshallese should be developed. Alternatives to traditional healthcare providers, such as community health workers, may be a viable strategy with this population given only one-third reported having a regular doctor.

from Health via xlomafota13 on Inoreader http://ift.tt/2jTqaoS
via IFTTT

Skepticism Regarding Vaccine and Gluten-Free Food Safety Among Patients with Celiac Disease and Non-celiac Gluten Sensitivity

Abstract

Background

There has been a marked increase in the adoption of the gluten-free (GF) diet.

Aims

To query individuals with celiac disease (CD) and non-celiac gluten sensitivity (NCGS) on their beliefs toward the health effects of gluten, and safety of vaccines and GF food products.

Methods

We distributed a Web-based survey to individuals with CD and NCGS on a CD center e-mail list. We used univariate and multivariate analysis to compare responses of respondents with CD and NCGS.

Results

The overall response rate was 27% (NCGS n = 217, CD n = 1291). Subjects with NCGS were more likely than those with CD to disagree with the statement that "vaccines are safe for people with celiac disease" (NCGS 41.3% vs. CD 26.4% (p < 0.0001), and were more likely to decline vaccination when offered (30.9 vs. 24.2%, p = 0.007). After adjusting for age and gender, NCGS subjects were more likely than CD subjects to avoid genetically modified (GMO) foods (aOR 2.30; 95% CI 1.71–3.10), eat only organic products (aOR 2.87; 95% CI 2.04–4.03), believe that the FDA is an unreliable source of information (aOR 1.82, 95% CI 1.26–2.64), and believe a GF diet improves energy and concentration (aOR 2.52; 95% CI 1.86–3.43).

Conclusions

Subjects with NCGS were more likely than those with CD to have doubts about vaccine safety and believe in the value of non-GMO and organic foods. Our findings suggest that the lack of reliable information on gluten and its content in food and medications may reinforce beliefs that result in a detriment to public health.

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2jScavC
via IFTTT

Endoscopic Treatment of Biliary Leaks After Laparoscopic Cholecystectomy: Cut or Plug?

from Gastroenterology via xlomafota13 on Inoreader http://ift.tt/2j1RcJP
via IFTTT

Tissue specific expression and in-silico characterization of a putative Cysteine synthase gene from Lathyrus sativus L.

Publication date: Available online 13 December 2017
Source:Gene Expression Patterns
Author(s): Saikat Chakraborty, Joy Mitra, Milan Kumar Samanta, Narattam Sikdar, Jagannath Bhattacharyya, Anulina Manna, Subrata Pradhan, Anirban Chakraborty, Bikas Ranjan Pati
Grass pea (Lathyrus sativus L.) is a worldwide popular pulse crop especially for its protein rich seeds with least production cost. However, the use of the crop became controversial due to the presence of non-protein amino acid, β-N-oxalyl-L-α, β-diaminopropionic acid (β-ODAP) in its seed and leaf, which is known as the principle neurotoxin to cause neurolathyrism (a motor neurodegenerative disease of humans and animals) during prolonged consumption as regular diet. Till date, the knowledge on β-ODAP biosynthesis in Lathyrus sp. is limited only to a small part of the complex bio-chemical steps involved including a few known sulfur-containing enzymes (viz. cysteine synthase, ODAP synthase etc.). In Lathyrus sativus, biosynthesis of β-ODAP varies differentially in a tissue-specific manner as well as in response to several environmental stresses viz. zinc deficiency, iron over-exposure, moisture stress etc. In the present study, a novel cysteine synthase gene (LsCSase) from Lathyrus sativus L was identified and characterized through bioinformatics approaches. The bioinformatic analysis revealed that LsCSase showed maximum similarity with the O-acetyl serine (thiol) lyase of Medicago truncatula with respect to several significant sequence-specific conserved motifs (cysK, CBS like, ADH_zinc_N, PALP), sub-cellular localization (chloroplast or cytoplasm) etc., similar to other members of cysteine synthase protein family. Moreover, the tissue-specific regulation of the LsCSase as well as its transcriptional activation under certain previously reported stressed conditions (low Zn⁺²-high Fe⁺², PEG induced osmotic stress) were also documented through quantitative real-time PCR analyses, suggesting a possible link between the LsCSase gene activation and β-ODAP biosynthesis to manage external stresses in grass pea. This preliminary study offers a probable way towards the development of less toxic consumer-safe grass pea by down-regulation or deactivation of such gene/s (cysteine synthase) through genetic manipulations.



from Genetics via xlomafota13 on Inoreader http://ift.tt/2zbBUvd
via IFTTT

Does prophylactic ondansetron reduce norepinephrine consumption in patients undergoing cesarean section with spinal anesthesia?

Abstract

Purpose

Spinal anesthesia-induced hypotension (SAIH) during cesarean delivery is not rare and frequently leads to materno-fetal discrepancy and collapse. More recently, norepinephrine has been proposed for the prevention and treatment of SAIH with fewer tendencies to decrease heart rate and cardiac output. Ondansetron has been reported to reduce the incidence of SAIH in patients undergoing cesarean section. The aim of the present study was to assess the effect of prophylactic ondansetron on the incidence of SAIH, norepinephrine consumption, and adverse effects.

Methods

We recruited 108 parturients with uncomplicated pregnancies undergoing elective cesarean delivery under spinal anesthesia. The parturients were divided into two groups randomly. The first group (n = 54) received 8 mg ondansetron IV (group O) and the second group (n = 54) received the same volume (4 ml) of saline (group S), 5 min before spinal anesthesia. The incidence of hypotension, cumulative episodes of hypotension, total norepinephrine consumption, and adverse effects were recorded.

Results

There was no significant difference between the two groups in demographic data, parturient characteristics, and duration of surgery. No significant difference was found in the incidence of hypotension in the saline and ondansetron groups (p = 0.767). However, the cumulative episodes of hypotension and norepinephrine consumptions were significantly greater in group S than in group O (p = 0.009) (p = 0.009). There was also no significant difference in the incidence of adverse effects between the two groups.

Conclusion

Eight milligrams of intravenous ondansetron given 5 min before spinal anesthesia attenuated but did not prevent spinal anesthesia-induced hypotension in parturients undergoing elective cesarean delivery.

from Anaesthesiology via xlomafota13 on Inoreader http://ift.tt/2AF4ZBj
via IFTTT

Genetic Diversity of KPC-Producing Escherichia coli, Klebsiella oxytoca, Serratia marcescens, and Citrobacter freundii Isolates from Argentina

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


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/2C1SNHd
via IFTTT

The Development of the External Granular Layer of the Cerebellum and Neurobehavioral Correlates in Neonatal Rats Following Intrauterine and Postnatal Exposure to Caffeine

Journal of Caffeine Research , Vol. 0, No. 0.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/2o3bFDp
via IFTTT

Kinetic and Dynamic Description of Caffeine

Journal of Caffeine Research , Vol. 0, No. 0.


from Mary Ann Liebert, Inc. publishers via xlomafota13 on Inoreader http://ift.tt/2kqjb6x
via IFTTT