Τρίτη, 19 Νοεμβρίου 2019

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com, Telephone consultation 11855 int 1193,




Biomolecules, Vol. 9, Pages 748: What Happened to the Phycobilisome? Biomolecules, Vol. 9, Pages 748: What Happened to the Phycobilisome? Biomolecules doi: 10.3390/biom9110748 Authors: Beverley R. Green The phycobilisome (PBS) is the major light-harvesting complex of photosynthesis in cyanobacteria, red algae, and glaucophyte algae. In spite of the fact that it is very well structured to absorb light and transfer it efficiently to photosynthetic reaction centers, it has been completely lost in the green algae and plants. It is difficult to see how selection... Biomolecules 02:00 Mark above section as read  Medicina Medicina, Vol. 55, Pages 748: TZAP Mutation Leads to Poor Prognosis of Patients with Breast Cancer † Medicina, Vol. 55, Pages 748: TZAP Mutation Leads to Poor Prognosis of Patients with Breast Cancer † Medicina doi: 10.3390/medicina55110748 Authors: Yu-Ran Heo Moo-Hyun Lee Sun-Young Kwon Jihyoung Cho Jae-Ho Lee Background and Objectives: ZBTB48 is a telomere-associated factor that has been renamed as telomeric zinc finger-associated protein (TZAP). It binds preferentially to long telomeres, competing with telomeric repeat factors 1 and 2. Materials and Methods: We analyzed... Medicina Mon Nov 18, 2019 02:00 Medicina, Vol. 55, Pages 746: A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL®) Robot and Conventional Training, and Its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design Medicina, Vol. 55, Pages 746: A Consecutive 25-Week Program of Gait Training, Using the Alternating Hybrid Assistive Limb (HAL®) Robot and Conventional Training, and Its Effects on the Walking Ability of a Patient with Chronic Thoracic Spinal Cord Injury: A Single Case Reversal Design Medicina doi: 10.3390/medicina55110746 Authors: Kanazawa Yoshikawa Koseki Takeuchi Mutsuzaki Background and Objectives: In this study, we examined the effect of a consecutive 25-week gait... Medicina Mon Nov 18, 2019 02:00 Medicina, Vol. 55, Pages 747: Could the Combination of Two Non-Psychotropic Cannabinoids Counteract Neuroinflammation? Effectiveness of Cannabidiol Associated with Cannabigerol Medicina, Vol. 55, Pages 747: Could the Combination of Two Non-Psychotropic Cannabinoids Counteract Neuroinflammation? Effectiveness of Cannabidiol Associated with Cannabigerol Medicina doi: 10.3390/medicina55110747 Authors: Mammana Cavalli Gugliandolo Silvestro Pollastro Bramanti Mazzon Background and Objectives: Neuroinflammation is associated with many neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). In this study, we investigate... Medicina Mon Nov 18, 2019 02:00 Mark above section as read  Microorganisms Microorganisms, Vol. 7, Pages 576: Phylogeny of Anoxygenic Photosynthesis Based on Sequences of Photosynthetic Reaction Center Proteins and a Key Enzyme in Bacteriochlorophyll Biosynthesis, the Chlorophyllide Reductase Microorganisms, Vol. 7, Pages 576: Phylogeny of Anoxygenic Photosynthesis Based on Sequences of Photosynthetic Reaction Center Proteins and a Key Enzyme in Bacteriochlorophyll Biosynthesis, the Chlorophyllide ReductaseMicroorganisms doi: 10.3390/microorganisms7110576Authors:Johannes F. ImhoffTanja RahnSven KünzelSven C. NeulingerPhotosynthesis is a key process for the establishment and maintenance of life on earth, and it is manifested in several major lineages of the prokaryote tree of life. The... Microorganisms 02:00 Microorganisms, Vol. 7, Pages 575: A Role for COX20 in Tolerance to Oxidative Stress and Programmed Cell Death in Saccharomyces cerevisiae Microorganisms, Vol. 7, Pages 575: A Role for COX20 in Tolerance to Oxidative Stress and Programmed Cell Death in Saccharomyces cerevisiaeMicroorganisms doi: 10.3390/microorganisms7110575Authors: Keerthiraju Du Tucker GreethamIndustrial production of bioethanol from lignocellulosic materials (LCM′s) is reliant on a microorganism being tolerant to the stresses inherent to fermentation. Previous work has highlighted the importance of a cytochrome oxidase chaperone gene (COX20) in improving... Microorganisms Mon Nov 18, 2019 02:00 Microorganisms, Vol. 7, Pages 574: The Effects of Flavomycin and Colistin Sulfate Pre-Treatment on Ileal Bacterial Community Composition, the Response to Salmonella typhimurium and Host Gene Expression in Broiler Chickens Microorganisms, Vol. 7, Pages 574: The Effects of Flavomycin and Colistin Sulfate Pre-Treatment on Ileal Bacterial Community Composition, the Response to Salmonella typhimurium and Host Gene Expression in Broiler ChickensMicroorganisms doi: 10.3390/microorganisms7110574Authors: He Yang Dong Yan Zhang The composition of the bacterial community affects the intestinal health and growth performance of broiler chickens. The main purpose of this study was to explore the effects of flavomycin and colistin... Microorganisms Mon Nov 18, 2019 02:00 Microorganisms, Vol. 7, Pages 573: Kinematic Locomotion Changes in C57BL/6 Mice Infected with Toxoplasma Strain ME49 Microorganisms, Vol. 7, Pages 573: Kinematic Locomotion Changes in C57BL/6 Mice Infected with Toxoplasma Strain ME49Microorganisms doi: 10.3390/microorganisms7110573Authors:María de la Luz Galván-RamírezAngel Gustavo Salas-LaisSergio Horacio Dueñas-JiménezGerardo Mendizabal-RuizRamón Franco TopeteSofía Citlalli Berumen-SolísLaura Roció Rodríguez PérezKarina Franco TopeteChronic infection with the intracellular parasite Toxoplasma gondii produces an accumulation of cysts in the brain and muscle, causing... Microorganisms Mon Nov 18, 2019 02:00 Microorganisms, Vol. 7, Pages 572: The Type III Accessory Protein HrpE of Xanthomonas oryzae pv. oryzae Surpasses the Secretion Role, and Enhances Plant Resistance and Photosynthesis Microorganisms, Vol. 7, Pages 572: The Type III Accessory Protein HrpE of Xanthomonas oryzae pv. oryzae Surpasses the Secretion Role, and Enhances Plant Resistance and PhotosynthesisMicroorganisms doi: 10.3390/microorganisms7110572Authors:Taha Majid Mahmood SheikhLiyuan ZhangMuhammad ZubairAlvina HanifPing LiAyaz FarzandHaider AliMuhammad Saqib BilalYiqun HuXiaochen ChenCongfeng SongMeixiang ZhangHansong DongMany species of plant-pathogenic gram-negative bacteria deploy the type III (T3) secretion... Microorganisms Mon Nov 18, 2019 02:00 Mark above section as read  Molecules Molecules, Vol. 24, Pages 4190: A Survey of Molecular Imaging of Opioid Receptors Molecules, Vol. 24, Pages 4190: A Survey of Molecular Imaging of Opioid Receptors Molecules doi: 10.3390/molecules24224190 Authors: Paul Cumming János Marton Tuomas O. Lilius Dag Erlend Olberg Axel Rominger The discovery of endogenous peptide ligands for morphine binding sites occurred in parallel with the identification of three subclasses of opioid receptor (OR), traditionally designated as μ, δ, and κ, along with the more recently defined opioid-receptor-like... Molecules 02:00 Molecules, Vol. 24, Pages 4191: Synthesis and Antiproliferative Evaluation of Novel Hybrids of Dehydroabietic Acid Bearing 1,2,3-Triazole Moiety Molecules, Vol. 24, Pages 4191: Synthesis and Antiproliferative Evaluation of Novel Hybrids of Dehydroabietic Acid Bearing 1,2,3-Triazole Moiety Molecules doi: 10.3390/molecules24224191 Authors: Fang-Yao Li Lin Huang Qian Li Xiu Wang Xian-Li Ma Cai-Na Jiang Xiao-Qun Zhou Wen-Gui Duan Fu-Hou Lei To discover novel potent cytotoxic diterpenoids, a series of hybrids of dehydroabietic acid containing 1,2,3-triazole moiety were designed and synthesized. The target compounds... Molecules 02:00 Molecules, Vol. 24, Pages 4187: NAD Analogs in Aid of Chemical Biology and Medicinal Chemistry Molecules, Vol. 24, Pages 4187: NAD Analogs in Aid of Chemical Biology and Medicinal Chemistry Molecules doi: 10.3390/molecules24224187 Authors: Anais Depaix Joanna Kowalska Nicotinamide adenine dinucleotide (NAD) serves as an essential redox co-factor and mediator of multiple biological processes. Besides its well-established role in electron transfer reactions, NAD serves as a substrate for other biotransformations, which, at the molecular level, can be classified as protein post-translational... Molecules 02:00 Molecules, Vol. 24, Pages 4188: The Versatile Role of Matrix Metalloproteinase for the Diverse Results of Fibrosis Treatment Molecules, Vol. 24, Pages 4188: The Versatile Role of Matrix Metalloproteinase for the Diverse Results of Fibrosis Treatment Molecules doi: 10.3390/molecules24224188 Authors: Hong-Meng Chuang Yu-Shuan Chen Horng-Jyh Harn Fibrosis is a type of chronic organ failure, resulting in the excessive secretion of extracellular matrix (ECM). ECM protects wound tissue from infection and additional injury, and is gradually degraded during wound healing. For some unknown reasons, myofibroblasts... Molecules 02:00 Molecules, Vol. 24, Pages 4189: DNA-Templated Fluorescent Nanoclusters for Metal Ions Detection Molecules, Vol. 24, Pages 4189: DNA-Templated Fluorescent Nanoclusters for Metal Ions Detection Molecules doi: 10.3390/molecules24224189 Authors: Chunxia Song Jingyuan Xu Ying Chen Liangliang Zhang Ying Lu Zhihe Qing DNA-templated fluorescent nanoclusters (NCs) have attracted increasing research interest on account of their prominent features, such as DNA sequence-dependent fluorescence, easy functionalization, wide availability, water solubility, and excellent biocompatibility.... Molecules 02:00 Molecules, Vol. 24, Pages 4186: Determination of Urinary Hydroxyl PAHs Using Graphene Oxide@Diatomite Based Solid-Phase Extraction and High-Performance Liquid Chromatography Molecules, Vol. 24, Pages 4186: Determination of Urinary Hydroxyl PAHs Using Graphene Oxide@Diatomite Based Solid-Phase Extraction and High-Performance Liquid Chromatography Molecules doi: 10.3390/molecules24224186 Authors: Yuanman Liu Ziling Li Ziyang Zhang Tengwen Zhao Manman Wang Xuesheng Wang A diatomite supported graphene oxide composite (GO@Dt–NH2) was fabricated and explored as a solid-phase extraction adsorbent coupled with high performance liquid chromatography... Molecules 02:00 Molecules, Vol. 24, Pages 4185: Identifying Promiscuous Compounds with Activity against Different Target Classes Molecules, Vol. 24, Pages 4185: Identifying Promiscuous Compounds with Activity against Different Target Classes Molecules doi: 10.3390/molecules24224185 Authors: Christian Feldmann Filip Miljković Dimitar Yonchev Jürgen Bajorath Compounds with multitarget activity are of high interest for polypharmacological drug discovery. Such promiscuous compounds might be active against closely related target proteins from the same family or against distantly related or unrelated targets.... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4183: Optimization of Ultrasound-Assisted Extraction Conditions Followed by Solid Phase Extraction Fractionation from Orthosiphon stamineus Benth (Lamiace) Leaves for Antiproliferative Effect on Prostate Cancer Cells Molecules, Vol. 24, Pages 4183: Optimization of Ultrasound-Assisted Extraction Conditions Followed by Solid Phase Extraction Fractionation from Orthosiphon stamineus Benth (Lamiace) Leaves for Antiproliferative Effect on Prostate Cancer Cells Molecules doi: 10.3390/molecules24224183 Authors: Siti Hasyimah Suhaimi Rosnani Hasham Mohamad Khairul Hafiz Idris Hassan Fahmi Ismail Nor Hazwani Mohd Ariffin Fadzilah Adibah Abdul Majid Primarily, optimization of ultrasonic-assisted... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4184: Two-Step Azidoalkenylation of Terminal Alkenes Using Iodomethyl Sulfones Molecules, Vol. 24, Pages 4184: Two-Step Azidoalkenylation of Terminal Alkenes Using Iodomethyl Sulfones Molecules doi: 10.3390/molecules24224184 Authors: Millius Lapointe Renaud The radical azidoalkylation of alkenes that was initially developed with α-iodoesters and α-iodoketones was extended to other activated iodomethyl derivatives. By using iodomethyl aryl sulfones, the preparation of γ-azidosulfones was easily achieved. Facile conversion of... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4182: Current Trends on Seaweeds: Looking at Chemical Composition, Phytopharmacology, and Cosmetic Applications Molecules, Vol. 24, Pages 4182: Current Trends on Seaweeds: Looking at Chemical Composition, Phytopharmacology, and Cosmetic Applications Molecules doi: 10.3390/molecules24224182 Authors: Salehi Sharifi-Rad Seca Pinto Michalak Trincone Mishra Nigam Zam Martins Seaweeds have received huge interest in recent years given their promising potentialities. Their antioxidant, anti-inflammatory, antitumor, hypolipemic, and anticoagulant effects are among the... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4181: 8-Hydroxyquinoline Glycoconjugates: Modifications in the Linker Structure and Their Effect on the Cytotoxicity of the Obtained Compounds Molecules, Vol. 24, Pages 4181: 8-Hydroxyquinoline Glycoconjugates: Modifications in the Linker Structure and Their Effect on the Cytotoxicity of the Obtained Compounds Molecules doi: 10.3390/molecules24224181 Authors: Monika Krawczyk Gabriela Pastuch-Gawołek Aleksandra Pluta Karol Erfurt Adrian Domiński Piotr Kurcok Small molecule nitrogen heterocycles are very important structures, widely used in the design of potential pharmaceuticals. Particularly, derivatives of 8-hydroxyquinoline... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4180: Key-Marker Volatile Compounds in Aromatic Rice (Oryza sativa) Grains: An HS-SPME Extraction Method Combined with GC×GC-TOFMS Molecules, Vol. 24, Pages 4180: Key-Marker Volatile Compounds in Aromatic Rice (Oryza sativa) Grains: An HS-SPME Extraction Method Combined with GC×GC-TOFMS Molecules doi: 10.3390/molecules24224180 Authors: Widiastuti Setyaningsih Tomasz Majchrzak Tomasz Dymerski Jacek Namieśnik Miguel Palma The aroma of rice essentially contributes to the quality of rice grains. For some varieties, their aroma properties really drive consumer preferences. In this paper, using a dynamic headspace... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4176: Carnosic Acid Attenuates Cadmium Induced Nephrotoxicity by Inhibiting Oxidative Stress, Promoting Nrf2/HO-1 Signalling and Impairing TGF-β1/Smad/Collagen IV Signalling Molecules, Vol. 24, Pages 4176: Carnosic Acid Attenuates Cadmium Induced Nephrotoxicity by Inhibiting Oxidative Stress, Promoting Nrf2/HO-1 Signalling and Impairing TGF-β1/Smad/Collagen IV Signalling Molecules doi: 10.3390/molecules24224176 Authors: Sonjit Das Saikat Dewanjee Tarun K. Dua Swarnalata Joardar Pratik Chakraborty Shovonlal Bhowmick Achintya Saha Simanta Bhattacharjee Vincenzo De Feo Cadmium (Cd) imparts nephrotoxicity via triggering oxidative stress... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4177: Cu(II)-Catalyzed C-N Coupling of (Hetero)aryl Halides and N-Nucleophiles Promoted by α-Benzoin Oxime Molecules, Vol. 24, Pages 4177: Cu(II)-Catalyzed C-N Coupling of (Hetero)aryl Halides and N-Nucleophiles Promoted by α-Benzoin Oxime Molecules doi: 10.3390/molecules24224177 Authors: Chunling Yuan Lei Zhang Yingdai Zhao We first reported the new application of a translate metal chelating ligand α-benzoin oxime for improving Cu-catalyzed C-N coupling reactions. The system could catalyse coupling reactions of (hetero)aryl halides with a wide of nucleophiles (e.g., azoles,... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4178: A Newly Discovered Phenylethanoid Glycoside from Stevia rebaudiana Bertoni Affects Insulin Secretion in Rat INS-1 Islet β Cells Molecules, Vol. 24, Pages 4178: A Newly Discovered Phenylethanoid Glycoside from Stevia rebaudiana Bertoni Affects Insulin Secretion in Rat INS-1 Islet β Cells Molecules doi: 10.3390/molecules24224178 Authors: Jing He Nai-Liang Zhu Jing Kong Ping Peng Lin-Fu Li Xiao-Lu Wei Yan-Yan Jiang Yan-Ling Zhang Bao-Lin Bian Gai-Mei She Ren-Bing Shi The tea-like beverage Stevia rebaudiana Bertoni (Stevia) is popular in China because it reduces blood glucose and has... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4179: Curcumin Nicotinate Selectively Induces Cancer Cell Apoptosis and Cycle Arrest through a P53-Mediated Mechanism Molecules, Vol. 24, Pages 4179: Curcumin Nicotinate Selectively Induces Cancer Cell Apoptosis and Cycle Arrest through a P53-Mediated Mechanism Molecules doi: 10.3390/molecules24224179 Authors: Ying-chun He Lan He Ramina Khoshaba Fang-guo Lu Chuan Cai Fang-liang Zhou Duan-fang Liao Deliang Cao Curcumin is an anticancer agent, but adverse effects and low bioavailability are its main drawbacks, which drives efforts in chemical modifications of curcumin. This study... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4175: Anti-Acetylcholinesterase Activities of Mono-Herbal Extracts and Exhibited Synergistic Effects of the Phytoconstituents: A Biochemical and Computational Study Molecules, Vol. 24, Pages 4175: Anti-Acetylcholinesterase Activities of Mono-Herbal Extracts and Exhibited Synergistic Effects of the Phytoconstituents: A Biochemical and Computational Study Molecules doi: 10.3390/molecules24224175 Authors: Acharya Balkrishna Subarna Pokhrel Meenu Tomer Sudeep Verma Ajay Kumar Pradeep Nain Abhishek Gupta Anurag Varshney Alzheimer's disease (AD), a neurodegenerative disease, is the most common form of dementia. Inhibition... Molecules Mon Nov 18, 2019 02:00 Molecules, Vol. 24, Pages 4174: Experimental Data and Modelling of the Solubility of High-Carotenoid Paprika Extract in Supercritical Carbon Dioxide Molecules, Vol. 24, Pages 4174: Experimental Data and Modelling of the Solubility of High-Carotenoid Paprika Extract in Supercritical Carbon Dioxide Molecules doi: 10.3390/molecules24224174 Authors: Dorota Kostrzewa Agnieszka Dobrzyńska-Inger August Turczyn The studies of solubility of the paprika extract with a high concentration of carotenoids in carbon dioxide under the pressure of 20–50 MPa and at temperatures of 313.15–333.15 K were carried out using the... Molecules Mon Nov 18, 2019 02:00 Mark above section as read  Nanomaterials Nanomaterials, Vol. 9, Pages 1640: Direct Observation of Monolayer MoS2 Prepared by CVD Using In-Situ Differential Reflectance Spectroscopy Nanomaterials, Vol. 9, Pages 1640: Direct Observation of Monolayer MoS2 Prepared by CVD Using In-Situ Differential Reflectance Spectroscopy Nanomaterials doi: 10.3390/nano9111640 Authors: Yina Wang Lei Zhang Chenhui Su Hang Xiao Shanshan Lv Faye Zhang Qingmei Sui Lei Jia Mingshun Jiang The in-situ observation is of great significance to the study of the growth mechanism and controllability of two-dimensional transition metal dichalcogenides (TMDCs). Here, the... Nanomaterials 02:00 Nanomaterials, Vol. 9, Pages 1639: Influence of Annealing Temperature on Weak-Cavity Top-Emission Red Quantum Dot Light Emitting Diode Nanomaterials, Vol. 9, Pages 1639: Influence of Annealing Temperature on Weak-Cavity Top-Emission Red Quantum Dot Light Emitting Diode Nanomaterials doi: 10.3390/nano9111639 Authors: Chun-Yu Lee Ya-Pei Kuo Peng-Yu Chen Hsieh-Hsing Lu Ming Yi Lin In this report, we show that the annealing temperature in QDs/Mg-doped ZnO film plays a very important role in determining QLEDs performance. Measurements of capacitance and single carrier device reveal that the change of the device... Nanomaterials 02:00 Nanomaterials, Vol. 9, Pages 1637: DOPO-Functionalized Molybdenum Disulfide and its Impact on the Thermal Properties of Polyethylene and Poly(Lactic Acid) Composites Nanomaterials, Vol. 9, Pages 1637: DOPO-Functionalized Molybdenum Disulfide and its Impact on the Thermal Properties of Polyethylene and Poly(Lactic Acid) Composites Nanomaterials doi: 10.3390/nano9111637 Authors: Wenelska Homa Popovic Maslana Mijowska The fabrication of conventional or biodegradable polymers with improved thermal and fire-resistant properties is an important task for their successful application in various branches of the industry. In this work, few-layered... Nanomaterials Mon Nov 18, 2019 02:00 Nanomaterials, Vol. 9, Pages 1636: One-Step Hydrothermal Synthesis of P25 @ Few Layered MoS2 Nanosheets toward Enhanced Bi-catalytic Activities: Photocatalysis and Electrocatalysis Nanomaterials, Vol. 9, Pages 1636: One-Step Hydrothermal Synthesis of P25 @ Few Layered MoS2 Nanosheets toward Enhanced Bi-catalytic Activities: Photocatalysis and Electrocatalysis Nanomaterials doi: 10.3390/nano9111636 Authors: Zhou Zhang Wang Wang Xu Wang Liu P25 loaded few layered molybdenum disulfide (MoS2) nanosheets (P25@MoS2) are successfully synthesized through a facile one-step hydrothermal process. The bi-catalytic activities, i.e., photocatalytic and... Nanomaterials Mon Nov 18, 2019 02:00 Nanomaterials, Vol. 9, Pages 1638: V3S4 Nanosheets Anchored on N, S Co-Doped Graphene with Pseudocapacitive Effect for Fast and Durable Lithium Storage Nanomaterials, Vol. 9, Pages 1638: V3S4 Nanosheets Anchored on N, S Co-Doped Graphene with Pseudocapacitive Effect for Fast and Durable Lithium Storage Nanomaterials doi: 10.3390/nano9111638 Authors: Wu Miao Zhou Zhang Liu Guo Liu Construction of a suitable hybrid structure has been considered an important approach to address the defects of metal sulfide anode materials. V3S4 nanosheets anchored on an N, S co-coped graphene (VS/NSG) aerogel were successfully... Nanomaterials Mon Nov 18, 2019 02:00 Nanomaterials, Vol. 9, Pages 1635: Synthesis of Mn0.5Zn0.5SmxEuxFe1.8−2xO4 Nanoparticles via the Hydrothermal Approach Induced Anti-Cancer and Anti-Bacterial Activities Nanomaterials, Vol. 9, Pages 1635: Synthesis of Mn0.5Zn0.5SmxEuxFe1.8−2xO4 Nanoparticles via the Hydrothermal Approach Induced Anti-Cancer and Anti-Bacterial Activities Nanomaterials doi: 10.3390/nano9111635 Authors: Sultan Akhtar Suriya Rehman Munirah A. Almessiere Firdos Alam Khan Yassine Slimani Abdulhadi Baykal Manganese metallic nanoparticles are attractive materials for various biological and medical applications. In the present study, we synthesized unique Mn0.5Zn0.5SmxEuxFe1.8−2xO4... Nanomaterials Mon Nov 18, 2019 02:00 Nanomaterials, Vol. 9, Pages 1632: Reveal the Deformation Mechanism of (110) Silicon from Cryogenic Temperature to Elevated Temperature by Molecular Dynamics Simulation Nanomaterials, Vol. 9, Pages 1632: Reveal the Deformation Mechanism of (110) Silicon from Cryogenic Temperature to Elevated Temperature by Molecular Dynamics Simulation Nanomaterials doi: 10.3390/nano9111632 Authors: Jing Han Yuanming Song Wei Tang Cong Wang Liang Fang Hua Zhu Jiyun Zhao Jiapeng Sun Silicon undergoes a brittle-to-ductile transition as its characteristic dimension reduces from macroscale to nanoscale. The thorough understanding of the plastic deformation... Nanomaterials Mon Nov 18, 2019 02:00 Mark above section as read  Nutrients Nutrients, Vol. 11, Pages 2825: Consumption of Meat and Dairy Products Is Not Associated with the Risk for Rheumatoid Arthritis among Women: A Population-Based Cohort Study Nutrients, Vol. 11, Pages 2825: Consumption of Meat and Dairy Products Is Not Associated with the Risk for Rheumatoid Arthritis among Women: A Population-Based Cohort Study Nutrients doi: 10.3390/nu11112825 Authors: Björn Sundström Lotta Ljung Daniela Di Giuseppe Diet has gained attention as a risk factor for the development of rheumatoid arthritis (RA), especially with regards to food of animal origin, such as meat and dairy products. By using data from national patient registers... Nutrients 02:00 Nutrients, Vol. 11, Pages 2826: Impact of Vitamin D on Physical Efficiency and Exercise Performance—A Review Nutrients, Vol. 11, Pages 2826: Impact of Vitamin D on Physical Efficiency and Exercise Performance—A Review Nutrients doi: 10.3390/nu11112826 Authors: Michał Wiciński Dawid Adamkiewicz Monika Adamkiewicz Maciej Śniegocki Marta Podhorecka Paweł Szychta Bartosz Malinowski Vitamin D deficiency amongst athletes and the general population seems to be a prominent problem. The most recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship... Nutrients 02:00 Nutrients, Vol. 11, Pages 2824: Exercise Mitigates the Loss of Muscle Mass by Attenuating the Activation of Autophagy during Severe Energy Deficit Nutrients, Vol. 11, Pages 2824: Exercise Mitigates the Loss of Muscle Mass by Attenuating the Activation of Autophagy during Severe Energy Deficit Nutrients doi: 10.3390/nu11112824 Authors: Marcos Martin-Rincon Alberto Pérez-López David Morales-Alamo Ismael Perez-Suarez Pedro de Pablos-Velasco Mario Perez-Valera Sergio Perez-Regalado Miriam Martinez-Canton Miriam Gelabert-Rebato Julian William Juan-Habib Hans-Christer Holmberg Jose A L Calbet The loss... Nutrients 02:00 Nutrients, Vol. 11, Pages 2823: Dietary Trace Minerals Nutrients, Vol. 11, Pages 2823: Dietary Trace Minerals Nutrients doi: 10.3390/nu11112823 Authors: Elad Tako Dietary trace minerals are pivotal and hold a key role in numerous metabolic processes. Trace mineral deficiencies (except for iodine, iron, and zinc) do not often develop spontaneously in adults on ordinary diets; infants are more vulnerable because their growth is rapid and intake varies. Trace mineral imbalances can result from hereditary disorders (e.g., hemochromatosis, Wilson... Nutrients 02:00 Nutrients, Vol. 11, Pages 2821: Plasma versus Erythrocyte Vitamin E in Renal Transplant Recipients, and Duality of Tocopherol Species Nutrients, Vol. 11, Pages 2821: Plasma versus Erythrocyte Vitamin E in Renal Transplant Recipients, and Duality of Tocopherol Species Nutrients doi: 10.3390/nu11112821 Authors: Camilo G. Sotomayor Ramón Rodrigo António W. Gomes-Neto Juan Guillermo Gormaz Robert A. Pol Isidor Minović Manfred L. Eggersdorfer Michel Vos Ineke J. Riphagen Martin H. de Borst Ilja M. Nolte Stefan P. Berger Gerjan J. Navis Stephan J. L. Bakker Redox imbalance is an adverse... Nutrients 02:00 Nutrients, Vol. 11, Pages 2822: Temporal Trends in Maternal Food Intake Frequencies and Associations with Gestational Diabetes: The Cambridge Baby Growth Study Nutrients, Vol. 11, Pages 2822: Temporal Trends in Maternal Food Intake Frequencies and Associations with Gestational Diabetes: The Cambridge Baby Growth Study Nutrients doi: 10.3390/nu11112822 Authors: Clive Petry Ken Ong Ieuan Hughes Carlo Acerini David Dunger Previous studies have suggested that in the first decade of this century the incidence of gestational diabetes (GDM) in pregnancy rose worldwide. In the Cambridge Baby Growth Study cohort we observed that this temporal... Nutrients 02:00 Nutrients, Vol. 11, Pages 2820: Cholesterol Disturbances and the Role of Proper Nutrition in CKD Patients Nutrients, Vol. 11, Pages 2820: Cholesterol Disturbances and the Role of Proper Nutrition in CKD Patients Nutrients doi: 10.3390/nu11112820 Authors: Anna Gluba-Brzozka Beata Franczyk Jacek Rysz Chronic kidney disease (CKD) is a widespread disease with increasing prevalence in the modern society. Lipid disturbances are common in this group of patients. In most patients with CKD atherogenic dyslipidemia is observed. Dyslipidemia in patients with renal diseases increases the risk... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2819: Lactobacillus plantarum P2R3FA Isolated from Traditional Cereal-Based Fermented Food Increase Folate Status in Deficient Rats Nutrients, Vol. 11, Pages 2819: Lactobacillus plantarum P2R3FA Isolated from Traditional Cereal-Based Fermented Food Increase Folate Status in Deficient Rats Nutrients doi: 10.3390/nu11112819 Authors: Aynadis Tamene Kaleab Baye Susanna Kariluoto Minnamari Edelmann Fabrice Bationo Nicolas Leconte Christèle Humblot Folate deficiencies are widespread around the world. Promoting consumption of folate-rich foods could be a sustainable option to alleviate this problem. However,... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2818: Enhanced Triacylglycerol Content and Gene Expression for Triacylglycerol Metabolism, Acyl-Ceramide Synthesis, and Corneocyte Lipid Formation in the Epidermis of Borage Oil Fed Guinea Pigs Nutrients, Vol. 11, Pages 2818: Enhanced Triacylglycerol Content and Gene Expression for Triacylglycerol Metabolism, Acyl-Ceramide Synthesis, and Corneocyte Lipid Formation in the Epidermis of Borage Oil Fed Guinea Pigs Nutrients doi: 10.3390/nu11112818 Authors: Ju-Young Lee Kwang-Hyeon Liu Yunhi Cho Kun-Pyo Kim Triacylglycerol (TAG) metabolism is related to the acyl-ceramide (Cer) synthesis and corneocyte lipid envelope (CLE) formation involved in maintaining the epidermal... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2816: The Effect of Various Doses of Phenylalanine Supplementation on Blood Phenylalanine and Tyrosine Concentrations in Tyrosinemia Type 1 Patients Nutrients, Vol. 11, Pages 2816: The Effect of Various Doses of Phenylalanine Supplementation on Blood Phenylalanine and Tyrosine Concentrations in Tyrosinemia Type 1 Patients Nutrients doi: 10.3390/nu11112816 Authors: Willem G. van Ginkel Hannah E. van Reemst Nienke S. Kienstra Anne Daly Iris L. Rodenburg Anita MacDonald Johannes G.M. Burgerhof Pim de Blaauw Jennifer van de Krogt Saikat Santra M. Rebecca Heiner-Fokkema Francjan J. van Spronsen Tyrosinemia... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2813: Rural–Urban Differences in Dietary Behavior and Obesity: Results of the Riskesdas Study in 10–18-Year-Old Indonesian Children and Adolescents Nutrients, Vol. 11, Pages 2813: Rural–Urban Differences in Dietary Behavior and Obesity: Results of the Riskesdas Study in 10–18-Year-Old Indonesian Children and Adolescents Nutrients doi: 10.3390/nu11112813 Authors: Esti Nurwanti Hamam Hadi Jung-Su Chang Jane C.-J. Chao Bunga Astria Paramashanti Joel Gittelsohn Chyi-Huey Bai Obesity has become a significant problem for developing countries, including Indonesia. High duration of sedentary activity and high intake of... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2815: Vitamin B12 Status Upon Short-Term Intervention with a Vegan Diet—A Randomized Controlled Trial in Healthy Participants Nutrients, Vol. 11, Pages 2815: Vitamin B12 Status Upon Short-Term Intervention with a Vegan Diet—A Randomized Controlled Trial in Healthy Participants Nutrients doi: 10.3390/nu11112815 Authors: Ann-Kathrin Lederer Luciana Hannibal Manuel Hettich Sidney Behringer Ute Spiekerkoetter Carmen Steinborn Carsten Gründemann Amy Marisa Zimmermann-Klemd Alexander Müller Thomas Simmet Michael Schmiech Andrea Maul-Pavicic Yvonne Samstag Roman Huber Vegans... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2814: Are There Adverse Events after the Use of Sexual Enhancement Nutrition Supplements? A Nationwide Online Survey from Japan Nutrients, Vol. 11, Pages 2814: Are There Adverse Events after the Use of Sexual Enhancement Nutrition Supplements? A Nationwide Online Survey from Japan Nutrients doi: 10.3390/nu11112814 Authors: Chiharu Nishijima Etsuko Kobayashi Yoko Sato Tsuyoshi Chiba Dozens of safety alerts for sexual enhancement and weight loss dietary supplements have been launched from the government not only in Japan but also overseas. However, adverse events have been reported only for the use of... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2812: Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions Nutrients, Vol. 11, Pages 2812: Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions Nutrients doi: 10.3390/nu11112812 Authors: Maria Vittoria Ristori Andrea Quagliariello Sofia Reddel Gianluca Ianiro Stefano Vicari Antonio Gasbarrini Lorenza Putignani Autism spectrum disorder (ASD) is a complex behavioral syndrome that is characterized by speech and language disorders, intellectual impairment, learning and motor dysfunctions.... Nutrients Mon Nov 18, 2019 02:00 Nutrients, Vol. 11, Pages 2817: Butyric Acid and Leucine Induce α-Defensin Secretion from Small Intestinal Paneth Cells Nutrients, Vol. 11, Pages 2817: Butyric Acid and Leucine Induce α-Defensin Secretion from Small Intestinal Paneth Cells Nutrients doi: 10.3390/nu11112817 Authors: Akiko Takakuwa Kiminori Nakamura Mani Kikuchi Rina Sugimoto Shuya Ohira Yuki Yokoi Tokiyoshi Ayabe The intestine not only plays a role in fundamental processes in digestion and nutrient absorption, but it also has a role in eliminating ingested pathogenic bacteria and viruses. Paneth cells, which reside at... Nutrients Mon Nov 18, 2019 02:00 Mark above section as read  Pathogens Pathogens, Vol. 8, Pages 243: Aggregatibacter Actinomycetemcomitans: Clinical Significance of a Pathobiont Subjected to Ample Changes in Classification and Nomenclature Pathogens, Vol. 8, Pages 243: Aggregatibacter Actinomycetemcomitans: Clinical Significance of a Pathobiont Subjected to Ample Changes in Classification and Nomenclature Pathogens doi: 10.3390/pathogens8040243 Authors: Nørskov-Lauritsen Claesson Birkeholm Jensen Åberg Haubek Aggregatibacter actinomycetemcomitans is a Gram-negative bacterium that is part of the oral microbiota. The aggregative nature of this pathogen or pathobiont is crucial to its involvement in human... Pathogens Mon Nov 18, 2019 02:00 Pathogens, Vol. 8, Pages 242: Com1 as a Promising Protein for the Differential Diagnosis of the Two Forms of Q Fever Pathogens, Vol. 8, Pages 242: Com1 as a Promising Protein for the Differential Diagnosis of the Two Forms of Q Fever Pathogens doi: 10.3390/pathogens8040242 Authors: Vranakis Mathioudaki Kokkini Psaroulaki Coxiella burnetii is the causative agent of acute and chronic Q fever in humans. Although the isolates studied so far showed a difference in virulence potential between those causing the two forms of the disease, implying a difference in their proteomic profile, the methods... Pathogens Mon Nov 18, 2019 02:00 Mark above section as read  Plants Plants, Vol. 8, Pages 521: Responses of Rice Growth to Day and Night Temperature and Relative Air Humidity—Dry Matter, Leaf Area, and Partitioning Plants, Vol. 8, Pages 521: Responses of Rice Growth to Day and Night Temperature and Relative Air Humidity—Dry Matter, Leaf Area, and Partitioning Plants doi: 10.3390/plants8110521 Authors: Stuerz Asch Asymmetric changes of day and night temperature have already been observed because of Climate Change. However, knowledge on environmental conditions either during day or night serving as trigger for growth processes is scarce. In this study, one rice (Oryza sativa) variety (IR64)... Plants Mon Nov 18, 2019 02:00 Plants, Vol. 8, Pages 520: Cunninghamia lanceolata PSK Peptide Hormone Genes Promote Primary Root Growth and Adventitious Root Formation Plants, Vol. 8, Pages 520: Cunninghamia lanceolata PSK Peptide Hormone Genes Promote Primary Root Growth and Adventitious Root Formation Plants doi: 10.3390/plants8110520 Authors: Hua Wu Renhua Zheng Zhaodong Hao Yan Meng Yuhao Weng Xiaohong Zhou Liming Zhu Xiangyang Hu Guibin Wang Jisen Shi Jinhui Chen Phytosulfokine-α (PSK-α) is a newly discovered short peptide that acts as a phytohormone in various plants. Previous studies have shown... Plants Mon Nov 18, 2019 02:00 Mark above section as read  Religions Religions, Vol. 10, Pages 636: The Anuvrat Movement: A Case Study of Jain-inspired Ethical and Eco-conscious Living Religions, Vol. 10, Pages 636: The Anuvrat Movement: A Case Study of Jain-inspired Ethical and Eco-conscious Living Religions doi: 10.3390/rel10110636 Authors: Michael Reading From proclaiming the equality of all life forms to the stringent emphasis placed upon nonviolent behavior (ahimsa), and once more to the pronounced intention for limiting one's possessions (aparigraha), Jainism has often been pointed to for its admirably ecofriendly example. Incorporating some of this... Religions Mon Nov 18, 2019 02:00 Religions, Vol. 10, Pages 635: French Salafists' Economic Ethics: Between Election and New Forms of Politicization Religions, Vol. 10, Pages 635: French Salafists' Economic Ethics: Between Election and New Forms of Politicization Religions doi: 10.3390/rel10110635 Authors: Mohamed-Ali Adraoui This article sheds light on the way in which activities such as the production and consumption of wealth are conceptualized, interpreted and put into practice within quietist Salafist communities in France. Unlike their jihadi and politicized counterparts, quietist Salafis in lands where Islam is the minority... Religions Mon Nov 18, 2019 02:00 Mark above section as read  Robotics Robotics, Vol. 8, Pages 97: A Pedestrian Avoidance Method Considering Personal Space for a Guide Robot Robotics, Vol. 8, Pages 97: A Pedestrian Avoidance Method Considering Personal Space for a Guide Robot Robotics doi: 10.3390/robotics8040097 Authors: Yutaka Hiroi Akinori Ito Many methods have been proposed for avoiding obstacles in robotic systems. However, a robotic system that moves without colliding with obstacles and people, while still being mentally safe to the persons nearby, has not yet been realized. In this paper, we describe the development of a method for a mobile robot... Robotics Mon Nov 18, 2019 02:00 Mark above section as read  Sports Sports, Vol. 7, Pages 240: Exploring Children's Physical Activity Behaviours According to Location: A Mixed-Methods Case Study Sports, Vol. 7, Pages 240: Exploring Children's Physical Activity Behaviours According to Location: A Mixed-Methods Case Study Sports doi: 10.3390/sports7110240 Authors: Irfan Khawaja Lorayne Woodfield Peter Collins Adam Benkwitz Alan Nevill The school environment is ideally placed to facilitate physical activity (PA) with numerous windows of opportunity from break and lunch times, to lesson times and extracurricular clubs. However, little is known about how children interact... Sports Mon Nov 18, 2019 02:00 Sports, Vol. 7, Pages 239: Vitamin D Status Differs by Sex, Sport-Season, and Skin Pigmentation among Elite Collegiate Basketball Players Sports, Vol. 7, Pages 239: Vitamin D Status Differs by Sex, Sport-Season, and Skin Pigmentation among Elite Collegiate Basketball Players Sports doi: 10.3390/sports7110239 Authors: Jennifer B. Fields Daniel C. Payne Sina Gallo Deanna R. Busteed Margaret T. Jones Vitamin D plays a key role in bone health, musculoskeletal function, and sport performance. Collegiate athletes competing in indoor sports may be at greater risk of vitamin D deficiency due to limited outdoor time.... Sports Mon Nov 18, 2019 02:00 Mark above section as read  Toxins Toxins, Vol. 11, Pages 674: A Novel Adsorbent Albite Modified with Cetylpyridinium Chloride for Efficient Removal of Zearalenone Toxins, Vol. 11, Pages 674: A Novel Adsorbent Albite Modified with Cetylpyridinium Chloride for Efficient Removal of Zearalenone Toxins doi: 10.3390/toxins11110674 Authors: Zhang Zhang Wang Dong Cheng Xu Shan Zearalenone (ZEN) is a non-steroidal estrogenic mycotoxin and constitutes a potential health threat to humans and livestock. This study aimed to explore the potential of albite modified by the cationic surfactant cetylpyridinium chloride (CPC) as ZEN adsorbent.... Toxins Mon Nov 18, 2019 02:00 Toxins, Vol. 11, Pages 673: Missiles of Mass Disruption: Composition and Glandular Origin of Venom Used as a Projectile Defensive Weapon by the Assassin Bug Platymeris rhadamanthus Toxins, Vol. 11, Pages 673: Missiles of Mass Disruption: Composition and Glandular Origin of Venom Used as a Projectile Defensive Weapon by the Assassin Bug Platymeris rhadamanthus Toxins doi: 10.3390/toxins11110673 Authors: Walker Robinson Undheim Jin Han Fry Vetter King Assassin bugs (Reduviidae) produce venoms that are insecticidal, and which induce pain in predators, but the composition and function of their individual venom components is poorly understood.... Toxins Mon Nov 18, 2019 02:00 Toxins, Vol. 11, Pages 672: Cloning and Immunosuppressive Properties of an Acyl-Activating Enzyme from the Venom Apparatus of Tetrastichus brontispae (Hymenoptera: Eulophidae) Toxins, Vol. 11, Pages 672: Cloning and Immunosuppressive Properties of an Acyl-Activating Enzyme from the Venom Apparatus of Tetrastichus brontispae (Hymenoptera: Eulophidae) Toxins doi: 10.3390/toxins11110672 Authors: Xiao-Mei Zhang Hua-Jian Zhang Min Liu Bin Liu Xia-Fang Zhang Cheng-Jun Ma Ting-Ting Fu You-Ming Hou Bao-Zhen Tang Venom injected into the host plays vital roles in facilitating successful parasitization and development for parasitoid wasps, especially... Toxins Mon Nov 18, 2019 02:00 Mark above section as read  Vaccines Vaccines, Vol. 7, Pages 188: Trends in Socioeconomic Inequalities in Full Vaccination Coverage among Vietnamese Children aged 12–23 Months, 2000–2014: Evidence for Mitigating Disparities in Vaccination Vaccines, Vol. 7, Pages 188: Trends in Socioeconomic Inequalities in Full Vaccination Coverage among Vietnamese Children aged 12–23 Months, 2000–2014: Evidence for Mitigating Disparities in Vaccination Vaccines doi: 10.3390/vaccines7040188 Authors: Vo Huynh Anh Do Doan Nguyen Nguyen Van There has been no report on the situation of socioeconomic inequalities in the full vaccination coverage among Vietnamese children. This study aims to assess the trends and changes... Vaccines Mon Nov 18, 2019 02:00 Mark above section as read  Viruses Viruses, Vol. 11, Pages 1077: HBV Infection in HIV-Driven Immune Suppression Viruses, Vol. 11, Pages 1077: HBV Infection in HIV-Driven Immune Suppression Viruses doi: 10.3390/v11111077 Authors: Loredana Sarmati Vincenzo Malagnino Worldwide, approximately 10% of all human immunodeficiency virus (HIV)-infected people are also chronically coinfected with hepatitis B virus (HBV). HBV infection has a poor prognosis in HIV-positive people and has been documented by an increased risk of developing chronic HBV infection (CHB), progression to liver fibrosis and end-stage... Viruses 02:00 Viruses, Vol. 11, Pages 1076: Review on Outbreak Dynamics, the Endemic Serotypes, and Diversified Topotypic Profiles of Foot and Mouth Disease Virus Isolates in Ethiopia from 2008 to 2018 Viruses, Vol. 11, Pages 1076: Review on Outbreak Dynamics, the Endemic Serotypes, and Diversified Topotypic Profiles of Foot and Mouth Disease Virus Isolates in Ethiopia from 2008 to 2018 Viruses doi: 10.3390/v11111076 Authors: Ashenafi Kiros Wubshet Junfei Dai Qian Li Jie Zhang Foot and mouth disease (FMD) endemicity in Ethiopia's livestock remains an ongoing cause for economic concern, with new topotypes still arising even in previously unaffected areas. FMD outbreaks... Viruses Mon Nov 18, 2019 02:00 Viruses, Vol. 11, Pages 1075: Molecular Detection and Characterization of the First Cowpox Virus Isolate Derived from a Bank Vole Viruses, Vol. 11, Pages 1075: Molecular Detection and Characterization of the First Cowpox Virus Isolate Derived from a Bank Vole Viruses doi: 10.3390/v11111075 Authors: Kathrin Jeske Saskia Weber Florian Pfaff Christian Imholt Jens Jacob Martin Beer Rainer G. Ulrich Donata Hoffmann Cowpox virus (CPXV) is a zoonotic orthopoxvirus (OPV) that infects a wide range of mammals. CPXV-specific DNA and antibodies were detected in different vole species, such as common voles... Viruses Mon Nov 18, 2019 02:00 Viruses, Vol. 11, Pages 1074: Characterization and Pathogenicity of the Porcine Deltacoronavirus Isolated in Southwest China Viruses, Vol. 11, Pages 1074: Characterization and Pathogenicity of the Porcine Deltacoronavirus Isolated in Southwest China Viruses doi: 10.3390/v11111074 Authors: Yujia Zhao Huan Qu Jingfei Hu Jiayu Fu Rui Chen Cheng Li Sanjie Cao Yiping Wen Rui Wu Qin Zhao Qigui Yan Xintian Wen Xiaobo Huang Porcine deltacoronavirus (PDCoV) is a newly emerging enteric pathogen in swine that causes diarrhea in neonatal piglets and creates an additional economic burden... Viruses Mon Nov 18, 2019 02:00 Viruses, Vol. 11, Pages 1073: Towards Understanding KSHV Fusion and Entry Viruses, Vol. 11, Pages 1073: Towards Understanding KSHV Fusion and Entry Viruses doi: 10.3390/v11111073 Authors: Stephen J. Dollery How viruses enter cells is of critical importance to pathogenesis in the host and for treatment strategies. Over the last several years, the herpesvirus field has made numerous and thoroughly fascinating discoveries about the entry of alpha-, beta-, and gamma-herpesviruses, giving rise to knowledge of entry at the amino acid level and the realization that,... Viruses Mon Nov 18, 2019 02:00 Mark above section as read  Vision Vision, Vol. 3, Pages 63: Hughes's Reverspectives: Radical Uses of Linear Perspective on Non-Coplanar Surfaces Vision, Vol. 3, Pages 63: Hughes's Reverspectives: Radical Uses of Linear Perspective on Non-Coplanar Surfaces Vision doi: 10.3390/vision3040063 Authors: Thomas V. Papathomas Patrick Hughes Two major uses of linear perspective are in planar paintings—the flat canvas is incongruent with the painted 3-D scene—and in forced perspectives, such as theater stages that are concave truncated pyramids, where the physical geometry and the depicted scene are congruent. Patrick... Vision Mon Nov 18, 2019 02:00 Mark above section as read  Water Water, Vol. 11, Pages 2418: Characteristics of Water Isotopes and Water Source Identification During the Wet Season in Naqu River Basin, Qinghai-Tibet Plateau Water, Vol. 11, Pages 2418: Characteristics of Water Isotopes and Water Source Identification During the Wet Season in Naqu River Basin, Qinghai-Tibet Plateau Water doi: 10.3390/w11112418 Authors: Xi Chen Guoli Wang Fuqiang Wang Denghua Yan Heng Zhao Climate change is affecting the discharge of headstreams from mountainous areas on the Qinghai–Tibet Plateau. To constrain future changes in discharge, it is important to understand the present-day formation mechanism and components... Water Mon Nov 18, 2019 02:00 Water, Vol. 11, Pages 2417: Parameter Uncertainty of a Snowmelt Runoff Model and Its Impact on Future Projections of Snowmelt Runoff in a Data-Scarce Deglaciating River Basin Water, Vol. 11, Pages 2417: Parameter Uncertainty of a Snowmelt Runoff Model and Its Impact on Future Projections of Snowmelt Runoff in a Data-Scarce Deglaciating River Basin Water doi: 10.3390/w11112417 Authors: Yiheng Xiang Lu Li Jie Chen Chong-Yu Xu Jun Xia Hua Chen Jie Liu The impacts of climate change on water resources in snow- and glacier-dominated basins are of great importance for water resource management. The Snowmelt Runoff Model (SRM) was developed to simulate... Water Mon Nov 18, 2019 02:00 Water, Vol. 11, Pages 2416: Does Crop Rotation Enhance Groundwater Health? A Review of the Winter Wheat Fallow Policy in the North China Plain Water, Vol. 11, Pages 2416: Does Crop Rotation Enhance Groundwater Health? A Review of the Winter Wheat Fallow Policy in the North China Plain Water doi: 10.3390/w11112416 Authors: Ming Lei Yuqian Zhang Yuxuan Dang Xiangbin Kong Jingtao Yao Agricultural water management is a vital component of realizing the United Nation's Sustainable Development Goals because of water shortages worldwide leading to a severe threat to ecological environments and global food security.... Water Mon Nov 18, 2019 02:00 Mark above section as read
Biomolecules, Vol. 9, Pages 748: What Happened to the Phycobilisome?Biomolecules, Vol. 9, Pages 748: What Happened to the Phycobilisome? Biomolecules doi: 10.3390/biom9110748 Authors: Beverley R. Green The phycobilisome (PBS) is the major light-harvesting complex of photosynthesis in cyanobacteria, red algae, and glaucophyte algae. In spite of the fact that it is very well structured to absorb light and transfer it efficiently to photosynthetic reaction centers, it has been completely lost in the...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Antioxidants, Vol. 8, Pages 566: Fibroblasts to Keratinocytes Redox Signaling: The Possible Role of ROS in Psoriatic Plaque Formation Antioxidants, Vol. 8, Pages 566: Fibroblasts to Keratinocytes Redox Signaling: The Possible Role of ROS in Psoriatic Plaque Formation Antioxidants doi: 10.3390/antiox8110566 Authors: Barygina Becatti Prignano Lotti Taddei Fiorillo Although the role of reactive oxygen species-mediated (ROS-mediated) signalling in physiologic and pathologic skin conditions has been proven, no data exist on the skin cells ROS-mediated communication. Primary fibroblasts were obtained... Antioxidants Mon Nov 18, 2019 02:00 Mark above section as read  Atmosphere Atmosphere, Vol. 10, Pages 723: Impact of Sea Breeze Circulation on the Transport of Ship Emissions in Tangshan Port, China Atmosphere, Vol. 10, Pages 723: Impact of Sea Breeze Circulation on the Transport of Ship Emissions in Tangshan Port, China Atmosphere doi: 10.3390/atmos10110723 Authors: Fang Shang Dongsheng Chen Xiurui Guo Jianlei Lang Ying Zhou Yue Li Xinyi Fu A sea breeze is a local circulation that occurs in coastal regions from the poles to the equator. The adverse influence of ship emissions on air quality in coastal areas may be aggravated by the onshore flow of sea breeze circulation.... Atmosphere Mon Nov 18, 2019 02:00 Atmosphere, Vol. 10, Pages 722: Observational Analysis of the Characteristics of the Synoptic Situation and Evolution of the Organized Warm-Sector Rainfall in the Coastal Region of South China in the Pre-Summer Rainy Season Atmosphere, Vol. 10, Pages 722: Observational Analysis of the Characteristics of the Synoptic Situation and Evolution of the Organized Warm-Sector Rainfall in the Coastal Region of South China in the Pre-Summer Rainy Season Atmosphere doi: 10.3390/atmos10110722 Authors: Zhaoming Liang Robert G. Fovell Ying Liu The characteristics of the synoptic situation and the evolution of the organized warm-sector rainfalls (OWSRs) in the coastal region of South China in the pre-summer rainy... Atmosphere Mon Nov 18, 2019 02:00 Atmosphere, Vol. 10, Pages 721: Intercomparison of Ground- and Satellite-Based Total Ozone Data Products at Marambio Base, Antarctic Peninsula Region Atmosphere, Vol. 10, Pages 721: Intercomparison of Ground- and Satellite-Based Total Ozone Data Products at Marambio Base, Antarctic Peninsula Region Atmosphere doi: 10.3390/atmos10110721 Authors: Klára Čížková Kamil Láska Ladislav Metelka Martin Staněk This study aims to compare the ground-based Brewer spectrophotometer total ozone column measurements with the Dobson spectrophotometer and various satellite overpass data available at Marambio Base during the period 2011–2013.... Atmosphere Mon Nov 18, 2019 02:00 Atmosphere, Vol. 10, Pages 720: Recently Strengthened Influence of ENSO on the Wintertime East Asian Surface Air Temperature Atmosphere, Vol. 10, Pages 720: Recently Strengthened Influence of ENSO on the Wintertime East Asian Surface Air Temperature Atmosphere doi: 10.3390/atmos10110720 Authors: Hainan Gong Lin Wang Wen Chen Previous studies have indicated that El Niño–Southern Oscillation (ENSO) exerts a significant influence on the East Asian winter climate. This study reveals an interdecadal strengthening of the connection between ENSO and the East Asian surface air temperature... Atmosphere Mon Nov 18, 2019 02:00 Mark above section as read  Behavioral Sciences Behavioral Sciences, Vol. 9, Pages 116: Older Adults' Perceptions of Psychotherapy in Cyprus Behavioral Sciences, Vol. 9, Pages 116: Older Adults' Perceptions of Psychotherapy in Cyprus Behavioral Sciences doi: 10.3390/bs9110116 Authors: Ioanna Katsounari The purpose of the study was to explore older adults' views and perceptions of psychotherapy in Cyprus. A total of 25 older adults, aged between 65–89, participated in semi-structured interviews. Thematic analysis identified three main themes: Familiar term/Unfamiliar process; existential crises during this... Behavioral Sciences 02:00 Mark above section as read  Biomolecules Biomolecules, Vol. 9, Pages 747: Investigating the Systems-Level Effect of Pueraria lobata for Menopause-Related Metabolic Diseases Using an Ovariectomized Rat Model and Network Pharmacological Analysis Biomolecules, Vol. 9, Pages 747: Investigating the Systems-Level Effect of Pueraria lobata for Menopause-Related Metabolic Diseases Using an Ovariectomized Rat Model and Network Pharmacological Analysis Biomolecules doi: 10.3390/biom9110747 Authors: Ji Hong Oh Seon-Eun Baek Won-Yung Lee Ji Yun Baek Tuy An Trinh Do Hwi Park Hye Lim Lee Ki Sung Kang Chang-Eop Kim Jeong-Eun Yoo This study was conducted to evaluate the biological activities of Pueraria lobata (PL)... Biomolecules Mon Nov 18, 2019 02:00 Biomolecules, Vol. 9, Pages 745: Molecular Dynamics Simulations Suggest a Non-Doublet Decoding Model of –1 Frameshifting by tRNASer3 Biomolecules, Vol. 9, Pages 745: Molecular Dynamics Simulations Suggest a Non-Doublet Decoding Model of –1 Frameshifting by tRNASer3 Biomolecules doi: 10.3390/biom9110745 Authors: Caulfield Coban Tek Flores In-frame decoding in the ribosome occurs through canonical or wobble Watson–Crick pairing of three mRNA codon bases (a triplet) with a triplet of anticodon bases in tRNA. Departures from the triplet–triplet interaction can result in frameshifting,... Biomolecules Mon Nov 18, 2019 02:00 Biomolecules, Vol. 9, Pages 746: Pharmacological Discrimination of Effects of MK801 on Thalamocortical, Mesothalamic, and Mesocortical Transmissions Biomolecules, Vol. 9, Pages 746: Pharmacological Discrimination of Effects of MK801 on Thalamocortical, Mesothalamic, and Mesocortical Transmissions Biomolecules doi: 10.3390/biom9110746 Authors: Okada Fukuyama Nakano Ueda N-methyl-d-aspartate/glutamate receptor (NMDAR) is one of the major voltage-sensitive ligand-gated cation channel. Several noncompetitive NMDAR antagonists contribute to pathophysiology of schizophrenia and mood disorders; however, the effects of inhibition... Biomolecules Mon Nov 18, 2019 02:00 Mark above section as read  Brain Sciences Brain Sciences, Vol. 9, Pages 329: Vestibular Compensation after Vestibular Dysfunction Induced by Arsanilic Acid in Mice Brain Sciences, Vol. 9, Pages 329: Vestibular Compensation after Vestibular Dysfunction Induced by Arsanilic Acid in Mice Brain Sciences doi: 10.3390/brainsci9110329 Authors: Taeko Ito Kouko Tatsumi Yasumitsu Takimoto Tadashi Nishimura Takao Imai Toshiaki Yamanaka Noriaki Takeda Akio Wanaka Tadashi Kitahara When vestibular function is lost, vestibular compensation works for the reacquisition of body balance. For the study of vestibular dysfunction and vestibular... Brain Sciences Mon Nov 18, 2019 02:00 Mark above section as read  Cancers Cancers, Vol. 11, Pages 1815: Nucleocytoplasmic Shuttling of STATs. A Target for Intervention? Cancers, Vol. 11, Pages 1815: Nucleocytoplasmic Shuttling of STATs. A Target for Intervention? Cancers doi: 10.3390/cancers11111815 Authors: Sabrina Ernst Gerhard Müller-Newen Signal transducer and activator of transcription (STAT) proteins are transcription factors that in the latent state are located predominantly in the cytoplasm. Activation of STATs through phosphorylation of a single tyrosine residue results in nuclear translocation. The requirement of tyrosine phosphorylation... Cancers 02:00 Cancers, Vol. 11, Pages 1814: A Novel Calcium-Mediated EMT Pathway Controlled by Lipids: An Opportunity for Prostate Cancer Adjuvant Therapy Cancers, Vol. 11, Pages 1814: A Novel Calcium-Mediated EMT Pathway Controlled by Lipids: An Opportunity for Prostate Cancer Adjuvant Therapy Cancers doi: 10.3390/cancers11111814 Authors: Figiel Bery Chantôme Fontaine Pasqualin Maupoil Domingo Guibon Bruyère Potier-Cartereau Vandier Fromont Mahéo The composition of periprostatic adipose tissue (PPAT) has been shown to play a role in prostate cancer (PCa) progression. We recently reported... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1813: Evaluation of the Accuracy of Liquid-Based Oral Brush Cytology in Screening for Oral Squamous Cell Carcinoma Cancers, Vol. 11, Pages 1813: Evaluation of the Accuracy of Liquid-Based Oral Brush Cytology in Screening for Oral Squamous Cell Carcinoma Cancers doi: 10.3390/cancers11111813 Authors: Deuerling Gaida Neumann Remmerbach This study evaluates the accuracy of the results of liquid-based oral brush cytology and compares it to the histology and/or the clinical follow-ups of the respective patients. A total of 1352 exfoliated specimens were collected with an Orcellex brush from... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1812: Synergistic Autophagy Effect of miR-212-3p in Zoledronic Acid-Treated In Vitro and Orthotopic In Vivo Models and in Patient-Derived Osteosarcoma Cells Cancers, Vol. 11, Pages 1812: Synergistic Autophagy Effect of miR-212-3p in Zoledronic Acid-Treated In Vitro and Orthotopic In Vivo Models and in Patient-Derived Osteosarcoma Cells Cancers doi: 10.3390/cancers11111812 Authors: Ju Yeon Oh Eun Ho Kim Yeon-Joo Lee Sei Sai Sun Ha Lim Jang Woo Park Hye Kyung Chung Joon Kim Guillaume Vares Akihisa Takahashi Youn Kyoung Jeong Mi-Sook Kim Chang-Bae Kong Osteosarcoma (OS) originates from osteoid bone tissues... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1811: Mitigating Effect of 1-Palmitoyl-2-Linoleoyl-3-Acetyl-Rac-Glycerol (PLAG) on a Murine Model of 5-Fluorouracil-Induced Hematological Toxicity Cancers, Vol. 11, Pages 1811: Mitigating Effect of 1-Palmitoyl-2-Linoleoyl-3-Acetyl-Rac-Glycerol (PLAG) on a Murine Model of 5-Fluorouracil-Induced Hematological Toxicity Cancers doi: 10.3390/cancers11111811 Authors: Jinseon Jeong Yong-Jae Kim Do Young Lee Ki-Young Sohn Sun Young Yoon Jae Wha Kim 5-Fluorouracil (5-FU) is an antimetabolite chemotherapy widely used for the treatment of various cancers. However, many cancer patients experience hematological side effects following... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1810: The Gasdermin E gene Potential as a Pan-Cancer Biomarker, While Discriminating between Different Tumor Types Cancers, Vol. 11, Pages 1810: The Gasdermin E gene Potential as a Pan-Cancer Biomarker, While Discriminating between Different Tumor Types Cancers doi: 10.3390/cancers11111810 Authors: Joe Ibrahim Ken Op de Beeck Erik Fransen Marc Peeters Guy Van Camp Due to the elevated rates of incidence and mortality of cancer, early and accurate detection is crucial for achieving optimal treatment. Molecular biomarkers remain important screening and detection tools, especially in light... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1809: Bulk and Single-Cell Next-Generation Sequencing: Individualizing Treatment for Colorectal Cancer Cancers, Vol. 11, Pages 1809: Bulk and Single-Cell Next-Generation Sequencing: Individualizing Treatment for Colorectal Cancer Cancers doi: 10.3390/cancers11111809 Authors: Ioannis D. Kyrochristos Demosthenes E. Ziogas Anna Goussia Georgios K. Glantzounis Dimitrios H. Roukos The increasing incidence combined with constant rates of early diagnosis and mortality of colorectal cancer (CRC) over the past decade worldwide, as well as minor overall survival improvements in the... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1808: hENT1 Testing in Pancreatic Ductal Adenocarcinoma: Are We Ready? A Multimodal Evaluation of hENT1 Status Cancers, Vol. 11, Pages 1808: hENT1 Testing in Pancreatic Ductal Adenocarcinoma: Are We Ready? A Multimodal Evaluation of hENT1 Status Cancers doi: 10.3390/cancers11111808 Authors: Jerome Raffenne Remy Nicolle Francesco Puleo Delphine Le Corre Camille Boyez Raphael Marechal Jean François Emile Peter Demetter Armelle Bardier Pierre Laurent-Puig Louis de Mestier Valerie Paradis Anne Couvelard Jean Luc VanLathem John R. MacKey Jean-Baptiste Bachet... Cancers Mon Nov 18, 2019 02:00 Mark above section as read  Cells Cells, Vol. 8, Pages 1461: The Role of MicroRNAs upon Epithelial-to-Mesenchymal Transition in Inflammatory Bowel Disease Cells, Vol. 8, Pages 1461: The Role of MicroRNAs upon Epithelial-to-Mesenchymal Transition in Inflammatory Bowel Disease Cells doi: 10.3390/cells8111461 Authors: Éva Boros István Nagy Increasing evidence suggest the significance of inflammation in the progression of cancer, for example the development of colorectal cancer in Inflammatory Bowel Disease (IBD) patients. Long-lasting inflammation in the gastrointestinal tract causes serious systemic complications and breaks the homeostasis... Cells 02:00 Cells, Vol. 8, Pages 1460: Carbamazepine Enhances Adipogenesis by Inhibiting Wnt/β-catenin Expression Cells, Vol. 8, Pages 1460: Carbamazepine Enhances Adipogenesis by Inhibiting Wnt/β-catenin Expression Cells doi: 10.3390/cells8111460 Authors: Im Kim Chau Um Carbamazepine is a drug that is widely used in the treatment of epilepsy and bipolar disorder. The prevalence of obesity in patients treated with carbamazepine has been frequently reported. However, whether carbamazepine affects adipogenesis, one of the critical steps in the development of obesity, remains unclear.... Cells Mon Nov 18, 2019 02:00 Cells, Vol. 8, Pages 1459: Novel Epigenetic Biomarkers in Pregnancy-Related Disorders and Cancers Cells, Vol. 8, Pages 1459: Novel Epigenetic Biomarkers in Pregnancy-Related Disorders and Cancers Cells doi: 10.3390/cells8111459 Authors: Karin-Kujundzic Sola Predavec Potkonjak Somen Mioc Serman Vranic Serman As the majority of cancers and gestational diseases are prognostically stage- and grade-dependent, the ultimate goal of ongoing studies in precision medicine is to provide early and timely diagnosis of such disorders. These studies have enabled... Cells Mon Nov 18, 2019 02:00 Cells, Vol. 8, Pages 1457: Natural Histogel-Based Bio-Scaffolds for Sustaining Angiogenesis in Beige Adipose Tissue Cells, Vol. 8, Pages 1457: Natural Histogel-Based Bio-Scaffolds for Sustaining Angiogenesis in Beige Adipose Tissue Cells doi: 10.3390/cells8111457 Authors: Margherita Di Somma Wandert Schaafsma Elisabetta Grillo Maria Vliora Eleni Dakou Michela Corsini Cosetta Ravelli Roberto Ronca Paraskevi Sakellariou Jef Vanparijs Begona Castro Stefania Mitola In the treatment of obesity and its related disorders, one of the measures adopted is weight reduction by... Cells Mon Nov 18, 2019 02:00 Cells, Vol. 8, Pages 1456: Differential Roles of Lipin1 and Lipin2 in the Hepatitis C Virus Replication Cycle Cells, Vol. 8, Pages 1456: Differential Roles of Lipin1 and Lipin2 in the Hepatitis C Virus Replication Cycle Cells doi: 10.3390/cells8111456 Authors: Victoria Castro Gema Calvo Ginés Ávila-Pérez Marlène Dreux Pablo Gastaminza Although their origin, nature and structure are not identical, a common feature of positive-strand RNA viruses is their ability to subvert host lipids and intracellular membranes to generate replication and assembly complexes. Recently, lipin1, a cellular... Cells Mon Nov 18, 2019 02:00 Cells, Vol. 8, Pages 1458: Emerging Role of Cellular Prion Protein in the Maintenance and Expansion of Glioma Stem Cells Cells, Vol. 8, Pages 1458: Emerging Role of Cellular Prion Protein in the Maintenance and Expansion of Glioma Stem Cells Cells doi: 10.3390/cells8111458 Authors: Stefano Thellung Alessandro Corsaro Alessia G. Bosio Martina Zambito Federica Barbieri Michele Mazzanti Tullio Florio Cellular prion protein (PrPC) is a membrane-anchored glycoprotein representing the physiological counterpart of PrP scrapie (PrPSc), which plays a pathogenetic role in prion diseases. Relatively... Cells Mon Nov 18, 2019 02:00 Cells, Vol. 8, Pages 1454: Mitochondrial Mass Assessment in a Selected Cell Line under Different Metabolic Conditions Cells, Vol. 8, Pages 1454: Mitochondrial Mass Assessment in a Selected Cell Line under Different Metabolic Conditions Cells doi: 10.3390/cells8111454 Authors: Anna Costanzini Gianluca Sgarbi Alessandra Maresca Valentina Del Dotto Giancarlo Solaini Alessandra Baracca Changes of quantity and/or morphology of cell mitochondria are often associated with metabolic modulation, pathology, and apoptosis. Exogenous fluorescent probes used to investigate changes in mitochondrial... Cells Mon Nov 18, 2019 02:00 Cells, Vol. 8, Pages 1455: miRNA-29b Inhibits Prostate Tumor Growth and Induces Apoptosis by Increasing Bim Expression Cells, Vol. 8, Pages 1455: miRNA-29b Inhibits Prostate Tumor Growth and Induces Apoptosis by Increasing Bim Expression Cells doi: 10.3390/cells8111455 Authors: Subhayan Sur Robert Steele Xingyi Shi Ratna B. Ray Prostate cancer is one of the most common cancers among men. Currently available therapies improve patient survival against local prostate cancer but have shown severe side effects. Advanced prostate cancer is still incurable. Studies have suggested the involvement of... Cells Mon Nov 18, 2019 02:00 Mark above section as read  Dentistry Journal Dentistry Journal, Vol. 7, Pages 108: Is the Use of Antimicrobial Photodynamic Therapy or Systemic Antibiotics More Effective in Improving Periodontal Health When Used in Conjunction with Localised Non-Surgical Periodontal Therapy? A Systematic Review Dentistry Journal, Vol. 7, Pages 108: Is the Use of Antimicrobial Photodynamic Therapy or Systemic Antibiotics More Effective in Improving Periodontal Health When Used in Conjunction with Localised Non-Surgical Periodontal Therapy? A Systematic Review Dentistry Journal doi: 10.3390/dj7040108 Authors: Animesh Pal Sanjeev Paul Rachel Perry James Puryer Periodontal disease can be treated in several ways. This paper reviewed whether antimicrobial photodynamic therapy (aPDT) in addition... Dentistry Journal Mon Nov 18, 2019 02:00 Mark above section as read  Diagnostics Diagnostics, Vol. 9, Pages 196: Identification of Pneumococcal Serotypes by PCR–Restriction Fragment Length Polymorphism Diagnostics, Vol. 9, Pages 196: Identification of Pneumococcal Serotypes by PCR–Restriction Fragment Length Polymorphism Diagnostics doi: 10.3390/diagnostics9040196 Authors: García-Suárez González-Rodríguez Cima-Cabal Yuste Vazquez Santiago Streptococcus pneumoniae shows more than 90 capsular serotypes that can be distinguished by their reactivity against antisera. The main objective of this work was the development of a molecular method for serotyping without the... Diagnostics Mon Nov 18, 2019 02:00 Diagnostics, Vol. 9, Pages 195: Neonatal Mass Urine Screening Approach for Early Detection of Mucopolysaccharidoses by UPLC-MS/MS Diagnostics, Vol. 9, Pages 195: Neonatal Mass Urine Screening Approach for Early Detection of Mucopolysaccharidoses by UPLC-MS/MS Diagnostics doi: 10.3390/diagnostics9040195 Authors: Iskren Menkovic Anne-Sophie Marchand Michel Boutin Christiane Auray-Blais Mucopolysaccharidoses (MPSs) are lysosomal storage disorders caused by deficiencies of enzymes involved in the catabolism of glycosaminoglycans (GAGs). Various treatments such as enzyme replacement therapy and/or hematopoietic... Diagnostics Mon Nov 18, 2019 02:00 Mark above section as read  Healthcare Healthcare, Vol. 7, Pages 149: Nutritional Knowledge and Self-Reported Nutritional Practice against Malnutrition among Physicians in Jeddah, Saudi Arabia Healthcare, Vol. 7, Pages 149: Nutritional Knowledge and Self-Reported Nutritional Practice against Malnutrition among Physicians in Jeddah, Saudi Arabia Healthcare doi: 10.3390/healthcare7040149 Authors: Alkhaldy The new era of healthcare emphasizes the integration of nutritional care into healthcare management to improve patient outcomes. Previous studies indicated that nutritional knowledge among physicians is insufficient. Thus far, only a limited number of studies have assessed... Healthcare 02:00 Mark above section as read  Heritage Heritage, Vol. 2, Pages 2763-2783: X-Ray Dating of Ancient Linen Fabrics Heritage, Vol. 2, Pages 2763-2783: X-Ray Dating of Ancient Linen Fabrics Heritage doi: 10.3390/heritage2040171 Authors: De Caro Giannini Lassandro Scattarella Sibillano Matricciani Fanti We propose a new method for dating ancient linen threads by inspecting their structural degradation by means of wide-angle X-ray scattering. X-ray dating of a textile sample can be performed nondestructively and on a submillimeter area, e.g., 0.2 0.5 mm2, exploiting new table-top... Heritage Mon Nov 18, 2019 02:00 Mark above section as read  International Journal of Environmental Research and Public Health IJERPH, Vol. 16, Pages 4574: The Role of Environmental Tax in Alleviating the Impact of Environmental Pollution on Residents' Happiness in China IJERPH, Vol. 16, Pages 4574: The Role of Environmental Tax in Alleviating the Impact of Environmental Pollution on Residents' Happiness in China International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224574 Authors: Yu Liu Rong-Lin Li Yang Song Zhi-Jiang Zhang Background: Environmental tax has been implemented by the government in response to the demands of the residents to control environmental pollution. However, a tax has a wide effect on many... International Journal of Environmental Research and Public Health 02:00 IJERPH, Vol. 16, Pages 4572: Strengthening Routine Immunization Services in an Angolan Comuna: The Fight against the Burden of Unvaccinated Children in the Sustainable Development Goals Era IJERPH, Vol. 16, Pages 4572: Strengthening Routine Immunization Services in an Angolan Comuna: The Fight against the Burden of Unvaccinated Children in the Sustainable Development Goals Era International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224572 Authors: Mattia Fattorini Calistus Wilunda Gloria Raguzzoni Cecilia Quercioli Gabriele Messina Maria Pia Fantini Giovanni Putoto In May 2018, the non-governmental organization (NGO) Doctors... International Journal of Environmental Research and Public Health 02:00 IJERPH, Vol. 16, Pages 4573: Demand for a Housing Offer Addressed to Senior Citizens in Poland IJERPH, Vol. 16, Pages 4573: Demand for a Housing Offer Addressed to Senior Citizens in Poland International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224573 Authors: Katarzyna Przybyła Maria Hełdak Izabela Kurtyka-Marcak The purpose of this study is to identify the willingness of pensioners to move from an apartment/house to an apartment/house located in a housing estate specifically designed for senior citizens. As such, this article forms part... International Journal of Environmental Research and Public Health 02:00 IJERPH, Vol. 16, Pages 4570: Analysis of Health in Environmental Assessments—A Literature Review and Survey with a Focus on Denmark IJERPH, Vol. 16, Pages 4570: Analysis of Health in Environmental Assessments—A Literature Review and Survey with a Focus on Denmark International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224570 Authors: Humboldt-Dachroeden Fischer-Bonde Gulis In the European Union, the Environmental Impact Assessment (EIA) Directive (2014/52/EU) and Strategic Environmental Assessment (SEA) Directive (2011/92/EU) emphasise the assessment of population and human... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4571: Specific Eccentric–Isokinetic Cluster Training Improves Static Strength Elements on Rings for Elite Gymnasts IJERPH, Vol. 16, Pages 4571: Specific Eccentric–Isokinetic Cluster Training Improves Static Strength Elements on Rings for Elite Gymnasts International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224571 Authors: Schärer Tacchelli Göpfert Gross Lüthy Taube Hübner In gymnastics, coaches are constantly searching for efficient training methods in order to improve the athletes' performance. Therefore, in this study we aimed to... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4568: Heatwave Events and Mortality Outcomes in Memphis, Tennessee: Testing Effect Modification by Socioeconomic Status and Urbanicity IJERPH, Vol. 16, Pages 4568: Heatwave Events and Mortality Outcomes in Memphis, Tennessee: Testing Effect Modification by Socioeconomic Status and Urbanicity International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224568 Authors: Li Akkus Yu Joyner Kmet Sweat Jia Heatwave studies typically estimate heat-related mortality and morbidity risks at the city level; few have addressed the heterogeneous risks by socioeconomic status (SES)... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4566: The Impacts of Green Innovation Input and Channel Service in a Dual-Channel Value Chain IJERPH, Vol. 16, Pages 4566: The Impacts of Green Innovation Input and Channel Service in a Dual-Channel Value Chain International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224566 Authors: Li Chen Huang Gui Liu This paper constructs a dual-channel value chain composed of one altruistic manufacturer and one altruistic retailer, where the manufacturer makes green innovation input for green products and sells its green products to its customers... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4567: Validity and Reliability of the Emergency Severity Index in a Spanish Hospital IJERPH, Vol. 16, Pages 4567: Validity and Reliability of the Emergency Severity Index in a Spanish Hospital International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224567 Authors: Luis Miguel Cairós-Ventura Maria de las Mercedes Novo-Muñoz José Ángel Rodríguez-Gómez Ángela María Ortega-Benítez Elena María Ortega-Barreda Armando Aguirre-Jaimehahah Saturation in hospital emergency departments is one of the main safety problems for the patient,... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4569: Assessment of Knowledge, Attitude and Practice towards Prevention of Respiratory Tract Infections among Hajj and Umrah Pilgrims from Malaysia in 2018 IJERPH, Vol. 16, Pages 4569: Assessment of Knowledge, Attitude and Practice towards Prevention of Respiratory Tract Infections among Hajj and Umrah Pilgrims from Malaysia in 2018 International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224569 Authors: Goni Hasan Naing Wan-Arfah Deris Arifin Baaba Respiratory tract infection (RTI) is a major public health challenge during the Muslim pilgrimage to Makkah. This study aims to evaluate... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4565: Informing Behaviour Change: What Sedentary Behaviours Do Families Perform at Home and How Can They Be Targeted? IJERPH, Vol. 16, Pages 4565: Informing Behaviour Change: What Sedentary Behaviours Do Families Perform at Home and How Can They Be Targeted? International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224565 Authors: Lauren Arundell Kate Parker Jo Salmon Jenny Veitch Anna Timperio Home-based interventions targeting children's sedentary behaviours have had limited and inconsistent effectiveness, possibly due to a mismatch between the behaviours... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4564: Symptoms of Discomfort and Problems Associated with Mode of Delivery During the Puerperium: An Observational Study IJERPH, Vol. 16, Pages 4564: Symptoms of Discomfort and Problems Associated with Mode of Delivery During the Puerperium: An Observational Study International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224564 Authors: Martínez-Galiano Delgado-Rodríguez Rodríguez-Almagro Hernández-Martínez Despite abundant literature on antenatal and delivery care received by pregnant women, there is a wide knowledge gap on the prevalence of symptoms of discomfort... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4563: Valuing Acute Health Risks of Air Pollution in the Jinchuan Mining Area, China: A Choice Experiment with Perceived Exposure and Hazardousness as Co-Determinants IJERPH, Vol. 16, Pages 4563: Valuing Acute Health Risks of Air Pollution in the Jinchuan Mining Area, China: A Choice Experiment with Perceived Exposure and Hazardousness as Co-Determinants International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224563 Authors: Li This paper analyzes the choice of illness-cure combinations to estimate people's willingness to pay (WTP) for the reduction of acute health risks correlated with air pollution caused... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4561: Adapting Digital Social Prescribing for Suicide Bereavement Support: The Findings of a Consultation Exercise to Explore the Acceptability of Implementing Digital Social Prescribing within an Existing Postvention Service IJERPH, Vol. 16, Pages 4561: Adapting Digital Social Prescribing for Suicide Bereavement Support: The Findings of a Consultation Exercise to Explore the Acceptability of Implementing Digital Social Prescribing within an Existing Postvention Service International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224561 Authors: Karen Galway Trisha Forbes Sharon Mallon Olinda Santin Paul Best Jennifer Neff Gerry Leavey Alexandra Pitman This paper... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4562: Investigation the EMG Activities of Lower Limb Muscles When Doing Squatting Exercise in Water and on Land IJERPH, Vol. 16, Pages 4562: Investigation the EMG Activities of Lower Limb Muscles When Doing Squatting Exercise in Water and on Land International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224562 Authors: Calvin H.N. Yuen Christine P.Y. Lam Kate C.T. Tong Jessica C.Y. Yeung Chloe H.Y. Yip Billy C.L. So (1) Background: Squatting is one of the common closed-kinetic chain (CKC) exercises for knee rehabilitation. Some patients cannot perform... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4559: Organizational Strategy and Corporate Social Responsibility: The Mediating Effect of Triple Bottom Line IJERPH, Vol. 16, Pages 4559: Organizational Strategy and Corporate Social Responsibility: The Mediating Effect of Triple Bottom Line International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224559 Authors: Abdul Kaium Masud Harun Ur Rashid Tehmina Khan Seong Mi Bae Jong Dae Kim Limited research in the area of the triple bottom line (TBL) mediation effect on the relationship between organizational strategic performance (OSP) and corporate social... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4557: The Association between Metabolic Syndrome and Biochemical Markers in Beijing Adolescents IJERPH, Vol. 16, Pages 4557: The Association between Metabolic Syndrome and Biochemical Markers in Beijing Adolescents International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224557 Authors: Yao Zhao Yingjie Yu Hong Li Mingying Li Dongran Zhang Dandan Guo Xiaohui Yu Ce Lu Hui Wang Objective: To describe the prevalence of metabolic syndrome (MetS) in adolescents and its association with several MetS-related biochemical markers. Methods:... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4560: Links between Cognitive Status and Trace Element Levels in Hair for an Environmentally Exposed Population: A Case Study in the Surroundings of the Estarreja Industrial Area IJERPH, Vol. 16, Pages 4560: Links between Cognitive Status and Trace Element Levels in Hair for an Environmentally Exposed Population: A Case Study in the Surroundings of the Estarreja Industrial Area International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224560 Authors: Marina M. S. Cabral Pinto Paula Marinho-Reis Agostinho Almeida Edgar Pinto Orquídia Neves Manuela Inácio Bianca Gerardo Sandra Freitas Mário R. Simões Pedro A. Dinis... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4556: Decreased Vertical Trunk Inclination Angle and Pelvic Inclination as the Result of Mid-High-Heeled Footwear on Static Posture Parameters in Asymptomatic Young Adult Women IJERPH, Vol. 16, Pages 4556: Decreased Vertical Trunk Inclination Angle and Pelvic Inclination as the Result of Mid-High-Heeled Footwear on Static Posture Parameters in Asymptomatic Young Adult Women International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224556 Authors: Jakub Michoński Marcin Witkowski Bożena Glinkowska Robert Sitnik Wojciech Glinkowski The influence of high-heel footwear on the lumbar lordosis angle, anterior pelvic tilt,... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4558: Oral Health Status and Need for Oral Care in an Aging Population: A Systematic Review IJERPH, Vol. 16, Pages 4558: Oral Health Status and Need for Oral Care in an Aging Population: A Systematic Review International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224558 Authors: Dorina Lauritano Giulia Moreo Fedora Della Vella Dario Di Stasio Francesco Carinci Alberta Lucchese Massimo Petruzzi Background. The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4555: Policy Debates Regarding Nicotine Vaping Products in Australia: A Qualitative Analysis of Submissions to a Government Inquiry from Health and Medical Organisations IJERPH, Vol. 16, Pages 4555: Policy Debates Regarding Nicotine Vaping Products in Australia: A Qualitative Analysis of Submissions to a Government Inquiry from Health and Medical Organisations International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224555 Authors: Daniel A Erku Kylie Morphett Kathryn J Steadman Coral E Gartner Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4554: Help or Hindrance? The Alcohol Industry and Alcohol Control in Portugal IJERPH, Vol. 16, Pages 4554: Help or Hindrance? The Alcohol Industry and Alcohol Control in Portugal International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224554 Authors: Maria Margarida Paixão Mélissa Mialon The influence of the alcohol industry, also known as "corporate political activity" (CPA), is documented as one of the main barriers in implementing effective alcohol control policies. In Portugal, despite an alcohol consumption... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4553: Variations in the Distribution of Chl-a and Simulation Using a Multiple Regression Model IJERPH, Vol. 16, Pages 4553: Variations in the Distribution of Chl-a and Simulation Using a Multiple Regression Model International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224553 Authors: Jiancai Deng Fang Chen Weiping Hu Xin Lu Bin Xu David P. Hamilton Chlorophyll a (Chl-a) is an important indicator of algal biomass in aquatic ecosystems. In this study, monthly monitoring data for Chl-a concentration were collected between 2005 and 2015... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 IJERPH, Vol. 16, Pages 4552: Assessing Agricultural Livelihood Vulnerability to Climate Change in Coastal Bangladesh IJERPH, Vol. 16, Pages 4552: Assessing Agricultural Livelihood Vulnerability to Climate Change in Coastal Bangladesh International Journal of Environmental Research and Public Health doi: 10.3390/ijerph16224552 Authors: Muhammad Ziaul Hoque Shenghui Cui Lilai Xu Imranul Islam Jianxiong Tang Shengping Ding The adverse impacts of climate change exert mounting pressure on agriculture-dependent livelihoods of many developing and developed nations. However, integrated and spatially... International Journal of Environmental Research and Public Health Mon Nov 18, 2019 02:00 Mark above section as read  International Journal of Molecular Sciences IJMS, Vol. 20, Pages 5805: Current and Future Concepts for the Treatment of Impaired Fracture Healing IJMS, Vol. 20, Pages 5805: Current and Future Concepts for the Treatment of Impaired Fracture Healing International Journal of Molecular Sciences doi: 10.3390/ijms20225805 Authors: Carsten W. Schlickewei Holger Kleinertz Darius M. Thiesen Konrad Mader Matthias Priemel Karl-Heinz Frosch Johannes Keller Bone regeneration represents a complex process, of which basic biologic principles have been evolutionarily conserved over a broad range of different species. Bone represents... International Journal of Molecular Sciences 02:00 IJMS, Vol. 20, Pages 5804: Role of HYBID (Hyaluronan Binding Protein Involved in Hyaluronan Depolymerization), Alias KIAA1199/CEMIP, in Hyaluronan Degradation in Normal and Photoaged Skin IJMS, Vol. 20, Pages 5804: Role of HYBID (Hyaluronan Binding Protein Involved in Hyaluronan Depolymerization), Alias KIAA1199/CEMIP, in Hyaluronan Degradation in Normal and Photoaged Skin International Journal of Molecular Sciences doi: 10.3390/ijms20225804 Authors: Hiroyuki Yoshida Yasunori Okada Photoaged skin is characterized clinically by apparent manifestations such as wrinkles and sagging, and histologically by an accumulation of abnormal elastin and a severe loss of collagen... International Journal of Molecular Sciences 02:00 IJMS, Vol. 20, Pages 5802: A Novel 'Candidatus Liberibacter asiaticus'-Encoded Sec-Dependent Secretory Protein Suppresses Programmed Cell Death in Nicotiana benthamiana IJMS, Vol. 20, Pages 5802: A Novel 'Candidatus Liberibacter asiaticus'-Encoded Sec-Dependent Secretory Protein Suppresses Programmed Cell Death in Nicotiana benthamiana International Journal of Molecular Sciences doi: 10.3390/ijms20225802 Authors: Zhang Wang Liu Fan Zhang Zhou Li 'Candidatus Liberibacter asiaticus' (CLas) is one of the causal agents of citrus Huanglongbing (HLB), a bacterial disease of citrus trees that greatly reduces fruit... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5803: Impact of Nitrogen Nutrition on Cannabis sativa: An Update on the Current Knowledge and Future Prospects IJMS, Vol. 20, Pages 5803: Impact of Nitrogen Nutrition on Cannabis sativa: An Update on the Current Knowledge and Future Prospects International Journal of Molecular Sciences doi: 10.3390/ijms20225803 Authors: Simone Landi Roberto Berni Giorgia Capasso Jean-Francois Hausman Gea Guerriero Sergio Esposito Nitrogen (N) availability represents one of the most critical factors affecting cultivated crops. N is indeed a crucial macronutrient influencing major aspects, from plant... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5801: Calcium Polyphosphate Nanoparticles Act as an Effective Inorganic Phosphate Source during Osteogenic Differentiation of Human Mesenchymal Stem Cells IJMS, Vol. 20, Pages 5801: Calcium Polyphosphate Nanoparticles Act as an Effective Inorganic Phosphate Source during Osteogenic Differentiation of Human Mesenchymal Stem Cells International Journal of Molecular Sciences doi: 10.3390/ijms20225801 Authors: Luan Phelipe Hatt Keith Thompson Werner E. G. Müller Martin James Stoddart Angela Rita Armiento The ability of bone-marrow-derived mesenchymal stem/stromal cells (BM-MSCs) to differentiate into osteoblasts makes them the... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5800: The Regulation of NFE2L2 (NRF2) Signalling and Epithelial-to-Mesenchymal Transition in Age-Related Macular Degeneration Pathology IJMS, Vol. 20, Pages 5800: The Regulation of NFE2L2 (NRF2) Signalling and Epithelial-to-Mesenchymal Transition in Age-Related Macular Degeneration Pathology International Journal of Molecular Sciences doi: 10.3390/ijms20225800 Authors: Hyttinen Kannan Felszeghy Niittykoski Salminen Kaarniranta Age-related macular degeneration (AMD) is a mounting cause of loss of sight in the elderly in the developed countries, a trend enhanced by the continual ageing of the population.... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5798: Interactive Effects of Salicylic Acid and Nitric Oxide in Enhancing Rice Tolerance to Cadmium Stress IJMS, Vol. 20, Pages 5798: Interactive Effects of Salicylic Acid and Nitric Oxide in Enhancing Rice Tolerance to Cadmium Stress International Journal of Molecular Sciences doi: 10.3390/ijms20225798 Authors: Mohammad Golam Mostofa Md. Mezanur Rahman Md. Mesbah Uddin Ansary Masayuki Fujita Lam-Son Phan Tran Cadmium (Cd) is one of the prominent environmental hazards, affecting plant productivity and posing human health risks worldwide. Although salicylic acid (SA) and nitric... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5799: An Update on Antibodies to Necleosome Components as Biomarkers of Sistemic Lupus Erythematosus and of Lupus Flares IJMS, Vol. 20, Pages 5799: An Update on Antibodies to Necleosome Components as Biomarkers of Sistemic Lupus Erythematosus and of Lupus Flares International Journal of Molecular Sciences doi: 10.3390/ijms20225799 Authors: Gian Marco Ghiggeri Matteo D'Alessandro Domenico Bartolomeo Maria Ludovica Degl'Innocenti Alberto Magnasco Francesca Lugani Marco Prunotto Maurizio Bruschi Systemic lupus erythematosus (SLE) is an autoimmune disease with variable clinical expression.... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5797: B Vitamins and Fatty Acids: What Do They Share with Small Vessel Disease-Related Dementia? IJMS, Vol. 20, Pages 5797: B Vitamins and Fatty Acids: What Do They Share with Small Vessel Disease-Related Dementia? International Journal of Molecular Sciences doi: 10.3390/ijms20225797 Authors: Rita Moretti Costanza Peinkhofer Many studies have been written on vitamin supplementation, fatty acid, and dementia, but results are still under debate, and no definite conclusion has yet been drawn. Nevertheless, a significant amount of lab evidence confirms that vitamins of the B group... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5796: Carotenoid Cleavage Dioxygenases: Identification, Expression, and Evolutionary Analysis of This Gene Family in Tobacco IJMS, Vol. 20, Pages 5796: Carotenoid Cleavage Dioxygenases: Identification, Expression, and Evolutionary Analysis of This Gene Family in Tobacco International Journal of Molecular Sciences doi: 10.3390/ijms20225796 Authors: Qianqian Zhou Qingchang Li Peng Li Songtao Zhang Che Liu Jingjing Jin Peijian Cao Yongxia Yang Carotenoid cleavage dioxygenases (CCDs) selectively catalyze carotenoids, forming smaller apocarotenoids that are essential for the synthesis of apocarotenoid... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5795: Behavioral Impairments and Oxidative Stress in the Brain, Muscle, and Gill Caused by Chronic Exposure of C70 Nanoparticles on Adult Zebrafish IJMS, Vol. 20, Pages 5795: Behavioral Impairments and Oxidative Stress in the Brain, Muscle, and Gill Caused by Chronic Exposure of C70 Nanoparticles on Adult Zebrafish International Journal of Molecular Sciences doi: 10.3390/ijms20225795 Authors: Sreeja Sarasamma Gilbert Audira Prabu Samikannu Stevhen Juniardi Petrus Siregar Erwei Hao Jung-Ren Chen Chung-Der Hsiao There is an imperative need to develop efficient whole-animal-based testing assays to determine the... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5794: Heat Shock Proteins in Glioblastoma Biology: Where Do We Stand? IJMS, Vol. 20, Pages 5794: Heat Shock Proteins in Glioblastoma Biology: Where Do We Stand? International Journal of Molecular Sciences doi: 10.3390/ijms20225794 Authors: Rebeca Piatniczka Iglesia Camila Felix de Lima Fernandes Bárbara Paranhos Coelho Mariana Brandão Prado Maria Isabel Melo Escobar Gustavo Henrique Doná Rodrigues Almeida Marilene Hohmuth Lopes Heat shock proteins (HSPs) are evolutionary conserved proteins that work as molecular chaperones and perform... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5793: The Chemokine CXCL16 Is a New Biomarker for Lymph Node Analysis of Colon Cancer Outcome IJMS, Vol. 20, Pages 5793: The Chemokine CXCL16 Is a New Biomarker for Lymph Node Analysis of Colon Cancer Outcome International Journal of Molecular Sciences doi: 10.3390/ijms20225793 Authors: Manar AbdelMageed Haytham Ali Lina Olsson Gudrun Lindmark Marie-Louise Hammarström Sten Hammarström Basel Sitohy Chemokines are important in the development and progression of tumors. We investigated the expression of CXCL14 and CXCL16 in colon cancer. Expression of mRNA was... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5792: PI3K/mTOR Pathway Inhibition: Opportunities in Oncology and Rare Genetic Diseases IJMS, Vol. 20, Pages 5792: PI3K/mTOR Pathway Inhibition: Opportunities in Oncology and Rare Genetic Diseases International Journal of Molecular Sciences doi: 10.3390/ijms20225792 Authors: Petra Hillmann Doriano Fabbro The phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling pathway has been implicated as a cancer target. Big pharma players and small companies have been developing small molecule inhibitors of PI3K and/or mTOR since the 1990s. Although... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5791: VEGF-A and ICAM-1 Gene Polymorphisms as Predictors of Clinical Outcome to First-Line Bevacizumab-Based Treatment in Metastatic Colorectal Cancer IJMS, Vol. 20, Pages 5791: VEGF-A and ICAM-1 Gene Polymorphisms as Predictors of Clinical Outcome to First-Line Bevacizumab-Based Treatment in Metastatic Colorectal Cancer International Journal of Molecular Sciences doi: 10.3390/ijms20225791 Authors: Apostolos Papachristos Polychronis Kemos Theodora Katsila Eirini Panoilia George P. Patrinos Haralabos Kalofonos Gregory B. Sivolapenko Bevacizumab is used to treat metastatic colorectal cancer (mCRC). However, there are... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 IJMS, Vol. 20, Pages 5790: Tellimagrandin II, A Type of Plant Polyphenol Extracted from Trapa bispinosa Inhibits Antibiotic Resistance of Drug-Resistant Staphylococcus aureus IJMS, Vol. 20, Pages 5790: Tellimagrandin II, A Type of Plant Polyphenol Extracted from Trapa bispinosa Inhibits Antibiotic Resistance of Drug-Resistant Staphylococcus aureus International Journal of Molecular Sciences doi: 10.3390/ijms20225790 Authors: Yu-Wei Chang Wan-Chun Huang Chun-Yu Lin Wen-Hung Wang Ling-Chien Hung Yen-Hsu Chen The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has become a critical global concern. Identifying new candidates of... International Journal of Molecular Sciences Mon Nov 18, 2019 02:00 Mark above section as read  Journal of Clinical Medicine JCM, Vol. 8, Pages 2017: Pharmaceutical Aspects of Artificial Nutrition JCM, Vol. 8, Pages 2017: Pharmaceutical Aspects of Artificial Nutrition Journal of Clinical Medicine doi: 10.3390/jcm8112017 Authors: Emilie Reber Markus Messerli Zeno Stanga Stefan Mühlebach Artificial nutrition, including enteral (EN) and parenteral (PN) nutrition, is indicated whenever adequate oral nutrition fails to sufficiently supply the necessary nutrients to the body. It is a convenient, efficacious, safe, and well-tolerated form of clinical nutrition in the hospital... Journal of Clinical Medicine 02:00 JCM, Vol. 8, Pages 2015: Maternal and Neonatal Hair Cortisol Levels Are Associated with Infant Neurodevelopment at Six Months of Age JCM, Vol. 8, Pages 2015: Maternal and Neonatal Hair Cortisol Levels Are Associated with Infant Neurodevelopment at Six Months of Age Journal of Clinical Medicine doi: 10.3390/jcm8112015 Authors: Rafael A. Caparros-Gonzalez Borja Romero-Gonzalez Raquel Gonzalez-Perez Lidia Lucena-Prieto Miguel Perez-Garcia Francisco Cruz-Quintana Maria Isabel Peralta-Ramirez Background: Maternal stress during pregnancy can affect fetal development during certain sensitive periods. Objective:... Journal of Clinical Medicine 02:00 JCM, Vol. 8, Pages 2013: Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum Time Course JCM, Vol. 8, Pages 2013: Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum Time Course Journal of Clinical Medicine doi: 10.3390/jcm8112013 Authors: Cavagna Trallero-Araguás Meloni Cavazzana Rojas-Serrano Feist Zanframundo Morandi Meyer Silva Costa Molberg Andersson Codullo Mosca Barsotti Neri Scirè Govoni Furini Lopez-Longo Martinez-Barrio Schneider ... Journal of Clinical Medicine Mon Nov 18, 2019 02:00 JCM, Vol. 8, Pages 2014: Systemic Lidocaine Infusion for Post-Operative Analgesia in Children Undergoing Laparoscopic Inguinal Hernia Repair: A Randomized Double-Blind Controlled Trial JCM, Vol. 8, Pages 2014: Systemic Lidocaine Infusion for Post-Operative Analgesia in Children Undergoing Laparoscopic Inguinal Hernia Repair: A Randomized Double-Blind Controlled Trial Journal of Clinical Medicine doi: 10.3390/jcm8112014 Authors: Lee Choi Byon Lee Lee Systemic lidocaine can provide satisfactory post-operative analgesia in adults. In this study, we assessed whether intravenous lidocaine is effective for post-operative analgesia and recovery in children... Journal of Clinical Medicine Mon Nov 18, 2019 02:00 JCM, Vol. 8, Pages 2012: Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial JCM, Vol. 8, Pages 2012: Effects of Non-Invasive Ventilation Combined with Oxygen Supplementation on Exercise Performance in COPD Patients with Static Lung Hyperinflation and Exercise-Induced Oxygen Desaturation: A Single Blind, Randomized Cross-Over Trial Journal of Clinical Medicine doi: 10.3390/jcm8112012 Authors: Maud Koopman Martijn A. Spruit Frits M.E. Franssen Jeannet Delbressine Emiel F.M. Wouters Denny Mathew Anton Vink Lowie E.G.W. Vanfleteren The effects... Journal of Clinical Medicine Mon Nov 18, 2019 02:00 JCM, Vol. 8, Pages 2011: Combined Effects of MMP-7, MMP-8 and MMP-26 on the Risk of Ischemic Stroke JCM, Vol. 8, Pages 2011: Combined Effects of MMP-7, MMP-8 and MMP-26 on the Risk of Ischemic Stroke Journal of Clinical Medicine doi: 10.3390/jcm8112011 Authors: Fang-I Hsieh Hung-Yi Chiou Chaur-Jong Hu Jiann-Shing Jeng Huey-Juan Lin Jiunn-Tay Lee Li-Ming Lien Ischemic stroke (IS) is multifactorial causation combining with traditional cardiovascular disease (CVD) and genetic risk factors. Combined effects of MMP-7, MMP-8 and MMP-26 on the risk of IS remain incompletely... Journal of Clinical Medicine Mon Nov 18, 2019 02:00 JCM, Vol. 8, Pages 2010: Association between Sleep Duration and Subclinical Thyroid Dysfunction Based on Nationally Representative Data JCM, Vol. 8, Pages 2010: Association between Sleep Duration and Subclinical Thyroid Dysfunction Based on Nationally Representative Data Journal of Clinical Medicine doi: 10.3390/jcm8112010 Authors: Woojun Kim Jeongmin Lee Jeonghoon Ha Kwanhoon Jo Dong-Jun Lim Jung-Min Lee Sang-Ah Chang Moo-Il Kang Min-Hee Kim Background: Sleep duration is an identified risk factor for adverse health outcomes. As the endocrine system is closely intertwined with sleep duration and... Journal of Clinical Medicine Mon Nov 18, 2019 02:00 Mark above section as read  Journal of Functional Biomaterials JFB, Vol. 10, Pages 52: Intrinsic Cellular Responses of Human Wharton's Jelly Mesenchymal Stem Cells Influenced by O2-Plasma-Modified and Unmodified Surface of Alkaline-Hydrolyzed 2D and 3D PCL Scaffolds JFB, Vol. 10, Pages 52: Intrinsic Cellular Responses of Human Wharton's Jelly Mesenchymal Stem Cells Influenced by O2-Plasma-Modified and Unmodified Surface of Alkaline-Hydrolyzed 2D and 3D PCL Scaffolds Journal of Functional Biomaterials doi: 10.3390/jfb10040052 Authors: Inthanon Janvikul Ongchai Chomdej Polycaprolactone (PCL), a hydrophobic-degradable polyester, has been widely investigated and extensively developed, to increase the biocompatibility for tissue engineering.... Journal of Functional Biomaterials Mon Nov 18, 2019 02:00 Mark above section as read  Journal of Imaging J. Imaging, Vol. 5, Pages 86: Usage of Vertical Fisheye-Images to Quantify Urban Light Pollution on Small Scales and the Impact of LED Conversion J. Imaging, Vol. 5, Pages 86: Usage of Vertical Fisheye-Images to Quantify Urban Light Pollution on Small Scales and the Impact of LED Conversion Journal of Imaging doi: 10.3390/jimaging5110086 Authors: Stefan Wallner The aim of this work was to develop an easy and quick technique for characterizing various lighting situations, that is, single lamps or illuminated signs and to quantify impacts on small scales like streets, buildings and near areas. The method uses a DSLR-camera equipped... Journal of Imaging Mon Nov 18, 2019 02:00 Mark above section as read
Antioxidants, Vol. 8, Pages 566: Fibroblasts to Keratinocytes Redox Signaling: The Possible Role of ROS in Psoriatic Plaque FormationAntioxidants, Vol. 8, Pages 566: Fibroblasts to Keratinocytes Redox Signaling: The Possible Role of ROS in Psoriatic Plaque Formation Antioxidants doi: 10.3390/antiox8110566 Authors: Barygina Becatti Prignano Lotti Taddei Fiorillo Although the role of reactive oxygen species-mediated (ROS-mediated) signalling in physiologic and pathologic skin conditions has been proven,...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:33
Induction of growth cessation by acacetin via β-catenin pathway and apoptosis by apoptosis inducing factor activation in colorectal carcinoma cells. Related ArticlesInduction of growth cessation by acacetin via β-catenin pathway and apoptosis by apoptosis inducing factor activation in colorectal carcinoma cells. Mol Biol Rep. 2019 Nov 16;: Authors: Prasad N, Sharma JR, Yadav UCS Abstract Acacetin, a bioflavanoid, contains anti-inflammatory and anti-cancer activities as shown in different experimental models. However, its anticancer potential and mechanism of action against colorectal cancer cells... pubmed: cell cycle arrest Mon Nov 18, 2019 15:12 Association and clinicopathologic significance of p38MAPK-ERK-JNK-CDC25C with polyploid giant cancer cell formation. Related ArticlesAssociation and clinicopathologic significance of p38MAPK-ERK-JNK-CDC25C with polyploid giant cancer cell formation. Med Oncol. 2019 Nov 16;37(1):6 Authors: Liu K, Lu R, Zhao Q, Du J, Li Y, Zheng M, Zhang S Abstract BACKGROUND: We previously showed that cobalt chloride (CoCl2) induction of polyploid giant cancer cells (PGCCs) was characterized by abnormal cell cycle-related protein expression and G2/M arrest. The role of the p38MAPK-ERK-JNK... pubmed: cell cycle arrest Mon Nov 18, 2019 15:12 Long non-coding RNA NEAT1 promotes bladder progression through regulating miR-410 mediated HMGB1. Related ArticlesLong non-coding RNA NEAT1 promotes bladder progression through regulating miR-410 mediated HMGB1. Biomed Pharmacother. 2019 Nov 14;121:109248 Authors: Shan G, Tang T, Xia Y, Qian HJ Abstract LncRNA NEAT1 is reported as a crucial oncogene in multiple cancers. But, its biological role in bladder cancer is barely understood. Therefore, we concentrated on the function and role of NEAT1 in bladder cancer. Firstly, NEAT1 expression in bladder... pubmed: cell cycle arrest Mon Nov 18, 2019 15:12 Synthesis and characterization of zinc oxide nanoparticles from Morus nigra and its anticancer activity of AGS gastric cancer cells. Related ArticlesSynthesis and characterization of zinc oxide nanoparticles from Morus nigra and its anticancer activity of AGS gastric cancer cells. J Photochem Photobiol B. 2019 Nov 09;202:111698 Authors: Tang Q, Xia H, Liang W, Huo X, Wei X Abstract Gastric cancer was a foremost one among the majority of regular carcinoma cases globally. Even the achievements on enhanced treatment approaches and early findings cannot decrease the mortality and morbidity... pubmed: cell cycle arrest Mon Nov 18, 2019 15:12 Mark above section as read  !@ Rare Cancers Prevalence and correlates of non-tissue prostate cancer diagnosis in the United States. Related ArticlesPrevalence and correlates of non-tissue prostate cancer diagnosis in the United States. J Geriatr Oncol. 2019 Nov 13;: Authors: Aksenov L, Gansler T, Sineshaw HM, Fedewa S, Yabroff KR, Jemal A, Moul J Abstract BACKGROUND: Given the potential complications of prostate biopsies, it is sometimes reasonable in selected patients to make a non-tissue diagnosis of prostate cancer. Little is known about prevalence and factors associated with... !@ Rare Cancers Mon Nov 18, 2019 14:46 Mark above section as read  J Clin Neurosci Corrigendum to "The local thermal effect of using monopolar electrosurgery in the presence of a deep brain stimulator: Cadaveric studies on a lamb brain" [J. Clin. Neurosci. (2019) 134-139]. Related ArticlesCorrigendum to "The local thermal effect of using monopolar electrosurgery in the presence of a deep brain stimulator: Cadaveric studies on a lamb brain" [J. Clin. Neurosci. (2019) 134-139]. J Clin Neurosci. 2019 Nov 13;: Authors: Tipper G, Taqvi AA, Singh A, Pohl U, Low H PMID: 31734161 [PubMed - as supplied by publisher] J Clin Neurosci Mon Nov 18, 2019 15:12 Mark above section as read  pubmed: epilepsy treatment Risk factors associated with drug resistant focal epilepsy in adults: A case control study. Related ArticlesRisk factors associated with drug resistant focal epilepsy in adults: A case control study. Seizure. 2019 Nov 05;73:46-50 Authors: Roy PL, Ronquillo LH, Ladino LD, Tellez-Zenteno JF Abstract PURPOSE: Using an adult cohort of patients with focal epilepsy, we aimed to identify risk factors for development of drug-resistant epilepsy, which if identifiable would allow patients to receive appropriate counsel and earlier surgical treatment.... pubmed: epilepsy treatment Mon Nov 18, 2019 15:02 Ginsenoside compound K alleviates sodium valproate-induced hepatotoxicity in rats via antioxidant effect, regulation of peroxisome pathway and iron homeostasis. Related ArticlesGinsenoside compound K alleviates sodium valproate-induced hepatotoxicity in rats via antioxidant effect, regulation of peroxisome pathway and iron homeostasis. Toxicol Appl Pharmacol. 2019 Nov 14;:114829 Authors: Zhou L, Chen L, Zeng X, Liao J, Ouyang D Abstract Sodium valproate (SVP) is a first-line treatment for various forms of epilepsy; however, it can cause severe liver injury. Ginsenoside compound K (G-CK) is the main active ingredient... pubmed: epilepsy treatment Mon Nov 18, 2019 15:02 Perampanel attenuates epileptiform phenotype in C6 glioma. Related ArticlesPerampanel attenuates epileptiform phenotype in C6 glioma. Neurosci Lett. 2019 Nov 14;:134629 Authors: Mayer J, Kirschstein T, Resch T, Porath K, Krause BJ, Köhling R, Lange F Abstract Epileptic seizures are frequent in patients with glioma, and anticonvulsive treatment is often indicated. Glioma cells release glutamate via the Xc- antiporter system, which appears to be a major pathomechanism of glioma-associated seizures and excitotoxicity.... pubmed: epilepsy treatment Mon Nov 18, 2019 15:02 Cenobamate: new hope for treatment-resistant epilepsy. Related ArticlesCenobamate: new hope for treatment-resistant epilepsy. Lancet Neurol. 2019 Nov 13;: Authors: Arnold S PMID: 31734104 [PubMed - as supplied by publisher] pubmed: epilepsy treatment Mon Nov 18, 2019 15:02 Safety and efficacy of adjunctive cenobamate (YKP3089) in patients with uncontrolled focal seizures: a multicentre, double-blind, randomised, placebo-controlled, dose-response trial. Related ArticlesSafety and efficacy of adjunctive cenobamate (YKP3089) in patients with uncontrolled focal seizures: a multicentre, double-blind, randomised, placebo-controlled, dose-response trial. Lancet Neurol. 2019 Nov 13;: Authors: Krauss GL, Klein P, Brandt C, Lee SK, Milanov I, Milovanovic M, Steinhoff BJ, Kamin M Abstract BACKGROUND: More than a third of patients with epilepsy are treatment resistant, and thus new, more effective therapies to... pubmed: epilepsy treatment Mon Nov 18, 2019 15:02 Mark above section as read  Head and Neck Assessment of Oral Mucositis among Patients Undergoing Radiotherapy for Head and Neck Cancer: An Audit. Related ArticlesAssessment of Oral Mucositis among Patients Undergoing Radiotherapy for Head and Neck Cancer: An Audit. Kathmandu Univ Med J (KUMJ). 2019 Jan.-Mar;17(65):61-65 Authors: Luitel A, Rimal J, Maharjan IK, Regmee P Abstract Background Radiation-induced oral mucositis is one of the major ionizing radiation toxicities and normal tissue injuries resulting from radiotherapy. It occurs in up to 80% of head and neck cancer irradiated patients, reaching... Head and Neck Mon Nov 18, 2019 14:39 Validation of the French Versions of the Speech Handicap Index and the Phonation Handicap Index in Patients Treated for Cancer of the Oral Cavity or Oropharynx. Related ArticlesValidation of the French Versions of the Speech Handicap Index and the Phonation Handicap Index in Patients Treated for Cancer of the Oral Cavity or Oropharynx. Folia Phoniatr Logop. 2019 Nov 15;:1-14 Authors: Balaguer M, Farinas J, Fichaux-Bourin P, Puech M, Pinquier J, Woisard V Abstract CONTEXT: Nowadays, clinical tools are available to evaluate the functional impact of speech disorders in neurological conditions, but few are validated... Head and Neck Mon Nov 18, 2019 14:39 Genome-Wide Profiling of Acquired Uniparental Disomy Reveals Prognostic Factors in Head and Neck Squamous Cell Carcinoma. Related ArticlesGenome-Wide Profiling of Acquired Uniparental Disomy Reveals Prognostic Factors in Head and Neck Squamous Cell Carcinoma. Neoplasia. 2019 Nov 14;21(11):1102-1109 Authors: Tuna M, Liu W, Amos CI, Mills GB Abstract Acquired uniparental disomy (aUPD) leads to homozygosity facilitating identification of monoallelically expressed genes. We analyzed single-nucleotide polymorphism array-based genotyping data of 448 head and neck squamous cell... Head and Neck Mon Nov 18, 2019 14:39 Allergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Related ArticlesAllergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Int J Pediatr Otorhinolaryngol. 2019 Oct 31;129:109759 Authors: Testa D, DI Bari M, Nunziata M, Cristofaro G, Massaro G, Marcuccio G, Motta G Abstract Allergic rhinitis (AR) is the most prevalent allergic disease in children and can be associated with asthma (A); this association can have significant effect on child's quality of life. The... Head and Neck Mon Nov 18, 2019 14:39 A retrospective study of patients with Robin sequence: Patient characteristics and their impact on clinical outcomes. Related ArticlesA retrospective study of patients with Robin sequence: Patient characteristics and their impact on clinical outcomes. Int J Pediatr Otorhinolaryngol. 2019 Nov 07;129:109769 Authors: Hamilton S, Dzioba A, Husein M Abstract INTRODUCTION: Robin sequence (RS) is a congenital set of abnormalities of the head and neck, consisting of a hypoplastic mandible (micrognathia), a tongue that is displaced posteriorly (glossoptosis), and obstruction... Head and Neck Mon Nov 18, 2019 14:39 Remote leptomeningeal dissemination in olfactory neuroblastoma mimicking multiple parasagittal meningiomas: a diagnostic and therapeutic challenge. Related ArticlesRemote leptomeningeal dissemination in olfactory neuroblastoma mimicking multiple parasagittal meningiomas: a diagnostic and therapeutic challenge. World Neurosurg. 2019 Nov 14;: Authors: Martinez-Perez R, Hardesty D, Palmer J, Zachariah M, Otto B, Carrau R, Prevedello D Abstract BACKGROUND: Olfactory neuroblastoma (ON) is a highly aggressive and locally recurrent neoplasm. Distant systemic metastases are not uncommon, but remote leptomeningeal... Head and Neck Mon Nov 18, 2019 14:39 Effect of obturators on facial form following surgery for head and neck cancer and impact on the perception of appearance. Related ArticlesEffect of obturators on facial form following surgery for head and neck cancer and impact on the perception of appearance. J Dent. 2019 Nov 14;:103230 Authors: Coward TJ, Richards R, Fenlon MR, Scott BJJ Abstract OBJECTIVES: To describe the correlation between changes in the surface area and depth of the face in individuals wearing an obturator compared with it not being in place, and self-reported Quality of Life in relation to appearance.... Head and Neck Mon Nov 18, 2019 14:39 Corrigendum to "Subtle Eyelid Retraction after Lower Blepharoplasty" [Journal of Plastic, Reconstructive & Aesthetic Surgery, 72 (10), 2019, 1682-1687]. Related ArticlesCorrigendum to "Subtle Eyelid Retraction after Lower Blepharoplasty" [Journal of Plastic, Reconstructive & Aesthetic Surgery, 72 (10), 2019, 1682-1687]. J Plast Reconstr Aesthet Surg. 2019 Nov 13;: Authors: Harounian J, Wulc AE, Brackup AB, Ramesh S PMID: 31734234 [PubMed - as supplied by publisher] Head and Neck Mon Nov 18, 2019 14:39 Sclerotherapy for lymphatic malformations of head and neck: Systematic review and meta-analysis. Related ArticlesSclerotherapy for lymphatic malformations of head and neck: Systematic review and meta-analysis. J Vasc Surg Venous Lymphat Disord. 2019 Nov 13;: Authors: De Maria L, De Sanctis P, Balakrishnan K, Tollefson M, Brinjikji W Abstract BACKGROUND: Percutaneous sclerotherapy is a commonly used modality for treatment of lymphatic malformations (LMs) of the head, face, and neck. The safety and efficacy of sclerotherapy with various agents for... Head and Neck Mon Nov 18, 2019 14:39 Image-guided surgery of head and neck carcinoma in rabbit models by intra-operatively defining tumour-infiltrated margins and metastatic lymph nodes. Related ArticlesImage-guided surgery of head and neck carcinoma in rabbit models by intra-operatively defining tumour-infiltrated margins and metastatic lymph nodes. EBioMedicine. 2019 Nov 13;: Authors: Sun P, Zhang Y, Li K, Wang C, Zeng F, Zhu J, Wu Y, Tao X Abstract BACKGROUND: The infiltrative nature and lymphatic metastasis of head and neck squamous cell carcinoma (HNSCC) are the main reasons leading to its poor prognosis. METHODS: A multimodal... Head and Neck Mon Nov 18, 2019 14:39 Treatment Outcomes of Arytenoid Dislocation by Closed Reduction: A Multidimensional Evaluation. Related ArticlesTreatment Outcomes of Arytenoid Dislocation by Closed Reduction: A Multidimensional Evaluation. J Voice. 2019 Nov 13;: Authors: Wu X, Mao W, Zhang J, Wei C Abstract OBJECTIVE: This study aimed to investigate the treatment outcomes of arytenoid dislocation by a multidimensional evaluation. METHODS: From April 2010 to May 2018, the records of 57 patients with a history of arytenoid dislocation were reviewed. All the patients were... Head and Neck Mon Nov 18, 2019 14:39 The clinical characteristics of patients with an isolate epiglottic collapse. Related ArticlesThe clinical characteristics of patients with an isolate epiglottic collapse. Auris Nasus Larynx. 2019 Nov 13;: Authors: Sung CM, Kim HC, Yang HC Abstract OBJECTIVE: We analyzed the clinical characteristics of patients with isolated epiglottic collapse (IEC) who had an epiglottic anteroposterior (AP) collapse as the only cause of snoring during drug-induced sleep endoscopy (DISE). METHODS: A retrospective analysis of 334 consecutive... Head and Neck Mon Nov 18, 2019 14:39 An update on autoimmune inner ear disease: A systematic review of pharmacotherapy. Related ArticlesAn update on autoimmune inner ear disease: A systematic review of pharmacotherapy. Am J Otolaryngol. 2019 Oct 28;:102310 Authors: Strum D, Kim S, Shim T, Monfared A PMID: 31733712 [PubMed - as supplied by publisher] Head and Neck Mon Nov 18, 2019 14:39 Mark above section as read  radioactive iodine The impact of thyroid diseases starting from birth on reproductive function. Related ArticlesThe impact of thyroid diseases starting from birth on reproductive function. Hormones (Athens). 2019 Nov 16;: Authors: Krassas GE, Markou KB Abstract The aim of this review is to provide relevant information regarding the impact of thyroid disease, starting from birth and mainly concerning hyperthyroidism and hypothyroidism, on reproduction. Hyperthyroidism occurs much less commonly in children than hypothyroidism, with Graves' disease... radioactive iodine Mon Nov 18, 2019 15:11 Mark above section as read  Latest Results for Current Microbiology Enzymatic Characteristics of a Polyphosphate/ATP-NAD Kinase, PanK, from Myxococcus xanthus Abstract NAD kinase is a crucial enzyme for production of NADP+. Myxococcus xanthus is a gram-negative soil bacterium that forms fruiting bodies and spores under starvation, and it accumulates polyphosphate (poly(P)) during early development. We found that M. xanthus NAD kinase (PanK) utilized both ATP and poly(P) as phosphoryl donors; therefore, PanK was designated as a poly(P)/ATP-NAD kinase. Unlike other poly(P)/ATP-NAD kinases, PanK hardly exhibited NADH kinase activity. The... Latest Results for Current Microbiology Mon Nov 18, 2019 02:00 Mark above section as read  Larynx Genetic factors in isolated and syndromic laryngeal cleft. Related ArticlesGenetic factors in isolated and syndromic laryngeal cleft. Paediatr Respir Rev. 2019 Oct 08;: Authors: Li Y, Rui X, Li N Abstract A laryngotracheoesophageal cleft (LC) is a rare congenital anomaly of the upper aerodigestive tract resulting from the absence of fusion of the posterior cricoid lamina, which affects an abnormal communication between the larynx, trachea and esophagus. The genetic etiology of LC remains elusive. The involvement... Larynx Mon Nov 18, 2019 18:53 Mark above section as read  Neuro-Oncology A multi-institutional analysis of clinical outcomes and patterns of care of 1p/19q codeleted oligodendrogliomas treated with adjuvant or salvage radiation therapy Abstract Purpose Practice patterns vary for adjuvant treatment of 1p/19q-codeleted oligodendroglioma patients. This study evaluates the outcomes of adjuvant (aRT) versus salvage radiation therapy (sRT) in a multi-institutional cohort. Methods Oligodendroglioma patients with confirmed 1p/19q codeletion who were treated with RT with or without chemotherapy... Neuro-Oncology Mon Nov 18, 2019 02:00 Mark above section as read  Thyroid Res Pract Severe hypothyroidism-associated acute renal failure – A case series from North India and review of literature Namrata S Rao, Abhilash Chandra, Kiran Preet MalhotraThyroid Research and Practice 2019 16(3):121-127 Background: Several cases of complete or partially reversible renal failure have been reported in association with severe hypothyroidism, which have responded to thyroxine replacement. However, its risk factors, pathology, pathophysiology, and time of recovery remain unclear. Aim: We report our experience with 31 cases of renal failure in association with severe hypothyroidism, from a goiter-endemic... Thyroid Res Pract Mon Nov 18, 2019 00:00 Cord blood thyroid-stimulating hormone as a screening tool for congenital hypothyroidism: A single-center 5-year experience Mahmood Dhahir Al-MendalawiThyroid Research and Practice 2019 16(3):144-144 Thyroid Res Pract Mon Nov 18, 2019 00:00 Assessment of serum midkine level in benign and malignant thyroid nodules. Can midkine be a marker of thyroid malignancy? Nermin Ahmed Sheriba, Maram Mohamed Mahdy, Rana Hashem Ibrahim Elattary, Maha Mohamed El-NabarawyThyroid Research and Practice 2019 16(3):95-99 Background: Thyroid nodules are a common clinical problem. The prevalence of malignancy in thyroid nodules is currently about 5%–15%. Fine-needle aspiration biopsy (FNAB) has improved the preoperative prediction of malignancy, but still has disadvantages including operator variability and nondiagnostic reports. Midkine (MK) is a novel heparin-binding... Thyroid Res Pract Mon Nov 18, 2019 00:00 Extensive squamous metaplasia in papillary carcinoma of the thyroid: A potential diagnostic pitfall Subhash Yadav, Rajiv Kumar, Munita Bal, Asawari PatilThyroid Research and Practice 2019 16(3):137-139 It is a rare event to find squamous cells in the thyroid gland. Squamous metaplasia (SM) of the thyroid follicular epithelium is one of such conditions. SM can occur in association with nonneoplastic as well as neoplastic thyroid lesions. Here, we report a case of papillary carcinoma of the thyroid in a 26-year-old female showing extensive SM. On immunohistochemistry, squamous as well as papillary... Thyroid Res Pract Mon Nov 18, 2019 00:00 Morphological variations of the thyroid gland: An insight on embryological and clinicoanatomical considerations Honnegowda Thittamaranahalli Muguregowda, G Krishna, KG PrakashThyroid Research and Practice 2019 16(3):100-104 Background: The thyroid gland, a highly vascular endocrine gland, is composed of two lateral lobes connected by isthmus. A wide range of morphological alterations of the thyroid gland such as hypoplasia, ectopy to hemiagenesis, and genesis are common because of disturbed embryogenesis. The significance of diagnosing such extensions of the thyroid gland is crucial. It may alter the normal... Thyroid Res Pract Mon Nov 18, 2019 00:00 Thyroidology and public health: Challenges within the medical profession Sanjay KalraThyroid Research and Practice 2019 16(3):93-94 Thyroid Res Pract Mon Nov 18, 2019 00:00 Role of nuclear grooves in the cytological diagnosis of papillary carcinoma thyroid Archana S Bhat, Lisa Varma, Hilda Fernandes, CS JayaprakashThyroid Research and Practice 2019 16(3):105-107 Introduction: It is well known that nuclear grooves play a major role in the diagnosis of papillary carcinoma thyroid (PCT). Furthermore, grooves are found in many nonneoplastic lesions of thyroid. Aims: The aim of this study is to calculate the percentage of nuclear grooves in histopathologically proven cases of papillary carcinoma and nonneoplastic lesions (Hashimoto's thyroiditis... Thyroid Res Pract Mon Nov 18, 2019 00:00 A case-based approach to aggressive variants of papillary thyroid carcinoma with literature review Joseph Antoine Flordelis Chatto, Annette Laurente SalillasThyroid Research and Practice 2019 16(3):128-136 Papillary thyroid caarcinoma (PTC) is the most common thyroid and endocrine malignancy. Although considered to be indolent, aggressive variants have been identified, including the Tall Cell (TCV), Columnar Cell (CCV), Hobnail (HPTC) and Solid Variants (SVPTC). The objective of this study is to pre-operatively recognize the cytologic features of these variants. Four cases with final diagnoses... Thyroid Res Pract Mon Nov 18, 2019 00:00 Iodine nutrition status in Graves' disease: A single-center study from Bangladesh Md Abu Jar Gaffar, A B. M. Kamrul-Hasan, Afsar Ahammed, Muhammad Abul Hasanat, Md FariduddinThyroid Research and Practice 2019 16(3):108-112 Context: An increase in occurrence of Graves' disease (GD) has been reported in many countries after the introduction of the salt iodization program. Aims: To observe iodine nutrition status in GD. Settings and Design: Cross-sectional observational study conducted in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka,... Thyroid Res Pract Mon Nov 18, 2019 00:00 Diagnostic issue and caveats of immunoreactivity for Ki67 in hyalinizing trabecular neoplasm with a review of literature Veer Karuna, Priya Gupta, Mamta Gupta, Kriti GroverThyroid Research and Practice 2019 16(3):140-143 Few benign and malignant tumors of thyroid lesion share many histological features, including papillary and trabecular pattern, hyalinized stroma, calcification, nuclear grooving, and nuclear inclusion. The lesions those have these common features are hyalinizing trabecular tumor, papillary thyroid carcinoma, medullary carcinoma, paraganglioma, trabecular follicular adenoma (TFA), and poorly differentiated... Thyroid Res Pract Mon Nov 18, 2019 00:00 Prognostic efficacy of thyroid profile with sequential organ failure assessment score in predicting mortality in intensive care unit patients Arvind Mishra, Rohin Saini, Madhukar Mittal, Dandu Himanshu, Kamlesh Kumar Gupta, Abbas Ali MahdiThyroid Research and Practice 2019 16(3):113-120 Introduction and Objectives: Thyroid hormone changes in critically ill patients are commonly observed phenomenon. This is known as sick euthyroid syndrome. Sequential organ faillure assessment (SOFA) score is used to track and determine the extent of a person's organ function or its rate of failure. We performed a prospective observation study to analyze... Thyroid Res Pract Mon Nov 18, 2019 00:00 Trend toward early euthyroxinemia in admitted patients of Graves' disease on carbimazole therapy Aparajita Roy, Rahul Gupta, Anshita Aggarwal, Bindu KulshreshthaThyroid Research and Practice 2019 16(3):145-146 Thyroid Res Pract Mon Nov 18, 2019 00:00 Mark above section as read  American Journal of Primatology Phylogeographic evidence for two species of muriqui (genus Brachyteles) Northern and southern muriquis group into two different genetic clusters separated by roughly 2.0 million years ago. Abstract The taxonomy of muriquis, the largest extant primates in the New World, is controversial. While some specialists argue for a monotypic genus (Brachyteles arachnoides), others favor a two‐species classification, splitting northern muriquis (Brachyteles hypoxanthus) from southern muriquis (B. arachnoides). This uncertainty affects how we study the differences between these... American Journal of Primatology Sun Nov 17, 2019 18:49 Mark above section as read  Current Treatment Options in Oncology Management of V600E and V600K BRAF -Mutant Melanoma Opinion statement The optimal management of advanced stage BRAF-mutated melanoma is widely debated and complicated by the availability of several different regimens that significantly improve outcomes but have not been directly compared. While there are many unanswered questions relevant to this patient population, the major uncertainty in current practice is the choice between BRAF/MEK inhibitors or immunotherapy for those with previously untreated metastatic or high-risk disease.... Current Treatment Options in Oncology Mon Nov 18, 2019 02:00 Mark above section as read  Lasers in Surgery and Medicine Single Ablative Fractional Resurfacing Laser Treatment For Forearm Actinic Keratoses: 6‐Month Follow‐Up Data From An Intrapatient Comparison Between Treated and Untreated Sites Background and Objectives Actinic keratoses (AK) are common pre‐cancerous lesions, which are associated with ultraviolet light exposure and aging. Wounding therapies such as fractionated laser resurfacing (FLR) have been previously demonstrated to effectively treat facial AK. However, the effectiveness of FLR on other sites commonly afflicted with AK has not been studied in detail. Previously, our group has reported that treatment of aged skin with wounding therapies including dermabrasion and ablative... Lasers in Surgery and Medicine Sun Nov 17, 2019 18:33 Percutaneous Interstitial Nd:YAG Laser Therapy for Axillary Osmidrosis Background and Objectives To investigate the effects of percutaneous interstitial Nd:YAG laser irradiation on the apocrine glands and molecules involved in odor production (apolipoprotein [ApoD], androgen receptor [AR]) in the subcutaneous tissue of a pig. Study Design/Materials and Methods Skin on the back of healthy adult miniature pigs was exposed to pulsed Nd:YAG laser irradiation at 5 or 10 W, or continuous Nd:YAG laser irradiation at 10 W. Samples were taken 1 hour, 1 week, and 1 month... Lasers in Surgery and Medicine Sun Nov 17, 2019 18:29 Mark above section as read  PeerJ Computer Science Bibliographic revision of Mesacanthion Filipjev, 1927 (Nematoda: Thoracostomopsidae) with description of a new species from Jeju Island, South Korea A new species of the genus Mesacanthion Filipjev, 1927 was discovered during a survey of natural beaches of Jeju Island in South Korea. The new species Mesacanthion jejuensis sp. nov. shares general morphology of the genus such as the outer labial and cephalic setae being situated at the middle of cephalic capsule, well-developed mandibles with two columns united by a curved bar, and three equally sized and shaped teeth shorter than the mandibles. The new species belongs to a group of Mesacanthion... PeerJ Computer Science Mon Nov 18, 2019 02:00 First palaeoneurological study of a sauropod dinosaur from France and its phylogenetic significance Despite continuous improvements, our knowledge of the palaeoneurology of sauropod dinosaurs is still deficient. This holds true even for Titanosauria, which is a particularly speciose clade of sauropods with representatives known from numerous Cretaceous sites in many countries on all continents. The data currently available regarding the palaeoneurology of titanosaurs is strongly biased towards Gondwanan forms (Argentina above all, but also India, Malawi and Australia). In contrast, the palaeoneurology... PeerJ Computer Science Mon Nov 18, 2019 02:00 Acquisition of fungi from the environment modifies ambrosia beetle mycobiome during invasion Microbial symbionts can play critical roles when their host attempts to colonize a new habitat. The lack of symbiont adaptation can in fact hinder the invasion process of their host. This scenario could change if the exotic species are able to acquire microorganisms from the invaded environment. Understanding the ecological factors that influence the take-up of new microorganisms is thus essential to clarify the mechanisms behind biological invasions. In this study, we tested whether different forest... PeerJ Computer Science Mon Nov 18, 2019 02:00 A recombinase polymerase amplification-lateral flow dipstick assay for rapid detection of the quarantine citrus pathogen in China, Phytophthora hibernalis Phytophthora hibernalis, the causal agent of brown rot of citrus fruit, is an important worldwide pathogen and a quarantine pest in China. Current diagnosis of the disease relies on disease symptoms, pathogen isolation and identification by DNA sequencing. However, symptoms caused by P. hibernalis can be confused with those by other Phytophthora and fungal species. Moreover, pathogen isolation, PCR amplification and sequencing are time-consuming. In this study, a rapid assay including 20-min recombinase... PeerJ Computer Science Mon Nov 18, 2019 02:00 Angiogenic signaling in the lungs of a metabolically suppressed hibernating mammal (Ictidomys tridecemlineatus) To conserve energy in times of limited resource availability, particularly during cold winters, hibernators suppress even the most basic of physiologic processes. Breathing rates decrease from 40 breaths/minute to less than 1 breath/min as they decrease body temperature from 37 °C to ambient. Nevertheless, after months of hibernation, these incredible mammals emerge from torpor unscathed. This study was conducted to better understand the protective and possibly anti-inflammatory adaptations that... PeerJ Computer Science Mon Nov 18, 2019 02:00 Host dietary specialization and neutral assembly shape gut bacterial communities of wild dragonflies Host-associated gut microbiota can have significant impacts on host ecology and evolution and are often host-specific. Multiple factors can contribute to such host-specificity: (1) host dietary specialization passively determining microbial colonization, (2) hosts selecting for specific diet-acquired microbiota, or (3) a combination of both. The latter possibilities indicate a functional association and should produce stable microbiota. We tested these alternatives by analyzing the gut bacterial... PeerJ Computer Science Mon Nov 18, 2019 02:00 Mark above section as read  Current Allergy and Asthma Reports Conditioning Regimens for Hematopoietic Cell Transplantation in Primary Immunodeficiency Abstract Purpose of Review Hematopoietic cell transplantation (HCT) is an established curative treatment for children with primary immunodeficiencies. This article reviews the latest developments in conditioning regimens for primary immunodeficiency (PID). It focuses on data regarding transplant outcomes according to newer reduced toxicity conditioning regimens used in HCT for PID. ... Current Allergy and Asthma Reports Mon Nov 18, 2019 02:00 Mark above section as read  Anti-Cancer Drugs - Published Ahead-of-Print Targeted therapy clinical trials in ovarian cancer: improved outcomes by gene mutation screening Epithelial ovarian cancer is the most common and leading cause of death for gynaecologic cancer in the western world. Current standard treatments with limited selection of chemotherapies cannot meet patients' urgent needs. Novel targeted therapies may improve patients' survival rate with less side effects that have been demonstrated by using approved medicines such as poly ADP-ribose polymerase and angiogenesis inhibitors. Many classes of targeted therapies impacting cell signalling pathways related... Anti-Cancer Drugs - Published Ahead-of-Print Fri Nov 15, 2019 02:00 A case of pelvic giant cell tumor of bone, complete remission with denosumab: long duration of response Although giant cell tumor of bone has been considered as a disease with benign course, it can lead to bone destruction and serious morbidity. A 19-year-old case was presented with hip pain. There was a recurrence after 9 months of curative surgical resection and zoledronic acid use, and as surgical morbidity would be high, antiosteoclastic receptor activator of nuclear factor kappa B ligand inhibitor denosumab treatment was administered. She had a complete remission after 18 months of denosumab treatment.... Anti-Cancer Drugs - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Berberine inhibits proliferation and migration of colorectal cancer cells by downregulation of GRP78 Objective Human colorectal cancer (CRC), a highly malignant and metastatic carcinoma, is resistant to many present anticancer therapies. The inhibition of tumor survival and growth through receptor suppression is a promising way to treat CRC. The study aimed to investigate the effect of a natural plant triterpenoid, berberine (BBR), on SW480 cells and whether its role is mediated by Glucose-regulated protein 78 (GRP78). Methods MTT assay, wound healing assay, and Annexin V-FITC assay were... Anti-Cancer Drugs - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Effect of miR-196a inhibition on esophageal cancer growth in vitro Esophageal cancer has recent shown a higher incidence but lower 5-year survival rate after normal clinical treatment in China. The aim of this study was to observe whether the inhibition of miR-196a affects esophageal cancer cell growth by modulating the nuclear factor-κB target gene and to detect the possible cooperative therapeutic effects on esophageal cancer by knocking down miR-196a expression combined with the specific inhibitor of nuclear factor-κB target genes. Thus, anti-miR-196a or sotrastaurin,... Anti-Cancer Drugs - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Mark above section as read  Journal of Neurosurgical Anesthesiology - Published Ahead-of-Print Neurosurgical Interventions for Neurotrauma in the Obstetric Population: A Systematic Review Trauma requiring neurosurgical intervention in the obstetric population is rare. Provision of care must include consideration for both maternal and fetal well-being, and conflicts may arise. Management strategies to reduce elevated maternal intracranial pressure (ICP) and provide adequate surgical exposure, for example, may compromise uteroplacental perfusion. There is scarce literature to guide anesthetic care and few resources summarizing management of these uncommon cases. We conducted a systematic... Journal of Neurosurgical Anesthesiology - Published Ahead-of-Print Thu Nov 14, 2019 02:00 Mark above section as read  International Journal of Cancer Effectiveness of the AS04‐adjuvanted HPV‐16/18 vaccine in reducing oropharyngeal HPV infections in young females – results from a community‐randomized trial We studied effectiveness of the AS04‐adjuvanted HPV‐16/18 (AS04‐HPV‐16/18) vaccine against human papillomavirus (HPV) oropharyngeal infections associated with the increase of head/neck cancers in western countries. All 38631 resident adolescents from 1994‐95 birth cohorts of 33 Finnish communities were invited in this community‐randomized trial (NCT00534638). During 2008‐2009, 11275 girls and 6129 boys were enrolled in 3 arms of 11 communities each. In Arm A, 90% of vaccinated girls/boys, and in... International Journal of Cancer Sun Nov 17, 2019 16:24 Mark above section as read  Thyroid Mucosa-Associated Lymphoid Tissue Lymphoma of the Thyroid Gland: A Systematic Review of the Literature Objective: Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type of the thyroid gland is a rare indolent malignant disease encountered in approximately 0.5% of patients with Hashimoto thyroiditis (HT). The purpose of the present systematic review was to accumulate the current evidence in the field. Study Design: We searched the Medline, Scopus, EMBASE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials CENTRAL databases from inception to May... Thyroid Mon Nov 18, 2019 09:48 Mark above section as read  Systematic Reviews - Latest Articles Screening for thyroid dysfunction and treatment of screen-detected thyroid dysfunction in asymptomatic, community-dwelling adults: a systematic review This systematic review was conducted to inform the Canadian Task Force on Preventive Health Care recommendations on screening for thyroid dysfunction (TD). The review sought to answer key questions on the bene... Systematic Reviews - Latest Articles Mon Nov 18, 2019 02:00 Mark above section as read  Otology & Neurotology - Published Ahead-of-Print The Importance of the Temporal Bone 3T MR Imaging in the Diagnosis of Menière's Disease Background: The aim of this study was to evaluate endolymphatic hydrops using the 3T temporal bone magnetic resonance imaging (MRI), performed according to the chosen protocol, and determine whether it could be applied as an objective diagnostic tool for Menière's disease. Methods: 105 participants diagnosed with probable (n = 50) and definite (n = 55) Menière's disease were included in this prospective study at Vilnius University Hospital, Santaros Clinics. Audiometry, vestibular function... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Electrode Array Type and Its Impact on Impedance Fluctuations and Loss of Residual Hearing in Cochlear Implantation Hypothesis/Objective: Determine variables associated with electrode impedance fluctuations and loss of residual hearing in cochlear implant (CI) recipients. Background: CI recipients with postoperative hearing preservation demonstrate superior speech perception with an electric-acoustic stimulation (EAS) device as compared with a CI-alone device. Maintaining superior speech perception over time relies on long-term hearing preservation; therefore, understanding variables that may contribute... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Comparison of Spontaneous Temporal Bone Cerebrospinal Fluid Leaks From the Middle and Posterior Fossa Objectives: To compare patients surgically managed for spontaneous cerebrospinal fluid (CSF) leaks of the temporal bone arising from the middle cranial fossa (MCF) and posterior cranial fossa (PCF) and to describe the surgical management of posterior fossa CSF leaks. Study Design: Retrospective case review. Setting: Academic tertiary center. Patients: Adult patients presenting with spontaneous temporal bone CSF leaks undergoing operative repair between January 2010 and August 2018.... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Factors Associated With Facial Nerve Paresis Following Gamma Knife for Vestibular Schwannoma Objective: Evaluate the incidence of and potential contributory factors to facial nerve paresis and other cranial neuropathies (CN) following stereotactic radiosurgery with Gamma Knife (GK) for primary treatment of vestibular schwannoma (VS). Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Charts were reviewed for all adult patients receiving primary GK treatment for unilateral VS between 2005 and 2013. Patients with NF2 or previous surgery... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Systematic Review and Network Meta-analysis of Cognitive and/or Behavioral Therapies (CBT) for Tinnitus Objective: To evaluate the efficacy of cognitive and/or behavioral therapies in improving health-related quality of life (HRQOL), depression, and anxiety associated with tinnitus. Data Sources: EMBASE, MEDLINE, PubMed, PsycINFO, and the Cochrane Registry were used to identify English studies from database inception until February 2018. Study Selection: Randomized controlled trials (RCTs) comparing cognitive and/or behavioral therapies to one another or to waitlist controls for the treatment... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Postoperative Healthcare Utilization of Elderly Adults After Cochlear Implantation Objective: To determine the association between geriatric age and postoperative healthcare utilization after cochlear implantation. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: : Older adults (>59 yr) who underwent unilateral cochlear implantation from 2009 until 2016. Intervention(s): : Standard electrode length cochlear implantation. Main Outcome Measure(s): : Postoperative surgical and audiological visit rate after cochlear... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Risks of Intracochlear Pressures From Laser Stapedotomy Hypothesis: Surgical manipulations during laser stapedotomy can produce intracochlear pressure changes comparable to pressures created by high-intensity acoustic stimuli. Background: New-onset sensorineural hearing loss is a known risk of stapes surgery and may result from pressure changes from laser use or other surgical manipulations. Here, we test the hypothesis that high sound pressure levels are generated in the cochlea during laser stapedotomy. Methods: Human cadaveric heads underwent... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 On the Relationship Between Menière's Disease and Endolymphatic Hydrops The relationship between Menière's disease and endolymphatic hydrops is ambiguous. On the one hand, the existence of cases of endolymphatic hydrops lacking the classic symptoms of Menière's disease has prompted the assertion that endolymphatic hydrops alone is insufficient to cause symptoms and drives the hypothesis that endolymphatic hydrops is a mere epiphenomenon. Yet, on the other hand, there is considerable evidence suggesting a relationship between the mechanical pressure effects of endolymphatic... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Long-Term Stability and Functional Outcome of an Active Middle Ear Implant Regarding Different Coupling Sites Objectives: Indication and implantation of active middle ear implants (AMEI) are well established. Choice of the coupling site depends from the individual anatomical situation. Long-term stability of different coupling sites in terms of functional outcome and complications are rare and were investigated in this study. Design: Retrospective analysis of 41 consecutive patients (45 ears) with coupling of the AMEI at the incus, stapes, and round window. Analysis of preoperative, postoperative,... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 3D-Printed Microneedles Create Precise Perforations in Human Round Window Membrane in Situ Hypothesis: Three-dimensional (3D)-printed microneedles can create precise holes on the scale of micrometers in the human round window membrane (HRWM). Background: An intact round window membrane is a barrier to delivery of therapeutic and diagnostic agents into the inner ear. Microperforation of the guinea pig round window membrane has been shown to overcome this barrier by enhancing diffusion 35-fold. In humans, the challenge is to design a microneedle that can precisely perforate the thicker... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Intratympanic Diltiazem-Chitosan Hydrogel as an Otoprotectant Against Cisplatin-Induced Ototoxicity in a Mouse Model Hypothesis: Local administration of the calcium-channel blocker (CCB), diltiazem, via intratympanic (IT) chitosan-glycerophosphate (CGP) hydrogel will protect against cisplatin-induced ototoxicity. Background: Cisplatin induces calcium-mediated apoptosis of cochlear outer hair cells (OHCs). Previous work demonstrated otoprotection and reduced auditory brainstem response (ABR) threshold shifts in a cisplatin-induced ototoxicity mouse model treated with multiple doses of IT diltiazem given... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Balloon Eustachian Tuboplasty Combined With Tympanocentesis Is not Superior to Balloon Eustachian Tuboplasty in Chronic Otitis Media With Effusion—A Randomized Clinical Trial Objective: Balloon Eustachian tuboplasty (BET) appears to be a promising therapeutic option for Eustachian tube dysfunction. However, data are lacking on its effect in adults with chronic otitis media with effusion (COME) and whether it should be combined with tympanocentesis. The aim of our study was to determine if there is a beneficial effect of BET combined with tympanocentesis compared with BET only and provide data on the effect of BET in adults with COME. Study Design: Randomized clinical... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 A Possible Role of Video-Head Impulse Test in Detecting Canal Involvement in Benign Paroxysmal Positional Vertigo Presenting With Positional Downbeat Nystagmus Objective: To describe the possible diagnostic role of video-head impulse test (vHIT) in patients presenting with positional downbeat nystagmus (PDN) due to benign paroxysmal positional vertigo (BPPV) involving the anterior canal (AC) or the non-ampullary arm of the posterior canal (PC). Patients: Three patients presenting with positional vertigo, PDN, symmetrical cervical and ocular vestibular-evoked myogenic potentials, and selective deficit of the vestibulo-ocular reflex (VOR) gain for... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Cochlear Implantation in Craniometaphyseal Dysplasia Objective: Describe the first case of cochlear implantation (CI) for auditory rehabilitation of a patient with craniometaphyseal dysplasia (CMD) and progressive mixed hearing loss. Patients: A 65-year-old woman with known autosomal dominant CMD presented with progressive mixed hearing loss and declining benefit from conventional hearing aids. Computed tomography and magnetic resonance imaging revealed hyperostosis of the entire craniofacial skeleton. Hearing evaluation demonstrated pure-tone... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Hearing Preservation Outcomes Using a Precurved Electrode Array Inserted With an External Sheath Objectives: Describe audiologic outcomes in hearing preservation cochlear implantation (CI) using a precurved electrode array inserted using an external sheath and evaluate association of electrode positioning and preservation of residual hearing. Study Design: Retrospective review. Setting: Tertiary otologic center. Patients: Twenty-four adult patients who underwent hearing preservation CI with precurved electrode array. Interventions: CI, intraoperative computed tomography... Otology & Neurotology - Published Ahead-of-Print Fri Nov 15, 2019 02:00 Mark above section as read  Otology & Neurotology Published Ahead-of-Print Mark above section as read  The American Journal of Surgical Pathology - Published Ahead-of-Print Assessment of Tumor-infiltrating Lymphocytes Using International TILs Working Group (ITWG) System Is a Strong Predictor of Overall Survival in Colorectal Carcinoma: A Study of 1034 Patients The presence of increased tumor-infiltrating lymphocytes (TILs) is established as a positive prognostic factor in many malignancies including colorectal carcinoma (CRC). However, multiple different approaches have been used to assess TILs. In 2014, the International TILs Working Group (ITWG) proposed a standardized methodology for evaluating TILs, initially in the context of breast cancer, but subsequently expanded to other malignancies. To date, the efficacy of the ITWG system has not been investigated... The American Journal of Surgical Pathology - Published Ahead-of-Print Thu Nov 14, 2019 02:00 HPV-related Sinonasal Carcinoma: Clinicopathologic Features, Diagnostic Utility of p16 and Rb Immunohistochemistry, and: EGFR: Copy Number Alteration The prevalence and prognostic value of human papillomavirus (HPV) infection and epidermal growth factor receptor (EGFR) alteration in sinonasal squamous cell carcinoma (SNSCC) are not known. The reliability of p16 overexpression as a surrogate for HPV infection in SNSCC is also unclear. We investigated the prognostic and diagnostic significances of HPV infection, EGFR alteration, and p16 expression in SNSCC. We analyzed high-risk HPV infection by HPV-RNA in situ hybridization and EGFR gene copy number... The American Journal of Surgical Pathology - Published Ahead-of-Print Thu Nov 14, 2019 02:00 Transcriptionally Active HPV and Targetable EGFR Mutations in Sinonasal Inverted Papilloma: An Association Between Low-risk HPV, Condylomatous Morphology, and Cancer Risk? Sinonasal inverted papillomas (IPs) commonly recur, and transform to malignancy in 5% to 10% of patients. It has long been debated whether IPs are caused by high-risk or low-risk (lr) human papillomavirus (HPV) and whether the HPV is transcriptionally active. EGFR mutations have also been recently implicated in the pathogenesis of IP with an unclear relationship to HPV status. IP cases over a 10-year period were tested for p16 by immunohistochemistry and for transcriptionally active hrHPV and lrHPV... The American Journal of Surgical Pathology - Published Ahead-of-Print Thu Nov 14, 2019 02:00 Molecular Profiling of Noncoding Mutations Distinguishes Nevoid Melanomas From Mitotically Active Nevi in Pregnancy The accurate recognition of subtle melanomas and their distinction from benign mimics is an oft-recurring diagnostic problem, critical for patient management. Melanomas that bear resemblance to benign nevi (so-called nevoid melanomas, NMs) and benign mitotically active nevi in pregnancy (MANP) are 2 lesions particularly prone to error. Molecular data, including analysis of noncoding regions, in MANP and NM are very limited. This study sought to identify differences in clinical, pathologic, and molecular... The American Journal of Surgical Pathology - Published Ahead-of-Print Thu Nov 14, 2019 02:00 Mark above section as read
Induction of growth cessation by acacetin via β-catenin pathway and apoptosis by apoptosis inducing factor activation in colorectal carcinoma cells.Related ArticlesInduction of growth cessation by acacetin via β-catenin pathway and apoptosis by apoptosis inducing factor activation in colorectal carcinoma cells. Mol Biol Rep. 2019 Nov 16;: Authors: Prasad N, Sharma JR, Yadav UCS Abstract Acacetin, a bioflavanoid, contains anti-inflammatory and anti-cancer activities as shown in different experimental...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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ESR statement on new approaches to undergraduate teaching in Radiology Abstract Medical education is evolving and electronic learning (e-Learning) strategies have now become an essential asset in radiology education. Radiology education is a significant part of the undergraduate medical curriculum and the use of e-Learning in radiology teaching in medical schools is on the rise. If coupled with clinical decision support systems, e-Learning can be a practical way of teaching students clinical decision making, such as selecting the diagnostic imaging... Imaging 02:00 Mark above section as read  Odontology Genetic polymorphisms influence gene expression of human periodontal ligament fibroblasts in the early phases of orthodontic tooth movement Abstract Genetic polymorphisms could be involved in the individual rate of OTM (orthodontic tooth movement) corresponding to the clinical phenomenon of "slow movers" and "fast movers". This study evaluated, if genetic polymorphisms in RANK, RANKL, OPG, COX2 and IL6 are associated with the expression of RANKL, OPG, COX2 and IL6 by human periodontal ligament (hPDL) fibroblasts during OTM. Primary hPDL fibroblasts from periodontal connective tissue of teeth extracted from 57 human... Odontology Mon Nov 18, 2019 02:00 Mark above section as read  pubmed: "am j case rep"[jour... Severe Cobalamin Deficiency Disguised as Schistocytes: A Case Report. Related ArticlesSevere Cobalamin Deficiency Disguised as Schistocytes: A Case Report. Am J Case Rep. 2019 Nov 17;20:1691-1694 Authors: Koubaissi SA, Degheili JA Abstract <strong>BACKGROUND</strong> Vitamin B12, also known as cobalamin (Cbl), is a major player in both erythropoiesis and myelination of the central nervous system. The 2 main manifestations of vitamin B12 deficiency are bone marrow failure and demyelinating disease. These manifestations... pubmed: "am j case rep"[jour... Mon Nov 18, 2019 16:12 Mark above section as read  pubmed: "int j surg case rep... Successful cardiopulmonary resuscitation following minimally invasive pectus excavatum repair: A case report. Related ArticlesSuccessful cardiopulmonary resuscitation following minimally invasive pectus excavatum repair: A case report. Int J Surg Case Rep. 2019 Oct 31;65:255-258 Authors: Glithero KJ, Tackett JJ, DeMason K, Burnweit CA Abstract INTRODUCTION: Pectus excavatum is the most common congenital chest wall deformity. The minimally invasive repair of pectus excavatum (MIRPE) is the most commonly practiced method of surgical treatment and there is concern... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 Clinical progression of renal vein leiomyoma: A case report. Related ArticlesClinical progression of renal vein leiomyoma: A case report. Int J Surg Case Rep. 2019 Nov 04;65:249-254 Authors: Dhawan K, Bansal N, Gupta NM, Dhawan S Abstract INTRODUCTION: Vascular leiomyoma originating in the renal vein is a rare entity. Our case allowed us charting of progression of renal vein leiomyoma for 8-years' duration. Apart from intraluminous growth causing displacement of viscera, the leiomyoma did not show any aggressive... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 Jejunal perforation complicating dermatomyositis. Related ArticlesJejunal perforation complicating dermatomyositis. Int J Surg Case Rep. 2019 Apr 10;65:245-248 Authors: Lee D, Jeong WS, Hyun CL, Kim J Abstract INTRODUCTION: Small bowel perforation is rare in dermatomyositis (DM). However, it is associated with high rates of morbidity and mortality. In line with the SCARE criteria, we describe a case of jejunal perforation for a DM patient (Agha et al., 2018 [1]). CASE PRESENTATION: A 63-year-old... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 Ceramic liner fracture in ceramic on ceramic Total hip arthoplasty: A case report. Related ArticlesCeramic liner fracture in ceramic on ceramic Total hip arthoplasty: A case report. Int J Surg Case Rep. 2019 Nov 05;65:242-244 Authors: Pawar ED, Yadav AK, Sharma A, Harsoor A Abstract INTRODUCTION: Revision rates of total hip arthoplasty have decreased after introducing total hip arthroplasty using ceramic component due to reduce wear and osteolysis. CASE REPORT: 29 year old male case of bilateral hip avascular necrosis operated... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 Cesarean scar pregnancy: A case report with surgical management after initially effective conservative treatment. Related ArticlesCesarean scar pregnancy: A case report with surgical management after initially effective conservative treatment. Int J Surg Case Rep. 2019 Nov 06;65:238-241 Authors: Tsakiridis I, Chatzikalogiannis I, Mamopoulos A, Dagklis T, Tsakmakidis G, Athanasiadis A, Kalogiannidis I Abstract INTRODUCTION: The incidence of cesarean scar pregnancies (CSPs) is increasing, possibly due to higher rates of cesarean sections. We report a case of a CSP... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 A case with hepatic portal vein gas who required delayed elective surgery. Related ArticlesA case with hepatic portal vein gas who required delayed elective surgery. Int J Surg Case Rep. 2019 Nov 06;65:233-237 Authors: Ikegame K, Iimuro Y, Furuya K, Nakagomi H, Omata M Abstract INTRODUCTION: Hepatic portal venous gas (HPVG) is believed to be an indication for emergent surgery because it is associated with high mortality rate. However, the recent increase in the use of modern abdominal computed tomography (CT) has resulted in... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 A case of thymoma in myasthenia gravis: Successful outcome after thymectomy. Related ArticlesA case of thymoma in myasthenia gravis: Successful outcome after thymectomy. Int J Surg Case Rep. 2019 Nov 05;65:229-232 Authors: Dahal S, Bhandari N, Dhakal P, Karmacharya RM, Singh AK, Tuladhar SM, Devbhandari M Abstract INTRODUCTION: Thymic abnormalities occur as hyperplasia and thymoma. Myasthenia gravis is commonly present in thymoma. Thymectomy possesses risk due to anatomical proximity with vital thoracic structures and myasthenia... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 Surgical outcome of collateral ligament injury with metacarpal head fracture in a near amputation after power saw injury: Case report. Related ArticlesSurgical outcome of collateral ligament injury with metacarpal head fracture in a near amputation after power saw injury: Case report. Int J Surg Case Rep. 2019 Nov 02;65:225-228 Authors: Liawrungrueang W Abstract INTRODUCTION: The incidence of thumb amputation is high in developing and industrialized countries. A power saw injury is very traumatic to the soft tissue and neurovascular system, and thus difficult for orthopedic and plastic... pubmed: "int j surg case rep... Mon Nov 18, 2019 16:17 Mark above section as read  International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Grisel syndrome, sigmoid sinus thrombosis and rheumatic carditis: Case report of a rare association. Related ArticlesGrisel syndrome, sigmoid sinus thrombosis and rheumatic carditis: Case report of a rare association. Int J Pediatr Otorhinolaryngol. 2019 Nov 09;129:109774 Authors: Cucuzza ME, D'Ambra A, Evola FR, Greco F, Smilari P Abstract Grisel's syndrome (GS) is a non traumatic atlanto-axial rotatory subluxation of C1-C2 joint. A six year old girl, 20 days after an episode of fever, developed a torticollis and a 3/6 heart murmur. The echocardiography... International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Mon Nov 18, 2019 16:11 Allergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Related ArticlesAllergic rhinitis and asthma assessment of risk factors in pediatric patients: A systematic review. Int J Pediatr Otorhinolaryngol. 2019 Oct 31;129:109759 Authors: Testa D, DI Bari M, Nunziata M, Cristofaro G, Massaro G, Marcuccio G, Motta G Abstract Allergic rhinitis (AR) is the most prevalent allergic disease in children and can be associated with asthma (A); this association can have significant effect on child's quality of life. The... International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Mon Nov 18, 2019 16:11 A retrospective study of patients with Robin sequence: Patient characteristics and their impact on clinical outcomes. Related ArticlesA retrospective study of patients with Robin sequence: Patient characteristics and their impact on clinical outcomes. Int J Pediatr Otorhinolaryngol. 2019 Nov 07;129:109769 Authors: Hamilton S, Dzioba A, Husein M Abstract INTRODUCTION: Robin sequence (RS) is a congenital set of abnormalities of the head and neck, consisting of a hypoplastic mandible (micrognathia), a tongue that is displaced posteriorly (glossoptosis), and obstruction... International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Mon Nov 18, 2019 16:11 Linguistic adaptation and validation of Italian version of OSA-18, a quality of life questionnaire for evaluation of children with obstructive sleep apnea-hypopnea syndrome (OSAS). Related ArticlesLinguistic adaptation and validation of Italian version of OSA-18, a quality of life questionnaire for evaluation of children with obstructive sleep apnea-hypopnea syndrome (OSAS). Int J Pediatr Otorhinolaryngol. 2019 Oct 17;129:109727 Authors: Arezzo E, Festa P, D'Antò V, Michelotti A, De Vincentiis GC, Sitzia E, Giuliani M, Piga S, Galeotti A PMID: 31734562 [PubMed - as supplied by publisher] International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Mon Nov 18, 2019 16:11 Mark above section as read  Human physiology Genetic architecture of subspecies divergence in trace mineral accumulation and elemental correlations in the rice grain. Related ArticlesGenetic architecture of subspecies divergence in trace mineral accumulation and elemental correlations in the rice grain. Theor Appl Genet. 2019 Nov 16;: Authors: Tan Y, Sun L, Song Q, Mao D, Zhou J, Jiang Y, Wang J, Fan T, Zhu Q, Huang D, Xiao H, Chen C Abstract KEY MESSAGE: Genome differentiation has shaped the divergence in element concentration between rice subspecies and contributed to the correlation among trace minerals in the... Human physiology Mon Nov 18, 2019 16:10 Arsenic induces human chondrocyte senescence and accelerates rat articular cartilage aging. Related ArticlesArsenic induces human chondrocyte senescence and accelerates rat articular cartilage aging. Arch Toxicol. 2019 Nov 16;: Authors: Chung YP, Chen YW, Weng TI, Yang RS, Liu SH Abstract Arsenic-contaminated drinking water is known to be a serious human health problem. A previous epidemiological study has indicated that arsenic levels in blood were higher in arthritis patients compared to age-matched control subjects. Bone is known as an important... Human physiology Mon Nov 18, 2019 16:10 Outbreaks of Mucorales and the Species Involved. Related ArticlesOutbreaks of Mucorales and the Species Involved. Mycopathologia. 2019 Nov 16;: Authors: Walther G, Wagner L, Kurzai O Abstract The order Mucorales is an ancient group of fungi classified in the subphylum Mucoromycotina. Mucorales are mainly fast-growing saprotrophs that belong to the first colonizers of diverse organic materials and represent a permanent part of the human environment. Several species are able to cause human infections... Human physiology Mon Nov 18, 2019 16:10 Flexural strength, biocompatibility, and antimicrobial activity of a polymethyl methacrylate denture resin enhanced with graphene and silver nanoparticles. Related ArticlesFlexural strength, biocompatibility, and antimicrobial activity of a polymethyl methacrylate denture resin enhanced with graphene and silver nanoparticles. Clin Oral Investig. 2019 Nov 16;: Authors: Bacali C, Baldea I, Moldovan M, Carpa R, Olteanu DE, Filip GA, Nastase V, Lascu L, Badea M, Constantiniuc M, Badea F Abstract OBJECTIVE: The study evaluates the effect of adding graphene-Ag nanoparticles (G-AgNp) to a PMMA auto-polymerizing... Human physiology Mon Nov 18, 2019 16:10 Relationship between Resting Systemic Arterial Blood Pressure and Pain Sensitivity Parameters in Young Healthy Indian Medical Students. Related ArticlesRelationship between Resting Systemic Arterial Blood Pressure and Pain Sensitivity Parameters in Young Healthy Indian Medical Students. Kathmandu Univ Med J (KUMJ). 2019 Jan.-Mar;17(65):51-56 Authors: Mendpara SJ, Akhani PN, Palan BM, Harsoda JM Abstract Background Pain interests clinicians and researchers alike. Several animal and human studies have attempted to establish and explain the relationship between blood pressure and nociception.... Human physiology Mon Nov 18, 2019 16:10 The inhibition of lactoperoxidase catalytic activity through mesna (2-mercaptoethane sodium sulfonate). Related ArticlesThe inhibition of lactoperoxidase catalytic activity through mesna (2-mercaptoethane sodium sulfonate). J Inorg Biochem. 2019 Nov 12;203:110911 Authors: Jahanbakhsh S, Dekhne MS, Kohan-Ghadr HR, Bai D, Awonuga A, Morris RT, Yang Z, Abu-Soud HM Abstract Here, we show that mesna (sodium-2-mercaptoethane sulfonate), primarily used to prevent nephrotoxicity and urinary tract toxicity caused by chemotherapeutic agents such as cyclophosphamide... Human physiology Mon Nov 18, 2019 16:10 Serotonin 5-HT2A receptor expression and functionality in postmortem frontal cortex of subjects with schizophrenia: Selective biased agonism via Gαi1-proteins. Related ArticlesSerotonin 5-HT2A receptor expression and functionality in postmortem frontal cortex of subjects with schizophrenia: Selective biased agonism via Gαi1-proteins. Eur Neuropsychopharmacol. 2019 Nov 14;: Authors: García-Bea A, Miranda-Azpiazu P, Muguruza C, Marmolejo-Martinez-Artesero S, Diez-Alarcia R, Gabilondo AM, Callado LF, Morentin B, González-Maeso J, Meana JJ Abstract Serotonin 5-HT2A receptors (5-HT2ARs) have been implicated in schizophrenia.... Human physiology Mon Nov 18, 2019 16:10 Comparative analysis of fresh chondrocytes, cultured chondrocytes and chondroprogenitors derived from human articular cartilage. Related ArticlesComparative analysis of fresh chondrocytes, cultured chondrocytes and chondroprogenitors derived from human articular cartilage. Acta Histochem. 2019 Nov 13;:151462 Authors: Vinod E, Kachroo U, Amirtham SM, Ramasamy B, Sathishkumar S Abstract INTRODUCTION: Interest in chondroprogenitors arose due to their inherent stem cell like properties, and their initial characterization was based on identification of a small percentage of CD49e positive... Human physiology Mon Nov 18, 2019 16:10 Cognition and Reward Circuits in Schizophrenia: Synergistic, Not Separate. Related ArticlesCognition and Reward Circuits in Schizophrenia: Synergistic, Not Separate. Biol Psychiatry. 2019 Oct 03;: Authors: Robison AJ, Thakkar KN, Diwadkar VA Abstract Schizophrenia has been studied from the perspective of cognitive or reward-related impairments, yet it cannot be wholly related to one or the other process and their corresponding neural circuits. We posit a comprehensive circuit-based model proposing that dysfunctional interactions... Human physiology Mon Nov 18, 2019 16:10 Mark above section as read  O.R.L. Journal for oto-rhino-laryngology and its borderlands Radiofrequency Coblation-Assisted Resection of Skull Base Neoplasms Using an Endoscopic Endonasal Approach Objectives: We describe our early experiences with resecting skull base tumors using a radiofrequency ablation-assisted endoscopic endonasal approach. Ninety-seven patients with skull base tumors who were admitted to the Otorhinolaryngology department at Shanghai Jiaotong University Affiliated Shanghai Sixth People's Hospital between January 2014 and December 2016 were operated on using a radiofrequency ablation-assisted endoscopic endonasal approach. Complete resection was achieved in all patients.... O.R.L. Journal for oto-rhino-laryngology and its borderlands Mon Nov 18, 2019 12:42 Mark above section as read  Journal of plastic, reconstructive & aesthetic surgery : JPRAS Intraluminal fluid infusion in a rat jejunum ischemia/reperfusion model is associated with improved tissue perfusion and less mucosal damage. Related ArticlesIntraluminal fluid infusion in a rat jejunum ischemia/reperfusion model is associated with improved tissue perfusion and less mucosal damage. J Plast Reconstr Aesthet Surg. 2019 Oct 04;: Authors: Yalcin D, Saçak B, Yalcin M, Yildirim A, Karademir B, Ercan F, Celebiler Ö Abstract OBJECTIVE: This study used an experimental model mimicking early postoperative enteral feeding after the transfer of free jejunal flap and tested the hypothesis... Journal of plastic, reconstructive & aesthetic surgery : JPRAS Mon Nov 18, 2019 16:02 Response to: Letter to the editor: Wasted research time and its impact on training in plastic surgery. Related ArticlesResponse to: Letter to the editor: Wasted research time and its impact on training in plastic surgery. J Plast Reconstr Aesthet Surg. 2019 Nov 06;: Authors: Sepehripour S, Dheansa BS PMID: 31734235 [PubMed - as supplied by publisher] Journal of plastic, reconstructive & aesthetic surgery : JPRAS Mon Nov 18, 2019 16:02 Corrigendum to "Subtle Eyelid Retraction after Lower Blepharoplasty" [Journal of Plastic, Reconstructive & Aesthetic Surgery, 72 (10), 2019, 1682-1687]. Related ArticlesCorrigendum to "Subtle Eyelid Retraction after Lower Blepharoplasty" [Journal of Plastic, Reconstructive & Aesthetic Surgery, 72 (10), 2019, 1682-1687]. J Plast Reconstr Aesthet Surg. 2019 Nov 13;: Authors: Harounian J, Wulc AE, Brackup AB, Ramesh S PMID: 31734234 [PubMed - as supplied by publisher] Journal of plastic, reconstructive & aesthetic surgery : JPRAS Mon Nov 18, 2019 16:02 Outcomes with microsurgery of common peroneal nerve lesions. Related ArticlesOutcomes with microsurgery of common peroneal nerve lesions. J Plast Reconstr Aesthet Surg. 2019 Apr 11;: Authors: Terzis JK, Kostas I Abstract OBJECTIVES: The purpose of this retrospective study is to present our results with peroneal nerve lesions, to examine the relative significance of various factors, to assess their effect on outcome, and to establish guidelines of treatment for the microsurgical management of these difficult lesions.... Journal of plastic, reconstructive & aesthetic surgery : JPRAS Mon Nov 18, 2019 16:02 Mark above section as read  Infectious disorders drug targets,http://goo.gl/XqkpND Granulomatosis with Polyangiitis (GPA) in a 15-year-old girl with facial Acne-like ulcers: A Case Report. Related ArticlesGranulomatosis with Polyangiitis (GPA) in a 15-year-old girl with facial Acne-like ulcers: A Case Report. Infect Disord Drug Targets. 2019 Nov 14;: Authors: Jamali Moghadam SR, Salehi MR, Mojtahedi SY, Fadaei N, Dadras O, Seyed Alinaghi SA, Mohammadifirouzeh M Abstract Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis (WG), is a multisystem autoimmune disease of unknown etiology often misdiagnosed as pneumonia.... Infectious disorders drug targets,http://goo.gl/XqkpND Mon Nov 18, 2019 17:06 Mark above section as read  pubmed: snoring The clinical characteristics of patients with an isolate epiglottic collapse. Related ArticlesThe clinical characteristics of patients with an isolate epiglottic collapse. Auris Nasus Larynx. 2019 Nov 13;: Authors: Sung CM, Kim HC, Yang HC Abstract OBJECTIVE: We analyzed the clinical characteristics of patients with isolated epiglottic collapse (IEC) who had an epiglottic anteroposterior (AP) collapse as the only cause of snoring during drug-induced sleep endoscopy (DISE). METHODS: A retrospective analysis of 334 consecutive... pubmed: snoring Mon Nov 18, 2019 15:56 Mark above section as read  Oncology Critical role of interleukin (IL)-17 in inflammatory and immune disorders: An updated review of the evidence focusing in controversies. Related ArticlesCritical role of interleukin (IL)-17 in inflammatory and immune disorders: An updated review of the evidence focusing in controversies. Autoimmun Rev. 2019 Nov 14;:102429 Authors: Ruiz de Morales JMG, Puig L, Daudén E, Cañete JD, Pablos JL, Martín AO, Juanatey CG, Adán A, Montalbán X, Borruel N, Ortí G, Martín EH, García-Vidal C, Morales CV, Vázquez VM, González-Gay MÁ Abstract Interleukin 17 (IL-17) is a proinflammatory cytokine that... Oncology Mon Nov 18, 2019 14:57 Significance of TIM3 expression in cancer: From biology to the clinic. Related ArticlesSignificance of TIM3 expression in cancer: From biology to the clinic. Semin Oncol. 2019 Nov 06;: Authors: Solinas C, De Silva P, Bron D, Willard-Gallo K, Sangiolo D Abstract Targeting inhibitory immune checkpoint molecules has dramatically changed treatment paradigms in medical oncology. Understanding the best strategies to unleash a pre-existing immune response or to induce an efficient immune response against tumors has emerged as... Oncology Mon Nov 18, 2019 14:57 Mark above section as read  Nature Communications - current - nature.com science feeds Inhibition of DNA damage response at telomeres improves the detrimental phenotypes of Hutchinson–Gilford Progeria Syndrome Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-13018-3Hutchinson–Gilford progeria syndrome causes premature aging. Here the authors show that activation of the DNA damage response at dysfunctional telomeres and transcription of telomeric non-coding RNAs contributes to the pathogenesis, which can be ameliorated by treatment with sequence-specific telomeric antisense oligonucleotides. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Interspecific introgression mediates adaptation to whole genome duplication Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-13159-5Whole genome duplication (WGD) presents new challenges to the establishment of optimal allelic combinations and to the meiotic machinery. Here, the authors show that adaptive gene flow from Arabidopsis arenosa could rescue the nascent A. lyrata from extinction following WGD. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Quorum sensing modulates the formation of virulent <i>Legionella</i> persisters within infected cells Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-13021-8The pathogenic bacterium Legionella pneumophila infects lung macrophages and environmental amoebae. Here, Personnic et al. show that the pathogen reversibly forms virulent, antibiotic-tolerant subpopulations during infection of macrophages and amoebae, in a process regulated by the Lqs quorum-sensing system. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Microbial reduction of metal-organic frameworks enables synergistic chromium removal Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-13219-wInteractions between electroactive bacteria and metal oxides are used for bioremediation. Here, the authors report on the application of Fe(III)-containing metal organic frameworks as substrates for bacterial growth which allow for remediation of lethal levels of chromium with high efficacy over several cycles. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Geodynamic evolution of southwestern North America since the Late Eocene Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-12950-8The tectonic evolution of southwestern North America remains debated. Here, the authors present a complete time-dependent geodynamic model of the tectonic evolution of southwestern North America, which can explain the extensional collapse of the Basin and Range Province since the Late Eocene. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Controlled nonlinear magnetic damping in spin-Hall nano-devices Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-13246-7Nonlinear damping enhancement imposes strict limitations on the operation and efficiency of magnetic nano-devices. Here the authors show that nonlinear damping can be controlled by the ellipticity of magnetization precession, which provides a route for the implementation of efficient active spintronic and magnonic devices driven by spin current. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 A network-based approach to identify deregulated pathways and drug effects in metabolic syndrome Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-13208-zMetabolic syndrome is characterized by complex phenotypes that increases the risk of cardiovascular disease and type 2 diabetes. Here the authors' integrative network analysis suggests BTK inhibitor ibrutinib to be a promising treatment through its obesity-associated inflammation lowering effect. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Key drivers of cloud response to surface-active organics Nature Communications, Published online: 18 November 2019; doi:10.1038/s41467-019-12982-0Aerosol-cloud interactions are a large source of uncertainty in radiative forcing estimates. Here, the authors show that the radiative effects of clouds are influenced by a combination of aerosol particle distribution, environmental conditions and atmosphere dynamics. Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Inhibition of DNA damage response at telomeres improves the detrimental phenotypes of Hutchinson–Gilford Progeria Syndrome Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Interspecific introgression mediates adaptation to whole genome duplication Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Quorum sensing modulates the formation of virulent <i>Legionella</i> persisters within infected cells Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Microbial reduction of metal-organic frameworks enables synergistic chromium removal Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Geodynamic evolution of southwestern North America since the Late Eocene Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Controlled nonlinear magnetic damping in spin-Hall nano-devices Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 A network-based approach to identify deregulated pathways and drug effects in metabolic syndrome Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Key drivers of cloud response to surface-active organics Nature Communications - current - nature.com science feeds Mon Nov 18, 2019 02:00 Mark above section as read  International Journal of Surgery Physical recovery after laparoscopic vs. open liver resection - a prospective cohort study. Related ArticlesPhysical recovery after laparoscopic vs. open liver resection - a prospective cohort study. Int J Surg. 2019 Nov 14;: Authors: Kampf S, Sponder M, Bergler-Klein J, Sandurkov C, Fitschek F, Bodingbauer M, Stremitzer S, Kaczirek K, Schwarz C Abstract BACKGROUND: While the number of laparoscopic liver resections (LLRs) is increasing worldwide, its impact on physical recovery remains unclear. We hypothesized that LLR is associated with better... International Journal of Surgery Mon Nov 18, 2019 14:54 Long non-coding RNA MALAT1 as a valuable biomarker for prognosis in osteosarcoma: A systematic review and meta-analysis. Related ArticlesLong non-coding RNA MALAT1 as a valuable biomarker for prognosis in osteosarcoma: A systematic review and meta-analysis. Int J Surg. 2019 Nov 14;: Authors: Liu M, Yang P, Mao G, Deng J, Peng G, Ning X, Yang H, Sun H Abstract BACKGROUND: Long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (lncRNA, MALAT1) has been found to be aberrantly expressed in osteosarcoma, while high MALAT1 expression is correlated with both... International Journal of Surgery Mon Nov 18, 2019 14:54 Mark above section as read  pubmed: "j inorg biochem"[jo... Mark above section as read  Dysphonia Defining the Anatomy of the Vagus Nerve and Its Clinical Relevance for the Neurosurgical Treatment of Glossopharyngeal Neuralgia. Related ArticlesDefining the Anatomy of the Vagus Nerve and Its Clinical Relevance for the Neurosurgical Treatment of Glossopharyngeal Neuralgia. Stereotact Funct Neurosurg. 2019 Nov 15;:1-5 Authors: Krüger MT, Dong CCJ, Honey CR Abstract The neurosurgical treatment of glossopharyngeal neuralgia includes microvascular decompression or rhizotomy of the nerve. When considering open section of the glossopharyngeal nerve, numerous authors have recommended... Dysphonia Mon Nov 18, 2019 15:41 Mark above section as read  The Journal of Antibiotics - Issue - nature.com science feeds A new indole glycoside from <i>Kitasatospora</i> sp. MG372-hF19 carrying a 6-deoxy-α-<span class="small-caps">l</span>-talopyranose moiety The Journal of Antibiotics, Published online: 18 November 2019; doi:10.1038/s41429-019-0258-9A new indole glycoside from Kitasatospora sp. MG372-hF19 carrying a 6-deoxy-α-l-talopyranose moiety The Journal of Antibiotics - Issue - nature.com science feeds Mon Nov 18, 2019 02:00 Mark above section as read  http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Safety and efficacy of superior turbinate biopsies as a source of olfactory epithelium appropriate for morphological analysis. Related ArticlesSafety and efficacy of superior turbinate biopsies as a source of olfactory epithelium appropriate for morphological analysis. Eur Arch Otorhinolaryngol. 2019 Nov 16;: Authors: Garcia ECD, Rossaneis AC, Pipino AS, Gomes GV, de Rezende Pinna F, Voegels RL, Doty RL, Verri WA, Fornazieri MA Abstract PURPOSE: There is no standardized approach for preserving olfactory function in the side of the nose where biopsy of the olfactory epithelium... http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Mon Nov 18, 2019 15:34 Mark above section as read  pubmed: "world neurosurg"[jo... Remote leptomeningeal dissemination in olfactory neuroblastoma mimicking multiple parasagittal meningiomas: a diagnostic and therapeutic challenge. Related ArticlesRemote leptomeningeal dissemination in olfactory neuroblastoma mimicking multiple parasagittal meningiomas: a diagnostic and therapeutic challenge. World Neurosurg. 2019 Nov 14;: Authors: Martinez-Perez R, Hardesty D, Palmer J, Zachariah M, Otto B, Carrau R, Prevedello D Abstract BACKGROUND: Olfactory neuroblastoma (ON) is a highly aggressive and locally recurrent neoplasm. Distant systemic metastases are not uncommon, but remote leptomeningeal... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Incidence and Implications of Incidental Durotomy in Transforaminal Endoscopic Spine Surgery: Case Series. Related ArticlesIncidence and Implications of Incidental Durotomy in Transforaminal Endoscopic Spine Surgery: Case Series. World Neurosurg. 2019 Nov 14;: Authors: Telfeian A PMID: 31734429 [PubMed - as supplied by publisher] pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Ruptured Distal Superior Cerebellar Artery Aneurysm After Gamma Knife Radiosurgery for Trigeminal Neuralgia: A Case Report and Review of the Literature. Related ArticlesRuptured Distal Superior Cerebellar Artery Aneurysm After Gamma Knife Radiosurgery for Trigeminal Neuralgia: A Case Report and Review of the Literature. World Neurosurg. 2019 Nov 14;: Authors: Dominguez L, Saway B, Benko MJ, Guilliams E, Marvin EA, Entwistle JJ PMID: 31734428 [PubMed - as supplied by publisher] pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 The Early Neurosurgical World Wide Web - Experiences Focused on Awake Craniotomy. Related ArticlesThe Early Neurosurgical World Wide Web - Experiences Focused on Awake Craniotomy. World Neurosurg. 2019 Nov 14;: Authors: Mehdorn HM Abstract The importance of international cooperation in neurosurgery incl. site visits to foreign hospitals is highlighted. The development of knowledge about function localization in brain surgery serves as an example. International cooperation led to modern day neurosurgery as shown e.g. in awake craniotomy.PMID:... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Title: Clinical Outcome After Microvascular Decompression According to the Progression Rates of Hemifacial Spasm. Related ArticlesTitle: Clinical Outcome After Microvascular Decompression According to the Progression Rates of Hemifacial Spasm. World Neurosurg. 2019 Nov 14;: Authors: Lee JA, Kong DS, Lee S, Park SK, Park K Abstract OBJECTIVE: The progression rate for clinical manifestations in hemifacial spasm (HFS) varies; however, little is known about the factors contributing to such observations. The purpose of this study was to identify the independent factors... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Tumours of the Neurohypophysis - One unit's experience and literature review. Related ArticlesTumours of the Neurohypophysis - One unit's experience and literature review. World Neurosurg. 2019 Nov 14;: Authors: Borg MA, Jaunmuktane DZ, Dorward MN Abstract PURPOSE: To evaluate and understand the clinical behaviour and radiological correlates of tumours originating from the posterior pituitary gland. To review the management strategy for these rare tumours and add to the limited existing literature. METHODS: Retrospective... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 IMMERSING PATIENTS IN A VIRTUAL REALITY ENVIRONMENT FOR BRAIN MAPPING DURING AWAKE SURGERY. SAFETY STUDY. Related ArticlesIMMERSING PATIENTS IN A VIRTUAL REALITY ENVIRONMENT FOR BRAIN MAPPING DURING AWAKE SURGERY. SAFETY STUDY. World Neurosurg. 2019 Nov 14;: Authors: Delion M, Klinger E, Bernard F, Aubin G, Minassian AT, Menei P Abstract OBJECTIVE: Brain mapping by direct electrical stimulation (DES) during awake craniotomy is now a standard procedure which reduces the risk of permanent neurologic deficits. Virtual reality technology (VR) immerses the patient... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Undiagnosed obstructive sleep apnea as a predictor of 90-day readmission for brain tumor patients. Related ArticlesUndiagnosed obstructive sleep apnea as a predictor of 90-day readmission for brain tumor patients. World Neurosurg. 2019 Nov 14;: Authors: Caplan IF, Glauser G, Goodrich S, Chen HI, Lucas TH, Lee JYK, McClintock SD, Malhotra NR Abstract BACKGROUND: Previously undiagnosed OSA is a known contributor to negative postoperative outcomes. The STOP-Bang questionnaire is a screening tool for obstructive sleep apnea (OSA) that has been validated... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 From the Occipital Condyle to the Sphenoid Sinus, extradural extension of the far lateral transcondylar approach with endoscopic assistance. Related ArticlesFrom the Occipital Condyle to the Sphenoid Sinus, extradural extension of the far lateral transcondylar approach with endoscopic assistance. World Neurosurg. 2019 Nov 14;: Authors: Tardivo V, Labidi M, Passeri T, Bernat AL, Zenga F, Voormolen E, Penet N, Froelich S PMID: 31734422 [PubMed - as supplied by publisher] pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Intramedullary Spinal Metastatic Renal Cell Carcinoma: Systematic Review of Disease Presentation, Treatment and Prognosis with Case Illustration. Related ArticlesIntramedullary Spinal Metastatic Renal Cell Carcinoma: Systematic Review of Disease Presentation, Treatment and Prognosis with Case Illustration. World Neurosurg. 2019 Nov 14;: Authors: Barrie U, Elguindy M, Pernik M, Adeyemo E, Aoun SG, Hall K, Reyes VP, El Ahmadieh TY, Bagley CA PMID: 31734421 [PubMed - as supplied by publisher] pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Oblique Lateral Interbody Fusion (OLIF) with Supplemental Anterolateral Screw and Rod Instrumentation: a Preliminary Clinical Study. Related ArticlesOblique Lateral Interbody Fusion (OLIF) with Supplemental Anterolateral Screw and Rod Instrumentation: a Preliminary Clinical Study. World Neurosurg. 2019 Nov 14;: Authors: Liu J, Feng H Abstract OBJECTIVE: This study aimed to evaluate the technical details, clinical effectiveness, and complications of oblique lateral interbody fusion (OLIF) supplemented with anterolateral screw-rod instrumentation in managing degenerative lumbar diseases.... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Effect of Sevoflurane Postconditioning on the Incidence of Symptomatic Cerebral Hyperperfusion after Revascularization Surgery in Adult Patients with Moyamoya Disease. Related ArticlesEffect of Sevoflurane Postconditioning on the Incidence of Symptomatic Cerebral Hyperperfusion after Revascularization Surgery in Adult Patients with Moyamoya Disease. World Neurosurg. 2019 Nov 14;: Authors: Yoon HK, Oh H, Lee HC, Cho WS, Kim JE, Park JW, Choi H, Park HP Abstract OBJECTIVE: Various experimental studies reported neuroprotective effects of sevoflurane postconditioning against cerebral ischemia-reperfusion injury. We thus... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Non-Contrast T2-Weighted MR Sequences for Long Term Monitoring of Asymptomatic Convexity Meningiomas. Related ArticlesNon-Contrast T2-Weighted MR Sequences for Long Term Monitoring of Asymptomatic Convexity Meningiomas. World Neurosurg. 2019 Nov 14;: Authors: He JQ, Iv M, Li G, Zhang M, Hayden-Gephart M Abstract BACKGROUND: Gadolinium based contrast agents (GBCA) used to enhance MRs have been linked to tissue deposition, including in the brain. The management of indolent tumors such as meningiomas requires frequent MRs to monitor for interval growth.... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Comparative analysis of continuous suturing, interrupted suturing, and cyanoacrylate-based lid techniques for end-to-end microvascular anastomosis: laboratory investigation. Related ArticlesComparative analysis of continuous suturing, interrupted suturing, and cyanoacrylate-based lid techniques for end-to-end microvascular anastomosis: laboratory investigation. World Neurosurg. 2019 Nov 14;: Authors: Bot GM, Zhao X, McElenney BK, Meybodi AT, Belykh E, Lawton MT, Preul MC Abstract OBJECTIVE: Mastery of the microsurgical anastomosis is an indispensable component of neurosurgical training. However, in many resource-limited... pubmed: "world neurosurg"[jo... Mon Nov 18, 2019 16:47 Mark above section as read  pubmed: future oncology Mark above section as read  Audiology Cognitive Decline Begins in the Earliest Stages of Hearing Loss The association between hearing loss and impaired cognition may be present at earlier levels of hearing loss than previously recognized, and the current 25 dB threshold for defining adult hearing loss may be too high, according to a new study (JAMA Otolaryngol Head Neck Surg. 2019; doi: 10.1001/jamaoto.2019.3375). Researchers at Columbia University Vagelos College of Physicians and Surgeons examined the data of 6451 individuals aged 50 or older who underwent pure-tone audiometry and cognitive testing... Audiology Fri Nov 15, 2019 15:31 Mark above section as read  pubmed: sleep apnea Evaluation of the Efficacy of Single Anastomosis Sleeve Ileal (SASI) Bypass for Patients with Morbid Obesity: a Multicenter Study. Related ArticlesEvaluation of the Efficacy of Single Anastomosis Sleeve Ileal (SASI) Bypass for Patients with Morbid Obesity: a Multicenter Study. Obes Surg. 2019 Nov 16;: Authors: Mahdy T, Emile SH, Madyan A, Schou C, Alwahidi A, Ribeiro R, Sewefy A, Büsing M, Al-Haifi M, Salih E, Shikora S Abstract BACKGROUND: Single anastomosis sleeve ileal (SASI) bypass is a newly introduced bariatric and metabolic procedure. The present multicenter study aimed to... pubmed: sleep apnea Mon Nov 18, 2019 17:46 Association of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Related ArticlesAssociation of obstructive sleep apnea with severity of patients hospitalized for acute asthma. Ann Allergy Asthma Immunol. 2019 Nov 14;: Authors: Oka S, Goto T, Hirayama A, Faridi MK, Camargo CA, Hasegawa K Abstract BACKGROUND: Studies suggest that obstructive sleep apnea (OSA) is associated with suboptimal disease control and worse chronic severity of asthma. However, little is known about the relations of OSA with acute asthma severity... pubmed: sleep apnea Mon Nov 18, 2019 17:46 Comparison of one-anastomosis gastric bypass and Roux-en-Y gastric bypass for treatment of obesity: a 5-year study. Related ArticlesComparison of one-anastomosis gastric bypass and Roux-en-Y gastric bypass for treatment of obesity: a 5-year study. Surg Obes Relat Dis. 2019 May 24;: Authors: Bhandari M, Nautiyal HK, Kosta S, Mathur W, Fobi M Abstract BACKGROUND: Roux-en-Y gastric bypass (RYGB) is the gold standard in bariatric surgery. One-anastomosis gastric bypass (OAGB) has been reported to have equivalent or better weight loss, with added advantages of being technically... pubmed: sleep apnea Mon Nov 18, 2019 17:46 Mark above section as read  ScienceDirect Publication: Medical Hypotheses Trazodone and Mirtazapine: A possible opioid involvement in their use (at low dose) for sleep? Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): S. Schreiber, C.G. PickAbstractThe efficacy of each antidepressant available has been found equal to that of amitriptyline in double-blind studies. However, a few of them are being prescribed (at under-therapeutic doses) for sleep, in non-depressed persons, when there are relative contraindications for sedative-hypnotics. Following previous studies regarding the antinociceptive mechanisms of various antidepressants,... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 Pulsed electromagnetic field (PEMF): A potential adjuvant treatment for infected nonunion Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): Xu-sheng Qiu, Xu-gang Li, Yi-xin ChenAbstractInfected nonunion is still a challenge for orthopaedic surgeons. The goal of treatment is to eliminate infection and achieve bone union. Surgery is the only effective method currently. However, it is invasive and the results are still unsatisfactory. Therefore, Seeking a noninvasive and effective method to resolve infected nonunion is necessary. Pulsed electromagnetic... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 Pre-conceptional Folic Acid Supplementation: A possible Cause for the Increasing Rates of Ankyloglossia Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): Yona Amitai, Helen Shental, Luba Atkins-Manelis, Gideon Koren, Chen Stein ZamirAbstractBackgroundThere is an increasing awareness to ankyloglossia (tongue-tie) in infants, with marked increase in its report in the medical literature. Some reports indicate increase in prevalence. Whether the increase ankyloglossia rate is a real phenomenon or merely reflects increased awareness and reports has to be determined.... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 An innate brainstem self-other system involving orienting, affective responding, and polyvalent relational seeking: some clinical implications for a "Deep Brain Reorienting" trauma psychotherapy approach Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): F.M. Corrigan, J. Christie-SandsAbstractUnderlying any complex relational intersubjectivity there is an inherent urge to connect, to have proximity, to engage in an experience of interpersonal contact. The hypothesis set out here is that this most basic urge to connect is dependent on circuits based in three main components: the midbrain superior colliculi (SC), the midbrain periaqueductal gray (PAG), and the... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 Comment on "A thermodynamic approach to the problem of consciousness" Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): Seyedsaeid Ahmadvand, Bijan Peik, Babak AzarfarAbstractRecently, Beshkar has published a paper on the nature of qualia. His argument is based on several assumptions leading to a conjecture that qualia have a negentropic nature and so as consciousness. The assumptions are: 1) quale (singular of qualia) is the building block of consciousness and thus they are equivalent, 2) qualia and consciousness are both subjective... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 Proposal for a New Diagnosis for U.S. Diplomats in Havana, Cuba, Experiencing Vestibular and Neurological Symptoms Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): Mehdi Abouzari, Khodayar Goshtasbi, Brooke Sarna, Harrison W. Lin, Hamid R. DjalilianAbstractBetween 2016 and 2017, several U.S. diplomats in Havana, Cuba, experienced perplexing vestibular and neurological symptoms attributed to an unknown source. They presented with significant vestibular and headache symptoms similar to individuals who experience vestibular migraine (VM). As such, we hypothesize that VM may... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 GLP 1 Receptor agonists, glycemic variability, oxidative stress and acute coronary syndrome Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): Maria Isabel del Olmo García, Juan Francisco Merino-TorresAbstractGlycemic variability (GV) has been recently described as an independent cardiovascular risk factor in patients with acute coronary syndrome (ACS). Also, new findings suggest that GV plays an important role in the development of complications related to impaired glucose metabolism and oxidative stress. On the other hand, although treatment for diabetes... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 Application of breast cancer diagnosis based on a combination of convolutional neural networks, ridge regression and linear discriminant analysis using invasive breast cancer images processed with autoencoders Publication date: Available online 18 November 2019Source: Medical HypothesesAuthor(s): Mesut Toğaçar, Burhan Ergen, Zafer CömertAbstractInvasive ductal carcinoma cancer, which invades the breast tissues by destroying the milk channels, is the most common type of breast cancer in women. Approximately, 80% of breast cancer patients have invasive ductal carcinoma and roughly 66.6% of these patients are older than 55 years. This situation points out a powerful relationship between the type of breast... ScienceDirect Publication: Medical Hypotheses Mon Nov 18, 2019 13:20 Mark above section as read  Disease Markers Plasma Fibrin Clot Properties Are Unfavorably Altered in Women following Venous Thromboembolism Associated with Combined Hormonal Contraception The use of hormonal contraception is associated with an increased risk of venous thromboembolism (VTE). Unfavorably altered fibrin clot phenotype has been reported in patients following unprovoked VTE who are at risk of recurrences. It remains unknown whether fibrin clot characteristics in women with contraception-related VTE differ from those in unprovoked VTE. We studied three age-matched groups of women: (1) after contraception-related VTE, () (2) after unprovoked VTE (), and (3) controls ().... Disease Markers Mon Nov 18, 2019 13:05 Circulating MicroRNAs as Prognostic Molecular Biomarkers in Human Head and Neck Cancer: A Systematic Review and Meta-Analysis Background. Circulating microRNAs (miRNAs) are potential molecular biomarkers for cancer detection; however, little is known about their prognostic role in head and neck cancer. This current study is aimed at evaluating the role of novel miRNAs in the survival of head and neck cancer patients. Materials and Methods. We performed a systematic literature search using online databases for articles published between December 2006 and February 2019. A meta-analysis was conducted to assess the correlation... Disease Markers Mon Nov 18, 2019 11:05 Mark above section as read
ESR statement on new approaches to undergraduate teaching in RadiologyAbstract Medical education is evolving and electronic learning (e-Learning) strategies have now become an essential asset in radiology education. Radiology education is a significant part of the undergraduate medical curriculum and the use of e-Learning in radiology teaching in medical schools is on the rise. If coupled with clinical decision support systems, e-Learning can be a practical way of teaching students clinical decision...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke Intensive therapy to lower serum lipid levels with the use of statins is recommended after transient ischemic attack (TIA) or ischemic stroke of atherosclerotic origin. These recommendations are based on the results of the Stroke Prevention by Aggressive Reduction in Cholesterol Level (SPARCL)… NEJM : Research Mon Nov 18, 2019 02:00 Mark above section as read  Upper respiratory tract infection Effectiveness of adjunctive nebulized antibiotics in critically ill patients with respiratory tract infections. Related ArticlesEffectiveness of adjunctive nebulized antibiotics in critically ill patients with respiratory tract infections. Eur J Clin Microbiol Infect Dis. 2019 Nov 16;: Authors: Leache L, Aquerreta I, Aldaz A, Monedero P, Idoate A, Ortega A Abstract The purpose of the study was to analyze the effectiveness of adding nebulized antibiotics to systemic antimicrobials in critically ill patients with respiratory tract infections (pneumonia or tracheobronchitis)... Upper respiratory tract infection Mon Nov 18, 2019 18:47 Fatality of Staphylococcus aureus infections in a Greek university hospital: role of inappropriate empiric treatment, methicillin resistance, and toxin genes' presence. Related ArticlesFatality of Staphylococcus aureus infections in a Greek university hospital: role of inappropriate empiric treatment, methicillin resistance, and toxin genes' presence. Eur J Clin Microbiol Infect Dis. 2019 Nov 16;: Authors: Katsarou I, Paraskevopoulou NM, Papadimitriou-Olivgeris M, Giormezis N, Militsopoulou M, Kolonitsiou F, Marangos M, Anastassiou ED, Spiliopoulou I Abstract The aim of the present study was to identify predictors of... Upper respiratory tract infection Mon Nov 18, 2019 18:47 Evaluation of the efficacy of Lactobacillus plantarum HEAL9 and Lactobacillus paracasei 8700:2 on aspects of common cold infections in children attending day care: a randomised, double-blind, placebo-controlled clinical study. Related ArticlesEvaluation of the efficacy of Lactobacillus plantarum HEAL9 and Lactobacillus paracasei 8700:2 on aspects of common cold infections in children attending day care: a randomised, double-blind, placebo-controlled clinical study. Eur J Nutr. 2019 Nov 16;: Authors: Lazou Ahrén I, Berggren A, Teixeira C, Martinsson Niskanen T, Larsson N Abstract BACKGROUND: The combination of Lactobacillus plantarum HEAL9 and Lactobacillus paracasei 8700:2... Upper respiratory tract infection Mon Nov 18, 2019 18:47 Complex rhinobronchial dystrophy and immunodeficiency: Chance association or exceptional congenital syndrome? Related ArticlesComplex rhinobronchial dystrophy and immunodeficiency: Chance association or exceptional congenital syndrome? Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Nov 13;: Authors: Migueres N, de Blay F, Braun JJ Abstract INTRODUCTION: We report a case of an exceptional syndromic association of apparently congenital rhinobronchial dystrophy associated with congenital anosmia and common variable immunodeficiency in a twelve-year-old girl. ... Upper respiratory tract infection Mon Nov 18, 2019 18:47 Procalcitonin: Where Are We Now? Related ArticlesProcalcitonin: Where Are We Now? Crit Care Clin. 2020 Jan;36(1):23-40 Authors: Hamade B, Huang DT Abstract Procalcitonin is a biomarker that is generally elevated in bacterial infections. This review describes a conceptual framework for biomarkers using lessons from the history of troponin, applies this framework to procalcitonin with a review of observational studies and randomized trials in and out of the intensive care unit, and concludes... Upper respiratory tract infection Mon Nov 18, 2019 18:47 Mark above section as read  Human homeostasis Dynamics of interaction and effects of microplastics on planarian tissue regeneration and cellular homeostasis. Related ArticlesDynamics of interaction and effects of microplastics on planarian tissue regeneration and cellular homeostasis. Aquat Toxicol. 2019 Nov 09;218:105354 Authors: Gambino G, Falleni A, Nigro M, Salvetti A, Cecchettini A, Ippolito C, Guidi P, Rossi L Abstract Increasing microplastics pollution of marine and terrestrial water is a concerning issue for ecosystems and human health. Nevertheless, the interaction of microplastics with freshwater... Human homeostasis Mon Nov 18, 2019 18:44 Repeated ethanol exposure influences key enzymes in cholesterol and lipid homeostasis via the AMPK pathway in the rat prefrontal cortex. Related ArticlesRepeated ethanol exposure influences key enzymes in cholesterol and lipid homeostasis via the AMPK pathway in the rat prefrontal cortex. Alcohol. 2019 Nov 14;: Authors: Xu S, Jeong SJ, Li G, Koo JW, Kang UG Abstract Cholesterol homeostasis has been proposed to be implicated in the development of addiction. However, the effects of ethanol on cholesterol homeostasis within the brain are not well understood. One of the most important regulators... Human homeostasis Mon Nov 18, 2019 18:44 Changes of skin electrical potential in acupoints from Ren Mai and Du Mai conduits during Qigong practice: Documentation of a clinical phenomenon. Related ArticlesChanges of skin electrical potential in acupoints from Ren Mai and Du Mai conduits during Qigong practice: Documentation of a clinical phenomenon. J Bodyw Mov Ther. 2019 Oct;23(4):713-720 Authors: Matos LC, Machado J, Greten HJ, Monteiro FJ Abstract Qigong is a therapeutic method of traditional Chinese medicine (TCM) that combines slow, soft movements and postures with breath control and a special mental state of 'awareness'. TCM holds... Human homeostasis Mon Nov 18, 2019 18:44 Mark above section as read  Nature Chemistry A review and critique of academic lab safety research Nature Chemistry, Published online: 18 November 2019; doi:10.1038/s41557-019-0375-xDespite the regular occurrence of high-profile accidents leading to serious injuries or deaths among lab personnel, the state of academic lab safety research has languished. Existing studies in this area are summarized and critiqued in this Review and suggestions are made for future research directions. Nature Chemistry Mon Nov 18, 2019 02:00 Alkenyl boost for Catellani Nature Chemistry, Published online: 18 November 2019; doi:10.1038/s41557-019-0361-3The Catellani reaction is a multi-component cascade sequence, catalysed by palladium and norbornene, which typically uses aromatic starting materials. Now, through the use of a modified norbornene co-catalyst, the scope of this reaction has been extended to alkenyl reagents, enabling the preparation of all-carbon tetrasubstituted olefins. Nature Chemistry Mon Nov 18, 2019 02:00 Modular and regioselective synthesis of all-carbon tetrasubstituted olefins enabled by an alkenyl Catellani reaction Nature Chemistry, Published online: 18 November 2019; doi:10.1038/s41557-019-0358-yAll-carbon tetrasubstituted olefins are challenging to prepare in a regio- and stereocontrolled fashion. Now, using an amide-substituted norbornene as a co-catalyst, alkenyl halide- or triflate-mediated palladium/norbornene (Pd/NBE) catalysis has been demonstrated, providing an efficient strategy for modular and regioselective construction of all-carbon tetrasubstituted olefins. Nature Chemistry Mon Nov 18, 2019 02:00 Iron(<span class="small-caps">ii</span>) coordination complexes with panchromatic absorption and nanosecond charge-transfer excited state lifetimes Nature Chemistry, Published online: 18 November 2019; doi:10.1038/s41557-019-0357-zReplacing rare elements in benchmark photosensitizers with iron would facilitate the large-scale implementation of solar energy conversion, but iron complexes generally do not exhibit sufficiently long-lived photoexcited states. Now, it has been shown that iron(ii) complexes with carefully designed ligands can absorb broadly across the visible light spectrum and have charge-transfer excited states with nanosecond lifetimes. Nature Chemistry Mon Nov 18, 2019 02:00 Mark above section as read  Case Reports in Pathology Intestinal Adenocarcinoma Arising from a Mature Cystic Teratoma Mature cystic teratomas are the most common ovarian germ cell tumour and account for 10–20% of all ovarian neoplasms. Malignant transformation of mature cystic teratomas is rare and has an incidence rate of less than 1%. The most common malignancy are squamous cell carcinomas. Here we present the case of an intestinal adenocarcinoma which is an exceedingly rare malignant entity arising within a mature cystic teratoma. Clinical presentation, imaging and histopathological diagnosis are discussed and... Case Reports in Pathology Mon Nov 18, 2019 18:05 Mark above section as read  Clinical Chemistry and Laboratory Medicine (CCLM) A more accurate prediction to rule in and rule out pre-eclampsia using the sFlt-1/PlGF ratio and NT-proBNP as biomarkers Journal Name: Clinical Chemistry and Laboratory Medicine (CCLM)Issue: Ahead of print Clinical Chemistry and Laboratory Medicine (CCLM) Mon Nov 18, 2019 18:04 Impact of delta check time intervals on error detection capability Journal Name: Clinical Chemistry and Laboratory Medicine (CCLM)Issue: Ahead of print Clinical Chemistry and Laboratory Medicine (CCLM) Mon Nov 18, 2019 18:04 Mark above section as read  Journal of Neuroscience Methods Measuring emotion recognition by people with Parkinson's disease using eye-tracking with dynamic facial expressions Publication date: Available online 17 November 2019Source: Journal of Neuroscience MethodsAuthor(s): Judith Bek, Ellen Poliakoff, Karen LanderAbstractBackgroundMotion is an important cue to emotion recognition, and it has been suggested that we recognize emotions via internal simulation of others' expressions. There is a reduction of facial expression in Parkinson's disease (PD), which may influence the ability to use motion to recognise emotions in others. However, the majority of previous work... Journal of Neuroscience Methods Mon Nov 18, 2019 17:49 Mark above section as read  Psychophysiology Evaluative conditioning affects the subsequent acquisition of differential fear conditioning as indexed by electrodermal responding and stimulus evaluations Abstract It is currently unclear whether the acquisition of negative stimulus valence in evaluative and fear conditioning paradigms is interrelated or independent. The present study used a transfer paradigm to address this question. Three groups of participants were trained in a picture‐picture evaluative conditioning paradigm before completing acquisition of differential fear conditioning using graphical shapes as conditional stimuli (CSs). In group congruent, the shape used as CS+ (paired with... Psychophysiology Sun Nov 17, 2019 22:00 The mindful attention and awareness scale is associated with lower levels of high‐frequency heart rate variability in a laboratory context Abstract Trait mindfulness has been associated with well‐being. A key component of trait mindfulness is intentional attention and awareness which is most commonly measured by the Mindful Attention and Awareness Scale (MAAS). This study investigated the relationship between the MAAS and cardiovascular (HF‐HRV, heart rate) reactivity to two laboratory stressors that evoked different patterns of change in heart rate (HR). One stressor (viewing a video of a surgery) evoked HR deceleration while the... Psychophysiology Sun Nov 17, 2019 19:54 Pupillometric investigation into the speed‐accuracy trade‐off in a visuo‐motor aiming task Abstract Convergent lines of evidence suggest that fluctuations in the size of the pupil may be associated with the trade‐off between the speed (adrenergic, sympathetic) and accuracy (cholinergic, parasympathetic) of behavior across a variety of task contexts. Here, we explored whether pupil size was related to this trade‐off during a visuospatial motor aiming task. Participants were shown visual targets at random locations on a screen and were instructed and incentivized to move a computer mouse‐controlled... Psychophysiology Sun Nov 17, 2019 19:48 Mark above section as read  האקדמיה ללשון העברית סטודנט או סטודנטית לתמיכה באתר האקדמיה האקדמיה ללשון העברית מחפשתסטודנט או סטודנטית לתמיכה באתר האקדמיה תיאור התפקיד תמיכה טכנית בהפעלת אתר האקדמיה, הזנת שוטפת של תכנים, סיוע לעורך התוכן, איתור תקלות ועבודה מול אנשי מערכות המידע. דרישות התפקיד היכרות בסיסית עם HTML, CSS, JavaScript ותוכנות Office. ידע וניסיון ב-wordpress – יתרון ידע ב-PHP – יתרון יכולת למידה גבוהה יוזמה ועצמאות שליטה בתוכנות עריכה של גרפיקה, שמע ווידאו – יתרון היקף העבודה עד 120 שעות בחודש מקום העבודה בקריית האוניברסיטה, גבעת רם, ירושלים שכר סטודנט לפי תנאי... האקדמיה ללשון העברית Mon Nov 18, 2019 15:59 Mark above section as read  Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Αιφνίδιος καρδιακός θάνατος: Η εξέταση που εντοπίζει τα άτομα υψηλού κινδύνου Ο αιφνίδιος καρδιακός θάνατος πλήττει περίπου 220.000 ενήλικες στις ΗΠΑ ετησίως, οι περισσότεροι από τους οποίους δεν έχουν κανένα προηγούμενο καρδιακό σύμπτωμα. Εντοπίζοντας σπάνια γονίδια που αυξάνουν τον κίνδυνο αιφνίδιου καρδιακού θανάτου ερευνητές από το Γενικό Νοσοκομείο της Μασαχουσέτης, το Ινστιτούτο Broad του MIT και το Χάρβαρντ μπορούν πλέον να αποφανθούν για το ποια άτομα θα μπορούσαν να ωφεληθούν από στρατηγικές πρόληψης πριν την εμφάνιση συμπτωμάτων. Σύμφωνα με τα ευρήματα που παρουσιάστηκαν... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 14:08 Καρδιά: Τελικά πόσο αναγκαία είναι τα stent και σε ποιους ασθενείς Πολλοί ασθενείς με σοβαρή αλλά σταθερή καρδιοπάθεια που συνήθως υποβάλλονται σε αγγειοπλαστική με εμφύτευση stent για την αντιμετώπιση της αθηροσκλήρωσης, έχουν εξίσου καλή πορεία και με τη λήψη της σωστής φαρμακευτικής αγωγής και τις ανάλογες αλλαγές στον τρόπο ζωής, σύμφωνα με νέα μεγάλη μελέτη που παρουσιάστηκε στο ετήσιο συνέδριο της Αμερικανικής Καρδιολογικής Εταιρείας. Ουσιαστικά η μελέτη ISCHEMIA ανατρέπει τη μέχρι τώρα ιατρική πρακτική της τοποθέτησης stent σε καρδιοπαθείς που θεωρούνται... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 13:44 Η ανακάλυψη που θα σας εξασφαλίσει έναν καλό ύπνο Αν και ο ύπνος είναι καθοριστικής σημασίας για τον οργανισμό όλων των έμβιων όντων, οι γενετικοί μηχανισμοί που τον ρυθμίζουν παραμένουν ακόμα ασαφείς. Επιστήμονες, όμως, από το Ινστιτούτο Τεχνολογίας της Καλιφόρνια (Caltech) εντόπισαν σε πειραματικό μοντέλο, στο ψάρι-ζέβρα (Danio rerio), ένα γενετικό μονοπάτι απαραίτητο για τον καλό ύπνο, το οποίο φαίνεται να ρυθμίζει και τον ύπνο στον ανθρώπινο οργανισμό. Το μονοπάτι αυτό ρυθμίζει τα επίπεδα ενός συγκεκριμένου νευρικού συστατικού που κάποια μέρα... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 13:31 Σύστημα προβλέπει τον κίνδυνο θανάτου πριν από τους γιατρούς Ένα νέο πρόγραμμα τεχνητής νοημοσύνης μπορεί να εξετάσει ηλεκτροκαρδιογραφήματα και να εντοπίσει τους ασθενείς με καρδιακή αρρυθμία (κολπική μαρμαρυγή) που κινδυνεύουν από πρόωρο θάνατο μέσα στο επόμενο έτος, κάνοντας προβλέψεις καλύτερα και από καρδιολόγους. Η κολπική μαρμαρυγή σχετίζεται με αυξημένο κίνδυνο εμφράγματος και εγκεφαλικού επεισοδίου. Οι ερευνητές του Ιατρικού Κέντρου Geisinger της Πενσιλβάνια, που έκαναν δύο σχετικές ανακοινώσεις στο ετήσιο συνέδριο της Αμερικανικής Καρδιολογικής... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 10:00 Η τεχνική που σας βοηθά να κάνετε λιγότερα λάθη Αν είστε από αυτούς που ξεχνούν εύκολα ή κάνουν πολλά λάθη όταν βιάζονται, ο διαλογισμός ίσως να σας βοηθήσει να γίνετε λιγότερο… επιρρεπής στα κακώς κείμενα της καθημερινότητας, υποστηρίζει μία έρευνα του Πανεπιστημίου του Michigan που δημοσιεύθηκε στο Brain Sciences, η μεγαλύτερη του είδους της μέχρι σήμερα. Η έρευνα εξέτασε το πώς ο ανοιχτός, καθοδηγούμενος διαλογισμός που επικεντρώνεται στην αντίληψη των συναισθημάτων, των σκέψεων και των αισθήσεων καθώς αυτά απελευθερώνονται από το μυαλό και... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 09:30 Η κατάσταση που τριπλασιάζει τον κίνδυνο για την καρδιά Οι μοναχικοί ασθενείς με καρδιακά προβλήματα είναι πιο πιθανό να πεθάνουν εντός ενός χρόνου αφότου νοσηλευτούν. Σε αυτό το συμπέρασμα κατέληξε ερευνητική ομάδα του Πανεπιστημιακού Νοσοκομείου της Κοπεγχάγης σε δημοσίευση που έκανε στο Heart. Οι γυναίκες που ήταν μόνες είχαν τρεις φορές περισσότερες πιθανότητες να πεθάνουν 12 μήνες μετά τη νοσηλεία τους, ενώ ο κίνδυνος για τους άνδρες που ήταν μόνοι ήταν διπλάσιος. Η ερευνητική ομάδα εξέτασε τα αποτελέσματα που προέκυψαν εντός ενός έτους μετά από... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 09:20 Σύνδρομο Χρόνιας Κόπωσης: Το φάρμακο που θα σας ανακουφίσει Ερευνητές ανακάλυψαν ότι η δραστική ουσία ναλτρεξόνη αποκαθιστά σε μεγάλο βαθμό τη λειτουργία των ελαττωματικών υποδοχέων που σχετίζονται με την μυαλγική εγκεφαλομυελίτιδα, γνωστή ως Σύνδρομο Χρόνιας Κόπωσης, σύμφωνα με τη σχετική δημοσίευση στο Frontiers in Immunology. Οι επιστήμονες από το Εθνικό Κέντρο Νευροανοσολογίας και Αναδυόμενων Παθήσεων (NCNED) του Πανεπιστημίου Griffith είναι οι πρώτοι στον κόσμο που αναπτύσσουν το σύστημα gold standard (η καλύτερη υπάρχουσα μέθοδος), ευρύτερα γνωστό... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 08:50 Νέο πειραματικό εμβόλιο υπόσχεται καλύτερη αντιμετώπιση του καρκίνου Μια πρόδρομη μορφή δενδριτικών κυττάρων φαίνεται πως αποτελεί έναν αποδοτικό και αποτελεσματικό τρόπο ενεργοποίησης του ανοσοποιητικού συστήματος έτσι ώστε να καταπολεμήσει τους καρκινικούς όγκους, σύμφωνα με μια μελέτη που πραγματοποιήθηκε σε ζωικά και κυτταρικά μοντέλα από ερευνητές του Αντικαρκινικού Ινστιτούτου του Πανεπιστημίου Duke. Όπως περιγράφεται στη σχετική δημοσίευση στο Journal of Clinical Investigation, τα ευρήματα παρέχουν μια εναλλακτική έναντι του εμβολίου των δενδριτικών κυττάρων,... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 08:15 Άνοια: Ποιοι διατρέχουν τριπλάσιο κίνδυνο Οι άνθρωποι που δεν μπορούν να διαβάσουν ή να γράψουν λόγω αναλφαβητισμού, αντιμετωπίζουν σχεδόν τριπλάσιο κίνδυνο να εμφανίσουν άνοια κάποια στιγμή στη ζωή τους, σύμφωνα με μια νέα αμερικανική επιστημονική έρευνα. Οι ερευνητές, με επικεφαλής την Δρ. Jennifer Manly του Ιατρικού Κολεγίου του Πανεπιστημίου Κολούμπια της Νέας Υόρκης, που έκαναν τη σχετική δημοσίευση στο Neurology της Αμερικανικής Ακαδημίας Νευρολογίας, μελέτησαν 983 ανθρώπους άνω των 65 ετών, από τους οποίους οι 237 ήταν αναλφάβητοι... Επιστημονικές Εξελίξεις – ygeiamou | Το αξιόπιστο site για την Υγεία, τη Διατροφή και την Ευεξία Mon Nov 18, 2019 08:02 Mark above section as read  Latest Results for Sports Medicine Sports Injury Prevention is Complex: We Need to Invest in Better Processes, Not Singular Solutions Abstract In recent years, an understanding has developed that sports injuries are the emergent outcomes of complex, dynamic systems. Thus, the influence of local contextual factors on injury outcomes is increasingly being acknowledged. These realisations place injury prevention research at a crossroads. Currently, injury prevention researchers develop universally applicable injury prevention solutions, but the adoption of these solutions in practice is low. This occurs because... Latest Results for Sports Medicine Mon Nov 18, 2019 02:00 Mark above section as read  Mediators of Inflammation The Ubiquitin-Specific Protease 18 Promotes Hepatitis C Virus Production by Increasing Viral Infectivity Background and Aims. Ubiquitin-specific protease 18 (USP18) is involved in immunoregulation and response to interferon- (IFN-) based treatment in patients chronically infected with hepatitis C virus (HCV). We investigated whether and how its upregulation alters HCV infection. Methods. Overexpression of wild-type (USP18 WT) or catalytically inactive mutant (USP18 C64S) USP18 was examined for effects on HCV replication in the absence and presence of IFNα or IFNλ using both the HCV-infective model and... Mediators of Inflammation Mon Nov 18, 2019 17:05 Interleukin-17: Potential Target for Chronic Wounds Chronic wounds exhibit persistent inflammation with markedly delayed healing. The significant burden of chronic wounds, which are often resistant to standard therapy, prompts further research on novel therapies. Since the interleukin-17 family has been implicated as a group of proinflammatory cytokines in immune-mediated diseases in the gut and connective tissue, as well as inflammatory skin conditions, we consider here if it may contribute to the pathogenesis of chronic wounds. In this review, we... Mediators of Inflammation Mon Nov 18, 2019 16:05 Could Increased Expression of Hsp27, an "Anti-Inflammatory" Chaperone, Contribute to the Monocyte-Derived Dendritic Cell Bias towards Tolerance Induction in Breast Cancer Patients? Dendritic cells (DCs) are the most efficient antigen-presenting cells and link the innate immune sensing of the environment to the initiation of adaptive immune responses, which may be directed to either acceptance or elimination of the recognized antigen. In cancer patients, though DCs would be expected to present tumor antigens to T lymphocytes and induce tumor-eliminating responses, this is frequently not the case. The complex tumor microenvironment subverts the immune response, blocks some effector... Mediators of Inflammation Mon Nov 18, 2019 13:05 Mark above section as read  Experimental Physiology Stimulation of autophagy improves vascular function in the mesenteric arteries of type 2 diabetic mice New Findings What is the central question of this study? Impaired autophagy has been reported to be involved in type 2 diabetes. However, role of autophagy in vascular dysfunction in type 2 diabetes remains unanswered. What is the main finding and its importance? The main findings of this study are autophagy is decreased in the mesenteric arteries of type 2 diabetic mice and stimulation of autophagy using rapamycin and trehalose improves vascular function, which is associated with normalization... Experimental Physiology Sun Nov 17, 2019 15:13 Mark above section as read  ScienceDirect Publication: Photodiagnosis and Photodynamic Therapy Choriocapillary vascular density in central serous chorioretinopathy complicated by choroidal neovascularization Publication date: Available online 17 November 2019Source: Photodiagnosis and Photodynamic TherapyAuthor(s): Gilda Cennamo, Chiara Comune, Federica Mirra, Pasquale Napolitano, Daniela Montorio, Giuseppe de CrecchioABSTRACTBackgroundTo evaluate choriocapillary vascular density (CVD) in eyes with central serous chorioretinopathy (CSC) complicated by choroidal neovascularization (CNV), at baseline and after intravitreal injections (IVR) of Ranibizumab, using optical coherence tomography angiography... ScienceDirect Publication: Photodiagnosis and Photodynamic Therapy Mon Nov 18, 2019 17:00 Mark above section as read  Magnetic Resonance Imaging Coil-Combined Split Slice-GRAPPA for Simultaneous Multi-Slice Diffusion MRI Publication date: Available online 18 November 2019Source: Magnetic Resonance ImagingAuthor(s): SK. HashemizadehKolowri, Rong-Rong Chen, Ganesh Adluru, Leslie Ying, Edward VR. DiBellaAbstractObjective: To develop a kernel optimization method called coil-combined split slice-GRAPPA (CC-SSG) to improve the accuracy of the reconstructed coil-combined images for simultaneous multi-slice (SMS) diffusion weighted imaging (DWI) data.Methods: The CC-SSG method optimizes the tuning parameters in the k-space... Magnetic Resonance Imaging Mon Nov 18, 2019 16:42 Accelerated dynamic contrast enhanced MRI based on region of interest compressed sensing Publication date: Available online 18 November 2019Source: Magnetic Resonance ImagingAuthor(s): Amaresha Shridhar Konar, Nithin N. Vajuvalli, Rashmi Rao, Divya Jain, D.R. Ramesh Babu, Sairam GeethanathAbstractMagnetic Resonance Imaging (MRI) provides excellent soft tissue contrast with one significant limitation of slow data acquisition. Dynamic Contrast Enhanced MRI (DCE-MRI) is one of the widely employed techniques to estimate tumor tissue physiological parameters using contrast agents. DCE-MRI... Magnetic Resonance Imaging Mon Nov 18, 2019 16:42 Mark above section as read  American Journal of Otolaryngology Relationship between inflammation and the severity of Recurrent Respiratory Papillomatosis Publication date: Available online 18 November 2019Source: American Journal of OtolaryngologyAuthor(s): Vivian Narana Ribeiro El Achkar, Andressa Duarte, Román Carlos, Jorge Esquiche León, Alfredo Ribeiro-Silva, Shirley Shizue Nagata Pignatari, Estela KaminagakuraAbstractObjectiveTo characterize inflammatory cells in Recurrent Respiratory Papillomatosis (RRP) and to correlate it with severity using the Derkay laryngoscopic scale.Materials and methodsThe data and biopsies from 36 patients with Juvenile... American Journal of Otolaryngology Mon Nov 18, 2019 16:19 Mark above section as read  Case Reports in Medicine Benign Subcutaneous Nodules and Hypereosinophilic Syndrome: A Rare Presentation of an Uncommon Entity A 40-year-old gentleman presented with a history of multiple swellings involving his face, scalp, left axilla, back, and right thigh for the past 8 years. For the last 6 months, he developed intermittent low-grade fever, anorexia, weight loss, and gradually worsening breathlessness. On evaluation, the patient was found to have abnormally elevated absolute eosinophil count. Workup for the etiology of eosinophilia was unrewarding. All investigations related to an underlying myeloproliferative disorder... Case Reports in Medicine Mon Nov 18, 2019 13:05 Mark above section as read  Experimental Brain Research Pro- and antisaccade task-switching: response suppression—and not vector inversion—contributes to a task-set inertia Abstract Alternating between different tasks represents an executive function essential to activities of daily living. In the oculomotor literature, reaction times (RT) for a 'standard' and stimulus-driven (SD) prosaccade (i.e., saccade to target at target onset) are increased when preceded by a 'non-standard' antisaccade (i.e., saccade mirror-symmetrical to target at target onset), whereas the converse switch does not elicit an RT cost. The prosaccade switch-cost has been attributed... Experimental Brain Research Mon Nov 18, 2019 02:00 Neural mechanism of selective finger movement independent of synergistic movement Abstract Muscle synergy is important for simplifying functional movement, which constitutes spatiotemporal patterns of activity across muscles. To execute selective finger movements that are independent of synergistic movement patterns, we hypothesized that inhibitory neural activity is necessary to suppress enslaved finger movement caused by synergist muscles. To test this hypothesis, we focused on a pair of synergist muscles used in the hand opening movement, namely the index... Experimental Brain Research Mon Nov 18, 2019 02:00 Mark above section as read  Alcohol ALCOHOL; +33 new citations 33 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: ALCOHOL These pubmed results were generated on 2019/11/18PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites. Alcohol Mon Nov 18, 2019 15:53 ALCOHOL; +33 new citations 33 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: ALCOHOL These pubmed results were generated on 2019/11/18PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites. Alcohol Mon Nov 18, 2019 13:52 Mark above section as read  European Journal of Neuroscience Myelin and oligodendrocyte lineage cell dysfunctions: New players in the etiology and treatment of depression and stress‐related disorders Abstract Depressive disorders are complex, multifactorial disorders that have been traditionally attributed exclusively to neuronal abnormalities. However, recent studies have increased our understanding of the contribution of glial cells – and particularly of oligodendroglia – to the pathogenesis and treatment outcome of depression and stress‐related disorders. This review scrutinizes recent studies focusing on the neurosupportive functions exerted by myelin and oligodendrocyte lineage cells and... European Journal of Neuroscience Sun Nov 17, 2019 20:19 Mark above section as read  NeuroImage Task-induced brain connectivity promotes the detection of individual differences in brain-behavior relationships Publication date: Available online 18 November 2019Source: NeuroImageAuthor(s): Rongtao Jiang, Nianming Zuo, Judith M. Ford, Shile Qi, Dongmei Zhi, Chuanjun Zhuo, Yong Xu, Zening Fu, Juan Bustillo, Jessica A. Turner, Vince D. Calhoun, Jing SuiAbstractAlthough both resting and task-induced functional connectivity (FC) have been used to characterize the human brain and cognitive abilities, the potential of task-induced FCs in individualized prediction for out-of-scanner cognitive traits remains largely... NeuroImage Mon Nov 18, 2019 15:42 Effective connectivity modulations related to win and loss outcomes Publication date: Available online 17 November 2019Source: NeuroImageAuthor(s): Frederik Van de Steen, Ruth M. Krebs, Nigel Colenbier, Hannes Almgren, Daniele MarinazzoAbstractPrevious studies have characterized the brain regions involved in encoding monetary reward and punishment outcomes. The question of how this information is integrated across brain regions has received less attention. Here, we investigated changes in effective connectivity related to the processing of positive and negative monetary... NeuroImage Mon Nov 18, 2019 15:42 Mark above section as read  ClinicalTrials Hip Arthroscopy Versus Total Hip Arthroplasty RCT Condition:   Hip OsteoarthritisInterventions:   Procedure: Hip Arthroscopy;   Procedure: Total Hip ArthroplastySponsor:   Western University, CanadaNot yet recruiting ClinicalTrials Mon Nov 18, 2019 15:24 A Phase II Study on Adjuvant Vaccination With Dendritic Cells Loaded With Autologous Tumor Homogenate in Resected Stage IV Rare Cancers. Conditions:   Head Neck Tumors;   Neuroendocrine Tumors;   Soft Tissue Sarcoma;   Rare Cancer;   VaccinationInterventions:   Biological: Autologous DC vaccine;   Drug: Interleukin-2Sponsor:   Istituto Scientifico Romagnolo per lo Studio e la cura dei TumoriNot yet recruiting ClinicalTrials Mon Nov 18, 2019 15:24 A Drug-Drug Interaction Study of CYP3A4 Inhibition and Pan-CYP Induction on APX001 Condition:   Fungal InfectionInterventions:   Drug: APX001;   Drug: Itraconazole;   Drug: RifampinSponsor:   Amplyx PharmaceuticalsRecruiting ClinicalTrials Mon Nov 18, 2019 15:24 Oral Pathology Asynchronous Telementoring Pilot Study Condition:   Oral CancerIntervention:   Device: intraoral camerasSponsor:   NYU Langone HealthNot yet recruiting ClinicalTrials Mon Nov 18, 2019 15:24 Mark above section as read  International journal of basic and clinical endocrinology A randomized trial comparing health-related quality-of-life and utility measures between routine fine-needle aspiration cytology (FNAC) and surveillance alone in patients with thyroid incidentaloma measuring 1–2 cm Abstract Purpose To present the impact of treatment on health-related quality-of-life (HRQOL) and health utility measures from the randomized controlled trial (ClinicalTrials.gov Identifier: NCT02398721) that investigated the FNAC versus watchful surveillance in patients with incidental benign thyroid nodules. Methods Health utility and HRQOL were evaluated... International journal of basic and clinical endocrinology Mon Nov 18, 2019 02:00 Interobserver agreement and efficacy of consensus reading in Kwak-, EU-, and ACR-thyroid imaging recording and data systems and ATA guidelines for the ultrasound risk stratification of thyroid nodules Abstract Purpose To investigate the interobserver agreement (IA) and the impact of consensus reading using four risk stratification systems for thyroid nodules (TN). Methods Four experienced specialists independently rated US images of 80 TN according to the Kwak-TIRADS, EU-TIRADS, ACR TI-RADS, and ATA Guidelines. The cases were randomly extracted from a... International journal of basic and clinical endocrinology Mon Nov 18, 2019 02:00 Mark above section as read  ScienceDirect Publication: Annals of Allergy, Asthma & Immunology Skin Testing with Ultraheat Treated (UHT) Cow's Milk in Children with Cow's Milk Allergy. Publication date: Available online 18 November 2019Source: Annals of Allergy, Asthma & ImmunologyAuthor(s): Bella Shadur, Andrew Fong, Betina Altavilla, Rebecca Anne Saad, Brynn Kevin Wainstein ScienceDirect Publication: Annals of Allergy, Asthma & Immunology Mon Nov 18, 2019 15:13 Decades of Poor Availability of Epinephrine Auto-Injectors – Global Problems in Need of Global Solutions Publication date: Available online 18 November 2019Source: Annals of Allergy, Asthma & ImmunologyAuthor(s): Susan Waserman, Ernie Avilla, Laurie Harada, Joni Huang, Monika Kastner ScienceDirect Publication: Annals of Allergy, Asthma & Immunology Mon Nov 18, 2019 15:13 Mark above section as read  Allergy Drug‐induced IgG‐neutrophil‐mediated anaphylaxis in humans: uncovered! Abstract Seminal work by Oettgen et al.1 in the early 90's revealed the existence of alternative pathways of anaphylaxis (non IgE‐mediated) in IgE‐deficient mice. These are mediated by IgG‐immune complexes which, depending on their nature, signal on a number of myeloid cells including macrophages/monocytes, basophils, mast cells and neutrophils. While extensively characterized in mice, conclusive evidence of the existence of alternative pathways of anaphylaxis in humans have remained elusive. Allergy Sun Nov 17, 2019 20:04 Mark above section as read  oral surg oral med A nodule in the palatal mucosa. Related ArticlesA nodule in the palatal mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 May 30;: Authors: Pontes HAR, de Souza LL, Rodrigues-Fernandes CI, Fernandes LA, Santos VL, de Souza ABC, de Carvalho VL, Khan W, de Almeida OP, Fonseca FP, Pontes FSC PMID: 31734141 [PubMed - as supplied by publisher] oral surg oral med Mon Nov 18, 2019 15:12 Mark above section as read  Critical Reviews in Oncology/Hematology (open access) Revisiting the impact of lifestyle on colorectal cancer risk in a gender perspective Publication date: Available online 18 November 2019Source: Critical Reviews in Oncology/HematologyAuthor(s): Lucia Conti, Manuela Del Cornò, Sandra GessaniAbstractColorectal cancer (CRC) is a leading cause of cancer-related mortality in the world. Patterns and trends in CRC incidence and mortality correlate with increasing adoption of Western lifestyles and with the overweight/obesity epidemic. Both genetic background and a range of modifiable environmental/lifestyle factors play a role in CRC etiology.... Critical Reviews in Oncology/Hematology (open access) Mon Nov 18, 2019 15:11 Mark above section as read  Journal of Cancer Research and Clinical Oncology Oncogenic potential of nucleoporins in non-hematological cancers: recent update beyond chromosome translocation and gene fusion Abstract Introduction The nuclear pore complex is comprised of approximately 30 proteins named nucleoporins (Nups) and tightly regulates nucleocytoplasmic transport of macromolecules across the nuclear membrane. Genetic alterations in many NUP genes are associated with many human maladies, such as neurological disease, autoimmune disorders and cancer. Methods ... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Modified DHAP regimen in the salvage treatment of refractory or relapsed lymphomas Abstract Background The combination of dexamethasone, high-dose cytarabine, and cisplatin (DHAP) is an established salvage regimen for lymphoma patients. We hypothesized that a modified administration schedule for cisplatin and cytarabine results in lower toxicity and improved efficacy. Methods We retrospectively analysed 119 patients with relapsed... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 A systematic review of treatment outcomes in localised and metastatic spermatocytic tumors of the testis Abstract Introduction Because spermatocytic tumors of the testis are rare, only limited evidence exists regarding the malignant potential and the optimal management of localized and metastatic disease. Materials and methods We performed a systematic review through MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Web of Science... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Vimentin expression in circulating tumor cells (CTCs) associated with liver metastases predicts poor progression-free survival in patients with advanced lung cancer Abstract Objective To investigate the presence of vimentin expression in CTCs and its clinical relevance in patients with advanced lung cancer. Methods Peripheral blood was obtained from 61 treatment-naive patients with advanced lung cancer. Subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH) platform was... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Brain metastasis as exclusion criteria in clinical trials involving extensive-stage small cell lung cancer Abstract Background The American Society of Clinical Oncology and Friends of Cancer Research submitted recommendations to the FDA to reduce barriers in clinical trial participation. They proposed the removal of several specific exclusion criteria, including brain metastasis. Clinical trials involving small cell lung cancer (SCLC) have varying exclusion criteria regarding brain metastasis. ... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 The efficacy and toxicity of the CHG priming regimen (low-dose cytarabine, homoharringtonine, and G-CSF) in higher risk MDS patients relapsed or refractory to decitabine Abstract Purpose Myelodysplastic syndromes (MDSs) refractory or relapsed after hypomethylating agents (HMAs) remain a therapeutic challenge. The CHG regimen has been demonstrated to be effective in initially treating higher risk MDS. The current study evaluated the efficacy and toxicity of the CHG regimen in patients who were resistant to decitabine. Methods ... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Prognostic value and clinicopathological roles of phenotypes of tumour-associated macrophages in colorectal cancer Abstract Background The role of tumour-associated macrophages (TAMs) in predicting the prognosis of colorectal cancer (CRC) remains controversial. This is especially so because the prognostic significance and clinicopathological relevance of different subtypes of TAMs in the immune microenvironment of CRC have not yet been established. Objective ... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Tumor-infiltrating lymphocytes and CD8 + T cells predict survival of triple-negative breast cancer Abstract Purpose Tumor inflammatory response was evaluated as a prognostic feature in triple-negative breast cancer (TNBC) and compared with the clinical prognosticators of breast cancer and selected biomarkers of cancer cell proliferation. Methods TNBC patients (n = 179) with complete clinical data and up to 18-year follow-up were obtained... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Radiomics for diagnosis of dual-phenotype hepatocellular carcinoma using Gd-EOB-DTPA-enhanced MRI and patient prognosis Abstract Purpose To describe the clinical characteristics and outcomes of patients with dual-phenotype hepatocellular carcinoma (DPHCC) and investigate the use of radiomics to establish an image-based signature for preoperative differential diagnosis. Methods This study included 50 patients with a postoperative pathological diagnosis of DPHCC... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Therapeutic delivery of microRNA-143 by cationic lipoplexes for non-small cell lung cancer treatment in vivo Abstract Purpose Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths worldwide and new improvements are urgently needed. Several miRNA-targeted therapeutics have reached clinical development. MicroRNA-143 (miR-143) was found to significantly suppress the migration and invasion of NSCLC. It might be of great potential for NSCLC treatment. However, the therapeutic effect of miR-143 against NSCLC in... Journal of Cancer Research and Clinical Oncology Mon Nov 18, 2019 15:08 Mark above section as read  radiol anat Anatomy and white matter connections of the lateral occipital cortex. Related ArticlesAnatomy and white matter connections of the lateral occipital cortex. Surg Radiol Anat. 2019 Nov 16;: Authors: Palejwala AH, O'Connor KP, Pelargos P, Briggs RG, Milton CK, Conner AK, Milligan TM, O'Donoghue DL, Glenn CA, Sughrue ME Abstract PURPOSE: White matter tracts link different regions of the brain, and the known functions of those interconnected regions may offer clues about the roles that white matter tracts play in information... radiol anat Mon Nov 18, 2019 14:50 Mark above section as read  Surgical and Radiologic Anatomy Morphometric analysis and surgical adequacy of palmaris longus as a tendon graft. A systematic review of cadaveric studies Abstract Introduction The tendon of the palmaris longus is commonly used as a tendon graft in many reconstructive surgeries. Easy to access and at proximity to the hand, the palmaris longus tendon is considered as the optimal tendon source for hand reconstructive surgery. However, and besides its inconsistency, the size of the palmaris longus tendon is reported to show variability. The aim of this study is to look for the surgical adequacy... Surgical and Radiologic Anatomy Mon Nov 18, 2019 02:00 Mark above section as read  Alcohol and Homeostasis Mark above section as read  Radiation Molecular Biology. Meetings Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Radiation Molecular Biology. Mon Nov 18, 2019 14:43 In Reply to Gultekin and Yildiz Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Jérôme Doyen, Danny Jazmati, Dirk Geismar, Sabine Frisch, Stefanie Schulze Schleithoff, Xavier Vermeren, Monika Scheer, Christoph Blasé, Stephan Tippelt, Beate Timmermann Radiation Molecular Biology. Mon Nov 18, 2019 14:43 In Regard to Doyen et al Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Melis Gultekin, Ferah Yildiz Radiation Molecular Biology. Mon Nov 18, 2019 14:43 In Reply to Braunstein Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Samantha M. Buszek, Simona F. Shaitelman Radiation Molecular Biology. Mon Nov 18, 2019 14:43 In Regard to Buszek et al Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Lior Z. Braunstein Radiation Molecular Biology. Mon Nov 18, 2019 14:43 In Reply to Khosla et al Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Youlia M. Kirova, Geoffroy Boulle, Brigitte De La Lande, Alain Fourquet Radiation Molecular Biology. Mon Nov 18, 2019 14:43 In Regard to Boulle et al Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Divya Khosla, Rakesh Kapoor, Ritesh Kumar Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Erratum to Fady B. Geara, MD, PhD; Ritsuko Komaki, MD; Susan L. Tucker, PhD; Penny Perkins, PhD; Elizabeth L. Travis, PhD; James D. Cox, MD. 2149 Determinants of Lung Fibrosis After Chemoradiation for Small Cell Carcinoma of the Lung: Evidence for Inherent Interindividual Variation. <em>Int J Radiat Oncol Biol Phys</em> 1996;36(suppl):350. Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Don't Get Stuck on the Shoulder: Radiation Oncologists Should Get Into the CAR With T-Cell Therapies Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): John P. Plastaras, Elise A. Chong, Stephen J. Schuster Radiation Molecular Biology. Mon Nov 18, 2019 14:43 What Would I Want Done for My Mother? Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Jonathan P.S. Knisely Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Offer Hypofractionated SRS… If Her Performance Status Is Good Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): John P. Kirkpatrick, Peter E. FecciThis article is a Gray Zone opinion that will be published at a later dateThe full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy. Radiation Molecular Biology. Mon Nov 18, 2019 14:43 The Choice of Postoperative Stereotactic Radiosurgery After Resection of an Isolated Brain Metastasis Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Matthew J. Shepard, Jason P. Sheehan Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Radiation Therapy for Surgically Resected Brain Metastasis: What Is Your Approach? Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Richard Li, Nayana Vora Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Implementation of New Biology-Based Radiation Therapy Technology: When Is It Ready So "Perfect Makes Practice?" Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): C. Norman Coleman, Mansoor M. Ahmed Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Using Multiparametric Magnetic Resonance Imaging to Shift Prostate Cancer Diagnosis Toward Clinically Significant Disease and Minimize Overdiagnosis (and Overtreatment) Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Ann Henry Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Issue Highlights Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Erratum to: Lee AW, Ng WT, Pan JJ, et al. International Guideline on Dose Prioritization and Acceptance Criteria in Radiation Therapy Planning for Nasopharyngeal Carcinoma. <em>Int J Radiat Oncol Biol Phys</em> 2019;105:567-580 Publication date: 1 December 2019Source: International Journal of Radiation Oncology*Biology*Physics, Volume 105, Issue 5Author(s): Radiation Molecular Biology. Mon Nov 18, 2019 14:43 Mark above section as read
A Comparison of Two LDL Cholesterol Targets after Ischemic StrokeIntensive therapy to lower serum lipid levels with the use of statins is recommended after transient ischemic attack (TIA) or ischemic stroke of atherosclerotic origin. These recommendations are based on the results of the Stroke Prevention by Aggressive Reduction in Cholesterol Level (SPARCL)…NEJM : ResearchMon Nov 18, 2019 02:00Mark above section as read Upper respiratory tract infectionEffectiveness of adjunctive nebulized antibiotics...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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 bioRxiv Subject Collection: Evolutionary Biology, Chromosome painting does not support a sex chromosome turnover in Lacerta agilis Linnaeus, 1758 [NEW RESULTS] Reptiles show a remarkable diversity of sex determination mechanisms and sex chromosome systems, derived from different autosomal pairs. The origin of the ZW sex chromosomes of Lacerta agilis, a widespread Eurasian lizard species, is a matter of discussion: is it a small macrochromosome from the 11-18 group, common to all lacertids, or this species has unique ZW pair derived from the large chromosome 5. Using independent molecular cytogenetic methods, we investigated the karyotype of L. agilis exigua... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Dynamics of genetic variation in Transcription Factors and its implications for the evolution of regulatory networks in Bacteria [NEW RESULTS] The evolution of bacterial regulatory networks has largely been explained at macroevolutionary scales through lateral gene transfer and gene duplication. Transcription factors (TF) have been found to be less conserved across species than their target genes (TG). This would be expected if TFs accumulate mutations faster than TGs. This hypothesis is supported by several lab evolution studies which found TFs, especially global regulators, to be frequently mutated. Despite these studies, the contribution... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Selective sweeps under dominance and inbreeding [NEW RESULTS] A major research goal in evolutionary genetics is to uncover loci experiencing positive selection. One approach involves finding 'selective sweeps' patterns, which can either be 'hard sweeps' formed by de novo mutation, or 'soft sweeps' arising from recurrent mutation or existing standing variation. Existing theory generally assumes outcrossing populations, and it is unclear how dominance affects soft sweeps. We consider how arbitrary dominance and inbreeding via self-fertilisation affect hard and... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Rates of molecular evolution predict intraspecies genetic diversity [NEW RESULTS] Because the evolution of modern humans from early mammals has been a continuous process, human genetic diversity at the molecular level should reflect mammalian genetic diversity. To test this prediction, we contrasted the proportion of segregating sites, q, in human data from the 1000 Genome Project with phylogenetic trees of genes in 96 mammalian genomes ranging from human to platypus. The evolvability of a gene in the human population was found to be positively correlated with the long-term molecular... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Approximating the coalescent under facultative sex [NEW RESULTS] Genome studies of facultative sexual species are providing insight into the evolutionary consequences of mixed reproductive modes. However, it is unclear if the evolutionary history of facultative sexuals' genomes can be captured by standard population genetic models; in particular, whether they can be approximated by Wright-Fisher dynamics while assuming a rescaled effective population size Ne. Here, I determine when the gene genealogies of diploid facultative sexuals, which can either reproduce... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Chromosome painting does not support a sex chromosome turnover in Lacerta agilis Linnaeus, 1758 [NEW RESULTS] Reptiles show a remarkable diversity of sex determination mechanisms and sex chromosome systems, derived from different autosomal pairs. The origin of the ZW sex chromosomes of Lacerta agilis, a widespread Eurasian lizard species, is a matter of discussion: is it a small macrochromosome from the 11-18 group, common to all lacertids, or this species has unique ZW pair derived from the large chromosome 5. Using independent molecular cytogenetic methods, we investigated the karyotype of L. agilis exigua... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Recombination, variance in genetic relatedness, and selection against introgressed DNA [NEW RESULTS] The genomic proportion that two relatives share identically by descent - their genetic relatedness - can vary depending on the patterns of recombination and segregation in their pedigree. Here, we calculate the precise connection between genome-wide genetic shuffling and variance in genetic relatedness. For the relationships of grandparent-grandoffspring and siblings, the variance in genetic relatedness is a simple decreasing function of[r] , the average proportion of locus pairs that recombine in... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Counting the paternal founders of Austroasiatic speakers associated with the language dispersal in South Asia [NEW RESULTS] The phylogenetic analysis of Y chromosomal haplogroup O2a-M95 was crucial to determine the nested structure of South Asian branches within the larger tree, predominantly present in East and Southeast Asia. However, it had previously been unclear how many founders brought the haplogroup O2a-M95 to South Asia. On the basis of the updated Y chromosomal tree for haplogroup O2a-M95, we analysed 1,437 male samples from South Asia for various downstream markers, carefully selected from the extant phylogenetic... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Evidence for mutation-order speciation in an Australian wildflower [NEW RESULTS] In a number of animal species, divergent natural selection has repeatedly and independently driven the evolution of reproductive isolation between populations adapted to contrasting, but not to similar environments. This process is known as parallel ecological speciation, and examples in plants are enigmatically rare. Here, we perform a comprehensive test of the ecological speciation hypothesis in an Australian wildflower where parapatric populations found in coastal sand dunes (Dune ecotype) and... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Muller's Ratchet and the Long-Term Fate of Chromosomal Inversions [NEW RESULTS] Chromosomal inversions contribute widely to adaptation and speciation, yet they present a unique evolutionary puzzle as both their allelic content and frequency evolve in a feedback loop. In this simulation study, we quantified the role of the allelic content in determining the long-term fate of the inversion. Recessive deleterious mutations accumulated rapidly on both arrangements with most of them being private to a given arrangement. The emerging overdominance led to maintenance of the inversion... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Divergence in hormone signalling links local adaptation and hybrid failure [NEW RESULTS] Natural selection is a major driver for the origins of adaptations and new species. Whether or not the processes driving adaptation and speciation share a molecular basis remains largely unknown. Here, we show that divergence in hormone signalling contributed to the evolution of complex adaptations and intrinsic reproductive isolation in the Australian wildflower Senecio lautus. We provide evidence that differences in the auxin pathway, a hormone required for plant growth and development, has led... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Replicated anthropogenic hybridisations reveal parallel patterns of admixture in marine mussels. [NEW RESULTS] Human-mediated transport creates secondary contacts between genetically differentiated lineages, bringing new opportunities for gene exchange. When similar introductions occur in different places, they provide informally replicated experiments for studying hybridisation. We here examined 4279 Mytilus mussels, sampled in Europe and genotyped with 77 ancestry informative markers. We identified a type of introduced mussels, called 'dock mussels', associated with port habitats and displaying a particular... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Longer is not always better: Optimizing barcode length for large-scale species discovery and identification [NEW RESULTS] New techniques for the species-level sorting of millions of specimens are needed in order to accelerate species discovery, determine how many species live on earth, and develop efficient biomonitoring techniques. These sorting methods should be reliable, scalable and cost-effective, as well as being largely insensitive to low-quality genomic DNA, given that this is usually all that can be obtained from museum specimens. Mini-barcodes seem to satisfy these criteria, but it is unclear how well they... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Translational readthrough goes unseen by natural selection [NEW RESULTS] Occasionally during protein synthesis, the ribosome bypasses the stop codon and continues translation to the next stop codon in frame. This error is called translational readthrough (TR). Earlier research suggest that TR is a relatively common error, in several taxa, yet the evolutionary relevance of this translational error is still unclear. By analysing ribosome profiling data, we have conducted species comparisons between yeasts to infer conservation of TR between orthologs. Moreover, we infer... bioRxiv Subject Collection: Evolutionary Biology Mon Nov 18, 2019 02:00 Mark above section as read  Latest Results for Sleep and Breathing Association between body mass index and effectiveness of continuous positive airway pressure in patients with obstructive sleep apnea: a retrospective study Abstract Purpose Ineffective use of continuous positive airway pressure (CPAP) therapy can result in inconvenience and additional costs in patients with obstructive sleep apnea (OSA). This study investigated the predictive value of body mass index (BMI) to assess the efficacy of CPAP in patients with OSA. Methods Data were extracted from a retrospective study... Latest Results for Sleep and Breathing Mon Nov 18, 2019 02:00 Mark above section as read  Journal of Voice Tongue Edema Secondary to Suspension Laryngoscopy Suspension microlaryngoscopy (SML) is generally a safe, same-day procedure. Complications have been linked to prolonged operative time and substantial force applied to the tongue. This report of two cases describes marked tongue edema following SML, a complication not yet reported in the literature. Journal of Voice Mon Nov 18, 2019 02:00 Mark above section as read  Journal of Medical Case Reports - Latest Articles Spontaneous disappearance and recurrence of impending macular hole: a case report There have been several reports of spontaneous closure and reopening of a macular hole, however, in most of those cases, it was observed in eyes post vitrectomy. Here, we report a case of multiple episodes of ... Journal of Medical Case Reports - Latest Articles Sun Nov 17, 2019 02:00 Mark above section as read  The Journal of Immunology current issue Top Reads [TOP READS] The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Low-Dose IL-2 Therapy in Transplantation, Autoimmunity, and Inflammatory Diseases [TRANSLATING IMMUNOLOGY] Regulatory T cells (Tregs) play a central role in the induction and maintenance of immune homeostasis and self-tolerance. Tregs constantly express the high-affinity receptor to IL-2. IL-2 is a pleiotropic cytokine and a key survival factor for Tregs. It maintains Tregs' suppressive function by promoting Foxp3 expression and subsequent production of immunoregulatory cytokines. Administration of low-dose IL-2 is shown to be a promising approach to prevent allograft rejection and to treat autoimmune... The Journal of Immunology current issue Mon Nov 18, 2019 23:00 A Dynamic Variation of Pulmonary ACE2 Is Required to Modulate Neutrophilic Inflammation in Response to Pseudomonas aeruginosa Lung Infection in Mice [INNATE IMMUNITY AND INFLAMMATION] Key PointsPseudomonas bacterial lung infection leads to pulmonary ACE2 dynamic variation. The ACE2 dynamic alteration is critical in regulating neutrophilic lung inflammation. ACE2 modulates IL-17–mediated neutrophil influx by impacting STAT3 activity. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Inflammasomes: Their Role in Normal and Complicated Pregnancies [BRIEF REVIEWS] Inflammasomes are cytoplasmic multiprotein complexes that coordinate inflammatory responses, including those that take place during pregnancy. Inflammasomes and their downstream mediators caspase-1 and IL-1β are expressed by gestational tissues (e.g., the placenta and chorioamniotic membranes) during normal pregnancy. Yet, only the activation of the NLRP3 inflammasome in the chorioamniotic membranes has been partially implicated in the sterile inflammatory process of term parturition. In vivo and... The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Multiple Signaling Pathways Involved in Human Dendritic Cell Maturation Are Affected by the Fungal Quorum-Sensing Molecule Farnesol [INFECTIOUS DISEASE AND HOST RESPONSE] Key PointsFOH promotes CD1d expression in human DC via activation of PPAR, RARα, and p38 MAPK. FOH modulates cytokine release through nuclear receptors, MAPK, and NF-B pathways. FOH diminishes human DC capacity to activate iNKT, Th1, and FOXP3+ regulatory T cells. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Cutting Edge: TCR Signal Strength Regulates Acetyl-CoA Metabolism via AKT [CUTTING EDGE] Key PointsTCR signal strength regulates acetyl-CoA metabolism. Weak TCR signals promote phosphorylation of citrate synthase via Akt. TCR signal strength differentially regulates acetyl-lysine containing proteins. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Uhrf1-Mediated Tnf-{alpha} Gene Methylation Controls Proinflammatory Macrophages in Experimental Colitis Resembling Inflammatory Bowel Disease [MUCOSAL IMMUNOLOGY] Key PointsUhrf1-mediated DNA methylation represses Tnf-α expression in macrophages. Uhrf1 deficiency augments Tnf-α expression, resulting in aggravated colitis. Tnf-α triggers macrophage activation through destabilizing Uhrf1 protein. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Inhibition of Allergic Reactivity through Targeting Fc{varepsilon}RI-Bound IgE with Humanized Low-Affinity Antibodies [ALLERGY AND OTHER HYPERSENSITIVITIES] Key PointsLARI inhibits allergic reactivity while displaying an excellent safety profile. LARI blunts allergic responses via multiple mechanisms at multiple steps. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Role of IL-15 Signaling in the Pathogenesis of Simian Immunodeficiency Virus Infection in Rhesus Macaques [INFECTIOUS DISEASE AND HOST RESPONSE] Key PointsAnti–IL-15 depletes NK cells and disrupts TEM homeostasis in SIV-infected RM. IL-15 inhibition does not alter SIV replication dynamics or CD4+ T cell depletion. IL-15 inhibition does accelerate reactivation of an oncogenic -herpesvirus. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Malt1 Protease Deficiency in Mice Disrupts Immune Homeostasis at Environmental Barriers and Drives Systemic T Cell-Mediated Autoimmunity [AUTOIMMUNITY] Key PointsAutoreactive T cells drive the lethal disease in Malt1PD mice. Malt1PD mice display B cell hyperactivation to environmental Ags. IPEX-like disease occurs in Malt1PD mice despite in vitro Treg suppressive activity. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Long-Term Microgliosis Driven by Acute Systemic Inflammation [INNATE IMMUNITY AND INFLAMMATION] Key PointsEarly monocyte infiltration causes long-term microgliosis in sepsis. Brain microglia self-proliferate during severe sepsis. Microglia proliferation is associated with local M-CSF. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 cAMP Response Element Modulator {alpha} Induces Dual Specificity Protein Phosphatase 4 to Promote Effector T Cells in Juvenile-Onset Lupus [AUTOIMMUNITY] Key PointsCREMα induces DUSP4 phosphatase expression in CD4+ T cells. DUSP4 promotes IL-17A and reduces IL-2 production by effector T cells. The CREMα/DUSP4 axis is involved in the pathophysiology of SLE. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Ubc9 Interacts with and SUMOylates the TCR Adaptor SLP-76 for NFAT Transcription in T Cells [MOLECULAR AND STRUCTURAL IMMUNOLOGY] Key PointsUbc9 interacts with and SUMOylates the immune adaptor SLP-76 in T cells. Synergy of SLP-76–Ubc9 on IL-2 transcription is SLP-76 SUMOylation dependent. SLP-76 SUMOylation is required for Ubc9-NFAT complex assembly for IL-2 transcription. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Functional Characterization of CD11c+ Age-Associated B Cells as Memory B Cells [AUTOIMMUNITY] Key PointsCD11c+ ABCs exhibit functional characteristics of MBCs. ABCs express polyreactive B cell receptors binding diverse self-antigens. Adoptively transferred ABCs contribute to rapid recall responses to viral Ags. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Dendritic Cells Control Regulatory T Cell Function Required for Maintenance of Intestinal Tissue Homeostasis [MUCOSAL IMMUNOLOGY] Key PointsInhibitory receptors are upregulated on peripheral Tregs of DC-deficient mice. Tregs from DC-deficient mice are functionally impaired. Tregs require DCs for inhibition of T cell transfer-induced colitis. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 UBASH3A Regulates the Synthesis and Dynamics of TCR-CD3 Complexes [AUTOIMMUNITY] Key PointsUBASH3A interacts with the TCR–CD3 complex and regulates its turnover. UBASH3A facilitates the downmodulation of cell-surface TCR–CD3 upon TCR engagement. UBASH3A binds to CBL-B, another T1D-associated protein that inhibits T cell function. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 MR1-Independent Activation of Human Mucosal-Associated Invariant T Cells by Mycobacteria [IMMUNOTHERAPY AND VACCINES] Key PointsMAIT cells comprise half the CD8 T cell IFN- response to BCG in blood. Frequencies of MAIT cells were not sustainably modulated by BCG vaccination. Innate cytokines mediate BCG-induced MAIT cell responses in whole blood. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 TNF-Induced Interstitial Lung Disease in a Murine Arthritis Model: Accumulation of Activated Monocytes, Conventional Dendritic Cells, and CD21+/CD23- B Cell Follicles Is Prevented with Anti-TNF Therapy [AUTOIMMUNITY] Key PointsTNF-Tg mice develop NSIP-like lung disease with increased cDC2 and macrophages. Anti-TNF therapy modulates prefibrotic ILD in TNF-Tg mice. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 The IL-12- and IL-23-Dependent NK Cell Response Is Essential for Protective Immunity against Secondary Toxoplasma gondii Infection [INFECTIOUS DISEASE AND HOST RESPONSE] Key PointsNK cells are required for immune control of secondary T. gondii infection. NK cells do not develop intrinsic memory-like features during T. gondii infection. Secondary NK cell responses depend upon IL-12 and IL-23. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Regulatory T Cell Transmigration and Intravascular Migration Undergo Mechanistically Distinct Regulation at Different Phases of the Inflammatory Response [IMMUNE REGULATION] Key PointsRegulatory T cells can undergo extensive intravascular crawling in skin vessels. Mechanisms of regulatory T cell transmigration can be modulated dynamically. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 The TL1A-DR3 Axis Selectively Drives Effector Functions in Human MAIT Cells [INNATE IMMUNITY AND INFLAMMATION] Key PointsDR3 is highly expressed on human MAIT cells. DR3 ligand TL1A licenses innate TNF-α production and boosts polyfunctionality. TL1A equally augments TCR-dependent MAIT cell effector functions. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 RELM{alpha} Licenses Macrophages for Damage-Associated Molecular Pattern Activation to Instigate Pulmonary Vascular Remodeling [IMMUNE REGULATION] Key PointsRELMα (hResistin) activates pulmonary macrophages in PAH patients and hypoxic mice. RELMα (hResistin) induces HMGB1 acetylation by suppressing Sirt1 in macrophages. The RELMα–HMGB1 axis causes macrophage-mediated PASMC proliferation. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Glycogen Synthase Kinase 3{beta} Regulates Antiviral Responses of TLR3 via TRAF2-Src Axis [INNATE IMMUNITY AND INFLAMMATION] Key PointsGSK3β interacts with Src tyrosine kinase. Src positively regulates antiviral immune response. Src undergoes K63-linked ubiquitination by TRAF2. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 TLR2 Stimulation Increases Cellular Metabolism in CD8+ T Cells and Thereby Enhances CD8+ T Cell Activation, Function, and Antiviral Activity [IMMUNE REGULATION] Key PointsTLR2 directly regulates the anti-CD3–activated CD8+ T cells independently on APCs. Bioenergy metabolism is important for TLR2-mediated enhancement of CD8+ T cells. TLR2 enhances the antiviral CD8+ T cell response and the efficacy of HBV vaccine. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Exercise Promotes Resolution of Acute Inflammation by Catecholamine-Mediated Stimulation of Resolvin D1 Biosynthesis [INNATE IMMUNITY AND INFLAMMATION] Key PointsExercise enhances resolution of acute inflammation and RvD1 biosynthesis. Epinephrine stimulates macrophage production of RvD1 through α1-AR. α1-AR blockade in vivo abrogates exercise-enhanced resolution. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Downregulation of MHC Class II by Ubiquitination Is Required for the Migration of CD206+ Dendritic Cells to Skin-Draining Lymph Nodes [IMMUNE REGULATION] Key PointsMHCII molecule upregulation is not required for the development of skin moDCs. Skin CD206+ moDCs do not migrate to LNs in the absence of MHCII ubiquitination. GM-CSF restores the migration of skin moDCs by upregulating CCR7 and IRF4. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Recognition of Lewis X by Anti-Lex Monoclonal Antibody IG5F6 [MOLECULAR AND STRUCTURAL IMMUNOLOGY] Key PointsRecognition of monomeric Lex by IG5F6 using a panel of Lex analogues was studied. Anti-Lex mAbs bind in different ways; the hydrophobic patch of β-d-Gal is essential. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Folliculin Interacting Protein 1 Maintains Metabolic Homeostasis during B Cell Development by Modulating AMPK, mTORC1, and TFE3 [IMMUNE SYSTEM DEVELOPMENT] Key PointsFnip1 is required for pre–B cell development/survival independent of p53 and Bcl-xL. Fnip1 is required for optimal inhibition of mTORC1 in response to amino acid restriction. Fnip1 regulates TFE3 nuclear translocation and lysosome biogenesis in pre–B cells. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Pharyngeal Immunity in Early Vertebrates Provides Functional and Evolutionary Insight into Mucosal Homeostasis [MUCOSAL IMMUNOLOGY] Key PointsA mucosally associated lymphoid tissue is identified in teleost pharyngeal cavity. Trout pharyngeal bacteria are mainly coated with secretory IgT. Teleost IgT plays a vital role in protecting the PC from invading pathogens. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Ancient BCMA-like Genes Herald B Cell Regulation in Lampreys [IMMUNOGENETICS] Key PointsTwo lamprey BCMA-like receptors interact with a single lamprey BAFF protein. BCMAL1 and BCMAL2 genes are differentially expressed during VLRB cell stimulation. BAFF-based mechanisms for B cell regulation appeared early in vertebrate evolution. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 STAT3-Induced Wnt5a Provides Chronic Lymphocytic Leukemia Cells with Survival Advantage [TUMOR IMMUNOLOGY] Key PointsSTAT3 induces the expression of Wnt5a in CLL cells. Wnt5a provides CLL cells with survival advantage. The Journal of Immunology current issue Mon Nov 18, 2019 23:00 Mark above section as read  Evolutionary Biology News -- ScienceDaily Researchers clear the path for 'designer' plants A team of researchers has found a way to identify gene regulatory elements that could help produce 'designer' plants and lead to improvements in food crops at a critical time. Evolutionary Biology News -- ScienceDaily Mon Nov 18, 2019 21:03 Mark above section as read  Medgadget Launch of Index At-Home Biological Age Test: Interview with Dr. Morgan Levine, Yale School of Medicine and Head of Bioinformatics at Elysium Health Elysium Health, a life sciences company selling health products with a particular focus on interventions that target fundamental processes of aging, has developed the Index at-home biological age test. The company claims that the test allows users to determine their biological age at home, and provides science-backed healthy living recommendations that may be able to impact overall health. Aging is the largest risk-factor for a huge array of diseases and health issues, and, indeed, mortality.... Medgadget Mon Nov 18, 2019 22:48 Optical Coherence Tomography Finally Used to Measure Cartilage Health Optical coherence tomography (OCT) is an imaging modality that provides a micron-level look at the tissues being examined. It is used in ophthalmology to assess the eyes and for imaging the interior of arteries to help with atherectomies. Although OCT has significant potential to help clinicians evaluate the health of tissues, it has proven difficult to use deep within the body. Now, researchers at Duke University have managed to equip a rigid borescope, the kind used to look inside joints... Medgadget Mon Nov 18, 2019 21:09 FDA Clears First Duodenoscope with Disposable Business End Pentax Medical won FDA clearance for its ED34-i10T2 duodenoscope that features a disposable elevator end piece, making it easier to guarantee that the scope is properly sterilized between patients. This is the first scope of its kind, although we recently covered the clearance of ScopeSeal, a disposable device that snaps over a scope's business end to keep it clean. Thanks to a disposable end piece, there are fewer parts to process when sterilizing the new ED34-i10T2 duodenoscope.... Medgadget Mon Nov 18, 2019 19:27 Mark above section as read  Latest Results for European Biophysics Journal In-cell structural dynamics of an EGF receptor during ligand-induced dimer–oligomer transition Abstract The epidermal growth factor receptor (EGFR) is a membrane protein that regulates cell proliferation, differentiation and survival, and is a drug target for cancer therapy. Ligand-induced activation of the EGFR kinase is generally regarded to require ligand-bound-dimers, while phosphorylation and down-stream signalling is modulated by oligomers. Recent work has unveiled changes in EGFR dynamics from ligand-induced dimerization in membranes extracted from cells, however,... Latest Results for European Biophysics Journal Mon Nov 18, 2019 02:00 Mark above section as read  Anthropology-News The Clinical Importance of Space in Sexual Health With ongoing attacks on reproductive rights and an ever-growing list of politicians, celebrities, and billionaires accused of sexual assault and harassment, we need more safe spaces, especially for individuals seeking access to sexual health care. In Toronto, calls for inclusivity and diversity in sexual health care services abound, marking a paradigmatic shift from earlier forms of sexual health care in the interwar and postwar periods, where public sexual health services existed primarily to prevent... Anthropology-News Mon Nov 18, 2019 22:30 Museum Anthropology at the 2019 AAA/CASCA Annual Meeting The Council for Museum Anthropology is looking forward to a vibrant AAA/CASCA program this year. All members (or those interested in joining) are encouraged to attend both the CMA business meeting (Friday, November 22 at 12:15 p.m.) and reception (Friday, November 22 at 8:00 p.m.). In addition, Aaron Glass, this year's winner of the CMA Michael Ames Award for Innovative Museum Anthropology, will be installing a complete panel version of the award-winning exhibit "The Story Box" at the Annual Meeting... Anthropology-News Mon Nov 18, 2019 20:30 Mark above section as read  European Journal of Surgical Oncology (EJSO) The impact of liver resection on survival for locally advanced intrahepatic cholangiocarcinoma tumors: A propensity score analysis Publication date: Available online 17 November 2019Source: European Journal of Surgical OncologyAuthor(s): M. Moustafa, E. Fasolo, D. Bassi, F.E. D'amico, E. Gringeri, Timothy M. Pawlik, U. CilloAbstractBackgroundAim of work was to investigate the prognostic impact of liver resection (LR) on locally advanced Intrahepatic Cholangiocarcinoma (IC) in comparison to alternative palliative chemotherapy (CTx).MethodA retrospective cohort study performed utilizing Surveillance, Epidemiology, and End Results... European Journal of Surgical Oncology (EJSO) Mon Nov 18, 2019 22:19 Mark above section as read  Journal of Cancer Education Establishing and Evaluating an ASCO Learning Cohort: a Longitudinal Project Assessing the Learning Needs and Behaviors of Oncology Professionals Abstract Background: In 2013, the American Society of Clinical Oncology (ASCO)'s Continuing Education Committee recommended establishing an interprofessional, longitudinal cohort pilot project. The main goals of the cohort were to gain feedback from oncology providers on how they use resources to address their learning needs and gain insights into the utility of different ASCO educational activities. ... Journal of Cancer Education Mon Nov 18, 2019 02:00 Mark above section as read  Routledge: Acta Linguistica Hafniensia: Table of Contents Enumerative there-clauses and there-clefts: specification and information structure . Routledge: Acta Linguistica Hafniensia: Table of Contents Mon Nov 18, 2019 13:33 Mark above section as read  Journal of Endocrinological Investigation Association between biochemical control and comorbidities in patients with acromegaly: an Italian longitudinal retrospective chart review study Abstract Purpose Achieving biochemical control (normalization of insulin-like growth factor-1 [IGF-1] and growth hormone [GH]) is a key goal in acromegaly management. However, IGF-1 and GH fluctuate over time. The true potential impact of time-varying biochemical control status on comorbidities is unclear and relies on multiple, longitudinal IGF-1 and GH measurements. This study assessed the association between time-varying biochemical... Journal of Endocrinological Investigation Mon Nov 18, 2019 02:00 Mark above section as read  Cancer Biology & Therapy: Table of Contents: Taylor and Francis MiR-133a-5p inhibits androgen receptor (AR)-induced proliferation in prostate cancer cells via targeting FUsed in Sarcoma (FUS) and AR . Cancer Biology & Therapy: Table of Contents: Taylor and Francis Mon Nov 18, 2019 08:09 Mark above section as read  Imaging A radiologic review of hoarse voice from anatomic and neurologic perspectives Abstract The differential diagnosis for hoarseness is extensive and includes a multitude of etiologies that span a large geographic area from the brainstem to the mediastinum. Therefore, localizing a causative lesion can be extremely difficult for clinicians and radiologists alike. In this review, we will first discuss the normal anatomy of the larynx and its innervation via the vagus and recurrent laryngeal nerves. We will then proceed with a guided tour of the various infectious/inflammatory,... Imaging Mon Nov 18, 2019 02:00 Mark above section as read  JoVE: Journal of Visualized Experiments Spatial Temporal Analysis of Fieldwise Flow in Microvasculature To quantify microvascular flow from high speed capillary flow image sequences, we developed STAFF (Spatial Temporal Analysis of Fieldwise Flow) software. Across the full image field and over time, STAFF evaluates flow velocities and generates a sequence of color-coded spatial maps for visualization and tabular output for quantitative analyses. JoVE: Journal of Visualized Experiments Mon Nov 18, 2019 21:00 Preparation of Mitochondria from Ovarian Cancer Tissues and Control Ovarian Tissues for Quantitative Proteomics Analysis This article presents a protocol of differential-speed centrifugation in combination with density gradient centrifugation to separate mitochondria from human ovarian cancer tissues and control ovarian tissues for quantitative proteomics analysis, resulting in a high-quality mitochondrial sample and high-throughput and high-reproducibility quantitative proteomics analysis of a human ovarian cancer mitochondrial proteome. JoVE: Journal of Visualized Experiments Mon Nov 18, 2019 20:00 Mark above section as read  Royal Society of Chemistry (Great Britain) Society for Analytical Chemistry Society of Public Analysts (Great Britain) Electrodeposition behavior of homoleptic transition metal acetonitrile complexes interrogated with piezoelectric gravimetry Analyst, 2019, Accepted ManuscriptDOI: 10.1039/C9AN01952A, PaperDavid Joseph Sconyers, James BlakemoreHomoleptic acetonitrile complexes of first-row transition metal ions are a common product of the detrimental speciation of coordination complexes and organometallic compounds. However, the electrochemical properties of such species are...The content of this RSS Feed (c) The Royal Society of Chemistry Royal Society of Chemistry (Great Britain) Society for Analytical Chemistry Society of Public Analysts (Great Britain) Mon Nov 18, 2019 02:00 Electrochemical aptamer-based sensor prepared by utilizing strong interaction between DNA aptamer and diamond Analyst, 2019, Accepted ManuscriptDOI: 10.1039/C9AN01976F, PaperKai Asai, Takashi Yamamoto, Shinichi Nagashima, Genki Ogata, Hiroshi Hibino, Yasuaki EinagaStable and continuous biosensing of electroactive species in vivo have been achieved by boron-doped diamond (BDD) electrodes owing to the outstanding electrochemical properties. However, the present problem of the biosensing...The content of this RSS Feed (c) The Royal Society of Chemistry Royal Society of Chemistry (Great Britain) Society for Analytical Chemistry Society of Public Analysts (Great Britain) Mon Nov 18, 2019 02:00 Rapid differentiation of Campylobacter jejuni cell wall mutants using Raman spectroscopy, SERS and mass spectrometry combined with chemometrics Analyst, 2019, Accepted ManuscriptDOI: 10.1039/C9AN02026H, PaperMalama Chisanga, Dennis Linton, Howbeer Muhamadali, David I. Ellis, Richard Kimber, Aleksandr Mironov, Royston GoodacreThe Gram-negative bacterial pathogen Campylobacter jejuni is a major cause of foodborne gastroenteritis worldwide. Rapid detection and identification of C. jejuni informs timely prescription of appropriate therapeutics and epidemiological investigations....The content of this RSS Feed (c) The Royal Society of Chemistry Royal Society of Chemistry (Great Britain) Society for Analytical Chemistry Society of Public Analysts (Great Britain) Mon Nov 18, 2019 02:00 Mark above section as read  OEM Online First The neglected millions: the global state of aquaculture workers occupational safety, health and well-being A scoping project was funded by the Food and Agriculture Organization in 2017 on the health and safety of aquaculture workers. This project developed a template covering basic types of aquaculture production, health and safety hazards and risks, and related data on injuries and occupational ill health, regulations, social welfare conditions, and labour and industry activity in the sector. Profiles using the template were then produced for key aquaculture regions and nations across the globe where... OEM Online First Mon Nov 18, 2019 19:00 Mark above section as read  Mucosal Immunology - Issue - nature.com science feeds IgA and the intestinal microbiota: the importance of being specific Mucosal Immunology, Published online: 18 November 2019; doi:10.1038/s41385-019-0227-4IgA and the intestinal microbiota: the importance of being specific Mucosal Immunology - Issue - nature.com science feeds Mon Nov 18, 2019 02:00 IgA and the intestinal microbiota: the importance of being specific Mucosal Immunology - Issue - nature.com science feeds Mon Nov 18, 2019 02:00 Mark above section as read  Strahlentherapie und Onkologie Durvalumab nach Radiochemotherapie beim lokal fortgeschrittenen inoperablen NSCLC – ein Sprung nach vorn Strahlentherapie und Onkologie Mon Nov 18, 2019 02:00 Prospective trial on telemonitoring of geriatric cancer patients using handheld devices Abstract Purpose and objective Randomized trials indicate that electronic or app-based assessment of patient-reported outcomes may improve outcomes in cancer patients. To analyze if an app-based follow-up would be accepted by elderly cancer patients, we conducted a single-center prospective feasibility study (NCT03196050). Materials and methods Cancer patients... Strahlentherapie und Onkologie Mon Nov 18, 2019 02:00 Mark above section as read  Hearing Research Contribution of spectral pinna cues for sound localization in children with congenital unilateral conductive hearing loss after hearing rehabilitation Publication date: Available online 17 November 2019Source: Hearing ResearchAuthor(s): Katharina Vogt, Jan-Willem Wasmann, A. John Van Opstal, Ad F.M. Snik, Martijn J.H. AgterbergAbstractCongenital unilateral conductive hearing loss (UCHL) jeopardizes directional hearing and speech perception in noisy conditions. Potentially, children with congenital UCHL can benefit from fitting a hearing device, such as a bone-conduction device (BCD). However, the literature reports limited benefit from fitting... Hearing Research Mon Nov 18, 2019 19:27 Mark above section as read  Pediatric Otorhinolaryngology Relation of Public Health Staffing To Follow-up After Newborn Hearing Screening IN THREE HEALTH DISTRICTS IN GEORGIA, 2009-2015 Publication date: Available online 18 November 2019Source: International Journal of Pediatric OtorhinolaryngologyAuthor(s): Kareem Al-Mulki, N. Wendell ToddAbstractObjectiveTo describe the association, or non-association, of public health district staffing (specifically, Early Hearing Detection and Intervention [EHDI] coordinator/navigator) and loss to follow-up in newborns who did not pass hearing screening in selected public health districts in Georgia, USA.MethodsBy Freedom of Information request,... Pediatric Otorhinolaryngology Mon Nov 18, 2019 19:10 Mark above section as read  Angewandte Chemie International Edition Self‐Assembled Gold Arrays That Allow Rectification by Nanoscale Selectivity Deposition of a monolayer nanoarray on the surface of a micrometer‐thick substrate is demonstrated, producing rectification characteristics at the nanoscale. The heterogeneity of the structure and the charge density are the two key factors affecting rectification. By altering the asymmetric electrolyte environment, the fabricated heterogeneous membrane can be used in energy conversion. Abstract The deposition of a monolayer nanoarray on the surface of a micrometer‐thick substrate is demonstrated,... Angewandte Chemie International Edition Mon Nov 18, 2019 19:04 Dodecatwistarene Imides with Zigzag‐Twisted Conformation for Organic Electronics 1D nonplanar graphene nanoribbons generally have three possible conformers: helical, zigzag, and mixed conformations. In this research, a novel kind of 1D nonplanar graphene nanoribbon, namely dodecatwistarene imides featuring twelve linearly fused benzene rings, was obtained by bottom‐up synthesis of palladium‐catalyzed Stille coupling and C‐H activation. Single‐crystal X‐ray diffraction analyses revealed that it displays a zigzag‐twisted conformation caused by steric hindrance between imide groups... Angewandte Chemie International Edition Mon Nov 18, 2019 19:04 Lessons in Strain and Stability: Enantioselective Synthesis of (+)‐[5]‐Ladderanoic Acid A game of strain: The synthesis of highly strained natural products provides unexpected opportunities for the development of new reactions and strategies. In the synthesis of (+)‐[5]‐ladderanoic acid unexpected strain release driven transformations were uncovered, thus requiring a drastic revision of the synthetic design that ultimately led to the development of a novel stepwise cyclobutane assembly by an allylboration/Zweifel olefination sequence. Abstract The synthesis of structurally complex... Angewandte Chemie International Edition Mon Nov 18, 2019 19:04 Calcium Hydride Reduction of Polycyclic Aromatic Hydrocarbons A molecular calcium hydride effects the two electron reduction of polyaromatic hydrocarbons, including naphthalene (E0 = ‐3.1 V). Angewandte Chemie International Edition Mon Nov 18, 2019 16:19 A Supported Nickel Catalyst Stabilized by a Surface Digging Effect for Efficient Methane Oxidation A surface digging effect of supported Ni NPs on an amorphous N‐doped carbon is described, during which the surface‐loaded Ni NPs etch and sink into the carbon support underneath to prevent sintering. The sinking Ni NPs could be transformed into thermodynamically stable and active metal‐defect sites for activation of C−H bonds for methane oxidation by simply elevating temperature. Abstract A surface digging effect of supported Ni NPs on an amorphous N‐doped carbon is described, during which... Angewandte Chemie International Edition Mon Nov 18, 2019 15:53 Unconventional Route to Oxygen‐Vacancy‐Enabled Highly Efficient Electron Extraction and Transport in Perovskite Solar Cells The acid treatment of TiO2 weakens the bonding of octahedral chains in anatase TiO2, rendering the formation of amorphous TiO2 buffer layer on the surface of anatase TiO2. This amorphous TiO2 buffer layer contains rich oxygen vacancies, which increase the donor density of TiO2. Abstract The ability to effectively transfer photoexcited electrons and holes is an important endeavor toward achieving high‐efficiency solar energy conversion. Now, a simple yet robust acid‐treatment strategy is used... Angewandte Chemie International Edition Mon Nov 18, 2019 15:52 Ultrafast Condensation of Carbon Nitride on Electrodes with Exceptional Boosted Photocurrent and Electrochemiluminescence Ultrafast heating addresses the thermodynamic contradiction of precursor volatilization during polymerization and leads to strongly adhesive carbon nitride on electrodes with a gradient C‐rich texture. Charge separation and mobility are accelerated and a remarkable photocurrent and a record cathodic electrochemiluminescence efficiency are observed. Abstract Semiconducting polymeric carbon nitride (CN) has drawn wide attention ranging from photocatalysis to more recent biosensing owing to unique... Angewandte Chemie International Edition Mon Nov 18, 2019 15:50 An Unprecedented Kernel Growth Mode and the Layer‐Number‐Odevity‐Dependent Properties in Gold Nanoclusters The nanocluster Au56(TBBT)34 was synthesized. X‐ray crystallography revealed a defective kernel layer stacking mode different from that shared by a magic series of nanoclusters, Au28(TBBT)20, Au36(TBBT)24, Au44(TBBT)28, Au52(TBBT)32, and Au56(TBBT)34. Not only the size but also the odevity of the kernel layer number influences both polarity and photoluminescence of the metal nanoclusters. Abstract Kernel atoms of Au nanoclusters are packed layer‐by‐layer along the [001] direction with every... Angewandte Chemie International Edition Mon Nov 18, 2019 15:49 Thiophenylazobenzene: an Alternative Photoisomerization Controlled by Lone‐Pair⋅⋅⋅π Interaction My own way: Thiophenylazobenzene is a sulfur‐based azoheteroarene photoswitch with impressive fatigue resistance, photoisomerization efficiency, and highly selective photoconversion. Its (Z)‐isomer adopts an unusual orthogonal geometry stabilized by an intramolecular lone‐pair⋅⋅⋅π interaction governing the ultrafast photoisomerization, which requires a mechanism involving significant movement along the inversion reaction coordinate. Abstract Azoheteroarene photoswitches have attracted attention... Angewandte Chemie International Edition Mon Nov 18, 2019 15:49 Live‐Cell Localization Microscopy with a Fluorogenic and Self‐Blinking Tetrazine Probe Blink and you'll miss it: A rationally designed small‐molecule label comprising fluorogenic and self‐blinking features has been designed and synthesized for bioorthogonal chemistry and super‐resolution microscopy in living cells. Abstract Recent developments in fluorescence microscopy call for novel small‐molecule‐based labels with multiple functionalities to satisfy different experimental requirements. A current limitation in the advancement of live‐cell single‐molecule localization microscopy... Angewandte Chemie International Edition Mon Nov 18, 2019 14:37 Evolved Aliphatic Halogenases Enable Regiocomplementary C−H Functionalization of Pharmaceutically Relevant Beyond natural: A protein catalyst was engineered to perform selective halogenation of a fragment of martinelline, a pharmaceutically relevant non‐native substrate. Directed evolution of non‐heme iron halogenase WelO5* afforded a variant with an up to 400‐fold higher apparent k cat and a 290‐fold higher TTN for this target substrate than the wildtype enzyme while achieving high stereo‐ and regioselectivity (>99 %). Abstract Non‐heme iron halogenases are synthetically valuable biocatalysts... Angewandte Chemie International Edition Mon Nov 18, 2019 14:29 Carbene‐Catalyzed Enantioselective Aromatic N‐Nucleophilic Addition of Heteroarenes to Ketones Activation code: The aromatic nitrogen atoms of heteroarylaldehydes are activated by carbene catalysts to react with ketone electrophiles. A broad scope of cyclic N,O‐acetal products are afforded in good to excellent yields and optical purities. The reaction involves the formation of an aza‐fulvene acylazolium intermediate. Several products exhibit excellent antibacterial activities and are valuable in the development of novel agrichemicals. Abstract The aromatic nitrogen atoms of heteroarylaldehydes... Angewandte Chemie International Edition Mon Nov 18, 2019 14:29 Site‐Selective Alkoxylation of Benzylic C−H Bonds by Photoredox Catalysis Partner up: Photocatalysis offers a one‐step strategy to selectively functionalize the benzylic positions of electron‐rich arenes with alcohols. It merges the photoredox activation of arenes with copper(II)‐mediated oxidation of the resulting benzylic radicals, enabling the introduction of benzylic C−O bonds with high site selectivity, chemoselectivity, and functional‐group tolerance using only two equiv of the alcohol coupling partner. Abstract Methods that enable the direct C−H alkoxylation... Angewandte Chemie International Edition Mon Nov 18, 2019 14:27 Topochemical Synthesis of Two‐Dimensional Transition‐Metal Phosphides Using Phosphorene Templates Material gains: A general bottom‐up topochemical strategy has been developed to synthesize solution‐processable two‐dimensional transition‐metal phosphides, which exhibit semiconducting features and superior activity towards the oxygen evolution reaction. Notably, Co2P is a p‐type semiconductor, with a hole mobility of 20.8 cm2 V−1 s−1 at 300 K in field‐effect transistors. Abstract Transition‐metal phosphides (TMPs) have emerged as a fascinating class of narrow‐gap semiconductors and electrocatalysts.... Angewandte Chemie International Edition Mon Nov 18, 2019 14:27 The Structure of Sub‐nm Platinum Clusters at Elevated Temperatures Fast dynamic STEM combined with a spatio‐temporal image denoising algorithm is employed to explore the structure and stability of Pt clusters on carbon, which represents a highly relevant catalysis system. At room temperature, dynamic amorphous 2D structures are found, while above ≈300 °C, the clusters transform into a crystalline state. Abstract Little is known about metallic clusters consisting merely of a dozen of atoms or even less, despite of their importance in catalysis and crystal nucleation.... Angewandte Chemie International Edition Mon Nov 18, 2019 14:26 Palladium‐Catalyzed [2+2+1] Spiroannulation via Alkyne‐Directed Remote C−H Arylation and Subsequent Arene Dearomatization Easy as 1‐2‐3: A chemoselective Pd0‐catalyzed alkyne‐directed [2+2+1] spiroannulation of aryl iodides with bromophenol derivatives has been established for the assembly of spirocycle‐embedded polycyclic frameworks. This two‐component reaction proceeds via remote C−H cleavage, biaryl cross‐coupling, and arene dearomatization. Abstract Palladium‐catalyzed alkene‐directed cross‐coupling of aryl iodide with another aryl halide through C−H arylation opens a unique avenue for unsymmetrical biaryl‐derived... Angewandte Chemie International Edition Mon Nov 18, 2019 14:25 Discriminative Detection of Biothiols by Electron Paramagnetic Resonance Spectroscopy using a Methanethiosulfonate Trityl Probe It's a trap! The simultaneous detection and quantitation of multiple different biothiols in a single sample by EPR spectroscopy has been demonstrated using a technique termed EPR thiol‐trapping. This technique was used to monitor the efflux of glutathione and cysteine from HepG2 cells. Abstract Biothiols, such as glutathione (GSH), homocysteine (Hcy), and cysteine (Cys), coexist in biological systems with diverse biological roles. Thus, analytical techniques that can detect, quantify, and distinguish... Angewandte Chemie International Edition Mon Nov 18, 2019 14:24 Polar‐Functionalized, Crosslinkable, Self‐Healing, and Photoresponsive Polyolefins Going polar: An efficient route was reported to generate polar‐functionalized, crosslinkable, self‐healing, and photoresponsive polyolefins with thermoplastic, elastomeric, and thermosetting properties. Abstract The nonpolar nature of polyolefins is one of their biggest limitations. Now, an efficient route to generate polar‐functionalized, crosslinkable, self‐healing, photoresponsive polyolefins with thermoplastic, elastomeric, and thermosetting properties is reported. Tunable amounts of carboxylic... Angewandte Chemie International Edition Mon Nov 18, 2019 14:23 A Chiral Polycyclic Aromatic Hydrocarbon Monkey Saddle Based on a truxene a chiral monkey saddle shaped polyaromatic hydrocarbon (PAH) with three eight‐membered rings was accessible in only three synthetic steps. The enantiomers were separated by chiral HPLC and investigated photophysically. Abstract A contorted polycyclic aromatic hydrocarbon (PAH) in the shape of a monkey saddle has been synthesized in three steps from a readily available truxene precursor. The monkey saddle PAH is consisting of three five‐, seven six‐, and three eight‐membered... Angewandte Chemie International Edition Mon Nov 18, 2019 14:23 Electrochemistry Broadens the Scope of Flavin Photocatalysis: Photoelectrocatalytic Oxidation of Unactivated Alcohols Dynamic duo: The combination of electrochemistry and photochemistry allows the generation of highly reactive catalytic intermediates without the need for a chemical oxidant. This photoelectrocatalytic strategy thus accessed the elusive reactivity of flavins for oxidizing unactivated aliphatic alcohols. HAT=hydrogen‐atom transfer. Abstract Riboflavin‐derived photocatalysts have been extensively studied in the context of alcohol oxidation. However, to date, the scope of this catalytic methodology... Angewandte Chemie International Edition Mon Nov 18, 2019 14:20 Difluoro(aryl)(perfluoroalkyl)‐λ4‐sulfanes and Selanes: Missing Links of Trichloroisocyanuric Acid/Potassium Fluoride Chemistry The TCICA/KF approach to oxidative fluorination of heteroatoms has emerged as a surprisingly simple, safe, and versatile surrogate to classically challenging fluorination reactions. The mild syntheses of metastable difluoro(aryl)(perfluoroalkyl)‐λ4‐sulfanes and selanes is reported and preliminary evidence is provided that difluoro(aryl)(trifluoro‐methyl)‐λ4‐sulfanes may act as fluorinating reagents. Abstract The TCICA/KF approach to oxidative fluorination of heteroatoms has emerged as a surprisingly... Angewandte Chemie International Edition Mon Nov 18, 2019 14:19 Supramolecular Photothermal Effects: A Promising Mechanism for Efficient Thermal Conversion Bring the heat! Supramolecular assemblies provide an elegant way to fabricate organic photothermal materials with enhanced stability and photothermal conversion efficiency, which can be termed supramolecular photothermal effects. By elaborating the inherent mechanisms, the supramolecular photothermal effects are expected to greatly benefit the design of novel high‐efficiency photothermal materials and their applications in a variety of fields. Abstract Supramolecular assemblies have been very... Angewandte Chemie International Edition Mon Nov 18, 2019 14:19 Flexible Total Synthesis of 11‐Deoxylandomycins and Their non‐Natural Analogues by Way of Asymmetric Metal Catalysis A de novo first collective total synthesis of 11‐deoxylandomycins is reported. A signature step is featured by the Pd‐catalyzed asymmetric addition of alcohol to ene‐alkoxyallenes that assembles oligomeric 2,3,6‐trideoxyoligosaccharides. The unique feature of the protocol is illustrated by a flexible access to various natural 11‐deoxylandomycins as well as non‐natural analogues. Angewandte Chemie International Edition Mon Nov 18, 2019 13:55 Control of Intramolecular Hydrogen Bonding in a Conformation‐switchable Helical Spring Polymer by Solvent and Temperature A substituted poly(phenylacetylene) derivative with two hydroxymethyl groups at the meta position of the side phenyl ring (PPAHB) was examined as a conformation‐switchable helical spring polymer that responds to solvent and heat stimuli in a precisely controlled manner. The intramolecular hydrogen bonding that gives rise to the helical structure of the polymer was destroyed and regenerated by adjusting the hydrogen bonding strength (pKHB) values of various combinations of solvents or by varying the... Angewandte Chemie International Edition Sun Nov 17, 2019 20:49 Direct and Tandem Routes for the Copolymerization of Ethylene with Polar Functionalized Internal Olefins Transition metal‐catalyzed ethylene copolymerization with polar monomers is a highly challenging reaction. After decades of research, the scope of suitable comonomer substrates has expanded from special to fundamental polar monomers and, recently, to 1,1‐disubstituted ethylenes. In this contribution, we aim to describe a direct and tandem strategy to realize ethylene copolymerization with various 1,2‐disubstituted ethylenes. The direct route is sensitive to steric effects from both the comonomers... Angewandte Chemie International Edition Sun Nov 17, 2019 16:59 Stereodivergent Anion Binding Catalysis with Molecular Motors A photoresponsive chiral catalyst based on an oligotriazole‐functionalized unidirectional molecular motor has been developed for stereodivergent anion binding catalysis. The motor function controls the helical chirality of supramolecular assemblies with chloride anions, which by means of chirality transfer enables the enantioselective addition of a silyl ketene acetal nucleophile to oxocarbenium cations. Reversal of stereoselectivity (up to 142% Δee) was achieved through rotation of the motor core... Angewandte Chemie International Edition Sun Nov 17, 2019 16:58 Green Metal‐Free Photochemical Hydroacylation of Unactivated Olefins Direct alkylation of C(sp2)‐H bonds in order to convert an aldehyde into a ketone is a notorious transformation, due to the laborious challenge of the formation of ketyl or acyl radicals. Herein, we report a green, cheap, metal‐free and efficient method for the hydroacylation of olefins in water. This photochemical protocol utilizes phenylglyoxylic acid, a commercially available small organic molecule, as the photoinitiator, water as the solvent and household fluorescent lamps as the irradiation... Angewandte Chemie International Edition Sun Nov 17, 2019 16:48 Mark above section as read
 bioRxiv Subject Collection: Evolutionary Biology,Chromosome painting does not support a sex chromosome turnover in Lacerta agilis Linnaeus, 1758 [NEW RESULTS]Reptiles show a remarkable diversity of sex determination mechanisms and sex chromosome systems, derived from different autosomal pairs. The origin of the ZW sex chromosomes of Lacerta agilis, a widespread Eurasian lizard species, is a matter of discussion: is it a small macrochromosome from the 11-18 group, common to all lacertids, or this...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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NIR spectroscopic determination of urine components in spot urine: preliminary investigation towards optical point-of-care test Abstract Presently, there is no convenient method to measure 24-h urinary Na excretion, which is an important index of daily Na intake, and 24-h urine collection involves a complex process. However, the Na-to-creatinine ratio (NCR) in spot urine has the potential to evaluate 24-h Na excretion and is useful for point-of-care testing. Thus, this study aimed to realize a near-infrared spectroscopic system to assess NCR in spot urine: (1) We attempted to estimate Na concentration using... Latest Results for Medical 02:00 Novel transcutaneous sensor combining optical tcPO 2 and electrochemical tcPCO 2 monitoring with reflectance pulse oximetry Abstract This study investigated the accuracy, drift, and clinical usefulness of a new optical transcutaneous oxygen tension (tcPO2) measuring technique, combined with a conventional electrochemical transcutaneous carbon dioxide (tcPCO2) measurement and reflectance pulse oximetry in the novel transcutaneous OxiVenT™ Sensor. In vitro gas studies were performed to measure accuracy and drift of tcPO2 and tcPCO2. Clinical usefulness for tcPO2 and tcPCO2 monitoring was assessed in neonates.... Latest Results for Medical Mon Nov 18, 2019 02:00 Subject-specific finite element analysis of a lumbar cage produced by electron beam melting Abstract The aim of this study was the analysis of the mechanical behaviour of a partially porous lumbar custom-made cage by means of a subject-specific finite element analysis (FEA). The cage, made of Ti6Al4V ELI alloy, was produced via electron beam melting (EBM) process and surgically implanted in a female subject, 50 years old. The novelty of this study was the customized design of the cage and of its internal structure, which is impossible to obtain with the traditional production... Latest Results for Medical Mon Nov 18, 2019 02:00 Priority based health data monitoring with IEEE 802.11af technology in wireless medical sensor networks Abstract In this work, the IEEE 802.11af technology–based wireless sensor network for health data monitoring with priority classes is proposed. In IEEE 802.11af technology, a White Space Device (WSD), a Station (STA), and an Access Point (AP) communicate through television white spectrum opportunistically without causing any harmful interference to licensed` services. In the proposed network; WSDs, STA, and AP employ Frequency Division Multiple Access (FDMA) technique with the... Latest Results for Medical Mon Nov 18, 2019 02:00 Experimental validation of adaptive pedicle screws—a novel implant concept using shape memory alloys Abstract Pedicle screw fixation is a standard procedure in spine surgery. A secure anchoring in deficient (e.g., osteoporotic) bone or in a secondary supply after a revision is a major challenge. This study aimed to test the primary stability of a new self-expanding shape memory actuator screw concept with the traditional screw design. The actuator part braces itself against the osseous environment after implantation by heating to body temperature. Thirty screws and twenty-four... Latest Results for Medical Mon Nov 18, 2019 02:00 Mark above section as read  Cancers Cancers, Vol. 11, Pages 1815: Nucleocytoplasmic Shuttling of STATs. A Target for Intervention? Cancers, Vol. 11, Pages 1815: Nucleocytoplasmic Shuttling of STATs. A Target for Intervention? Cancers doi: 10.3390/cancers11111815 Authors: Sabrina Ernst Gerhard Müller-Newen Signal transducer and activator of transcription (STAT) proteins are transcription factors that in the latent state are located predominantly in the cytoplasm. Activation of STATs through phosphorylation of a single tyrosine residue results in nuclear translocation. The requirement of tyrosine phosphorylation... Cancers 02:00 Cancers, Vol. 11, Pages 1814: A Novel Calcium-Mediated EMT Pathway Controlled by Lipids: An Opportunity for Prostate Cancer Adjuvant Therapy Cancers, Vol. 11, Pages 1814: A Novel Calcium-Mediated EMT Pathway Controlled by Lipids: An Opportunity for Prostate Cancer Adjuvant Therapy Cancers doi: 10.3390/cancers11111814 Authors: Figiel Bery Chantôme Fontaine Pasqualin Maupoil Domingo Guibon Bruyère Potier-Cartereau Vandier Fromont Mahéo The composition of periprostatic adipose tissue (PPAT) has been shown to play a role in prostate cancer (PCa) progression. We recently reported... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1813: Evaluation of the Accuracy of Liquid-Based Oral Brush Cytology in Screening for Oral Squamous Cell Carcinoma Cancers, Vol. 11, Pages 1813: Evaluation of the Accuracy of Liquid-Based Oral Brush Cytology in Screening for Oral Squamous Cell Carcinoma Cancers doi: 10.3390/cancers11111813 Authors: Deuerling Gaida Neumann Remmerbach This study evaluates the accuracy of the results of liquid-based oral brush cytology and compares it to the histology and/or the clinical follow-ups of the respective patients. A total of 1352 exfoliated specimens were collected with an Orcellex brush from... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1812: Synergistic Autophagy Effect of miR-212-3p in Zoledronic Acid-Treated In Vitro and Orthotopic In Vivo Models and in Patient-Derived Osteosarcoma Cells Cancers, Vol. 11, Pages 1812: Synergistic Autophagy Effect of miR-212-3p in Zoledronic Acid-Treated In Vitro and Orthotopic In Vivo Models and in Patient-Derived Osteosarcoma Cells Cancers doi: 10.3390/cancers11111812 Authors: Ju Yeon Oh Eun Ho Kim Yeon-Joo Lee Sei Sai Sun Ha Lim Jang Woo Park Hye Kyung Chung Joon Kim Guillaume Vares Akihisa Takahashi Youn Kyoung Jeong Mi-Sook Kim Chang-Bae Kong Osteosarcoma (OS) originates from osteoid bone tissues... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1810: The Gasdermin E gene Potential as a Pan-Cancer Biomarker, While Discriminating between Different Tumor Types Cancers, Vol. 11, Pages 1810: The Gasdermin E gene Potential as a Pan-Cancer Biomarker, While Discriminating between Different Tumor Types Cancers doi: 10.3390/cancers11111810 Authors: Joe Ibrahim Ken Op de Beeck Erik Fransen Marc Peeters Guy Van Camp Due to the elevated rates of incidence and mortality of cancer, early and accurate detection is crucial for achieving optimal treatment. Molecular biomarkers remain important screening and detection tools, especially in light... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1809: Bulk and Single-Cell Next-Generation Sequencing: Individualizing Treatment for Colorectal Cancer Cancers, Vol. 11, Pages 1809: Bulk and Single-Cell Next-Generation Sequencing: Individualizing Treatment for Colorectal Cancer Cancers doi: 10.3390/cancers11111809 Authors: Ioannis D. Kyrochristos Demosthenes E. Ziogas Anna Goussia Georgios K. Glantzounis Dimitrios H. Roukos The increasing incidence combined with constant rates of early diagnosis and mortality of colorectal cancer (CRC) over the past decade worldwide, as well as minor overall survival improvements in the... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1808: hENT1 Testing in Pancreatic Ductal Adenocarcinoma: Are We Ready? A Multimodal Evaluation of hENT1 Status Cancers, Vol. 11, Pages 1808: hENT1 Testing in Pancreatic Ductal Adenocarcinoma: Are We Ready? A Multimodal Evaluation of hENT1 Status Cancers doi: 10.3390/cancers11111808 Authors: Jerome Raffenne Remy Nicolle Francesco Puleo Delphine Le Corre Camille Boyez Raphael Marechal Jean François Emile Peter Demetter Armelle Bardier Pierre Laurent-Puig Louis de Mestier Valerie Paradis Anne Couvelard Jean Luc VanLathem John R. MacKey Jean-Baptiste Bachet... Cancers Mon Nov 18, 2019 02:00 Cancers, Vol. 11, Pages 1811: Mitigating Effect of 1-Palmitoyl-2-Linoleoyl-3-Acetyl-Rac-Glycerol (PLAG) on a Murine Model of 5-Fluorouracil-Induced Hematological Toxicity Cancers, Vol. 11, Pages 1811: Mitigating Effect of 1-Palmitoyl-2-Linoleoyl-3-Acetyl-Rac-Glycerol (PLAG) on a Murine Model of 5-Fluorouracil-Induced Hematological Toxicity Cancers doi: 10.3390/cancers11111811 Authors: Jinseon Jeong Yong-Jae Kim Do Young Lee Ki-Young Sohn Sun Young Yoon Jae Wha Kim 5-Fluorouracil (5-FU) is an antimetabolite chemotherapy widely used for the treatment of various cancers. However, many cancer patients experience hematological side effects following... Cancers Mon Nov 18, 2019 02:00 Mark above section as read  BioMed Research International Assessment of Corneal Pachymetry Distribution and Morphologic Changes in Subclinical Keratoconus with Normal Biomechanics Purpose. To investigate the pachymetry distribution of central cornea and morphologic changes in subclinical keratoconus with normal biomechanics and determine their potential benefit for the screening of very early keratoconus. Methods. This retrospective comparative study was performed in 33 clinically unaffected eyes with normal topography and biomechanics from 33 keratoconus patients with very asymmetric ectasia (VAE-NTB; Corvis Biomechanical Index defined) and 70 truly normal eyes from 70 age-matched... BioMed Research International 07:05 PSO-LocBact: A Consensus Method for Optimizing Multiple Classifier Results for Predicting the Subcellular Localization of Bacterial Proteins Several computational approaches for predicting subcellular localization have been developed and proposed. These approaches provide diverse performance because of their different combinations of protein features, training datasets, training strategies, and computational machine learning algorithms. In some cases, these tools may yield inconsistent and conflicting prediction results. It is important to consider such conflicting or contradictory predictions from multiple prediction programs during... BioMed Research International 05:05 Mining TCGA Database for Tumor Microenvironment-Related Genes of Prognostic Value in Hepatocellular Carcinoma Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies. Recent studies reveal that tumor microenvironment (TME) components significantly affect HCC growth and progression, particularly the infiltrating stromal and immune cells. Thus, mining of TME-related biomarkers is crucial to improve the survival of patients with HCC. Public access of The Cancer Genome Atlas (TCGA) database allows convenient performance of gene expression-based analysis of big data, which contributes... BioMed Research International 05:05 Musculoskeletal Factors and Geriatric Syndromes Related to the Absence of Musculoskeletal Degenerative Disease in Elderly People Aged over 70 Years Purpose. To investigate factors with a significant relationship with the absence of musculoskeletal disease (MSD: osteoporosis, knee osteoarthritis (K-OA), and lumbar spondylosis (L-OA)) in elderly people ≥70 years old. Methods. The subjects were 279 people (134 males, 145 females, mean age: 75.2 years) who attended an annual health checkup and were prospectively included in the study. Osteoporosis was defined as %YAM ≤70%, K-OA as Kellgren–Lawrence grade ≥2, and L-OA as osteophytes of Nathan class... BioMed Research International Mon Nov 18, 2019 15:30 Mitochondrial D-loop Sequence Variability in Three Native Insular Griffon Vulture (Gyps fulvus) Populations from the Mediterranean Basin The islands of Sardinia, Crete, and Cyprus are hosting the last native insular griffon populations in the Mediterranean basin. Their states have been evaluated from "vulnerable" to "critically endangered". The sequence analysis of molecular markers, particularly the mtDNA D-loop region, provides useful information in studying the evolution of closely related taxa and the conservation of endangered species. Therefore, a study of D-loop region sequence was carried out to estimate the genetic diversity... BioMed Research International Mon Nov 18, 2019 10:05 Gut Microbiome of Chinese Forest Musk Deer Examined across Gender and Age Animal gut microbiota begins to colonize after birth and is functionally indispensable for maintaining the health of the host. It has been reported that gender and age influence the composition of the intestinal microbiome. However, the effects of gender and age on the intestinal microorganism of forest musk deer (FMD) remain unclear. The aim of this study was to establish the relationship between the structure and composition of fecal microbiota of male and female forest musk deer with age. Here,... BioMed Research International Mon Nov 18, 2019 10:05 Mark above section as read  Journal of Adolescent and Young Adult Oncology "It Made Me the Person I Am Today…": Survivors of Childhood, Adolescent, and Young Adult Cancer Reflect on Their Experiences Journal of Adolescent and Young Adult Oncology, Ahead of Print. Journal of Adolescent and Young Adult Oncology Mon Nov 18, 2019 10:00 Mark above section as read  liebertpub1 The Long-Term Outcome of Treatment for Graves' Hyperthyroidism Thyroid, Volume 29, Issue 11, Page 1545-1557, November 2019. liebertpub1 Thu Nov 14, 2019 10:00 Future Meetings Thyroid, Volume 29, Issue 11, Page 1708-1709, November 2019. liebertpub1 Thu Nov 14, 2019 10:00 Mitogen-Activated Protein Kinase Pathway Inhibition for Redifferentiation of Radioiodine Refractory Differentiated Thyroid Cancer: An Evolving Protocol Thyroid, Volume 29, Issue 11, Page 1634-1645, November 2019. liebertpub1 Thu Nov 14, 2019 10:00 A Phase 2 Study of Pembrolizumab Combined with Chemoradiotherapy as Initial Treatment for Anaplastic Thyroid Cancer Thyroid, Volume 29, Issue 11, Page 1615-1622, November 2019. liebertpub1 Thu Nov 14, 2019 10:00 A Novel ALK Fusion in Pediatric Medullary Thyroid Carcinoma Thyroid, Volume 29, Issue 11, Page 1704-1707, November 2019. liebertpub1 Thu Nov 14, 2019 10:00 Mark above section as read  Chemical Senses Metal-containing Particulate Matter and Associated Reduced Olfactory Identification Ability in Children from an Area of High Atmospheric Exposure in Mexico City AbstractAir pollution has been linked to poor olfactory function in human adults. Among pollutants, particulate matter (PM) is especially relevant, as it may contain toxic metal ions that can reach the brain via olfactory pathways. Our purpose was to investigate the relation between atmospheric PM and olfactory identification performance in children. Using a validated method, we tested the olfactory identification performance of 120 children, 6–12 years old, from two locations in Mexico City; a focal... Chemical Senses 02:00 Mark above section as read  RNA In Advance Alternative Splicing Coupled with Transcript Degradation Modulates OAS1g Antiviral Activity [Report] At the heart of an innate immune response lies a tightly regulated gene expression program. This precise regulation is crucial because small changes can shift the balance from protective to destructive immunity. Here we identify a frequently used alternative splice site in the gene oligoadenylate synthetase 1g (Oas1g), a key component of the 2-5A antiviral system. Usage of this splice site leads to the generation of a transcript subject to decay, and removal of the site leads to increased expression... RNA In Advance Mon Nov 18, 2019 23:24 Mark above section as read  Clinical Cancer Research Online First Articles Capecitabine and temozolomide versus FOLFIRI in RAS mutated, MGMT methylated metastatic colorectal cancer Purpose To determine whether second-line therapy with capecitabine and temozolomide was superior to irinotecan, leucovorin and fluorouracil (FOLFIRI) in patients with RAS mutated, MGMT methylated metastatic colorectal cancer. Experimental design In this randomized, phase 2 trial, we enrolled patients with RAS mutated, MGMT methylated mCRC after failure of oxaliplatin-based regimen. Patients with centrally confirmed MGMT methylation were stratified by first-line progression-free survival and prior... Clinical Cancer Research Online First Articles Mon Nov 18, 2019 16:38 Mark above section as read  Cancer TRIP13 promotes the cell proliferation, migration and invasion of glioblastoma through the FBXW7/c-MYC axis British Journal of Cancer, Published online: 19 November 2019; doi:10.1038/s41416-019-0633-0TRIP13 promotes the cell proliferation, migration and invasion of glioblastoma through the FBXW7/c-MYC axis Cancer 02:00 TRIP13 promotes the cell proliferation, migration and invasion of glioblastoma through the FBXW7/c-MYC axis Cancer 01:08 Mark above section as read  Oncogenesis - nature.com science feeds Long non-coding RNA GAS5 acts as proliferation "brakes" in CD133+ cells responsible for tumor recurrence Oncogenesis, Published online: 18 November 2019; doi:10.1038/s41389-019-0177-4Long non-coding RNA GAS5 acts as proliferation "brakes" in CD133+ cells responsible for tumor recurrence Oncogenesis - nature.com science feeds Mon Nov 18, 2019 02:00 Long non-coding RNA GAS5 acts as proliferation "brakes" in CD133+ cells responsible for tumor recurrence Oncogenesis - nature.com science feeds Mon Nov 18, 2019 02:00 Mark above section as read  Journal of the American Chemical Society: Latest Articles (ACS Publications) [ASAP] Time-Dependent Pulses of Lithium Ions in Cascaded Signaling and Out-of-Equilibrium (Supra)molecular Logic Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b10763 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Selective Separation of Polyaromatic Hydrocarbons by Phase Transfer of Coordination Cages Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b10741 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Olefin Metathesis in Confined Geometries: A Biomimetic Approach toward Selective Macrocyclization Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b08776 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] The Effect of Ring Expansion in Thienobenzo[<italic toggle="yes">b</italic>]indacenodithiophene Polymers for Organic Field-Effect Transistors Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b09367 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] The Bioorthogonal Isonitrile–Chlorooxime Ligation Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b07632 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Excision of 5-Carboxylcytosine by Thymine DNA Glycosylase Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b10376 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Enantioselective Olefin Hydrocyanation without Cyanide Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b10875 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Synthesis, Characterization, and Electrochemical Applications of Chiral Imprinted Mesoporous Ni Surfaces Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b10507 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Highly Selective and Catalytic Generation of Acyclic Quaternary Carbon Stereocenters via Functionalization of 1,3-Dienes with CO<sub>2</sub> Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b09721 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 [ASAP] Inorganic Phototropism in Electrodeposition of Se–Te Journal of the American Chemical SocietyDOI: 10.1021/jacs.9b10579 Journal of the American Chemical Society: Latest Articles (ACS Publications) Mon Nov 18, 2019 07:00 Mark above section as read  Experimental and Clinical Endocrinology & Diabetes Molecular Mechanisms of Thyroid Hormone Transport by l-Type Amino Acid Transporter Exp Clin Endocrinol DiabetesDOI: 10.1055/a-1032-8369Thyroid hormones (TH) pass through the plasma membrane into the target cells via transporter proteins. Thyroid hormone transporters that have been identified until now belong to two different solute carrier (SLC) subfamilies i) the major facilitator superfamily (MFS) and ii) the amino acid polyamine-organocation (APC) superfamily. Both are comprised by 12 transmembrane helices, however with different structural topology. The TH transporter MCT8,... Experimental and Clinical Endocrinology & Diabetes Mon Nov 18, 2019 01:00 Diabetes Mellitus and Chronic Obstructive Pulmonary Disease: An Overview Exp Clin Endocrinol DiabetesDOI: 10.1055/a-1038-3883Chronic obstructive pulmonary disease (COPD) is a common disease with an increasing prevalence, characterised by persistent respiratory symptoms and airflow limitation. Apart from cigarette smoking, certain occupational and environmental exposures, low socioeconomic status and genetic factors may contribute to the pathogenesis of COPD. Comorbidities, e. g. diabetes mellitus (DM), can negatively affect quality of life, COPD outcomes and cardiovascular... Experimental and Clinical Endocrinology & Diabetes Mon Nov 18, 2019 01:00 Mark above section as read  Analytical Chemistry [ASAP] Sheathless Acoustic Fluorescence Activated Cell Sorting (aFACS) with High Cell Viability Analytical ChemistryDOI: 10.1021/acs.analchem.9b03021 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Polyaniline Films as Electrochemical-Proton Pump for Acidification of Thin Layer Samples Analytical ChemistryDOI: 10.1021/acs.analchem.9b03402 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Electrokinetically Driven Exosome Separation and Concentration Using Dielectrophoretic-Enhanced PDMS-Based Microfluidics Analytical ChemistryDOI: 10.1021/acs.analchem.9b03448 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] N-Doped Carbon As Peroxidase-Like Nanozymes for Total Antioxidant Capacity Assay Analytical ChemistryDOI: 10.1021/acs.analchem.9b04333 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Faraday-Cage-Type Electrochemiluminescence Immunoassay: A Rise of Advanced Biosensing Strategy Analytical ChemistryDOI: 10.1021/acs.analchem.9b04503 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Numerical Elucidation of Flow and Dispersion in Ordered Packed Beds: Nonspherical Polygons and the Effect of Particle Overlap on Chromatographic Performance Analytical ChemistryDOI: 10.1021/acs.analchem.9b03598 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Highly Sensitive Colorimetric Detection of a Variety of Analytes via the Tyndall Effect Analytical ChemistryDOI: 10.1021/acs.analchem.9b03824 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Fiber-Optic Chemical Sensors and Biosensors (2015–2019) Analytical ChemistryDOI: 10.1021/acs.analchem.9b04708 Analytical Chemistry Mon Nov 18, 2019 07:00 [ASAP] Target-Induced Cascade Amplification for Homogeneous Virus Detection Analytical ChemistryDOI: 10.1021/acs.analchem.9b03805 Analytical Chemistry Mon Nov 18, 2019 07:00 Mark above section as read  Sprache · Stimme · Gehör Logopädische Behandlung unilateraler Stimmlippenparalysen Sprache Stimme GehörDOI: 10.1055/a-0949-7863© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Sprache · Stimme · Gehör Mon Nov 18, 2019 01:00 Mark above section as read  Laryngo-Rhino-Otologie Liebe Leserinnen und Leser der LRO, liebe Kolleginnen und Kollegen, Laryngo-Rhino-Otol 2019; 98: 755-755DOI: 10.1055/a-0954-7752© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Freie Transplantate Laryngo-Rhino-Otol 2019; 98: 826-829DOI: 10.1055/a-0954-7877© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Tonsillektomie bei Erwachsenen medizinisch und ökonomisch sinnvoll Laryngo-Rhino-Otol 2019; 98: 760-761DOI: 10.1055/a-0898-8562Tzelnick S et al. Long-Term Outcomes of Tonsillectomy for Recurrent Tonsillitis in Adults. Laryngoscope 2019; 9999: 1–4. doi:10.1002/lary.27928 Ein Cochrane Review von 2014 beantwortete die Frage nach der Effektivität von Tonsillektomien bei Erwachsenen nicht abschließend, sprach aber für einen positiven Einfluss auf die Lebensqualität. Die retrospektive Studie aus Israel belegt nun eine deutliche Reduktion der Tonsillitis-Episoden... Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Sialolithiasis: aktuelle Diagnostik und Therapie Laryngo-Rhino-Otol 2019; 98: 815-823DOI: 10.1055/a-0896-9572Die Sialolithiasis als eine der häufigsten Speicheldrüsenerkrankungen betrifft die Glandula submandibularis im Vergleich zur Glandula parotis deutlich häufiger. Im Verlauf der Erkrankung kommt es in vielen Fällen zu rezidivierenden Sialadenitiden. Durch verbesserte Diagnostik besteht neben der Submandibulektomie auch die Möglichkeit einer drüsenerhaltenden Therapie, z. B. mittels Miniaturendoskopie (Sialendoskopie).[...]© Georg Thieme Verlag... Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Tinnitus oftmals mit temporomandibulärer Dysfunktion assoziiert Laryngo-Rhino-Otol 2019; 98: 761-761DOI: 10.1055/a-0996-6580Omidvar S et al. Association Between Tinnitus and Temporomandibular Disorders: A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2019; 128: 662–675 Tinnitus ist eines der häufigsten otologischen Symptome bei Patienten mit Kiefergelenkserkrankungen. Iranische Ärzte durchsuchten die Literatur, um den möglichen Zusammenhang zwischen Tinnitus und der temporomandibulären Dysfunktion (TMD) darzustellen. ... Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Rheumatologische Erkrankungen und Schlaf – Schlafmedizinische Aspekte der Diagnostik und Therapie – Eine literaturbasierte Übersicht Laryngo-Rhino-Otol 2019; 98: 776-788DOI: 10.1055/a-0960-6616Ziel des auf einer PubMed-Recherche basierenden Übersichtsartikels ist es, die Schlafphysiologie und die pathophysiologischen Zusammenhänge von rheumatologischen Erkrankungen und primären sowie sekundären Schlafstörungen darzustellen. Dabei werden die somnologische Diagnostik und Therapie als ergänzende Verfahren in die rheumatologische Behandlungsstrategie eingebunden. Epidemiologie 70 % aller Rheumapatienten berichten über einen... Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Partielle Rekurrensparese – Parese des Ramus anterior Nervi laryngei inferioris (recurrentis) Laryngo-Rhino-Otol 2019; 98: 762-763DOI: 10.1055/a-0954-7785© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Aus der Gutachtenpraxis: Isolierter Tinnitus bei einem Callcenter-Agenten – ein Arbeitsunfall? Laryngo-Rhino-Otol 2019; 98: 812-814DOI: 10.1055/a-0954-7807© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Eosinophile Ösophagitis Update 2017: Neue Leitlinien der europäischen Studiengruppe EUREOS Laryngo-Rhino-Otol 2019; 98: 764-775DOI: 10.1055/a-0960-6553Die eosinophile Ösophagitis gilt heute als eine der häufigsten Erkrankungen der Speiseröhre und eine der häufigsten Ursachen für Dysphagie und Bolusobstruktion bei Kindern und Erwachsenen. Die zunehmende Bedeutung dieser Erkrankung und neue klinisch-wissenschaftliche Erkenntnisse erforderten eine Aktualisierung der bis dato existierenden internationalen Leitlinien. Die europäische Studiengruppe Eosinophile Ösophagitis (EUREOS) hat daher,... Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Fragen für die Facharztprüfung Laryngo-Rhino-Otol 2019; 98: 824-825DOI: 10.1055/a-0954-7819© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Dakryolithen und iatrogene Fremdkörper als klassische Auslöser entzündlicher Pseudotumoren der ableitenden Tränenwege Laryngo-Rhino-Otol 2019; 98: 806-811DOI: 10.1055/a-0841-9713© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Full text Laryngo-Rhino-Otologie Mon Nov 18, 2019 01:00 Mark above section as read  G3: .Genes, Genomes, Genetics Mission - Online First Articles Transcription Profiles of Age-at-Maturity-Associated Genes Suggest Cell Fate Commitment Regulation as a Key Factor in the Atlantic Salmon Maturation Process Despite recent taxonomic diversification in studies linking genotype with phenotype, follow-up studies aimed at understanding the molecular processes of such genotype-phenotype associations remain rare. The age at which an individual reaches sexual maturity is an important fitness trait in many wild species. However, the molecular mechanisms regulating maturation timing processes remain obscure. A recent genome-wide association study in Atlantic salmon (Salmo salar) identified large-effect age-at-maturity-associated... G3: .Genes, Genomes, Genetics Mission - Online First Articles 00:34 Evolutionary Dynamics of the SKN-1 -> MED -> END-1,3 Regulatory Gene Cascade in Caenorhabditis Endoderm Specification Gene regulatory networks and their evolution are important in the study of animal development. In the nematode, Caenorhabditis elegans, the endoderm (gut) is generated from a single embryonic precursor, E. Gut is specified by the maternal factor SKN-1, which activates the MED -> END-1,3 -> ELT-2,7 cascade of GATA transcription factors. In this work, genome sequences from over two dozen species within the Caenorhabditis genus are used to identify MED and END-1,3 orthologues. Predictions are... G3: .Genes, Genomes, Genetics Mission - Online First Articles 00:34 Mark above section as read  European Journal of Nuclear Medicine and Molecular Imaging An aggressive functioning pituitary adenoma treated with peptide receptor radionuclide therapy European Journal of Nuclear Medicine and Molecular Imaging Mon Nov 18, 2019 02:00 The number of microspheres in Y90 radioembolization directly affects normal tissue radiation exposure Abstract Purpose In Y90 radioembolization, the number of microspheres infused varies by more than a factor of 20 over the shelf-life of the glass radioembolization device. We investigated the effect of the number of Y90 microspheres on normal liver tissue. Method Healthy pigs received lobar radioembolization with glass Y90 microspheres at 4, 8, 12, and 16... European Journal of Nuclear Medicine and Molecular Imaging Mon Nov 18, 2019 02:00 From metabolic connectivity to molecular connectivity: application to dopaminergic pathways Abstract Introduction This study aims to reveal the feasibility and potential of molecular connectivity based on neurotransmission in comparison with the metabolic connectivity with an application to dopaminergic pathways. For this purpose, we propose to compare the neurotransmission connectivity findings using 123I-FP-CIT SPECT and 18F-FDOPA PET with the metabolic connectivity findings using 18F-FDG PET. ... European Journal of Nuclear Medicine and Molecular Imaging Mon Nov 18, 2019 02:00 Zirconium-89 labelled rituximab PET-CT imaging of Graves' orbitopathy European Journal of Nuclear Medicine and Molecular Imaging Mon Nov 18, 2019 02:00 Letter to the Editor: 18 F-NaF not cited in the EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma European Journal of Nuclear Medicine and Molecular Imaging Mon Nov 18, 2019 02:00 Mark above section as read  Annals of Allergy, Asthma & Immunology Skin Testing with Ultraheat Treated (UHT) Cow's Milk in Children with Cow's Milk Allergy. Cow's milk allergy is very common affecting between 2% and 3%, and in some reports up to 7%, of young infants and children1. It has been found that approximately 75% of cow's milk allergic children are able to tolerate heated cow's milk, such as in baked goods, while remaining reactive to unheated milk2-4. In addition, regular consumption of heated cow's milk may hasten the development of tolerance to unheated cow's milk in a proportion of cow's milk allergic children5. Annals of Allergy, Asthma & Immunology Mon Nov 18, 2019 02:00 Decades of Poor Availability of Epinephrine Auto-Injectors – Global Problems in Need of Global Solutions Guidelines recommend prompt use of intramuscular epinephrine as first-line treatment for anaphylaxis 1-5. Patients at-risk of anaphylaxis are generally couselled by medical professionals to carry epinephrine in the form of an epinephrine auto-injector (EAI) to treat a severe allergic reaction. Despite its critical role as a life-saving medication, availability of EAIs differs around the world. Shortages of EAIs have compounded this problem. Annals of Allergy, Asthma & Immunology Mon Nov 18, 2019 02:00 Mark above section as read  Oral Diseases MicroRNA‐21 Promotes Orthodontic Tooth Movement by Modulating the RANKL/OPG Balance in T Cells Abstract Objectives The present study was designed to investigate the effects of microRNA‐21 (miR‐21) on orthodontic tooth movement. Methods The orthodontic tooth movement model was established in C57BL/6 and miR‐21‐/‐ mice with or without implantation of activated T cells. Histological and histomorphometrical analyses were performed by hematoxylin‐eosin staining. Tartrate‐resistant acid phosphate staining was used to analyze the osteoclast numbers during tooth movement. Enzyme‐linked immunosorbent... Oral Diseases Mon Nov 18, 2019 16:06 Inhibitory effect of serotype a of Aggregatibacter actinomycetemcomitans on the increased destructive potential of serotype b Abstract Objective The serotype b of Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) induces higher cytokine production in dendritic cells (DCs) compared with the other serotypes. However, this increased immuno‐stimulatory potential was modified when DCs were co‐infected with the other A. actinomycetemcomitans serotypes. This study aimed to analyze whether the production of interferon‐gamma (IFN‐γ), C‐reactive protein (CRP), matrix metalloproteinase (MMP)‐2, and MMP‐9, as well... Oral Diseases Mon Nov 18, 2019 15:36 Mark above section as read  RNA current issue Identification of human genetic variants controlling circular RNA expression [ARTICLE] Circular RNAs (circRNAs) are abundant in eukaryotic transcriptomes and have been linked to various human disorders. However, understanding genetic control of circular RNA expression is in the early stages. Here we present the first integrated analysis of circRNAs and genome sequence variation from lymphoblastoid cell lines of the 1000 Genomes Project. We identified thousands of circRNAs in the RNA-seq data and show their association with local single-nucleotide polymorphic sites, referred to as circQTLs,... RNA current issue Mon Nov 18, 2019 16:30 Broad regulation of gene isoform expression by Wnt signaling in cancer [ARTICLE] Differential gene isoform expression is a ubiquitous mechanism to enhance proteome diversity and maintain cell homeostasis. Mechanisms such as splicing that drive gene isoform variability are highly dynamic and responsive to changes in cell signaling pathways. Wnt/β-catenin signaling has profound effects on cell activity and cell fate and is known to modify several splicing events by altering the expression of individual splicing factors. However, a global assessment of how extensively Wnt signaling... RNA current issue Mon Nov 18, 2019 16:30 On the emergence of structural complexity in RNA replicators [BIOINFORMATICS] The RNA world hypothesis relies on the ability of ribonucleic acids to spontaneously acquire complex structures capable of supporting essential biological functions. Multiple sophisticated evolutionary models have been proposed for their emergence, but they often assume specific conditions. In this work, we explore a simple and parsimonious scenario describing the emergence of complex molecular structures at the early stages of life. We show that at specific GC content regimes, an undirected replication... RNA current issue Mon Nov 18, 2019 16:30 RNA: Reviewers for Volume 25, 2019 [REVIEWER INDEX] RNA current issue Mon Nov 18, 2019 16:30 Genetic robustness of let-7 miRNA sequence-structure pairs [BIOINFORMATICS] Genetic robustness, the preservation of evolved phenotypes against genotypic mutations, is one of the central concepts in evolution. In recent years a large body of work has focused on the origins, mechanisms, and consequences of robustness in a wide range of biological systems. In particular, research on ncRNAs studied the ability of sequences to maintain folded structures against single-point mutations. In these studies, the structure is merely a reference. However, recent work revealed evidence... RNA current issue Mon Nov 18, 2019 16:30 HNRNPH1-dependent splicing of a fusion oncogene reveals a targetable RNA G-quadruplex interaction [ARTICLE] The primary oncogenic event in ~85% of Ewing sarcomas is a chromosomal translocation that generates a fusion oncogene encoding an aberrant transcription factor. The exact genomic breakpoints within the translocated genes, EWSR1 and FLI1, vary; however, in EWSR1, breakpoints typically occur within introns 7 or 8. We previously found that in Ewing sarcoma cells harboring EWSR1 intron 8 breakpoints, the RNA-binding protein HNRNPH1 facilitates a splicing event that excludes EWSR1 exon 8 from the EWS–FLI1... RNA current issue Mon Nov 18, 2019 16:30 CRIP: predicting circRNA-RBP-binding sites using a codon-based encoding and hybrid deep neural networks [BIOINFORMATICS] Circular RNAs (circRNAs), with their crucial roles in gene regulation and disease development, have become rising stars in the RNA world. To understand the regulatory function of circRNAs, many studies focus on the interactions between circRNAs and RNA-binding proteins (RBPs). Recently, the abundant CLIP-seq experimental data has enabled the large-scale identification and analysis of circRNA–RBP interactions, whereas, as far as we know, no computational tool based on machine learning has been proposed... RNA current issue Mon Nov 18, 2019 16:30 Exon size and sequence conservation improves identification of splice-altering nucleotides [ARTICLE] Pre-mRNA splicing is regulated through multiple trans-acting splicing factors. These regulators interact with the pre-mRNA at intronic and exonic positions. Given that most exons are protein coding, the evolution of exons must be modulated by a combination of selective coding and splicing pressures. It has previously been demonstrated that selective splicing pressures are more easily deconvoluted when phylogenetic comparisons are made for exons of identical size, suggesting that exon size–filtered... RNA current issue Mon Nov 18, 2019 16:30 Evidence that the nadA motif is a bacterial riboswitch for the ubiquitous enzyme cofactor NAD+ [REPORT] The nadA motif is a riboswitch candidate present in various Acidobacteria species that was previously identified by bioinformatic analysis of bacterial DNA data sets. More than 100 unique representatives have been identified exclusively upstream of nadA genes, which code for an enzyme in the biosynthetic pathway of the ubiquitous coenzyme NAD+. The architecture of nadA motif RNAs suggests they use structurally similar tandem ligand-binding aptamer domains to control translation initiation. Biochemical... RNA current issue Mon Nov 18, 2019 16:30 Jonathan R. Warner (1936-2019)--pioneer of ribosome biosynthesis [OBITUARY] RNA current issue Mon Nov 18, 2019 16:30 A structure-based model for the prediction of protein-RNA binding affinity [ARTICLE] Protein–RNA recognition is highly affinity-driven and regulates a wide array of cellular functions. In this study, we have curated a binding affinity data set of 40 protein–RNA complexes, for which at least one unbound partner is available in the docking benchmark. The data set covers a wide affinity range of eight orders of magnitude as well as four different structural classes. On average, we find the complexes with single-stranded RNA have the highest affinity, whereas the complexes with the duplex... RNA current issue Mon Nov 18, 2019 16:30 Circular code motifs in the ribosome: a missing link in the evolution of translation? [ARTICLE] The origin of the genetic code remains enigmatic five decades after it was elucidated, although there is growing evidence that the code coevolved progressively with the ribosome. A number of primordial codes were proposed as ancestors of the modern genetic code, including comma-free codes such as the RRY, RNY, or GNC codes (R = G or A, Y = C or T, N = any nucleotide), and the X circular code, an error-correcting code that also allows identification and maintenance of the reading frame. It was demonstrated... RNA current issue Mon Nov 18, 2019 16:30 Interplay between substrate recognition, 5' end tRNA processing and methylation activity of human mitochondrial RNase P [ARTICLE] Human mitochondrial ribonuclease P (mtRNase P) is an essential three-protein complex that catalyzes the 5' end maturation of mitochondrial precursor tRNAs (pre-tRNAs). Mitochondrial RNase P Protein 3 (MRPP3), a protein-only RNase P (PRORP), is the nuclease component of the mtRNase P complex and requires a two-protein S-adenosyl-methionine (SAM)-dependent methyltransferase MRPP1/2 subcomplex to function. Dysfunction of mtRNase P is linked to several human mitochondrial diseases, such as mitochondrial... RNA current issue Mon Nov 18, 2019 16:30 Coding regions affect mRNA stability in human cells [ARTICLE] A new paradigm has emerged that coding regions can regulate mRNA stability in model organisms. Here, due to differences in cognate tRNA abundance, synonymous codons are translated at different speeds, and slow codons then stimulate mRNA decay. To ask if this phenomenon also occurs in humans, we isolated RNA stability effects due to coding regions using the human ORFeome collection. We find that many open reading frame (ORF) characteristics, such as length and secondary structure, fail to provide... RNA current issue Mon Nov 18, 2019 16:30 Local translation of yeast ERG4 mRNA at the endoplasmic reticulum requires the brefeldin A resistance protein Bfr1 [ARTICLE] Brefeldin A resistance factor 1 (Bfr1p) is a nonessential RNA-binding protein and multicopy suppressor of brefeldin A sensitivity in Saccharomyces cerevisiae. Deletion of BFR1 leads to multiple defects, including altered cell shape and size, change in ploidy, induction of P-bodies and chromosomal missegregation. Bfr1p has been shown to associate with polysomes, binds to several hundred mRNAs, and can target some of them to P-bodies. Although this implies a role of Bfr1p in translational control of... RNA current issue Mon Nov 18, 2019 16:30 Thermodynamic examination of pH and magnesium effect on U6 RNA internal loop [ARTICLE] U6 RNA contains a 1 x 2-nt internal loop that folds and unfold during spliceosomal assembly and activation. The 1 x 2 loop consists of a C67•A79 base pair that forms an additional hydrogen bond upon protonation, C67•A+79, and uracil (U80) that coordinates the catalytically essential magnesium ions. We designed a series of RNA and DNA constructs with a 1 x 2 loop sequence contained in the ISL, and its modifications, to measure the thermodynamic effects of protonation and magnesium binding using UV-visible... RNA current issue Mon Nov 18, 2019 16:30 Biophysical characterizations of the recognition of the AAUAAA polyadenylation signal [ARTICLE] Most eukaryotic messenger RNA precursors must undergo 3'-end cleavage and polyadenylation for maturation. We and others recently reported the structure of the AAUAAA polyadenylation signal (PAS) in complex with the protein factors CPSF-30, WDR33, and CPSF-160, revealing the molecular mechanism for this recognition. Here we have characterized in detail the interactions between the PAS RNA and the protein factors using fluorescence polarization experiments. Our studies show that AAUAAA is recognized... RNA current issue Mon Nov 18, 2019 16:30 RNA detection with high specificity and sensitivity using nested fluorogenic Mango NASBA [METHOD] There is a pressing need for nucleic acid–based assays that are capable of rapidly and reliably detecting pathogenic organisms. Many of the techniques available for the detection of pathogenic RNA possess one or more limiting factors that make the detection of low-copy RNA challenging. Although RT-PCR is the most commonly used method for detecting pathogen-related RNA, it requires expensive thermocycling equipment and is comparatively slow. Isothermal methods promise procedural simplicity but have... RNA current issue Mon Nov 18, 2019 16:30 The long noncoding RNA NEAT1_1 is seemingly dispensable for normal tissue homeostasis and cancer cell growth [ARTICLE] NEAT1 is one of the most studied lncRNAs, in part because its silencing in mice causes defects in mammary gland development and corpus luteum formation and protects them from skin cancer development. Moreover, depleting NEAT1 in established cancer cell lines reduces growth and sensitizes cells to DNA damaging agents. However, NEAT1 produces two isoforms and because the short isoform, NEAT1_1, completely overlaps the 5' part of the long NEAT1_2 isoform; the respective contributions of each of the... RNA current issue Mon Nov 18, 2019 16:30 RNA: Author Index for Volume 25, 2019 [AUTHOR INDEX] RNA current issue Mon Nov 18, 2019 16:30 Mark above section as read
NIR spectroscopic determination of urine components in spot urine: preliminary investigation towards optical point-of-care testAbstract Presently, there is no convenient method to measure 24-h urinary Na excretion, which is an important index of daily Na intake, and 24-h urine collection involves a complex process. However, the Na-to-creatinine ratio (NCR) in spot urine has the potential to evaluate 24-h Na excretion and is useful for point-of-care testing. Thus, this study aimed to realize a near-infrared...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Liver alterations in anorexia nervosa are not caused by insulin resistance AbstractBackground Liver dysfunction has been widely reported in connection with anorexia nervosa (AN) but the pathogenesis of these alterations has never been fully understood despite reported theories about the presence of insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD). The aim of this study is to investigate if hypertransaminasemia in AN is linked to IR and NAFLD.Methods Anthropometric data and laboratory exams of 34 patients and 34 controls were analyzed, including alanine-aminotransferase, aspartate-aminotransferase and homeostatic model assessment of insulin resistance (HOMA-IR) index. All subjects also underwent magnetic resonance imaging (MRI), ultrasonography (US), and transient elastography (TE).Results Evidence of increased alanine aminotransferase in AN patients was confirmed in our sample together with a lower HOMA-IR index compared to controls. Positive results in US appeared in 16 patients vs none in controls (p = 0.0007); patients with liver parenchyma abnormalities in US were not different than normal-US patients in any of the studied variables. Only one patient showed non-alcoholic fatty liver disease in MRI while abnormal TE was found in four patients and never in controls.Conclusions Liver damage suggested by increased serum liver enzymes cannot be due to liver steatosis but potentially to a different liver disease (not identified by MRI) or to an early liver fibrosis not associated with an insulin-resistant status. Association between long boarding time in the emergency department and hospital mortality: a single-center propensity score-based analysis Abstract Once diagnostic work-up and first therapy are completed in patients visiting the emergency department (ED), boarding them within the ED until an in-hospital bed became available is a common practice in busy hospitals. Whether this practice may harm the patients remains a debate. We sought to determine whether an ED boarding time longer than 4 h places the patients at increased risk of in-hospital death. This retrospective, propensity score-matched analysis and propensity score-based inverse probability weighting analysis was conducted in an adult ED in a single, academic, 1136-bed hospital in France. All patients hospitalized via the adult ED from January 1, 2013 to March 31, 2018 were included. Hospital mortality (primary outcome) and hospital length of stay (LOS) were assessed in (1) a matched cohort (1:1 matching of ED visits with or without ED boarding time longer than 4 h but similar propensity score to experience an ED boarding time longer than 4 h); and (2) the whole study cohort. Sensitivity analysis to unmeasured confounding and analyses in pre-specified cohorts of patients were conducted. Among 68,632 included ED visits, 17,271 (25.2%) had an ED boarding time longer than 4 h. Conditional logistic regression performed on a 10,581 pair-matched cohort, and generalized estimating equations with adjustment on confounders and stabilized propensity score-based inverse probability weighting applied on the whole cohort showed a significantly increased risk of hospital death in patients experiencing an ED boarding time longer than 4 h: odds ratio (OR) of 1.13 (95% confidence interval [95% CI] 1.05–1.22), P = 0.001; and OR of 1.12 (95% CI 1.03–1.22), P = 0.007, respectively. Sensitivity analyses showed that these findings might be robust to unmeasured confounding. Hospital LOS was significantly longer in patients exposed to ED boarding time longer than 4 h: median difference 2 days (95% CI 1–2) (P < 0.001) in matched analysis and mean difference 1.15 days (95% CI 1.02–1.28) (P < 0.001) in multivariable unmatched analysis. In this single-center propensity score-based cohort analysis, patients experiencing an ED boarding time longer than 4 h before being transferred to an in-patient bed were at increased risk of hospital death. Risk stratification of patients with chest pain or anginal equivalents in the emergency department Abstract We studied whether previously developed cardiac risk scores—including history, ECG, age, risk factors, and troponin (HEART); Thrombolysis in Myocardial Infarction (TIMI); Global Registry of Acute Coronary Events (GRACE); and Emergency Department Assessment of Chest Pain (EDACS)—could be applied to predict major adverse cardiac events (MACE) in patients with possible coronary artery disease, including anginal equivalents. Patients with chest pain or anginal equivalents who underwent coronary computed tomographic angiography were included. The primary outcome was 30-day MACE. We compared the cardiac risk scores by the area under the receiver-operating characteristic curves (AUC). The primary outcome occurred in 200 patients (16.0%) of the 1247 patients included. For the prediction of MACE, the AUC of the HEART score (0.765) was superior to those of the TIMI (0.726), GRACE (0.612), and EDACS (0.631) scores. Among patients identified by each score as being at low risk, the MACE rate was the lowest for the HEART score (5.7%), followed by the TIMI (8.8%), EDACS (11.2%), and GRACE (12.2%) scores. At a sensitivity level of a < 2% rate of misses, the negative predictive value of the HEART score (1.0) outperformed those of the GRACE (0.932) and EDACS (0.964). The HEART score appeared to be more predictive of MACEs than the TIMI, GRACE, and EDACS in patients with chest pain or anginal equivalents. However, previously suggested cutoff could not safely identify low-risk patients for early discharge because of the unacceptably high rate of missed MACEs. A double-edged sword: e-cigarettes, and other electronic nicotine delivery systems (ENDS): reply Is delayed cardioversion the better approach in recent-onset atrial fibrillation? No Abstract Symptomatic atrial fibrillation (AF) is a common cause of emergency department (ED) referrals. In case of hemodynamic stability, the choice to either perform early cardioversion (pharmacologic or electrical) or to prescribe rate-lowering drugs and differ any attempts to restore sinus rhythm (i.e., wait-and-see approach) has been widely debated. Results of the recent Rate Control versus Electrical Cardioversion Trial 7-Acute Cardioversion versus Wait and See (RACE 7 ACWAS) have been considered a strong argument in favor of the wait-and-see approach. In this debate, we discuss several issues that would support early cardioversion, ranging from patients' satisfaction and costs to concerns about safety. Furthermore, the wait-and-see approach may translate into a missed opportunity to encourage widespread use of a "pill-in-the-pocket" home treatment: this underused option could allow rapid solving of many AF episodes, potentially avoiding future ED referrals. Our opinion is that a delayed cardioversion may introduce unneeded complications in the straightforward management of a common clinical problem. Therefore, early cardioversion should continue to be the preferred option because of its proven efficacy, safety and convenience. Correction to: Incidence of hyperkalemia in the emergency department: a 10-year retrospective study In the original publication of the article, the 3rd author name was swapped. The correct author name should read as Damien Masson. Treatment with ferric carboxymaltose in stable patients with severe iron deficiency anemia in the emergency department Abstract The AABB Choosing Wisely Campaign recommends "don't transfuse for iron deficiency without hemodynamic instability". However, the management of iron deficiency anemia (IDA) in the emergency department (ED) is heterogeneous and patients are often over-transfused. Intravenous iron is effective in correcting anemia and new formulations, including ferric carboxymaltose (FCM), allow the administration of high doses with low immunogenicity. The aim of this retrospective study was to analyze the management of hemodynamically stable patients aged 18–55 years with severe IDA (hemoglobin < 8 g/dL), who presented to the ED from January 2014 to July 2018. Patients who received FCM (FCM1) and those who did not receive FCM (FCM0) were compared. Efficacy and safety of FCM at follow-up were evaluated. Seventy-one subjects fulfilled the inclusion criteria (FCM0 n = 48; FCM1 n = 23). The mean Hb at admission was 6.6 g/dL. 40% in the FCM0 and 13% in FCM1 were transfused (p = 0.02). 21% of FCM0 patients were admitted to the ward, while all FCM1 were discharged (p = 0.02). Within 2 weeks, the Hb increase was 2.8 ± 1 g/dL in the FCM1 group. Sixteen FCM1 patients were evaluated at 52 ± 28 days (median 42, range 27–122): the average Hb increase was 5.3 ± 1.4 g/dL. In summary, we showed that FCM administration in the ED in hemodynamically stable patients was associated with fewer transfusions and hospital admissions compared to the FCM0 group; moreover, it succeeded in safely, effectively and rapidly increasing Hb levels after discharge from the ED. Further studies are needed to develop recommendations for IDA in the ED and to identify transfusion thresholds for non-hospitalized patients. A double-edged sword: E-cigarettes, and other electronic nicotine delivery systems (ENDS) Presence of air in the inferior vena cava: an uncommon radiologic presentation of emphysematous pyelonephritis Two different techniques of ultrasound-guided peripheral venous catheter placement versus the traditional approach in the pre-hospital emergency setting: a randomized study Abstract We performed a randomized pre-hospital clinical study to compare two different techniques of ultrasound-guided peripheral venous catheter (PVC) insertion and the conventional cannulation technique in the pre-hospital emergency setting, with a specific focus on the procedural success rate and the time required to introduce PVC. This pre-hospital prospective controlled randomized clinical trial allocated patients treated by emergency medical service to undergo PVC insertion fully controlled by ultrasound (ultrasound guidance of the PVC tip until it penetrates the lumen, group A), PVC insertion partially controlled by ultrasound (target vein identification only, group B) or to receive PVC without any ultrasound guidance (group C). The study outcomes were monitored until the patient was admitted to the hospital. A total of 300 adult patients were enrolled. The success of the first attempt (group A: 88%, group B: 94%, group C: 76%, p < 0.001) and overall success rate (A: 99%, B: 99%, C: 90%, p < 0.001) were significantly higher in the group A, followed by group B when compared to group C. The number of attempts was significantly lower (A: 1.18 ± 0.54, B: 1.05 ± 0.22, C: 1.22 ± 0.57, p < 0.001) and the time required for the procedure shorter (A: 75.3 ± 60.6, B: 43.5 ± 26.0, C: 82.3 ± 100.9 s, p < 0.001) in group B compared to groups A and C. Both techniques of ultrasound-guided PVC placement were associated with higher success rates than the conventional method. However, PVC insertion partially controlled by ultrasound was superior to full ultrasound guidance in terms of time and number of cannulation attempts required.
Liver alterations in anorexia nervosa are not caused by insulin resistanceAbstractBackgroundLiver dysfunction has been widely reported in connection with anorexia nervosa (AN) but the pathogenesis of these alterations has never been fully understood despite reported theories about the presence of insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD). The aim of this study is to investigate if hypertransaminasemia in AN is linked to IR and NAFLD.MethodsAnthropometric data and laboratory...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:19
Real-Time Audiovisual Feedback Training Improves Cardiopulmonary Resuscitation Performance: A Controlled Study Objective The aim of the study was to quantitatively measure the effect of teaching cardiopulmonary resuscitation (CPR) using a real-time audiovisual feedback manikin system on first-year medical student's CPR performance. Methods This is a prospective, manikin-based intervention study, including 2 consecutive classes of medical school students enlisted to a mandatory first aid course. One class (control group) was taught using manikin-based standard CPR education models. The second class (intervention group) was taught similarly, but with the addition of real-time CPR quality feedback provided by the manikins. Students' performance was assessed using a standardized Objective Structured Clinical Examination scenario, during which no real-time feedback was provided. Critical CPR parameters were measured including compression depth, chest recoil, ventilation volume, and "hands-off" time. Results A total of 201 participants were included in the study, 106 in the control group and 95 in the intervention group. Baseline demographic characteristics and previous medical knowledge were similar for the 2 groups. A significant improvement was observed for all primary study outcomes in favor of the real-time feedback group for median (interquartile range) chest compression fraction [57 (52.75%–60%) vs. 49 (43%–55%), P < 0.001], compressions with adequate depth [66.5 (19.5%–95.25%) vs. 0 (0%–12%), P < 0.001], ventilations with adequate volume [68.5 (33%–89%) vs. 37 (0%–70%), P < 0.00], and a simulator-derived composite "total CPR score" [39 (24%–61.25%) vs. 13 (3.5%–22%), P < 0.001]. In multiple regression analysis, the real-time feedback group's performance was significantly better than the control group in all primary outcomes, adjusting for participant's characteristics of age, sex, and body mass index. Conclusions The use of audiovisual feedback techniques to teach CPR improves skill acquisition with significant improvement in crucial prognosis-improving parameters, as tested in a "no-feedback" test scenario. Reprints: Ron Eshel, BSc, Ben-Gurion University of the Negev, Ha'machtarot 20 A Ra'anana, Israel (e-mail: Ron.Eshel@gmail.com). The authors declare no conflict of interest. Neither Laerdal nor any other commercial company revised, altered, or influenced the study protocol or this article at any stage. This study was conducted as part of the requirements for graduation from the medical school of the Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare Evaluation of the Patterns of Learning in the Labor Cervical Examination Objective The aim of the study was to evaluate patterns of skill acquisition in the labor cervical examination in novice providers, such as the change in accuracy and overestimation and underestimation over time and the impact of dilation and effacement on accuracy. Methods In this descriptive longitudinal study, medical students each performed 120 simulated cervical examinations. Accuracy and how often students overestimated and underestimated dilation and effacement during was determined for each set of 10 repetitions. Accuracy data were grouped and compared by dilation (1–3, 4–6, and 7–10 cm) and effacement (90%, 75%, 50%, and 25%). Results Student accuracy in dilation significantly improved throughout the course of the study (P < 0.001). At the beginning of the study, students more often overestimated dilation, but this decreased over time (P < 0.001). In addition, the accuracy of the students' estimations was 84%, 62%, and 52% for dilations of 1–3, 4–6, and 7–10 cm, respectively (P < 0.001). Student accuracy in effacement significantly improved throughout the course of the study (P < 0.001). At the beginning of the study, students more often overestimated effacement, but as training progressed, more students tended to overestimate and underestimate equally often (P < 0.001). In addition, accuracy of the students' estimations was 93%, 88%, 81%, and 35% for effacements of 90%, 75%, 50%, and 25%, respectively (P < 0.001). Conclusions Knowing that students tend to overestimate cervical dilation and effacement early in training and that cervices of high dilation and low effacement are more difficult to assess will be helpful in designing more efficient cervical examination training regimens. Reprints: Joshua F. Nitsche, MD, PhD, Division of Maternal Fetal Medicine, Department of OB/GYN, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157 (e-mail: jnitsche@wakehealth.edu). The authors declare no conflict of interest. An abstract of this article was presented at the annual meeting of the Association for Professors of Gynecology and Obstetrics/Council on Resident Education in Obstetrics and Gynecology, National Harbor, MD, February 28 to March 3, 2018. © 2019 Society for Simulation in Healthcare Clinical Impact of the Introduction of Pediatric Intussusception Air Enema Reduction Technology in a Low- to Middle-Income Country Using Low-Cost Simulation-Based Medical Education Introduction Pediatric intussusception is a common cause of bowel obstruction in infants. Air enema (AE) reduction is routine first-line management in many countries; however, there is a high rate of operative intervention in low- and middle-income countries. The aims of the study were to use simulation-based medical education with an intussusception simulator to introduce AE reduction to Myanmar and to assess its effect on provider behaviors and the resulting clinical care. Methods Clinical evaluation was conducted by comparing clinical outcomes data for children with intussusception 12 months before implementation with that from 12 months subsequent to implementation. These included the following: AE success rates, recurrence rates, length of stay, intestinal resection, and operative intervention rates. An educational workshop was developed that used a low-cost mannequin to facilitate practice at the reduction of intussusception using AE. Curriculum evaluation was performed through 5-point rating scale self-assessment in several domains. Data analysis was performed with Mann-Whitney U test, Student t test, or Wilcoxon signed-ranks test as appropriate; a P value of less than 0.05 was considered to be significant. Results After implementation, there was a significant reduction in the overall operative intervention rates [82.5% (85/103) vs. 58.7% (44/75), P = 0.006]. Intestinal resection rates increased [15.3% (13/85) vs. 35.9% (14/39), P = 0.02]. The success rate with attempted AE reduction was 94.4% (34/36), with a recurrence rate of 5.6% (2/36). The simulation-based medical education workshop was completed by 25 local participants. There was a significant difference in the confidence of performing (1.9 vs. 3.6, P ≤ 0.0001) or assisting (2.8 vs. 3.7, P = 0.018) an AE reduction before and after the workshop. Conclusions Simulation-based educational techniques can be successfully applied in a low- and middle-income country to facilitate the safe introduction of new equipment and techniques with significant beneficial impact on provider behaviors and the resulting clinical care. Reprints: Ramesh Mark Nataraja, MBBS BSc (Hons), GCCS (Hons), GDipSurgEd FRCSEd (Paed.Surg), FFSTEd, FRACS (Paeds), Department of Paediatric Surgery, Monash Children's Hospital, Monash University, 246 Clayton Rd, Clayton, Melbourne, Australia, 3168 (e-mail: ram.nataraja@monashhealth.org). The authors declare no conflict of interest. Supported by the Australian Government and the Royal Australasian College of Surgeons. © 2019 Society for Simulation in Healthcare A Conceptual Framework for the Development of Debriefing Skills: A Journey of Discovery, Growth, and Maturity Summary Statement Despite the critical importance of debriefing in simulation-based education, existing literature offers little guidance on how debriefing skills develop over time. An elaboration of the trajectory through which debriefing expertise evolves would help inform educators looking to enhance their skills. In this article, we present a new conceptual framework for the development of debriefing skills based on a modification of Dreyfus and Dreyfus' model of skill development. For each of the 3 stages of debriefing skill development—discovery, growth, and maturity, we highlight characteristics of debriefers, requisite knowledge, and key skills. We propose how faculty development experiences map to each stage of debriefing skill development. We hope the new conceptual framework will advance the art and science of debriefing by shaping future faculty development initiatives, research, and innovation in debriefing. Reprints: Adam Cheng, MD, FRCPC, University of Calgary, KidSim-ASPIRE Research Program, Alberta Children's Hospital, Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, Canada T3B 6A8 (e-mail: chenger@me.com). A.C., V.G., and M.M. are faculty for the Debriefing Academy, which runs debriefing courses for healthcare professionals. M.K. is faculty at the Simulation Center of the University Hospital and the Debriefing Academy, both providing debriefing faculty development training. W.E. receives salary support from the Center for Medical Simulation and the Debriefing Academy to teach on simulation educator courses; he also receives per diem honorarium from PAEDSIM e.V. to teach on simulation educator courses in Germany. K.B. is faculty at the NYC Health + Hospitals/Simulation Center, which provides debriefing faculty development training. © 2019 Society for Simulation in Healthcare "It's Not an Acting Job… Don't Underestimate What a Simulated Patient Does": A Qualitative Study Exploring the Perspectives of Simulated Patients in Health Professions Education Introduction Simulated patients (SPs) are individuals who have learned to realistically portray patient roles in health professional education. Program recommendations are increasing for simulation programs, and as key stakeholders, SPs' perspectives seem underrepresented. The aim of the study was to explore the experiences, perspectives, and practices of SPs to gain insights on topics of importance to SPs and inform program recommendations. Methods An interpretivist research paradigm and qualitative design were adopted. Eighteen SPs participated in 2 focus groups that were audio recorded, transcribed, and deidentified. Three researchers completed inductive thematic analysis. Institutional ethical approval was obtained. Results Three themes represented the different elements of SP practice: becoming and being a SP, preparing for a SP role, and performing a SP role. Simulated patients identify as educated specialists with unique responsibilities and attributes. Simulated patients are committed to representing the perspectives of real patients, while simultaneously supporting learners and educators. Simulated patients can feel unprepared to perform a role but have innovated responsive strategies. Conclusions Simulated patients considered 3 primary aspects to their practice and shared ways that they might be well supported. Simulated patients represent a community of practice, characterized by mutual engagement, joint enterprise, and a shared repertoire. Ongoing SP input in SP programs may benefit SPs and lead to higher-quality educational experiences for learners. Reprints: Shane A. Pritchard, BPhysio, Department of Physiotherapy, Monash University, PO Box 527, Frankston, Victoria, Australia 3199 (e-mail: shane.pritchard@gmail.com). The authors declare no conflict of interest. Supported by funding from Health Workforce Australia (CTR12-010) and an Australian Government Research Training Program (RTP) scholarship. © 2019 Society for Simulation in Healthcare Benefits and Limitations of Transurethral Resection of the Prostate Training With a Novel Virtual Reality Simulator Purpose Profound endourological skills are required for optimal postoperative outcome parameters after transurethral resection of the prostate (TURP). We investigated the Karl Storz (Tuttlingen, Germany) UroTrainer for virtual simulation training of the TURP. Materials and Methods Twenty urologists underwent a virtual reality (VR) TURP training. After a needs analysis, performance scores and self-rated surgical skills were compared before and after the curriculum, the realism of the simulator was assessed, and the optimal level of experience for VR training was evaluated. Statistical testing was done with SPSS 25. Results Forty percent of participants indicated frequent intraoperative overload during real-life TURP and 80% indicated that VR training might be beneficial for endourological skills development, underlining the need to advance classical endourological training. For the complete cohort, overall VR performance scores (P = 0.022) and completeness of resection (P < 0.001) significantly improved. Self-rated parameters including identification of anatomical structures (P = 0.046), sparing the sphincter (P = 0.002), and handling of the resectoscope (P = 0.033) became significantly better during the VR curriculum. Participants indicated progress regarding handling of the resectoscope (70%), bleeding control (55%), and finding the correct resection depth (50%). Although overall realism and handling of the resectoscope was good, virtual bleeding control and correct tissue feedback should be improved in future VR simulators. Seventy percent of participants indicated 10 to 50 virtual TURP cases to be optimal and 80% junior residents to be the key target group for VR TURP training. Conclusions There is a need to improve training the TURP and VR simulators might be a valuable supplement, especially for urologists beginning with the endourological desobstruction of the prostate. Reprints: Gerald B. Schulz, MD, Department of Urology, Ludwig-Maximilians-University Marchioninistr, 15, 81377 Munich, Germany (e-mail: gerald.schulz@med.uni-muenchen.de). The authors declare no conflict of interest. F.J. and A.K. share the last authorship. The authors state that the study was performed in complete accordance with the local ethical requirements. The internal review board exempted the study protocol of ethical review. No patients or animals were involved within this study. © 2019 Society for Simulation in Healthcare Medical Student Skill Retention After Cardiopulmonary Resuscitation Training: A Cross-sectional Simulation Study Introduction The retention of cardiopulmonary resuscitation skills and the ideal frequency of retraining remain unanswered. This study investigated the retention of cardiopulmonary resuscitation skills by medical students for up to 42 months after training. Methods In a cross-sectional study, 205 medical students received 10 hours of training in basic life support in 3 practical classes, during their first semester at school. Then, they were divided into 4 groups, according to the time elapsed since the training: 73 after 1 month, 55 after 18 months, 41 after 30 months, and 36 after 42 months. Nineteen cardiopulmonary resuscitation skills and 8 potential technical errors were evaluated by mannequin-based simulation and reviewed using filming. Results The mean retention of the skills was 90% after 1 month, 74% after 18 months, 62% after 30 months, and 61% after 42 months (P < 0.001). The depth of chest compressions had the greatest retention over time (87.8%), with no significant differences among groups. Compressions performed greater than 120 per minute were less likely to be done with adequate depth. Ventilation showed a progressive decrease in retention from 93% (n = 68) after 1 month to 19% (n = 7) after 42 months (P < 0.001). All 205 students were able to turn the automated external defibrillator on and deliver the shock. Conclusions The depth of chest compressions and the use of an automated external defibrillator were the skills with the highest retention over time. Based on a skills retention prediction curve, we suggest that 18 to 24 months as the minimum retraining interval to maintain at least 70% of skills. Reprints: Rafael Saad, MD, PhD, Dr. Arnaldo Ave, 455, Room 1210, Sao Paulo, Brazil (e-mail: rafaelsaad89@gmail.com). Supported by School of Medicine, University of Sao Paulo. The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare Learning Impacts of Pretraining Video-Assisted Debriefing With Simulated Errors or Trainees' Errors in Medical Students in Basic Life Support Training: A Randomized Controlled Trial Background Previous studies demonstrated that pretraining video-assisted debriefing (VAD) with trainees' errors (TE) videotaped in a skills pretest improved skill learning of basic life support (BLS). However, conducting a pretest and preparing TE video examples is resource intensive. Exposing individual trainee's errors to peers might be a threat to learners' psychological safety. We hypothesized pretraining VAD with simulated errors (SE, performed by actors) might have the same beneficial effect on skills learning as pretraining VAD with TE, but avoid drawbacks of TE. Methods Three hundred twenty-two third-year medical students were randomized into 3 groups (the control [C], TE, SE). A videotaped BLS skills pretest was conducted in 3 groups. Then, group C received traditional training with concurrent feedback. Video-assisted debriefing with TE in the pretest or SE was delivered in groups TE or SE, respectively, followed by BLS training without any feedback. Basic life support skills were retested 1 week later (posttest). Students completed a survey to express their preference to TE or SE for VAD in the future. Results Higher BLS skills scores were observed in groups TE (85.7 ± 7.0) and SE (86.8 ± 7.5) in the posttest, compared with group C (68.7 ± 13.3, P < 0.001). No skills difference was observed between group TE and SE in the posttest. More trainees (65.8%) preferred SE for VAD. Conclusions Pretraining VAD with SE had an equivalent beneficial effect as VAD with TE on BLS skills learning in medical students. More trainees preferred SE for VAD with regard to psychological safety. Reprints: Hong Xiao, MD, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, PR China (e-mail: 619526767@qq.com). The authors declare no conflict of interest. Supported by the following research grants: National Key R&D Program of China (2018YFC2001800); a Medical Education Research Grant from Medical Education Committee of Chinese Medical Association and Medical Education Association of High Education Society of China in 2018 (2018-N07004); and a Key Project of Innovation in New Centurial High Education in Sichuan University in 2017 (SCU8052). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare Evaluating Best Methods for Crisis Resource Management Education: Didactic Teaching or Noncontextual Active Learning Introduction Health care training traditionally focuses on medical knowledge; however, this is not the only component of successful patient management. Nontechnical skills, such as crisis resource management (CRM), have significant impact on patient care. This study examines whether there is a difference in CRM skills taught by traditional lecture in comparison with low-fidelity simulation consisting of noncontextual learning through team problem-solving activities. Methods Two groups of multidisciplinary preclinical students were taught CRM through lecture or noncontextual active learning. Both groups were given a cardiopulmonary resuscitation simulation and clinical performance assessed by basic life support (BLS) checklist and CRM skills by Ottawa Global Rating Scale. The groups were reassessed at 4 months. A third group, who received no CRM education, served as a control group. Results The mean BLS scores after CRM education were 18.9 and 24.9 with mean Ottawa Global Rating Scale (GRS) scores of 22.4 and 29.1 in the didactic teaching and noncontextual groups, respectively. The difference between intervention groups was significant for BLS (P = 0.02) and Ottawa GRS (P = 0.03) score. At 4-month follow-up, there was no statistically significant difference in BLS (P = 1.0) or Ottawa GRS score (P = 0.55) between intervention groups. In comparison with the control group, there was a marginally significant difference in Ottawa GRS score (P = 0.06) at 4-month follow-up. Conclusions Noncontextual active learning of CRM using low-fidelity simulation results in improved CRM performance in comparison with didactic teaching. The benefits of CRM education do not seem to be sustained after one education session, suggesting the need for continued education and practice of skills to improve retention. Reprints: Sandy Widder, MD FRCSC, Department of Surgery, University of Alberta Hospital, 8440-112 St NW, 2D4.27 Walter C MacKenzie Health Sciences Centre, Edmonton, AB T6G 2B7, Canada (e-mail: Sandy.Widder2@albertahealthservices.ca). The authors declare no conflict of interest. © 2019 Society for Simulation in Healthcare Educational Interventions to Enhance Situation Awareness: A Systematic Review and Meta-analysis Summary Statement We conducted a systematic review to evaluate the comparative effectiveness of educational interventions on health care professionals' situation awareness (SA). We searched MEDLINE, CINAHL, HW Wilson, ERIC, Scopus, EMBASE, PsycINFO, psycARTICLES, Psychology and Behavioural Science Collection and the Cochrane library. Articles that reported a targeted SA intervention or a broader intervention incorporating SA, and an objective outcome measure of SA were included. Thirty-nine articles were eligible for inclusion, of these 4 reported targeted SA interventions. Simulation-based education (SBE) was the most prevalent educational modality (31 articles). Meta-analysis of trial designs (19 articles) yielded a pooled moderate effect size of 0.61 (95% confidence interval = 0.17 to 1.06, P = 0.007, I2 = 42%) in favor of SBE as compared with other modalities and a nonsignificant moderate effect in favor of additional nontechnical skills training (effect size = 0.54, 95% confidence interval = 0.18 to 1.26, P = 0.14, I2 = 63%). Though constrained by the number of articles eligible for inclusion, our results suggest that in comparison with other modalities, SBE yields better SA outcomes. Reprints: Nuala Walshe, RN, MTLHE, School of Nursing and Midwifery, Brookfield Health Science Complex, University College Cork, Cork T12 K8AF, Ireland (e-mail: n.walshe@ucc.ie). The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare
Real-Time Audiovisual Feedback Training Improves Cardiopulmonary Resuscitation Performance: A Controlled StudyObjective The aim of the study was to quantitatively measure the effect of teaching cardiopulmonary resuscitation (CPR) using a real-time audiovisual feedback manikin system on first-year medical student's CPR performance. Methods This is a prospective, manikin-based intervention study, including 2 consecutive classes of medical school students enlisted to a mandatory first aid course. One...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Real-Time Audiovisual Feedback Training Improves Cardiopulmonary Resuscitation Performance: A Controlled Study Objective The aim of the study was to quantitatively measure the effect of teaching cardiopulmonary resuscitation (CPR) using a real-time audiovisual feedback manikin system on first-year medical student's CPR performance. Methods This is a prospective, manikin-based intervention study, including 2 consecutive classes of medical school students enlisted to a mandatory first aid course. One class (control group) was taught using manikin-based standard CPR education models. The second class (intervention group) was taught similarly, but with the addition of real-time CPR quality feedback provided by the manikins. Students' performance was assessed using a standardized Objective Structured Clinical Examination scenario, during which no real-time feedback was provided. Critical CPR parameters were measured including compression depth, chest recoil, ventilation volume, and "hands-off" time. Results A total of 201 participants were included in the study, 106 in the control group and 95 in the intervention group. Baseline demographic characteristics and previous medical knowledge were similar for the 2 groups. A significant improvement was observed for all primary study outcomes in favor of the real-time feedback group for median (interquartile range) chest compression fraction [57 (52.75%–60%) vs. 49 (43%–55%), P < 0.001], compressions with adequate depth [66.5 (19.5%–95.25%) vs. 0 (0%–12%), P < 0.001], ventilations with adequate volume [68.5 (33%–89%) vs. 37 (0%–70%), P < 0.00], and a simulator-derived composite "total CPR score" [39 (24%–61.25%) vs. 13 (3.5%–22%), P < 0.001]. In multiple regression analysis, the real-time feedback group's performance was significantly better than the control group in all primary outcomes, adjusting for participant's characteristics of age, sex, and body mass index. Conclusions The use of audiovisual feedback techniques to teach CPR improves skill acquisition with significant improvement in crucial prognosis-improving parameters, as tested in a "no-feedback" test scenario. Reprints: Ron Eshel, BSc, Ben-Gurion University of the Negev, Ha'machtarot 20 A Ra'anana, Israel (e-mail: Ron.Eshel@gmail.com). The authors declare no conflict of interest. Neither Laerdal nor any other commercial company revised, altered, or influenced the study protocol or this article at any stage. This study was conducted as part of the requirements for graduation from the medical school of the Faculty of Health Sciences, Ben-Gurion University of the Negev, Negev, Israel. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare Evaluation of the Patterns of Learning in the Labor Cervical Examination Objective The aim of the study was to evaluate patterns of skill acquisition in the labor cervical examination in novice providers, such as the change in accuracy and overestimation and underestimation over time and the impact of dilation and effacement on accuracy. Methods In this descriptive longitudinal study, medical students each performed 120 simulated cervical examinations. Accuracy and how often students overestimated and underestimated dilation and effacement during was determined for each set of 10 repetitions. Accuracy data were grouped and compared by dilation (1–3, 4–6, and 7–10 cm) and effacement (90%, 75%, 50%, and 25%). Results Student accuracy in dilation significantly improved throughout the course of the study (P < 0.001). At the beginning of the study, students more often overestimated dilation, but this decreased over time (P < 0.001). In addition, the accuracy of the students' estimations was 84%, 62%, and 52% for dilations of 1–3, 4–6, and 7–10 cm, respectively (P < 0.001). Student accuracy in effacement significantly improved throughout the course of the study (P < 0.001). At the beginning of the study, students more often overestimated effacement, but as training progressed, more students tended to overestimate and underestimate equally often (P < 0.001). In addition, accuracy of the students' estimations was 93%, 88%, 81%, and 35% for effacements of 90%, 75%, 50%, and 25%, respectively (P < 0.001). Conclusions Knowing that students tend to overestimate cervical dilation and effacement early in training and that cervices of high dilation and low effacement are more difficult to assess will be helpful in designing more efficient cervical examination training regimens. Reprints: Joshua F. Nitsche, MD, PhD, Division of Maternal Fetal Medicine, Department of OB/GYN, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157 (e-mail: jnitsche@wakehealth.edu). The authors declare no conflict of interest. An abstract of this article was presented at the annual meeting of the Association for Professors of Gynecology and Obstetrics/Council on Resident Education in Obstetrics and Gynecology, National Harbor, MD, February 28 to March 3, 2018. © 2019 Society for Simulation in Healthcare Clinical Impact of the Introduction of Pediatric Intussusception Air Enema Reduction Technology in a Low- to Middle-Income Country Using Low-Cost Simulation-Based Medical Education Introduction Pediatric intussusception is a common cause of bowel obstruction in infants. Air enema (AE) reduction is routine first-line management in many countries; however, there is a high rate of operative intervention in low- and middle-income countries. The aims of the study were to use simulation-based medical education with an intussusception simulator to introduce AE reduction to Myanmar and to assess its effect on provider behaviors and the resulting clinical care. Methods Clinical evaluation was conducted by comparing clinical outcomes data for children with intussusception 12 months before implementation with that from 12 months subsequent to implementation. These included the following: AE success rates, recurrence rates, length of stay, intestinal resection, and operative intervention rates. An educational workshop was developed that used a low-cost mannequin to facilitate practice at the reduction of intussusception using AE. Curriculum evaluation was performed through 5-point rating scale self-assessment in several domains. Data analysis was performed with Mann-Whitney U test, Student t test, or Wilcoxon signed-ranks test as appropriate; a P value of less than 0.05 was considered to be significant. Results After implementation, there was a significant reduction in the overall operative intervention rates [82.5% (85/103) vs. 58.7% (44/75), P = 0.006]. Intestinal resection rates increased [15.3% (13/85) vs. 35.9% (14/39), P = 0.02]. The success rate with attempted AE reduction was 94.4% (34/36), with a recurrence rate of 5.6% (2/36). The simulation-based medical education workshop was completed by 25 local participants. There was a significant difference in the confidence of performing (1.9 vs. 3.6, P ≤ 0.0001) or assisting (2.8 vs. 3.7, P = 0.018) an AE reduction before and after the workshop. Conclusions Simulation-based educational techniques can be successfully applied in a low- and middle-income country to facilitate the safe introduction of new equipment and techniques with significant beneficial impact on provider behaviors and the resulting clinical care. Reprints: Ramesh Mark Nataraja, MBBS BSc (Hons), GCCS (Hons), GDipSurgEd FRCSEd (Paed.Surg), FFSTEd, FRACS (Paeds), Department of Paediatric Surgery, Monash Children's Hospital, Monash University, 246 Clayton Rd, Clayton, Melbourne, Australia, 3168 (e-mail: ram.nataraja@monashhealth.org). The authors declare no conflict of interest. Supported by the Australian Government and the Royal Australasian College of Surgeons. © 2019 Society for Simulation in Healthcare A Conceptual Framework for the Development of Debriefing Skills: A Journey of Discovery, Growth, and Maturity Summary Statement Despite the critical importance of debriefing in simulation-based education, existing literature offers little guidance on how debriefing skills develop over time. An elaboration of the trajectory through which debriefing expertise evolves would help inform educators looking to enhance their skills. In this article, we present a new conceptual framework for the development of debriefing skills based on a modification of Dreyfus and Dreyfus' model of skill development. For each of the 3 stages of debriefing skill development—discovery, growth, and maturity, we highlight characteristics of debriefers, requisite knowledge, and key skills. We propose how faculty development experiences map to each stage of debriefing skill development. We hope the new conceptual framework will advance the art and science of debriefing by shaping future faculty development initiatives, research, and innovation in debriefing. Reprints: Adam Cheng, MD, FRCPC, University of Calgary, KidSim-ASPIRE Research Program, Alberta Children's Hospital, Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, Canada T3B 6A8 (e-mail: chenger@me.com). A.C., V.G., and M.M. are faculty for the Debriefing Academy, which runs debriefing courses for healthcare professionals. M.K. is faculty at the Simulation Center of the University Hospital and the Debriefing Academy, both providing debriefing faculty development training. W.E. receives salary support from the Center for Medical Simulation and the Debriefing Academy to teach on simulation educator courses; he also receives per diem honorarium from PAEDSIM e.V. to teach on simulation educator courses in Germany. K.B. is faculty at the NYC Health + Hospitals/Simulation Center, which provides debriefing faculty development training. © 2019 Society for Simulation in Healthcare "It's Not an Acting Job… Don't Underestimate What a Simulated Patient Does": A Qualitative Study Exploring the Perspectives of Simulated Patients in Health Professions Education Introduction Simulated patients (SPs) are individuals who have learned to realistically portray patient roles in health professional education. Program recommendations are increasing for simulation programs, and as key stakeholders, SPs' perspectives seem underrepresented. The aim of the study was to explore the experiences, perspectives, and practices of SPs to gain insights on topics of importance to SPs and inform program recommendations. Methods An interpretivist research paradigm and qualitative design were adopted. Eighteen SPs participated in 2 focus groups that were audio recorded, transcribed, and deidentified. Three researchers completed inductive thematic analysis. Institutional ethical approval was obtained. Results Three themes represented the different elements of SP practice: becoming and being a SP, preparing for a SP role, and performing a SP role. Simulated patients identify as educated specialists with unique responsibilities and attributes. Simulated patients are committed to representing the perspectives of real patients, while simultaneously supporting learners and educators. Simulated patients can feel unprepared to perform a role but have innovated responsive strategies. Conclusions Simulated patients considered 3 primary aspects to their practice and shared ways that they might be well supported. Simulated patients represent a community of practice, characterized by mutual engagement, joint enterprise, and a shared repertoire. Ongoing SP input in SP programs may benefit SPs and lead to higher-quality educational experiences for learners. Reprints: Shane A. Pritchard, BPhysio, Department of Physiotherapy, Monash University, PO Box 527, Frankston, Victoria, Australia 3199 (e-mail: shane.pritchard@gmail.com). The authors declare no conflict of interest. Supported by funding from Health Workforce Australia (CTR12-010) and an Australian Government Research Training Program (RTP) scholarship. © 2019 Society for Simulation in Healthcare Benefits and Limitations of Transurethral Resection of the Prostate Training With a Novel Virtual Reality Simulator Purpose Profound endourological skills are required for optimal postoperative outcome parameters after transurethral resection of the prostate (TURP). We investigated the Karl Storz (Tuttlingen, Germany) UroTrainer for virtual simulation training of the TURP. Materials and Methods Twenty urologists underwent a virtual reality (VR) TURP training. After a needs analysis, performance scores and self-rated surgical skills were compared before and after the curriculum, the realism of the simulator was assessed, and the optimal level of experience for VR training was evaluated. Statistical testing was done with SPSS 25. Results Forty percent of participants indicated frequent intraoperative overload during real-life TURP and 80% indicated that VR training might be beneficial for endourological skills development, underlining the need to advance classical endourological training. For the complete cohort, overall VR performance scores (P = 0.022) and completeness of resection (P < 0.001) significantly improved. Self-rated parameters including identification of anatomical structures (P = 0.046), sparing the sphincter (P = 0.002), and handling of the resectoscope (P = 0.033) became significantly better during the VR curriculum. Participants indicated progress regarding handling of the resectoscope (70%), bleeding control (55%), and finding the correct resection depth (50%). Although overall realism and handling of the resectoscope was good, virtual bleeding control and correct tissue feedback should be improved in future VR simulators. Seventy percent of participants indicated 10 to 50 virtual TURP cases to be optimal and 80% junior residents to be the key target group for VR TURP training. Conclusions There is a need to improve training the TURP and VR simulators might be a valuable supplement, especially for urologists beginning with the endourological desobstruction of the prostate. Reprints: Gerald B. Schulz, MD, Department of Urology, Ludwig-Maximilians-University Marchioninistr, 15, 81377 Munich, Germany (e-mail: gerald.schulz@med.uni-muenchen.de). The authors declare no conflict of interest. F.J. and A.K. share the last authorship. The authors state that the study was performed in complete accordance with the local ethical requirements. The internal review board exempted the study protocol of ethical review. No patients or animals were involved within this study. © 2019 Society for Simulation in Healthcare Medical Student Skill Retention After Cardiopulmonary Resuscitation Training: A Cross-sectional Simulation Study Introduction The retention of cardiopulmonary resuscitation skills and the ideal frequency of retraining remain unanswered. This study investigated the retention of cardiopulmonary resuscitation skills by medical students for up to 42 months after training. Methods In a cross-sectional study, 205 medical students received 10 hours of training in basic life support in 3 practical classes, during their first semester at school. Then, they were divided into 4 groups, according to the time elapsed since the training: 73 after 1 month, 55 after 18 months, 41 after 30 months, and 36 after 42 months. Nineteen cardiopulmonary resuscitation skills and 8 potential technical errors were evaluated by mannequin-based simulation and reviewed using filming. Results The mean retention of the skills was 90% after 1 month, 74% after 18 months, 62% after 30 months, and 61% after 42 months (P < 0.001). The depth of chest compressions had the greatest retention over time (87.8%), with no significant differences among groups. Compressions performed greater than 120 per minute were less likely to be done with adequate depth. Ventilation showed a progressive decrease in retention from 93% (n = 68) after 1 month to 19% (n = 7) after 42 months (P < 0.001). All 205 students were able to turn the automated external defibrillator on and deliver the shock. Conclusions The depth of chest compressions and the use of an automated external defibrillator were the skills with the highest retention over time. Based on a skills retention prediction curve, we suggest that 18 to 24 months as the minimum retraining interval to maintain at least 70% of skills. Reprints: Rafael Saad, MD, PhD, Dr. Arnaldo Ave, 455, Room 1210, Sao Paulo, Brazil (e-mail: rafaelsaad89@gmail.com). Supported by School of Medicine, University of Sao Paulo. The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare Learning Impacts of Pretraining Video-Assisted Debriefing With Simulated Errors or Trainees' Errors in Medical Students in Basic Life Support Training: A Randomized Controlled Trial Background Previous studies demonstrated that pretraining video-assisted debriefing (VAD) with trainees' errors (TE) videotaped in a skills pretest improved skill learning of basic life support (BLS). However, conducting a pretest and preparing TE video examples is resource intensive. Exposing individual trainee's errors to peers might be a threat to learners' psychological safety. We hypothesized pretraining VAD with simulated errors (SE, performed by actors) might have the same beneficial effect on skills learning as pretraining VAD with TE, but avoid drawbacks of TE. Methods Three hundred twenty-two third-year medical students were randomized into 3 groups (the control [C], TE, SE). A videotaped BLS skills pretest was conducted in 3 groups. Then, group C received traditional training with concurrent feedback. Video-assisted debriefing with TE in the pretest or SE was delivered in groups TE or SE, respectively, followed by BLS training without any feedback. Basic life support skills were retested 1 week later (posttest). Students completed a survey to express their preference to TE or SE for VAD in the future. Results Higher BLS skills scores were observed in groups TE (85.7 ± 7.0) and SE (86.8 ± 7.5) in the posttest, compared with group C (68.7 ± 13.3, P < 0.001). No skills difference was observed between group TE and SE in the posttest. More trainees (65.8%) preferred SE for VAD. Conclusions Pretraining VAD with SE had an equivalent beneficial effect as VAD with TE on BLS skills learning in medical students. More trainees preferred SE for VAD with regard to psychological safety. Reprints: Hong Xiao, MD, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, PR China (e-mail: 619526767@qq.com). The authors declare no conflict of interest. Supported by the following research grants: National Key R&D Program of China (2018YFC2001800); a Medical Education Research Grant from Medical Education Committee of Chinese Medical Association and Medical Education Association of High Education Society of China in 2018 (2018-N07004); and a Key Project of Innovation in New Centurial High Education in Sichuan University in 2017 (SCU8052). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare Evaluating Best Methods for Crisis Resource Management Education: Didactic Teaching or Noncontextual Active Learning Introduction Health care training traditionally focuses on medical knowledge; however, this is not the only component of successful patient management. Nontechnical skills, such as crisis resource management (CRM), have significant impact on patient care. This study examines whether there is a difference in CRM skills taught by traditional lecture in comparison with low-fidelity simulation consisting of noncontextual learning through team problem-solving activities. Methods Two groups of multidisciplinary preclinical students were taught CRM through lecture or noncontextual active learning. Both groups were given a cardiopulmonary resuscitation simulation and clinical performance assessed by basic life support (BLS) checklist and CRM skills by Ottawa Global Rating Scale. The groups were reassessed at 4 months. A third group, who received no CRM education, served as a control group. Results The mean BLS scores after CRM education were 18.9 and 24.9 with mean Ottawa Global Rating Scale (GRS) scores of 22.4 and 29.1 in the didactic teaching and noncontextual groups, respectively. The difference between intervention groups was significant for BLS (P = 0.02) and Ottawa GRS (P = 0.03) score. At 4-month follow-up, there was no statistically significant difference in BLS (P = 1.0) or Ottawa GRS score (P = 0.55) between intervention groups. In comparison with the control group, there was a marginally significant difference in Ottawa GRS score (P = 0.06) at 4-month follow-up. Conclusions Noncontextual active learning of CRM using low-fidelity simulation results in improved CRM performance in comparison with didactic teaching. The benefits of CRM education do not seem to be sustained after one education session, suggesting the need for continued education and practice of skills to improve retention. Reprints: Sandy Widder, MD FRCSC, Department of Surgery, University of Alberta Hospital, 8440-112 St NW, 2D4.27 Walter C MacKenzie Health Sciences Centre, Edmonton, AB T6G 2B7, Canada (e-mail: Sandy.Widder2@albertahealthservices.ca). The authors declare no conflict of interest. © 2019 Society for Simulation in Healthcare Educational Interventions to Enhance Situation Awareness: A Systematic Review and Meta-analysis Summary Statement We conducted a systematic review to evaluate the comparative effectiveness of educational interventions on health care professionals' situation awareness (SA). We searched MEDLINE, CINAHL, HW Wilson, ERIC, Scopus, EMBASE, PsycINFO, psycARTICLES, Psychology and Behavioural Science Collection and the Cochrane library. Articles that reported a targeted SA intervention or a broader intervention incorporating SA, and an objective outcome measure of SA were included. Thirty-nine articles were eligible for inclusion, of these 4 reported targeted SA interventions. Simulation-based education (SBE) was the most prevalent educational modality (31 articles). Meta-analysis of trial designs (19 articles) yielded a pooled moderate effect size of 0.61 (95% confidence interval = 0.17 to 1.06, P = 0.007, I2 = 42%) in favor of SBE as compared with other modalities and a nonsignificant moderate effect in favor of additional nontechnical skills training (effect size = 0.54, 95% confidence interval = 0.18 to 1.26, P = 0.14, I2 = 63%). Though constrained by the number of articles eligible for inclusion, our results suggest that in comparison with other modalities, SBE yields better SA outcomes. Reprints: Nuala Walshe, RN, MTLHE, School of Nursing and Midwifery, Brookfield Health Science Complex, University College Cork, Cork T12 K8AF, Ireland (e-mail: n.walshe@ucc.ie). The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.simulationinhealthcare.com). © 2019 Society for Simulation in Healthcare
Real-Time Audiovisual Feedback Training Improves Cardiopulmonary Resuscitation Performance: A Controlled StudyObjective The aim of the study was to quantitatively measure the effect of teaching cardiopulmonary resuscitation (CPR) using a real-time audiovisual feedback manikin system on first-year medical student's CPR performance. Methods This is a prospective, manikin-based intervention study, including 2 consecutive classes of medical school students enlisted to a mandatory first aid course. One...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Awareness and practice of zinc therapy in diarrheal management among under-five caregivers in Enugu State, Nigeria Joshua I Ugwu, Ikechukwu E Ezeagu, Madu D Ibegbu International Journal of Medicine and Health Development 2019 24(2):63-69 Background: Acute diarrhea remains one of the leading causes of under -five years of age (u-5) childhood deaths in Nigeria. Use of zinc (Zn) sulfate monohydrate with low-osmolality oral rehydration solution (ORS) therapy reduces both the duration and severity of the diarrhea episodes in children. There has been little progress in the widespread introduction and adoption of ORS plus Zn sulfate (ORS+Zn) therapy in Nigeria. Aims and Objectives: The aim of this study was to assess the level of awareness and practice of ORS+Zn therapy among u-5 caregivers. Materials and Methods: Two local government areas, each representing urban and rural settings, were randomly selected. Awareness and practice of ORS+Zn therapy by 386 caregivers was assessed using a semi-structured interviewer-administered questionnaire. Frequency and percentages were used for categorical data and the influence of sociodemography was analyzed by using Pearson's correlation method. Results: Awareness and practice of Zn therapy was higher among the caregivers in the urban setting, who seems to be more exposed to information on the efficacy of ORS+Zn therapy (p < 0.05). Caregivers of u-5 children living in the rural settings were deficient in information on the use of ORS and Zn salts in the management of child diarrhea. In summary, of the 386 caregivers, 123 (62%) indicated awareness of Zn salt, and of these only 39 (10%) practiced Zn salt treatment. Level of education seems to influence awareness and practice positively in the urban setting (p < 0.05). Economic status underscored by employment type, clinic visits, and health campaigns influenced positively the adoption of ORS+Zn therapy in the rural and urban communities (p < 0.05). Tertiary education, which is the highest level of education, showed a positive association with awareness and practice of ORS+Zn treatment in both study areas (p < 0.05). One hundred and ninety-nine caregivers (52%) of all the respondents still preferred to treat child diarrhea with ORS with antibiotics adjuvant. Conclusion: Practice of ORS+Zn therapy is low and seems to be influenced by level of education, awareness, and location and availability. Advocacy and sensitization programs should be intensified, and intake of food rich in Zn and Zn supplement should be promoted in infant-feeding practices. Investigating the level of awareness and extent of financial risk protection among the population in Enugu state, southeast Nigeria Chijioke Okoli, Eric Obikeze, Charles Ezenduka, Ejikeme Arodiwe, Ogbonnia Ochonma, Obinna Onwujekwe International Journal of Medicine and Health Development 2019 24(2):70-77 Objective: The study investigated the level of awareness and extent of financial risk protection among the population in Enugu state, southeast Nigeria. Materials and Methods: A mixed-method approach involving cross-sectional quantitative and qualitative methods was adopted for data collection and analysis. The study was conducted in two purposively selected urban and rural local government settings in Enugu North and East senatorial zones, respectively. Results: The quantitative results show that most of the respondents (77.1%) were women and 80.2% were married. Slightly above a quarter of the respondents (25.6%) were self-employed, whereas 29.1% were main income earners. Out-of-pocket (OOP) dominates payment mechanisms (94.9%), whereas more than half (54.4%) of the respondents went to patent medicine dealers for treatment in the last one month. Logistic regression shows overall significance in use of prepayment mechanisms with χ2 = 56.57 and P = 0.001. More so, finding indicates that 55.9% of respondents have heard of prepayment mechanisms mainly from television (30.4%) and radio program (20.2%), while 89.5% has not used any prepayment mechanism in the State. Conclusion: OOP still dominates payment mechanism in Enugu state. Although over half of the respondents (55.9%) have heard of prepayment mechanisms, approximately 90% has not used any prepayment mechanism in the State. This calls for policy that will ensure moving away from OOP payment to prepayment mechanism through health system strengthening and awareness creation for the populace. Comparative study of six-month and eight-month treatment of new smear positive tuberculosis cases at a tertiary health facility in Enugu, South-Eastern Nigeria Babatunde I Omotowo, Ijeoma Itanyi, Edmund O Ndibuagu, Chuka C Agunwa, Ikechukwu E Obi, Arthur C Idoko, Anne C Ndu International Journal of Medicine and Health Development 2019 24(2):78-84 Introduction: Factors that affect tuberculosis (TB) treatment outcomes are important and should be investigated to achieve the targets of TB control program. Aims and Objectives: The aim of this study was to compare treatment outcomes of new smear positive TB patients treated for six months with those treated for eight months. Materials and Methods: A retrospective study of 600 new smear-positive TB patients was carried out. The data were analyzed using Stata version 22 (SPSS Inc., Chicago, Illinois, USA), and the values of P < 0.05 were considered statistically significant. Binary logistic regression was used to identify factors that influenced treatment outcomes. Results: Overall, a higher proportion of patients (78.6%) who were treated for six months had successful treatment outcomes as compared with those treated for eight months 64.4% (P = < 0.001, OR = 2.03, CI = 1.41–2.91). After adjusting for confounders, sex (P = 0.040, AOR = 0.65, CI = 0.44–0.98), treatment duration (P < 0.001, AOR = 2.27, CI = 1.53–3.39), and pretreatment weight (P = 0.007, AOR = 1.28, CI = 1.07–1.52) independently predicted treatment outcome. Conclusion: The treatment success rate was better among the patients treated for six-month duration than those treated for eight-month duration. The current six-month regimen recommended by WHO should be maintained. Loss to follow-up and TB/HIV coinfection management should be improved. A need for specialized education in pediatric radiography in Nigeria Odira C Ewuzie International Journal of Medicine and Health Development 2019 24(2):85-88 Introduction: Pediatrics is a vast field with many facets. The importance of having dedicated specialists trained in the treatment and care of pediatric patients has long been recognized. It is necessary to determine if the profession of radiography is making similar progress in improving on the pediatric radiography services offered in the country. Objective: The objective of this study was to establish if there was a perceived need for specialized pediatric radiographic education in Nigeria. Subjects and Methods: This was a descriptive cross-sectional survey, which accessed radiographers' take on the need for specialized education in pediatric imaging. A Google Form link was distributed through various Nigerian radiographers' WhatsApp groups, inviting interested radiographers to participate in stating their opinions on the need for specialized pediatric radiographic education in the country and other related questions. Data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Results were presented using tables and charts. Results: Seventy-six radiographers working in 25 states across the federation participated in the online survey. A total of 90.8% of the respondents stated there was a need for specialized radiographic education in pediatric imaging, and 64.5% felt that this education or training opportunities for radiographers was inadequate. Only 43.4% were comfortable performing pediatric imaging. Conclusion: Majority of the radiography departments in Nigeria do not have dedicated equipment or staff for pediatric radiography. Undergoing specialized pediatric imaging training will benefit radiographers who are keen on improving the radiography services offered to pediatric patients. Second-phase delay in accessing major elective surgeries from a public tertiary health institution in Nigeria: The role of financial constraints Ikenna I Nnabugwu, Fredrick O Ugwumba, Jude K Ede International Journal of Medicine and Health Development 2019 24(2):89-94 Background: Many factors contribute to second-phase delay in accessing surgical care electively especially in low-income settings. The aim of this study was to evaluate second-phase delay in elective surgical care in a tertiary hospital. Materials and Methods: This study is a hospital-based cross-sectional survey conducted at a tertiary health institution in Nigeria from February to September 2017. Sampling units were households that accessed major elective surgical operation from the general surgery and urology units of the institution for an adult member (≥18 years of age) of the household. Analysis was performed using the Statistical Package for Social Sciences software version 20.0 (IBM SPSS Inc, Chicago, USA). Results: In total, 495 households representing same number of patients participated in the study. Second-phase interval was within one month in 16.2% of households. It was delayed 2–6 months in 55.2% of households, 6–12 months in 16.2% of households, and more than 12 months in 12.5% of households. Financial constraint was reported as reason for the observed second-phase interval in 54.7% of households with 93.4% of these households delayed for longer than one month and 38.0% for more than six months. Financial constraint was significantly more prevalent among larger households (OR 7.64; 95%CI 1.89–30.78; P < 0.01) and households in the lower wealth quartiles (OR 0.73; 95%CI 0.55–0.97; P = 0.03). Few households (7.1%) accessed health insurance for the prescribed major surgery and only 8.6% of those insured households reported financial constraints. Conclusion: Longer second-phase delay attributable to financial constraints is prevalent among larger households comprising mostly children, households in the lower socioeconomic quartiles, and uninsured households. Entry points into a Nigerian medical school at the graduate and undergraduate levels: A three-year prospective and retrospective comparison of performances at the first MBBS professional examinations Ed Nwobodo, Uchechukwu Dimkpa, Chidiebere Ugwu, Ugochukwu B Anyaehie International Journal of Medicine and Health Development 2019 24(2):95-99 Background: It is alleged that there is a mismatch between candidates' performance in University Matriculation Examination (UME) and their subsequent academic achievement in medical schools in Nigeria. Aim: The present study compares the performance of medical students admitted via Direct Entry (DE) module and that of UME using their 1st professional examination. Methodology: A total of 343 undergraduate medical students of College of Medicine, Nnamdi Azikiwe University, Nnewi, Anambra state, Nigeria were used for this study. 270 of the students were admitted through UME, while 73 were admitted through DE modes of admission. The results of the 1st MBBS examinations taken in the years 2014 to 2017 were collated, analyzed and compared between the two groups of students. Results: The rate of success in 1st MBBS examination was greater in the DE students (74%) compared with the UME students (44.1%). The failure rate was higher in the UME entrants (55.9%) compared with the direct entrants (26%). The frequency of withdrawals in the group with UME (n = 28) was greater than that of the group with DE (n = 0). Chi square test of association indicated significant (p < 0.001) association between performance of students in 1st MBBS examination and the mode of admission. Logistic regression test shows that the odds of failure were against students with UME module than those with DE. Conclusion: The present study indicates that the admission module of DE with previous degree increases the chances of academic success in medical education in Nigeria. This suggests the need for a review of the mode of admission into medical schools to favour students that have a previous degree. Prospective analysis of extremity gunshot injuries treated in a Nigerian regional trauma center Omolade A Lasebikan, Njoku I Omoke, Ndubuisi O Onyemaechi, Emmanuel C Iyidobi, Wilson I Anetekhai International Journal of Medicine and Health Development 2019 24(2):100-106 Background: Extremity gunshot injuries are a common cause of morbidity and mortality in our environment. They pose a management challenge because of the complex soft tissue and bony injuries. Objectives: The objectives of this study was to determine the pattern and treatment outcomes of these injuries in our setting. Materials and Methods: This was a prospective study of extremity gunshot injuries treated at National Orthopaedic Hospital, Enugu, Nigeria over a 12-month period. Results: Fifty-five patients were studied, with a mean age of 36.9 ± 13.39 years and a male-to-female ratio of 8.2:1. The two top causes of gunshot injuries were armed robbery (41; 74.5%) and assaults/communal clash (6; 10.9%), and the most common type of gun was the rifle (21; 38.2%). Gunshot fracture was the commonest type of injury among the patients (39, 70.9%). Only 34.5.1% of our patients presented to hospital within the first 6h. Secondary wound closure was the commonest method of wound cover. Majority of the gunshot fractures were treated non-operatively. The duration of hospitalization ranged from 2 days to 13 weeks with a mean duration of 4.9 weeks. Late presentation, presence of fracture, and wound infection were associated with prolonged hospital stay. Outcome of treatment was good in 80% of patients and the mortality rate was 1.8%. Conclusion: The young adult males are more involved in extremity gunshot injuries. The fracture rate of these injuries is high with associated increased morbidity. Effective control measures aimed at reducing the incidence of gunshot injuries will reduce the negative socioeconomic impact of these injuries. Unregulated drug use and consequences in the Nigerian health sector Chinwe L Onyekonwu, Chijioke G Onyekonwu, Emmanuel O Ugwu International Journal of Medicine and Health Development 2019 24(2):107-113 Background: The Nigerian health system is bedeviled with poor regulatory services, frequent interruption of services as a result of disharmony among different cadres of health-care providers, inadequate manpower, poor management and leadership, and poor access to care due to non-enrollment in health insurance. Health-care spending is often catastrophic in most cases as payment is usually out of pocket for most service users. This has led to proliferation and patronage of unlicensed and unregulated health-care providers. Some patients are able to afford out of pocket payment but often meet suboptimal functioning services when they present to the hospitals which are also bedeviled by inadequate manpower and health-care facilities. Others who cannot afford the payments first patronize quacks and present later to the hospitals, sometimes with complications and attendant increase in morbidity and mortality. Aims and Objectives: The aim of this study was to highlight some problems that may arise as a result of unregulated drug use in the Nigerian populace and the role of an efficient health system with improved health insurance access, in curbing these problems. Materials and Methods: The reality of the Nigerian Health Care System as it stands today was highlighted and objectives of the National Health Insurance Scheme at inception cited. Three clinical cases of complications arising from poor access to health care and drug use regulation were described. Conclusion: Access to health care in Nigeria has remained poor and mostly out of pocket despite the goal of the National Health Insurance Scheme to provide health care at reduced costs. Patronage of unlicensed health-care providers remains high due to poor access to health care, poverty, and illiteracy with untoward effects on affected individuals. There is an urgent need to scale up access to health insurance across all sectors and ensure efficient service delivery through regular monitoring by appropriate regulatory agencies and constant education of the populace to discourage patronage of quack health-care providers. Carbamazepine-associated urinary incontinence: A case report and literature review Jamir P Rissardo, Ana L Fornari Caprara International Journal of Medicine and Health Development 2019 24(2):114-117 Carbamazepine (CBZ) is an anticonvulsant approved for the management of many neurological and psychiatric disorders. We present a case of an adult male with epilepsy who reported new seizures, and the dose of CBZ administered was 1600mg daily. CBZ dose was increased to 1800mg daily. The subject complained of urinary incontinence without dysuria that started after the CBZ dose increase. It was associated with urgency, hesitancy, dribbling of urine, and poor stream. Laboratory tests were within normal limits. He admitted dry mouth, flushing, constipation, and accommodation paralysis starting after CBZ increase. Assuming that these symptoms were an adverse drug reaction, CBZ was withdrawn and valproate was started. The individual had full recovery within four weeks. To the best of our knowledge, only two case reports of similar nature are available, but this is the first one to be reported with young male adult. Emphasizing on the need of preparedness and antibiotics supply for the containment of the plague outbreak Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava International Journal of Medicine and Health Development 2019 24(2):118-119
Awareness and practice of zinc therapy in diarrheal management among under-five caregivers in Enugu State, NigeriaJoshua I Ugwu, Ikechukwu E Ezeagu, Madu D IbegbuInternational Journal of Medicine and Health Development 2019 24(2):63-69Background: Acute diarrhea remains one of the leading causes of under -five years of age (u-5) childhood deaths in Nigeria. Use of zinc (Zn) sulfate monohydrate with low-osmolality oral rehydration solution (ORS) therapy reduces both the duration and severity of the...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Achieving the Lowest Effective Antipsychotic Dose for Patients with Remitted Psychosis: A Proposed Guided Dose-Reduction Algorithm Abstract Continuing antipsychotic treatment in patients with schizophrenia under clinical remission remains controversial. Even though the mainstream opinion declares an outweighed balance against medication discontinuation, recent reviews and critiques suggest that some patients may remain symptom free and well functioning after stopping antipsychotics, but few predictors can identify who can try medication discontinuation, whilst no guidelines exist for reducing medication to reach the lowest effective dose safely. Analyzing the findings from studies employing different methodologies, adopting evidence from pharmacodynamic research, and observing dose reduction in stable patients, as well as taking inspiration from the metaphor of the Cantor set in natural philosophy, we introduce an alternative solution and propose a guided dose-reduction algorithm that follows a set of clear precautions and instructions. The algorithm recommends only a fraction (no more than 25%) of the dosage to be reduced at a time, with at least a 6-month stabilization period required before reducing another 25% of the dose. Patients are empowered to actively participate in decision making when they are ready for further dose tapering, or should they retreat to a previous dosage if warning signs of a relapse re-emerge. An intermittent or irregular dosing schedule can be used to adapt this algorithm to real-world practice. Our preliminary findings suggest that patients with remitted psychosis can do well along this path. We anticipate that this approach can help optimize the risk–benefit ratio and instill a hope in patients with schizophrenia that they can maintain in stable remission under a lower antipsychotic dose without an increased risk of relapse. Acknowledgement to Referees Adverse Events Associated with Melatonin for the Treatment of Primary or Secondary Sleep Disorders: A Systematic Review AbstractBackground Melatonin is widely available either on prescription for the treatment of sleep disorders or as an over-the-counter dietary supplement. Melatonin has also recently been licensed in the UK for the short-term treatment of jetlag. Little is known about the potential for adverse events (AEs), in particular AEs resulting from long-term use. Concern has been raised over the possible risks of exposure in certain populations including pre-adolescent children and patients with epilepsy or asthma.Objectives The aim of this systematic review was to assess the evidence for AEs associated with short-term and longer-term melatonin treatment for sleep disorders.Methods A literature search of the PubMed/Medline database and Google Scholar was conducted to identify randomised, placebo-controlled trials (RCTs) of exogenous melatonin administered for primary or secondary sleep disorders. Studies were included if they reported on both the types and frequencies of AEs. Studies of pre-term infants, studies of < 1 week in duration or involving single doses of melatonin and studies in languages other than English were excluded. Findings from open-label studies that raised concerns relating to AE reports in patients were also examined. Studies were assessed for quality of reporting against the Consolidated Standards of Reporting Trials (CONSORT) checklist and for risk of bias against the Cochrane Collaboration risk-of-bias criteria.Results 37 RCTs met criteria for inclusion. Daily melatonin doses ranged from 0.15 mg to 12 mg. Subjects were monitored for up to 29 weeks, but most studies were of much shorter duration (4 weeks or less). The most frequently reported AEs were daytime sleepiness (1.66%), headache (0.74%), other sleep-related AEs (0.74%), dizziness (0.74%) and hypothermia (0.62%). Very few AEs considered to be serious or of clinical significance were reported. These included agitation, fatigue, mood swings, nightmares, skin irritation and palpitations. Most AEs either resolved spontaneously within a few days with no adjustment in melatonin, or immediately upon withdrawal of treatment. Melatonin was generally regarded as safe and well tolerated. Many studies predated publication of the CONSORT checklist and consequently did not conform closely to the guidelines. Similarly, only eight studies were judged 'good' overall with respect to the Cochrane risk-of-bias criteria. Of the remaining papers, 16 were considered 'fair' and 13 'poor' but publication of almost half of the papers preceded that of the earliest version of the guidelines.Conclusion Few, generally mild to moderate, AEs were associated with exogenous melatonin. No AEs that were life threatening or of major clinical significance were identified. The scarcity of evidence from long-term RCTs, however, limits the conclusions regarding the safety of continuous melatonin therapy over extended periods. There are insufficient robust data to allow a meaningful appraisal of concerns that melatonin may result in more clinically significant adverse effects in potentially at-risk populations. Future studies should be designed to comply with appropriate quality standards for RCTs, which most past studies have not. Fingolimod Increases Brain-Derived Neurotrophic Factor Level Secretion from Circulating T Cells of Patients with Multiple Sclerosis AbstractBackground The pathophysiology of multiple sclerosis involves an autoimmune and a neurodegenerative mechanism. Central nervous system-infiltrating immune cells in multiple sclerosis also possess a neuroprotective activity through secretion of neurotrophins, such as brain-derived neurotrophic factor. Fingolimod was shown to slow the progression of disability and loss of brain volume.Objective The objective of this study was to explore whether fingolimod induces secretion of neurotrophins by immune cells.Methods Blood was drawn from 21 patients before the initiation of treatment with fingolimod and at 6 and 12 months of follow-up. The levels of the neurotrophic factors brain-derived neurotrophic factor, glial cell-derived neurotrophic factor, β-nerve growth factor, neurotrophin-3, neurotrophin-4, basic fibroblast growth factor, epidermal growth factor, and vascular endothelial growth factor were screened in the supernatants of separated T cells and monocyte cultures using a customized, multiplex enzyme-linked immunosorbent assay. Brain-derived neurotrophic factor levels were further validated by a specific enzyme-linked immunosorbent assay.Results Treatment with fingolimod significantly increased brain-derived neurotrophic factor secretion from T cells. A specific enzyme-linked immunosorbent assay confirmed these results in the supernatant of T cells after 6 and 12 months of therapy.Conclusions T cells that reach the bloodstream of fingolimod-treated patients with multiple sclerosis may contribute to the neuroprotective effect of this therapy by increased secretion of brain-derived neurotrophic factor. This mechanism of action of fingolimod in patients with multiple sclerosis has not been previously reported. An Update on Vitamin D and Disease Activity in Multiple Sclerosis Abstract Vitamin D and its main active metabolite 1,25-dihydroxyvitamin D serve a crucial role in maintenance of a healthy calcium metabolism, yet have additional roles in immune and central nervous system cell homeostasis. Serum levels of 25-hydroxyvitamin D are a biomarker of future disease activity in patients with early relapsing–remitting multiple sclerosis (RRMS), and vitamin D supplementation in patients with low circulating 25-dihydroxyvitamin D levels has been anticipated as a potential efficacious treatment strategy. The results of the first large randomized clinical trials (RCTs), the SOLAR and CHOLINE studies, have now been published. The SOLAR study compared 14,000 IU of vitamin D3 (cholecalciferol) per day with placebo for 48 weeks in 232 randomized patients, whereas CHOLINE compared vitamin D3 100,000 IU every other week with placebo for 96 weeks in 129 randomized patients. All patients in both studies also used interferon-β-1a. None of the studies met their primary endpoints, which were no evidence of disease activity (NEDA-3) at 48 weeks in SOLAR and annualized relapse rate at 96 weeks in CHOLINE. Both studies did, however, suggest modest effects on secondary endpoints. Thus, vitamin D reduced the number of new or enlarging lesions and new T2 lesions in SOLAR, and the annualized relapse rate and number of new T1 lesions, volume of hypointense T1 lesions, and disability progression in the 90 patients who completed 96 weeks' follow-up in CHOLINE. We conclude that none of the RCTs on vitamin supplementation in MS have met their primary clinical endpoint in the intention to treat cohorts. This contrasts the observation studies, where each 25 nmol/l increase in 25-hydroxyvitamin D levels were associated with 14–34% reduced relapse risk and 15–50% reduced risk of new lesions on magnetic resonnance imaging. This discrepancy may have several explanations, including confounding and reverse causality in the observational studies. The power calculations of the RCTs have been based on the observational studies, and the RCTs may have been underpowered to detect less prominent yet important effects of vitamin D supplementation. Although the effect of vitamin D supplementation is uncertain and less pronounced than suggested by observational studies, current evidence still support that people with MS should avoid vitamin D insufficiency, and preferentially aim for vitamin D levels around 100 nmol/L or somewhat higher. Ischemic and Thrombotic Events Associated with Concomitant Xa-inhibiting Direct Oral Anticoagulants and Antiepileptic Drugs: Analysis of the FDA Adverse Event Reporting System (FAERS) AbstractIntroduction Factor Xa-inhibiting direct oral anticoagulants (FXa-DOACs) undergo hepatic metabolism via cytochrome P-450 (CYP450). Concomitant use of rifampicin, an inducer of these enzymes, with FXa-DOACs, has been shown to decrease FXa-DOAC concentrations in healthy subjects. Several common antiepileptic drugs (AEDs) are known to induce CYP450 enzymes as well. However, little is known regarding the impact of this potential interaction on treatment outcomes with FXa-DOACs.Methods We analyzed adverse event cases submitted to the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from January 2013 to December 2018. We compared the proportion of cases reporting thromboembolic and ischemic adverse events (TAIAEs) with the concomitant use of FXa-DOACs and enzyme-inducing AEDs to the proportion of cases with FXa-DOACs and other AEDs.Results During this period, 9693 adverse event cases reported concomitant use of FXa-DOACs and AEDs. Almost all reports (> 99%) involved the use of rivaroxaban or apixaban. Compared with other AEDs, enzyme-inducing AEDs were associated with an 86% increase in the odds of reporting TAIAEs [reporting odds ratio (ROR) 1.86, 95% confidence interval (CI) 1.61–2.15; p < 0.0001]. In secondary separate analyses of rivaroxaban and apixaban, enzyme-inducing AEDs were similarly associated with increased reporting of a TAIAE (ROR 1.79, 95% CI 1.50–2.12, and ROR 1.88, 95% CI 1.41–2.48, respectively).Conclusion Using real world data, we observed an increase in the odds of reporting anticoagulation treatment failure among patients treated with FXa-DOACs and concomitant enzyme-inducing AEDs compared to those treated with other AEDs. Risk Factors Associated with the Occurrence of Neonatal Opioid Withdrawal Syndrome: A Review Abstract In a number of countries, the prevalence of neonatal opioid withdrawal syndrome (NOWS) is increasing. While NOWS is ultimately the result of opioid exposure in utero, a wide range of risk factors have been associated with the prevalence of NOWS, extending beyond just drug exposure. This article reviews the available literature on factors associated with the incidence of NOWS in opioid-exposed neonates. A range of risk factors have been associated with NOWS, including features of neonatal drug exposure, maternal and neonatal characteristics, aspects of labor and delivery, and genetics. Increased length of gestation and higher birth weight were consistently associated with an increased risk of NOWS, while breast feeding and 'rooming-in' were associated with a reduced risk of NOWS. Additionally, several genetic factors have also been associated with NOWS severity. There is conflicting evidence on the association between NOWS and other risk factors including opioid dose, neonate sex, and the use of some medications during pregnancy. This may be in part attributable to differences in how NOWS is diagnosed and the variety of methodologies across studies. While a large number of risk factors associated with NOWS are non-modifiable, encouraging pregnant women to reduce other drug use (including smoking), breast feed their child, and the judicious use of medications during pregnancy may help reduce the prevalence of NOWS. The presence or absence of NOWS in an opioid-exposed neonate is associated with a wide range of factors. Some of these modifiable risk factors may be potential targets for the primary prevention of NOWS. Recent Advances in Pharmacotherapy for Episodic Migraine Abstract In 2018, three calcitonin gene-related peptide (CGRP) pathway monoclonal antibodies, erenumab, fremanezumab and galcanezumab, were approved in various parts of the world, including Europe and the US, and another, eptinezumab, is pending, for the prevention of migraine. In this article, episodic migraine treatment is reviewed, although these medicines are approved and are just as effective for chronic migraine. These new medicines usher a new phase in the preventive management of migraine with migraine-specific treatments. Data from phase III trials of CGRP pathway monoclonal antibodies have shown they are efficacious, with adverse effect rates comparable to placebo. The combination of clear efficacy and excellent tolerability will be welcome in an area where poor adherence to current preventives is common. Rimegepant, ubrogepant and lasmiditan are migraine-specific acute therapies yet to be approved by regulators. Phase III data for the respective CGRP receptor antagonists, the gepants, and the serotonin 5-HT1F receptor agonist, the ditan, have been positive and free of cardiovascular adverse effects. These medicines are not vasoconstrictors. When approved, they could meet the acute therapy demand of patients with cardiovascular risk factors where triptans are contraindicated. Beyond this, gepants will see the most disruptive development in migraine management in generations with medicines that can have both acute and preventive effects, the latter evidenced by data from the discontinued drug telcagepant and the early-phase drug atogepant. Moreover, one can expect no risk of medication overuse syndromes with gepants since the more patients take, the less migraines they have. During the next years, as experience with monoclonal antibodies grows in clinical practice, we can expect an evolution in migraine management to take shape. Clinicians will be able to offer treatment patients want rather than trying to fit migraineurs into therapeutic boxes for their management. Despite pessimistic susurrations of a largely addlepated form, many patients, and physicians, will welcome new options, and the challenges of new treatment paradigms, with optimism. Targeting Iron Dyshomeostasis for Treatment of Neurodegenerative Disorders Abstract While iron has an important role in the normal functioning of the brain owing to its involvement in several physiological processes, dyshomeostasis has been found in many neurodegenerative disorders, as evidenced by both histopathological and imaging studies. Although the exact causes have remained elusive, the fact that altered iron levels have been found in disparate diseases suggests that iron may contribute to their development and/or progression. As such, the processes involved in iron dyshomeostasis may represent novel therapeutic targets. There are, however, many questions about the exact interplay between neurodegeneration and altered iron homeostasis. Some insight can be gained by considering the parallels with respect to what occurs in healthy aging, which is also characterized by increased iron throughout many regions in the brain along with progressive neurodegeneration. Nevertheless, the exact mechanisms of iron-mediated damage are likely disease specific to a certain degree, given that iron plays a crucial role in many disparate biological processes, which are not always affected in the same way across different neurodegenerative disorders. Moreover, it is not even entirely clear yet whether iron actually has a causative role in all of the diseases where altered iron levels have been noted. For example, there is strong evidence of iron dyshomeostasis leading to neurodegeneration in Parkinson's disease, but there is still some question as to whether changes in iron levels are merely an epiphenomenon in multiple sclerosis. Recent advances in neuroimaging now offer the possibility to detect and monitor iron levels in vivo, which allows for an improved understanding of both the temporal and spatial dynamics of iron changes and associated neurodegeneration compared to post-mortem studies. In this regard, iron-based imaging will likely play an important role in the development of therapeutic approaches aimed at addressing altered iron dynamics in neurodegenerative diseases. Currently, the bulk of such therapies have focused on chelating excess iron. Although there is some evidence that these treatment options may yield some benefit, they are not without their own limitations. They are generally effective at reducing brain iron levels, as assessed by imaging, but clinical benefits are more modest. New drugs that specifically target iron-related pathological processes may offer the possibility to prevent, or at the least, slow down irreversible neurodegeneration, which represents an unmet therapeutic target. The Potential Therapeutic Capacity of Inhibiting the Brain Renin–Angiotensin System in the Treatment of Co-Morbid Conditions in Epilepsy Abstract Epilepsy is one of the most prevalent neurological diseases and although numerous novel anticonvulsants have been approved, the proportion of patients who are refractory to medical treatment of seizures and have progressive co-morbidities such as cognitive impairment and depression remains at about 20–30%. In the last decade, extensive research has identified a therapeutic capacity of the components of the brain renin–angiotensin system (RAS) in seizure- and epilepsy-related phenomena. Alleviating the activity of RAS in the central nervous system is considered to be a potential adjuvant strategy for the treatment of numerous detrimental consequences of epileptogenesis. One of the main advantages of RAS is associated with its modulatory influence on different neurotransmitter systems, thereby exerting a fine-tuning control mechanism for brain excitability. The most recent scientific findings regarding the involvement of the components of brain RAS show that angiotensin II (Ang II), angiotensin-converting enzyme (ACE), Ang II type 1 (AT1) and type 2 (AT2) receptors are involved in the control of epilepsy and its accompanying complications, and therefore they are currently of therapeutic interest in the treatment of this disease. However, data on the role of different components of brain RAS on co-morbid conditions in epilepsy, including hypertension, are insufficient. Experimental and clinical findings related to the involvement of Ang II, ACE, AT1, and AT2 receptors in the control of epilepsy and accompanying complications may point to new therapeutic opportunities and adjuvants for the treatment of common co-morbid conditions of epilepsy.
Achieving the Lowest Effective Antipsychotic Dose for Patients with Remitted Psychosis: A Proposed Guided Dose-Reduction AlgorithmAbstractContinuing antipsychotic treatment in patients with schizophrenia under clinical remission remains controversial. Even though the mainstream opinion declares an outweighed balance against medication discontinuation, recent reviews and critiques suggest that some patients may remain symptom free and well functioning after stopping antipsychotics, but few predictors...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Patient-Reported Outcomes in Adult Idiopathic Inflammatory Myopathies AbstractPurpose of Review Idiopathic inflammatory myopathies (IIM) have considerable impact on patient symptoms and quality of life. We have reviewed the evolution of patient-centered care and use of patient-reported outcome measures (PROMs) for adults with IIM.Recent Findings Use of PROMs in myositis care and research is limited, although the importance of incorporation into routine practice and trials has become increasingly recognized. Several key domains/measures have been identified including the patient global assessment of disease activity, physical function as measured by the health assessment questionnaire-disability index (HAQ-DI), Short Form Health Survey-36 (SF-36), or the Patient-Reported Outcome Measurement Information System ® (PROMIS®) in adult IIM. Data are limited for these instruments concerning their reliability, content and construct validity, and responsiveness.Summary Incorporation of the patient perspective into clinical care and research may be used to address the unmet/unaddressed needs of the patient living with myositis. Several ongoing projects aim to bring validated PROMs to the IIM community. "Mobile Health" for the Management of Spondyloarthritis and Its Application in China AbstractPurpose of the Review Spondyloarthritis (SpA) is a group of inflammatory diseases characterized by inflammation in the spine, peripheral joints, and entheses that usually start at the prime of one's life and lead to impaired physical function and reduced quality of life. Ankylosing spondylitis (AS) is prototype of SpA. This article reviews the opportunities and challenges of using mobile health (mHealth) in managing SpA, and report some of our experiences using a mHealth solution for management of SpA patients and performing related research in China.Recent Findings The recent rapid development of mobile communications and the common use of intelligent electronic devices have led to the increasing application of mHealth for chronic disease management by healthcare providers and patients alike. This is a promising new technology that can help mitigate limitations in time and space for patient management, promote easier communication between patients and their healthcare providers, reduce medical expenses, and optimize medical services. We have developed a smartphone-based mHealth SpA management system (SpAMS) that also helps the patients to monitor, manage, and share information on their disease with their physician at regular intervals.Summary There is a shift from a paternalistic model of healthcare to more personalized healthcare in which disease management is conducted by the patient together with their healthcare providers. The increasing utility of mHealth is expected to benefit disease management, promote patient–doctor communication, reduce medical expenses, and optimize medical services. Chlamydia -Induced Reactive Arthritis: Disappearing Entity or Lack of Research? AbstractPurpose of Review Recent studies regarding the frequency of Chlamydia-induced reactive arthritis (ReA) are reviewed, with a focus on the question of whether the entity is in fact disappearing or whether it is simply being underdiagnosed/underreported. Epidemiological reports indicate diversity in the frequency of Chlamydia-associated ReA in various parts of the world, with evidence of declining incidence in some regions.Recent Findings The hypothesis that early effective treatment with antibiotics prevents the manifestation of Chlamydia-associated ReA requires further investigation.Summary For clinicians, it is important to remember that ReA secondary to Lymphogranuloma venereum (LGV) serovars L1–L3 of C. trachomatis is probably underestimated due to a limited awareness of this condition, the re-emergence in Western countries of LGV overall, and the present increasingly rare classical inguinal presentation. Understanding the Cryoglobulinemias AbstractPurpose of the Review Cryoglobulins are immunoglobulins with the ability to precipitate at temperatures <37 °C. They are related to hematological disorders, infections [especially hepatitis C virus (HCV)], and autoimmune diseases. In this article, the state of the art on Cryoglobulinemic Vasculitis (CV), in a helpful and schematic way, with a special focus on HCV related Mixed Cryoglobulinemia treatment are reviewed.Recent Findings Direct – acting antivirals (DAA) against HCV have emerged as an important key in HCV treatment to related Cryoglobulinemic Vasculitis, and should be kept in mind as the initial treatment in non–severe manifestations. On the other hand, a recent consensus panel has published their recommendations for treatment in severe and life threatening manifestations of Mixed Cryoglobulinemias.Summary HCV-Cryoglobulinemic vasculitis is the most frequent form of CV. There are new treatment options in HCV-CV with DAA, with an important number of patients achieving complete response and sustained virologic response (SVR). In cases of severe forms of CV, treatment with Rituximab and PLEX are options. The lack of data on maintenance therapy could impulse future studies in this setting. Qigong and Musculoskeletal Pain AbstractPurpose of Review Musculoskeletal pain is a widespread symptom that commonly produces considerable disability, particularly in later life. This brief review strove to summarize and critically review the recent research base concerning the use of Qigong as a possible strategy for alleviating longstanding or chronic musculoskeletal pain states.Methods Research reports and literature reviews specifically focusing on Qigong and its impact on various forms of musculoskeletal pain between 2015 and 2019 were sought and analyzed, along with related data.Results Collectively, these data reveal that while more research is indicated, Qigong practice may help to attenuate pain in varying degrees among adults with different forms of chronic pain with few side-effects.Conclusion More research is needed to ensure health professionals working with adults who have chronic unrelenting musculoskeletal pain may safely recommend these exercises as one possible remedy for reducing intractable musculoskeletal pain. The Pathogenesis of Ankylosing Spondylitis: an Update AbstractPurpose of Review Ankylosing spondyloarthritis (AS) is a chronic inflammatory disease that involves the axial joints and entheses. Extra-spinal manifestations such as anterior uveitis, psoriasis, and colitis also occur frequently. This review on the pathogenesis of AS includes an update on the recent discoveries within the field.Recent Findings HLA-B*27 is still considered of major importance in the pathogenesis, and it has recently been shown to profoundly affect the gut microbiome and its metabolites and the handling of bacteria during infection. Biochemical and biophysical properties of HLA-B*27 influence its ability to misfold, to induce an endoplasmic reticulum stress response, and to promote autophagy/unfolded protein responses (UPR). HLA-B*27 free heavy chains may induce inflammation through T cells, NK cells, and myeloid cells. Induction of UPR genes results in release of tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), IL-23, and interferon-γ and increase in T helper (Th) 17 cells. Several other HLA-B and non-B molecules have been associated with AS, although their role in the pathogenesis is unknown.Summary Genotypes of endoplasmic reticulum aminopeptidases (ERAP) 1 and 2 have been associated with alterations in the antigenic pool expressed by HLA-B*27 molecules. In the gut, innate immune cells type 3 (ILC3) influence T cell expression of IL-17 and IL-22. Gamma-delta (γ/δ) T cells are induced by IL-23 to produce IL-17. IL-7 induces mucosa-associated invariant T (MAIT) cells to produce IL-17. Besides the microbiome, zonulin may be important through its effects on the permeability of tight junctions in the intestinal epithelial barrier. Clinical Insights into Diffuse Alveolar Hemorrhage in Antiphospholipid Syndrome AbstractPurpose of Review Diffuse alveolar hemorrhage (DAH) is a rare but devastating manifestation of antiphospholipid syndrome (APS) patients with or without other systemic autoimmune diseases. Data regarding diagnosis and treatment are limited to case series. We review diagnostic and therapeutic strategies employed in APS patients with DAH and discuss our experience in managing these complex patients.Recent Findings Pulmonary capillaritis likely contributes to the pathogenesis, however is only observed in half of the biopsies. Corticosteroids induce remission in the majority of patients, however almost half recur and require a steroid-sparing immunosuppressive to maintain remission. Cyclophosphamide- or rituximab-based regimens achieve the highest remission rates (50%); other strategies include intravenous immunoglobulin, plasmapheresis, mycophenolate mofetil, and/or azathioprine.Summary Given the rarity of DAH in APS, treatment is guided by interdisciplinary experience. Why certain patients achieve full remission with corticosteroids while others require immunosuppressive agents is unknown; future research should focus on the pathophysiology and optimal management. Transitional Care in Rheumatology: a Review of the Literature from the Past 5 Years AbstractPurpose of Review Effective transitional care for adolescents and young adults (AYA) with rheumatic musculoskeletal disease (RMD) is fundamental to rheumatology care provision. Here we review the recent evidence from the literature on transition in rheumatology and debate why universal implementation has yet to be recognised.Recent Findings Evidence of need for transitional care continues to be reported. The triphasic nature of transitional care remains poorly recognised, and the third phase following transfer to adult rheumatology is particularly under-researched in spite of the recognition of the age-related trajectories of transition skill development during young adulthood. Several rheumatology-specific transitional care interventions have now been evaluated but the search for valid measures including outcome continues. Finally, the need to study transition at a health system level is increasingly recognised.Summary Future research in this area should consider the developmental trajectories of AYA as well as the social-ecological model of transition readiness, which focuses on the interactions between AYA, caregivers and providers (and the systems they are part of) as these are the likely targets of any intervention to improve health transitions. Orbital Vasculitides–Differential Diagnosis AbstractPurpose of Review The orbit is subject to a variety of vascular insults that manifest with both specific and nonspecific patterns of vision compromise. The aim of the following review is to highlight the ophthalmic clinical features of systemic vasculitides that most frequently involve the orbit and differentiate them from the most common non-vasculitic orbital disorders.Recent Findings New studies continue to explore the autoimmune nature of vasculitic disease and seek to determine optimal use of newer therapies such as biologic agents.Summary The pattern of ocular involvement in the context of clinical history allows the knowledgeable physician to distill a differential diagnosis into a specific or likely cause. Establishing a diagnosis in a timely fashion allows for a custom-tailored approach to therapy. Novel Developments in Primary Immunodeficiencies (PID)—a Rheumatological Perspective AbstractPurpose of Review The purpose of this review is to provide an overview of the most relevant new disorders, disease entities, or disease phenotypes of primary immune deficiency disorders (PID) for the interested rheumatologist, using the new phenotypic classification by the IUIS (International Union of Immunological Societies) as practical guide.Recent Findings Newly recognized disorders of immune dysregulation with underlying mutations in genes pertaining to the function of regulatory T cells (e.g., CTLA-4, LRBA, or BACH2) are characterized by multiple autoimmune diseases—mostly autoimmune cytopenia—combined with an increased susceptibility to infections due to hypogammaglobulinemia. On the other hand, new mutations (e.g., in NF-kB1, PI3Kδ, PI3KR1, PKCδ) leading to the clinical picture of CVID (common variable immmune deficiency) have been shown to increasingly associate with autoimmune diseases.Summary The mutual association of autoimmune diseases with PID warrants increased awareness of immunodeficiencies when diagnosing autoimmune diseases with a possible need to initiate appropriate genetic tests.
Patient-Reported Outcomes in Adult Idiopathic Inflammatory MyopathiesAbstractPurpose of ReviewIdiopathic inflammatory myopathies (IIM) have considerable impact on patient symptoms and quality of life. We have reviewed the evolution of patient-centered care and use of patient-reported outcome measures (PROMs) for adults with IIM.Recent FindingsUse of PROMs in myositis care and research is limited, although the importance of incorporation into routine practice and trials has become increasingly recognized....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Predictors and prevalence of bipolar disorders in patients with a major depressive disorder Reda M Ismail, Hala T Mohamed, Rania A Hamed, Sherif A Helal Egyptian Journal of Psychiatry 2019 40(3):127-136 Introduction Onset of bipolar disorder (BD) involves a major depressive episode (MDE) in approximately half of type-I (BD-I) patients and three-quarters of those diagnosed with type-II (BD-II). Aim To detect the soft signs and the predictors of BD in patients with a MDE. Participants and methods A sample of 500 patients was solicited fulfilling the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnostic criteria for a current MDE. Patients were given the HCL-32-R2 questionnaire to assess the presence of manic/hypomanic symptoms; those scoring less than 14 were considered bipolar. We also examined whether demographics, psychiatric history, clinical characteristics, and the incidence of comorbid conditions differed significantly between patients with BD and unipolar disorder. Results A number of factors were highly predictive of bipolarity, including age at illness onset, family history of bipolarity, seasonality, mixed state, manic switch, mood irritability, and mood reactivity. Of the comorbidities examined, thyroid disorders, cardiovascular disorders, generalized anxiety disorder, presence of psychotic features, and borderline personality disorder occurred at a higher rate in patients with BDs than in those with unipolar disorders. Conclusion A number of factors in the patient's psychiatric history as well as clinical aspects of the episode itself may signal an increased likelihood of bipolarity. Schizophrenia symptom dimensions in correlation to patients' demographic and clinical characteristics Samah Rabei, Haitham Osama ElBoraie, Nesrin Elsaadouni, Mohamed Ezzat Elhadidy Egyptian Journal of Psychiatry 2019 40(3):137-140 Background Schizophrenia symptom dimensions could vary with clinical and demographic variables. Materials and methods A total of 100 patients with schizophrenia were diagnosed based on the Diagnostic and statistical manual criteria of the American Psychiatric association. Positive and negative symptom scale was used to assess schizophrenia symptoms. The search for possible correlations between dimensions and demographic and clinical variables was done by Pearson correlation coefficient. Results and conclusion Symptom dimensions showed a correlation with age, onset, duration, hospitalization, compliance to medication, duration without treatment, and family history of schizophrenia. Intercorrelation of symptom dimensions in patients with schizophrenia Nesrin Elsaadouni, Haitham Elboraie, Samah Rabei, Ahmed Elboraie Egyptian Journal of Psychiatry 2019 40(3):141-146 Background The heterogeneity of schizophrenia symptoms is well documented. The positive and negative distinction is limited to cover the entire spectrum of schizophrenia phenomenology. Aim The aim of the study is to find out the major symptom dimensions of phenomenology in a sample of schizophrenic patients. Materials and methods We recruited 100 schizophrenic patients. Diagnosis was based on diagnostic and statistical manual criteria. Positive and negative symptoms scale was used to assess schizophrenia symptoms. Patients' scores were subjected to factor analysis with varimax rotation. Internal consistency was determined by the use of Cronbach's α. Results Five dimensions (factors) were produced: negative, excitement, positive, depressive, and cognitive dimensions. Internal consistency was quite satisfactory. Psychosocial aspects and personality dimensions among a sample of patients with irritable bowel syndrome Hala M Abd Elaziz, Reda M Ismail, Hala T Mohammed, Shimaa Y Abd Elaziz Egyptian Journal of Psychiatry 2019 40(3):147-154 Background Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal tract, a burden to society through total direct costs, reduced social functioning, and quality of life impairment. Aim The aim of the study was to determine the associated psychosocial risk factors and personality traits in a sample of IBS patients. Participants and methods A total of 100 patients of IBS were recruited from the Gastroenterology and Internal Medicine Outpatient Clinics Departments at Al Zahraa University Hospital during the period from January 2018 to August 2018 and 100 apparently healthy participants as the control group (aged 18–45 years) were subjected to clinical psychiatric assessment, Eysenck's Personality Questionnaire, Stressor life events questionnaire, and Structured Clinical Interview for DSM-IV Axis I. Results The total number of cases was 100 [25 (25%) men and 75 (75%) women] with a mean age of 34.18±6.4 years; there was statistical significance regarding age, sex, marital status, and high significance in family history of IBS, education, employment; 51% had long duration of illness of more than 5 years. High neuroticism score was detected in 63% of the patients versus (VS) 20% of the control group and 52% of the patients had low extroversion VS 16% in the control group. There was high statistical significance in family, economic, social, emotional, health, and personal stressors. Moreover, 66% of the patients had psychiatric comorbidity, high statistical significance with generalized anxiety disorder and hypochondriasis, and statistical significance with somatization, dysthymic disorder, mixed anxiety depression, and panic disorder. Conclusion In this study, we found that IBS was associated with significant psychological distress and psychiatric comorbidities as psychosocial factors, so good assessment and early recognition will permit early intervention to improve outcome of the IBS and quality of life. Effect of adult attention-deficit hyperactivity on disability and quality of life of bipolar patients Amira A Fouad, Heba A Fouad, Shimaa I Amin Egyptian Journal of Psychiatry 2019 40(3):155-161 Background Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disease, usually first diagnosed during childhood or adolescence. A significant portion (∼50–65%) of ADHD symptoms persist into adulthood. Adult ADHD and bipolar disorder (BD) are common comorbid psychiatric conditions. Comorbidity between BD and adult ADHD has been reported in both ADHD and BD cases. Aim To determine the effect of comorbid adult ADHD on disability and quality of life of patients with bipolar disorder. Patients and methods This is a cross-sectional study that was done at the Psychiatric Department in the Zagazig University Hospitals, Sharkia Governorate, Egypt, during the period from May to November, 2017. One hundred and two euthymic patients with Diagnostic and statistical manual of mental disorders, 4th ed. − text revision diagnosis of BD I were selected by simple random probability sampling from the patients with bipolar disorder who came for follow-up and to receive their medications from psychiatric outpatient clinic. Results The mean age of the participants ranged from 18 to 40 years, and 51% were female. Patients with bipolar disorder with adult ADHD had more disability in work, social life, and family life than patients with pure bipolar disorder. Moreover, patients with bipolar disorder without adult ADHD had significant better quality of life in all domains as reflected by higher scores in WHO quality-of-life scale than patients with adult ADHD. Conclusion Adult ADHD is a frequent comorbid disorder in patients with BD. Adult ADHD comorbidity negatively affects functioning and quality of life of patients with BD. Psychiatric aspects of children who witness domestic violence Zeinab Gomma, El Sayed Saleh, Yomna Rizk, Dalia Asfour Egyptian Journal of Psychiatry 2019 40(3):162-169 Background The presence of domestic violence witnessed by children leads to development of different mental disorders of childhood. Objectives This study was aimed to assess the prevalence of psychiatric disorders in children who witness domestic violence. Patients and methods A community-based case–control study was designed to assess the prevalence of psychiatric disorder in children who witness domestic violence of both sexes aged 6–18 years old with different socioeconomic classes. Tools of measurement used in the current study were Hurt, Insulted, Threatened with Harm and Screamed tool; socioeconomic scale by El-Gilany; symptoms check list (SCL-90); and Structured Clinical Interview for DSM-IV Childhood Diagnoses for child's interview. Results The most common disorders among children witness domestic violence is conduct disorder (15%), major depressive disorder (10%), and attention-deficit hyperactive disorder (8.3%). Children who are not affected among studied families (cases) represented 33.3%. There was a statistically significant difference among cases that witness domestic violence and controls who did not witness it regarding additional signs, loss of appetite, insomniac problems, death ideas, aggressive symptom, and reactive sensitivity symptoms reported as well as global stress indices measured by SCL-90. The most common reason for domestic violence was the financial reasons. Fathers are more responsible for most of the violence incidents. Conclusions Ignoring of suffering and the long duration spent with domestic violent atmosphere without seeking help increase the risk for psychiatric disorder in those children. So legal empowerment and aid projects are essential in raising awareness to influence cultural change and put an end to domestic violence.
Predictors and prevalence of bipolar disorders in patients with a major depressive disorderReda M Ismail, Hala T Mohamed, Rania A Hamed, Sherif A HelalEgyptian Journal of Psychiatry 2019 40(3):127-136Introduction Onset of bipolar disorder (BD) involves a major depressive episode (MDE) in approximately half of type-I (BD-I) patients and three-quarters of those diagnosed with type-II (BD-II). Aim To detect the soft signs and the predictors of BD in patients with a MDE. Participants and methods A sample...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Information for CME Credit—Adherence to Cervical Cancer Screening Guidelines Among Women Aged 66–68 Years in a Large Community-Based Practice Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Ettinger de Cuba SA, Bovell-Ammon AR, Cook JT, et al. SNAP, young children's health, and family food security and healthcare access. Am J Prev Med. 2019;57(4)525–532 Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): U.S. Immigration Law Enforcement Practices and Health Inequities Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Paul J. Fleming, Nicole L. Novak, William D. Lopez Expanding Diabetes Prevention: Obstacles and Potential Solutions Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Michael Bergman The Obesity Parenting Intervention Scale: Factorial Validity and Invariance Among Head Start Parents Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Roger Figueroa, Jaclyn A. Saltzman, Alyssa Aftosmes-Tobio, Kirsten K. Davison IntroductionObesity affects 15.7% of U.S. preschoolers, with higher rates among low-income and Spanish-speaking populations. Food, physical activity, and sleep parenting practices, referred to collectively as obesity-related parenting practices, are linked with children's risk of obesity and are a common target in family-based obesity interventions. Yet, there is no brief, validated measure of obesity-related parenting practices that is appropriate for use in intervention studies and for diverse audiences. This study tests the factorial validity of a brief measure of obesity-related parenting and measurement invariance of the English and Spanish versions of the scale, as well as among mothers and fathers. MethodsParents of children enrolled in Head Start (n=578; 500 mothers and 78 fathers) completed a brief survey of food (7 items), physical activity (5 items), and sleep parenting (3 items) in fall of 2017 and 2018. Scale items were drawn from existing measures and the evidence base, initially drafted in English, and then translated to Spanish. One parent per family completed the scale independently in English (n=448) or Spanish (n=130). A confirmatory factor analysis framework was adopted to test a 3-factor model for the total sample. Multi-group structural equation modeling was used to assess measurement invariance of the scale by the language of administration (English or Spanish) and among mothers and fathers separately. ResultsResults supported a 3-factor model of obesity parenting with a single factor each for food, physical activity, and sleep parenting. There was statistically significant measurement invariance across all groups (p<0.05). Internal consistency was adequate across factors (α=0.65−0.80). ConclusionsThis brief obesity-parenting scale demonstrates adequate factorial validity in English and Spanish and among mothers and fathers. This measure has been integrated into an intervention, and future work will test sensitivity to change. A Methodologic Systematic Review of Mobile Health Behavior Change Randomized Trials Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Theodora Oikonomidi, Alexandre Vivot, Viet-Thi Tran, Carolina Riveros, Elisabeth Robin, Philippe Ravaud ContextMobile health helps providers offer accessible, affordable, tailored behavior change interventions. However, research assessing mobile health interventions may feature methodologic shortcomings and poor reporting. This review aims to summarize the characteristics, methods, and intervention reporting of RCTs evaluating mobile health behavior change interventions. Evidence acquisitionThis was a methodologic systematic review of RCTs assessing mobile health behavior change interventions published in PubMed from January 1, 2014 to January 1, 2018, in journals with the upper half of Impact Factors (Clarivate Analytics). Three reviewers independently extracted sample characteristics. Primary outcomes were classified as patient-important or not using definitions from the literature. Any non–patient-important outcomes were then reclassified by a panel of 3 patients. Intervention reporting was assessed by the mobile health Evidence Reporting and Assessment checklist. Data were analyzed in December 2018. Evidence synthesisMost of the 231 included RCTs assessed text messaging (51%) or smartphone app (28%) interventions aiming to change nutrition and physical activity (36%) or treatment adherence (25%). Only 8% of RCTs had a patient-important primary outcome, follow-up of ≥6 months, and intent-to-treat analysis. Most primary outcomes were behavioral measures (60%). Follow-up was <3 months in 29% of RCTs. Regarding reporting, 12 of the 16 checklist items were reported in less than half of RCTs (e.g., usability/content testing, 32%; data security, 13%). ConclusionsReports of RCTs assessing mobile health behavior change interventions lack information that would be useful for providers, including reporting of long-term intervention impact on patient-important primary outcomes and information needed for intervention replicability. Firearm Storage Practices and Risk Perceptions Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Amanda I. Mauri, Julia A. Wolfson, Deborah Azrael, Matthew Miller IntroductionDuring the past 2 decades, gun owners have become more likely to store household firearms loaded and unlocked, and believe that guns make homes safer rather than more dangerous. MethodsSelf-reported household firearm storage practices were described among 2,001 gun owners in relation to whether they report that firearms make homes (1) safer, (2) more dangerous, or (3) it depends. Data were from a probability-based online survey administered in 2015 (completion rate, 55%) and analyzed in 2018. ResultsNearly 60% of gun owners said that guns make homes safer (57.6%, 95% CI=55.1%, 60.1%), 39.9% (95% CI=37.4%, 42.5%) said that it depends (on other factors), and 2.5% (95% CI=1.8%, 3.4%) said that guns make homes more dangerous. A higher proportion of gun owners who reported that they believe guns increase household safety said that they store household firearms loaded and unlocked (39.2%, 95% CI=35.9%, 42.6%), compared with those who thought guns make the home either more dangerous (3.7%, 95% CI=1.3%, 10.1%) or those who thought the effect of guns on household safety depends on additional factors (17.5%, 95% CI=14.7%, 20.7%). ConclusionsGun owners who are most likely to assert categorically that firearms in the home make homes safer are, as a group, far more likely to store guns in their home loaded and unlocked. Drone and Other Hobbyist Aircraft Injuries Seen in U.S. Emergency Departments, 2010–2017 Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Jack A. Johnson, Megan R. Svach, Lawrence H. Brown IntroductionRecreational radio-controlled hobbyist aircraft—particularly "drones"—have become increasingly popular in the last decade. The purpose of this study is to describe injuries associated with hobbyist drones and compare them with injuries associated with other hobbyist aircraft. MethodsIn this 2018 cross-sectional analysis of National Electronic Injury Surveillance System data for 2010–2017, case narrative fields were searched to identify emergency department visits related to hobbyist aircraft injuries. The incidence of hobbyist aircraft injuries was estimated, and summary statistics, chi-square tests, and t-tests were used to describe and compare the demographic and clinical characteristics of drone and other hobbyist aircraft-related cases. ResultsAn estimated 12,842 hobbyist aircraft injuries presented to U.S. emergency departments during 2010–2017. An increased incidence attributable to drone-related injuries emerged in 2015. Overall, most injuries involved male patients aged 50 years on average. Propeller injuries were the leading mechanism. An estimated 270 patients required hospital admission. Patients injured by drones were younger (mean, 34 years vs 58 years; p<0.001) and more likely to be female than patients injured by hobbyist planes. Drone-related injuries were more likely than plane-related injuries to result from blunt trauma (e.g., being struck or falling during aircraft retrieval; 40.5% vs 7.9%, p<0.001). Helicopter-related injuries more closely resembled drone-related injuries than plane-related injuries. ConclusionsHobbyist aircraft-related injuries are increasing, particularly drone-related injuries. Tailored injury prevention measures and product safety materials are needed to address all hobbyist aircraft-related injuries, with a particular focus on drone-related injury prevention measures. Predicting Opioid Overdose Deaths Using Prescription Drug Monitoring Program Data Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Lindsey M. Ferris, Brendan Saloner, Noa Krawczyk, Kristen E. Schneider, Molly P. Jarman, Kate Jackson, B. Casey Lyons, Matthew D. Eisenberg, Tom M. Richards, Klaus W. Lemke, Jonathan P. Weiner IntroductionPrescription Drug Monitoring Program data can provide insights into a patient's likelihood of an opioid overdose, yet clinicians and public health officials lack indicators to identify individuals at highest risk accurately. A predictive model was developed and validated using Prescription Drug Monitoring Program prescription histories to identify those at risk for fatal overdose because of any opioid or illicit opioids. MethodsFrom December 2018 to July 2019, a retrospective cohort analysis was performed on Maryland residents aged 18–80 years with a filled opioid prescription (n=565,175) from January to June 2016. Fatal opioid overdoses were identified from the Office of the Chief Medical Examiner and were linked at the person-level with Prescription Drug Monitoring Program data. Split-half technique was used to develop and validate a multivariate logistic regression with a 6-month lookback period and assessed model calibration and discrimination. ResultsPredictors of any opioid-related fatal overdose included male sex, age 65–80 years, Medicaid, Medicare, 1 or more long-acting opioid fills, 1 or more buprenorphine fills, 2 to 3 and 4 or more short-acting schedule II opioid fills, opioid days' supply ≥91 days, average morphine milligram equivalent daily dose, 2 or more benzodiazepine fills, and 1 or more muscle relaxant fills. Model discrimination for the validation cohort was good (area under the curve: any, 0.81; illicit, 0.77). ConclusionsA model for predicting fatal opioid overdoses was developed using Prescription Drug Monitoring Program data. Given the recent national epidemic of deaths involving heroin and fentanyl, it is noteworthy that the model performed equally well in identifying those at risk for overdose deaths from both illicit and prescription opioids. The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): J. Travis Donahoe, Edward C. Norton, Michael R. Elliott, Andrea R. Titus, Lucie Kalousová, Nancy L. Fleischer IntroductionThis study sought to empirically evaluate whether the Medicaid expansion under the Affordable Care Act increased smoking cessation among low-income childless adult smokers. MethodsThe effects of the Medicaid expansion on smoking quit attempts and the probability of 30- and 90-day smoking cessation were evaluated using logistic regression and data from the 2010–2011 and 2014–2015 waves of the Tobacco Use Supplement to the Current Population Survey. Using boosted logistic regression, the Tobacco Use Supplement was restricted to an analytic sample composed of childless adults with high probability of being <138% of the federal poverty level. Propensity score weighting was used to compare changes in smoking cessation among a sample of current and past smokers in states that expanded Medicaid with a control sample of current and past smokers in states that did not expand Medicaid with similar sociodemographic characteristics and smoking histories. This study additionally controlled for state socioeconomic trends, welfare policies, and tobacco control policies. Analysis was conducted between January 2018 and June 2019. ResultsAfter weighting by propensity score and adjusting for state socioeconomic trends, welfare policies, and tobacco control policies, the Medicaid expansion was not associated with increases in smoking quit attempts or smoking cessation. ConclusionsThe Medicaid expansion did not appear to improve smoking cessation, despite extending health insurance eligibility to 2.3 million low-income smokers. Greater commitments to reducing barriers to cessation benefits and increasing smoking cessation in state Medicaid programs are needed to reduce smoking in low-income populations.
Information for CME Credit—Adherence to Cervical Cancer Screening Guidelines Among Women Aged 66–68 Years in a Large Community-Based PracticePublication date: December 2019Source: American Journal of Preventive Medicine, Volume 57, Issue 6Author(s):Ettinger de Cuba SA, Bovell-Ammon AR, Cook JT, et al. SNAP, young children's health, and family food security and healthcare access. Am J Prev Med. 2019;57(4)525–532Publication date: December 2019Source: American Journal of Preventive Medicine, Volume...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Multicellular growth of the Basidiomycota phytopathogen fungus Sporisorium reilianum induced by acid conditions Abstract Fungi are considered model organisms for the analysis of important phenomena of eukaryotes. For example, some of them have been described as models to understand the phenomenon of multicellularity acquisition by different unicellular organisms phylogenetically distant. Interestingly, in this work, we describe the multicellular development in the model fungus S. reilianum. We observed that Sporisorium reilianum, a Basidiomycota cereal pathogen that at neutral pH grows with a yeast-like morphology during its saprophytic haploid stage, when incubated at acid pH grew in the form of multicellular clusters. The multicellularity observed in S. reilianum was of clonal type, where buds of "stem" cells growing as yeasts remain joined by their cell wall septa, after cytokinesis. The elaboration and analysis of a regulatory network of S. reilianum showed that the putative zinc finger transcription factor CBQ73544.1 regulates a number of genes involved in cell cycle, cellular division, signal transduction pathways, and biogenesis of cell wall. Interestingly, homologous of these genes have been found to be regulated during Saccharomyces cerevisiae multicellular growth. In adddition, some of these genes were found to be negatively regulated during multicellularity of S. reilianum. With these data, we suggest that S. reilianum is an interesting model for the study of multicellular development. Combination of mass spectrometry and DNA sequencing for detection of antibiotic resistance in diagnostic laboratories Abstract In the last two decades, microbiology laboratories have radically changed by the introduction of novel technologies, like Next-Generation Sequencing (NGS) and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Nevertheless, emergence of antibiotic-resistant microorganisms represents a global threat of current medicine, being responsible for increasing mortality and health-care direct and indirect costs. In addition, the identification of antibiotic-resistant microorganisms, like OXA-48 carbapenemase-producing Enterobacteriaceae, has been changeling for clinical microbiology laboratories. Even the cost of NGS technology and MALDI-TOF MS equipment is relatively high, both technologies are increasingly used in diagnostic and research protocols. Therefore, the aim of this review is to present applications of these technologies used in clinical microbiology, especially in detection of antibiotic resistance and its surveillance, and to propose a combinatory approach of MALDI-TOF MS and NGS for the investigation of microbial associated infections. Assessing the intestinal carriage rates of vancomycin-resistant enterococci (VRE) at a tertiary care hospital in Hungary Abstract Excessive use of antibiotics contributes to the selection of resistant bacteria and intestinal colonization with multiresistant pathogens poses a risk factor for subsequent infections. The present study assessed vancomycin-resistant enterococci (VRE) carriage rates in patients admitted to our tertiary care hospital. Stool samples sent for routine culturing were screened with vancomycin containing solid or broth enrichment media. VRE isolates were identified with matrix-assisted laser desorption/ionization-time of flight mass spectrometry and antibiotic susceptibilities were tested by E-test. Vancomycin resistance genes were detected by polymerase chain reaction. Medical records of carriers were examined for suspected risk factors for colonization. Altogether 3025 stool specimens were analyzed. Solid media identified a VRE carriage rate of 2.2% while broth enrichment detected 5.8%. Seventy percent of the isolates were Enterococcus faecium. VanB genotype was detected in 38.2%, VanA in 37.3%, VanC1 in 22.6%, and VanC2 in 1.9%. All VRE were sensitive to linezolid, daptomycin, and tigecycline. Collective risk factors for carriage were diabetes, normal flora absence, Clostridioides difficile positivity, longer hospital stay, and advanced age. 78.5% of the carriers received antibiotic therapy which was metronidazole in most cases (47.3%). We recommend regular screening of risk groups such as patients with diabetes, history of recent hospitalization, or former C. difficile infection as an imperative step for preventing VRE dissemination. Atypical URA5 gene restriction fragment length polymorphism banding profile in Cryptococcus neoformans strains Abstract URA5-RFLP is one of the most widely used genotyping methods relating to Cryptococcus neoformans and C. gattii consensus genotype nomenclature. In order to identify a molecular type, this method uses a visual comparison of digested PCR products of tested and reference strains, therefore any anomaly in RFLP patterns of studied isolates makes recognition difficult or impossible. This report describes a strain of VNIV type showing an atypical URA5-RFLP pattern as well as a group of AD hybrids displaying the same anomaly. The atypical RFLP pattern is the result of a point mutation and emergence of a new restriction site. Emergence of the allele presenting a new banding pattern may lead to misidentification using the URA5-RFLP technique; the results of this study as well as the literature data may suggest the spread of the allele in the environment. Production of pyruvic acid from glycerol by Yarrowia lipolytica Abstract The aim of the study was to screen Yarrowia lipolytica strains for keto acid production and determine optimal conditions for pyruvic acid biosynthesis from glycerol by the best producer. The analyzed parameters were thiamine concentration, medium pH, stirring speed, and substrate concentration. The screening was performed in flask cultures, whereas pyruvic acid production was carried out in 5-L stirred-tank reactor with 2 L of working volume. In total, 24 Y. lipolytica strains were compared for their abilities to produce pyruvic and α-ketoglutaric acids. The total concentration of both acids ranged from 0.1 to 15.03 g/L. Ten strains were selected for keto acid biosynthesis in bioreactor. The Y. lipolytica SKO 6 strain was identified as the best producer of pyruvic acid. In the selected conditions (thiamine concentration 1.5 μg/L, pH 4.0, stirring speed 800 rpm, 150 g/L of glycerol), the strain Y. lipolytica SKO 6 produced 99.3 g/L of pyruvic acid, with process yield of 0.63 g/g and volumetric production rate of 1.18 g/L/h. Higher titer of pyruvic acid was obtained during fed-batch culture with 200 g/L of glycerol, reaching 125.8 g/L from pure glycerol (yield 0.68 g/g) and 124.4 g/L from crude glycerol (yield 0.62 g/g). Results obtained for the strain Y. lipolytica SKO 6 proved the suitability of microbial production of pyruvic acid at industrial scale. Characterization of Salmonella Typhimurium and its monophasic variant 1,4, [5],12:i:- isolated from different sources Abstract In order to characterize the most commonly detected Salmonella serotypes, we tested 124 isolates of S. Typhimurium and 89 isolates of the monophasic variant of S. Typhimurium (S. 1,4, [5],12:i:-) for their antimicrobial susceptibility by means of the Kirby–Bauer disk-diffusion method, and for the detection of 19 genes (four Phage Markers (g13, Sieb, eat, g8), ten prophage-related virulence genes (gipA, gtgB, nanH, gogB, grvA, sopE, sspH1, sspH2, sodC1, gtgE), and five plasmid-borne virulence genes (spvC, pefA, mig5, rcK, srgA)) by means of PCR-based assays. A total of 213 strains were analyzed from, humans (n = 122), animals (n = 25), food (n = 46), and irrigation water (n = 20). S. Typhimurium isolates showed higher variability, in both their resistance profiles and molecular typing, than S. 1,4, [5],12:i:-. Strains from irrigation water displayed significantly higher susceptibility to antibiotics than those from the other sources. Resistance to ampicillin, streptomycin, sulfonamide, and tetracycline was the most commonly detected resistance profile (R-type), being in serovar S. 1,4, [5],12:i:-, frequently associated to resistance to other antimicrobials. Significant differences in genetic profiles in the two abovementioned Salmonella serotypes were found. None of the plasmid-borne virulence genes investigated were detected in S. 1,4, [5],12:i:- isolates, while those genes, characterized 37.9% of the S. Typhimurium strains. Differences in the prevalence of some molecular targets between the two Salmonella serotypes deserve further study. Importantly, the grvA gene was found exclusively in S. Typhimurium strains, whereas sopE, sodC, gtgB, and gipA were mainly detected, with a statistically significant difference, in S. 1,4, [5],12:i:- isolates. Metabolic profiling of Fusarium oxysporum f. sp. conglutinans race 2 in dual cultures with biocontrol agents Bacillus amyloliquefaciens , Pseudomonas aeruginosa , and Trichoderma harzianum Abstract There are increasing efforts to identify biocontrol-active microbial metabolites in order to improve strategies for biocontrol of phytopathogens. In this work, Fusarium oxysporum f. sp. conglutinans was confronted with three different biocontrol agents: Trichoderma harzianum, Bacillus amyloliquefaciens, and Pseudomonas aeruginosa in dual culture bioassays. Metabolites produced during the microbial interactions were screened by a matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). T. harzianum exhibited the strongest inhibition of growth of F. oxysporum resulting in overlay of the pathogen colony with its mycelium. Recorded metabolite profiles suggested a direct attack of F. oxysporum mycelium by T. harzianum and B. amyloliquefaciens by means of membrane-attacking peptaibols and a set of antimicrobial lipopeptides and siderophores, respectively. The direct mode of the biocontrol activity of T. harzianum and B. amyloliquefaciens corresponded to their ability to suppress F. oxysporum production of mycotoxin beauvericin suggesting that this ability is not specific only for Trichoderma species. In the case of P. aeruginosa, siderophores pyoverdine E/D and two rhamnolipids were produced as major bacterial metabolites; the rhamnolipid production was blocked by F. oxysporum. The results showed that this type of biocontrol activity was the least effective against F. oxysporum. The effective application of MALDI-MS profiling to the screening of nonvolatile microbial metabolites produced during the interaction of the phytopathogen and the biocontrol microorganisms was demonstrated. The acid phosphatase Pho5 of Saccharomyces cerevisiae is not involved in polyphosphate breakdown Abstract Inorganic polyphosphate is involved in architecture and functioning of yeast cell wall. The strain of Saccharomyces cerevisiae constitutively overexpressing acid phosphatase Pho5 was constructed for studying the Pho5 properties and its possible participation in polyphosphate metabolism. The parent strain was transformed by the vector carrying the PHO5 gene under a strong constitutive promoter of glyceraldehyde-3-phosphate dehydrogenase of S. cerevisiae. The culture liquid and biomass of transformant strain contained approximately equal total acid phosphatase activity. The levels of acid phosphatase activity associated with the cell wall and culture liquid increased in the transformant strain compared to the parent strain ~ 10- and 20-fold, respectively. The Pho5 preparation (specific activity of 46 U/mg protein and yield of 95 U/L) was obtained from culture liquid of overproducing strain. The overproducing strain had no changes in polyphosphate level. The activity of Pho5 with long-chained polyP was negligible. We concluded that Pho5 is not involved in polyphosphate metabolism. Purified Pho5 showed a similar activity with p-nitrophenylphosphate, ATP, ADP, glycerophosphate, and glucose-6-phosphate. The substrate specificity of Pho5 and its extracellular localization suggest its function: the hydrolysis of organic compounds with phosphoester bonds at phosphate limitation. The influence of N and S poles of static magnetic field (SMF) on Candida albicans hyphal formation and antifungal activity of amphotericin B Abstract Due to the increasing number of Candida albicans' infections and the resistance of this pathogenic fungus to drugs, new therapeutic strategies are sought. One of such strategies may be the use of static magnetic field (SMF). C. albicans cultures were subjected to static magnetic field of the induction 0.5 T in the presence of fluconazole and amphotericin B. We identified a reduction of C. albicans hyphal length. Also, a statistically significant additional effect on the viability of C. albicans was revealed when SMF was combined with the antimycotic drug amphotericin B. The synergistic effect of this antimycotic and SMF may be due to the fact that amphotericin B binds to ergosterol in plasma membrane and SMF similarly to MF could influence domain orientation in plasma membrane (PM). Community structures and comparison of nosZ and 16S rRNA genes from culturable denitrifying bacteria Abstract The objectives of this study were (i) to isolate and characterize of cultivable denitrifying bacteria using classic microbiological and molecular methods, (ii) to compare of 16S rRNA and nosZ genes as molecular markers, (iii) to determine bacterial community structure and diversity in soil samples using single-strand conformation polymorphism (SSCP) analysis. In this study, 49 bacterial isolates were cultivated and phylogenetic analyses grouped them into two phyla: Proteobacteria (37 species) and Firmicutes (12 species). Our study showed that the nosZ functional gen could be used to identify denitrifying bacteria abundance in environment but could not be used to identify pure bacterial cultures. In addition, the bacterial community structure showed significant differences among the various soil types. Phylogenetic analysis of community structure indicated that 51 clones could be divided into 2 phylotypes. Uncultured bacteria (80.4%) and Gammaproteobacteria (19.6%) were the dominant components of the soil bacterial community. For 16S rRNA, PCR products of 49 bacteria were obtained with 27F-1492R primer pairs. For nosZ, PCR products were obtained with primers 1F-1R (259 bp), 2F-2R (267 bp), and F-1622R (453 bp) of 39 bacteria that the single nosZ band provided on the agarose gel. The bacterial 16S rRNA gene clone library was dominated by Gammaproteobacteria and Bacilli. The nosZ clone sequences did not represent the bacteria from which they were obtained but were found to be closer to the environmental clones. Our study showed that the nosZ functional gene could be used to identify denitrification abundance in environment but could not be used to identify pure bacterial cultures. It was also found that the nosZ sequences showed uncultured denitrifier species.
Multicellular growth of the Basidiomycota phytopathogen fungus Sporisorium reilianum induced by acid conditionsAbstractFungi are considered model organisms for the analysis of important phenomena of eukaryotes. For example, some of them have been described as models to understand the phenomenon of multicellularity acquisition by different unicellular organisms phylogenetically distant. Interestingly, in this work, we describe the multicellular development in the model fungus S. reilianum. We observed...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Spatiotemporal clustering of suicides in the US from 1999 to 2016: a spatial epidemiological approach AbstractPurpose This study aims to describe and characterize the spatial and temporal clustering patterns of suicide in the ten states with the greatest suicide burden in the United States from 1999 to 2016.Methods All suicide deaths from January 1, 1999 to December 31, 2016 in the United States were identified using data from the Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset. The ten states with the highest age-adjusted suicide rates were Montana, Alaska, Wyoming, New Mexico, Nevada, Utah, Idaho, Colorado, Arizona, and Oklahoma. A spatiotemporal scan statistic using a discrete Poisson model was employed to retrospectively detect spatiotemporal suicide clusters.Results From 1999 to 2016, a total of 649,843 suicides were recorded in the United States. Nineteen statistically significant spatiotemporal suicide mortality clusters were identified in the states with the greatest suicide rates, and 13.53% of the suicide cases within these states clustered spatiotemporally. The risk ratio of the clusters ranged from 1.45 to 3.64 (p < 0.001). All states had at least one cluster, with three clusters spanning multiple states, and four clusters were found in Arizona. While there was no clear secular trend in the average size of suicide clusters, the number of clusters increased from 1999 to 2016.Conclusions Hot spots for suicidal behavior in the United States warrant public health intervention and continued surveillance. As suicide rates in the US continue to increase annually, public health efforts could be maximized by focusing on regions with substantial clustering. Predictive factors for changes in quality of life among children and adolescents in youth welfare institutions AbstractPurpose Children and adolescents living in youth welfare institutions often have a below average quality of life (QoL), for reasons that include developmental difficulties, history of traumatic experiences, and mental disorders. Youth welfare measures are needed that would have a positive impact, but there is a lack of longitudinal research on which measures are most effective. This study investigated what factors are associated with an improvement in QoL during residential stay.Methods Residents of youth care facilities in Switzerland and their professional caregivers completed questionnaires that addressed QoL, psychopathology, and experience of traumatic events at two time points. In addition, information regarding mental disorders was obtained through structured clinical interviews. Analyses were conducted on the data obtained from 204 respondents aged 11–18 years. Comparisons with a school sample were conducted.Results Compared to a school sample, a majority of participants rated their QoL equal, whereas their caregivers rated it as lower. Factors predictive of a poorer QoL were high levels of internalizing and externalizing psychopathology, presence of co-morbidities, and female gender. At the second assessment, the caregivers reported a small improvement, which was associated with reductions in both internalizing and externalizing psychopathology.Conclusions The finding that a reduction in severity of psychopathology may result in an improvement in QoL underlines the importance of providing professional support for mentally ill residents of youth welfare institutions. Further research is needed to determine the causality of this association. Depressive symptoms, suicidal ideation, and mental health care-seeking in central Mozambique AbstractPurpose There is scant research on depressive symptoms (DS), suicidal ideation (SI), and mental health care-seeking in Mozambique.Methods Generalized estimating equations were used to assess factors associated with DS, SI, and mental health care-seeking among 3080 individuals interviewed in a representative household survey in Sofala and Manica provinces, Mozambique.Results 19% (CI 17–21%) of respondents reported DS in the past year and 17% (CI 15–18%) lifetime SI. Overall, only 10% (CI 8–11%) of respondents ever sought any care for mental illness, though 26% (CI 23–29%) of those reporting DS and/or SI sought care. 90% of those who sought care for DS received treatment; however, only 46% of those who sought care for SI received treatment. Factors associated with DS and SI include: female gender, divorced/separated, widowed, and > 55 years old. Respondents in the bottom wealth quintile reported lower DS, while those in upper wealth quintiles reported higher prevalence of SI. Individuals with DS or SI had significantly elevated measures of disability—especially in doing household chores, work/school activities, standing for long periods, and walking long distances. Factors associated with care-seeking include: female gender, rural residence, divorced/separated, and > 45 years old. Individuals in lower wealth quintiles and with no religious affiliation had lower odds of seeking care.Conclusions DS and SI are prevalent in central Mozambique and treatment gaps are high (68% and 89%, respectively). An urgent need exists for demand- and supply-side interventions to optimize the delivery of comprehensive community-based mental healthcare in Mozambique. Factors associated with discontinuation of antidepressant treatment after a single prescription among patients aged 55 or over: evidence from English primary care AbstractPurpose Antidepressants are frequently prescribed to older people with depression but little is known on predictors of discontinuation in this population. We, therefore, investigated factors associated with early discontinuation of antidepressants in older adults with new diagnoses or symptoms of depression in English primary care.Methods Data from a nationally representative cohort of patients aged 55 and over were used to evaluate the association between discontinuation of antidepressant medication after a single prescription and potential explanatory variables, including socio-demographic factors, polypharmacy and age-related problems such as dementia.Results Overall, during the study period we observed 34,715 new courses of antidepressant treatment initiated after recorded symptoms or diagnoses of depression. Antidepressant discontinuation after a single prescription was more common in people with depressive symptoms (32%) than in those with diagnosed depression (21.6%). In those diagnosed with depression and in women with depressive symptoms we found that, after adjusting for confounders, the odds of early discontinuation significantly increased after age 65 with a peak at around age 80 and then either levelled or reduced thereafter. Early discontinuation was also significantly less common in people with dementia and in those with diagnosed depression living in more rural areas.Conclusions Early discontinuation of antidepressants increases in the post-retirement years and is higher in those with no formal diagnosis of depression, those without dementia and those with diagnosed depression living in urban areas. Alternative treatment strategies, such as non-drug therapies, or more active patient follow-up should be further considered in these circumstances. Physical activity of people with mental disorders compared to the general population: a systematic review of longitudinal cohort studies AbstractPurpose We investigated if (a) people with lower physical activity have an increased risk of subsequent mental disorders (compared to those with higher physical activity); and (b) people with mental disorders have reduced subsequent physical activity (compared to those without mental disorders).Methods A systematic review of population-based longitudinal studies examining physical activity and mental disorders was conducted. Mental disorders were defined by International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders. The results were described in a narrative summary.Results Twenty-two studies were included. The majority (19) examined mood disorders and physical activity. Only two studies found consistent association between lower physical activity and a reduced risk of subsequent mental disorders. One study found the bidirectional association between physical activity and major depression. Twelve studies found mixed results (i.e., no consistency in direction and significance of the findings), and seven studies found no association between the variables of interest.Conclusions There is a lack of consistent evidence linking physical activity to be either a risk factor or consequence of mental disorders.PROSPERO registration ID CRD42017071737. Concurrent use of benzodiazepines, antidepressants, and opioid analgesics with zolpidem and risk for suicide: a case–control and case–crossover study AbstractPurpose To evaluate whether the concurrent use of benzodiazepines, antidepressants, and opioid analgesics with zolpidem increases the risk of suicide or triggers suicide compared with the use of zolpidem alone.Methods We conducted a case–control and case–crossover study using the Korean National Health Insurance Service-National Sample Cohort database. Cases were older than 20 years with a suicide record (International Codes of Disease 10th Revision codes: X-60-X84 and Y87.0 intentional self-harm) between January 1, 2004, and December 31, 2013. For case–control design, ten controls were matched to each case by age, sex, index year, region, income, and health insurance type. For case–crossover analysis, we set hazard period to 60 days and assigned five corresponding sets of control periods of equal length. Exposure was assessed during 60 days before suicide for combinations of benzodiazepines, antidepressants, opioid analgesics with zolpidem against zolpidem alone. We conducted a conditional logistic regression to estimate odds ratios (ORs) and their 95% confidence intervals (CIs).Results In the case–control study, the risk of suicide was 2.80-fold higher in cases taking benzodiazepines and antidepressants with zolpidem than in those taking zolpidem alone (adjusted OR [aOR], 2.80; 95% CI, 1.38–5.70). However, in the case–crossover study, suicide risk showed no significant difference (crude OR [cOR], 0.92; 95% CI, 0.55–1.52) and was underpowered.Conclusions The results of the traditional case–control study confirmed that the concurrent use of benzodiazepines and antidepressants with zolpidem was associated with an increased risk of suicide compared with the use of zolpidem alone. However, there was no significant difference in the magnitude of risk in the within-person comparison design. Barriers and predictors of medication use for childhood ADHD: findings from a UK population-representative cohort AbstractPurpose Little is known about sociodemographic and clinical factors that predict and act as barriers to ADHD medication independently of symptom severity. We examined the proportion of children using medication for ADHD, age of initiation of medication, and predictors of medication use in a population-representative cohort.Methods Data from the Millennium Cohort Study on child ADHD, medication use for ADHD at age 14 (in 2014–2015) and child, parent and sociodemographic variables were collated. Logistic regression models were used to identify factors that predict medication use for ADHD (the main outcome measure), adjusting for symptom severity at age seven.Results The weighted prevalence of ADHD was 3.97% (N = 11,708). 45.57% of children with ADHD (N = 305) were taking medication. The median age at initiation was 9 years (range 3–14). Male gender (AOR 3.66, 95% CI 1.75, 7.66) and conduct problems at age seven (AOR 1.24 95% CI 1.04, 1.47) and 14 predicted medication use at age 14 after adjusting for symptom severity.Conclusions Our study is the first to assess predictors of medication whist adjusting for ADHD symptom severity. Girls with ADHD were less likely to be prescribed medication, even when they displayed similar ADHD symptom levels to boys. Conduct problems also predicted medication independently of ADHD symptoms. ADHD may be more often medicated in boys because clinicians may think a prototypical ADHD child is male, and perhaps conduct problems make boys more disruptive in the classroom, leading to boys being more often treated. The role of neuroticism in self-harm and suicidal ideation: results from two UK population-based cohorts AbstractBackground Self-harm is common, debilitating and associated with completed suicide and increased all-cause mortality, but there is uncertainty about its causal risk factors, limiting risk assessment and effective management. Neuroticism is a stable personality trait associated with self-harm and suicidal ideation, and correlated with coping styles, but its value as an independent predictor of these outcomes is disputed.Methods Prior history of hospital-treated self-harm was obtained by record-linkage to administrative health data in Generation Scotland:Scottish Family Health Study (N = 15,798; self-harm cases = 339) and by a self-report variable in UK Biobank (N = 35,227; self-harm cases = 772). Neuroticism in both cohorts was measured using the Eysenck Personality Questionnaire-Short Form. Associations of neuroticism with self-harm were tested using multivariable regression following adjustment for age, sex, cognitive ability, educational attainment, socioeconomic deprivation, and relationship status. A subset of GS:SFHS was followed-up with suicidal ideation elicited by self-report (n = 3342, suicidal ideation cases = 158) and coping styles measured by the Coping Inventory for Stressful Situations. The relationship of neuroticism to suicidal ideation, and the role of coping style, was then investigated using multivariable logistic regression.Results Neuroticism was positively associated with hospital-associated self-harm in GS:SFHS (per EPQ-SF unit odds ratio 1.2 95% credible interval 1.1–1.2, pFDR 0.0003) and UKB (per EPQ-SF unit odds ratio 1.1 95% confidence interval 1.1–1.2, pFDR 9.8 × 10−17). Neuroticism, and the neuroticism-correlated coping style, emotion-oriented coping (EoC), were also associated with suicidal ideation in multivariable models.Conclusions Neuroticism is an independent predictor of hospital-treated self-harm risk. Neuroticism and emotion-orientated coping styles are also predictive of suicidal ideation. Suicide mortality follow-up of the Swiss National Cohort (1990–2014): sex-specific risk estimates by occupational socio-economic group in working-age population AbstractPurpose To identify occupations and socio-economic groups with detrimental or protective effect on suicide mortality.Methods For every occupation and economic activity/industry, we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using national cause-specific mortality rates. We further stratified analyses by socio-economic variables, job-skill level, and by three calendar periods (1990–1998/1999–2006/2007–2014).Results The study sample comprised 5,834,618 participants (94,918,456 person-years). The highest DSRs were observed among unemployed/job-seeking group, in agricultural, fishery and related male workers, and in health and social activities female workers. The lowest DSRs were observed in real estate and renting, research and development, IT and other business activities in men and in agriculture, hunting and forestry industry in women. A consistent reduction in DSRs across three calendar periods was observed in men. In female corporate managers, DSRs increased over the 2007–2014 period compared with 1999–2006. Compared to general working-age population, unemployed/job-seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife-associated professionals; and agricultural workers as well as among female writers and performing artists.Conclusions The findings suggest the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality and a relationship between suicide and poor psychosocial working conditions in elementary occupations. Sex-specific results need further investigation. Identifying typologies among persons admitted to hospital for non-fatal intentional self-harm in Victoria, Australia AbstractPurpose The aim of this study was to determine whether people who have been hospitalised as the result of non-fatal self-harm form meaningful groups based on mechanism of injury, and demographic and mental health-related factors.Methods A retrospective analysis of 18,103 hospital admissions for self-harm in Victoria, Australia over the 3-year period 2014/2015–2016/2017 recorded on the Victorian Admitted Episodes Dataset (VAED). The VAED records all hospital admissions in public and private hospitals in Victoria. The primary analysis used a two-step method of cluster analysis. Initial analysis determined two distinct groups, one composed of individuals who had a recorded mental illness diagnosis and one composed of individuals with no recorded mental illness diagnosis. Subsequent cluster analysis identified four subgroups within each of the initial two groups.Results Within the diagnosed mental illness subgroups, each subgroup was characterised by a particular mental disorder or a combination of disorders. Within the no diagnosis of mental illness groups, the youngest group was also the most homogenous (all females who self-poisoned), the oldest group had a high proportion of rural/regional residents, the group with the highest proportion of males also had the highest proportion of people who used cutting as the method of self-harm, and the group with the highest proportion of metropolitan residents also had the highest proportion of people who were married.Conclusions Preventative interventions need to take into account that those who are admitted to hospital for self-harm are a heterogeneous group.
Spatiotemporal clustering of suicides in the US from 1999 to 2016: a spatial epidemiological approachAbstractPurposeThis study aims to describe and characterize the spatial and temporal clustering patterns of suicide in the ten states with the greatest suicide burden in the United States from 1999 to 2016.MethodsAll suicide deaths from January 1, 1999 to December 31, 2016 in the United States were identified using data from the Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Information for CME Credit—Adherence to Cervical Cancer Screening Guidelines Among Women Aged 66–68 Years in a Large Community-Based Practice Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Ettinger de Cuba SA, Bovell-Ammon AR, Cook JT, et al. SNAP, young children's health, and family food security and healthcare access. Am J Prev Med. 2019;57(4)525–532 Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): U.S. Immigration Law Enforcement Practices and Health Inequities Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Paul J. Fleming, Nicole L. Novak, William D. Lopez Expanding Diabetes Prevention: Obstacles and Potential Solutions Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Michael Bergman The Obesity Parenting Intervention Scale: Factorial Validity and Invariance Among Head Start Parents Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Roger Figueroa, Jaclyn A. Saltzman, Alyssa Aftosmes-Tobio, Kirsten K. Davison IntroductionObesity affects 15.7% of U.S. preschoolers, with higher rates among low-income and Spanish-speaking populations. Food, physical activity, and sleep parenting practices, referred to collectively as obesity-related parenting practices, are linked with children's risk of obesity and are a common target in family-based obesity interventions. Yet, there is no brief, validated measure of obesity-related parenting practices that is appropriate for use in intervention studies and for diverse audiences. This study tests the factorial validity of a brief measure of obesity-related parenting and measurement invariance of the English and Spanish versions of the scale, as well as among mothers and fathers. MethodsParents of children enrolled in Head Start (n=578; 500 mothers and 78 fathers) completed a brief survey of food (7 items), physical activity (5 items), and sleep parenting (3 items) in fall of 2017 and 2018. Scale items were drawn from existing measures and the evidence base, initially drafted in English, and then translated to Spanish. One parent per family completed the scale independently in English (n=448) or Spanish (n=130). A confirmatory factor analysis framework was adopted to test a 3-factor model for the total sample. Multi-group structural equation modeling was used to assess measurement invariance of the scale by the language of administration (English or Spanish) and among mothers and fathers separately. ResultsResults supported a 3-factor model of obesity parenting with a single factor each for food, physical activity, and sleep parenting. There was statistically significant measurement invariance across all groups (p<0.05). Internal consistency was adequate across factors (α=0.65−0.80). ConclusionsThis brief obesity-parenting scale demonstrates adequate factorial validity in English and Spanish and among mothers and fathers. This measure has been integrated into an intervention, and future work will test sensitivity to change. A Methodologic Systematic Review of Mobile Health Behavior Change Randomized Trials Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Theodora Oikonomidi, Alexandre Vivot, Viet-Thi Tran, Carolina Riveros, Elisabeth Robin, Philippe Ravaud ContextMobile health helps providers offer accessible, affordable, tailored behavior change interventions. However, research assessing mobile health interventions may feature methodologic shortcomings and poor reporting. This review aims to summarize the characteristics, methods, and intervention reporting of RCTs evaluating mobile health behavior change interventions. Evidence acquisitionThis was a methodologic systematic review of RCTs assessing mobile health behavior change interventions published in PubMed from January 1, 2014 to January 1, 2018, in journals with the upper half of Impact Factors (Clarivate Analytics). Three reviewers independently extracted sample characteristics. Primary outcomes were classified as patient-important or not using definitions from the literature. Any non–patient-important outcomes were then reclassified by a panel of 3 patients. Intervention reporting was assessed by the mobile health Evidence Reporting and Assessment checklist. Data were analyzed in December 2018. Evidence synthesisMost of the 231 included RCTs assessed text messaging (51%) or smartphone app (28%) interventions aiming to change nutrition and physical activity (36%) or treatment adherence (25%). Only 8% of RCTs had a patient-important primary outcome, follow-up of ≥6 months, and intent-to-treat analysis. Most primary outcomes were behavioral measures (60%). Follow-up was <3 months in 29% of RCTs. Regarding reporting, 12 of the 16 checklist items were reported in less than half of RCTs (e.g., usability/content testing, 32%; data security, 13%). ConclusionsReports of RCTs assessing mobile health behavior change interventions lack information that would be useful for providers, including reporting of long-term intervention impact on patient-important primary outcomes and information needed for intervention replicability. Firearm Storage Practices and Risk Perceptions Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Amanda I. Mauri, Julia A. Wolfson, Deborah Azrael, Matthew Miller IntroductionDuring the past 2 decades, gun owners have become more likely to store household firearms loaded and unlocked, and believe that guns make homes safer rather than more dangerous. MethodsSelf-reported household firearm storage practices were described among 2,001 gun owners in relation to whether they report that firearms make homes (1) safer, (2) more dangerous, or (3) it depends. Data were from a probability-based online survey administered in 2015 (completion rate, 55%) and analyzed in 2018. ResultsNearly 60% of gun owners said that guns make homes safer (57.6%, 95% CI=55.1%, 60.1%), 39.9% (95% CI=37.4%, 42.5%) said that it depends (on other factors), and 2.5% (95% CI=1.8%, 3.4%) said that guns make homes more dangerous. A higher proportion of gun owners who reported that they believe guns increase household safety said that they store household firearms loaded and unlocked (39.2%, 95% CI=35.9%, 42.6%), compared with those who thought guns make the home either more dangerous (3.7%, 95% CI=1.3%, 10.1%) or those who thought the effect of guns on household safety depends on additional factors (17.5%, 95% CI=14.7%, 20.7%). ConclusionsGun owners who are most likely to assert categorically that firearms in the home make homes safer are, as a group, far more likely to store guns in their home loaded and unlocked. Drone and Other Hobbyist Aircraft Injuries Seen in U.S. Emergency Departments, 2010–2017 Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Jack A. Johnson, Megan R. Svach, Lawrence H. Brown IntroductionRecreational radio-controlled hobbyist aircraft—particularly "drones"—have become increasingly popular in the last decade. The purpose of this study is to describe injuries associated with hobbyist drones and compare them with injuries associated with other hobbyist aircraft. MethodsIn this 2018 cross-sectional analysis of National Electronic Injury Surveillance System data for 2010–2017, case narrative fields were searched to identify emergency department visits related to hobbyist aircraft injuries. The incidence of hobbyist aircraft injuries was estimated, and summary statistics, chi-square tests, and t-tests were used to describe and compare the demographic and clinical characteristics of drone and other hobbyist aircraft-related cases. ResultsAn estimated 12,842 hobbyist aircraft injuries presented to U.S. emergency departments during 2010–2017. An increased incidence attributable to drone-related injuries emerged in 2015. Overall, most injuries involved male patients aged 50 years on average. Propeller injuries were the leading mechanism. An estimated 270 patients required hospital admission. Patients injured by drones were younger (mean, 34 years vs 58 years; p<0.001) and more likely to be female than patients injured by hobbyist planes. Drone-related injuries were more likely than plane-related injuries to result from blunt trauma (e.g., being struck or falling during aircraft retrieval; 40.5% vs 7.9%, p<0.001). Helicopter-related injuries more closely resembled drone-related injuries than plane-related injuries. ConclusionsHobbyist aircraft-related injuries are increasing, particularly drone-related injuries. Tailored injury prevention measures and product safety materials are needed to address all hobbyist aircraft-related injuries, with a particular focus on drone-related injury prevention measures. Predicting Opioid Overdose Deaths Using Prescription Drug Monitoring Program Data Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): Lindsey M. Ferris, Brendan Saloner, Noa Krawczyk, Kristen E. Schneider, Molly P. Jarman, Kate Jackson, B. Casey Lyons, Matthew D. Eisenberg, Tom M. Richards, Klaus W. Lemke, Jonathan P. Weiner IntroductionPrescription Drug Monitoring Program data can provide insights into a patient's likelihood of an opioid overdose, yet clinicians and public health officials lack indicators to identify individuals at highest risk accurately. A predictive model was developed and validated using Prescription Drug Monitoring Program prescription histories to identify those at risk for fatal overdose because of any opioid or illicit opioids. MethodsFrom December 2018 to July 2019, a retrospective cohort analysis was performed on Maryland residents aged 18–80 years with a filled opioid prescription (n=565,175) from January to June 2016. Fatal opioid overdoses were identified from the Office of the Chief Medical Examiner and were linked at the person-level with Prescription Drug Monitoring Program data. Split-half technique was used to develop and validate a multivariate logistic regression with a 6-month lookback period and assessed model calibration and discrimination. ResultsPredictors of any opioid-related fatal overdose included male sex, age 65–80 years, Medicaid, Medicare, 1 or more long-acting opioid fills, 1 or more buprenorphine fills, 2 to 3 and 4 or more short-acting schedule II opioid fills, opioid days' supply ≥91 days, average morphine milligram equivalent daily dose, 2 or more benzodiazepine fills, and 1 or more muscle relaxant fills. Model discrimination for the validation cohort was good (area under the curve: any, 0.81; illicit, 0.77). ConclusionsA model for predicting fatal opioid overdoses was developed using Prescription Drug Monitoring Program data. Given the recent national epidemic of deaths involving heroin and fentanyl, it is noteworthy that the model performed equally well in identifying those at risk for overdose deaths from both illicit and prescription opioids. The Affordable Care Act Medicaid Expansion and Smoking Cessation Among Low-Income Smokers Publication date: December 2019 Source: American Journal of Preventive Medicine, Volume 57, Issue 6 Author(s): J. Travis Donahoe, Edward C. Norton, Michael R. Elliott, Andrea R. Titus, Lucie Kalousová, Nancy L. Fleischer IntroductionThis study sought to empirically evaluate whether the Medicaid expansion under the Affordable Care Act increased smoking cessation among low-income childless adult smokers. MethodsThe effects of the Medicaid expansion on smoking quit attempts and the probability of 30- and 90-day smoking cessation were evaluated using logistic regression and data from the 2010–2011 and 2014–2015 waves of the Tobacco Use Supplement to the Current Population Survey. Using boosted logistic regression, the Tobacco Use Supplement was restricted to an analytic sample composed of childless adults with high probability of being <138% of the federal poverty level. Propensity score weighting was used to compare changes in smoking cessation among a sample of current and past smokers in states that expanded Medicaid with a control sample of current and past smokers in states that did not expand Medicaid with similar sociodemographic characteristics and smoking histories. This study additionally controlled for state socioeconomic trends, welfare policies, and tobacco control policies. Analysis was conducted between January 2018 and June 2019. ResultsAfter weighting by propensity score and adjusting for state socioeconomic trends, welfare policies, and tobacco control policies, the Medicaid expansion was not associated with increases in smoking quit attempts or smoking cessation. ConclusionsThe Medicaid expansion did not appear to improve smoking cessation, despite extending health insurance eligibility to 2.3 million low-income smokers. Greater commitments to reducing barriers to cessation benefits and increasing smoking cessation in state Medicaid programs are needed to reduce smoking in low-income populations.
Information for CME Credit—Adherence to Cervical Cancer Screening Guidelines Among Women Aged 66–68 Years in a Large Community-Based PracticePublication date: December 2019Source: American Journal of Preventive Medicine, Volume 57, Issue 6Author(s):Ettinger de Cuba SA, Bovell-Ammon AR, Cook JT, et al. SNAP, young children's health, and family food security and healthcare access. Am J Prev Med. 2019;57(4)525–532Publication date: December 2019Source: American Journal of Preventive Medicine, Volume...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): E. Mark Haacke, Yongsheng Chen, David Utriainen, Bo Wu, Yu Wang, Shuang Xia, Naying He, Chunyan Zhang, Xiao Wang, M. Marcella Lagana, Yu Luo, Ali Fatemi, Saifeng Liu, Sara Gharabaghi, Dongmei Wu, Sean K. Sethi, Feng Huang, Taotao Sun, Feifei Qu, Brijesh K. Yadav Abstract One major thrust in radiology today is image standardization with a focus on rapidly acquired quantitative multi-contrast information. This is critical for multi-center trials, for the collection of big data and for the use of artificial intelligence in evaluating the data. Strategically acquired gradient echo (STAGE) imaging is one such method that can provide 8 qualitative and 7 quantitative pieces of information in 5 min or less at 3 T. STAGE provides qualitative images in the form of proton density weighted images, T1 weighted images, T2* weighted images and simulated double inversion recovery (DIR) images. STAGE also provides quantitative data in the form of proton spin density, T1, T2* and susceptibility maps as well as segmentation of white matter, gray matter and cerebrospinal fluid. STAGE uses vendors' product gradient echo sequences. It can be applied from 0.35 T to 7 T across all manufacturers producing similar results in contrast and quantification of the data. In this paper, we discuss the strengths and weaknesses of STAGE, demonstrate its contrast-to-noise (CNR) behavior relative to a large clinical data set and introduce a few new image contrasts derived from STAGE, including DIR images and a new concept referred to as true susceptibility weighted imaging (tSWI) linked to fluid attenuated inversion recovery (FLAIR) or tSWI-FLAIR for the evaluation of multiple sclerosis lesions. The robustness of STAGE T1 mapping was tested using the NIST/NIH phantom, while the reproducibility was tested by scanning a given individual ten times in one session and the same subject scanned once a week over a 12-week period. Assessment of the CNR for the enhanced T1W image (T1WE) showed a significantly better contrast between gray matter and white matter than conventional T1W images in both patients with Parkinson's disease and healthy controls. We also present some clinical cases using STAGE imaging in patients with stroke, metastasis, multiple sclerosis and a fetus with ventriculomegaly. Overall, STAGE is a comprehensive protocol that provides the clinician with numerous qualitative and quantitative images. An evaluation of the reproducibility of 1H-MRS GABA and GSH levels acquired in healthy volunteers with J-difference editing sequences at varying echo times Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): James J. Prisciandaro, Mark Mikkelsen, Muhammad G. Saleh, Richard A.E. Edden Abstract Recent advances in J-difference-edited proton magnetic resonance spectroscopy (1H MRS) data acquisition and processing have led to the development of Hadamard Encoding and Reconstruction of MEGA-Edited Spectroscopy (HERMES) techniques, which enable the simultaneous measurement of ɣ-aminobutyric acid (GABA), the primary inhibitory amino acid neurotransmitter in the central nervous system, and of glutathione (GSH), the most abundant antioxidant in living tissue, at the commonly available magnetic field strength of 3 T. However, the reproducibility of brain levels of GABA and GSH measured across multiple scans in human subjects using HERMES remains to be established. In the present study, twelve healthy volunteers completed two consecutive HERMES scans of the dorsal anterior cingulate cortex (dACC) to assess the test-retest reproducibility of the technique for GABA and GSH measurements at TE = 80 ms. Eleven of the twelve participants additionally completed two consecutive MEGA-PRESS scans at TE = 120 ms, with editing pulses configured for GSH acquisition, to compare the reliability of GSH in the same voxel measured using the standard MEGA-PRESS at TE = 120 ms. The primary findings of study were that, 1) the coefficient of variation (CV) of measuring GABA with HERMES was 16.7%, which is in agreement with the reliability we previously reported for measuring GABA using MEGA-PRESS; and 2) the reliability of measuring GSH with MEGA-PRESS at TE = 120 ms was more than twice as high as that for measuring the antioxidant with HERMES at TE = 80 ms (CV = 7.3% vs. 19.0% respectively). These findings suggest that HERMES and MEGA-PRESS offer similar reliabilities for measuring GABA, while MEGA-PRESS at TE = 120 ms is more reliable for measuring GSH relative to HERMES at TE = 80 ms. In-situ observation for natural gas hydrate in porous medium: Water performance and formation characteristic Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Lunxiang Zhang, Mingrui Sun, Lingjie Sun, Tao Yu, Yongchen Song, Jiafei Zhao, Lei Yang, Hongsheng Dong Abstract Extensive efforts have been made regarding gas hydrate sample reconstruction in the laboratory for a better understanding and development of natural gas resources. Magnetic resonance imaging (MRI) is a useful method for directly observing the reconstruction of methane hydrate, yet relevant studies remain limited. In this study, a 9.4-T 400-MHz MRI instrument was employed to investigate CH4 hydrate formation in porous media involving various initial water saturation levels and sand diameters. Pressure histories and MRI signal variations were monitored to discuss the process of CH4 hydrate growth, and the three main formation stages of induction, rapid growth, and slow formation were determined. Furthermore, the liquid water performance in MRI micro-images was analyzed to predict the characteristics of CH4 hydrate formation. The results indicated that CH4 hydrate formed in a spatially and temporally random manner and that pore plugging occurred owing to the residual water encased in grown hydrate. Additionally, phase saturations, water conversion percentages, and formation rates were defined to evaluate the effect of sand diameter and initial water saturation on CH4 hydrate formation. With the reduction in the diameter of quartz glass beads from 400 μm to 100 μm, the average hydrate formation rate increased from 0.0010 min−1 to 0.0034 min−1, respectively. When the initial water saturation decreased to the optimized value (0.22 in this study), the water conversion percentage and hydrate saturation increased. Non-contrast enhanced diagnosis of acute myocarditis based on the 17-segment heart model using 2D-feature tracking magnetic resonance imaging Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Mona Salehi Ravesh, Matthias Eden, Patrick Langguth, Tim-Christian Piesch, Johanna Karolin Lehmann, Annett Lebenatus, David Hauttemann, Joachim Graessner, Norbert Frey, Olav Jansen, Marcus Both Abstract PurposeThe aim of this study was to investigate the diagnostic value of myocardial deformation analysis based on the 17-segment heart model using non-contrast enhanced (CE) 2D tissue feature tracking (2D-FT) technique. Material and methodsSeventy patients with suspected myocarditis underwent a cardiovascular magnetic resonance (CMR) examination at 1.5 Tesla. A contrast-agent-free part of this CMR protocol was additionally performed in forty healthy volunteers (HV). Besides standard CMR data sets, 2D-FT derived segmental and global longitudinal, radial, and circumferential deformation parameters were analyzed. The 2D-FT results were compared to the combined findings from CMR imaging and endomyocardial biopsy (EMB). ResultsPatients were assigned to three groups depending on their ejection fraction (EF) (<40%, 40–55%, ≥55%). Compared to HV, impaired EF (<55%) was significantly correlated to reduced segmental and global strain and strain rate values. The circumferential deformation analysis was more sensitive to myocardial changes than longitudinal and radial analysis. The segmental strain/strain rate had an accuracy of 84.3%/70.0% for the diagnosis of an acute myocarditis, stated by EMB and CMR in 42 of 70 patients. In patients with preserved EF, acute myocarditis could be ruled out using only segmental strain analysis with a negative predictive value of 87.5%. ConclusionIn patients with suspected myocarditis, the deformation analysis based on the 17-segment heart model provides valuable information about functional myocardial inhomogeneity. This quantitative approach could be used in addition to the clinical standard CMR protocol and represents a promising tool in the framework of a prospective automatized multiparametric CMR imaging analysis. MRF-ZOOM for the unbalanced steady-state free precession (ubSSFP) magnetic resonance fingerprinting Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Ze Wang, Di Cui, Jian Zhang, Ed.X. Wu, Edward S. Hui Abstract In magnetic resonance fingerprinting (MRF), tissue parameters are determined by finding the best-match to the acquired MR signal from a predefined signal dictionary. This dictionary searching (DS) process is generally performed in an exhaustive manner, which requires a large predefined dictionary and long searching time. A fast MRF DS algorithm, MRF-ZOOM, was recently proposed based on DS objective function optimization. As a proof-of-concept study, MRF-ZOOM was only tested with one of the earliest MRF sequences but not with the recently more popular unbalanced steady state free precession MRF sequence (MRF-ubSSFP, or MRF-FISP). Meanwhile noise effects on MRF and MRF-ZOOM have not been examined. The purpose of this study was to address these open questions and to verify whether MRF-ZOOM can be combined with a dictionary-compression based method to gain further speed. Numerical simulations were performed to evaluate the DS objective function properties, noise effects on MRF, and to compare MRF-ZOOM with other methods in terms of speed and accuracy. In-vivo experiments were performed as well. Evaluation results showed that premises of MRF-ZOOM held for MRF-FISP; noise did not affect MRF-ZOOM more than the conventional MRF method; when SNR ≥ 1, MRF quantification yielded accurate results. Dictionary compression introduced quantification errors more to T2 quantification. MRF-ZOOM was thousands of times faster than the conventional MRF method. Combining MRF-ZOOM with dictionary compression showed no benefit in terms of fitting speed. In conclusion, MRF-ZOOM is valid for MRF- FISP, and can remarkably save MRF dictionary generation and searching time without sacrificing matching accuracy. Tsallis-Entropy Segmentation through MRF and Alzheimer anatomic reference for Brain Magnetic Resonance Parcellation Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Mehran Azimbagirad, Fabrício H. Simozo, Antonio C.S. Senra Filho, Luiz O. Murta Junior Abstract Quantifying the intracranial tissue volume changes in magnetic resonance imaging (MRI) assists specialists to analyze the effects of natural or pathological changes. Since these changes can be subtle, the accuracy of the automatic compartmentalization method is always criticized by specialists. We propose and then evaluate an automatic segmentation method based on modified q-entropy (Mqe) through a modified Markov Random Field (MMRF) enhanced by Alzheimer anatomic reference (AAR) to provide a high accuracy brain tissues parcellation approach (Mqe-MMRF). We underwent two strategies to evaluate Mqe-MMRF; a simulation of different levels of noise and non-uniformity effect on MRI data (7 subjects) and a set of twenty MRI data available from MRBrainS13 as patient brain tissue segmentation challenge. We accessed eleven quality metrics compared to reference tissues delineations to evaluate Mqe-MMRF. MRI segmentation scores decreased by only 4.6% on quality metrics after noise and non-uniformity simulations of 40% and 9%, respectively. We found significant mean improvements in the metrics of the five training subjects, for whole-brain 0.86%, White Matter 3.20%, Gray Matter 3.99%, and Cerebrospinal Fluid 4.16% (p-values < 0.02) when Mqe-MMRF compared to the other reference methods. We also processed the Mqe-MMRF on 15 evaluation subjects group from MRBrainS13 online challenge, and the results held a higher rank than the reference tools; FreeSurfer, SPM, and FSL. Since the proposed method improved the precision of brain segmentation, specifically, for GM, and thus one can use it in quantitative and morphological brain studies. Graphical abstract The correlation of fractional anisotropy parameters with Ki-67 index, and the clinical implication in grading of non-enhancing gliomas and neuronal-glial tumors Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Xiang Liu, Wei Tian, Balasubramanya Kolar, Mahlon D. Johnson, Michael T Milano, Haihui Jiang, Song Lin, Dongmei Li, Nimish A. Mohile, Yan M. Li, Kevin A. Walter, Sven Ekholm, Henry Z Wang Abstract PurposeTo investigate the correlation between the FA parameters and Ki-67 labeling index, and their diagnostic performance in grading supratentorial non-enhancing gliomas and neuronal-glial tumors (GNGT). MethodsThis institutional review board-approved, Health Insurance Portability and Accountability (HIPAA) compliant retrospective study enrolled 35 patients, including 19 with low grade GNGT and 16 with high grade GNGT. The mean FA, maximal FA and mean maximal FA values derived from diffusion tensor imaging were measured. The correlation between the FA parameters and the Ki-67 labeling index was assessed by Spearman rank test. The receiver operating characteristic curve analysis and multivariate logistic regression analysis were performed to detect the optimal imaging parameters in grading GNGT. ResultsThe three FA parameters of low grade GNGT were significantly lower than the high grade GNGT (p < 0.001). The mean FA, maximal FA and mean maximal FA had significant positive correlation with Ki-67 labeling index (p = 0.001, p < 0.001, p < 0.001 respectively). The maximal FA showed a higher sensitivity and specificity in grading of non-enhancing GNGT with specificity of 78.9%, sensitivity of 100.0%, respectively. ConclusionsThe FA parameters correlated with Ki-67 labeling index, and were useful surrogates in preoperative grading supratentorial non-enhancing GNGT. Generation of human thalamus atlases from 7 T data and application to intrathalamic nuclei segmentation in clinical 3 T T1-weighted images Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Yuan Liu, Pierre-François D'Haese, Allen T. Newton, Benoit M. Dawant Abstract The thalamus serves as the central relay station for the brain. It processes and relays sensory and motor signals between different subcortical regions and the cerebral cortex and it can be divided into several neuronal clusters referred to as nuclei. Each of these can possibly be subdivided into sub-nuclei. Accurate and reliable identification of thalamic nuclei is important for surgical interventions and neuroanatomical studies. This is however a challenging task because the small size of the nuclei and the lack of contrast over the thalamus region in clinically acquired images does not permit the visualization of their boundaries. A number of methods have been developed for thalamus parcellation but the vast majority of these relies on diffusion imaging or functional imaging. The low resolution of these images only permit localizing the largest nuclei. In this work we propose a method to segment smaller nuclei. We first present a protocol to build histological-like atlases from a series of high-field (7 Tesla) MR images acquired with different pulse sequences that each permits to visualize the boundaries of a subset of the nuclei. We use this protocol to scan 9 subjects and we manually delineate 23 thalamic nuclei following the Morel atlas naming convention for each of these subjects. Manual contours for the nuclei are subsequently utilized to create statistical shape models. With these data, we compare four methods for the segmentation of thalamic nuclei in 3 T images we have also acquired for the 9 subjects included in the study: (1) single atlas, (2) multi atlas, (3) statistical shape, and (4) hierarchical statistical shape in which thalamic nuclei are hierarchically fitted to the images, starting from the largest ones. Results of a leave-one-out validation study conducted on the nine image sets we have acquired show that the multi atlas approach improves upon the single atlas approach for most nuclei. Segmentations obtained with the hierarchical statistical shape model yield the highest accuracy, with dice coefficients ranging from 0.53 to 0.90, mean surface errors from 0.27 mm to 0.64 mm, and maximum surface errors from 1.31 mm to 2.52 mm for all nuclei averaged across test cases. This suggests the feasibility of using such approach for localizing thalamic substructures in clinically acquired MR volumes. It may have a direct impact on surgeries such as Deep Brain Stimulation procedures that require the implantation of stimulating electrodes in specific thalamic nuclei. Quantitative ferumoxytol-enhanced MRI in pregnancy: A feasibility study in the nonhuman primate Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Ante Zhu, Scott B. Reeder, Kevin M. Johnson, Sydney M. Nguyen, Sean B. Fain, Ian M. Bird, Thaddeus G. Golos, Oliver Wieben, Dinesh M. Shah, Diego Hernando Abstract ObjectivesTo assess the feasibility of ferumoxytol-enhanced MRI in pregnancy with a nonhuman primate model. Materials and methodsIn this prospective study, eleven pregnant rhesus macaques at day 98 ± 5 of gestation were divided into three groups, untreated control (UC) (n = 3), saline control (SC) (n = 4) and interleukin 1 beta (IL-1β) treated (IT) (n = 4), which were administered with either saline or IL-1β into the amniotic fluid. All animals were imaged at multiple time points before and after ferumoxytol administration (4 mg/kg). Longitudinal R2* and susceptibility of tissues were obtained using region-of-interest analysis and the longitudinal changes were assessed using linear mixed models and Student's t-test. ResultsIn fetuses, a slope of 0.3 s−1/day (P = 0.008), 0.00 ppm/day (P = 0.699) and − 0.2 s−1/day (P = 0.023) was observed in liver R2*, liver susceptibility, and lung R2*, respectively. In placentas, R2* and susceptibility increased immediately after ferumoxytol administration (P < 0.001) and decreased to baseline within two days. The mean change from baseline showed no significant difference between the SC group and the IT group at all scan time points. In maternal livers, R2* increased immediately after ferumoxytol administration, further increased at one-day, and then decreased but remained elevated (P < 0.001). The mean change from baseline showed no significant difference between the SC group and the IT group at all scan time points. ConclusionsThis work demonstrates the feasibility of quantitative ferumoxytol-enhanced MRI to measure dynamics of ferumoxytol delivery and washout in the placenta. Stable MRI measurements indicated no evidence of iron deposition in fetal tissues of nonhuman primates after maternal ferumoxytol exposure. Evaluation of B0-correction of relative CBF maps using tagging distance dependent Z-spectrum (TADDZ) Publication date: January 2020 Source: Magnetic Resonance Imaging, Volume 65 Author(s): Frederick C. Damen, Rong-Wen Tain, Riya Thomas, Weigo Li, Leon Tai, Kejia Cai Abstract Arterial spin labeling (ASL) MRI, based on endogenous contrast from blood water, is used in research and diagnosis of cerebral vascular conditions. However, artifacts due to imperfect imaging conditions such as B0-inhomogeneity (ΔB0) could lead to variations in the quantification of relative cerebral blood flow (CBF). In this study, we evaluate a new approach using tagging distance dependent Z-spectrum (TADDZ) data, similar to the ΔB0 corrections in the chemical exchange saturation transfer (CEST) experiments, to remove the imaging plane B0 inhomogeneity induced CBF artifacts in ASL MRI. Our results indicate that imaging-plane B0-inhomogeneity can lead to variations and errors in the relative CBF maps especially under small tagging distances. Along with an acquired B0 map, TADDZ data helps to eliminate B0-inhomogeneity induced artifacts in the resulting relative CBF maps. We demonstrated the effective use of TADDZ data to reduce variation while subjected to systematic changes in ΔB0. In addition, TADDZ corrected ASL MRI, with improved consistency, was shown to outperform conventional ASL MRI by differentiating the subtle CBF difference in Alzheimer's disease (AD) mice brains with different APOE genotypes.
STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging methodPublication date: January 2020Source: Magnetic Resonance Imaging, Volume 65Author(s): E. Mark Haacke, Yongsheng Chen, David Utriainen, Bo Wu, Yu Wang, Shuang Xia, Naying He, Chunyan Zhang, Xiao Wang, M. Marcella Lagana, Yu Luo, Ali Fatemi, Saifeng Liu, Sara Gharabaghi, Dongmei Wu, Sean K. Sethi, Feng Huang, Taotao Sun, Feifei Qu,...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Thyroidology and public health: Challenges within the medical profession Sanjay Kalra Thyroid Research and Practice 2019 16(3):93-94 Assessment of serum midkine level in benign and malignant thyroid nodules. Can midkine be a marker of thyroid malignancy? Nermin Ahmed Sheriba, Maram Mohamed Mahdy, Rana Hashem Ibrahim Elattary, Maha Mohamed El-Nabarawy Thyroid Research and Practice 2019 16(3):95-99 Background: Thyroid nodules are a common clinical problem. The prevalence of malignancy in thyroid nodules is currently about 5%–15%. Fine-needle aspiration biopsy (FNAB) has improved the preoperative prediction of malignancy, but still has disadvantages including operator variability and nondiagnostic reports. Midkine (MK) is a novel heparin-binding growth factor; MK levels have been proposed as indicative of malignancy in numerous tumors. MK overexpression in thyroid cancer has been reported to be in correlation with clinicopathological features of the tumor, hypothesizing that MK might play a role as a biomarker for diagnosis and more aggressive behavior of thyroid cancer. Aim: The aim of this study is to evaluate the value of serum MK (SMK) as a marker of malignancy in patients with nodular thyroid disease. Patients and Methods: The current study included 75 individuals with age ranging from 25 to 80 years divided into 25 with malignant thyroid nodule (Group A), 25 with benign thyroid nodule (Group B), and 25 healthy individuals as a control group (Group C). Free triiodothyronine, free thyroxin, thyroid-stimulating hormone, and SMK levels were assessed. Individuals with thyroid nodules were submitted for neck ultrasonography and FNAB. Results: On comparing the three studied groups, a high statistically significant difference in plasma MK levels was found (P < 0.001), being higher in Group A (malignant nodule) with a mean of 1.127 ± 0.527 than Group B (benign nodule) with a mean of 0.536 ± 0.301 with P < 0.001* and also higher in Group A (malignant nodule) with a mean of 1.127 ± 0.527 than Group C (control) with a mean of 0.366 ± 0.230 with P < 0.001*. There was significant difference regarding MK levels, with thyroid nodule contour being higher in thyroid nodule with irregular contour than thyroid nodule with regular contour (P < 0.001*) and calcification being higher in microcalcification than macrocalcification (P = 0.006*). There was high statistically significant difference regarding the level of MK between papillary carcinoma and follicular carcinoma (P < 0.001*). Conclusions: SMK might be the indicator of malignant thyroid cytopathology, suggesting that MK might serve as a novel biomarker in the assessment of thyroid nodules. The present study explored the usefulness of MK as a biomarker in the differentiation between benign and malignant thyroid nodules in samples from serum. Morphological variations of the thyroid gland: An insight on embryological and clinicoanatomical considerations Honnegowda Thittamaranahalli Muguregowda, G Krishna, KG Prakash Thyroid Research and Practice 2019 16(3):100-104 Background: The thyroid gland, a highly vascular endocrine gland, is composed of two lateral lobes connected by isthmus. A wide range of morphological alterations of the thyroid gland such as hypoplasia, ectopy to hemiagenesis, and genesis are common because of disturbed embryogenesis. The significance of diagnosing such extensions of the thyroid gland is crucial. It may alter the normal anatomical relationship of the thyroid gland with other adjacent cervical structures. Further, it may be confused with a tumor mass on magnetic resonance imaging and scintillation scans. Methods: The primary aim is to study the thyroid gland for gross anatomical variations (weight, height, and breadth) and secondarily to document the morphometric and congenital/developmental variation gross of the thyroid gland in 65 cadavers from the coastal belt of South India. The glands were according to the various age groups of the cadavers. Results: The mean thyroid weight was 26.01 ± 7.14 g. In males, it was 26.59 ± 6.96 g, whereas in females, it was 20.93 ± 8.98 g. The pyramidal lobe was present in 35 (53.8%), and the presence of the levator glandulae thyroideae was noted in 25 (38.48%) of male cadavers. Agenesis of the isthmus was found in 20 (30.76%). However, the accessory thyroid tissue was found in only one female cadaver. Conclusions: Our morphometric study on cadaveric thyroid glands highlights individual and ethnic variations. Knowledge of various developmental anomalies and unusual variations of the thyroid gland is of paramount importance to differentiate it from other pathologies such as autonomous thyroid nodule and thyroiditis. Role of nuclear grooves in the cytological diagnosis of papillary carcinoma thyroid Archana S Bhat, Lisa Varma, Hilda Fernandes, CS Jayaprakash Thyroid Research and Practice 2019 16(3):105-107 Introduction: It is well known that nuclear grooves play a major role in the diagnosis of papillary carcinoma thyroid (PCT). Furthermore, grooves are found in many nonneoplastic lesions of thyroid. Aims: The aim of this study is to calculate the percentage of nuclear grooves in histopathologically proven cases of papillary carcinoma and nonneoplastic lesions (Hashimoto's thyroiditis and colloid goiter). Materials and Methods: This retrospective study was carried out by reviewing the data and cytology smears of 21 histopathologically confirmed cases of PCT and 10 cases each of Hashimoto's thyroiditis and colloid goiter. The percentage of nuclear grooves was calculated in oil immersion by counting 100–500 cells depending on the cellularity. Results: The percentage of nuclear grooving ranged from 15% to 85% in the papillary carcinoma cases. Greater than 20% nuclear grooves were observed in 19 (90.4%) of the cases. Nuclear crowding and overlapping, pale chromatin, nuclear grooves, nuclear enlargement, and prominent nucleoli were seen in all (100%) cases. Intranuclear cytoplasmic pseudoinclusions were seen in only 5 (23.8%) of the cases. Histiocytes, metaplastic cells, and multinucleated giant cells were seen in 12 (57.1%), 10 (47.6%), and 6 (28.5%) of the cases. The percentage of nuclear grooves in nonneoplastic cases overall observed was <10%. The sensitivity and specificity of grooves for PCT at ≥20% were 90.5% and 100%, respectively. Conclusion: Whenever in doubt, a diagnosis of papillary carcinoma can be offered confidently by this semiquantitative approach for grooves in combination with other features. Iodine nutrition status in Graves' disease: A single-center study from Bangladesh Md Abu Jar Gaffar, A B. M. Kamrul-Hasan, Afsar Ahammed, Muhammad Abul Hasanat, Md Fariduddin Thyroid Research and Practice 2019 16(3):108-112 Context: An increase in occurrence of Graves' disease (GD) has been reported in many countries after the introduction of the salt iodization program. Aims: To observe iodine nutrition status in GD. Settings and Design: Cross-sectional observational study conducted in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from May 2013 to September 2014. Methods and Material: This study included 140 GD patients (55 newly detected, 85 already under treatment). Urinary iodine concentration (UIC) was measured in spot urine sample following wet digestion method. The iodine nutrition status was categorized according to the internationally recommended cutoffs of UIC (excessive: ≥300 μg/L, more than optimal: 200-299 μg/L, optimal: 100-199 μg/L, deficiency: <100 μg/L). Results: The median UIC in subjects with Graves' disease was 96.69 μg/L. 21.2% of the study subjects had iodine status to be considered as more than optimal or excessive, 25.7% had optimal iodine level, and more than half (51.4%) had iodine deficiency. The mean UIC were similar in newly diagnosed and treated groups, and among subjects with different thyroid functional status. UIC did not differ among male and female subjects and among subjects from different socioeconomic groups. UIC showed no correlations with age, socioeconomic condition, the family history of thyroid disease, TSH, FT4, and thyroid function status of the study participants. Conclusions: Effective monitoring of salt iodization program is needed to prevent iodine-excess related increase in the prevalence of Graves' disease. Prognostic efficacy of thyroid profile with sequential organ failure assessment score in predicting mortality in intensive care unit patients Arvind Mishra, Rohin Saini, Madhukar Mittal, Dandu Himanshu, Kamlesh Kumar Gupta, Abbas Ali Mahdi Thyroid Research and Practice 2019 16(3):113-120 Introduction and Objectives: Thyroid hormone changes in critically ill patients are commonly observed phenomenon. This is known as sick euthyroid syndrome. Sequential organ faillure assessment (SOFA) score is used to track and determine the extent of a person's organ function or its rate of failure. We performed a prospective observation study to analyze the prognostic rather than diagnostic efficacy of thyroid function test (TFT) (T3, T4, thyroid-stimulating hormone [TSH], free triiodothyronine [fT3], and free thyroxine [fT4]) in unselected critically ill patients and compare the prognostic efficacy of fT3, fT4, TSH, T3, and T4 with SOFAS in predicting mortality in critically ill patients. Materials and Methods: We studied a sample of unselected 338 patients admitted in the intensive care unit (ICU) and measured their TFT, routine biochemical parameters within 48 h of admission along with SOFA scores and assessed their individual and combined efficacy in predicting mortality. All patients with known thyroid illness were excluded from this study. Results: There were 200 survivors and 138 nonsurvivors, the nonsurvivors had higher SOFAS score and lower free T3 levels and lower T3 levels compared to survivors. ICU survival was predicted using SOFAS score alone and a combination of TFT with SOFA score. Conclusions: In critically ill patients with higher SOFA score, lower values of serum fT3 and T3 levels were clinically significantly associated with mortality and free T3 have additional powers to improve predictive ability to SOFAS in predicting mortality in ICU patients. Severe hypothyroidism-associated acute renal failure – A case series from North India and review of literature Namrata S Rao, Abhilash Chandra, Kiran Preet Malhotra Thyroid Research and Practice 2019 16(3):121-127 Background: Several cases of complete or partially reversible renal failure have been reported in association with severe hypothyroidism, which have responded to thyroxine replacement. However, its risk factors, pathology, pathophysiology, and time of recovery remain unclear. Aim: We report our experience with 31 cases of renal failure in association with severe hypothyroidism, from a goiter-endemic belt in North India, along with a review of existing literature. Materials and Methods: We retrieved cases presenting to our centre, from August 2013 to April 2018 and collected information regarding clinical presentation, laboratory parameters including renal and thyroid function tests, creating kinase, urinary findings and follow-up data pertaining to time and extent of renal function recovery. In three cases, renal biopsies were also done, and these were reviewed by a pathologist. Results: In our study, females slightly outnumber males. More than one-third of patients were known hypothyroid and had defaulted on medications. The severity of serum thyroid-stimulating hormone and CK elevation were not associated with the severity of renal failure or its extent or time of recovery. Older age, coexistence of diabetes mellitus and/or hypertension, higher serum creatinine at presentation, and urinary abnormalities (proteinuria and/or active sediments) correlated significantly with lack of complete renal recovery. All the three biopsies revealed significant tubulointerstitial fibrosis. Conclusions: Thyroid function tests should be performed in the evaluation of unexplained renal failure, even in cases with underlying chronic kidney disease. It is also an important preventable cause of renal failure in known hypothyroid patients. A case-based approach to aggressive variants of papillary thyroid carcinoma with literature review Joseph Antoine Flordelis Chatto, Annette Laurente Salillas Thyroid Research and Practice 2019 16(3):128-136 Papillary thyroid caarcinoma (PTC) is the most common thyroid and endocrine malignancy. Although considered to be indolent, aggressive variants have been identified, including the Tall Cell (TCV), Columnar Cell (CCV), Hobnail (HPTC) and Solid Variants (SVPTC). The objective of this study is to pre-operatively recognize the cytologic features of these variants. Four cases with final diagnoses of TCV, CCV, HPTC and SVPTC were reviewed and compared with Fine Needle Aspiration Biopsy (FNAB) smears. The first case is a 44-year-old female diagnosed with TCV pre-operatively through FNAB and was confirmed through tissue biopsy showing malignant glands in papillary formation with greater than 50% of tall cells. The second patient is a 54-year-old female with CCV showing stratified columnar cells with cytoplasmic supranuclear and subnuclear vacuoles. Third is a 57-year-old female with HPTC exhibiting eccentrically-located nuclei imparting a hobnail appearance with cellular dyscohesiveness. The fourth case is a 59-year-old female diagnosed with SVPTC showing predominantly solid sheets surrounded by thin, delicate fibrous stroma. They all have nuclear features of PTC. TCV, CCV, HPTC and SVPTC are related to extrathyroidal extension, angiolymphatic invasion, positive surgical margin and lymph node metastasis. FNAB is an important tool to recognize these variants preoperatively and plan for amore comprehensive management. Extensive squamous metaplasia in papillary carcinoma of the thyroid: A potential diagnostic pitfall Subhash Yadav, Rajiv Kumar, Munita Bal, Asawari Patil Thyroid Research and Practice 2019 16(3):137-139 It is a rare event to find squamous cells in the thyroid gland. Squamous metaplasia (SM) of the thyroid follicular epithelium is one of such conditions. SM can occur in association with nonneoplastic as well as neoplastic thyroid lesions. Here, we report a case of papillary carcinoma of the thyroid in a 26-year-old female showing extensive SM. On immunohistochemistry, squamous as well as papillary carcinoma component expresses CK7 and thyroglobulin. High molecular weight cytokeratin and p63 were positive in only in the squamous area, while TTF-1 was negative in these cells. Extensive SM in the thyroid can be misinterpreted as primary or metastatic squamous cell carcinoma. Further, the tumor may be mislabeled as collision tumors of thyroid. As it might lead to therapeutic implications, the distinction of SM in thyroid is necessary. Diagnostic issue and caveats of immunoreactivity for Ki67 in hyalinizing trabecular neoplasm with a review of literature Veer Karuna, Priya Gupta, Mamta Gupta, Kriti Grover Thyroid Research and Practice 2019 16(3):140-143 Few benign and malignant tumors of thyroid lesion share many histological features, including papillary and trabecular pattern, hyalinized stroma, calcification, nuclear grooving, and nuclear inclusion. The lesions those have these common features are hyalinizing trabecular tumor, papillary thyroid carcinoma, medullary carcinoma, paraganglioma, trabecular follicular adenoma (TFA), and poorly differentiated tumor (PDT). These tumors are derived from thyroid follicular cell except PDT and paraganglioma. Hyalinized trabecular tumor and TFA are rare tumors. Due to these common features, they create a diagnostic pitfall for a false-positive or false-negative diagnosis. Therefore, histopathological and immunohistochemical studies are needed to make a definite diagnosis. The present case describes a relatively rare thyroid tumor – hyalinizing trabecular tumor – with its varied morphological features creating diagnostic difficulties and role of immunohistochemistry in formulating definitive diagnosis.
Thyroidology and public health: Challenges within the medical professionSanjay KalraThyroid Research and Practice 2019 16(3):93-94Assessment of serum midkine level in benign and malignant thyroid nodules. Can midkine be a marker of thyroid malignancy?Nermin Ahmed Sheriba, Maram Mohamed Mahdy, Rana Hashem Ibrahim Elattary, Maha Mohamed El-NabarawyThyroid Research and Practice 2019 16(3):95-99Background: Thyroid nodules are a common clinical problem. The prevalence of malignancy in thyroid nodules...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Statistical need of the hour Sanjeev Kumar Jain, Nidhi Sharma, Sonika Sharma Acta Medica International 2019 6(2):51-52 Impact of CD40 gene polymorphism on coronary artery disease in an Indian population: A pilot study Sapna Singh, Manisha Naithani, Sarama Saha Acta Medica International 2019 6(2):53-57 Context: Coronary artery disease (CAD) is number one killer in India. CD40/CD40 L may have crucial contribution in the development of CAD because of its dual prothrombotic and proinflammatory role. However, no study has been conducted to observe the effect of CD40 gene polymorphism on CAD in Indian populations. Aims: To determine the allelic frequency of CD40 gene and its influence on Indian individuals having unstable chest pain and cardiac muscle infarction which are variants of CAD. Settings and Design: A clinic-based observational study was conducted in Maulana Azad Medical College. Eighty angiographically proven patients of CAD and fifty healthy individuals registered for this study. Materials and Methods: Polymerase chain reaction and restriction fragment length polymorphism were used for studying CD40 gene polymorphism. Statistical Analysis Used: Frequency distribution of genotype was analyzed by standard Chi-square test using SPSS software version 21. Results: The C and T allele frequencies were 71.25% and 28.75%, respectively, in diseased individuals. Significant difference was observed among patients with CAD and healthy references regarding distribution of genotypes (χ2 = 10, P = 0.007) although allele frequencies (χ2 = 2.94, P = 0.09) of CD40 gene did not show any significance. The presence of C allele augmented the chance of having CADs compared to the wild type (odds ratio: 1.13; 95% confidence interval: 0.687–1.887). Conclusions: Important correlation was noted between rs1883832 C/T polymorphism of CD40 gene and risk of development of CADs among Indian populations. Oxidative stress and biomarker of tumor necrosis factor-alpha, malondialdehyde, and ferric reducing antioxidant power in hypertension Manish Kumar Verma, Anoop Jaiswal, Preeti Sharma, Pradeep Kumar, Anand Narayan Singh Acta Medica International 2019 6(2):58-64 Background: Concurrent with the imbalance of oxidizing agents and antioxidants, high blood pressure (BP) is a major physical condition burden in the current scenario. Tumor necrosis factor-alpha (TNF-α) plays a vital role in the pathogenesis of hypertension (HTN). TNF-α inhibitor improves clinical symptoms; however, their outcome on high BP has not been investigated. We investigated the inflammatory marker TNF-α, malondialdehyde (MDA), and ferric reducing antioxidant power (FRAP) in hypertensive patients. We measured BP randomly using an ambulatory observe in hypertensive patients. Measured systolic BP was 140 mmHg and/or diastolic BP was 90 mmHg were considered hypertensive. Materials and Methods: A total of 60 cases were considered in the study involving 30 hypertensive patients and 30 normal controls (30). Measurements of serum concentrations of TNF-α, MDA, and FRAP in HTN patients were done in both the groups. Results: Serum TNF-α was found to be remarkably increased in study participants as compared to the normal group (r = 0.32,P < 0.0001*). Serum MDA was also raised in hypertensive as compared to the control group (r = 0.99**,P < 0.0001*), whereas serum FRAP was found to be decreased in the hypertensive group in comparison to the healthy controls (r = 0.23,P < 0.0001*). Conclusions: It is concluded that high BP leads to the generation of oxidative stress with a remarkable elevation of TNF-α and MDA levels. The indicates decrease level of Ferric Reducing Antioxidant Power (FRAP) and suggest a possible role of oxidative stress in the pathophysiology of hypertension. Assessment of vital respiratory indices of petrol pump workers of Kathmandu Rajan Pandit Acta Medica International 2019 6(2):65-67 Introduction: Petrol pump is a place where workers are exposed to both fuel vapor and the vehicular exhaust fumes. Automobile exhaust, a complex mixture of different gasses such as sulfur dioxide, carbon dioxide, carbon monoxide, nitrogen dioxide, and particulate matter, has an adverse impact on the respiratory system. The present cross-sectional study, therefore, has been designed to determine the few vital respiratory indices of petrol pump workers. Methods: Forty nonsmoker petrol pump workers and other forty participants, as a control group from the same locality, were considered in this study. All inclusion and exclusion criteria were followed. After participants were familiarized with spiro-excel (PC bases) spirometer, they were asked to perform maneuver – a forced expiratory following full inspiration – until they could duplicate the maneuvers successfully on three consecutive attempts. Parameters such as forced vital capacity (FVC), forced expiratory volume in the 1st s (FEV1), FEV1/FVC (%), peak expiratory flow rate (PEFR), and forced expiratory flow at 25%–75% (FEF25%–75%) were recorded in sitting position preceded by 5-min rest, and the best values of three attempts were considered for data analysis using SPSS 16.0 version, and t-test (P < 0.05) was used for statistical analysis. Results: The mean ± standard deviation values of FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR for petrol pump workers versus control groups were 3.44 ± 0.23 versus 3.94 ± 0.25 L, 2.64 ± 0.20 versus 3.24 ± 0.29 L, 77.11% ± 0.08% versus 82.61% ± 0.09%, 4.36 ± 0.37 versus 5.58 ± 0.36 L/s, and 6.35 ± 0.27 versus 7.62 ± 0.45 L/s, respectively. Conclusion: The significant decrease in FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR in this study showed that long-term exposure to gasoline fumes/products leads to inflicted changes in lungs functions and could result to obstructive lung disease. Clinical profile and maternal depression and anxiety in children and adolescents with intellectual disability: A study from outpatient child psychiatry Bilal Ahmad Bhat, Shabir Ahmad Dar, Wasim Qadir, Mudassir Hassan Pandith Acta Medica International 2019 6(2):68-73 Background: With prevalence between 1% and 3%, intellectual disability (ID) not only affects the children and adolescents with this disability but also the caregivers, particularly the mothers. Aims: The aim was to study the clinical profile of children and adolescents with ID along with the prevalence of depressive and anxiety disorders in their mothers. Settings and Design: Cross-sectional descriptive study was conducted in Outpatient child psychiatry clinic. Methodology: Children and adolescents diagnosed with ID by a psychiatrist and clinical psychologist where subjected to a semi-structured questionnaire to record the sociodemographic status, antenatal history, perinatal history, and developmental history, presenting complaints, current behavioral problems, and medical history. Psychiatric comorbidity in the study participants and depression and anxiety disorders in their mothers was also assessed. Results: With the mean age of 8.68 years ± 2.63, majority (81.2%) belonged to the age group of 6–12 years with predominance of boys (60%). Antenatal factors were present in about 18%, whereas perinatal factors were present in about 48%. Delayed developmental history was present in 75%. Psychiatric comorbidity was present in about 32%, whereas current behavioral problems were present in about 47%. Majority (about 71%) had mild ID. Maternal depression and anxiety disorders were present in about 70%. Statistical Analysis: Descriptive analysis was performed with the Statistical Package for the Social Sciences. Conclusion: High rates of antenatal and perinatal factors with a history of developmental delay in a significant number of children and adolescents with ID were found. Mild ID predominated. Behavioral problems, psychiatric comorbidity, and medical comorbidity were frequently observed. Maternal depression and anxiety were also very high. Prevalence of different types of sphenoid sinus pneumatization in the Indian population: A noncontrast computed tomography-based study Abdul Haseeb Wani, Arshed Hussain Parry, Imza Feroz, Naseer Ahmad Choh, Tariq A Gojwari Acta Medica International 2019 6(2):74-77 Background: Trans-sphenoidal approach for various surgical interventions of sella and suprasellar pathologies is fraught with the risk of injuring vital neurovascular structures which lie nearby. Preoperative knowledge of the pattern of sphenoid sinus pneumatisation is of paramount importance to anticipate and simultaneously undertake appropriate precautions to avert any complication. Objective: To determine the prevalence of different types of sphenoid sinus pneumatisation in our population. Materials and Methods: NCCT head images of 613 patients were analysed retrospectively to determine the type of sphenoid sinus pneumatisation. Individuals in the age range of 20 to 75 years were included in the study. Individuals with age less than 20 years (pneumatisation incomplete), previous surgery involving skull base/sphenoid sinus and trauma causing hemo-sinus/fractures around skull base or having space occupying lesions around skull base/sphenoid sinus were excluded from the study. Results: The age range of evaluated patients was 20 to 75 years with mean age of 45.67 years of which 368 (60.03%) were males and 245 (39.97%) were females. There was no significant statistical difference in the prevalence of various types of sphenoid sinus pneumatisation between male and female subjects (P-value >0.05). The commonest type of sphenoid sinus pneumatisation was post-sellar type (82.71%) followed by sellar (14.68%) and pre-sellar (2.45%) type. Conchal type was extremely rare. Conclusions: Preoperative computed tomographic (CT) evaluation of sellar region is a requisite whenever trans-sphenoidal surgery is contemplated to determine the location and extent of sphenoid sinus walls to shorten operative time and to minimize morbid consequences. Determination of the gallbladder wall thickness in patients with cholecystitis and cholelithiasis by ultrasonography in North Indian population Vishram Singh, Durgesh Singh, Ashutosh Tandon, Yogesh Yadav, Richa Tiwari Acta Medica International 2019 6(2):78-81 Objective: The objective of the study was to determine the gallbladder (GB) wall thickness in patients with cholecystitis and cholelithiasis with the help of ultrasonography in North Indian population for the estimation of epidemiology. Aim: The aim was to estimate epidemiology of the GB wall thickness in patients with cholecystitis and cholelithiasis by ultrasonography in North Indian population. Materials and Methods: This was a hospital-based case–control study. Patients with cholecystitis and cholelithiasis of age between 15 and 70 years of either sex were included in the study. The GB wall thickness was determined in the fasting state. A total of 50 samples, 36 cases (with diseased bladder) and 14 controls (with normal bladder) were included in the study. Results: More than one-third of cases (38.9%) were between 30 and 40 years. The mean age of cases and controls was 42.22 ± 12.81 and 35.43 ± 11.85 years, respectively. More than one-third of both cases (36.1%) and controls (35.7%) were males. The GB wall thickness was significantly (P = 0.005) higher among the cases (4.06 ± 2.28 mm) than that of controls (2.22 ± 0.67 mm). Full distention of the GB was in more than half of both cases (69.4%) and controls (57.1%). Partial distended was in 11.1% of cases and in 21.4% of controls. Contracted (8.3%) and overdistended (2.8%) were only seen among cases. The GB wall thickness of ≥3 mm was among 66.7% of patients and in 14.3% of controls. The GB wall thickness of <3 mm was 92% lower in cases compared to controls (odds ratio = 0.08, 95% confidence interval = 0.01–0.43, P = 0.001). Conclusion: During ultrasonography, a higher degree of the GB wall thickness was found in patients with cholecystitis and cholelithiasis as compared to the control group. Role of a noninvasive stool-based molecular test in screening and early detection of colorectal cancers Khalid Ahmad Al-Sindi, Mulazim Hussain Bukhari, Mohmed Ali Al-Hamar Acta Medica International 2019 6(2):82-88 Background: Colonoscopy is considered the gold standard for most currently established screening programs for colorectal carcinoma (CRC), but due to its invasive nature, there were several emerging needs for the use of a substitutive, sensitive, non-invasive triaging modalities, such as utilizing immunochromatographic fecal occult blood tests (IFOBT) or molecular stool based tests such as Glycolytic M2-Pyruvate Kinase (M2-PK). Objectives: Firstly, to evaluate the sensitivity of a molecular stool based (M2PK) test, as a non-invasive, screening modality for detecting CRC and other colorectal disease (CRD). Secondary, to insight the current prevalence of CRC precursors in the Kingdom of Bahrain and recommend a customized age of enrollment in National Screening Program for CRC, once established and Thirdly, to compare the sensitivity of this fecal tumor marker based M2-PK test, as a potential replacement for the currently used IFOB test, in an attempt to promote for the need to establish a National Screening Program for Colorectal Cancer (NSPCC) based on such molecular based test or a similar platform in the kingdom, much comparable to the currently established international screening programs. Design: Prospective, cross sectional study. Duration and Place of Study: July 2012-December 2016, King Hamad University Hospital (KHUH), Bahrain. Sample Size: 2,100 (Based on Bahrain Population statistics: 1,248.348. Materials and Methods: The stool samples were collected shortly after launching a nationwide public awareness campaign against CRD in all major governmental and private sector hospitals and clinics. Out of the intended 2100 target samples, 1074 individuals managed to go through the well-structured distributed questioner and have been selected according to the inclusion/exclusion criteria and submitted their stools' samples for the detection of any CRD. A combined (molecular M2-PK and IFOBT) stool tests were used to detect any CRD in all examined stool samples. A total of 105 M2-PK' positive and 85 M2-PK'negative individuals underwent a subsequent specialist consultation and a fast track colonoscopy. Results: Out of the intended 2100 study sample, 1552 Participants were obtained during the study period and out of those, 1199 have been selected based on the inclusion and exclusion criteria. The no-show selected participants were 624 and only 575 individuals have submitted their Stool samples along with fully completed questioners. Out of those 575, only 287 stool samples were positive with M2-PK test, while 197 of the same stool samples were positive with IFOBT. Among these positive cases, only 105 of participants agreed after their medical consultation to undergo for full colonoscopies and biopsies for microscopic examination. These 105 successful full colonoscopies reveled 85 (81%) individuals negative for any neoplastic lesion and only 20 individuals (19%) showed neoplastic lesion. These 20 neoplastic findings included, 17 (85%) adenomatous polyps, 02 (10%), adenocarcinomas, and 01 (5%) was neuroendocrine carcinoma. The 17 adenomatous polyps were 09 tubular adenomas, 01 villous adenoma, and 07 tubulovillous adenomas. The colonoscopy findings in those (85) negative cases for neoplastic lesion were (6) hemorrhoids, (13) hyperplastic polyps, (10) normal mucosae with normal biopsies, (9) diverticulosis, (1) angiodysplasia, (1) inflammatory bowel disease and (1) solitary rectal ulcer. Conclusion: The screening of CRC by Stool Based molecular test such M2-PK showed high sensitivity for the detection of neoplastic Colorectal lesions compared to IFOBT. The study also found that stool based molecular (M2-PK) test, is a rapid, non-invasive, and convenient technique, which can be used as a platform for a forthcoming CRC National Screening Program in the Kingdom of Bahrain. Functional reach test: Establishing the reference value in healthy adults of Gujarat, India Vyoma Bharat Dani, Riki Shah, Rima Sheth Acta Medica International 2019 6(2):89-92 Context: Functional reach test (FRT) is a quick and simple, single-task dynamic test to measure the balance of an individual during functional task and is considered to be a predictor of fall in older adults. There is a lack of availability of data from a large population-based study, especially in India. Aim: The aim of the present study is to establish the reference value for FRT in healthy adults of Gujarat, India. Materials and Methods: It was a cross-sectional, observational study. Five hundred and twenty-one healthy individuals, aged 40–70 years, were recruited based on convenience sampling. All the participants were made to perform FRT in a controlled environment in community. Three readings of the actual test were obtained and averaged. Results: Data were analyzed with mean, standard deviation, confidence intervals (confidence interval 95%), and Pearson's correlation coefficient (r) with α = 0.05 by the age groups (40–50, 51–60, 61–70 years) and gender. The mean FRT value for healthy adults of Gujarat (age 40–70 years) was found to be 34.94 ± 3.9 cm and 33.43 ± 3.69 cm for males and females, respectively. It also showed significant negative correlation with weight and body mass index and also demonstrated age-related decline for both male and female participants. Conclusion: The reference value for FRT in healthy adults was found to be 34.18 (±3.79) cm. These large population-based data can be used as a reference with a specific age group considering due variability with regards to age, sex, anthropometric measures, genetics, and geographical changes. Robotic-assisted radical adrenalectomy for large adrenocortical carcinoma Altaf Khan, Vinit Kumar Singh, Muhammed A P. Manzoor, M Mujeeburahiman, Nischith Dsouza Acta Medica International 2019 6(2):93-95 Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignancy with poor prognosis. Laparoscopic adrenalectomy has been a favorite surgical approach for the treatment of adrenal masses. The use of robotic-assisted surgery is the latest development for minimally invasive surgical management of adrenal masses. Here, we describe a rare case of ACC in a 51-year-old male patient who presented with pain in the lumbar region, and robot-assisted laparoscopic radical adrenalectomy was successfully performed transperitoneally with the assistance of the da Vinci robotic system. We also discuss the summary of clinical features of ACC. Robot-assisted laparoscopic adrenalectomy is safe, is easier with lesser blood loss, and is comfortable to the patient due to its low complication rates. The patient improved after tumor removal.
Statistical need of the hourSanjeev Kumar Jain, Nidhi Sharma, Sonika SharmaActa Medica International 2019 6(2):51-52Impact of CD40 gene polymorphism on coronary artery disease in an Indian population: A pilot studySapna Singh, Manisha Naithani, Sarama SahaActa Medica International 2019 6(2):53-57Context: Coronary artery disease (CAD) is number one killer in India. CD40/CD40 L may have crucial contribution in the development of CAD because of its dual prothrombotic and proinflammatory role. However,...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Standard safety policy: a retrospect of the Korean chicken egg crisis in 2017 Abstract On August 14, 2017, a report released by the Ministry of Agriculture, Food, and Rural Affairs confirmed the presence of pesticides in chicken eggs in South Korea. The literature has identified various causes for the crisis, such as the lack of criteria for permissible amounts of residual pesticides, and dichotomized management and supervision systems. This study investigated current laws and enactments relevant to South Korea's 2017 crisis of pesticide-contaminated eggs, seeking to extract applicable safety standards. Of the 12 laws directly related to eggs, eight contained a combined total of 19 safety standards. The main problems of these standards include the lack of criteria to regulate permissible amounts of residual pesticides, the lack of standardized countermeasures against residual chemicals, conflicting standards between higher-ranking and lower-ranking legal norms, and confusing misuse of terminology. It is suggested that these problems in egg-related safety standards can be addressed by South Korea adopting the internationally recognized Codex Alimentarius standard, with strengthened application of stricter administrative measures exceeding the Maximum Residue Levels in the field, using unified terminology. Thus, the present study aims to investigate the 2017 crisis to extract safety standards from the law and analyze related problems. The study also makes suggestions to improve applicable safety standards in the hope of preventing the recurrence of similar crises. PAGIF method to verify animal species in dairy products: improved separation performance, sensitivity and efficiency Abstract Over more than 20 years, isoelectric focusing (IEF) in a polyacrylamide gel (PAGIF) has been the only official method in Germany to verify the animal species in dairy products, including cheese. The method remains valid until now, using the analytical standards and the detection and quantification limits of that time. With the introduction of faster, cheaper and more sensitive methods, the PAGIF is in danger to lose importance in food control. Therefore, based on the § 64 method(s) of the German Food and Feed Code (LFGB), the pH gradient has been optimized, on the one hand, to sharpen the protein bands and thus to improve the detection limit (cow's milk: 0.1%, previously 1%) and on the other hand, to make it possible to analyze simultaneously several animal species, such as cow, sheep, goat and buffalo in one single gel. By condensing the workflow and improving the original performance data, the revised PAGIF will continue to be the official method in food control alongside new analytical methods. Prevalence of Salmonella spp. in Egyptian dairy products: molecular, antimicrobial profiles and a reduction trial using d -tryptophan Abstract The study aims to determine the prevalence and serotypes of Salmonella spp. in milk and dairy products sold on Egyptian markets, characterize their virulence-associated genes, and assess their antimicrobial profile. Furthermore, d-tryptophan was used as a new approach for controlling the growth of Salmonella in combination with heat stress. A total of 125 samples (raw market milk, bulk tank milk, Kareish cheese, white soft cheese, and small scale ice cream, 25 each) were used for assessing the prevalence of Salmonella spp. Nine Salmonella isolates with different serotypes were recovered from bulk tank milk (4/9; 44.44%) and Kariesh cheese (5/9; 55.55%), respectively. Antimicrobial susceptibility testing indicated that all isolates were resistant to streptomycin and erythromycin. PCR analysis revealed that 100%, 66.67% and 88.89% of the obtained isolates possessed invA, avrA and stn genes, respectively. d-Tryptophan (40 mM) in combination with heat stress had a significant inhibitory effect on Salmonella enterica subsp. enterica serovar Typhimurium (S. Typhimurium) added to control milk samples. The results indicate insufficient hygienic measures adopted during handling by dairies in Egypt. Therefore, strict hygienic approaches are recommended during milking, processing and distribution of dairy products in Egypt. A synergistic effect of d-tryptophan and heat stress is considered as a promising tool for controlling growth of Salmonella in milk. Stichprobenplanung in der Lebensmittelüberwachung: Reduktion des notwendigen Stichprobenumfangs durch Pooling Zusammenfassung Es wird ein Verfahren zur Berechnung des notwendigen Stichprobenumfangs in einem Pooling-Design zur Ermittlung des Substanzgehalts in Lebensmitteln beschrieben. Mit diesem kann die Poolgröße und die Anzahl notwendiger Messungen zur Bestimmung eines Mittelwerts mit einer vorgegebenen Konfidenzintervallbreite berechnet werden. Wie stark sich die Anzahl analytischer Messungen durch Pooling mehrerer Proben in einer Sammelprobe reduzieren lässt, hängt dabei von der Relation zwischen biologischer Varianz (Variation zwischen Proben unterschiedlichen Ursprungs) und technischer Varianz (Variation zwischen Wiederholungsmessungen) ab. Die Anwendung der Methode wird am Beispiel der Bestimmung von Dioxinen und polychlorierten Biphenylen (PCB) in Hühnereiern erläutert, kann jedoch auf andere Kontaminanten und Lebensmittel übertragen werden. Toy swords revisited: identification of additional odour-active contaminants Abstract Odorants related to offensive odours in three children's toy swords were identified and characterized by human sensory and chemical analyses. Samples were initially evaluated by a trained sensory panel. Panellists reported unpleasant smells in all samples that were dominated by mothball-like, phenolic and rubber-like notes and additionally almond-like and fatty notes. The odorants from the samples were then extracted using dichloromethane and subsequent solvent-assisted flavour evaporation distillation. Enriched distillates were then analysed by means of single and two-dimensional gas chromatography–mass spectrometry/olfactometry. An additional screening analysis for polycyclic aromatic hydrocarbons was also performed on all samples. The most predominant odorants identified in the samples were naphthalene, 1- and 2-methylnaphthalene and diverse dimethylnaphthalene isomers with gasoline-like smells. Acetophenone, with an almond-like, flowery smell, was also detected. Furthermore, the phenolic/leather-like smelling substances 3-ethylphenol, 3-hydroxyacetophenone, and 3-methoxyacetophenone were identified in one sample. Characteristics of enterotoxin-producing methicillin-resistant Staphylococcus aureus strains isolated from meat in Tehran, Iran Abstract In this study, we investigated the clonality, antibiotic susceptibility and presence of different enterotoxin genes among 49 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from 131 fresh raw meat samples in Tehran, Iran during 2016. 47% of beef, 30% of chicken and 27% of turkey samples were MRSA positive. PhenePlate (PhP typing) revealed the presence of 12 PhP types consisting of five common types and seven single types, and 86% of the strains harbored staphylococcal cassette chromosome mec (SCCmec) type III and type 3 cassette chromosome recombinases (ccr). Moreover, SCCmec type IVa was positive in all isolates with SGA prophage types. High level resistance to ciprofloxacin, erythromycin, tobramycin and kanamycin was also observed. The rate of resistance to most of the antibiotics tested was higher in chicken samples compared to other meat samples. Out of eleven different enterotoxin genes found, sea, sek and seq were the dominant genes in all strains. Our results illustrate the presence and persistence of highly resistant clonal groups of enterotoxin-producing MRSA in meat samples. These isolates had PhP and SCCmec types and prophage patterns which were similar to the clinical isolates previously reported in Iran, supporting the notion of dissemination of the MRSA in the hospital, community, as well food products in Iran.
Standard safety policy: a retrospect of the Korean chicken egg crisis in 2017AbstractOn August 14, 2017, a report released by the Ministry of Agriculture, Food, and Rural Affairs confirmed the presence of pesticides in chicken eggs in South Korea. The literature has identified various causes for the crisis, such as the lack of criteria for permissible amounts of residual pesticides, and dichotomized management and supervision systems. This study investigated current laws and enactments relevant to...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:12
Understanding high ε-poly- l -lysine production by Streptomyces albulus using pH shock strategy in the level of transcriptomics Abstract ε-Poly-l-lysine (ε-PL) is a natural food preservative, which exhibits antimicrobial activity against a wide spectra of microorganisms. The production of ε-PL was significantly enhanced by pH shock in our previous study, but the underlying mechanism is poorly understood. According to transcriptional and physiological analyses in this study, the mprA/B and pepD signal transduction system was first proved to be presented and activated in Streptomyces albulus M-Z18 by pH shock, which positively regulated the transcription of ε-PL synthetase (Pls) gene and enhanced the Pls activity during fermentation. Furthermore, pH shock changed the ratio of unsaturation to saturation fatty acid in the membrane through up-regulating the transcription of fatty acid desaturase genes (SAZ_RS14940, SAZ_RS14945). In addition, pH shock also enhanced the transcription of cytochrome c oxidase (SAZ_RS15070, SAZ_RS15075), ferredoxin reductase (SAZ_RS34975) and iron sulfur protein (SAZ_RS31410) genes, and finally resulted in the improvement of cell respiratory activity. As a result, pH shock was considered to influence a wide range of proteins including regulators, fatty acid desaturase, respiratory chain component, and ATP-binding cassette transporter during fermentation. These combined influences might contribute to enhanced ε-PL productivity with pH shock. Adaptive mechanism of Acidithiobacillus thiooxidans CCTCC M 2012104 under stress during bioleaching of low-grade chalcopyrite based on physiological and comparative transcriptomic analysis Abstract Acidithiobacillus thiooxidans (A. thiooxidans) is often used for sulfur-bearing ores bioleaching, but its adaptive mechanism to harsh environments remains unclear. Here, we explored the adaptive mechanism of A. thiooxidans in the process of low-grade chalcopyrite bioleaching based on the physiology and comparative transcriptome analysis. It was indicated that A. thiooxidans maintains intracellular pH homeostasis by regulating unsaturated fatty acids, especially cyclopropane fatty acids, intracellular ATP, amino acid metabolism, and antioxidant factors. Comparative transcriptome analysis indicated that the key genes involved in sulfur oxidation, sor and soxABXYZ, were significantly up-regulated, generating more energy to resist extreme environmental stress by more active sulfur metabolism. Confocal laser scanning microscope analysis found that down-regulation of flagellar-related genes was likely to promote the biofilm formation. System-level understanding of leaching microorganisms under extreme stress can contribute to the evolution of these extremophiles via genetic engineering modification work, which further improves bioleaching in future. Enhanced production of heterologous proteins via engineering the cell surface of Bacillus licheniformis Abstract Cell surface engineering was proven as the efficient strategy for enhanced production of target metabolites. In this study, we want to improve the yield of target protein by engineering cell surface in Bacillus licheniformis. First, our results confirmed that deletions of d-alanyl-lipoteichoic acid synthetase gene dltD, cardiolipin synthase gene clsA and CDP-diacylglycerol-serine O-phosphatidyltransferase gene pssA were not conducive to cell growth, and the biomass of gene deletion strains were, respectively, decreased by 10.54 ± 1.43%, 14.17 ± 1.51%, and 17.55 ± 1.28%, while the concentrations of total extracellular proteins were improved, due to the increases of cell surface net negative charge and cell membrane permeability. In addition, the activities of target proteins, nattokinase, and α-amylase were also improved significantly in gene deletion strains. Furthermore, the triplicate gene (dltD, clsA, and pssA) deletion strain was constructed, which further led to the 45.71 ± 2.43% increase of cell surface net negative charge and 26.45 ± 2.31% increase of cell membrane permeability, and the activities of nattokinase and α-amylase reached 37.15 ± 0.89 FU/mL and 305.3 ± 8.4 U/mL, increased by 46.09 ± 3.51% and 96.34 ± 7.24%, respectively. Taken together, our results confirmed that cell surface engineering via deleting dltD, clsA, and pssA is an efficient strategy for enhanced production of target proteins, and this research provided a promising host strain of B. licheniformis for efficient protein expression. Identification and characterization of the ZRT, IRT-like protein (ZIP) family genes reveal their involvement in growth and kojic acid production in Aspergillus oryzae Abstract The ZRT, IRT-like protein (ZIP) family exists in many species and plays an important role in many biological processes, but little is known about ZIP genes in Aspergillus oryzae. Here, 10 ZIP genes in A. oryzae were identified and these were classified into four groups based on phylogenetic analysis. The structures of these AoZip genes were determined, which indicated a great divergence of AoZip members from different groups. Synteny analysis revealed that AoZip7, AoZip8, and AoZip10 are conserved among Aspergillus species. We also found that the promoter regions of AoZip2, AoZip7, AoZip8, and AoZip10 contain multiple conserved response elements. Expression analysis revealed that AoZips exhibited different expression patterns in response to different metal treatments. Moreover, overexpression and RNA-interference (RNAi) of AoZip2 led to a decrease in mycelium growth diameter and inhibited conidia formation. AoZip2 overexpression and RNAi strains showed distinct sensitivity to severely Zn/Mn-depleted stress. In addition, kojic acid production was markedly lower in AoZip2 overexpression and RNAi strains than in the control strains, and the expression of kojA, kojR, and kojT was down-regulated in AoZip2 overexpression and RNAi strains. This study provides new insights into our understanding of ZIP genes and lays a foundation for further investigation of their roles in Aspergillus oryzae. The expression, secretion and activity of the aspartic protease MpAPr1 in Metschnikowia pulcherrima IWBT Y1123 Abstract Protease-secreting yeasts have broad biotechnological potential for application to various industrial processes, including winemaking. However, this activity is influenced by the yeast response to environmental factors such as nitrogen and protein sources, as are found in grape juice. In this study, the wine-relevant yeast Metschnikowia pulcherrima IWBT Y1123, with known protease-secreting ability, was subjected to different nitrogen-containing compounds to monitor their impact on protease secretion and activity. Protease activity increased above basal levels for haemoglobin-containing treatments, indicating an inductive influence of proteins. On the other hand, treatments containing both haemoglobin and assimilable nitrogen sources led to a delayed increase in protease activity and protein degradation, suggesting a nitrogen catabolite repression mechanism at work. Protease activity and expression were furthermore evaluated in grape juice, which revealed increased expression and activity levels over time as promising results for further investigations into the impact of this yeast on wine properties. Redirecting the lipid metabolism of the yeast Starmerella bombicola from glycolipid to fatty acid production Abstract Free fatty acids are basic oleochemicals implemented in a range of applications including surfactants, lubricants, paints, plastics, and cosmetics. Microbial fatty acid biosynthesis has gained much attention as it provides a sustainable alternative for petrol- and plant oil-derived chemicals. The yeast Starmerella bombicola is a microbial cell factory that naturally employs its powerful lipid metabolism for the production of the biodetergents sophorolipids (> 300 g/L). However, in this study we exploit the lipidic potential of S. bombicola and convert it from the glycolipid production platform into a free fatty acid cell factory. We used several metabolic engineering strategies to promote extracellular fatty acid accumulation which include blocking competing pathways (sophorolipid biosynthesis and β-oxidation) and preventing free fatty acid activation. The best producing mutant (Δcyp52m1Δfaa1Δmfe2) secreted 0.933 g/L (± 0.04) free fatty acids with a majority of C18:1 (43.8%) followed by C18:0 and C16:0 (40.0 and 13.2%, respectively). Interestingly, deletion of SbFaa1 in a strain still producing sophorolipids also resulted in 25% increased de novo sophorolipid synthesis (P = 0.0089) and when oil was supplemented to the same strain, a 50% increase in sophorolipid production was observed compared to the wild type (P = 0.03). We believe that our work is pivotal for the further development and exploration of S. bombicola as a platform for synthesis of environmentally friendly oleochemicals. Microbial production of O -methylated flavanones from methylated phenylpropanoic acids in engineered Escherichia coli Abstract Methylated flavonoids possess improved bioactivities compared to their unmethylated counterparts. In this study, for the efficient production of O-methylated flavonoids from simple methylated phenylpropanoic acids, a recombinant Escherichia coli strain expressing 4-coumarate:coenzyme A ligase (4CL) from Oryza sativa and chalcone synthase (CHS) from Hordeum vulgare was constructed; this strain produced significant amount of homoeriodictyol (~ 52 mg/L) as well as a few amount of hesperetin (0.4 mg/L), respectively, from ferulic acid and 4-methylcaffeic acid. This demonstrates, for the first time, that the scarce but valuable methylated flavanones can be successfully produced from methylated phenylpropanoic acids in a microbial host via an artificial biosynthetic pathway consisting of 4CL and CHS that can accept O-methylated precursors. Beneficial mutations for carotenoid production identified from laboratory-evolved Saccharomyces cerevisiae Abstract Adaptive laboratory evolution (ALE) is a powerful tool used to increase strain fitness in the presence of environmental stressors. If production and strain fitness can be coupled, ALE can be used to increase product formation. In earlier work, carotenoids hyperproducing mutants were obtained using an ALE strategy. Here, de novo mutations were identified in hyperproducers, and reconstructed mutants were explored to determine the exact impact of each mutation on production and tolerance. A single mutation in YMRCTy1-3 conferred increased carotenoid production, and when combined with other beneficial mutations led to further increased β-carotene production. Findings also suggest that the ALE strategy selected for mutations that confer increased carotenoid production as primary phenotype. Raman spectroscopy analysis and total lipid quantification revealed positive correlation between increased lipid content and increased β-carotene production. Finally, we demonstrated that the best combinations of mutations identified for β-carotene production were also beneficial for production of lycopene. Efficient production of glutathione with multi-pathway engineering in Corynebacterium glutamicum Abstract Glutathione is a bioactive tripeptide composed of glycine, l-cysteine, and l-glutamate, and has been widely used in pharmaceutical, food, and healthy products. The current metabolic studies of glutathione were mainly focused on the native producing strains with precursor amino acid supplementation. In the present work, Corynebacterium glutamicum, a workhorse for industrial production of a series of amino acids, was engineered to produce glutathione. First, the introduction of glutathione synthetase gene gshF from Streptococcus agalactiae fulfilled the ability of glutathione production in C. glutamicum and revealed that l-cysteine was the limiting factor. Then, considering the inherent capability of l-glutamate synthesis and the availability of external addition of low-cost glycine, l-cysteine biosynthesis was enhanced using a varieties of pathway engineering methods, such as disrupting the degradation pathways of l-cysteine and l-serine, and removing the repressor responsible for sulfur metabolism. Finally, the simultaneously introduction of gshF and enhancement of cysteine formation enabled C. glutamicum strain to produce glutathione greatly. Without external addition of l-cysteine and l-glutamate, 756 mg/L glutathione was produced. This is first time to demonstrate the potential of the glutathione non-producing strain C. glutamicum for glutathione production and provide a novel strategy to construct glutathione-producing strains. Biological functions of nirS in Pseudomonas aeruginosa ATCC 9027 under aerobic conditions Abstract Through our previous study, we found an up-regulation in the expression of nitrite reductase (nirS) in the isothiazolone-resistant strain of Pseudomonas aeruginosa. However, the definitive molecular role of nirS in ascribing the resistance remained elusive. In the present study, the nirS gene was deleted from the chromosome of P. aeruginosa ATCC 9027 and the resulting phenotypic changes of ΔnirS were studied alongside the wild-type (WT) strain under aerobic conditions. The results demonstrated a decline in the formations of biofilms but not planktonic growth by ΔnirS as compared to WT, especially in the presence of benzisothiazolinone (BIT). Meanwhile, the deletion of nirS impaired swimming motility of P. aeruginosa under the stress of BIT. To assess the influence of nirS on the transcriptome of P. aeruginosa, RNA-seq experiments comparing the ΔnirS with WT were also performed. A total of 694 genes were found to be differentially expressed in ΔnirS, of which 192 were up-regulated, while 502 were down-regulated. In addition, these differently expressed genes were noted to significantly enrich the carbon metabolism along with glyoxylate and dicarboxylate metabolisms. Meanwhile, results from RT-PCR suggested the contribution of mexEF-oprN to the development of BIT resistance by ΔnirS. Further, c-di-GMP was less in ΔnirS than in WT, as revealed by HPLC. Taken together, our results confirm that nirS of P. aeruginosa ATCC 9027 plays a role in BIT resistance along with biofilm formation and further affects several metabolic patterns under aerobic conditions.
Understanding high ε-poly- l -lysine production by Streptomyces albulus using pH shock strategy in the level of transcriptomicsAbstractε-Poly-l-lysine (ε-PL) is a natural food preservative, which exhibits antimicrobial activity against a wide spectra of microorganisms. The production of ε-PL was significantly enhanced by pH shock in our previous study, but the underlying mechanism is poorly understood. According to transcriptional and physiological analyses in this study, the mprA/B and pepD signal...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:11
Deoxyribonucleic Acid Repair Activity Is Associated with Healed Coronary Plaque Rupture by Optical Coherence Tomography Abstract Deoxyribonucleic acid (DNA) damage and repair signaling cascades are related to the development of atherosclerosis. Pathological studies have demonstrated that healed coronary plaque rupture (HCPR) contributes to plaque progression and predisposes to sudden ischemic cardiac death. The objective of this study is to investigate the relationship between HCPR detected by optical coherence tomography (OCT) and DNA ligase. Forty-two patients with both OCT and DNA ligase were prospectively enrolled. The population included patients with stable angina pectoris (SA) and non-ST-elevation myocardial infarction (NSTEMI). It was found that the prevalence of HCPR was greater in subjects with higher DNA ligase activity (correlation coefficient 0.36, p = 0.019). The presence of HCPR in patients with NSTEMI was greater than in patients with SA per OCT analysis; however, there was no statistical difference in this limited population (22.53% versus 12.83%, respectively, p = 0.116). DNA repair activity by DNA ligase was associated with HCPR in advanced coronary artery plaque by OCT. Amyloid Cardiomyopathy in the Rare Transthyretin Tyr78Phe Mutation Abstract Tyr78Phe is a rare pathogenic transthyretin (TTR) mutation. Few previous reports described a late-onset hereditary transthyretin-related amyloidosis (ATTR-m) form with a variable phenotype, mainly dominated by neurological manifestations. We describe the case of a 69-year-old male with massive but asymptomatic cardiac infiltration and only subclinical neurological involvement, and review the literature to depict characteristics of the Tyr78Phe TTR mutation. Application of Proteomics Profiling for Biomarker Discovery in Hypertrophic Cardiomyopathy Abstract High-throughput proteomics profiling has never been applied to discover biomarkers in patients with hypertrophic cardiomyopathy (HCM). The objective was to identify plasma protein biomarkers that can distinguish HCM from controls. We performed a case-control study of patients with HCM (n = 15) and controls (n = 22). We carried out plasma proteomics profiling of 1129 proteins using the SOMAscan assay. We used the sparse partial least squares discriminant analysis to identify 50 most discriminant proteins. We also determined the area under the curve (AUC) of the receiver operating characteristic curve using the Monte Carlo cross validation with balanced subsampling. The average AUC was 0.94 (95% confidence interval, 0.82–1.00) and the discriminative accuracy was 89%. In HCM, 13 out of the 50 proteins correlated with troponin I and 12 with New York Heart Association class. Proteomics profiling can be used to elucidate protein biomarkers that distinguish HCM from controls. Oxidized HDL, as a Novel Biomarker for Calcific Aortic Valve Disease, Promotes the Calcification of Aortic Valve Interstitial Cells Abstract Calcific aortic valve disease (CAVD) is characterized by progressive mineralization of the aortic valve. Lipid infiltration and oxidative stress are the driving forces for the initiation and development of this disease. However, it remains unknown whether oxidized high-density lipoprotein (ox-HDL) plays a role in the mineralization of aortic valve interstitial cells (AVICs). Serum ox-HDL levels were determined in 168 severe CAVD patients and 168 age- and gender-matched non-CAVD controls. Results showed that ox-HDL concentrations were significantly increased in CAVD compared with the control group (131.52 ± 30.96 ng/mL vs. 112.58 ± 32.20 ng/mL, P < 0.001) and were correlated with CAVD severity. Multivariable logistic regression revealed that ox-HDL levels were independently associated with CAVD after adjusting for the incidence of coronary artery disease (CAD) (odds ratio 1.019, 95% CI 1.012–1.027, P < 0.001) or atherosclerotic risk factors (odds ratio 1.027, 95% CI 1.017–1.037, P < 0.001). Chronic ox-HDL stimulation of AVICs increased alkaline phosphatase activity (ALP) and calcium deposits in AVICs in vitro. Mechanistic studies further showed that ox-HDL upregulated several osteogenic factors, including BMP-2, Runx2, and Msx2 expressions in AVICs. This is the first study to demonstrate a relationship between increased ox-HDL concentration and CAVD incidence. Exercise Attenuates Acute β-Adrenergic Overactivation – Induced Cardiac Fibrosis by Modulating Cytokines Abstract During acute sympathetic stress, the overactivation of β-adrenergic receptors (β-ARs) causes cardiac fibrosis by triggering inflammation and cytokine expression. It is unknown whether exercise training inhibits acute β-AR overactivation–induced cytokine expression and cardiac injury. Here, we report that running exercise inhibited cardiac fibrosis and improved cardiac function in mice treated with isoproterenol (ISO), a β-AR agonist. A cytokine antibody array revealed that running exercise prevented most of the changes in cytokine expression induced by ISO. Specifically, ISO-induced upregulation of 18 cytokines was prevented by running exercise. A Kyoto encyclopedia of genes and genomes analysis of these cytokines revealed that Hedgehog and RAP1 signaling pathways were involved in the regulation of cytokine expression by exercise. The changes in the expression of some cytokines that were prevented by exercise were verified by an enzyme-linked immunosorbent assay and real-time PCR. In conclusion, running exercise prevented the cytokine expression changes after acute β-AR overactivation and therefore attenuated cardiac fibrosis. Acute sympathetic stress is an important risk factor for the patients with cardiovascular diseases, and the present study revealed that exercise training can prevent against the upregulation of cytokines and the subsequent cardiac injury induced by acute sympathetic stress, suggesting that exercise training may be beneficial for cardiovascular patients who are in risk of acute sympathetic stress. This finding provides a theoretical basis for the application of exercise training in patients who may suffer from acute sympathetic stress. 3D Myocardial Scar Prediction Model Derived from Multimodality Analysis of Electromechanical Mapping and Magnetic Resonance Imaging Abstract Many cardiac catheter interventions require accurate discrimination between healthy and infarcted myocardia. The gold standard for infarct imaging is late gadolinium–enhanced MRI (LGE-MRI), but during cardiac procedures electroanatomical or electromechanical mapping (EAM or EMM, respectively) is usually employed. We aimed to improve the ability of EMM to identify myocardial infarction by combining multiple EMM parameters in a statistical model. From a porcine infarction model, 3D electromechanical maps were 3D registered to LGE-MRI. A multivariable mixed-effects logistic regression model was fitted to predict the presence of infarct based on EMM parameters. Furthermore, we correlated feature-tracking strain parameters to EMM measures of local mechanical deformation. We registered 787 EMM points from 13 animals to the corresponding MRI locations. The mean registration error was 2.5 ± 1.16 mm. Our model showed a strong ability to predict the presence of infarction (C-statistic = 0.85). Strain parameters were only weakly correlated to EMM measures. The model is accurate in discriminating infarcted from healthy myocardium. Unipolar and bipolar voltages were the strongest predictors. Early Wave Reflection and Pulse Wave Velocity Are Associated with Diastolic Dysfunction in Rheumatoid Arthritis Abstract Rheumatoid arthritis (RA) impacts arterial and diastolic function. This study examined whether arterial properties can determine diastolic function in RA. In 173 RA patients, arterial function measures including carotid femoral pulse wave velocity (PWV), central systolic and pulse pressure, pulse pressure amplification, and the magnitude and timing of the forward and reflected waves were measured using applanation tonometry. Diastolic function parameters including the ratio of early-to-late transmitral velocity (E/A) and ratio of E to the mean of the lateral and septal wall myocardial tissue lengthening (e') were measured using echocardiography. The timing of the reflected wave was associated with E/A; PWV was related to E/e'. The timing of the reflected wave, forward wave magnitude, and pulse pressure amplification were associated with impaired relaxation; PWV was related to increased left ventricular (LV) filling pressure. Early wave reflection and PWV are associated with LV-impaired relaxation and increased filling pressure, respectively, in RA. Prevalence of Cardiac Amyloidosis in Patients with Carpal Tunnel Syndrome Abstract Carpal tunnel syndrome (CTS) is a common finding among patients with cardiac amyloidosis. We sought to determine the prevalence of cardiac amyloidosis in patients who had undergone CTS surgery. From 2005 to 2014, 308 patients ≥ 60 years underwent CTS surgery. Of these, 233 (76%) agreed to participate in the study and 101 (73 ± 8 years; 68% females) showed left ventricular hypertrophy (LVH) ≥ 12 mm and underwent additional studies to diagnose AL and ATTR amyloidosis. Based on complementary studies, three patients were diagnosed with cardiac amyloidosis (two wild-type ATTR and one AL). The three patients showed bilateral CTS with no occupational risk factors. Prevalence of cardiac amyloidosis in the overall cohort was only 1.2% (3/233), but among patients with LVH and bilateral CTS, the prevalence was 5.5% (3/55) and 13.6% (3/22) if cases with an occupational risk factor were excluded. Cardiac amyloidosis should be excluded in the presence of bilateral CTS and particularly if an occupational risk factor is absent. The Influence of Aortic Valve Obstruction on the Hyperemic Intracoronary Physiology: Difference Between Resting Pd/Pa and FFR in Aortic Stenosis Abstract The reliability of fractional flow reserve (FFR) in aortic stenosis (AS) has been questioned because of the uncertain response to vasodilators. A retrospective multicenter cohort of 114 AS patients who underwent coronary physiology assessment was compared with 154 controls before and after propensity matching adjustment. The difference between resting distal coronary vs aortic pressure ratio (Pd/Pa) and FFR (ΔPd/Pa-FFR) was tested against the severity of AS. ΔPd/Pa-FFR was not influenced by the severity of AS in terms of aortic valve area (r = − 0.02, p = 0.83) and gradient (r = − 0.05, p = 0.64) or by the left ventricle hypertrophy (r = − 0.03, p = 0.88). Conversely, ΔPd/Pa-FFR was influenced by the presence of diabetes (r = − 0.24, p = 0.005), peripheral vascular disease (r = − 0.16, p = 0.047), and chronic kidney disease (r = − 0.19, p = 0.03). No significant difference was observed in the ΔPd/Pa-FFR between patients with AS and matched controls. Further studies are warranted to validate the FFR-guided revascularization in patients with AS. Curcumin Induces Endothelium-Dependent Relaxation by Activating Endothelial TRPV4 Channels Abstract It is well-known that curcumin, as a plant substance, has vascular protective effects. TRPV4 (transient receptor potential vanilloid 4) is a highly Ca2+-selective channel in vascular endothelium. In our study, fluorescent Ca2+ imaging in mesenteric arterial endothelial cells (MAECs) and overexpressed TRPV4 human embryonic kidney (HEK293) cells showed that curcumin dose-dependently stimulated Ca2+ influx. Whole-cell patch clamp proved that curcumin stimulated the TRPV4-mediated currents in TRPV4-HEK293 cells. The TRPV4-specific blocker HC067047 markedly decreased the whole-cell current. Molecular modeling and docking showed that the binding site of curcumin and TRPV4 was mainly in the amino acid sequence LYS340-LEU349 of TRPV4 protein. Furthermore, curcumin dose-dependently induced the endothelium-dependent vessel dilatation in small mesenteric arteries. Therefore, our results demonstrated that curcumin stimulates Ca2+ entry in endothelial cells and improves endothelium-dependent vessel relaxation by activating TRPV4 channels. Moreover, we identified the specific binding sites of curcumin and TRPV4, thereby highlighting its potential therapeutic target of cardiovascular diseases.
Deoxyribonucleic Acid Repair Activity Is Associated with Healed Coronary Plaque Rupture by Optical Coherence TomographyAbstractDeoxyribonucleic acid (DNA) damage and repair signaling cascades are related to the development of atherosclerosis. Pathological studies have demonstrated that healed coronary plaque rupture (HCPR) contributes to plaque progression and predisposes to sudden ischemic cardiac death. The objective of this study is to investigate the relationship between HCPR detected by optical...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:11
Metastatic pheochromocytoma and paraganglioma: Management of endocrine manifestations, surgery and ablative procedures, and systemic therapies Publication date: Available online 24 October 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Sina Jasim, Camilo Jimenez Metastatic pheochromocytomas and paragangliomas (MPPGs) are rare neuroendocrine tumors. Most patients present with advanced disease that is associated with manifestations of catecholamine release. Surgical resection of the primary tumor and ablative therapies of metastases—whenever possible—may improve clinical outcomes and, perhaps, lengthen the patient's overall survival. Significant steps in understanding the genetic alterations linked to MPPGs and scientific progress made on cancers that share a similar pathogenesis are leading to the recognition of potential systemic therapeutic options. Data derived from clinical trials evaluating targeted therapies such as tyrosine kinase inhibitors, radiopharmaceuticals, immunotherapy, and combinations of these will likely improve the outcomes of patients with advanced and progressive MPPGs. Exemplary of this success is the recent approval in the United States of the high-specific-activity iodine131 meta-iodine-benzylguanidine (MIBG) for patients with unresectable and progressive MPPGs that express the noradrenaline transporter. This review will discuss the therapeutic approaches for patients with MPPGs. Pheochromocytoma: An approach to diagnosis Publication date: Available online 22 October 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Emilia Sbardella, Ashley B. Grossman Pheochromocytomas are rare neuroendocrine chromaffin-derived tumors that arise within the adrenal medulla. They are usually benign, but if not diagnosed or if left untreated, they can have devastating consequences. Clinical consideration of the diagnosis is paramount, as they may have protean manifestations, and a high index of suspicion is essential if serious consequences are to be avoided. An accurate biochemical diagnosis is crucial for the management of these patients: either plasma or urinary metanephrines are both highly sensitive and specific if correctly employed, but knowledge of pre- and post-analytic interference is essential. Diagnostic imaging with cross-sectional CT and/or MRI offers high sensitivity in their detection, but lack specificity. The introduction of PET/CT/MR has led to a dramatic improvement in the localization of both pheochromocytomas and paragangliomas, together with the increasing availability of new functional imaging radionuclides. Optimal investigation and accurate diagnosis is best achieved at 'centers of excellence' with expert multidisciplinary teams. Disease monitoring of patients with pheochromocytoma or paraganglioma by biomarkers and imaging studies Publication date: Available online 21 October 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Florentine Schreiner, Felix Beuschlein Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors, a large proportion of which secrete catecholamines. PPGL are associated with a high cardiovascular morbidity and come with a risk of malignancy. The therapy of choice is surgical resection. Nevertheless, PPGL are associated with a lifelong risk of tumor persistence or recurrence. Currently, there are no clinical, biochemical, histopathological or imaging characteristics, which can predict or exclude malignant behavior or tumor recurrence. Therefore, long-term follow-up is recommended even after apparent complete surgical removal. Early detection of recurrence is essential to reduce cardiovascular morbidity and mortality due to catecholamine secretion, to prevent morbidity by mass effects of paraganglioma (PGL) or by metastatic spread of disease. Due to the rarity of these tumors, no prospective data on long-term surveillance exist. In fact, current recommendations are based on retrospective analyses, expert opinions and case studies. The aim of this review is to provide an overview on the current state of knowledge with regard to known factors that increase the risk of recurrence and might impact disease monitoring as well as the available possibilities for biochemical and imaging follow-up. Based on this overview, we aim to propose a practical approach for a patient-oriented follow-up after surgical removal of a PPGL. Autoimmune polyglandular diseases Publication date: Available online 4 October 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): George J. Kahaly, Lara Frommer Autoimmune polyglandular diseases (APD) are defined as the presence of two autoimmune –induced endocrine failures. With respect to the significant morbidity and potential mortality of APD, the diagnostic objective is to detect APD at an early stage, with the advantage of less frequent complications, effective therapy and better prognosis. This requires that patients at risk be regularly screened for subclinical endocrinopathies prior to clinical manifestation. Regarding the time interval between manifestation of first and further endocrinopathies, regular and long-term follow-up is warranted. Quality of life and psychosocial status are poor in APD patients and involved relatives. Familial clustering is high in patients with APD. Considering the high incidence of one or more endocrinopathies in first-degree relatives of patients with APD, family members should be regularly screened since they may also develop autoimmune endocrinopathies. Multidisciplinary management of these multiplex families in specialized centers is warranted. Modern endocrine surgery – Striving for a better quality of life Publication date: Available online 28 September 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Henning Dralle, Frank Weber Value of ileus-prophylactic surgery for metastatic neuroendocrine midgut tumours Publication date: Available online 25 September 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Frank Weber, Henning Dralle Neuroendocrine tumours of the small intestine (SINET) are a rare disease. However, a rising incidence rate and excellent long-term survival, even in the setting of metastatic disease lead to a high prevalence of SINET of up to 11/100.000. At the time of diagnosis, most patients already suffer from metastatic disease. About one third of patients demonstrate localized or regional metastatic disease at time of presentation. For those patients the indication for curative surgery is not debated and 10-year cancer specific survival of almost 90% can be achieved. Due to major limitations of existing studies actually there is no sufficient evidence in favour of ileus-prophylactic palliative surgery for metastatic SINET. Until now the available evidence favouring an ileus-prophylactic palliative small bowel resection for stage IV SI-NET must be weighed against available high-level evidence from randomized trials that showed long-term survival under systemic therapy. Importantly, there is not a single study that indicates surgery for a symptomatic patient should be postponed. Because the majority of patients are symptomatic at the time of diagnosis, the rationale for an ileus-prophylactic palliative surgery is to operate before progression of mesenteric tumour mass and desmoplasia takes place and before intestinal obstruction and ischaemia occurs. To what extent a prophylactic palliative small bowel resection will provide a survival benefit in a situation where the mesenteric tumour mass cannot be resected radically is not clearly addressed by the current level of evidence. Insights into the autoimmune aspect of premature ovarian insufficiency Publication date: Available online 16 September 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Kassem Sharif, Abdulla Watad, Charlie Bridgewood, Darja Kanduc, Howard Amital, Yehuda Shoenfeld Premature ovarian insufficiency (POI) refers to a continuum of decreasing ovarian function in women before the age of 40. To date, the cause of POI in the majority of cases remain unresolved. Many cases has been linked to genetic, toxic, infections, enzymatic and iatrogenic causes. A key function of the immune system is to identify and differentiate "self" and "non self" i.e. tolerance. Loss of self-tolerance results in an immune response against self-tissues and thus autoimmunity. Various investigations have highlighted the role of autoimmunity and its pertinence to POI. Several potential immune antigenic targets in the ovary have been reported to be involved in autoantibody induced autoimmune attack. The presence of lymphocytic oöphorits in ovarian samples of patients with POI provides histopathological evidence of autoimmune ovarian involvement. Finally, POI is strongly associated with other autoimmune conditions including for instance Addison disease, autoimmune polyglandular syndrome (APS) −1, APS-4, hypothyroidism, and diabetes mellitus among other autoimmune diseases. Taken together, these lines of evidence provide strong basis that support the role of autoimmunity as a potential cause of disease etiopathogenesis. Continuing research is increasingly providing more insight into the complex disease process. The aim of this review is to summarize the current literature related to the autoimmune nature of POI. Exacerbations of autoimmune diseases during pregnancy and postpartum Publication date: Available online 11 September 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Vânia Vieira Borba, Gisele Zandman-Goddard, Yehuda Shoenfeld Autoimmune diseases represent a complex heterogeneous group of disorders that occur as a results of immune homeostasis dysregulation and loss of self-tolerance. Interestingly, more than 80% of the cases are found among women at reproductive age. Normal pregnancy is associated with remarkable changes in the immune and endocrine signaling required to tolerate and support the development and survival of the placenta and the semi-allogenic fetus in the hostile maternal immune system environment. Gravidity and postpartum represent an extremely challenge period, and likewise the general population, women suffering from autoimmune disorders attempt pregnancy. Effective preconception counseling and subsequent gestation and postpartum follow-up are crucial for improving mother and child outcomes. This comprehensive review provides information about the different pathways modulating autoimmune diseases activity and severity, such as the influence hormones, microbiome, infections, vaccines, among others, as well as updated recommendations were needed, in order to offer those women better medical care and life quality. Autoimmune diseases and pregnancy Publication date: Available online 11 September 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Angela Tincani, Cecilia Nalli, Jamilya Khizroeva, Victoria Bitsadze, Andrea Lojacono, Laura Andreoli, Yehuda Shoenfeld, Alexander Makatsariya Pregnancy in autoimmune diseases remains an argument of debate. In last years great improvements were done and with the correct medical support women with disease such as Systemic Lupus Erythematosus or Antiphospholipid Syndrome can afford a pregnancy and have healthy babies. The starting point is a good counselling. Women should be informed about risks that can occur taking some medications while pregnant and, on the other hand, that there are medications that can be safety assumed during pregnancy. Furthermore, there are known maternal risks factor such as the presence of antiphospholipid antibodies or anti-Ro/SSA antibodies that must be carefully manage by both rheumatologists and obstetrics. In addition, also disease activity during pregnancy can represent an issue. For all these reason, a multidisciplinary approach is mandatory in order to give our patients an optimal medical support, before, during and after pregnancy. Prolactin and autoimmunity: The hormone as an inflammatory cytokine Publication date: Available online 11 September 2019 Source: Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Vânia Vieira Borba, Gisele Zandman-Goddard, Yehuda Shoenfeld Nowadays, more than 80 autoimmune disorders are recognized, in which an aberrant immune response against different organs and tissues plays a crucial role. Hormonal homeostasis has great influence in achieving competent and healthy immune system function. Prolactin has a bioactive function acting as a hormone and a cytokine. It influences the immune system modulation, mainly inhibiting the negative selection of autoreactive B lymphocytes. Hyperprolactinemia has been detected in many patients with different autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, multiple sclerosis, autoimmune thyroid disease, systemic sclerosis, among others, and its believed to play a crucial role in disease pathogenesis. A direct correlation between prolactin levels and disease activity was not clear. Genetic factors may have a role in humans as in animal models. Dopamine agonists have proven to offer clinical benefits among autoimmune patients and represent a promising therapy to be explored. In this review, the authors attempt to provide a critical overview on the role of prolactin in the immune system, exploring its contribution to the development of autoimmune diseases.
Metastatic pheochromocytoma and paraganglioma: Management of endocrine manifestations, surgery and ablative procedures, and systemic therapiesPublication date: Available online 24 October 2019Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): Sina Jasim, Camilo JimenezMetastatic pheochromocytomas and paragangliomas (MPPGs) are rare neuroendocrine tumors. Most patients present with advanced disease that is associated with manifestations of catecholamine release....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:10
The utility of thromboelastography and tranexamic acid in plasminogen activator inhibitor deficiency during pregnancy: a rare case report Complete plasminogen activator inhibitor-1 (PAI-1) deficiency is a very rare genetic disorder that is associated with an increased risk of bleeding diathesis. Patients with PAI-1 deficiency are also known to be at increased risk for massive postpartum hemorrhage. We discuss one such rare case of PAI-1 deficiency in a young pregnant patient at 22 weeks of gestation with history of prolonged bleeding. Tranexamic acid was administered for menorrhagia and resumed later for labor and continued into the postpartum period since antifibrinolytics have been the mainstay in the management of PAI-1 deficiency. The patient delivered a healthy infant at 39 weeks. As PAI-1 deficiency causes increased fibrinolysis, the patient's coagulation panel was monitored by performing serial thromboelastograms to monitor for any increase in fibrinolysis. We believe that thromboelastograms might be a useful tool in the monitoring and management of fibrinolytic conditions such as PAI-1 deficiency. Correspondence to Nitya Prabhakaran, MD, Resident, Post Graduate Year 4, Pathology and Anatomic Sciences, Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, M263 Medical School Building, One Hospital Drive, Columbia, MO 65212, USA Tel: +1 573 882 1201; e-mail: prabhakarann@health.missouri.edu Received 29 May, 2019 Revised 21 October, 2019 Accepted 25 October, 2019 Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved. von Willebrand factor alloantibodies in type 3 von Willebrand disease The development of neutralizing antibodies is a rare complication of von Willebrand disease treatment. In major surgical procedures for severe forms of the disease, the recognition of ineffective therapy and alternative treatment protocols are lifesaving. We report the case of a 6-year-old girl with type 3 von Willebrand disease in whom inhibitors were sought due to ineffective haemostasis together with lower than expected von Willebrand factor (VWF) recoveries after a surgical procedure. Replacement therapy first with recombinant factor VIIa and then with high doses of recombinant factor VIII in continuous infusion successfully stopped the bleeding. A high level of anti-VWF antibodies was determined by the immunological method. A frameshift mutation associated with premature termination codon (c.2435delC, p.Pro812ArgfsTer31) was determined in our patient. Although the reports on association of this mutation with inhibitor risk are inconsistent, it represents an evidence-based diagnostic and management practice in recognition of high-risk VWF genotype. Correspondence to Barbara Faganel Kotnik, MD, PhD, Department of Haematology and Oncology, University Medical Centre Ljubljana, University Children's Hospital, Bohoričeva 20, 1000 Ljubljana, Slovenia. Tel: +386 1 522 9215; fax: +386 1 522 4038; e-mail: barbara.faganel@kclj.si Received 16 May, 2019 Revised 22 August, 2019 Accepted 26 September, 2019 Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved. Evaluation of biomarkers for monitoring thrombogenic potential of FXaI16L A zymogen-like activated factor X variant (FXaI16L) is being developed for treating acute bleeding conditions. Activated factor V is an essential cofactor to FXaI16L for activating prothrombin to thrombin. Thrombi/emboli formation was observed microscopically in FXaI16L toxicity studies in animals. The objective of this research was to evaluate candidate biomarkers for FXaI16L-induced thrombi/emboli formation to inform safety monitoring and dose-escalation decisions in FXaI16L clinical trials. Effects of intravenous FXaI16L administration on platelets, fibrinogen, activated partial thromboplastin time (aPTT), prothrombin time (PT), D-dimer, tissue factor pathway inhibitor, thrombin : antithrombin complex, antithrombin, and factor V, and protein C (PC) activities were evaluated in mice, rats, and monkeys. Mice had endogenous factor V activity 10× that of monkeys and were overly sensitive to FXaI16L-induced thrombi/emboli formation. In monkeys, decreases in fibrinogen and prolongation in aPTT and PT emerged as potential biomarkers for impending FXaI16L-induced thrombi/emboli formation, based on association of changes with microscopically observable thrombi/emboli (0–97 thrombi/emboli per monkey). PC decreases, measured by a clot-based assay, were also observed. A similar reduction in PC activity, when measured by clot-based assay, was observed in a phase 1 clinical trial. However, an in-vitro experiment with human plasma spiked with increasing concentrations of FXaI16L indicated dose-dependent FXaI16L-induced interference with clot-based assays and no depletion of PC or S by FXaI16L in non-clot-based assays. Nonclinical biomarker studies identified fibrinogen, aPTT and PT as potential biomarkers for monitoring the clinical safety of FXaI16L. Results of clot-based assays with FXaI16L treatment should be interpreted with caution. Correspondence to Michael W. Bolt, PhD, DABT, Drug Safety Research and Development, Pfizer Inc, 1 Portland St, Cambridge, MA 02139, USA Tel: +1 617 674 6408; e-mail: Michael.Bolt@Pfizer.com Received 3 May, 2019 Revised 27 August, 2019 Accepted 26 September, 2019 Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved. Congenital afibrinogenemia in a patient with vascular abnormalities and a novel variant: clinical-molecular description and literature review The objective is to report a patient with congenital afibrinogenemia and vascular abnormalities and also review the clinical and molecular issues. The female proband, diagnosed with congenital afibrinogenemia, was admitted at a hospital due to a hemorrhagic shock. Angiotomography revealed ectasias from ascending branch to the abdominal aorta, with multiple calcifications and atheroma. Clinical exome identified a homozygous novel pathogenic variant in FGG gene. In our review the main symptom, at diagnosis, was umbilical cord bleeding and the degree of clinical involvement varied from asymptomatic to severe. The FGA gene was the most affected and possible hot spots were observed. Variants considered as loss of function were the most frequent. The association of vascular abnormalities in a patient with congenital afibrinogenemia alerts for a closer follow-up of vascular issues in these patients. Correspondence to Luiza A. Virmond, Clinical Genetics Department, Universidade Federal de São Paulo, Rua Botucatu, 394, Vila Clementino, São Paulo 04023-061, SP, Brazil E-mail: virmondluiza@gmail.com Received 2 August, 2019 Accepted 15 October, 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.bloodcoagulation.com). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.bloodcoagulation.com). Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved. An obscure case of using apixaban anti-Xa levels in a morbidly obese patient who was nil per os with enterocutaneous fistula Apixaban anti-Xa levels have been introduced to monitor apixaban activity. Presented is a fundamental use of anti-Xa monitoring in questionable absorption in enterocutaneous fistula. A 57-year-old morbidly obese male (150 kg, BMI 42.5) presented to the emergency department with deep venous thromboses and pulmonary embolisms. He also had high-output enterocutaneous fistula managed with an abdominal collection device, total parental nutrition therapy, and nil per os status. He was able to take some oral (PO) medications; however, he reported finding whole capsules in his collection device. He refused enoxaparin injections for venous thromboembolism treatment. The decision was made to load with apixaban therapy with anti-Xa monitoring. After two 10-mg doses, peak apixaban anti-Xa level was 146 ng/ml which fell within on-therapy levels in the AMPLIFY study, prothrombin time 18 s, partial thromboplastin time 35.5 s, international normalized ration 1.5. Monitoring was an important factor in this patient with questionable absorption and further complicated by his morbid obesity which has not been adequately studied in clinical trials. Correspondence to Jennifer L. Cole, PharmD, BCPS, BCCCP, Clinical Pharmacy Specialist, Veterans Healthcare System of the Ozarks, Department of Pharmacy, 1100 North College Avenue, Fayetteville, AR 72703, USA Tel: +1 479 444 4020; e-mail: Jennifer.cole@va.gov Received 24 June, 2019 Revised 15 August, 2019 Accepted 6 October, 2019 Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved. Investigating the influence of LCT rs3754689 polymorphism on inhibitor development in Iranian and Afghan patients with severe hemophilia A Development of alloantibodies against factor VIII (FVIII) in patients with severe hemophilia A is the main complication of FVIII replacement therapy. There are many studies indicating several genetic factors associated with inhibitor development. A recent study showed that there is a correlation between the risk of inhibitor development and LCT rs3754689 polymorphism among Italian hemophilia A patients. The aim of this study was to speculate whether LCT rs3754689 polymorphism is correlated to inhibitor development in Afghan and Iranian patients. In addition, we assessed the association of F8 gene mutations and inhibitor development in Iranian patients. This case–control study was conducted on 33 severe hemophilia A patients with inhibitor and 119 samples without inhibitor. Genotyping was performed by Sanger sequencing, inverse and multiplex PCR. According to the obtained data, we found a significant correlation between LCT rs3754689 polymorphism and the risk of inhibitor development in Afghan patients (observed risk, 0.11; 95% confidence interval, 0.01–0.88; P = 0.012). Among Iranian patients, rs3754689 polymorphism showed no significant association with inhibitor development against FVIII (P > 0.05). However, we found a significant correlation between the risk of inhibitor formation and large deletions and nonsense mutations in F8 gene among Iranian patients (observed risk, 7.25; 95% confidence interval, 1.93–27.18; P = 0.003). Lack of association of rs3754689 polymorphism in Iranian population shows the various effects of genetic markers in different populations. More studies in different ethnicities or larger sample sizes are recommended. Correspondence to Sirous Zeinali, Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran; Dr Zeinali's Medical Genetics Laboratory, Kawsar Human Genetics Research Center, Tehran, Iran; Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran E-mail: zeinali@kawsar.ir Received 18 June, 2019 Revised 29 August, 2019 Accepted 26 September, 2019 Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved. Thrombin generation test with the calibrated automated thrombogram and anticoagulant activity of Mentha crispa Evaluate the in-vitro effect of Mentha crispa extract on blood coagulation, compare the conventional coagulometric tests with thrombin generation test (TGT), and study the qualitative micromolecular composition of M. crispa. Extract of M. crispa was incubated with plasma and used in the coagulometric tests: prothrombin and activated partial thromboplastin times, fibrinogen, and TGT. A phytochemical prospection was performed to evaluate the chemical composition of this extract. The extract was efficient in prolonging prothrombin time and activated partial thromboplastin time, and reducing fibrinogen levels and TGT parameters, indicating that the extract of M. crispa inhibited the intrinsic and extrinsic pathways of blood coagulation. The results obtained in TGT are in agreement with the results of conventional coagulometric tests and the in-vitro anticoagulant activity of M. crispa suggests that its use by patients using oral anticoagulants deserves caution. Correspondence to Paula M. Leite, Department of Pharmaceutical Products, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Belo Horizonte, Minas Gerais, Brazil. Tel: +55 31 3409 6936; fax: +55 31 3409 6935; e-mail: paulamleite02@gmail.com; ORCID ID 0000-0002-8499-5791 Received 27 June, 2019 Revised 13 September, 2019 Accepted 26 September, 2019 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.bloodcoagulation.com). Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved.
The utility of thromboelastography and tranexamic acid in plasminogen activator inhibitor deficiency during pregnancy: a rare case reportComplete plasminogen activator inhibitor-1 (PAI-1) deficiency is a very rare genetic disorder that is associated with an increased risk of bleeding diathesis. Patients with PAI-1 deficiency are also known to be at increased risk for massive postpartum hemorrhage. We discuss one such rare case of PAI-1 deficiency in a young pregnant patient at 22 weeks of gestation...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
09:10
Effects of combined nicotine and caffeine on the rat skeletal muscles: A histological and immunohistochemical study Faizah Alotaibi, Seham K Abounasef, Heba Fikry Journal of Microscopy and Ultrastructure 2019 7(4):147-152 Background: Nicotine and caffeine are pharmacologically active substances that consumed widely in the whole world. Most of the nicotine users also consume caffeine. Smokers tend to drink more coffee than nonsmokers. It is important to characterize these substances with regard to their effects on the histological and immunohistological structure. Objectives: The objective of the study is to assess the impact of combined administration of nicotine and caffeine on histological structure of the skeletal muscle tissue in the adult male Wistar rats. Materials and Methods: Twenty adult male Wistar rats with an average weight of 200–250 g were randomly divided into four equal groups: control, nicotine, caffeine, and combined (nicotine + caffeine). The diaphragm muscle was processed and stained with hematoxylin and eosin (H and E) stain, histochemically by periodic acid–Schiff (PAS) and immunohistochemically by anti-CD68 antibodies. Results: After injected nicotine, thick basement membrane with apparent increase in the positive CD68 macrophages inbetween the diaphragm muscle fibers. After injected caffeine, there was an apparent accumulation of mononuclear cells around some fibers with decrease in the PAS positive fibers. Combined injected (nicotine + caffeine) group, some fibers exhibited deep acidophilic cytoplasm with flat peripheral nuclei and apparent increase of the CD68 positive cells. There was an increase in PAS positive material around fibers appearing as a thick basement membrane. Conclusions: The present study proved that caffeine and nicotine either taken alone or in combination have many negative impacts on the active type of skeletal muscles like diaphragm leading to degenerative changes that may affect their function. Effect of suramin on renal proximal tubular cells damage induced by cisplatin in rats (histological and immunohistochemical study) Eman Ali El-Kordy Journal of Microscopy and Ultrastructure 2019 7(4):153-164 Background: Renal toxicity is the most common complication of cispaltin therapy that has broad-spectrum antitumor activity against a variety of human solid tumor. Suramin, a Food and Drug Administration-approved old drug is a polysulfonated compound of napthylurea originally designed to treat trypanosomiasis. Aim: The current work aimed to investigate the possible protective effect of different doses of suramin against cisplatin-induced renal proximal tubular cells (RPTCs) damage. Material and Methods: Fifty adult male rats were used and divided into five equal groups. Group I served as a control, group II received suramin alone (10 mg/kg). Groups III, IV and V were administered cisplatin once (5 mg/kg, intraperitoneally) alone or combined with low dosage suramin (5 mg/kg) or high dosage suramin (10 mg/kg) once intravenously respectively. Results: Compared with control rats, cisplatin administration caused proximal tubules damage, RPTCs vacuolation with pyknotic nuclei, loss of brush border and widespread caspase-3 immunostaining. Cisplatin-induced RPTCs toxicity was further confirmed morphometrically (a significantly decreased proximal tubular epithelium height and increased mean number of caspase-3-immunopositive cells). These changes were accompanied by biochemical alteration manifested as a significant increase of blood urea nitrogen and serum creatinine. Simultaneous administration of high-dose but not low-dose suramin to the cisplatin-treated rats improved the deleterious morphological and morphometrical effects on RPTCs and restored the aforementioned biochemical parameters to control values. Conclusion: In conclusion suramin in a dose dependant manner protects RPTCs from damage induced by cisplatin. Protective effect of pomegranate (Punica granatum) extract against diabetic changes in adult male rat liver: Histological study Khadija A Faddladdeen, Ahlam Abdulaziz Ojaimi Journal of Microscopy and Ultrastructure 2019 7(4):165-170 Background: Diabetes mellitus could be result from disorders in insulin secretion or receptors, characterized by hyperglycemia. Natural antioxidants including pomegranate have hypoglycemic effect. Aim of the Work: The present research was designed to evaluate the possible protective role of pomegranate peel extract (PPE) against diabetic-induced hepatic complication. Materials and Methods: Forty-eight male Wistar rats, weighed 200–250 g and aged 3 months, were sorted into four groups: Group 1: Used as control, Group 2: Normal rats received PPE (200 mg/kg bw/day) given orally for 11 consecutive weeks. Group 3: Streptozotocin (STZ)-diabetic rats, injected with 55 mg/kg bw of STZ, and Group 4: Normal rats received PPE for 11 weeks and then rats were injected with STZ (55 mg/kg/bw). Effectiveness of the PPE was assessed by measuring serum glucose and histopathology of liver tissue. Liver enzymes were also assayed. PPE was found to control diabetic hyperglycemia and decrease in body weight. Histological examination showed that pretreatment with PPE provided preservation against diabetes-induced hepatic histological changes (necrotic and apoptosis). Result: Alanine aminotransferase, alanine phosphatase, and aspartate aminotransferase levels were significantly elevated in Group 3 diabetics and decreased in Group 4 which confirmed histological finding. Conclusion: This study confirmed the hypothesized possible protective effect of PPE against diabetic-induced histological and functional alteration of rat liver and advised its use by diabetic patients. The possible protective role of barley seeds on the spleen after administration of glucocorticoids in adult albino rats: A histological and immunohistochemical study Manal M Shehata, Heba M Saad Eldien, Fatma Y Meligy, Shadha Y Bahaidarh Journal of Microscopy and Ultrastructure 2019 7(4):171-180 Background: Glucocorticoids (GCs) are the main treatment strategy in many autoimmune disease and inflammatory diseases; however, they have immunosuppressive effect on many organs. The barley seeds contain many antioxidant compounds, which may improve the antioxidant status and related physiological functions. Our aim in this work is to evaluate the possible protective role of barley seeds on some immune cells in the spleen against immunosuppressive effect of GCs in adult albino rats. Materials and Methods: Forty-five adult albino rats were equally divided into 3 groups. Group I: normal vehicle control (n = 15), Group II: steroid-treated animals (n = 15), and Group III: steroid/barley-treated group (n = 15). Specimens from spleen were processed for light and electron microscopy. Results: In steroid-treated group, the histological changes in white and red pulp were in the form of loss of architecture and wide empty spaces among the cells. Most of the cells showed degenerative change, dilatation of blood sinusoids, and deposition of fibrinoid material among the cells of the RP. However, multiple lysosomal bodies were observed in both dendritic and macrophage cells. These changes are improved in steroid/barley-treated group in the form of increasing the number and size of the lymphatic follicles. Most of the splenic cells regained normal structure. Dendritic cell marker CD86 and macrophage marker CD68 expression are increased. Conclusion: Barley protects the spleen tissues from steroid-induced structural changes; this could be mediated through its antioxidant effects, so barely is recommended as a healthy diet in patients consuming steroids. The spermatozoal ultrastructure of the Chinese mitten crab (Eriocheir Sinensis) Jie Zeng, Shasha Peng, Shengwei Zhong, Hui Zhang Journal of Microscopy and Ultrastructure 2019 7(4):181-184 Background: The Chinese mitten crab (Eriocheir sinensis) is an economically important aquatic species in China. The artificial breeding crabs are also increasing in number day by day. However, knowledge about spermatozoal organization of the crab is still very limited. Aims and Objectives: In the present study, the spermatozoal ultrastructure of the E. sinensis is illustrated for improving artificial breeding technique. Materials and Methods: The spermatozoa are observed by light microscopy and transmission electron microscopy. Results: Spermatozoa are located in the lumen of seminiferous tubules. The spermatocytes and spermatids are observed in the wall of seminiferous tubules. The spermatophores are both present in the lumen of vas deferens and seminal vesicles. A mature spermatozoon consists of a central electron dense acrosome and a peripheral electron lucent nucleus within structures-organelles complex. The acrosome is divided into three zones, including inner acrosome zone, outer acrosome zone and zonal texture. The centre of acrosome is the perforatorium within parallel arranged perforatorial tubules along vertical axis. The highest electron dense operculum surrounds the head side of perforatorium. Conclusion: The ultrastructure of spermatozoa of E. sinensis is illustrated. In particular, the outermost part of the acrosome appears as concentric circles and is described as zonal texture. Cardiogenic differentiation of murine bone marrow-derived mesenchymal stem cells by 5-azacytidine: A follow-up In vitro study Heba E. M. Sharaf Eldin, Marwa A. A. Ibrahim, Amany M. I. Mousa, Hala G Metwaly, Nadia F.E. Abo-Hassan Journal of Microscopy and Ultrastructure 2019 7(4):185-193 Background: Cell-based therapy is a promising tool in the management of myocardial infarction. Aim of the Work: The aim of this study is to examine the in vitro potential differentiation of murine bone marrow (BM)-derived stem cells into cardiomyocytes using 5-azacytidine after 1, 3, and 5 weeks and follow it up after 8 weeks. Materials and Methods: BM-derived mesenchymal stem cells (MSCs) were extracted from the bones of adult albino rats. MSCs were induced with 10 μM 5-azacytidine for 24 h. The cells were examined after 1, 3, 5, and 8 weeks. Cell characterization with immunocytochemistry for detection of CD105, desmin, and T-troponin and transmission electron microscopy was performed. Results: The 5-azacytidine-induced MSCs showed light and electron microscopic histological characteristics resembling cardiomyocytes and progressively expressed the cardiac muscle-specific markers over the 1st, 3rd, and 5th weeks, yet by the 8th week, these parameters were significantly downregulated. Conclusion: Prolonged survival of 5-azacytidine-induced MSCs in culture beyond the 8th week resulted in loss of the newly acquired cardiomyocyte characteristics. It is not recommended to prolong the maintenance of 5-azacytidine-induced MSCs in culture on the hope of increasing its cardiogenic potentiality beyond 5 weeks. Lipsticks: The microbial cellar: An original study K Siya, Jubin Thomas, RB Vinod Kumar, Ajish M Saji, Amal K Iype, S Akhil Journal of Microscopy and Ultrastructure 2019 7(4):194-197 Background: Microbial contamination of cosmetics products is of incredible significance since it will not only cause significant health hazardous but also act as a potential source of infections. Contamination will cause spoilage of the item and when pathogenic they become a genuine threat for its users. Aim: To evaluate the bacterial contamination in regularly used lipsticks. Objectives: To identify the pathogenic organism present in the lipsticks.To understand the potential complications of the organisms identified. Comparing the microbial count in used and new lipsticks. Increased copy number of anaplastic lymphoma kinase gene signal in lung carcinomas: Is it significant? Saumya Shukla, Nuzhat Husain, Kiran Preet Malhotra, Vandana Tiwari Journal of Microscopy and Ultrastructure 2019 7(4):198-200 The anaplastic lymphoma kinase gene re-arrangement which is present in 3-5% cases of non small cell lung cancer is a somatic gene re-arrangement. The gold standard for the identification of this gene re-arrangement is fluorescence in situ hybridization. Many variant hybridization patterns have been documented. We present a case of polysomy of ALK gene in the absence of ALK gene re-arrangement in a 45 year old female who presented with brain metastasis. This is a rare case of polysomy of ALK gene reported in a non small cell lung carcinoma. It may be indicative of a worse prognosis and may predict high metastatic potential in these tumors.
Effects of combined nicotine and caffeine on the rat skeletal muscles: A histological and immunohistochemical studyFaizah Alotaibi, Seham K Abounasef, Heba FikryJournal of Microscopy and Ultrastructure 2019 7(4):147-152Background: Nicotine and caffeine are pharmacologically active substances that consumed widely in the whole world. Most of the nicotine users also consume caffeine. Smokers tend to drink more coffee than nonsmokers. It is important to characterize these substances with regard to their...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Comparing Nonopioids Versus Opioids for Acute Pain in the Emergency Department: A Literature Review Background: Pain is the most common reason for patient visits in the emergency department (ED). Opioids have been long considered the standard of care for acute pain in the ED. Because of the opioid crisis, investigation and implementation of novel practices to manage pain is needed. The use of various nonopioids has been suggested as a plausible alternative to opioids, with emerging literature to support its use for acute pain in the ED. Study Question: To evaluate the safety, efficacy, opioid-sparing effects of nonopioids in patients who present with acute pain in the ED. Data Sources: We systematically searched PubMed and EMBASE (July 1970 to January 2019). Study Design: Randomized controlled trials that evaluated nonopioids versus opioids in the ED were eligible. The clinical outcomes measured were change in pain scores compared with baseline, the incidence of adverse events, and use of rescue analgesia. Results: Twenty-five randomized controlled trials that evaluated the use of nonopioids in 2323 patients [acetaminophen (APAP) (n = 651), diclofenac (n = 547), ketamine (n = 272), ketorolac (n = 225), lidocaine (n = 219), ibuprofen (n = 162), ibuprofen & APAP (n = 162), hydroxyzine & dihydroergotamine (n = 85)] met inclusion criteria. Four trials found significant greater reductions in pain scores, favoring nonopioids. In all trials, the duration of pain relief provided by nonopioids was not sustained over an extended period. Eighteen trials reported no significant differences in reduction of pain scores. Two trials reported improved pain reduction with opioids and one trial reported noninferiority. Conclusions: Evidence from primary literature suggests that nonopioids could be a feasible alternative to opioids for management of acute pain in the ED as it is effective, safe, and decreases the need for rescue analgesia. Address for correspondence: Assistant Director of Pharmacy, Mount Sinai Queens, Long Island City, Queens NY, 25–10 30th Avenue, Long Island City, NY 11102. E-mail: billy.sin@mountsinai.org The authors have no conflicts of interest to declare. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.americantherapeutics.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Acetazolamide-Associated Hyperosmolar Hyperglycemic Nonketotic Syndrome No abstract available Carfilzomib-Induced Pulmonary Hypertension No abstract available Inappropriate Use of Aztreonam Background: Aztreonam is not a preferred empiric antibiotic because of variable susceptibilities compared with alternative agents. In addition, it has no Gram-positive activity, necessitating coadministration with vancomycin when used empirically, and is more costly when compared with other Gram-negative active agents. Aztreonam is often given to patients with a reported penicillin allergy without further investigation into the reaction or other relevant allergy information. Study Question: How frequently is aztreonam being used inappropriately? Study Design: We conducted a retrospective chart review at an academic medical center to assess the appropriateness of our aztreonam use. Measures and Outcomes: Our primary outcome was frequency of appropriate aztreonam use, based on a true IgE-mediated allergy reported for each patient. We evaluated whether the patients had tolerated a beta-lactam in the past, and what the reported allergic reaction was. Results: We included 165 patients and found that 46.7% of our aztreonam use was inappropriate, based on previous use of a beta-lactam, or no documentation of an IgE-mediated response. Of the patients with a documented beta-lactam allergy, 63 (38.2%) patients had no allergy manifestation listed, and 37 (22.4%) patients had a non–IgE-mediated allergy manifestation. Of the total population, 61 (37%) patients had tolerated a beta-lactam in the past. Conclusions: Aztreonam should be avoided, except in the case of a true IgE-mediated allergic reaction. Our goal was to reduce the inappropriate use of aztreonam at our institution by one or more of the following: educating providers, reviewing aztreonam orders, requiring answering of order questions, or requiring an indication for use. Penicillin skin testing and desensitization are options as well. Address for correspondence: 600 S 43rd Street, 108T, Philadelphia, PA 19104. E-mail: mking3509@gmail.com L. Rose is on the speakers' bureau for Allergan. M. King is on the speakers' bureau for Tetraphase. The remaining authors have no conflicts of interest to declare. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Hundred Years of Insulin Therapy: Purified Early Insulins Background: The discovery of insulin has changed dramatically the outcome of patients with type 1 diabetes, giving them the possibility to survive. This is of particular concern due to the fact that type 1 diabetes most frequently occurs in children who were destined to die in ketoacidosis coma. Areas of Uncertainty: From insulin discovery to the availability of human insulin and human insulin analogs to be used in diabetes therapy, a series of problems have arisen as the difficulty of insulin purifications, the animal insulin used by the first researches were in fact contaminated by proteins, fats, and other impurities, and the presence of side effects such as allergy, antibodies generation, and lipoatrophy. Data Source Literature: Data strictly related to the argument have been searched in Pub Med and used. Results: Starting from insulin discovery in 1921 to nowadays, significant efforts have been made by a series of researches to purify animal insulin, discover the molecular structure of human insulin, and develop methods to synthetize human insulin and then insulin analogs. Conclusions: The history of insulin discovery here reported is fascinating; insulin is a hormone, a product of biotechnology, a field of research that saved and save the life of many diabetic patients. Address for correspondence: E-mail: annunziata.lapolla@unipd.it The authors have no conflicts of interest to declare. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Examining the Causes and Consequences of Increasing Insulin Costs With Prospective Interventions No abstract available Paliperidone-Associated Priapism in an Autistic Child No abstract available Cefepime-Associated Myoclonic Seizures No abstract available Angioedema in an Immunocompromised Patient No abstract available Insulin Therapy and Diabetic Pregnancy Background: A good metabolic control before conception and throughout pregnancy with diabetes decreases the risk of short- and long-term adverse outcomes of the mothers and their offsprings. Insulin treatment remains the gold standard treatment recommended for any type of diabetes. New technologies including new insulins and insulin analogues, continuous subcutaneous insulin infusion without and with sensors, the low-glucose predictive suspension function, and closed-loop systems that persistently and automatically self-adjust according to patients' continuous glucose monitoring readings have expanded the offer to clinicians for achieving tight glucose control. Areas of Uncertainty: Unsafe effects of insulin and insulin analogues in pregnancy with diabetes could be linked with changes in insulin immunogenicity, teratogenicity, and mitogenicity. Second-generation insulin analogues need to be tested and proven. Effectiveness and safety of new insulin delivery systems in real life of diabetic women in pregnancy need further confirmations. Sources: MEDLINE, EMBASE, Web of Science, Cochrane Library, randomized controlled trials, systematic review and meta-analysis, observational prospective and retrospective studies, case series reports for the most recent insulin analogues, published in English impacted journals, and consensus statements from scientific societies I excluded 60 from 221 papers as not suitable for the purpose of the subject. Results: Subcutaneous insulin infusion can be safely used during pregnancy and delivery of well-trained women. Sensors are increasingly accurate tools that improve the efficacy and safety of integrated systems' functioning. Continuous glucose monitoring provides metrics ("time in range" time in "hypoglycemia" and in "hyperglycemia," glucose variability, average glucose levels in different time intervals) used as a guide to diabetes management; these new metrics are object of discussion in special populations. Randomized controlled trials have shown that sensor-augmented pump therapy improves pregnancy outcomes in women with type 1 diabetes. Closed-loop insulin delivery provides better glycemic control than sensor-augmented pump therapy during pregnancy, before, and after delivery. Conclusion: Second-generation insulin analogues and newer insulin infusion systems that automatically self-adjust according to patients continuous glucose monitor readings are important tools improving the treatment and quality of life of these women. Multi-institutional and disciplinary teams are working to develop and evaluate a pregnancy-specific artificial pancreas. Address for correspondence: Professor of Endocrinology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psycology, "Sapienza" University of Rome, via di Grottarossa, 1035, CAP 00189, Rome, Italy. E-mail: angela.napoli@uniroma1.it Grant from Medtronic to "Clinical and Molecular Department" of "Sapienza" University, Rome. The author has no conflicts of interest to declare. Clinical Trials Identifier: NCT03761615. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Comparing Nonopioids Versus Opioids for Acute Pain in the Emergency Department: A Literature ReviewBackground: Pain is the most common reason for patient visits in the emergency department (ED). Opioids have been long considered the standard of care for acute pain in the ED. Because of the opioid crisis, investigation and implementation of novel practices to manage pain is needed. The use of various nonopioids has been suggested as a plausible alternative to opioids, with emerging literature to support...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Clostridium difficile Infection in Children Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Ana M. Alvarez, Mobeen H. Rathore Nonoccupational Postexposure Prophylaxis and Preexposure Prophylaxis for Human Immunodeficiency Virus Prevention in Adolescents and Young Adults Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Diane M. Straub, Tanya L. Kowalczyk Mullins Resurgence of Syphilis Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Joseph A. Puccio, Aileen Cannon, Kalyani Derasari, Rodney Friend Pediatric Multiple Sclerosis: A Review Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Megan M. Langille, Alice Rutatangwa, Carla Francisco Cerebral Palsy: Diagnosis, Epidemiology, Genetics, and Clinical Update Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Abimbola Michael-Asalu, Genevieve Taylor, Heather Campbell, Latashia-Lika Lelea, Russell S. Kirby Updates on Hypertension and New Guidelines Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Pamela S. Singer Tall Stature in Children Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Alexander K.C. Leung, Alexander A.C. Leung, Kam Lun Hon Review of Narcolepsy and Other Common Sleep Disorders in Children Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Sagarika Nallu, Giselle Y. Guerrero, Jaclyn Lewis-Croswell, Lara M. Wittine Feeding Issues in Young Children Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Melissa Harada, Nelly Amariglio, Hope Wills, Irene Koolwijk The Essentials of Essential Oils Publication date: August 2019 Source: Advances in Pediatrics, Volume 66 Author(s): Rebecca M. Plant, Lisa Dinh, Shaara Argo, Monica Shah
Clostridium difficile Infection in ChildrenPublication date: August 2019Source: Advances in Pediatrics, Volume 66Author(s): Ana M. Alvarez, Mobeen H. RathoreNonoccupational Postexposure Prophylaxis and Preexposure Prophylaxis for Human Immunodeficiency Virus Prevention in Adolescents and Young AdultsPublication date: August 2019Source: Advances in Pediatrics, Volume 66Author(s): Diane M. Straub, Tanya L. Kowalczyk MullinsResurgence of SyphilisPublication date: August 2019Source: Advances in Pediatrics,...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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What's new in emergencies, trauma and shock? Using queuing theory to optimize the emergency department triage process Leon D Sanchez, Joshua W Joseph Journal of Emergencies, Trauma, and Shock 2019 12(4):225-226 Gunshot wounds – From Lebanon, via Syria, to the streets of your city! Timothy Craig Hardcastle Journal of Emergencies, Trauma, and Shock 2019 12(4):227-228 The 2019 WACEM and academic college of emergency experts india position paper on developing the academic department of space medicine in India – The time has come! Vivek Chauhan, Sagar Galwankar, Kishore K Deepak, Anant Mohan, Randeep Guleria, Sanjeev Bhoi, Praveen Aggarwal Journal of Emergencies, Trauma, and Shock 2019 12(4):229-231 The 2019 WACEM expert document on the framework for setting up a simulation centre Fatimah Lateef, Shanqing Yin, Madhavi Suppiah Journal of Emergencies, Trauma, and Shock 2019 12(4):232-242 Almost every institution and academic medical center has its own simulation center today. It seems to have become a prerequisite and is incorporated into the guidelines of setting up new centers as well as in the upgrading and enhancement plans of existing institutions. In considering this, it is critical to consider the needs and demands of the healthcare population and staff the center will be serving. Setting up a simulation center is not an endeavor to be undertaken lightly. It entails a sustainable commitment in terms of political will, professional, educational and financial commitments. On the other hand, setting up a simulation center can be the most worthwhile and rewarding experience if the objectives and goals are met and effective learning occurs. The latter is an important element to be considered in the step toward nurturing an effective healthcare practitioner. In this paper, the principle author, who is the Director of the SingHealth Duke NUS Institute of Medical Simulation (SIMS) in Singapore, shares her views and experience of leading a world-class simulation facility. She has been involved in SIMS from its conception and is a strong advocate of medical education and lifelong learning. At the end of this paper, she shares a Checklist which puts together all the important considerations for anyone or any institution what is looking at setting up a simulation facility, a simulation-based training program, or even upgrading and upscaling their current simulation centre. The 2019 WACEM expert document on hybrid simulation for transforming health-care simulation through "mixing and matching" Fatimah Lateef, Xin Yi Too Journal of Emergencies, Trauma, and Shock 2019 12(4):243-247 With the multitude of options available under the umbrella of "simulation" today, we have a larger repertoire of choices in our educational journey and outreach. These provide a platform for us to really transform health-care simulation from the traditional, unimodality simulation, to more complex, high fidelity, integrated, and engaging multimodality techniques. The main thrust must be to enhance clinical decision-making in patient care, to solve real-world clinical problems. Hybrid simulation (HS) utilizes at least two different simulation modalities, whereby combining them will enable one type of simulation modality to enhance the other, with the proper alignment, coordination, and interfacing between the modalities. Although the term is often used interchangeably, HS is slightly different from multimodality simulation. The latter refers to the use of multiple types of simulation in the same scenario or place. The main objectives for using HS have to be as follows: (1) for the acquisition of knowledge and skills by the best combination of methodologies, (2) for clinical performance improvement at all levels of care through the creation of as close as possible to real-world situation and problems, (3) to be able to sustain motivation and passion of our spectrum learners in their educational continuum, and (4) to provide a rich, exciting, and stimulating learning platform and environment, which can trigger deep learning and understanding. This article will also share some examples and cases utilizing HS in transforming health-care simulation. Utility of point-of-care lung ultrasound for initial assessment of acute respiratory distress syndrome patients in the emergency department A Sanjan, S Vimal Krishnan, Siju V Abraham, Babu Urumese Palatty Journal of Emergencies, Trauma, and Shock 2019 12(4):248-253 Aim: Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED). Subjects and Methods: We evaluated a prospective convenience sample of 73 adult patients presenting to the ED. The bedside LUS was performed by the trained emergency physician on patients with undifferentiated dyspnea with a clinical diagnosis of ARDS according to the Berlin's criteria. The four major LUS findings were examined on structured 12-zone LUS. The observed profile consisted of A lines, well-separated B lines, coalescent B lines, and consolidation among patients who were clinically diagnosed as ARDS. These LUS findings may vary depending on the severity of ARDS. The findings were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA). Results: Of the 73 study individuals, majority were male 46 (63%). The distributions of study individuals were as follows: 27% – mild ARDS, 37% – moderate ARDS, and 36% – severe ARDS. Coalescent B lines are present in about 70.4% and 92.3% of moderate and severe ARDS patients, respectively. Consolidations are predominantly present in moderate (100%) and severe (92.3%) ARDS. Conclusion: LUS in the initial assessment of patients' with ARDS yielded significant findings in the three clinically designated categories. This study opens up the possibility of using POCUS as an adjunct in the initial assessment of ARDS patient in the ED. Is emergency department thoracotomy effective in trauma resuscitation? The retrospective study of the emergency department thoracotomy in trauma patients at thammasat university hospital, Thailand Amonpon Kanlerd, Nattida Sapsamarn, Karikarn Auksornchart Journal of Emergencies, Trauma, and Shock 2019 12(4):254-259 Introduction: The survival rate after the emergency department thoracotomy (EDT) in trauma patients varies from the previous study as 1.6% in blunt injury and 11.2% in penetrating injury. Most of the data came from Europe, the US, South Africa, and Japan. This study aims to identify the success of EDT of trauma patients at Thammasat University Hospital, Thailand, and to evaluate the effectiveness of EDT. This study may be representative data for Southeast Asia. Materials and Methods: This retrospective review of 21 consecutive EDT cases which performed by our staffs and chief of general surgery residents between June 2009 and July 2016. Age, gender, injury mechanisms, injury sites, patient transport methods, initial vital signs, fluids and blood component requirements, resuscitation times, laboratory results, and injury severity scores were all analyzed. Results: Of the 21 EDT cases, one patient was excluded due to being a nontraumatic case. The remaining twenty patients were primarily young (mean 36.5 years), male (85%), suffering from blunt injuries (75%), of which 45% were predominantly thoracic injuries. Most of the patients presented without any sign of life (75%), and the total time for resuscitation was 43.5 ± 19.6 min. Seven patients (35%) had the return of spontaneous circulation (ROSC) and were successful in being brought to the operating room. Unfortunately, all patients passed away within 24 h of the operation. Conclusions: The ROSC rate of EDT in this study was 35%, but with no survival benefit. Therefore, we cannot guarantee that EDT serves as an effective life-saving procedure. However, EDT may play a significant role in treating extremis injured patients. Neutrophil gelatinase-associated lipocalin as an early diagnostic biomarker of acute kidney injury in snake bite Subramanian Senthilkumaran, Ponniah Thirumalaikolundusubramanian, Namasivayam Elangovan Journal of Emergencies, Trauma, and Shock 2019 12(4):260-262 Background: Snakebite envenomation is a major public health problem in the developing world, and the effects of viper envenomation on renal tissues leading to acute kidney injury (AKI) are well known. However, the usefulness of neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker to detect AKI in viper envenomation cases were not studied much. Aims and Objectives: The present study was undertaken to find out plasma NGAL levels and assess its usefulness among the hospitalized Viperidae group of snakebite victims in predicting acute kidney injury. Materials and Methods: The plasma NGAL level was estimated within 6–8 h of all the 184 cases of viper bites along with other laboratory parameters. Results: It was elevated much before the elevation of serum creatinine levels, irrespective of the age, gender, and bite to hospital time. The sensitivity and specificity was 99.37 and 96.15, respectively. Elevated plasma NGAL levels in viper bite helped not only to detect AKI early but also assisted to plan for appropriate intervention. Conclusion: It is suggested to include estimation of plasma NGAL in the point of care testing, especially in emergency settings handling snakebite cases. However, more studies are recommended to find out its serial levels in snakebite cases following different kinds of snake envenomation with different clinical and laboratory manifestations in different age groups and gender belonging to different population so as to arrive at valid conclusions. Last breath in the emergency department Aakriti Jain, Noella Nathaniel Sase, Anne Rhea Mathew, Immanuel Judson Paul, Paul Prabhakar Abhilash Kundavaram, Priya Ganesan Journal of Emergencies, Trauma, and Shock 2019 12(4):263-267 Background: Early and aggressive time to intervention has been shown to increase the odds of survival and decrease mortality in critically ill patients. Since emergency medicine is a nascent specialty in India, a review and assessment of the mortality profile in the Emergency Department (ED) would help improve the quality of care. Aims: The aim of the study is to determine the mortality profile and causes of preventable deaths at large ED in South India. Methods: This retrospective chart review was conducted between January and December 2017. Patients admitted with Triage priority 1 and priority 2 of our ED, who died, despite treatment, were recruited in the study. Two ED consultants blinded from each other, independently audited all the charts to determine preventable and nonpreventable causes of death. Results: There were a total of 69,369 patients during the study period who presented to the ED. Despite resuscitation 189 (0.7%) died, the mortality rate was 2.43%. Cardiac-related (32%) and sepsis-related (31%) causes were the most common cause of death, 23.8% were due to preventable causes and 16.9% of which were due to inappropriate management. In patients with sepsis, the odds of death due to preventable causes were significantly high (odds ratio 4.31, 95% confidence intervals: 1.96–9.47; P < 0.001). Conclusions: Cardiac- and sepsis-related causes of death, together accounted for most of the mortality. In patients with sepsis, the odds of death due to preventable causes were more than four times higher than those without preventable causes. Application of queuing theory to optimize the triage process in a tertiary emergency care ("ER") department Atilio Moreno-Carrillo, Lina María �vila Arenas, Julián Andrés Fonseca, Camilo Andrés Caicedo, Sandra Verónica Tovar, Oscar Mauricio Muñoz-Velandia Journal of Emergencies, Trauma, and Shock 2019 12(4):268-273 Context: Time from triage to patient care is usually evaluated, but time elapsed between the arrival of patient to emergency room (ER) and triage (pretriage) is not usually measured. Aims: The present study evaluates how the application of the queuing (or "waiting line") theory in the triage process can generate effective strategies to improve patient care in the ER. Settings and Design: A "before-and-after" study was conducted in the ER of the Hospital Universitario San Ignacio, a tertiary emergency care in Bogotá, Colombia. Subjects and Methods: The pretriage time was evaluated, and queuing theory was applied to the evaluation; according to the results, the number and distribution of the necessary nursing personnel were determined. Statistical Analysis Used: The change in waiting times was compared using a paired t-test. Results: In a first 7 months evaluation period, 89,898 patient visits were considered, with an average pretriage time of 22.15 min. According to the arrival distribution by hours and days of the week and considering the results of the calculations made using queuing theory, the number of nurses needed in the service per hour was determined for each day of the week, and schedule changes were implemented without increasing staff. In a second similar evaluation period, 94,497 patient visits were considered demonstrating a reduction of the pretriage time to 7.5 min (mean difference 14.64 min, 95% confidence interval 14.42–14.85, P < 0.001). Conclusions: The use of queuing theory in the planning of the daily personnel requirements in the triage area of ER can reduce the pretriage time by 65% without incurring additional cost.
What's new in emergencies, trauma and shock? Using queuing theory to optimize the emergency department triage processLeon D Sanchez, Joshua W JosephJournal of Emergencies, Trauma, and Shock 2019 12(4):225-226Gunshot wounds – From Lebanon, via Syria, to the streets of your city!Timothy Craig HardcastleJournal of Emergencies, Trauma, and Shock 2019 12(4):227-228The 2019 WACEM and academic college of emergency experts india position paper on developing the academic department of space medicine in India...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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The human kindness curriculum: An innovative preclinical initiative to highlight kindness and empathy in medicine Johanna Shapiro, Julie Youm, Aaron Kheriaty, Tiffany Pham, Yanjun Chen, Ralph Clayma Education for Health 2019 32(2):53-61 Background: Prior studies have shown a marked drop in empathy among students during their third (clinical) year of medical school. Curricula developed to address this problem have varied greatly in content and have not always been subjected to validated measures of impact. Methods: In 2015, we initiated a Human Kindness (HK) curriculum for the initial 2 years of medical school. This mandatory 12-h curriculum (6 h/year) included an innovative series of lectures and patient interactions with regard to compassion and empathy in the clinical setting. Both quantitative (Jefferson Scale of Empathy [JSE]) and qualitative data were collected prospectively to evaluate the impact of the HK curriculum. Results: In the initial Pilot Year, neither 1st (Group 1) nor 2nd (Group 2) year medical students showed pre-post changes in JSE scores. Substantial changes were made to the curriculum based on faculty and student evaluations. In the following Implementation Year, both the new 1st (Group 3) and the now 2nd year (Group 4) students, who previously experienced the Pilot Year, showed significant improvements in post-course JSE scores; this improvement remained valid across subanalyses of gender, age, and student career focus (e.g., internal medicine, surgery, etc.). Despite the disappointingly flat initial Pilot Year JSE scores, the 3rd year students (Group 2) who experienced only the Pilot Year of the curriculum (i.e., 2nd year students at the time of the Pilot Year) had subsequent JSE scores that did not show the typical decline associated with the clinical years. Students generally evaluated the HK curriculum positively and rated it as being important to their medical education and development as a physician. Discussion: A required preclinical curriculum focused on HK resulted in significant improvements in medical student empathy; this improvement was maintained during the 1st clinical year of training. Approaches of anatomy teaching for seriously resource-deprived countries: A literature review Ana Yoe-Cheng Chang Chan, Olle ten Cate, Eugène J. F. M. Custers, Maarten S van Leeuwen, Ronald L. A. W. Bleys Education for Health 2019 32(2):62-74 Background: Teaching anatomy is an important but expensive part of the medical curriculum, potentially more than many countries can afford. In the search for efficient methods, cost-effectiveness is of utmost importance for such countries. The aim of this contribution is to provide a review of the literature on anatomy teaching methods, evaluating these for feasibility in resource-deprived countries. Methods: A literature review was carried out to identify distinct approaches to anatomy teaching published in the period 2000–2014, using the databases of PubMed, Wiley Online Library, Elsevier, HINARI, Springer, and ERIC. The approaches found were compared against their conceptual, operational, technical, and economic feasibility and Mayer's principles of effective instruction. Results: Our search yielded 432 papers that met the inclusion criteria. We identified 14 methods of teaching anatomy. Based on their conceptual feasibility, dissection and technology enhanced learning approaches appeared to have more benefits than others. Dissection has, besides benefits, many specific drawbacks. Lectures and peer teaching showed better technical and economic feasibility. Educational platforms, radiological imaging, and lectures showed the highest operational feasibility. Dissection and surgery were found to be less feasible with regard to operational, technical, and economic characteristics. Discussion: Based on our findings, the most important recommendations for anatomy teaching in seriously resource-deprived countries include a combination of complementary strategies in 3 different moments, lecturing at the beginning, using virtual learning environment (for self-study), and at the end, using demonstration through prosected specimens and radiological imaging. This provides reasonable insights in anatomy through both dead and living human bodies and their virtual representations. Evaluation of the educator's portfolio as a tool for self-reflection: Faculty perceptions Saee Deshpande, Suresh Chari, Usha Radke, Tapasya Karemore Education for Health 2019 32(2):75-78 Background: Preparing a teaching portfolio to document educational expertise has shown to be useful for both promotion and to stimulate faculty development. This article describes a study of the effectiveness of the Educator's Portfolio (EP) as a stimulus for faculty reflection about educational practice. Methods: A sensitizing session of thirty faculty from medical, dental, and physiotherapy colleges on the same campus was conducted; faculty members were asked to complete and submit their EPs. Out of 30 members, 25 responded (83%). Semi-structured interviews of 25 faculties who prepared EPs were conducted, and a qualitative content analysis of the resulting protocols was completed to determine how the EP development process had promoted their reflection on education. Results: All the 25 faculty members indicated that reflection about education had occurred. Four categories of reflection emerged, namely, (a) lack of understanding regarding how to categorize their work; (b) lack of evidence of the effectiveness of educational activities; (c) reformulating educational practice; and (d) source of motivation and self-regulation. Discussion: The findings indicate that EP preparation serves as a tool for reflection on educational practice, which promotes faculty development. Engaging family medicine residents in research training: An innovative research skills program in Israel Christina Solbach-Sabbach, Tamar Adar, Mordechai Alperin, Khaled Karkabi, Inbar Levkovich Education for Health 2019 32(2):79-83 Background: The importance of medical research in developing academic and clinical excellence is widely acknowledged. Obstacles hindering research in primary care include negative attitudes, lack of dedicated time, funding shortages, and a relative paucity of mentors. Residency is the appropriate stage for developing research skills and encouraging research performance. In this article, we describe an intensive research training program offered at the family medicine (FM) Department, Technion Faculty of Medicine in Haifa, Israel. The program aims to engage residents in FM in constructing a research protocol to provide them with a positive experience, help them to overcome barriers, and enhance their research performance. Methods: Learning is achieved through a course design that includes the following six components: (1) course website: a platform for online collaborative learning; (2) inverted classroom: theory is learned through website video lectures and presentations during resident's own time according to a guided schedule, while weekly classroom sessions are dedicated to step-by-step implementation of theory, group discussion, and individual mentoring; (3) Peer feedback; (4) personal mentoring; (5) presentation of the protocol to peers and senior department staff at the end of the course; and (6) evaluation of protocol presentation and engagement during the research course as well as possibilities for further development. Results: Five teams of residents went on to conduct full research projects. Their studies have been presented at seven national and three international conferences, and one has been published. The outcomes of these studies have been useful in FM practices and have inspired residents to continue scholarly work in our department. Discussion: Innovation in teaching methods enhances engagement in learning research skills among residents and may encourage them to conduct research in primary care. Charting a successful course: The academic and clinical success committee's impact on student success Chris Diem, Angela Hairrell Education for Health 2019 32(2):84-86 Background: The road from prematriculation to graduation looks different for each student at each institution. To successfully complete the curriculum, students must often overcome difficulties, both academic and nonacademic. Up to 15% of 3rd-year medical students in the United States are still struggling on the major components of their clerkships and 11% in their 4th year. While there is an established need for medical school remediation, there is little evidence supporting what specifically works across the board. These deficiencies often do not go away on their own and with the need to educate all students, the guidance provided by multiple stakeholders (i.e., administration, staff, faculty, and clinicians) would be necessary to chart a course of success for these students. Methods: The Academic and Clinical Success Committee (ACSC) at the Texas A and M University College of Medicine provides a venue to review individual students and provide input, resources, and support on a timely basis. This is a necessary ingredient in guiding the students facing academic and clinical challenges toward successful completion of graduation requirements. Results: Since its incorporation, the work of the ACSC has contributed to a decrease in failures on consecutive block examinations, a decreased failure rate on Step 2 clinical skills (CS), and increased capacity to help students at risk of failing Step 1 to not do so. Discussion: In this brief report, we illustrate how we developed the ACSC, the impact and levels of success it has had on students, and challenges we have faced. Checking in on check-out: Survey of Learning Priorities in Primary Care Residency Teaching Clinics Yvonne N Covin, Shannon Scielzo, Lynne Kirk, Blake Barker Education for Health 2019 32(2):87-90 Background: Despite focus on increasing the quality of ambulatory education training, few studies have examined residents' perceptions of learning during case discussions with their preceptors (i.e., "check-out"). The objective of this study was to assess the difference between residents' and preceptors' perceptions of behaviors that should occur during check-out discussions. Methods: We conducted a cross-sectional survey of categorical internal medicine and family medicine residents and preceptors. The survey was distributed electronically and assessed 20 components of the check-out discussion. Results: Of 38 preceptors, 22 (61%) completed the survey. Of 172 residents, 82 (48%) completed the survey. For residents, we identified discrepancies in desired and perceived check-out behaviors. Specifically, utilizing a dependent sample t-test, residents felt that all 20 areas needed additional teaching during check-out (P < 0.05). Preceptors believed that demonstrating physical examination skills in the patient room during check-out was significantly more important than did residents (P = 0.01). Increasing years of preceptor experience did not statistically relate to their valuation of components important to residents. Discussion: Our research highlighted a major deficiency in training in the check-out process, with residents desiring more patient management education in all components. Moreover, faculty and residents do not necessarily agree with what is an important focus in the "teachable moment." Our results serve as a training needs assessment for future faculty development seminars and highlight the need to consider resident learning needs in general. Future doctors' perspectives on health professionals' responsibility regarding nutrition care and why doctors should learn about nutrition: A qualitative study Victor Mogre, Fred C. J. Stevens, Paul A Aryee, Anthony Amalba, Albert J. J. A. Scherpbier Education for Health 2019 32(2):91-94 Background: Improved dietary and nutrition behavior may help reduce the occurrence of noncommunicable diseases which have become global public health emergencies in recent times. However, doctors do not readily provide nutrition counseling to their patients. We explored medical students' perspectives on health professionals' nutrition care responsibility, and why doctors should learn about nutrition and provide nutrition care in the general practice setting. Methods: Semistructured interviews were conducted among 23 undergraduate clinical level medical students (referred to as future doctors). All interviews were recorded and transcribed verbatim with data analysis following a comparative, coding, and thematic process. Results: Future doctors were of the view that all health professionals who come into contact with patients in the general practice setting are responsible for the provision of nutrition care to patients. Next to nutritionists/dieticians, future doctors felt doctors should be more concerned with the nutrition of their patients than any other health-care professionals in the general practice setting. Reasons why doctors should be more concerned about nutrition were as follows: patients having regular contacts with the doctor; doctors being the first point of contact; patients having more trust in the doctors' advice; helping to meet the holistic approach to patient care; and the fact that nutrition plays an important role in health outcomes of the patient. Discussion: Future doctors perceived all health professionals to be responsible for nutrition care and underscored the need for doctors to learn about nutrition and to be concerned about the nutrition of their patients. Developing an objective structured clinical examination in comprehensive geriatric assessment – A pilot study Michael Vassallo, Joseph Grey, Anthony Hemsley, Liliana Chris, Stuart G Parker Education for Health 2019 32(2):95-98 Background: Acquiring medical competencies alone does not necessarily lead to the delivery of quality clinical care. Many UK training programs are soon to be based on the curricula of entrustable professional capabilities (EPCs). These are tasks carried out in practice requiring proficiency in several competencies for quality practice. Assessments to evaluate EPCs for independent practice are needed. Comprehensive geriatric assessment (CGA) is an EPC in geriatric medicine. We describe the development of an assessment of CGA as an example of examining EPCs. Methods: A CGA station was introduced in the Diploma in Geriatric Medicine clinical examination. Candidates rotate through four stations: three single competency-based stations (history, communication/ethics and physical examination) and an EPC-based station in CGA. Results: One hundred and seventy-eight (female: 96 [53.9%]) candidates took it. There was a weak but significantly positive correlation between the score at CGA and the total score in the other stations (r = 0.46; P < 0.001). Most candidates passing the station passed the examination. Correlation with other stations similarly showed weak significant correlations (Station 1: r = 0.38; P < 0.001, Station 3: r = 0.28; P < 0.001, and Station 4: r = 0.37; P < 0.001). There was 61.4% (kappa: 0.61; P = 0.000) agreement between examiners whether a candidate passed or failed. Agreement was higher for the other stations, i.e. Station 1 (kappa: 0.85; P < 0.001), Station 3 (kappa: 0.72; P < 0.001), and Station 4 (kappa: 0.85; P < 0.001). Discussion: Performance on the station correlated positively with overall performance, suggesting that it has discriminatory value in differentiating candidates with varying ability and the more able candidates pass the examination. A Report from the 2017 Sino-US Medical Education Symposium in Wuhan, China Rimas Vincas Lukas, Ivy Jiang, Jonathan Lio, Brian Cooper, Hongmei Dong, Jingyi Fan, Renslow Sherer Education for Health 2019 32(2):99-100
The human kindness curriculum: An innovative preclinical initiative to highlight kindness and empathy in medicineJohanna Shapiro, Julie Youm, Aaron Kheriaty, Tiffany Pham, Yanjun Chen, Ralph ClaymaEducation for Health 2019 32(2):53-61Background: Prior studies have shown a marked drop in empathy among students during their third (clinical) year of medical school. Curricula developed to address this problem have varied greatly in content and have not always been subjected to validated measures of impact....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Global oral health: A proposal for a change of picture Gerhard K Seeberger Indian Journal of Dental Research 2019 30(4):483-485 Oral health, universal health coverage, and dental research SM Balaji Indian Journal of Dental Research 2019 30(4):486-486 Randomized clinical trial of four adhesion strategies: A 42 month study Maristela Dutra-Correa, Vanessa Harumi Kiyan, Marcia Tonetti Ciaramicoli, Vanessa Pecorari, Flávia Pires Rodrigues, Cintia Helena Coury Saraceni Indian Journal of Dental Research 2019 30(4):487-495 Context: The adhesives clinical effectiveness has been extensively reported for noncarious cervical lesions (NCCLs). However, there is a lack of information about the adhesive systems strategies and their effect on NCCL restoration longevity. Aims: This study aims to evaluate a 42-month performance of four dentin adhesive systems used for the restorative treatment of NCCLs. Settings and Design: NCCLs were randomly divided into four groups: (1) Scotchbond multi-purpose (MP); 2: Single bond plus (SB); 3: Scotchbond SE (SE); and 4: Easy bond (EB). Subjects and Methods: NCCLs (125) were randomly distributed: (1) MP; (2) SB; (3) SE; and (4) EB and were restored with a nanofilled resin-composite, evaluated along 18-36-42 months. Statistical Analysis Used: Kruskal–Wallis test: Comparison among the adhesive systems in each period. Friedman analysis: Comparison along the periods. Kaplan–Meier: Survival analysis. Results: Baseline and 42-month retention (RET) rates (%) were 100/100 for MP; 100/94.74 for SB; 100/87.5 for SE; and 100/100 for EB. The cumulative failure percentage was 9.52% for MP, 9.52% SB, 15.8% SE, and 10% EB. Restorations survival was not dependent on the used adhesive type. Marginal adaptation (MA) was similar to each group, but EB presented noticeable marginal deterioration. Wear was noticed in the 3-step etch-and-rinse (MP) restorations evaluated after 42 months. For the EB, baseline and 18-month wear evaluation were statistically similar. After 36 and 42 months, wear was also similar for EB. Conclusions: Adhesive systems showed similar performance within most important adhesive bonding efficiency achievement parameters: RET, MA, interfacial staining, recurrent caries, and postoperative sensitivity evaluated during 42 months. The incisive papilla as a guide to maxillary anterior teeth position for complete dentures Rosalin Kar, Niranjan Mishra, Debashish Pati, Krishna Gopal Birmiwal, Aparna Gupta, Subhrajit Raut Indian Journal of Dental Research 2019 30(4):496-499 Context: The incisive papilla as a guide for complete dentures. Aims: To evaluate incisive papilla as a guide to maxillary anterior teeth position for complete dentures. Settings and Design: To measure the linear distances from the incisive papilla to the maxillary central incisors in Odia population and compare it to other ethnic groups. Subjects and Methods: The subjects were selected following inclusion & exclusion criteria. The impressions of maxillary & mandibular arches were taken and poured with die stone to produce the cast. The incisive papilla & incisors were marked on casts with a pencil. The photographs of casts were traced on an acetate tracing paper. The anterior-most points of maxillary incisors, anterior, middle & posterior-most points of incisive papillae were marked on the tracing as A, I1,M, I2 respectively. The A to M and A to I2 distances were measured, analysed and compared with Caucasians, Southern Chinese, and Dravidians. Statistical Analysis: Independent sample "t" test and Analysis of Variance followed by the post-hoc Bonferroni test were used. Results: A sample of 100 subjects in the age group of 20 to 40 years with was selected. The A to M measurements of Odia population differed significantly from Caucasians but were similar to Southern Chinese population. The A to I2 measurements of Odia population differed significantly from Caucasians & Dravidians but were similar to Southern Chinese. Conclusion: The linear measurements from incisive papilla to maxillary incisors of the Odia population are similar to that of Southern Chinese but differ significantly from Caucasians and Dravidians. Prevalence of precancerous lesions in an adult population Benley George, Shibu T Sebastian, Rino R Soman, Vinod M Mulamoottil, Minimol K Johny Indian Journal of Dental Research 2019 30(4):500-505 Objectives: The present study aimed to identify the prevalence of precancerous lesions among an adult population in Kerala, India. Materials and Methods: A dental screening camp was organized in each district at two locations for two consecutive days to draw maximum participation of the community. All adult subject's attending the camp were initially screened for precancerous lesions using conventional light. An initial oral screening was done by two public health dentists and suspected cases were subjected to Identafi Oral cancer screening device and followed by histopathological evaluation. Results: The prevalence of oral precancerous lesions in the adult population of Kerala was 4.4%. Most of the lesions were associated with the use of tobacco followed by alcohol and spicy foods. Conclusion: The oral cancer detection device is an aid in detection of oral precancerous lesions. Efficacy of a mouthwash containing essential oils and curcumin as an adjunct to nonsurgical periodontal therapy among rheumatoid arthritis patients with chronic periodontitis: A randomized controlled trial Divvi Anusha, Preetha Elizabeth Chaly, Mohammed Junaid, JE Nijesh, K Shivashankar, Shyam Sivasamy Indian Journal of Dental Research 2019 30(4):506-511 Purpose: The purpose of this study was to assess the efficacy of mouthwash containing essential oils and curcumin (MEC) as an adjunct to nonsurgical periodontal therapy on the disease activity of rheumatoid arthritis (RA) among RA patients with chronic periodontitis (CP). Materials and Methods: A triple-blinded controlled trial was conducted among 45 female RA patients with CP randomized into three treatment groups as follows: Group A: scaling and root planing (SRP) with 0.2% chlorhexidine mouthwash as an adjunct (n = 15), Group B: SRP with MEC as an adjunct (n = 15), and Group C: SRP alone (n = 15). RA disease activity was assessed using erythrocyte sedimentation rate, serum C-reactive protein, serum anti-citrullinated protein antibody, and serum rheumatoid factor. Periodontal disease activity was assessed using plaque index, clinical attachment level (CAL), and pocket depth (PD). All parameters were recorded at baseline and 6 weeks thereafter. Data were assessed using one-way ANOVA and paired t-test. Results: A significant reduction in periodontal and RA disease activity parameters was observed from baseline to 6 weeks following intervention (P < 0.05). The highest percentage of mean reduction in plaque index and RA parameters from baseline to 6 weeks was observed in Group B followed by Groups A and C. The highest percentage of mean reduction in PD and CAL was observed in Group A followed by Groups B and C (P < 0.001). Conclusion: This study reveals that MEC as an adjunct to SRP is effective in reducing the disease activity of RA and CP, thereby warranting the use of the same. Comparative efficacy of analgesic gel phonophoresis and ultrasound in the treatment of temporomandibular joint disorders Sankar Narayanan Ramakrishnan, Nalini Aswath Indian Journal of Dental Research 2019 30(4):512-515 Aim: The aim of this study is to determine the efficacy of phonophoresis in patients with temporomandibular disorders. Objective: To prove that phonophoresis could be an effective treatment modality in in patients with temporomandibular disorders. Procedure: Fifty patients diagnosed clinically and radiographically as temporomandibular disorder were randomly assigned into either of the two groups, namely, (Group A) plain ultrasound and (Group B) phonophoresis. Acoustic gel containing no pharmacological agent was applied in the ultrasound group, whereas a gel containing aceclofenac was applied in the phonophoresis group. Each group was treated three times a week for 2 weeks. The assessment of pain and inflammation both before and after treatment were done using the visual analog scale (VAS) and Creactive protein (CRP). Results: Intergroup comparison was done and analyzed statistically using independent ttest. Intragroup comparison was done using paired ttest. A significant difference in VAS scores and CRP levels before and after treatment were seen within both ultrasound phonophoresis PH groups. No significant difference was noted statistically between ultrasound and phonophoresis group. Conclusion: The results of this study suggests that though plain ultrasound as well as phonophoresis with aceclofenac gel are effective in the management of temporomandibular disorders. Phonophoresis was found be slightly superior as evident in VAS scores and CRP levels though not statistically significant. Clinico-pathological correlations of odontogenic tumors: Some critical observations based on a 20 year institutional study and a comprehensive review of literature Shaheen Syed, Karla M Carvalho, Anita Spadigam, Anita Dhupar Indian Journal of Dental Research 2019 30(4):516-520 Context: Odontogenic tumors (OTs) represent a rare subset of pathologies of the oral and maxillofacial region. The classification of OTs has undergone several changes over the years due to a lack of uniform international identification criteria. The histomorphological similarity and the many variations in behavioral patterns elaborated by these lesions warrant research. Aims: Using the update from the fourth edition of the World Health Organisation Classification of Head and Neck Tumors (2017), this dental institution carried out an epidemiological study on OTs in the state of Goa (India) and compared the data obtained with similar studies on OTs done within India. Materials and Methods: The clinical and pathological data of OTs from August 1996 to December 2016 was retrieved from the oral and maxillofacial pathology department archives, belonging to the lone dental college and hospital in the state of Goa, India. Demographic data such as frequency, age, gender, and site along with pathological subtype was analysed. Statistical Analysis Used: Descriptive analysis (i.e. frequency of age, gender, and location), Chi-Square Test and Fischer Exact test. Results: The relative frequency of OTs was 2.61% of all oral biopsied specimens. The most common OT encountered was ameloblastoma (57.9%). The posterior aspect of the mandible was the most favored site (77.2%). The frequency of OTs decreased after the fourth decade. An overall marginal male predilection (55%) was seen. Conclusions: This study contributes to the establishment of a comprehensive loco-regional epidemiological database on OTs in India, aiding research on their aetio-pathogenesis and diagnosis. Periodontal health status among HIV-seropositive pregnant women Narendra Dev Jampani, Ravi Kiran Sunkavilli, Vajra Madhuri Songa, Lahari Buggapati, Srinivasa Reddy Pathagunti Indian Journal of Dental Research 2019 30(4):521-526 Aims and Objective: Routine oral health care is essential for those living with HIV (human immunodeficiency virus) infection, especially in pregnant women. Hormonal changes during pregnancy, immunosupression in HIV along with bacterial load in periodontal infections strongly influence the pregnancy outcomes. The aim of this study was to evaluate the periodontal health status in HIV seropositive pregnant women in Andhra Pradesh, India. Materials and Methods: This study includes a sample of 90 divided into three groups; HIV seropositive pregnant women (group PH; n = 30), HIV seropositive nonpregnant women (group H; n = 30), and healthy pregnant women without HIV infection (group P; n = 30). Clinical examination includes the recording of probing depths (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and periodontal screening and recording index (PSR) were assessed in three groups. Statistical analysis was done by Mann–Whitney U-test and Wilcoxon paired test using the software SPSS version 17. Results: Clinical parameters do not show any significant variation between the three groups. But slightly higher mean PD and CAL levels was observed in HIV seropositive pregnant and nonpregnant women compared with healthy pregnant women without HIV infection. About 13% of severe gingivitis cases were observed in HIV seropositive pregnant group compared with 6% in HIV seropositive and 3% in healthy pregnant group. Conclusions: Presence of slightly higher percentage of severe gingivitis in HIV seropositive pregnant women strengthens the fact of extra need for preventive oral health services during the prenatal period and provides recommendations for promoting maternal oral health in regional antiretroviral therapy centers in India. Salivary flow rate, pH and buffering capacity in patients undergoing fixed orthodontic treatment – A prospective study V Anu, PD Madan Kumar, M Shivakumar Indian Journal of Dental Research 2019 30(4):527-530 Background: Human saliva has got many important functions like lubrication of the oral tissues, making oral functions like speech, mastication and deglutition possible and also protecting teeth and oral mucosal surfaces in different ways. Dental Caries is one of the common complications in patients undergoing orthodontic treatment. Subjects with impaired saliva flow rate often show high caries incidence. A low flow rate combined with a low or moderate buffer effect clearly indicates poor salivary resistance against microbial attack. Aim: To investigate the changes in stimulated and unstimulated salivary flow rate, pH and buffer capacity in patients undergoing therapy with fixed orthodontic appliances. Materials and Methods: Salivary flow rate, pH and buffering capacity of 20 patients who underwent fixed orthodontic treatment at Department of Orthodontics, Ragas Dental College and Hospital, Chennai were examined using GC saliva check buffer kit. The procedure was carried out during the initiation of orthodontic treatment and subsequently, one month and six months after the placement of appliance. Results: Results showed there was a significant increase in the salivary flow rate one month and six months after placement of fixed appliance while pH and buffering capacity showed no significant changes. Conclusion: Salivary flow rate increases significantly during fixed orthodontic treatment. Salivary pH and buffering capacity showed no significant changes suggesting that they are not sole factors for demineralization in orthodontic patients.
Global oral health: A proposal for a change of pictureGerhard K SeebergerIndian Journal of Dental Research 2019 30(4):483-485Oral health, universal health coverage, and dental researchSM BalajiIndian Journal of Dental Research 2019 30(4):486-486Randomized clinical trial of four adhesion strategies: A 42 month studyMaristela Dutra-Correa, Vanessa Harumi Kiyan, Marcia Tonetti Ciaramicoli, Vanessa Pecorari, Flávia Pires Rodrigues, Cintia Helena Coury SaraceniIndian Journal of Dental Research 2019 30(4):487-495Context:...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Metagenomic next-generation sequencing in clinical microbiology Jobin John Jacob, Balaji Veeraraghavan, Karthick Vasudevan Indian Journal of Medical Microbiology 2019 37(2):133-140 Pneumococcal conjugate vaccine rollout in India: Expectations and challenges Rosemol Varghese, Balaji Veeraraghavan, Yuvraj Jeyaraman, Girish Kumar, Narendra Kumar Arora, S Balasubramanian Indian Journal of Medical Microbiology 2019 37(2):141-146 India is one among the four Asian countries with the greatest number of deaths due to pneumococcal infection among children under 5 years. pneumococcal conjugate vaccine (PCV) has been introduced in a phased manner in five major Indian states. Ambiguity remains in choosing the appropriate type of PCV and optimum schedule with maximum effectiveness specific for each country. Here, we discuss the evidences with respect to serotype coverage, immunogenicity, reactogenicity and dosage schedule for introduction of PCV13 in India. In addition, the expected PCV impact and the challenges are detailed. PCV13 is expected to provide >75% serotype coverage for invasive pneumococcal disease (IPD) serotypes in Indian children combined with the replacement by nonvaccine serotypes which is unpredictable due to lack of complete data. Nasopharyngeal (NP) surveillance is easy, feasible and can replace IPD surveillance in resource-poor settings. Continuous IPD as well as NP surveillance in all the regions are necessary to assess the impact of PCV in India. Current strategy for local- to global-level molecular epidemiological characterisation of global antimicrobial resistance surveillance system pathogens Dhiviya Prabaa Muthuirulandi Sethuvel, Naveen Kumar Devanga Ragupathi, Yamuna Devi Bakthavatchalam, Saranya Vijayakumar, Rosemol Varghese, Chaitra Shankar, Jobin John Jacob, Karthick Vasudevan, Divyaa Elangovan, Veeraraghavan Balaji Indian Journal of Medical Microbiology 2019 37(2):147-162 The prime goal of molecular epidemiology is to identify the origin and evolution of pathogens, which can potentially influence the public health worldwide. Traditional methods provide limited information which is not sufficient for outbreak investigation and studying transmission dynamics. The recent advancement of next-generation sequencing had a major impact on molecular epidemiological studies. Currently, whole-genome sequencing (WGS) has become the gold standard typing method, especially for clinically significant pathogens. Here, we aimed to describe the application of appropriate molecular typing methods for global antimicrobial resistance surveillance system pathogens based on the level of discrimination and epidemiological settings. This shows that sequence-based methods such as multi-locus sequence typing (MLST) are widely used due to cost-effectiveness and database accessibility. However, WGS is the only method of choice for studying Escherichia coli and Shigella spp. WGS is shown to have higher discrimination than other methods in typing Klebsiella pneumoniae, Acinetobacter baumannii and Salmonella spp. due to its changing accessory genome content. For Gram positives such as Streptococcus pneumoniae, WGS would be preferable to understand the evolution of the strains. Similarly, for Staphylococcus aureus, combination of MLST, staphylococcal protein A or SCCmec typing along with WGS could be the choice for epidemiological typing of hospital- and community-acquired strains. This review highlights that combinations of different typing methods should be used to get complete information since no one standalone method is sufficient to study the varying genome diversity. Experience of Indian association of medical microbiology external quality assurance scheme centre, New Delhi: Challenges and quality assessment of clinical microbiology laboratories Chand Wattal, Jaswinder Kaur Oberoi, Neeraj Goel, Sanghamitra Datta, Reena Raveendran, KJ Prasad Indian Journal of Medical Microbiology 2019 37(2):163-172 Introduction: EQAS program at New Delhi under IAMM was started in January 2014 across North and North east regions of India with 217 participants, which grew up to 540 by 2018. Materials and Methods: In 2014, 4 analytes per year were sent for 3 exercises, i.e. smear culture and serology. 2018 onwards PT analytes were increased from 4 to 12 and comparative performance of techniques analysed. Results: Out of the 22 smears sent for gram staining, ZN staining, Kinyoun staining and Albert staining, completely correct results ranged between 29.55% - 79.9%, 94.3% - 99.2%, 35.5% & 93.8%, respectively. Correct results for culture isolate identification & susceptibility testing and serology exercises varied between 70 & 92.4% and 73.1 & 98.59%, respectively. In the year 2018, 470 responses were received for bacterial culture identification & antibiotic susceptibility testing out of which manual and automated systems were used by 54% & 46% and 52.5% & 47.5% participants, respectively. Techniques used in BBV assays for HBsAg, HCV & HIV found all methods like ELISA, ELFA, CLIA and Card Test performing similarly. The major challenges in running the EQA program included requirement of large amount of specimens for PT item preparation, stability in hot and humid conditions and timely delivery of PT challenges in remote parts of the country. Conclusion: A large number of the participating laboratories (77%) had an overall score of >80% for all exercises, demonstrating acceptable baseline performance of EQAS registered laboratories. However, continued EQAS participation could further improve the quality of results. RNA-seq analysis reveals resistome genes and signalling pathway associated with vancomycin-intermediate Staphylococcus aureus Devika Subramanian, Jeyakumar Natarajan Indian Journal of Medical Microbiology 2019 37(2):173-185 Context: Vancomycin-intermediate Staphylococcus aureus remains one of the most prevalent multidrug-resistant pathogens causing healthcare infections that are difficult to treat. Aims: This study uses a comprehensive computational analysis to systematically investigate various gene expression profiles of resistant and sensitive S. aureus strains on exposure to antibiotics. Settings and Design: The transcriptional changes leading to the development of multiple antibiotic resistance were examined by an integrative analysis of nine differential expression experiments under selected conditions of vancomycin-intermediate and -sensitive strains for four different antibiotics using publicly available RNA-Seq datasets. Materials and Methods: For each antibiotic, three experimental conditions for expression analysis were selected to identify those genes that are particularly involved in the development of resistance. The results were further scrutinised to generate a resistome that can be analysed for their role in the development or adaptation to antibiotic resistance. Results: The 99 genes in the resistome are then compiled to create a multiple drug resistome of 25 known and novel genes identified to play a part in antibiotic resistance. The inclusion of agr genes and associated virulence factors in the identified resistome supports the role of agr quorum sensing system in multiple drug resistance. In addition, enrichment analysis also identified the kyoto encyclopedia of genes and genomes (KEGG) pathways – quorum sensing and two-component system pathways – in the resistome gene set. Conclusion: Further studies on understanding the role of the identified molecular targets such as SAA6008_00181, SAA6008_01127, agrA, agrC and coa in adapting to the pressure of antibiotics at sub-inhibitory concentrations can help in learning the molecular mechanisms causing resistance to the pathogens as well as finding other potential therapeutics. Clinico-microbiological analysis of toxigenic clostridium difficile from hospitalised patients in a tertiary care hospital, Mangalore, Karnataka, India Sherin Justin, Beena Antony Indian Journal of Medical Microbiology 2019 37(2):186-191 Purpose: Prevalence of Clostridium difficile, an anaerobic, Gram-positive, spore-forming bacillus, is very much underestimated in India. The present study was intended to assess the burden of toxigenic C. difficile in hospitalised patients with clinically significant diarrhoea and analysis of their clinical picture. Materials and Methods: This cross-sectional study was conducted in a tertiary care teaching hospital, South India, from January 2012 to December 2014. Stool samples were collected consecutively from 563 inpatients from various wards. The prevalence of toxigenic C. difficile was determined by toxigenic culture and a two-step algorithm. The clinical spectrum of these patients was also analysed. Associated pathogens were identified using standard procedures. Statistical analysis was done by frequency, percentage, Chi-square test and z-test. Results: Out of the 563 stool samples analysed, the prevalence of toxigenic C. difficile was 12.79% and that of non-toxigenic C. difficile was 10.83%. The prevalence of toxigenic C. difficile among oncology patients was highly significant (HS). Antibiotic treatment, prolonged hospital stay and underlying diseases/conditions were the risk factors which were HS, and fever was the significant clinical feature among the patients. Escherichia coli was the predominant associated pathogen isolated (18.47%). Conclusion: The presence of toxigenic C. difficile in our locality is a matter of concern. Constant supervision, appropriate treatment and preventive measures are crucial in controlling C. difficile infection. Assessment of efficacy of palm polymerase chain reaction with microscopy, rapid diagnostic test and conventional polymerase chain reaction for diagnosis of malaria Paras Mahale, Rajas Warke, Mira Ramaiya, Deepa Balasubramanian, Suvin Shetty, Ranjit Mankeshwar, Abhay Chowdhary Indian Journal of Medical Microbiology 2019 37(2):192-197 Purpose: Sensitive, specific, rapid and cost-effective technique for malaria diagnosis is need of the hour. Microscopy has been the gold standard for malaria diagnosis, but its interpersonnel variability and lack of sensitivity make it subjective test. Conventional polymerase chain reaction (cPCR) has proven to be sensitive technique, but costly and time-consuming. Considering these factors, we have compared microscopy and cPCR with newly derives ultra-fast, portable PCR machine called Palm PCR. Materials and Methods: Palm PCR is arranged with three heat blocks precisely made for three stages of PCR cycles with 34 min for 1100 bp Plasmodium genus outer primer to amplify and 10 min each for Plasmodium falciparum and Plasmodium vivax inner primers of 120 bp and 205 bp, respectively. A total of 191 suspected samples were processed and evaluated using receiver operating characteristic (ROC) curve analysis. Results: The area under ROC curve analysis for Palm PCR with reference standard microscopy for P. falciparum, P. vivax and Plasmodium was 0.8969, 0.9121 and 0.9116, respectively, and with reference standard cPCR was 1.0 for all of them. ROC curve area close of suggests that Palm PCR can be as significant as cPCR in malaria diagnosis. In fact, ultra-rapid amplification with same precision makes Palm PCR better technique than cPCR. Conclusion: Palm PCR is sensitive, rapid and works on battery with simple laboratory facility requirements. Portable electrophoresis and transilluminator combined with Palm PCR could be implemented as an important diagnostic tool in resource-limited and rural areas. Similar studies with wider parameters in rural areas will help us evaluate and maybe establish Palm PCR as PCR platform of choice for such specific set-ups. An emerging threat of ceftriaxone-resistant non-typhoidal salmonella in South India: Incidence and molecular profile Agila Kumari Pragasam, Shalini Anandan, James John, Ayyanraj Neeravi, Vignesh Narasimman, Dhiviya Prabaa Muthuirulandi Sethuvel, Divyaa Elangovan, Balaji Veeraraghavan Indian Journal of Medical Microbiology 2019 37(2):198-202 Background: Non-typhoidal Salmonella (NTS) infection is a serious public health problem globally. Although NTS infections are self-limited, antimicrobial therapy is recommended for severe infections and immunocompromised patients. Antimicrobial resistance (AMR) in these pathogens further limits its therapeutic options. Here, we report an incidence of ceftriaxone resistance in NTS over the past 9 years in a southern Indian region. Materials and Methods: Molecular mechanisms of resistance in ceftriaxone-resistant NTS have been tested by both phenotypic and molecular methods. Minimum inhibitory concentration was determined by the E-test and broth microdilution method. AMR gene markers of β-lactamases such as AmpCs (blaMOX, blaCMY, blaDHA, blaFOX, blaACC and blaACT) and extended-spectrum β-lactamases (ESBLs) (blaSHV, blaTEM, blaVEB, blaPER, blaCTXM-1like,blaCTXM-2like, blaCTXM-8like, blaCTXM-9like and blaCTXM-25like) were screened. The presence of IncH12 and IncI1 plasmid was also analysed. Results: The study reports a 5% prevalence of ceftriaxone resistance in NTS. The most common serogroup was Salmonella Group B followed by Salmonella Group E and Salmonella group C1/C2. The occurrence of blaCTX-M-1, blaTEM, blaCMY and blaSHV genes was observed in 54%, 54%, 48% and 3% of the isolates, respectively. Interestingly, few isolates carried dual resistance genes (ESBLs and AmpCs). IncH12 and IncI1 plasmid was identified in isolates carrying ESBL and AmpC genes, respectively. Conclusion: This study shows that ceftriaxone resistance is mainly mediated by β-lactamases such as ESBL and AmpC. As the incidence of ceftriaxone resistance is rising gradually over the years, it is imperative to monitor the AMR in this species. Review of a 7-year record of the bacteriological profile of airway secretions of children with cystic fibrosis in North India Vikas Gautam, Parinitha Kaza, Joseph L Mathew, Varpreet Kaur, Megha Sharma, Pallab Ray Indian Journal of Medical Microbiology 2019 37(2):203-209 Background: Cystic fibrosis (CF) is now a recognised entity in India, with prevalence rates between 1/10,000 and 1/50,000. However, no data were available with regard to the profile of respiratory pathogens in the Indian setting. Materials and Methods: The records of respiratory secretion bacterial cultures of children with CF in a tertiary care hospital in North India from January 2010 to December 2016 were reviewed. Culture data were evaluated; the organisms were noted and their antimicrobial susceptibilities were analysed. The microbiological profile and antimicrobial susceptibility pattern of CF patients were evaluated. Results: A total of 445 samples from 146 children were processed, of which 246 (55%) samples showed bacterial growth. Mixed infections 48 (19.5%) were common in older children. Children aged 3–6 months (62.5%) showed the highest culture positivity. The most commonly isolated organisms were Pseudomonas aeruginosa (52.6%) and Staphylococcus aureus. Children with initial cultures positive for P. aeruginosa had 55% of their subsequent cultures showing polymicrobial infections. P. aeruginosa was most susceptible to ciprofloxacin (89%) and piperacillin-tazobactum (88%). Among the staphylococcal isolates, 38% were methicillin-resistant S. aureus (MRSA). The percentage of MRSA increased from 66% in 2010 to 75% in 2012, followed by a decline to 24% in 2016. Conclusions: The pattern of airway colonisation in the Indian setting is different from the Caucasian population, and P. aeruginosa and Burkholderia cepacia complex appear early. Colonisation with P. aeruginosa benefits from therapy. In case of infection, care must be taken while initiating empiric therapy. It should be based on local antibiograms to prevent the emergence of resistant microbes. Characterisation of virulence genes associated with pathogenicity in Klebsiella pneumoniae PA Remya, M Shanthi, Uma Sekar Indian Journal of Medical Microbiology 2019 37(2):210-218 Purpose: This study was undertaken to characterise the virulence factors in clinical strains of Klebsiella pneumoniae and analyse their association with various infections caused and also to determine the association between virulence factors and antimicrobial resistance profile. Materials and Methods: A total number of 370 clinically significant, non-duplicate isolates of K. pneumoniae isolated from both hospitalised patients and patients attending clinics were included in this study. Polymerase chain reaction (PCR) was carried out for the detection of various virulence genes such as mucoviscosity-associated gene A (magA), gene associated with allantoin metabolism (allS), Klebsiella ferric iron uptake(Kfu), capsule-associated gene A (K2A), regulator of mucoid phenotype A (rmpA), enterobactin (entB), yersiniabactin (YbtS), aerobactin, Fimbrial adhesin (FimH) and uridine-diphosphate galacturonate 4-epimerase (uge). Antimicrobial susceptibility testing and PCR-based detection of beta-lactamase-encoding genes such as extended-spectrum beta-lactamases, AmpCs and carbapenemases were performed. Univariate analysis was done to find the association between virulence genes and mortality. Results: The siderophore, entB, was present in most (90.5%) of the isolates. Of the 370 isolates, 345 carried multiple virulence genes; 15 harboured single virulence genes and 10 did not harbour any of the studied virulence genes. The most common combination of occurrence was entB and FimH. A mortality rate of 12.75% (38/298) was observed among hospitalised patients. None of the virulence genes had any significant association with mortality. Conclusion: Pathogenic K. pneumoniae can harbour single to multiple virulence genes. Invasive infection with even a single virulence gene-harbouring K. pneumoniae can lead to poor outcomes. Both multidrug-resistant (MDR) and non-MDR K. pneumoniae can harbour a variety of virulence genes. None of the virulence genes have a significant association with mortality.
Metagenomic next-generation sequencing in clinical microbiologyJobin John Jacob, Balaji Veeraraghavan, Karthick VasudevanIndian Journal of Medical Microbiology 2019 37(2):133-140Pneumococcal conjugate vaccine rollout in India: Expectations and challengesRosemol Varghese, Balaji Veeraraghavan, Yuvraj Jeyaraman, Girish Kumar, Narendra Kumar Arora, S BalasubramanianIndian Journal of Medical Microbiology 2019 37(2):141-146India is one among the four Asian countries with the greatest number of deaths...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Family Care Rituals in the ICU to Reduce Symptoms of Post-Traumatic Stress Disorder in Family Members—A Multicenter, Multinational, Before-and-After Intervention Trial Objectives: To assess the feasibility and efficacy of implementing "Family Care Rituals" as a means of engaging family members in the care of patients admitted to the ICU with a high risk of ICU mortality on outcomes including stress-related symptoms in family members. Design: Prospective, before-and-after intervention evaluation. Setting: Two U.S. academic medical ICU's, and one Italian academic medical/surgical ICU. Subjects: Family members of patients who had an attending predicted ICU mortality of greater than 30% within the first 24 hours of admission. Interventions: A novel intervention titled "Family Care Rituals" during which, following a baseline observation period, family members enrolled in the intervention phase were given an informational booklet outlining opportunities for engagement in care of the patient during their ICU stay. Measurements and Main Results: Primary outcome was symptoms of post-traumatic stress disorder in family members 90 days after patient death or ICU discharge. Secondary outcomes included symptoms of depression, anxiety, and family satisfaction. At 90-day follow-up, 131 of 226 family members (58.0%) responded preintervention and 129 of 226 family members (57.1%) responded postintervention. Symptoms of post-traumatic stress disorder were significantly higher preintervention than postintervention (39.2% vs 27.1%; unadjusted odds ratio, 0.58; p = 0.046). There was no significant difference in symptoms of depression (26.5% vs 25.2%; unadjusted odds ratio, 0.93; p = 0.818), anxiety (41.0% vs 45.5%; unadjusted odds ratio, 1.20; p = 0.234), or mean satisfaction scores (85.1 vs 89.0; unadjusted odds ratio, 3.85; p = 0.052) preintervention versus postintervention 90 days after patient death or ICU discharge. Conclusions: Offering opportunities such as family care rituals for family members to be involved with providing care for family members in the ICU was associated with reduced symptoms of post-traumatic stress disorder. This intervention may lessen the burden of stress-related symptoms in family members of ICU patients. This research was completed at following institutions: Rhode Island Hospital, Rush Medical Center, Azienda Ospedaliero-Universitaria Careggi. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). The James M Cox Foundation provide support for this trial in the form of grant funding for study coordination, travel, supplies, and statistical analysis. Dr. Amass's institution received funding from the National Heart, Lung, and Blood Institute (grant T32 HL134625), and he received support for article research from the National Institutes of Health. Drs. Amass's, OMahoney's, Caine's, and Palmisciano's institutions received funding from the James M. Cox Foundation. Dr. Villa received funding from Baxter and Pall. Dr. OMahoney received support for article research from the Family Foundation Grant. Ms. McFadden, Mr. Walsh, Ms. Caine, and Ms. Palmisciano received support for article research from James M. Cox Foundation. Dr. De Gaudio's institution received funding from MSD Italia and Pall, and he received funding from Baxter. The remaining authors have disclosed that they do not have any potential conflicts of interest. Address requests for reprints to: Timothy H. Amass, MD, ScM, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine. Department of Veterans Affairs, Eastern Colorado Health System. 1700 N. Wheeling Street, Office F2-266, Denver, CO 80045 E-mail: tim.amass@gmail.com Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Alive and Ventilator Free: A Hierarchical, Composite Outcome for Clinical Trials in the Acute Respiratory Distress Syndrome Objectives: Survival from acute respiratory distress syndrome is improving, and outcomes beyond mortality may be important for testing new treatments. The "ventilator-free days" score, is an established composite that equates ventilation on day 28 to death. A hierarchical outcome treating death as a worse than prolonged ventilation would enhance face validity, but performance characteristics and reporting of such an outcome are unknown. We therefore evaluated the performance of a novel hierarchical composite endpoint, the Alive and Ventilator Free score. Design: Using data from four Acute Respiratory Distress Syndrome Network clinical trials, we compared Alive and Ventilator Free to the ventilator-free days score. Alive and Ventilator Free compares each patient with every other patient in a win-lose-tie for each comparison. Duration of mechanical ventilation is only compared if both patients survived. We evaluated power of Alive and Ventilator Free versus ventilator-free days score under various circumstances. Setting: ICUs within the Acute Respiratory Distress Syndrome Network. Patients: Individuals enrolled in four Acute Respiratory Distress Syndrome Network trials. Interventions: None for this analysis. Measurements and Main Results: Within the four trials (n = 2,410 patients), Alive and Ventilator Free and ventilator-free days score had similar power, with Alive and Ventilator Free slightly more powerful when a mortality difference was present, and ventilator-free days score slightly more powerful with a difference in duration of mechanical ventilation. Alive and Ventilator Free less often found in favor of treatments that increased mortality and increased days free of ventilation among survivors. Conclusions: A hierarchical composite endpoint, Alive and Ventilator Free, preserves statistical power while improving face validity. Alive and Ventilator Free is less prone to favor a treatment with discordant effects on survival and days free of ventilation. This general approach can support complex outcome hierarchies with multiple constituent outcomes. Approaches to interpretation of differences in Alive and Ventilator Free are also presented. Drs. Novack, Beitler, and Brown were involved in drafting the work. Drs. Yitshak-Sade, Thompson, Schoenfeld, Rubenfeld, and Talmor were involved in critical revision for important intellectual content. Drs. Novack, Beitler, Yitshak-Sade, and Brown were involved in statistical analysis. All authors were involved in substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. All authors were involved in final approval of the version to be published. All authors were involved in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by grant from the National Institutes of Health. Dr. Novack received funding from Cardiomed Consultants LLC. Drs. Beitler's and Schoenfeld's institution received funding from the National Institutes of Health (NIH). Drs. Beitler, Thompson, Schoenfeld, and Brown received support for article research from the NIH. Dr. Thompson's institution received funding from the National Heart, Lung, and Blood Institute (NHLBI) and Department of Defense; reports consulting for Bayer, Boehringer Ingelheim, and GlaxoSmithKline; and authorship for UpToDate, all outside the submitted work. Drs. Talmor (1UM1HL108724) and Beitler (K23HL133489) received funding from NHLBI. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: Samuel.Brown@imail.org Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Neuroprognostication Practices in Postcardiac Arrest Patients: An International Survey of Critical Care Providers Objectives: To characterize approaches to neurologic outcome prediction by practitioners who assess prognosis in unconscious cardiac arrest individuals, and assess compliance to available guidelines. Design: International cross-sectional study. Setting: We administered a web-based survey to members of Neurocritical Care Society, Society of Critical Care Medicine, and American Academy of Neurology who manage unconscious cardiac arrest patients to characterize practitioner demographics and current neuroprognostic practice patterns. Subjects: Physicians that are members of aforementioned societies who care for successfully resuscitated cardiac arrest individuals. Interventions: Not applicable. Measurements and Main Results: A total of 762 physicians from 22 countries responses were obtained. A significant proportion of respondents used absent corneal reflexes (33.5%) and absent pupillary reflexes (36.2%) at 24 hours, which is earlier than the recommended 72 hours in the standard guidelines. Certain components of the neurologic examination may be overvalued, such as absent motor response or extensor posturing, which 87% of respondents considered being very or critically important prognostic indicators. Respondents continue to rely on myoclonic status epilepticus and neuroimaging, which were favored over median nerve somatosensory evoked potentials for prognostication, although the latter has been demonstrated to have a higher predictive value. Regarding definitive recommendations based on poor neurologic prognosis, most physicians seem to wait until the postarrest timepoints proposed by current guidelines, but up to 25% use premature time windows. Conclusions: Neuroprognostic approaches to hypoxic-ischemic encephalopathy vary among physicians and are often not consistent with current guidelines. The overall inconsistency in approaches and deviation from evidence-based recommendations are concerning in this disease state where mortality is so integrally related to outcome prediction. Drs. Maciel and Barden contributed equally for this article and shared first authorship. This study was conducted at Yale University School of Medicine. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Dr. Maciel received funding from Claude D. Pepper Older Americans Independence Center Junior Scholar award that supports preclinical studies of mechanisms of secondary brain injury in a rodent cardiac arrest model. Dr. Dhakar received funding from Adamas Pharmaceuticals and research support from Marinus Pharmaceuticals and UCB Biopharma for clinical trials. Dr. Greer's institution received funding from National Institutes of Neurological Disorders and Stroke/National Institutes of Health, he received funding form medical-legal consultation, and he serves as Editor-in-Chief of Seminars in Neurology and has received compensation for medico-legal consultation. The remaining authors have disclosed that they do not have any potential conflicts of interest. ORCID 0000-0002-8763-5839 (to Dr. Maciel), ORCID 0000-0002-4901-4177 (to Dr. Barden), ORCID 0000-0002-7325-1148 (to Dr. Youn), ORCID 0000-0001-9275-2784 (to Dr. Dhakar), and ORCID 0000-0002-2026-8333 (to Dr. Gree). For information regarding this article, E-mail: carolina.maciel@neurology.ufl.edu Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Effect of Best Practice Advisories on Sedation Protocol Compliance and Drug-Related Hazardous Condition Mitigation Among Critical Care Patients Objectives: To determine whether best practice advisories improved sedation protocol compliance and could mitigate potential propofol-related hazardous conditions. Design: Retrospective observational cohort study. Setting: Two adult ICUs at two academic medical centers that share the same sedation protocol. Patients: Adults 18 years old or older admitted to the ICU between January 1, 2016, and January 31, 2018, who received a continuous infusion of propofol. Interventions: Two concurrent best practice advisories built in the electronic health record as a clinical decision support tool to enforce protocol compliance with triglyceride and lipase level monitoring and mitigate propofol-related hazardous conditions. Measurements and Main Results: The primary outcomes were baseline and day 3 compliance with triglyceride and lipase laboratory monitoring per protocol and time to discontinuation of propofol in the setting of triglyceride and/or lipase levels exceeding protocol cutoffs. A total of 1,394 patients were included in the study cohort (n = 700 in the pre–best practice advisory group; n = 694 in the post–best practice advisory group). In inverse probability weighted regression analyses, implementing the best practice advisory was associated with a 56.6% (95% CI, 52.6–60.9) absolute increase and a 173% relative increase (risk ratio, 2.73; 95% CI, 2.45–3.04) in baseline laboratory monitoring. The best practice advisory was associated with a 34.0% (95% CI, 20.9–47.1) absolute increase and a 74% (95% CI, 1.39–2.19) relative increase in day 3 laboratory monitoring after inverse probability weighted analyses. Among patients with laboratory values exceeding protocol cutoffs, implementation of the best practice advisory resulted in providers discontinuing propofol an average of 16.6 hours (95% CI, 4.8–28.3) sooner than pre–best practice advisory. Findings from alternate analyses using interrupted time series were consistent with the inverse probability weighted analyses. Conclusions: Best practice advisories can be effectively used in ICUs to improve sedation protocol compliance and may mitigate potential propofol-related hazardous conditions. Best practice advisories should undergo continuous quality assurance and optimizations to maximize clinical utility and minimize alert fatigue. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Dr. Zullo is supported by award 5K12HS022998 from the Agency for Healthcare Research and Quality. He is supported, in part, by a research grant from Sanofi Pasteur to Brown University on unrelated work that aims to understand the epidemiology of infections in long-term care facilities. He is also supported by a Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Health Services Research and Development. Dr. Amass' institution received funding from National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (grant number: T32HL134625), and the Brown University Respiratory Research Training Program, and he received support for article research from the NIH. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: rgreene1@lifespan.org Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Formyl Peptide Receptor-1 Blockade Prevents Receptor Regulation by Mitochondrial Danger-Associated Molecular Patterns and Preserves Neutrophil Function After Trauma Objectives: Trauma predisposes to systemic sterile inflammation (systemic inflammatory response syndrome) as well as infection, but the mechanisms linking injury to infection are poorly understood. Mitochondrial debris contains formyl peptides. These bind formyl peptide receptor-1, trafficking neutrophils to wounds, initiating systemic inflammatory response syndrome, and wound healing. Bacterial formyl peptides, however, also attract neutrophils via formyl peptide receptor-1. Thus, mitochondrial formyl peptides might suppress neutrophils antimicrobial function. Also, formyl peptide receptor-1 blockade used to mitigate systemic inflammatory response syndrome might predispose to sepsis. We examined how mitochondrial formyl peptides impact neutrophils functions contributing to antimicrobial responses and how formyl peptide receptor-1 antagonists affect those functions. Design: Prospective study of human and murine neutrophils and clinical cohort analysis. Setting: University research laboratory and level 1 trauma center. Patients: Trauma patients, volunteer controls. Animal Subjects: C57Bl/6, formyl peptide receptor-1, and formyl peptide receptor-2 knockout mice. Interventions: Human and murine neutrophils functions were activated with autologous mitochondrial debris, mitochondrial formyl peptides, or bacterial formyl peptides followed by chemokines or leukotrienes. The experiments were repeated using formyl peptide receptor-1 antagonist cyclosporin H, "designer" human formyl peptide receptor-1 antagonists (POL7178 and POL7200), or anti-formyl peptide receptor-1 antibodies. Mouse injury/lung infection model was used to evaluate effect of formyl peptide receptor-1 inhibition. Measurements and Main Results: Human neutrophils cytosolic calcium, chemotaxis, reactive oxygen species production, and phagocytosis were studied before and after exposure to mitochondrial debris, mitochondrial formyl peptides, and bacterial formyl peptides. Mitochondrial formyl peptide and bacterial formyl peptides had similar effects on neutrophils. Responses to chemokines and leukotrienes were suppressed by prior exposure to formyl peptides. POL7200 and POL7178 were specific antagonists of human formyl peptide receptor-1 and more effective than cyclosporin H or anti-formyl peptide receptor-1 antibodies. Formyl peptides inhibited mouse neutrophils responses to chemokines only if formyl peptide receptor-1 was present. Formyl peptide receptor-1 blockade did not inhibit neutrophils bacterial phagocytosis or reactive oxygen species production. Cyclosporin H increased bacterial clearance in lungs after injury. Conclusions: Formyl peptides both activate and desensitize neutrophils. Formyl peptide receptor-1 blockade prevents desensitization, potentially both diminishing systemic inflammatory response syndrome and protecting the host against secondary infection after tissue trauma or primary infection. This work was performed at Beth Israel Deaconess Medical Center. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by Department of Defense Focused Program Award W81XWH-16-1-0464 (Drs. Yaffe, Otterbein, and Hauser) and National Institute of Allergy Infectious Diseases grant 1R03AI35346-01 (Dr. Itagaki). Dr. Itagaki has a grant from National Institute of Allergy and Infectious Diseases/National Institutes of Health (NIH), 1R03AI135346-01. Drs. Itagaki, Kaczmarek, Wang, Gong, Gao, and Otterbein received support for article research from the NIH. Dr. Yaffe's institution received funding from Department of Defense (DoD); he received funding from The American Association for the Advancement of Science Science Signaling and Applied Biomath; and he received support for article research from the DoD. Drs. Wang, Gong, and Gao disclosed government work. Dr. Otterbein received funding from HillHurst Biopharmaceuticals (stock options). Drs. Hauser and Otterbein share a grant from DoD, W81XWH-16-1-0464. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: kitagaki@bidmc.harvard.edu; cjhauser@bidmc.harvard.edu Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Corticosteroids as Adjunctive Therapy in the Treatment of Influenza: An Updated Cochrane Systematic Review and Meta-analysis Objectives: Corticosteroids may be beneficial in sepsis, but uncertainty remains over their effects in severe influenza. This systematic review updates the current evidence regarding corticosteroids in the treatment of influenza and examines the effect of dose on outcome. Data Sources: Electronic databases (MEDLINE, EMBASE, CINAHL, LILACS, CENTRAL, and Web of Science) and trial registries were searched to October 2018 for randomized controlled trials, quasi-experimental designs, and observational cohort studies reporting corticosteroid versus no corticosteroid treatment in individuals with influenza. Study Selection and Data Extraction: Two researchers independently assessed studies for inclusion. Risk of bias was assessed using the Cochrane Risk of Bias tool (randomized controlled trials) or Newcastle-Ottawa Scale (observational studies). Where appropriate, we estimated the effect of corticosteroids by random-effects meta-analyses using the generic inverse variance method. Meta-regression analysis was used to assess the association of corticosteroid dose and mortality. Data Synthesis: We identified 30 eligible studies, all observational apart from one randomized controlled trial. Twenty-one observational studies were included in the meta-analysis of mortality, which suggested an adverse association with corticosteroid therapy (odds ratio, 3.90; 95% CI, 2.31–6.60; 15 studies; adjusted hazard ratio, 1.49; 95% CI, 1.09–2.02; six studies). Risk of bias assessment was consistent with potential confounding by indication. Pooled analysis of seven studies showed increased odds of hospital-acquired infection in people treated with corticosteroids (unadjusted odds ratio, 2.74; 95% CI, 1.51–4.95). Meta-regression of the effect of dose on mortality did not reveal an association, but reported doses of corticosteroids in included studies were high (mostly > 40 mg methylprednisolone [or equivalent] per day). Conclusions: Corticosteroid treatment in influenza is associated with increased mortality and hospital-acquired infection, but the evidence relates mainly to high corticosteroid doses and is of low quality with potential confounding by indication a major concern. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by grants from National Institute for Health Research Nottingham Biomedical Research Centre, (Nottingham University Hospitals National Health Service Trust and University of Nottingham), Nottingham, United Kingdom. This article is based on a Cochrane Review published in the Cochrane Database of Systematic Reviews (CDSR) 2019; issue 2, DOI: 10.1002/14651858.CD010406. (see www.cochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the CDSR should be consulted for the most recent version of the review. Dr. Lansbury disclosed that this work is part of an ongoing program undertaken by the Nottingham Biomedical Research Centre funded by the National Institute for Health Research (NIHR); she is the Head of the World Health Organization Collaborating Centre for Pandemic Influenza and Research at the University of Nottingham, which has a grant from the World Health Organization to provide technical assistance for the prevention and control of seasonal influenza; she has salary support funded by the NIHR; and she received support for article research from the NIHR. Dr. Rodrigo received salaries funded, in part, by an unrestricted grant from Pfizer and the NIHR. Professor Leonardi-Bee disclosed that she was a coapplicant on an educational grant from Hoffmann-La Roche to carry out research in the area of pandemic influenza. Hoffmann-La Roche did not support any aspects of this work. She also undertook consultancy work for the U.K. Food Standards Agency in 2013–2015 and for a Breast Milk Substitute manufacturer in 2017 to help them design a healthcare claim trial. Professor Nguyen-Van-Tam's institution received funding from the NIHR. He disclosed that the University of Nottingham Health Protection Research Group currently holds an unrestricted educational grant for influenza research from F. Hoffmann-La Roche, but this did not support any aspect of this work. He also disclosed that he is a former employee of SmithKline Beecham plc (now GlaxoSmithKline), Roche Products, and Aventis-Pasteur MSD (now Sanofi-Pasteur MSD), all prior to 2005, with no outstanding pecuniary interests by way of shareholdings, share options, or accrued pension rights. He is currently on secondment to the Department of Health and Social Care (U.K. government); he received support for article research from NIHR, Nottingham Biomedical Research Centre; and he disclosed off-label product use of corticosteroids. Professor Lim's institution received funding from NIHR Biomedical Research Centre and Pfizer (unrestricted investigator-initiated research grant for pneumococcal pneumonia) and the NIHR (corticosteroids in pandemic influenza clinical trial). This work was performed at the University of Nottingham, Nottingham, United Kingdom. Address requests for reprints to: Louise E. Lansbury, MBBS, PhD, Department of Epidemiology and Public Health, University of Nottingham, Room B104 Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, United Kingdom. E-mail: louise.lansbury@nottingham.ac.uk Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Suppression of Superoxide-Hydrogen Peroxide Production at Site IQ of Mitochondrial Complex I Attenuates Myocardial Stunning and Improves Postcardiac Arrest Outcomes Objectives: Cardiogenic shock following cardiopulmonary resuscitation for sudden cardiac arrest is common, occurring even in the absence of acute coronary artery occlusion, and contributes to high rates of postcardiopulmonary resuscitation mortality. The pathophysiology of this shock is unclear, and effective therapies for improving clinical outcomes are lacking. Design: Laboratory investigation. Setting: University laboratory. Subjects: C57BL/6 adult female mice. Interventions: Anesthetized and ventilated adult female C57BL/6 wild-type mice underwent a 4, 8, 12, or 16-minute potassium chloride-induced cardiac arrest followed by 90 seconds of cardiopulmonary resuscitation. Mice were then blindly randomized to a single IV injection of vehicle (phosphate-buffered saline) or suppressor of site IQ electron leak, an inhibitor of superoxide production by complex I of the mitochondrial electron transport chain. Suppressor of site IQ electron leak and vehicle were administered during cardiopulmonary resuscitation. Measurements and Main Results: Using a murine model of asystolic cardiac arrest, we discovered that duration of cardiac arrest prior to cardiopulmonary resuscitation determined postresuscitation success rates, degree of neurologic injury, and severity of myocardial dysfunction. Post-cardiopulmonary resuscitation cardiac dysfunction was not associated with myocardial necrosis, apoptosis, inflammation, or mitochondrial permeability transition pore opening. Furthermore, left ventricular function recovered within 72 hours of cardiopulmonary resuscitation, indicative of myocardial stunning. Postcardiopulmonary resuscitation, the myocardium exhibited increased reactive oxygen species and evidence of mitochondrial injury, specifically reperfusion-induced reactive oxygen species generation at electron transport chain complex I. Suppressor of site IQ electron leak, which inhibits complex I-dependent reactive oxygen species generation by suppression of site IQ electron leak, decreased myocardial reactive oxygen species generation and improved postcardiopulmonary resuscitation myocardial function, neurologic outcomes, and survival. Conclusions: The severity of cardiogenic shock following asystolic cardiac arrest is dependent on the length of cardiac arrest prior to cardiopulmonary resuscitation and is mediated by myocardial stunning resulting from mitochondrial electron transport chain complex I dysfunction. A novel pharmacologic agent targeting this mechanism, suppressor of site IQ electron leak, represents a potential, practical therapy for improving sudden cardiac arrest resuscitation outcomes. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by National Institutes of Health RO1HL133675 (to Dr. Sharp). Dr. Archer is supported by the Canadian Institutes of Health Research, The Henderson Foundation, and the Queen's Cardiopulmonary Unit. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: wsharp@medicine.bsd.uchicago.edu This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Renal Replacement Therapy: A Multinational Survey of Critical Care Practitioners Objectives: To assess the attitudes of practitioners with respect to net ultrafiltration prescription and practice among critically ill patients with acute kidney injury treated with renal replacement therapy. Design: Multinational internet-assisted survey. Setting: Critical care practitioners involved with 14 societies in 80 countries. Subjects: Intensivists, nephrologists, advanced practice providers, ICU and dialysis nurses. Intervention: A cross-sectional survey. Measurement and Main Results: Of 2,567 practitioners who initiated the survey, 1,569 (61.1%) completed the survey. Most practitioners were intensivists (72.7%) with a median duration of 13.2 years of practice (interquartile range, 7.2–22.0 yr). Two third of practitioners (71.0%; regional range, 55.0–95.5%) reported using continuous renal replacement therapy with a net ultrafiltration rate prescription of median 80.0 mL/hr (interquartile range, 49.0–111.0 mL/hr) for hemodynamically unstable and a maximal rate of 299.0 mL/hr (interquartile range, 200.0–365.0 mL/hr) for hemodynamically stable patients, with regional variation. Only a third of practitioners (31.5%; range, 13.7–47.8%) assessed hourly net fluid balance during continuous renal replacement therapy. Hemodynamic instability was reported in 20% (range, 20–38%) of patients and practitioners decreased the rate of fluid removal (70.3%); started or increased the dose of a vasopressor (51.5%); completely stopped fluid removal (35.8%); and administered a fluid bolus (31.6%), with significant regional variation. Compared with physicians, nurses were most likely to report patient intolerance to net ultrafiltration (73.4% vs 81.3%; p = 0.002), frequent interruptions (40.4% vs 54.5%; p < 0.001), and unavailability of trained staff (11.9% vs 15.6%; p = 0.04), whereas physicians reported unavailability of dialysis machines (14.3% vs 6.1%; p < 0.001) and costs associated with treatment as barriers (12.1% vs 3.0%; p < 0.001) with significant regional variation. Conclusions: Our study provides new knowledge about the presence and extent of international practice variation in net ultrafiltration. We also identified barriers and specific targets for quality improvement initiatives. Our data reflect the need for evidence-based practice guidelines for net ultrafiltration. Dr. Murugan had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis, and involved in drafting of the article, statistical analysis, and study supervision. Drs. Murugan, Ostermann, Peng, Puttarajappa, Weisbord, Palevsky, Kellum, and Bellomo were involved in study concept and design. Drs. Murugan, Ostermann, Peng, Kitamura, Romagnoli, Di Lullo, Srisawat, Todi, Bellomo, and Ronco were involved in acquisition of data. Drs. Murugan, Ostermann, Weisbord, Palevsky, Kellum, Bellomo, and Ronco were involved in analysis and interpretation of data. Drs. Murugan, Ostermann, Peng, and Kitamura were involved in administrative, technical, or material support. All authors were involved in critical revision of the article for important intellectual content. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Dr. Murugan received grant funding from the National Institute of Diabetes and Digestive and Kidney Diseases and Bioporto and funding from AM Pharma and La Jolla unrelated to this study. Dr. Romagnoli received funding from Baxter, MSD, and Masimo. Dr. Hoste's institution received funding from AM Pharma and Sopachem. Dr. Bagshaw received funding from Baxter. Dr. Weisbord received funding from Saghmos Therapeutics. Drs. Weisbord and Palevsky disclosed government work. Dr. Palevsky's institution received funding from Dascena, and he received funding from Baxter, Novartis, and GE Healthcare. Dr. Kellum received funding from Baxter (grant and consulting) and NxStage (consulting). The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: muruganr@upmc.edu Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Conditional Survival With Increasing Duration of ICU Admission: An Observational Study of Three Intensive Care Databases Objectives: Prolonged admissions to an ICU are associated with high resource utilization and personal cost to the patient. Previous reports suggest increasing length of stay may be associated with poor outcomes. Conditional survival represents the probability of future survival after a defined period of treatment on an ICU providing a description of how prognosis evolves over time. Our objective was to describe conditional survival as length of ICU stay increased. Design: Retrospective observational cohort study of three large intensive care databases. Setting: Three intensive care databases, two in the United States (Medical Information Mart for Intensive Care III and electronic ICU) and one in United Kingdom (Post Intensive Care Risk-Adjusted Alerting and Monitoring). Patients: Index admissions to intensive care for patients 18 years or older. Interventions: None. Measurements and Main Results: A total of 11,648, 38,532, and 165,125 index admissions were analyzed from Post Intensive Care Risk-Adjusted Alerting and Monitoring, Medical Information Mart for Intensive Care III and electronic ICU databases respectively. In all three cohorts, conditional survival declined over the first 5–10 days after ICU admission and changed little thereafter. In patients greater than or equal to 75 years old conditional survival continued to decline with increasing length of stay. Conclusions: After an initial period of 5–10 days, probability of future survival does not decrease with increasing length of stay in unselected patients admitted to ICUs. These findings were consistent between the three populations and suggest that a prolonged admission to an ICU is not a reason for a pessimism in younger patients but may indicate a poor prognosis in the older population. Drs. Marshall, Young, and Watkinson designed the study. Drs. Marshall and Hatch and Mr. Gerry conducted the analysis. All authors were responsible for interpreting the data and drafting of the article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). This publication has been made possible through access to a research database that was created with support from the Health Innovation Challenge Fund (HICF-0510-006; WT-094951), a parallel funding partnership between the Department of Health and Wellcome Trust. Access was granted by the owners of the research database, the University of Oxford Critical Care Research Group. Dr. Young's institution received funding from Health Innovation Challenge Fund (joint venture of Wellcome Trust and U.K. Department of Health. Dr. Watkinson's institution received funding from Drayson Health and National Institute for Health Research (NIHR) Biomedical Research Center, Oxford, and he received funding from Drayson Health. Dr. Hatch is funded by an NIHR Academic Clinical Fellowship. Gerry is funded by an NIHR Doctoral Fellowship (DRF-2016-09-073). Dr. Watkinson has developed an electronic observations application for which Drayson Health (now Sensyne Health) has purchased a sole license. The company has a research agreement with the University of Oxford and pay personal fees. No other authors have financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, nor other relationships or activities that could appear to have influenced the submitted work. Dr. Marshall has disclosed that he does not have any potential conflicts of interest. For information regarding this article, E-mail: dominic.marshall@bath.edu This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Investigating Swallowing and Tracheostomy Following Critical Illness: A Scoping Review Objectives: Tracheostomy and dysphagia often coexist during critical illness; however, given the patient's medical complexity, understanding the evidence to optimize swallowing assessment and intervention is challenging. The objective of this scoping review is to describe and explore the literature surrounding swallowing and tracheostomy in the acute care setting. Data Sources: Eight electronic databases were searched from inception to May 2017 inclusive, using a search strategy designed by an information scientist. We conducted manual searching of 10 journals, nine gray literature repositories, and forward and backward citation chasing. Study Selection: Two blinded reviewers determined eligibility according to inclusion criteria: English-language studies reporting on swallowing or dysphagia in adults (≥ 17 yr old) who had undergone tracheostomy placement while in acute care. Patients with head and/or neck cancer diagnoses were excluded. Data Extraction: We extracted data using a form designed a priori and conducted descriptive analyses. Data Synthesis: We identified 6,396 citations, of which 725 articles were reviewed and 85 (N) met inclusion criteria. We stratified studies according to content domains with some featuring in multiple categories: dysphagia frequency (n = 38), swallowing physiology (n = 27), risk factors (n = 31), interventions (n = 21), and assessment comparisons (n = 12) and by patient etiology. Sample sizes (with tracheostomy) ranged from 10 to 3,320, and dysphagia frequency ranged from 11% to 93% in studies with consecutive sampling. Study design, sampling method, assessment methods, and interpretation approach varied significantly across studies. Conclusions: The evidence base surrounding this subject is diverse, complicated by heterogeneous patient selection methods, design, and reporting. We suggest ways the evidence base may be developed. This work was performed at the School of Audiology and Speech Sciences, University of British Columbia; University of Alberta Hospitals, Edmonton, AB, Canada. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://journals.lww.com/ccmjournal). Supported, in part, by Dr. Skoretz' School of Audiology and Speech Sciences startup funds from the University of British Columbia's (UBC) Faculty of Medicine and UBC's student Work Learn program. Dr. Dawson's institution received funding from Queen Elizabeth Hospital Birmingham Charities. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: sskoretz@audiospeech.ubc.ca Copyright © by 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Family Care Rituals in the ICU to Reduce Symptoms of Post-Traumatic Stress Disorder in Family Members—A Multicenter, Multinational, Before-and-After Intervention TrialObjectives: To assess the feasibility and efficacy of implementing "Family Care Rituals" as a means of engaging family members in the care of patients admitted to the ICU with a high risk of ICU mortality on outcomes including stress-related symptoms in family members. Design: Prospective, before-and-after intervention evaluation. Setting:...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Where are such teachers? A legend, an icon, and a role model! Shridhar Dwivedi Indian Journal of Medical Specialities 2019 10(4):179-183 Clinicodemographic profiling of zika outbreak in Jaipur, Rajasthan Raman Sharma, Madhulata Agarwal, Mayank Gupta, Ruchi Singh, Sunil Kumar Mahavar, Rajni Sharma, Deepa Meena Indian Journal of Medical Specialities 2019 10(4):184-189 Background: The 2018 postmonsoon outbreak of Zika virus infection, in a localized pocket of city of Jaipur, Rajasthan, so far the largest in India, alarmed the health authorities to optimize surveillance and measures. Hence, a community-based study to analyze the clinicodemographic profile was conducted to gain better understanding of its squeal. This study aimed to analyze the clinicodemographic profile of this new entrant viral infection. Methods: The study was designed as a community-based observational study. 1,488,870 people in vicinity of the index case were surveyed clinically from October to November 2018. A total of 1925 febrile individuals including pregnant ones in various trimesters of their pregnancy were screened for Zika infection by reverse-transcriptase-polymerase-chain-reaction (RT-PCR). Among these, 153 were RT-PCR positive and 111 cases consenting for the study were included and data collected were analyzed using SPSS 16 software. Results: The mean age of the study population was 27.51 years (95% confidence interval = 24.78–30.25), 53% of the patients were females. Out of 59 Zika-positive females, 27 (46%) were pregnant; 12 (44.4%) were in first trimester and 9 (33%) and 6 (22.2%) in second and third trimester, respectively. The incubation period ranged from 2 to 10 days, the most common symptom being low grade fever in 82%, followed by myalgia in 64.9% and arthralgia in rheumatoid distribution in 55.9%. On examination, a widely distributed blanching maculopapular rash was seen in 28.8%; nonpurulent conjunctivitis differentiating it from dengue was seen in 16.2%. Conclusions: Although Zika, a commonly prevalent virus in dengue endemic belts, yet unknown to our territory, usually causes a mild febrile illness, it can be a cause of intense apprehension to many if infection occurs in the first trimester of pregnancy. Formulating guidelines to tackle Zika pregnancy is a daunting task and needs collaboration across the globe to carry out future research and to get the knowhow. Prevalence of obesity in Iranian children: Systematic review and meta-analysis Moloud Fakhri, Diana Sarokhani, Mandana Sarokhani, Ali Hasanpour Dehkordi, Leila Jouybari Indian Journal of Medical Specialities 2019 10(4):190-200 Background of the Study: Childhood obesity, in addition to the likelihood of its continuation in adulthood, is associated with an increase in mortality and various diseases. Purpose of the Study: This meta-analytic study aimed at determining the prevalence of obesity among Iranian children. Methodology: Two researchers independently searched national and international databases using MeSH, Scopus, PubMed, Science Direct, Web of Science, Springer, Magiran, Iranmedex, SID, Medlib, and the Google Scholar search engine. The heterogeneity between studies was evaluated using the I2 index. Data were analyzed using STATA software. This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Among 93 studies with a sample size of 3,845,768, the prevalence of obesity in Iranian children was 7% (girls 8% and boys 10%), and the prevalence of overweight was 12% (girls 17% and boys 15%). The incidence rate of obesity in children was 13% based on US centers for disease control and prevention (CDC) 2000 reference, 11% on international obesity task force (IOTF) reference, 9% on World Health Organization reference, 9% on Iranian reference, 5% on CDC reference, and 3% on national center for health statistics (NCHS) reference. Meta-regression diagram also showed that the prevalence of obesity in children was not dependent on sample size. However, the prevalence of obesity declined during the years 1999–2016, which was statistically significant. Conclusion: The prevalence of obesity in Iranian children was less than of their overweight. On the other hand, the prevalence of childhood obesity in girls was lower than that of boys, and the prevalence of child overweight among girls was higher than that of boys. Factors affecting quality of sleep in hospitalized patients: A cross-sectional survey in a tertiary care hospital Ovine Loyster D souza, Irene T. R. Alvares, Manjeshwar Shrinath Baliga Indian Journal of Medical Specialities 2019 10(4):201-206 Background: Sleep is very important for humans and more so to hospitalized patients. Alterations in the normal sleep pattern have negative impact on the medical conditions, mental health, cognitive performance and recovery of the hospitalized individuals. The primary aim of this study was to assess the quality of sleep among hospitalized patients and to find the correlation between the factors affecting sleep and sleep quality. The secondary objective was to understand the quality of sleep in people admitted for surgical and medical treatment. Methods: In this cross-sectional study, the hospitalized patients were examined. Sleeping habits of 100 inpatients of surgical and clinical wards were assessed through the Pittsburgh Sleep Quality Index (PSQI). A self-designed questionnaire was also used to ascertain the factors affecting the sleep. Content validity and test–retest reliability were evaluated. The data obtained were analyzed by the statistical methods of frequency, percentage, and Chi-square. Results: The cross-sectional study showed that the mean score for PSQI was 7.58 ± 3.14 and that 69% of the patients had poor sleep as inferred from the global PSQI >5 scores. Age and gender had no effect on the PSQI total score, but the number of roommates, type of the ward, hospitalization period, presence and severity of pain, taking sleep medication, and attitude toward the overall atmosphere and interior of wards has caused deviation in scores. Conclusion: Sleep problems are quite frequent in medical inpatients. Pain management and modification of the ward interior and atmosphere can impact inpatients sleep quality. Seroprevalence of hepatitis B infection among pregnant women in Southern Odisha Neha Samal, Sanghamitra Padhi, Laxmi Burman Indian Journal of Medical Specialities 2019 10(4):207-209 Background: Hepatitis B virus (HBV) infection continues to be a life- threatening health problem throughout world, infecting more than two billion people. While blood transfusion and unsafe therapeutic injection continue to be major risk factors, the role of vertical transmission remains under- estimated. Hence, this study was done to find out the prevalence of HBV infection and associated risk factors among healthy pregnant ladies in Southern Odisha. The present study was a prospective, observational study conducted, in the department of Microbiology, with collaboration of department of Obstetrics and Gynecology of MKCG Medical college from 1st March 2017 to 28th Feb 2018. Methodology: After collection of three to four millilitre of venous blood from the clients, sera was separated by centrifugation. They were then tested for Hepatitis B surface antigen (HBsAg) by Enzyme linked Immunsorbent assay (ELISA). Serological status of the subjects and correlation with their socio-economic characteristic was noted using a preset proforma. Babies born to HBsAg positive ladies were administered Hepatitis B vaccine and immunoglobulin. Results: Total 3,230 in non-duplicating serum samples were screened among which 150 (4.64%) were tested positive for HBsAg. Ladies with multiple sexual partners (57. 14%) followed by intravenous drug users (7.88%) were mostly positive for HBsAg. Conclusion: Exposure to risky social behavioural pattern, lack of awareness could be suggested as possible means of acquiring the infection. Immunization is the most effective and only way of preventing development of chronic carrier state. Hence all neonates were administered with hepatitis B vaccine and 0.5 ml of hepatitis B immunoglobulin within 12 hours of birth. Adoption and validation of the adolescent stress questionnaire for Indian high school students Ovine Loyster D Souza, Sucharitha Suresh, Manjeshwar Shrinath Baliga Indian Journal of Medical Specialities 2019 10(4):210-218 Introduction: Adolescent stress questionnaire (ASQ) – a 58-item inventory covering broad range of adolescent distress was developed and validated for Australian adolescents. The present study reports a modification of the ASQ for the Indian context. Methodology: Initially, a focus groups study was carried out with 8 adolescents and 8 experts to understand the relevance of the subject and domain contents of ASQ using the original ASQ. Later content validation was done by the experts in the field for the modified ASQ. The modified version was administered to (n = 20) adolescents for pilot testing. In the next stage, the scale was given to 153 adolescents and readministered to the same samples after 1 week. Statistical analysis was done to ascertain the internal consistency, component factor, and test–retest reliability as per the standard analysis. Results: During stage one, 38 questions were retained which were more relevant to Indian context. The internal consistency of 6 subscales was ≥8 and measuring 0.89 for overall questionnaire. The test–retest reliability measured 0.96 for the overall scale (P < 0.0001) for each domain. During the confirmatory factor analysis, above half (20 of 38) of the items confirmed high correlations with their component scale, with factor loadings P < 0.5. Conclusion: The modified ASQ had acceptable internal consistency and test–retest reliability. Further testing with adolescent students living in other parts is recommended to provide a more complete assessment of the questionnaire. Absent inferior venacava and anti phospholipid antibody syndrome: Compounding risk factor for deep vein thrombosis and recurrent pregnancy loss Aruna Nigam, Nidhi Gupta, Abhinav Jain, Arima Nigam Indian Journal of Medical Specialities 2019 10(4):219-221 The spectrum of congenital anomalies of the inferior vena cava (IVC) has been well described in the literature, but the absence of IVC is a rare occurrence. Most of these patients remain asymptomatic, and the age of presentation depends on the development of deep-venous thrombosis. A young female presented to us with irregular bleeding per vaginum and recurrent pregnancy loss. A thorough general examination of the female patient revealed dilated veins over the abdomen and lower limbs. Investigations of recurrent pregnancy loss led to the diagnosis of antiphospholipid antibody syndrome and computed tomography venography to find out the cause of dilated veins lead to the diagnosis of absent IVC. Both these factors, i.e., absent IVC and the presence of autoimmune antibodies, have compounded the risk factor of thrombosis and management challenging which is discussed. Area postrema syndrome: A lesser known variant of neuromyelitis optica spectrum disorder Gaurav Kumar Mittal, Shilpa Sekhar, John Jacob Mathew, Jennifer Singhdev Indian Journal of Medical Specialities 2019 10(4):222-224 One of the most specific presentations of neuromyelitis optica spectrum disorders (NMOSDs) is area postrema syndrome (APS). Although NMOSDs are now being increasingly encountered, APS is rarely reported in literature. With the emergence of the ever-expanding spectrum of neuromyelitis optica (NMO) comes various challenges in the prompt recognition, confirmation, and swift initiation of the therapy. Although with the new consensus criteria of the International Panel of NMO Diagnosis 2015, the earlier challenges of diagnosis have been removed to a great extent, still there is a long road ahead in the widespread dissemination of the current knowledge of NMOSD among health-care professionals in India. We hereby report a case of APS in a young female with endeavor to increase the awareness of this peculiar kind of presentation from India. Idiopathic hepatic granulomatosis: A challenging case of fever of unknown origin Ashutosh Garg, Vivek Pal Singh, Jai Khullar, Afreen Khan Indian Journal of Medical Specialities 2019 10(4):225-228 For any physician, fever of unknown origin (FUO) is an enigmatic problem, while being equally frustrating. It tests the limits of patience of both the physician and the patient. While the majority of such cases end up being of infective etiology, the rest are attributable to noninfectious inflammatory disorders (NIIDs) and neoplasms. Among the NIIDs, most turn out to be connective tissue disorders (CTDs). CTDs are commonly known to have granulomas on histopathology. However, hepatic granulomas are rarely encountered. We present a case of FUO in an elderly urban North Indian businessman who after thorough workup was diagnosed with idiopathic hepatic granulomatous disease. Response to disease-modifying therapy was rewarding. Cortical blindness in posterior reversible encephalopathy syndrome in postpartum eclampsia Sonakshi Singhal, Amit Baheti, Kirti Singh, Sourya Acharya, Neema Acharya Indian Journal of Medical Specialities 2019 10(4):229-230
Where are such teachers? A legend, an icon, and a role model!Shridhar DwivediIndian Journal of Medical Specialities 2019 10(4):179-183Clinicodemographic profiling of zika outbreak in Jaipur, RajasthanRaman Sharma, Madhulata Agarwal, Mayank Gupta, Ruchi Singh, Sunil Kumar Mahavar, Rajni Sharma, Deepa MeenaIndian Journal of Medical Specialities 2019 10(4):184-189Background: The 2018 postmonsoon outbreak of Zika virus infection, in a localized pocket of city of Jaipur, Rajasthan, so far the largest...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Relationship between inflammation and the severity of Recurrent Respiratory Papillomatosis Vivian Narana Ribeiro El Achkar, Andressa Duarte, Román Carlos, Jorge Esquiche León, ... Estela KaminagakuraIn Press, Journal Pre-proof, Available online 18 November 2019Purchase PDF Article preview Abstract Abstract Objective To characterize inflammatory cells in Recurrent Respiratory Papillomatosis (RRP) and to correlate it with severity using the Derkay laryngoscopic scale. Materials and methods The data and biopsies from 36 patients with Juvenile (JRRP) and 56 patients with Adult (ARRP) were collected and analyzed under light microscopy. The patients were separated into groups according to the Derkay index: ≥20 for the most severe and < 20 for the less severe cases. Immunohistochemical analysis using CD3, CD4, CD8, CD15, CD20, CD68, FoxP3 and MUM-1 antibodies was performed, and the inflammatory cells were quantified. All the clinicopathological characteristics and the results of the immunohistochemical analysis were compared among the groups proposed using the Chi-Square test and correlated through the Spearman correlation test. Results The ARRP showed significantly higher quantities of CD3+, CD8+ and MUM1+ cells (p < .05) than the JRRP samples. The presence of CD15+ cells showed positive correlation with the Derkay index (p < .05), while the MUM-1+ cells showed an inverse correlation (p = .01). Conclusion There are differences between the inflammatory cells population in the juvenile and adult groups and it can be related to disease severity. select article An association between marijuana use and tinnitusResearch articleAbstract onlyAn association between marijuana use and tinnitus Z. Jason Qian, Jennifer C. AlyonoIn Press, Corrected Proof, Available online 13 November 2019Purchase PDF Article preview Abstract Abstract Objective While some advocates have argued for marijuana as a treatment for tinnitus, the relationship between marijuana use and tinnitus is unknown. The objective of this study was to evaluate associations between marijuana use and the prevalence, severity, and rate of occurrence of tinnitus. Study design Cross-sectional analysis of nationally representative data. Setting National Health and Nutrition Examination Survey 2011–2012. Subjects and methods Statistical analysis was performed on data collected from 2705 non-institutionalized adults aged 20–69 who underwent audiometric testing and were administered questionnaires about hearing, drug use, current health status, and medical history. Results The use of marijuana at least once per month for the previous 12 months was significantly associated with experiencing tinnitus during that 12-month month (X2(1) = 19.41, p < 0.001). Subjects who used marijuana were more likely to experience tinnitus after accounting for covariables including age, gender, audiometric hearing loss, noise exposure history, depression, anxiety, smoking, salicylate use, cardiovascular disease, hypertension, and diabetes (OR = 1.75, 95% CI 1.02–3.01, p = 0.043). There were no associations between the severity or frequency of tinnitus occurrence and the quantity or frequency of marijuana use. Use of other substances such as alcohol, cocaine, methamphetamine, and heroin was not associated with tinnitus. Conclusion Regular marijuana use is associated with prevalent tinnitus. However, no dose response between marijuana use and tinnitus was observed. The relationship between marijuana use and tinnitus is complex and is likely modulated by psychosocial factors. select article Investigation of vitamin D levels in patients with Sudden Sensory-Neural Hearing Loss and its effect on treatmentResearch articleAbstract onlyInvestigation of vitamin D levels in patients with Sudden Sensory-Neural Hearing Loss and its effect on treatment Hossein Ghazavi, Amir-Abbas Kargoshai, Mohammad Jamshidi-koohsariIn Press, Corrected Proof, Available online 12 November 2019Purchase PDF Article preview Abstract Abstract Background Due to high prevalence of vitamin D deficiency and the possible association with Sudden Sensory-Neural Hearing Loss (SSNHL) finding the main causes and appropriate treatments are highly essential. This study aimed to investigate vitamin D levels in patients suffering SSNHL and its effect on response to treatment. Materials and methods This cross-sectional study was performed on two groups of case (34 SSNHL patients) and control (34 healthy subjects without risk of hearing loss). All patient information such as age, sex, audiogram illustration of hearing frequency and the level of vitamin D were recorded at baseline. Patients with SSNHL received routine treatments such as 10 days of 1 mg/kg/day steroid and the response or lack of complete response to treatment was recorded and analyzed according to the audiometry. Results Vitamin D level in SSNHL group with a mean of 19.28 ± 9.56 ng/ml was significantly less than the control group (25.71 ± 11.21 ng/ml; P value < 0.001). After treatment, 76.5% were completely recovered and 23.5% did not recover completely. Factors such as age, sex and level of initial hearing loss did not have a significant effect on the response to treatment, but the level of vitamin D in these patients had a significant relationship with the response to treatment (P value = 0.004); so that all patients with sufficient vitamin D level had completely recovered, versus 87.5% of patients with vitamin D deficiency and 12.5% of insufficient vitamin D had no response to treatment. Conclusion According to the results of the present study, the prevalence of vitamin D deficiency in patients with SSNHL was more than healthy people. SSNHL patients with deficient vitamin D had the highest percentage of no response to treatment. select article Osteoradionecrosis of the mandible: Why not to be more aggressive in earlier stage?CorrespondenceNo accessOsteoradionecrosis of the mandible: Why not to be more aggressive in earlier stage? Nidal F. AL DeekIn Press, Journal Pre-proof, Available online 12 November 2019Purchase PDF select article Impact of perforation size and predictive factors for successful pediatric gelfoam myringoplastyResearch articleAbstract onlyImpact of perforation size and predictive factors for successful pediatric gelfoam myringoplasty Elizabeth O. Shay, Janki Shah, Blake Smith, Samantha AnneIn Press, Corrected Proof, Available online 12 November 2019Purchase PDF Article preview Abstract Abstract Objectives Rates of success with pediatric myringoplasty range from 35 to 95%. The objective of this study is to evaluate the impact of perforation size on successful closure of the tympanic membrane (TM) after gelfoam myringoplasty. We also aim to identify variables that affect perforation closure rates and define predictive factors for successful TM closure. Methods A retrospective chart review of all patients that underwent gelfoam myringoplasty by a single surgeon from August 2008 through January 2015 was performed. Results One hundred fifty-nine patients met inclusion criteria and underwent a total of 219 procedures. Overall, gelfoam myringoplasty had an 83.1% rate of successful closure. Average perforation size was 15.31%. Classification tree analysis separated our cohort into three groups based on perforation size: Group 1 (<16.25%) had a 91% closure rate, group 2 (16.25% to <31.25%) had a 66.0% closure rate and group 3 (≥31.25%) had a 30.0% closure rate. Smaller perforations (P ≤0.001) were associated with increased success rates. Other factors associated with successful closure of the TM included younger age at the time of myringoplasty (P ≤0.001), fewer number of prior tympanostomy tubes (P = 0.016), and lesser duration of tube retention (P = 0.003). Conclusion Gelfoam myringoplasty provides good overall TM closure rates and may be considered as a potential first-line option for repair of perforations, including those involving up to 40% of the TM. Younger patients with smaller perforations, fewer sets of tubes, shorter length of tube retention are more likely to have successful closure of the tympanic membrane. select article Echinacea can help with Azithromycin in prevention of recurrent tonsillitis in childrenResearch articleAbstract onlyEchinacea can help with Azithromycin in prevention of recurrent tonsillitis in children Osama G. Abdel-Naby AwadIn Press, Journal Pre-proof, Available online 12 November 2019Purchase PDF Article preview Abstract Abstract Purpose Recurrent tonsillitis in children is a common disease affecting children quality of life and extends to their families. The aim of this study was to assess the effect of combined use of oral Azithromycin (AZT) plus Echinacea compared to exclusive use of AZT in children with recurrent tonsillitis. Material and methods A prospective comparative study including three groups of children with recurrent tonsillitis. Group 1: (100 patients) had no prophylactic treatment. Group 2 (100 patients) received [60 mg/kg] prophylactic dose of AZT divided as (10 mg/kg/day) over 6 consecutive days every month for 6 consecutive months. Group 3 (100 patients) received AZT as in group 2 plus commercially available Echinacea in a dose of 5 ml oral suspension; 3 times daily for 10 consecutive days every month for 6 consecutive months. Number of tonsillitis attacks and severity of tonsillitis symptoms were assessed and compared in different groups. Results Group 2 and group 3 had significant less number of tonsillitis attacks and severity of assessed symptoms during 6 months of prophylactic treatment with significant better results in group 3 (i.e. AZT plus Echinacea) compared to group 2 (I.e. AZT alone). However; there was no significant difference in patients with any prophylaxis. Conclusion The combined use of Echinacea with Azithromycin produced favorable outcome than Azithromycin alone in pediatric patients with recurrent tonsillitis. select article Surgical management of Eagle syndrome: A 17-year experience with open and ransoral robotic styloidectomyResearch articleAbstract onlySurgical management of Eagle syndrome: A 17-year experience with open and ransoral robotic styloidectomy Thomas H. Fitzpatrick, Benjamin D. Lovin, Marcus J. Magister, Joshua D. Waltonen, ... Christopher A. SullivanIn Press, Journal Pre-proof, Available online 12 November 2019Purchase PDF Article preview Abstract Abstract Eagle Syndrome (ES) is a rare disorder that can present with symptoms ranging from globus sensation to otalgia that is attributed to an elongated styloid process and/or calcified stylohyoid ligament. No standardized treatment algorithm exists, and although various surgical approaches have been described, data on the use of transoral robotic surgery (TORS) in this population is limited. To investigate the utility of TORS in the treatment of ES, a retrospective review in 19 ES patients was carried out at a single academic, tertiary medical center between 2000 and 2017. Nineteen patients underwent twenty-one styloid resections: 6 performed via TORS and 15 via transcervical approach. Across all patients, 90% reported some degree of lasting improvement in symptoms while 55% reported significant improvement. When TORS was compared to transcervical resection, there was no difference in the subjective rate of "meaningful" (83 vs. 57%) versus rate of "non-meaningful" symptom improvement (17 vs. 43%) (p = .35). There was a trend towards less estimated blood loss (EBL), operative time, and post-operative length of stay (LOS) with TORS versus transcervical cases (9.2 mL vs. 30.0 mL, 98 vs. 156 min, and 0.7 vs. 1.2 days); however, these did not reach statistical significance (p = .11, 0.13, and 0.42, respectively). Three patients (14% of total) experienced complications associated with an open approach, as compared to none with TORS. In select patients, TORS styloidectomy is a reasonable surgical alternative to traditional transoral and transcervical techniques as it provides similar symptom improvement, and reduced length of stay, blood loss, and operative time. select article Estimated versus actual; The accuracy of accounting for blood loss during endoscopic sinus surgeryResearch articleAbstract onlyEstimated versus actual; The accuracy of accounting for blood loss during endoscopic sinus surgery Michael J. EliasonIn Press, Corrected Proof, Available online 11 November 2019Purchase PDF Article preview Abstract Abstract Purpose Endoscopic sinus surgery (ESS) is the mainstay for chronic inflammatory and neoplastic sinonasal process and as a result many modalities have been studied to minimize blood loss and patient morbidity and to maximize intraoperative visualization. However, often conclusions of actual blood loss are based on surgeons' estimations without ever actually assessing the accuracy of these estimations. The objective of this study was to determine the accuracy of intraoperative blood loss estimates by attending otolaryngology surgeons among patients undergoing ESS. Materials and methods After obtaining institutional review board approval, data were collected on six surgeons performing ESS at a military academic medical center for 21 surgical cases. Specifically, both hourly and end-of-case total "estimated" (EBL) and "calculated actual" (ABL) blood loss values were recorded and compared statistically. Surgeons were blinded to the results until after all data were collected. Results The difference between mean EBL and ABL was 62.5 ml and was statistically significant (p = .007, Power 86.2%). EBL lagged ABL for both hourly intervals during a surgical case and the total end-of-surgery values. Conclusion The surgeons studied had EBL that were statistically significantly less than ABL both at hourly intervals during the surgery and at the conclusion of the case. As a result there exists potential for adverse consequences in clinical care and in efforts in medical research/advancement. select article The role of molecular testing in the diagnosis of medullary thyroid cancer: A case report of oncocytic medullary thyroid carcinoma and review of the literatureCase reportAbstract onlyThe role of molecular testing in the diagnosis of medullary thyroid cancer: A case report of oncocytic medullary thyroid carcinoma and review of the literature Sarah L. Spaulding, Rebecca Ho, Sedef Everest, Raymond L. ChaiIn Press, Corrected Proof, Available online 11 November 2019Purchase PDF Article preview Abstract Abstract Background Medullary thyroid carcinoma (MTC) is a somewhat rare, particularly aggressive form of thyroid cancer. The authors present what we believe to be the first case of MTC diagnosed solely on the basis of molecular testing, as well as a review of the literature concerning this topic and oncocytic variants of MTC. Case description A 30-year-old female patient with a 1.1 cm thyroid nodule underwent a fine-needle aspiration biopsy showing a Bethesda IV Hurthle cell neoplasm. Molecular testing of the specimen identified a RET M918 T mutation. The patient underwent a total thyroidectomy and bilateral central neck dissection. Initial pathologic analysis yielded a diagnosis of Hurthle cell adenoma. Based on the patient's known RET mutation, immunohistochemistry for calcitonin was performed and yielded a positive result. The final diagnosis was amended to an oncocytic variant of medullary thyroid carcinoma. Discussion Had this patient undergone fine-needle aspiration (FNA) biopsy without molecular testing or serum calcitonin measurement, the patient's disease would have been diagnosed as a Hurthle cell adenoma. Despite the lack of characteristic features of malignancy and the rarity of oncocytic MTC, the diagnostic pitfall in this oncocytic lesion was avoided due to molecular testing at the time of FNA biopsy. Conclusion This case draws attention to the unique clinical value of molecular testing in the diagnosis of MTC. The authors believe this case supports the consideration for molecular testing to prevent missed diagnoses in cases of rare benign-appearing disease. select article Cerumen impaction was composed of abnormal exfoliation of keratinocytes that was correlated with infectionResearch articleAbstract onlyCerumen impaction was composed of abnormal exfoliation of keratinocytes that was correlated with infection Shoude Zhang, Mao Jin, Guojin Zhou, Yuejiao ZhangIn Press, Corrected Proof, Available online 7 November 2019Purchase PDF Article preview Abstract Abstract Objective This study investigated the exact composition and tried to be helpful in explaining the etiologic mechanism of cerumen impaction in the external auditory canal (EAC). Methods A hundred impacted cerumen samples and 15 normal cerumen samples were collected by manual removal and divided into 2 groups. All samples were examined via microbial culture, hematoxylin–eosin staining, periodic acid–Schiff staining, and fungal fluorescent staining. Results Eighty-eight patients in group 1 were in the habit of using cotton buds. Forty-seven impacted cerumen samples tested positive for microbes, while only 1 sample of normal cerumen tested positive for microbes (p < .05). The most commonly isolated bacterium and fungus was Staphylococcus aureus and Aspergillus terreus respectively. All cerumen samples were composed of exfoliated keratinocytes and microorganisms assessed via pathologic examination. However, unlike normal cerumen, impacted cerumen contained nucleated keratinocytes and infiltrated neutrophils. Recurrent impaction was found only among patients who tested mold culture-positive. Conclusion Impacted cerumen is composed of abnormal exfoliated keratinocytes that was correlated with microbial-induced neutrophil-mediated inflammation. Mold infection is highly correlated with recurrent cerumen impaction. Microbial culture of removed impacted cerumen is strongly recommended. Ear cleaning with cotton buds, particularly when the EAC is wet might be one of the important causes of cerumen impaction which is need further studied. Level of evidence 2b. select article Risk factors for post-tonsillectomy hemorrhage in adult population: Does smoking history have an impact?Research articleNo accessRisk factors for post-tonsillectomy hemorrhage in adult population: Does smoking history have an impact? Nurullah Seyhun, Senem Kurt Dizdar, Alican Çoktur, Merve Ekici Bektaş, ... Suat TurgutIn Press, Corrected Proof, Available online 6 November 2019Purchase PDF select article Endoscopic repair of cribriform plate cerebrospinal fluid leaks: An easy and reproducible technique sparing the middle turbinateResearch articleAbstract onlyEndoscopic repair of cribriform plate cerebrospinal fluid leaks: An easy and reproducible technique sparing the middle turbinate Christopher J. Ito, Nelson May, Stilianos KountakisIn Press, Corrected Proof, Available online 1 November 2019Purchase PDF Article preview Abstract Abstract Objective The purpose of this study was to evaluate the outcomes of patients with cribriform cerebrospinal fluid leaks undergoing endoscopic repair with an easy and reproducible middle turbinate-sparing technique. Material and methods Date was obtained by retrospective chart review and includes a description of the technique with technical pearls and contraindications to the approach. Results We report 17 patients who underwent repair of cribriform cerebrospinal fluid leaks with a middle turbinate-sparing technique with 100% success rate at a mean follow up of 38 months. One patient complained of hyposmia. There were no other complications. Conclusions The endoscopic middle turbinate-sparing approach to repair cribriform cerebrospinal fluid leaks using a free mucosal graft is easy, effective, and reproducible. select article Orbital complication of acute ethmoiditis: A Tunisian paediatric cross sectional studyResearch articleAbstract onlyOrbital complication of acute ethmoiditis: A Tunisian paediatric cross sectional study Asma Ben Mabrouk, Selmen Wannes, Mehdi Hasnaoui, Amina Werdani, ... Bahri MahjoubIn Press, Corrected Proof, Available online 31 October 2019Purchase PDF Article preview Abstract Abstract Objective The anatomical and developmental particularities of sinus cavities in paediatric population lead acute ethmoiditis to be the earliest form of sinusitis in children. Orbital complications are frequent and could lead to visual and neurological impairment. This study investigated the clinical, biological and radiological features of orbital complications. We identified the predictive factors of severe ophthalmological lesions and/or associated cerebral complications of acute ethmoiditis. Design and methods This cross sectional study included all patients identified as having orbital extension of acute ethmoiditis in the database of a single academic paediatric care centre over a period of 14 years. All orbital and cerebral Scans of the included patients were reviewed and the cohort was classified using Chandler's classification as having less severe lesions (Chandler's 1 and 2) or more serious lesions (Chandler's 3, 4 and 5). Results In total, 16 patients (12 girls and 4 boys) were included among 39 consecutives cases of ethmoiditis recessed with a complication rate of 41%. Average consultation delay was 4.88 days. The mean age was 4.37 years. Fever was objectified in 13 cases (81%). Six patients (37.5%) had exophthalmos. Orbital extension spectrum was: stage I (n = 4, 25%), stage II (n = 4, 25%), stage III (n = 6, 37.5%), stage IV (n = 1, 6.5%), stage V (n = 1, 6.5%) and intra cranial extension was associated in two cases. Univariate analysis showed that fever, exophthalmos, ophthalmoplegia, positive CRP, age and white blood cells count were not associated with more severe lesions in the CT scan. Initially, all children received intravenous antibiotic treatment. Association of multiple antibiotics was prescribed in 75% of the cases. With 21.07 days ± 5.51 days as a total treatment duration. Only Four patients underwent surgical treatment. Conclusion Orbital complications of ethmoiditis are frequent. No clinical or biological criteria seem to predict the severity of orbital lesions. Both orbital and brain CT scan could help detect eventual complications on time to adapt antibiotic treatment and eventually bring forward surgical intervention. select article Alternative techniques in cochlear implant surgery: Subtotal petrosectomyCase reportAbstract onlyAlternative techniques in cochlear implant surgery: Subtotal petrosectomy Santiago Hernández, Juan C. Ospina, Elisa Gutiérrez-Gómez, María Teresa Rodríguez-Ruiz, Juan G. TrujilloIn Press, Corrected Proof, Available online 31 October 2019Purchase PDF Article preview Abstract Abstract Objectives To report and analyze three cases of subtotal petrosectomy (SP) in cochlear implant surgery at our institution, and establish the indications, surgical technique and complications encountered. Materials and method A retrospective descriptive study is proposed, analyzing a series of three clinical cases of subtotal petrosectomy as surgical technique for cochlear implant surgery at San Ignacio University Hospital (Bogotá, Colombia) from year 2004 to 2019. Results A total of three cases of subtotal petrosectomy as surgical technique in cochlear implant candidates were analyzed. The indications were the presence of a wide mastoid cavity after canal wall down mastoidectomy, extrusion of the electrode into the external auditory canal with a wide mastoid cavity and erosion of the posterior wall of the ear canal, and the presence of cholesteatoma in a cophotic ear with previous surgery. The ear canal was defunctionalized in all three cases; in two of them with obliteration of the Eustachian tube and in none of the cases the mastoid was obliterated. There was a single complication associated with the procedure corresponding to a small retention cholesteatoma in the skin of the obliterated duct sac, that didn't required surgical intervention. Conclusion Subtotal petrosectomy is a surgical alternative for cochlear implant surgery in patients with chronic ear pathology, wide cavities or cochlear implant extrusion, not associated to significant complications. select article Submental flap practice patterns and perceived outcomes: A survey of 212 AHNS surgeonsResearch articleAbstract onlySubmental flap practice patterns and perceived outcomes: A survey of 212 AHNS surgeons Liyang Tang, Andrew T. Day, Rebecca Lee, Eli Gordin, ... Jeremy D. RichmonIn Press, Corrected Proof, Available online 30 October 2019Purchase PDF Article preview Abstract Abstract Objectives To describe American Head and Neck Society (AHNS) surgeon submental flap (SMF) practice patterns and to evaluate variables associated with SMF complications. Methods The design is a cross-sectional study. An online survey was distributed to 782 AHNS surgeons between 11/11/16 and 12/31/16. Surgeon demographics, training, practice patterns and techniques were characterized and evaluated for associations with frequency of SMF complications. Results Among 212 AHNS surgeons, 108 (50.9%) reported performing SMFs, of whom 86 provided complete responses. Most surgeons who performed the SMF routinely reconstructed oral cavity defects with the flap (86.1%, n = 74). Thirty-seven surgeons (43.0%) experienced "very few" complications with the SMF. Surgeons who practiced in the United States versus internationally (p = 0.003), performed more total career SMFs (p = 0.02), and routinely reconstructed parotid and oropharyngeal defects (p = 0.04 and p < 0.001) with SMFs were more frequently perceived to have "very few" complications. SMF surgeons reported more perceived complications with the SMF compared to pectoralis major (p = 0.001) and radial forearm free flaps (p = 0.01). However, similar perceived complications were reported between all three flaps when surgeons performed >30 SMF. Among 94 surgeons not performing SMFs, 71.3% had interest in a SMF training course. Conclusions Practice patterns of surgeons performing SMFs are diverse, although most use the flap for oral cavity reconstruction. While 43% of surgeons performing the SMF reported "very few" complications, overall complication rates with the SMF were higher compared to other flaps, potentially due to limited experience with the SMF. Increased training opportunities in SMF harvest and inset are indicated. select article Clinical significance of head shake movement in three planes in individuals with dizzinessResearch articleAbstract onlyClinical significance of head shake movement in three planes in individuals with dizziness Büşra Altın, Songül AksoyIn Press, Corrected Proof, Available online 30 October 2019Purchase PDF Article preview Abstract Abstract Purpose This study aims to evaluate the efficacy of head shake movement on three head movement planes (yaw, pitch and, roll) in patients with dizziness despite normal vestibular test results. Materials and methods Twenty individuals aged between 20 and 51 years with complaints of dizziness were included in the study, and their results were compared with the results from twenty age- and gender-matched controls. Participants were assessed using the Sensory Organization Test, Head Shake-Sensory Organization Test which is based on the modification of the Sensory Organization Test on the yaw, pitch, and roll planes, videonystagmography, caloric test, and Dizziness Handicap Inventory. Results Significant differences were found in the yaw (p = 0.007), pitch (p < 0.001), and roll (p = 0.002) planes between the study and control groups of the Head Shake-Sensory Organization Test-5 scores. There were no statistically significant differences between the two groups of the Head Shake-Sensory Organization Test-2 scores in the yaw (p = 0.448), pitch (p = 0.213), and roll (p = 0.531) planes. When the sensitivity and specificity of Head Shake-Sensory Organization Test-5 conditions were examined, the highest specificity was observed in the pitch plane (100%), followed by the yaw (95%) and roll plane (95%). Conclusion Dynamic head movements are an important parameter for the evaluation of balance performance. The head shake modification could be used effectively in three-movement planes in individuals with dizziness. select article Therapeutic effects of metformin for noise induced hearing lossResearch articleAbstract onlyTherapeutic effects of metformin for noise induced hearing loss Özge Gedik, Remzi Doğan, Mehmet Ali Babademez, Ersin Karataş, ... Orhan ÖzturanIn Press, Corrected Proof, Available online 30 October 2019Purchase PDF Article preview Abstract Abstract Objective This study aimed to investigate the healing effect of metformin on noise induced hearing loss (NIHL) by measuring audiological, biochemical and histological parameters. Materials and methods 32 rats were divided into four groups (Group 1: Noise, Group 2: Noise + Metformin, Grup 3: Metformin, Grup 4: Control). Broadband noise was applied to Group 1 and Group 2 after basal measurements. Measuring audiological (distortion product otoacoustic emission (DPOAE) and Auditory Brainstem Response (ABR)), biochemical (total antioxidant status (TAS), total oxidant status (TOS), oxidative status index (OSI), DNA damage, IL-1 beta, IL-6, TNF alfa, HSF-1 and COX-2) and histological parameters. Results Group 2 had significant decreases in ABR thresholds on day 7 and day 14 compared to day 1. DPOAE values of Group 2 on the 7th and 14th days were significantly higher than the post-noise levels. DNA damage, TOS and OSI values of Group 1 were significantly higher than the other groups. The Cox-2 value of Group 1 was higher than all other groups. The HSF-1 value of Group 2 was significantly higher than that of Group 1. In terms of IL-1 Beta, IL-6 and TNF-alpha values, there was no significant difference between groups 2, 3 and 4 and these values were significantly lower than group 1. In histopathological results of our study, no significant difference was found between the groups being exposed to noise and the control group. Conclusion This study showed that early period of Metformin treatment has therapeutic effect on NIHL. select article Assessment of post-operative healing following endoscopic, transnasal, transsphenoidal pituitary surgery without formal sellar graftingResearch articleAbstract onlyAssessment of post-operative healing following endoscopic, transnasal, transsphenoidal pituitary surgery without formal sellar grafting Danny Jandali, Sarah Shearer, Richard Byrne, Peter Papagiannopoulos, ... Pete S. BatraIn Press, Journal Pre-proof, Available online 29 October 2019Purchase PDF Article preview Abstract Abstract Introduction Multiple options exist for sellar reconstruction after endoscopic transnasal, transsphenoidal surgery (TSS) including free mucosa, fat, bone and synthetic materials. The objective of this study was to assess healing and mucosalization of the sellar face following TSS without formal sellar grafting or reconstruction. Methods Single institution retrospective chart review was conducted for patients undergoing TSS without intraoperative CSF leaks between January 2014 and March 2017 at Rush University Medical Center. No formal sellar reconstruction was performed for the entire patient group. Follow-up endoscopic data and clinical notes were coded for time to mucosalization of the sella as well as degree of abnormal mucosal healing, epistaxis, crusting and scarring. Results 83 patients were included in this study. Mean time to mucosalization was 119 days (range, 17 to 402 days). Incidence of abnormal mucosal healing, epistaxis, crusting and scarring increased from the first to the second postoperative visit but trended down by the third visit. Nasal crusting was the most common finding, followed by abnormal mucosal healing. Chi square analysis showed smoking to be associated with prolonged time to full mucosalization of the sella. Two patients (2.4%) had post-operative CSF leaks requiring lumbar drain placement. Conclusion Adequate sellar healing is achievable in all cases without formal grafting or reconstruction after TSS. Great care must be exercised given the small inherent risk of unmasking a subclinical intraoperative CSF leak. Patients should be followed closely endoscopically during the first four months after TSS to minimize the impact of crusting. select article The effect of transcutaneous electrical nerve stimulation (TENS) on chronic subjective tinnitusResearch articleAbstract onlyThe effect of transcutaneous electrical nerve stimulation (TENS) on chronic subjective tinnitus Belgin Tutar, Sevgi Atar, Güler Berkiten, Onur Üstün, ... Yavuz UyarIn Press, Corrected Proof, Available online 29 October 2019Purchase PDF Article preview Abstract Abstract Objectives Chronic Subjective Tinnitus is a very highly prevalent disorder worldwide. There is no definitive treatment. The aim of this study is to investigate the efficacy of transcutaneous electrical nerve stimulation (TENS) applied to the auricula for treating tinnitus using the Depression Anxiety Stress Scales (DASS) and Tinnitus Handicap Inventory (THI). Methods The 60 patients were randomly divided into 3 groups of 20 patients. The first group (A) had one ear stimulated with TENS, and the second group (B) had both ears stimulated. Group C (placebo group) received no electrical or sound stimulation. All group patients received total of 10 sessions with a maximum of 4 days between the sessions. Results The THI and DASS scores decreased significantly after the treatment (p < 0.05). A significant difference was also observed between the groups after treatment (p < 0.05). While there was no difference between group A and B, it was shown that group C's post-treatment score was significantly higher than those of both groups (p < 0.05.) Conclusion It is important to note that TENS has a therapeutic effect on subjective chronic tinnitus as well as a placebo effect. select article An update on autoimmune inner ear disease: A systematic review of pharmacotherapyReview articleAbstract onlyAn update on autoimmune inner ear disease: A systematic review of pharmacotherapy David Strum, Sunny Kim, Timothy Shim, Ashkan MonfaredIn Press, Corrected Proof, Available online 28 October 2019Purchase PDF
Relationship between inflammation and the severity of Recurrent Respiratory PapillomatosisVivian Narana Ribeiro El Achkar, Andressa Duarte, Román Carlos, Jorge Esquiche León, ... Estela KaminagakuraIn Press, Journal Pre-proof, Available online 18 November 2019Purchase PDFArticle previewAbstractAbstractObjectiveTo characterize inflammatory cells in Recurrent Respiratory Papillomatosis (RRP) and to correlate it with severity using the Derkay laryngoscopic scale.Materials and methodsThe data and biopsies...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,