Publication date: 1 April 2016
Source:NeuroImage, Volume 129
Author(s): Anja Fengler, Lars Meyer, Angela D. Friederici
Unlike other aspects of language comprehension, the ability to process complex sentences develops rather late in life. Brain maturation as well as verbal working memory (vWM) expansion have been discussed as possible reasons. To determine the factors contributing to this functional development, we assessed three aspects in different age-groups (5–6years, 7–8years, and adults): first, functional brain activity during the processing of increasingly complex sentences; second, brain structure in language-related ROIs; and third, the behavioral comprehension performance on complex sentences and the performance on an independent vWM test. At the whole-brain level, brain functional data revealed a qualitatively similar neural network in children and adults including the left pars opercularis (PO), the left inferior parietal lobe together with the posterior superior temporal gyrus (IPL/pSTG), the supplementary motor area, and the cerebellum. While functional activation of the language-related ROIs PO and IPL/pSTG predicted sentence comprehension performance for all age-groups, only adults showed a functional selectivity in these brain regions with increased activation for more complex sentences. The attunement of both the PO and IPL/pSTG toward a functional selectivity for complex sentences is predicted by region-specific gray matter reduction while that of the IPL/pSTG is additionally predicted by vWM span. Thus, both structural brain maturation and vWM expansion provide the basis for the emergence of functional selectivity in language-related brain regions leading to more efficient sentence processing during development.
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Κυριακή 7 Φεβρουαρίου 2016
How the brain attunes to sentence processing: Relating behavior, structure, and function
The LDA beamformer: Optimal estimation of ERP source time series using linear discriminant analysis
Source:NeuroImage, Volume 129
Author(s): Matthias S. Treder, Anne K. Porbadnigk, Forooz Shahbazi Avarvand, Klaus-Robert Müller, Benjamin Blankertz
We introduce a novel beamforming approach for estimating event-related potential (ERP) source time series based on regularized linear discriminant analysis (LDA). The optimization problems in LDA and linearly-constrained minimum-variance (LCMV) beamformers are formally equivalent. The approaches differ in that, in LCMV beamformers, the spatial patterns are derived from a source model, whereas in an LDA beamformer the spatial patterns are derived directly from the data (i.e., the ERP peak). Using a formal proof and MEG simulations, we show that the LDA beamformer is robust to correlated sources and offers a higher signal-to-noise ratio than the LCMV beamformer and PCA. As an application, we use EEG data from an oddball experiment to show how the LDA beamformer can be harnessed to detect single-trial ERP latencies and estimate connectivity between ERP sources. Concluding, the LDA beamformer optimally reconstructs ERP sources by maximizing the ERP signal-to-noise ratio. Hence, it is a highly suited tool for analyzing ERP source time series, particularly in EEG/MEG studies wherein a source model is not available.
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"Anticancer Res"[jour]; +49 new citations
49 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2016/02/07
PubMed comprises more than 24 million 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.
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Sleep Apnea Treatment- The Canadian Experience
So, you're tired of feeling tired or hearing from your spouse about your snoring. You go to your family physician, which refers you to a Sleep Specialist. After the Sleep Study results are available you are told that you stop breathing in your sleep 30 times an hour, something that would concern most people. You are then told about lifestyle modifications that you may want to consider, and various therapeutic approaches. But the one they highly recommend, and that the government sponsored Health Plan covers is CPAP. Continuous Positive Airway Pressure, which involves blowing the appropriate level of air pressure up your nose on a continuous basis preventing your airway from collapsing during sleep. You simply breathe with and against the constant stream of air. This therapy is effective in preventing the airway from collapsing and eliminates snoring for virtually everyone. So, all is good! Until you take it home…
About 1/3 of patients take to CPAP very well, and actually become missionaries telling everyone around them how it's changed their lives. About 1/3 struggle with it daily and although they wear it to some degree, it is not all night and may not even be every night. For the remaining 1/3, you will find their CPAP stored under their bed or in their closet for a variety of reasons. Adherence studies have shown that after 6 years of prescription, 54% of patients are still wearing their CPAP. So, what happens to the other 46%?
Mostly, they remain untreated. Let's look at the reasons:
Some do not feel it worth their while to return to their Sleep Specialist because they feel that CPAP is the only option available there, and they've already tried that. So, they remain untreated.
Some return to their CPAP dispenser, which typically encourage them to try alternative masks and to stick with CPAP, explaining that it is the only worthwhile therapy, discouraging them from considering any alternatives. So, they remain untreated.
Some, ask their family physician for guidance, often being referred for an ENT consultation for palatal surgery which has a success rate of <50%, consequently, few of these procedures are performed. So, they remain untreated. This of course is no fault of the family physicians because even when they attend CE courses promoted as "Current Management of Sleep Disorders: A Comprehensive Update", all they hear about is CPAP.
Some, go to the drug store and pick up an oral appliance over the counter that states the following on the label, "FDA Approved for Mild to Moderate Sleep Apnea". Imagine that, the Regulatory Boards in Canada currently allow patients to manage their own Sleep Apnea! This of course ends up failing for a variety of reasons, so they remain untreated.
The information these patients need is this, The American Academy of Sleep Medicine AND the American Academy of Dental Sleep Medicine Joint Guidelines state that an oral appliance is an appropriate therapy for All Severities of Sleep Apnea if the patient prefers an oral appliance to CPAP. This is the current "Standard of Care".
Adherence studies show us that long term oral appliance adherence ranges from 85-95% and that patients typically wear their oral appliance longer each night when compared to CPAP wear. Although oral appliances may not be as effective in reducing the apnea level in some patients, for most, the fact that patients wear them more often and for longer seems to make their overall benefit similar, current studies evaluating both Efficacy and Actual Use suggesting that they have a similar Mean Disease Alleviation as CPAP. Yet, patients often don't hear about oral appliances as a viable option or are simply misinformed about their efficacy and or side effects. So, they remain untreated.
Adding insult to injury, 30% of patients referred for a Sleep Study simply don't go, 50% of these patients citing that they don't want to wear CPAP as their reason. Considering that 82% of them would have tested positive had they gone, this increases the number of patients with OSA needing our help to an even higher level. What happens to these additional patients? They remain untreated.
In countries like USA, France and Sweden, where government sponsored health plans cover oral appliance therapy. Many oral appliances are being delivered on a regular basis, even before trialing and or failing the use of CPAP. I guess for those countries, the answer for what happens to the other 46% is, they get an oral appliance!
But in Canada, what happens to the other 46%? Unfortunately, all too often, they remain untreated!
John Viviano DDS D ABDSM
Links to the pertaining articles…
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Microelectrode recording (MER) findings during sleep-awake anesthesia using dexmedetomidine in deep brain stimulation surgery for Parkinson’s disease
Source:Clinical Neurology and Neurosurgery
Author(s): Woo-Keun Kwon, Jong Hyun Kim, Ji-Hye Lee, Byung-Gun Lim, Il-ok Lee, Seong Beom Koh, Taek Hyun Kwon
ObjectiveThe preferred choice of anesthesia for deep brain stimulation (DBS) has been local anesthesia due to the need of patients' cooperation during the procedure, and concern on the interference of sedatives on microelectrode recording (MER) results. However, local anesthesia during the whole procedure may be impossible in some patients due to uncontrolled anxiety, fear, delirium or exhaustion. Therefore, sedative drugs have been used for DBS, but findings of MER during the procedures have not been reported in detail, especially in the globus pallidus internus (GPi). We introduce our experience using 'asleep-awake' technique by dexmedetomidine (DEX) anesthesia with MER findings during DBS in idiopathic Parkinson's disease (IPD) patients.Patients and MethodsData from 14 different subcortical nuclei from 8 consecutive IPD patients whom had DBS at the GPi (6 patients) and subthalamic nucleus (STN) (2 patients) were retrospectively reviewed. We used continuous DEX and intermittent small boluses of propofol during the painful procedure ('asleep phase'), accompanied with continuous intraoperative monitorings of bispectral index (BIS) and modified observer's assessment of sedation (MOAA/S). Then sedatives were discontinued during MER recording ('awake phase'). Characteristic findings and firing rates of neurons were analyzed and compared to those from other 6 patients who underwent surgery under local anesthesia.ResultsAll patients were satisfactorily sedated using this technique without any respiratory or hemodynamic complications. Characteristics of spike activities of each nucleus were inspected and analyzed quantitatively. We could inspect changes of spike activities according to level of patients' consciousness in some cases, but the localizing value was good to decide the target in all cases. Firing rates of group whom sedatives were given during asleep phase ('sedatives') were significantly lower than those of group under local anesthesia ('no sedative'). Intraoperative length of target nuclei, postoperative imaging and postoperative changes of UPDRS III score indicated satisfactory outcome.ConclusionWe concluded that though MER findings may change during DEX-based monitored 'sleep-awake' anesthesia, it did not affect the results of target localization for the clinical purpose. However, it should be considered that use of sedatives before MER could result in changes of firing rate and pattern depending on the patient's state of consciousness.
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The value of dynamic radiographic myelography in addition to magnetic resonance imaging in detection lumbar spinal canal stenosis: a prospective study
Source:Clinical Neurology and Neurosurgery
Author(s): Martin Merkle, Gottlieb Maier, Sören Danz, Jan Kaminsky, Marcos S. Tatagiba, Nader M. Hebela, Florian Roser
ObjectiveMRI is regarded as the study of choice in the diagnosis of lumbar spinal stenosis. In some cases, the supine MRI leads to a misdiagnosis in the extent of lumbar spinal stenosis. Dynamic myelography can detect lumbar spinal stenosis in these cases of where the MRI may not be as sensitive.To compare the sensitivities of dynamic radiographic myelography and supine MRI in lumbar canal stenosis (LCS) patients and to determine whether dynamic radiographic myelography is a valuable diagnostic exam in the work-up of lumbar canal stenosis.Patients & MethodsOver two years, the imaging data of 100 consecutive patients who were suspected of having LCS were prospectively analyzed. All lumbar intervertebral segments were evaluated in each patient on sagittal MR T2-weighted images and lateral plane images by myelography using a semi-quantitative scoring system. The differences in scores for 5 motion segments under 3 conditions (supine MRI, upright sitting myelography and standing myelography with extension) were analyzed statistically.ResultsOf 100 patients with 500 analyzed intervertebral segments, 23 patients with inconclusive supine MRI results had LCS in standing myelography with extension. Compared with upright sitting myelography and supine MRI, standing myelography with extension yielded the highest score for every segment from L1/2 to L5/S1. Compared with the upright sitting myelography position, 61 more patients received a diagnosis of lumbar stenosis in the standing myelography with extension position, and 121 more stenotic segments were diagnosed. Compared with the supine MRI position, standing myelography with extension detected 64 more stenotic patients and 137 more stenotic segments.Conclusion Based on a large patient sample, dynamic myelography is a valuable diagnostic tool in detecting lumbar spinal stenosis. Patients with lumbar spinal stenosis may have inconclusive supine MRI in 23% of cases being misdiagnosed as normal. This missed rate of LCS patients with unclear supine MRI results can be avoided with dynamic myelography. The combination of supine MRI and dynamic myelography is critical in the evaluation of LCS, especially if multisegmental findings are detected.
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Risk rtPA: An iOS Mobile Application based on TURN for Predicting 90-day Outcome after IV Thrombolysis
Source:Clinical Neurology and Neurosurgery
Author(s): David Asuzu, Karin Nystrӧm, Joseph Schindler, Charles Wira, David Greer, Janet Halliday, Kevin N. Sheth
ObjectiveWe recently developed Thrombolysis risk Using mRS and NIHSS (TURN), a simple score using only prestroke mRS scores and admission NIHSS scores to predict 90-day outcome after IV thrombolysis in ischemic stroke patients. Our purpose was to develop and test a mobile application for utilization of TURN at the bedside.MethodsWe developed Risk rtPA, an iOS mobile application based on TURN for prediction of 90-day excellent and severe outcome after IV thrombolysis. Excellent outcome was defined as 90-day mRS≤1. Severe outcome was defined as 90-day mRS≥5. Predictors for excellent and severe outcome were calculated using the inverse logit of −TURN and TURN respectively. We retrospectively validated our mobile application using data from 303 patients who received IV rt-PA during the NINDS rt-PA trial. Sensitivity and specificity analyses were performed using receiver operating characteristic (ROC) curves.ResultsPrediction of excellent and severe outcome using Risk rtPA followed an S-shaped curve as expected. We confirmed this finding using data from the NINDS trial. Cutoffs selected after ROC analysis predicted severe outcome with sensitivity of 94.4% and specificity of 52.2%, and excellent outcome with specificity of 83.9% and sensitivity of 61.2%.ConclusionThe Risk rtPA mobile application predicted 90-day excellent and severe outcome in most clinically relevant cases. This mobile application brings the TURN score to the bedside for prediction of 90-day outcome in ischemic stroke patients being evaluated for IV thrombolysis.
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Adjacent Segment Degeneration After Posterior Lumbar Fusion: An Analysis Of Possible Risk Factors
Source:Clinical Neurology and Neurosurgery
Author(s): Amir Abbas Ghasemi
OBJECTIVEMany surveys have been distributed about the risk factors for Adjacent Segment Degeneration(ASD) after lumbar fusion. Despite myriad of risk factors recognized for ASD evolution, study results have been inconsistent and there is not an agreement regarding which are the most important. Our study was done to identify factors which may be important in the development of symptomatic ASD after lumbar fusion.PATIENTS AND METHODSThis retrospective study evaluated 1250 consecutive patients who underwent posterior lumbar fusion and pedicular fixation between February 2006 and February 2009. A total of 13 patients with symptomatic ASD(clinical ASD) who underwent secondary surgery were identified. Another group of 22 patients without symptomatic ASD(subclinical ASD) after spinal fusion were marked as the control group. These two groups were compared for demographic data and clinical and radiographic features to investigate the possible predictive factors of symptomatic ASD.RESULTSThe overall incidence rate of symptomatic ASD was 1.04%. Radiographic risk factors for the development of a symptomatic ASD were increased sagittal balance, loss of lordosis, and adjacent disc space collapse. In the clinical ASD group, by multivariate logistic regression analysis, demonstrated that BMI,preoperative ADD on MRI and disc bulge maintained their significance in predicting likelihood of clinical ASD.CONCLUSIONPatients with increased BMI,preoperative ADD and disc bulge on MRI have a statistically significant increased risk of developing symptomatic ASD.
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Tongue entrapment within the lid of a plastic bottle
Publication date: Available online 6 February 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Yusuf Gadiwalla, Luis Bruzual, Daniel Altieri, Joanne Taylor, Nicholas Whear
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Editorial Board
Publication date: February 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 2
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Training Groups
Publication date: February 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 2
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Refining the head and neck cancer referral guidelines: a two centre analysis of 4715 referrals
Publication date: February 2016
Source:British Journal of Oral and Maxillofacial Surgery, Volume 54, Issue 2
Author(s): Theofano Tikka, Paul Pracy, Vinidh Paleri
Our aim was to identify the set of referral criteria that will offer optimal diagnostic efficacy in patients suspected to have head and neck cancer (HNC) in the primary care setting. We analysed the referral criteria and outcomes from two tertiary care cancer centres in the United Kingdom. Between 2007 and 2010, 4715 patients were referred via the fast track system with a suspected HNC. The main outcome measures were the parameters of diagnostic efficacy, a multivariate regression model to calculate estimated probability of HNC and the area under the receiver operating characteristic curve (AUROC). We found that the majority of referring symptoms had a positive predictive value higher than the 3% cut-off point stated to be significant for HNC detection in the 2015 NICE recommendations. Nevertheless, our multivariate analysis identified 9 symptoms to be linked with HNC. Of these, only 4 are included in the latest NICE guidelines. The best fit predictive model for this dataset included the following symptoms: hoarseness>3 weeks, dysphagia>3 weeks, odynophagia, unexplained neck mass, oral swelling >3 weeks, oral ulcer >3weeks, prolonged otalgia with normal otoscopy, presence of blood in mouth with concurrent sensation of lump in throat, and presence of otalgia with concurrent lump in throat sensation. Intermittent hoarseness and sensation of lump in throat were negatively associated with HNC. The AUROC demonstrated that our model had a higher predictive value (0.77) compared to those generated using the NICE 2005 (0.69) and 2015 (0.68) referral criteria (p<0.0001). An online risk calculator based on this study is available at http://ift.tt/1lNGt51. This paper presents a significantly refined version of referral guidelines which demonstrate greater diagnostic efficacy than the current NICE guidelines. We recommend that further iterative refinements of referral criteria be considered when referring patients with suspected HNC.
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Scenario drafting for early technology assessment of next generation sequencing in clinical oncology
Abstract
Background
Next Generation Sequencing (NGS) is expected to lift molecular diagnostics in clinical oncology to the next level. It enables simultaneous identification of mutations in a patient tumor, after which targeted therapy may be assigned. This approach could improve patient survival and/or assist in controlling healthcare costs by offering expensive treatment to only those likely to benefit. However, NGS has yet to make its way into the clinic. Health Technology Assessment can support the adoption and implementation of a novel technology, but at this early stage many of the required variables are still unknown.
Methods
Scenario drafting and expert elicitation via a questionnaire were used to identify factors that may act as a barrier or facilitate adoption of NGS-based molecular diagnostics. Attention was paid to predominantly elicit quantitative answers, allowing their use in future modelling of cost-effectiveness.
Results
Adequately informing patients and physicians, the latters' opinion on clinical utility and underlying evidence as well as presenting sequencing results within a relevant timeframe may act as pivotal facilitators. Reimbursement for NGS-based testing and accompanying therapies (both general and in case of off-label prescription) was found to be a potential barrier. Competition on the market and demonstrating clinical utility may also be challenging. Importantly, numerous quantitative values for variables related to each of these potential barriers/facilitators, such as such as desired panel characteristics, willingness to pay or the expected number of targets identified per person, were also elicited.
Conclusions
We have identified several factors that may either pose a barrier or facilitate the adoption of NGS in the clinic. We believe acting upon these findings, for instance by organizing educational events, advocating new ways of evidence generation and steering towards the most cost-effective solution, will accelerate the route from bench-to-bedside. Moreover, due to the methodology of expert elicitation, this study provides parameters that can be incorporated in future cost-effectiveness modeling to steer the development of NGS gene panels towards the most optimal direction.
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Improving Diagnosis of Atraumatic Splenic Lesions, Part II: Benign neoplasms/Non-neoplastic Mass-like Lesions
Publication date: Available online 6 February 2016
Source:Clinical Imaging
Author(s): Zina J. Ricci, Fernanda A. Mazzariol, Milana Flusberg, Victoria Chernyak, Sarah K. Oh, Bindu Kaul, Marjorie W. Stein, Alla M. Rozenblit
Focal atraumatic splenic lesions often pose a diagnostic challenge on cross sectional imaging. They can be categorized based on etiology, as non-neoplastic, benign neoplastic (discussed in Part II) and malignant neoplastic lesions, or, on prevalence, as common, uncommon and rare lesions. Familiarity with pertinent clinical parameters, etiology, pathology, prevalence and ancillary features such as splenomegaly, concomitant hepatic involvement, and extrasplenic findings, in addition to knowledge of imaging spectra of the lesions, can improve diagnostic confidence. Consideration of these factors together can arm the radiologist with the necessary tools to render a more confident diagnosis, and thus better aid management.
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Chemical shift MRI versus washout CT forcharacterizing adrenal incidentalomas
Publication date: Available online 6 February 2016
Source:Clinical Imaging
Author(s): Mohammad H. Abo Warda, Samar M. Shehata, Fatma Zaiton
Objectiveto compare the accuracy of CT and MRI in characterizing adrenal massesMaterials And Methods45 adrenal masses in 38 patients underwent unenhanced, enhanced CT and chemical-shift MRI. Sensitivities and accuracies using the lesion attenuation values, absolute or relative percentage washout for CT and adrenal-to-spleen ratio or signal intensity index for MRI. Follow up or histopathology as standard reference.Results15 lipid rich adenomas, 6 lipid poor adenomas and 24 non-adenomas. The sensitivities for adenoma on MRI versus CT were 81%, 95% respectively. The specificities were 100%.ConclusionCT is superior to MRI in characterizing adenomas.
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Visibility of prostate cancer on transrectal ultrasound during fusion with multi-parametric magnetic resonance imaging for biopsy
Publication date: Available online 6 February 2016
Source:Clinical Imaging
Author(s): Wendy J.M. van de Ven, J.P. Michiel Sedelaar, Marloes M.G. van der Leest, Christina A. Hulsbergen-van de Kaa, Jelle O. Barentsz, Jurgen J. Fütterer, Henkjan J. Huisman
ObjectivesTo determine TRUS visibility of MR lesions.MethodsData from 34 patients with 56 MR lesions and prostatectomy was used. Five observers localized and determined TRUS visibility during retrospective fusion. Visibility was correlated to PIRADS and Gleason scores.ResultsTRUS visibility occurred in 43% of all MR lesions and 62% of PIRADS 5 lesions. Visible lesions had a significantly lower localization variability. On prostatectomy, 58% of the TRUS visible lesions had a Gleason 4 or 5 component.ConclusionsAlmost half of the MR lesions were visible on TRUS. TRUS visible lesions were more aggressive than TRUS invisible lesions.
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Bilateral parotid oncocytoma with spontaneous intratumoral hemorrhage: A rare hypervascular parotid tumor with ASL perfusion
Publication date: Available online 6 February 2016
Source:Clinical Imaging
Author(s): Etsushi Iida, Richard H. Wiggins, Yoshimi Anzai
We present a rare case of bilateral parotid oncocytoma with spontaneous intratumoral hemorrhage. Magnetic resonance imaging revealed multiple, bilateral, well-defined masses within the parotid glands with increased vascularity based on arterial spin labeling MR perfusion imaging and restricted diffusion on diffusion-weighted imaging. During the clinical follow-up, the patient developed extensive hemorrhage from the largest tumor, presumably due to a combination of the hypervascular nature of oncocytoma and hemodialysis.
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Usefulness of the oblique view of three-dimensional isotropic T2-weighted fast spin-echo (VISTA) in the evaluation of anterior cruciate ligament reconstruction
Publication date: Available online 6 February 2016
Source:Clinical Imaging
Author(s): Jung Woo Yi, Hee Jin Park, So Yeon Lee, Myung Ho Rho, Eun Chul Chung, Mi Sung Kim, Jae Hyung Park, Se Jin Park
BackgroundTo compare the diagnostic performance of the oblique sagittal and oblique coronal views of the anterior cruciate ligament (ACL) on three-dimensional volume isotropic turbo spin-echo acquisition (3D VISTA) images with two-dimensional (2D) fast spin-echo (FSE) T2-weighted images in the diagnosis of complications in ACL reconstruction.Material and methodsThis retrospective study included 74 patients. Both sequences were independently interpreted by two radiologistsResultThere were no statistically significant differences in the sensitivity, specificity, or accuracy between the two images.ConclusionThe diagnostic performance of the two oblique views on 3D VISTA imaging was comparable to that of 2D FSE.
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"Anticancer Res"[jour]; +49 new citations
49 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2016/02/07
PubMed comprises more than 24 million 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.
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Gender as a Modifying Factor Influencing Myotonic Dystrophy Type 1 Phenotype Severity and Mortality: A Nationwide Multiple Databases Cross-Sectional Observational Study
by Celine Dogan, Marie De Antonio, Dalil Hamroun, Hugo Varet, Marianne Fabbro, Felix Rougier, Khadija Amarof, Marie-Christine Arne Bes, Anne-Laure Bedat-Millet, Anthony Behin, Remi Bellance, Françoise Bouhour, Celia Boutte, François Boyer, Emmanuelle Campana-Salort, Françoise Chapon, Pascal Cintas, Claude Desnuelle, Romain Deschamps, Valerie Drouin-Garraud, Xavier Ferrer, Helene Gervais-Bernard, Karima Ghorab, Pascal Laforet, Armelle Magot, Laurent Magy, Dominique Menard, Marie-Christine Minot, Aleksandra Nadaj-Pakleza, Sybille Pellieux, Yann Pereon, Marguerite Preudhomme, Jean Pouget, Sabrina Sacconi, Guilhem Sole, Tanya Stojkovich, Vincent Tiffreau, Andoni Urtizberea, Christophe Vial, Fabien Zagnoli, Gilbert Caranhac, Claude Bourlier, Gerard Riviere, Alain Geille, Romain K. Gherardi, Bruno Eymard, Jack Puymirat, Sandrine Katsahian, Guillaume Bassez
BackgroundMyotonic Dystrophy type 1 (DM1) is one of the most heterogeneous hereditary disease in terms of age of onset, clinical manifestations, and severity, challenging both medical management and clinical trials. The CTG expansion size is the main factor determining the age of onset although no factor can finely predict phenotype and prognosis. Differences between males and females have not been specifically reported. Our aim is to study gender impact on DM1 phenotype and severity.
MethodsWe first performed cross-sectional analysis of main multiorgan clinical parameters in 1409 adult DM1 patients (>18y) from the DM-Scope nationwide registry and observed different patterns in males and females. Then, we assessed gender impact on social and economic domains using the AFM-Téléthon DM1 survey (n = 970), and morbidity and mortality using the French National Health Service Database (n = 3301).
ResultsMen more frequently had (1) severe muscular disability with marked myotonia, muscle weakness, cardiac, and respiratory involvement; (2) developmental abnormalities with facial dysmorphism and cognitive impairment inferred from low educational levels and work in specialized environments; and (3) lonely life. Alternatively, women more frequently had cataracts, dysphagia, digestive tract dysfunction, incontinence, thyroid disorder and obesity. Most differences were out of proportion to those observed in the general population. Compared to women, males were more affected in their social and economic life. In addition, they were more frequently hospitalized for cardiac problems, and had a higher mortality rate.
ConclusionGender is a previously unrecognized factor influencing DM1 clinical profile and severity of the disease, with worse socio-economic consequences of the disease and higher morbidity and mortality in males. Gender should be considered in the design of both stratified medical management and clinical trials.
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Frequent Flyers: Ambulance history with Capt. Salty
Ambulances with red lights and emergency care capabilities started to appear in rural communities in the 1940s
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First Mass Gathering Medicine Summit to be held in NYC
The summit provides a forum in which medical professionals and risk managers can discuss the most relevant topics facing mass gathering medicine today
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HEI-OC1 Cells as a Model for Investigating Prestin Function
Publication date: Available online 6 February 2016
Source:Hearing Research
Author(s): Channy Park, Pru Thein, Gilda Kalinec, Federico Kalinec
The House Ear Institute–Organ of Corti 1 (HEI-OC1) is a mouse auditory cell line that endogenously express, among other several markers of cochlear hair cells, the motor protein prestin (SLC26A5). Since its discovery fifteen years ago, and because of the difficulties associated with working with outer hair cells, prestin studies have been performed mostly by expressing it exogenously in non-specific systems such as HEK293 and TSA201, embryonic kidney cells from human origin, or Chinese Hamster Ovary (CHO) cells. Here, we report flow cytometry and confocal laser scanning microscopy studies on the pattern of prestin expression, as well as nonlinear capacitance (NLC) and whole cell-patch clamping studies on prestin motor function, in HEI-OC1 cells cultured at permissive and non-permissive conditions. Our results indicate that both total prestin expression and plasma membrane localization increase in a time-dependent manner when HEI-OC1 cells differentiate under non-permissive culture conditions. In addition, we demonstrate that HEI-OC1 cells have a robust NLC associated to prestin motor function, which decreases when the density of prestin molecules present at the plasma membrane increases. Altogether, our results show that the response of endogenously expressed prestin in HEI-OC1 cells is different from the response of prestin expressed exogenously in non-auditory cells, and suggest that the HEI-OC1 cell line may be an important additional tool for investigating prestin function.
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Description and analysis of clinical pathways for oesophagogastric adenocarcinoma, in 10 European countries (the EURECCA upper Gastro Intestinal Group - European Registration of Cancer Care)
Publication date: Available online 6 February 2016
Source:European Journal of Surgical Oncology (EJSO)
Author(s): M. Messager, W. de Steur, P.G. Boelens, L.S. Jensen, C. Mariette, J.V. Reynolds, J. Osorio, M. Pera, J. Johansson, P. Kołodziejczyk, F. Roviello, G. De Manzoni, S.P. Mönig, W.H. Allum
AimsOutcomes for patients with oesophago-gastric cancer are variable across Europe. The reasons for this variability are not clear. The aim of this study was to describe and analyse clinical pathways to understand differences in service provision for oesophageal and gastric cancer in the countries participating in the EURECCA Upper GI group.MethodsA questionnaire was devised to assess clinical presentation, diagnosis, staging, treatment, pathology, follow-up and service frameworks across Europe for patients with oesophageal and gastric cancer. The questionnaire was issued to experts from 14 countries. The responses were analysed quantitatively and qualitatively and compared.ResultsThe response rate was (10/14) 71.4%. The approach to diagnosis was similar. Most countries established a diagnosis within 3 weeks of presentation. However, there were different approaches to staging with variable use of endoscopic ultrasound reflecting availability. There has been centralisation of treatments in most countries for oesophageal surgery. The most consistent area was the approach to pathology. There were variations in access to specialist nurse and dietitian support. Although most countries have multidisciplinary teams, their composition and frequency of meetings varied. The two main areas of significant difference were research and audit and overall service provision. Observations on service framework indicated that limited resources restricted many of the services.ConclusionThe principle approaches to diagnosis, treatment and pathology were similar. Factors affecting the quality of patient experience were variable. This may reflect availability of resources. Standard pathways of care may enhance both the quality of treatment and patient experience.
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Mutation in AIDS restriction gene affecting HIV infection and disease progression in a high risk group from Northeastern India
Publication date: Available online 6 February 2016
Source:Medical Journal Armed Forces India
Author(s): Partha Roy, Sekhar Chakrabarti
BackgroundHIV estimates for 2009 released by National AIDS Control Organization (NACO) reveals that 2.4 million people in India were living with HIV, 39% being female, 4.4% children and 82.4% adult males between the age group of 15 and 49 years. Persons with host genetic polymorphism CCR5Δ32 mutation are known to be partially or fully resistant to HIV infection. Persons with mutation affecting both the alleles (homozygous) are resistant to HIV infection whereas single allele (heterozygous) polymorphism leads to slower progression to AIDS. CCR5Δ32 mutation is commoner in Caucasians but less prevalent amongst Africans and Asians thereby rendering them susceptible to HIV infection.Method571 HIV serologically naive subjects from a young and homogenous male population hailing from the seven northeastern states; West Bengal and Gorkha people were selected. All the subjects belonged to a special high risk group, sexually active and typically working in difficult and uncongenial terrain involved in frequent moves including overseas missions. Their family lives are severely disrupted. 181 HIV seropositive cases of which 92 cases that were admitted in a large tertiary care hospital were also included. The distribution of CCR5Δ32 polymorphism amongst both HIV seronegative (HSN) and HIV seropositive study cohorts (HSP) using molecular methods was studied.Results and conclusionThere was failure to detect any CCR5Δ32 amongst this study group suggesting that this population from the northeastern India, West Bengal and Gorkha people are not protected by this specific host polymorphism in respect of acquisition of HIV infection as well as progression to AIDS.
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Synthesis of Keratin-based Nanofiber for Biomedical Engineering
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A Hormone-responsive 3D Culture Model of the Human Mammary Gland Epithelium
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Polymerization stress evolution of a bulk-fill flowable composite under different compliances
Publication date: Available online 6 February 2016
Source:Dental Materials
Author(s): Yongwen Guo, Forrest A. Landis, Zhengzhi Wang, Ding Bai, Li Jiang, Martin Y.M. Chiang
ObjectiveTo use a compliance-variable instrument to simultaneously measure and compare the polymerization stress (PS) evolution, degree of conversion (DC), and exotherm of a bulk-fill flowable composite to a packable composite.MethodsA bulk-fill flowable composite (Filtek Bulk-fill, FBF) and a conventional packable composite (Filtek Z250, Z250) purchased from 3M ESPE were investigated. The composites were studied using a cantilever-beam based instrument equipped with an in situ near infrared (NIR) spectrometer and a microprobe thermocouple. The measurements were carried out under various instrumental compliances (ranging from 0.3327μm/N to 12.3215μm/N) that are comparable to the compliances of clinically prepared tooth cavities. Correlations between the PS and temperature change as well as the DC were interpreted.ResultsThe maximum PS of both composites at 10min after irradiation decreased with the increase in the compliance of the cantilever beam. The FBF composite generated a lower final stress than the Z250 sample under instrumental compliances less than ca. 4μm/N; however, both materials generated statistically similar PS values at higher compliances. The reaction exotherm and the DC of both materials were found to be independent of compliance. The DC of the FBF sample was slightly higher than that of the packable Z250 composite while the peak exotherm of FBF was almost double that of the Z250 composite. For FBF, a characteristic drop in the PS was observed during the early stage of polymerization for all compliances studied which was not observed in the Z250 sample. This drop was shown to relate to the greater exotherm of the less-filled FBF sample relative to the Z250 composite.SignificanceWhile the composites with lower filler content (low viscosity) are generally considered to have lower PS than the conventional packable composites, a bulk-fill flowable composite was shown to produce lower PS under a lower compliance of constraint as would be experienced if the composite was used as the base material in clinical procedures.
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Radiothérapie guidée par l’image pour les petits animaux : une nouvelle ère pour les études précliniques
Publication date: Available online 6 February 2016
Source:Cancer/Radiothérapie
Author(s): G. Delpon, A.-M. Frelin-Labalme, S. Heinrich, V. Beaudouin, C. Noblet, M. Begue, C. Le Deroff, F. Pouzoulet, S. Chiavassa
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Mismatch repair earns Nobel Prize in Chemistry 2015 to Paul Modrich for a biochemical tour de force
Publication date: January 2016
Source:DNA Repair, Volume 37
Author(s): Miroslav Radman
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A history of the DNA repair and mutagenesis field
Publication date: January 2016
Source:DNA Repair, Volume 37
Author(s): Errol C. Friedberg
This article reviews the early history of the discovery of an DNA repair pathway designated as base excision repair (BER), since in contrast to the enzyme-catalyzed removal of damaged bases from DNA as nucleotides [called nucleotide excision repair (NER)], BER involves the removal of damaged or inappropriate bases, such as the presence of uracil instead of thymine, from DNA as free bases.
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A Personal Tribute to 2015 Nobel Laureate Paul Modrich
Publication date: January 2016
Source:DNA Repair, Volume 37
Author(s): Guo-Min Li
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Tomas Lindahl: 2015 Nobel Laureate
Publication date: January 2016
Source:DNA Repair, Volume 37
Author(s): Jeffrey H. Miller, Myron F. Goodman
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IFC(EDITORIAL BOARD)
Publication date: January 2016
Source:DNA Repair, Volume 37
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Spotlight on DNA repair and responses to DNA damage
Publication date: January 2016
Source:DNA Repair, Volume 37
Author(s): Susan Wallace, Samuel Wilson
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A tale of two cities: A tribute to Aziz Sancar's Nobel Prize in Chemistry for his molecular characterization of NER
Publication date: January 2016
Source:DNA Repair, Volume 37
Author(s): Bennett Van Houten
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Aldehyde dehyderogenase (ALDH1A1) delineating the normal and cancer stem cells in spectral lung lesions; an immunohistochemical appraisal
Publication date: Available online 6 February 2016
Source:Pathology - Research and Practice
Author(s): Fatma El-Zahraa Salah El Deen Yassin
Background& AimALDH1A1 is one of the promising cancer stem cell markers, it has been found in different cancers, including lung cancer. We aimed to assess its immunohistochemical expression in spectral lung lesions (neoplastic versus non neoplastic) and to correlate its expression with certain pathological parameters (e.g. histopathological type and tumor grade).Materials and methodsThe study included 105 specimens of spectral lung lesions (20 adjacent normal tissues, 64 non small cell carcinoma (NSCLCs), 16 small cell carcinoma (SCLCs) and six inflammatory pseudotumors, in addition to nine metastatic tumors to lymph nodes. Both H&E and immunohistochemical stained sections were assessed and evaluated according to Quick immunoreactivity score.ResultsALDH1A1 expression showed a broad dynamic range of immunoreactivity score (0-8) in different types of lung cancers with strong reactivity of normal stem cells. Significant statistical associations were found between ALDH1A1 expression and squamous cell carcinoma & SCLC (p=0.02 &0.003 respectively), with very high mean percentage of positive cells in SCLC (58.50±10.62), followed by adenocarcinoma and squamous cell carcinoma (38.37±35.12 &22.77±13.89 respectively). Adenocarcinomas were classified according to the IASLC/ATS/ERS classification and grouped by architectural grade into low, intermediate and high. Heterogeneity of ALDH1A1 immunoreactivity scores within adenocarcinoma can reflect histological patterns heterogeneity with a strong association to the grade. Strong diffuse expression was seen in inflammatory pseudotumors and impressive membranous expression was noticed in metastatic tumors. Important pitfalls of ALDH1A1 immunostaining were applied for accurate interpretations.ConclusionWe ascertained the presence of strong association between ALDH1A1 expression and both histological subtype & tumor grade of NSCLCs. We report a fascinating finding; ALDH1A1 heterogeneity within adenocarcinoma can be mapped to its histological patterns. Furthermore, we elucidated its presence in SCLCs and inflammatory pseudotumors. Also a comparative image was drawn between its expressions in the primary lung tissue and in the metastatic lymph nodes.
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Swimming training attenuates the morphological reorganization of the myocardium and local inflammation in the left ventricle of growing rats with untreated experimental diabetes
Publication date: Available online 6 February 2016
Source:Pathology - Research and Practice
Author(s): Edson da Silva, Antônio José Natali, Márcia Ferreira da Silva, Gilton de Jesus Gomes, Daise Nunes Queiroz da Cunha, Marileila Marques Toledo, Filipe Rios Drummond, Regiane Maria Soares Ramos, Eliziária Cardoso dos Santos, Rômulo Dias Novaes, Leandro Licursi de Oliveira, Izabel Regina dos Santos Costa Maldonado
Diabetic cardiomyopathy is associated with cardiac remodeling, myocardial dysfunction, low-grade inflammation, and reduced cardiac adiponectin in patients with type 1 diabetes mellitus (T1DM). Alternatively, physical exercise is an important strategy for the management of diabetes. This study aimed to investigate the influence of low-intensity swimming training in cardiac cytokines, structural remodeling, and cardiomyocyte contractile dysfunction in growing rats with untreated experimental DM. Thirty-day-old male Wistar rats were divided into four groups (n=14, per group): sedentary control (SC), exercised control (EC), sedentary diabetic (SD), and exercised diabetic (ED). Diabetes was induced by streptozotocin (60mg/kg, i.p.). Animals from exercised groups swam (5 days/week, 90minutes/day, loading up to 5% body weight around the animal's chest) for 8 weeks. The left ventricle (LV) was removed for molecular, morphological, and cardiomyocyte mechanical analysis. Diabetic animals presented cardiac remodeling with myocardial histoarchitectural disorganization, fibrosis, and necrosis. The capillary density was lower in diabetic animals. LV cardiomyocytes from diabetic animals exhibited more prolonged time to the peak of contraction and time to half relaxation than those from control animals. The cardiac levels of interleukin 10, nitric oxide, and total and high molecular weight (HMW) adiponectin were significantly decreased in diabetic animals. Exercise training reduced the level of TNF-α, increased capillary density, and attenuated the histopathological parameters assessed in diabetic rats. In conclusion, the cardiac structural remodeling coexists with reduced levels of total and HMW adiponectin, inflammation, and cardiomyocyte contractility dysfunction in experimental DM. More important, low-intensity swimming training attenuates part of these pathological changes, indicating the beneficial role for exercise in untreated T1DM.
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CLPTM1L polymorphism as a protective factor for lung cancer: a case–control study in southern Chinese population
Abstract
Variants of the cleft lip and palate trans-membrane 1 like (CLPTM1L) gene, located on chromosome 5p15.33, were previously determined to influence lung cancer susceptibility. Here, we performed a case-control study to examine the potential association of CLPTM1L single nucleotide polymorphisms (SNPs) with lung cancer in a Chinese Han population. We selected four SNPs in the CLPTM1L gene that were previously reported to be associated with lung cancer. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated to estimate the strength of the relationship between each CLPTM1L SNP and lung cancer risk. Allelic model analysis revealed that the minor alleles of all four SNPs were significantly associated with decreased lung cancer risk. Similar significant results were detected using genetic model analysis. In addition, we observed a protective effect of haplotype "TT" in the CLPTM1L gene. Our results verified that certain CLPTM1L polymorphisms are protective factors against lung cancer in a southern Chinese Han population and may be potential diagnostic and molecular markers for lung cancer patients.
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Impact on overall survival of the combination of BRAF inhibitors and stereotactic radiosurgery in patients with melanoma brain metastases
Abstract
The aim of this study was to evaluate the impact of BRAF inhibitors on survival outcomes in patients receiving stereotactic radiosurgery (SRS) for melanoma brain metastases. We prospectively collected treatment parameters and outcomes for 80 patients with melanoma brain metastases who underwent SRS. Thirty-five patients harbored the BRAF mutation (BRAF-M) and 45 patients did not (BRAF-WT). Univariate and multivariate analyses were performed to identify predictors of overall survival. The median overall survival from first SRS procedure was 6.7, 11.2 months if treated with a BRAF inhibitor and 4.5 months for BRAF-WT. Actuarial survival rates for BRAF-M patients on an inhibitor were 54 % at 6 months and 41 % at 12 months from the time of SRS. In contrast, BRAF-WT had overall survival rates of 28 % at 6 months and 19 % at 12 months. Overall survival was extended for patients on a BRAF inhibitor at or after the first SRS. The median time to intracranial progression was 3.9 months on a BRAF inhibitor and 1.7 months without. The local control rate for all treated tumors was 92.5 %, with no difference based on BRAF status. Patients with higher KPS, fewer treated intracranial metastases, controlled systemic disease, RPA Class 1 and BRAF-M patients had extended overall survival. Overall, patients with BRAF-M treated with both SRS and BRAF inhibitors, at or after SRS, have increased overall survival from the time of SRS. As patients live longer as a result of more effective systemic and local therapies, close surveillance and early management of intracranial disease with SRS will become increasingly important.
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TWiV 375: Zika and you will find
Hosts: Vincent Racaniello, Alan Dove, Rich Condit
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Salivary and Urinary Total Antioxidant Capacity as Biomarkers of Oxidative Stress in Humans
Total Antioxidant Capacity (TAC) is a biomarker often used in order to investigate oxidative stress in many pathological conditions. Saliva and urine can be collected noninvasively and represent attractive diagnostic fluids for detecting biomarkers of various pathological conditions. The reviewed case-control and intervention studies that measured salivary or urinary TAC revealed that diseases, antioxidant foods, or supplements and age, gender, and lifestyle factors influenced salivary or urinary TAC. Salivary and urinary TAC were particularly affected by oral or renal status, respectively, as well as by infection; therefore these factors must be taken into account in both case-control and intervention studies. Furthermore, some considerations on sample collection and normalization strategies could be made. In particular, unstimulated saliva could be the better approach to measure salivary TAC, whereas 24 h or spontaneous urine collection should be chosen on the basis of the study outcome and of the creatinine clearance. Finally, the uric acid-independent TAC could be the better approach to evaluate red-ox status of body, in particular after nutritional interventions and in diseases associated with hyperuricaemia.
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A Prediction Model for Membrane Proteins Using Moments Based Features
The most expedient unit of the human body is its cell. Encapsulated within the cell are many infinitesimal entities and molecules which are protected by a cell membrane. The proteins that are associated with this lipid based bilayer cell membrane are known as membrane proteins and are considered to play a significant role. These membrane proteins exhibit their effect in cellular activities inside and outside of the cell. According to the scientists in pharmaceutical organizations, these membrane proteins perform key task in drug interactions. In this study, a technique is presented that is based on various computationally intelligent methods used for the prediction of membrane protein without the experimental use of mass spectrometry. Statistical moments were used to extract features and furthermore a Multilayer Neural Network was trained using backpropagation for the prediction of membrane proteins. Results show that the proposed technique performs better than existing methodologies.
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Chewing efficiency and occlusal functional morphology in modern humans
Publication date: April 2016
Source:Journal of Human Evolution, Volume 93
Author(s): Myra F. Laird, Erin R. Vogel, Herman Pontzer
The reduction of occlusal dimensions in early Homo is often proposed to be a functional adaptation to diet. With their smaller occlusal surfaces, species of early Homo are suggested to have reduced food-processing abilities, particularly for foods with high material properties (e.g., increased toughness). Here, we employ chewing efficiency as a measure of masticatory performance to test the relationships between masticatory function and food properties. We predicted that humans are more efficient when processing foods of lower toughness and Young's modulus values, and that subjects with larger occlusal surfaces will be less efficient when processing foods with higher toughness and Young's modulus, as the greater area spreads out the overall bite force applied to food particles. Chewing efficiency was measured in 26 adults using high-speed motion capture and surface electromyography. The dentition of each subject was cast and the occlusal surface was quantified using dental topographic analysis. Toughness and displacement-limited index were negatively correlated with chewing efficiency, but Young's modulus was not. Increased occlusal two-dimensional area and surface area were positively correlated with chewing efficiency for all foods. Thus, larger occlusal surface areas were more efficient when processing foods of greater toughness. These results suggest that the reduction in occlusal area in early Homo was associated with a reduction in chewing efficiency, particularly for foods with greater toughness. Further, the larger occlusal surfaces of earlier hominins such as Australopithecus would have likely increased chewing efficiency and increased the probability of fracture when processing tough foods.
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Assessing Sentence Similarity through Lexical, Syntactic and Semantic Analysis
Publication date: Available online 6 February 2016
Source:Computer Speech & Language
Author(s): Rafael Ferreira, Rafael Dueire Lins, Steven J. Simske, Fred Freitas, Marcelo Riss
The degree of similarity between sentences is assessed by sentence similarity methods. Sentence similarity methods play an important role in areas such as summarization, search, and categorization of texts, machine translation, etc. The current methods for assessing sentence similarity are based only on the similarity between the words in the sentences. Such methods either represent sentences as bag of words vectors or are restricted to the syntactic information of the sentences. Two important problems in language understanding are not addressed by such strategies: the word order and the meaning of the sentence as a whole. The new sentence similarity assessment measure presented here largely improves and refines a recently published method that takes into account the lexical, syntactic and semantic components of sentences. The new method was benchmarked using Li-McLean, showing that it outperforms the state of the art systems and achieves results comparable to the evaluation made by humans. Besides that, the method proposed was extensively tested using the SemEval 2012 sentence similarity test set and in the evaluation of the degree of similarity between summaries using the CNN-corpus. In both cases, the measure proposed here was proved effective and useful.
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Pre-leukemic Phase of Chronic Myelogenous Leukemia: Morphologic, and Immunohistochemical Characterization of Seven Cases
Publication date: Available online 6 February 2016
Source:Annals of Diagnostic Pathology
Author(s): Le Le Aye, Sanam Loghavi, Ken H. Young, Imran Siddiqi, C. Cameron Yin, Mark J. Routbort, Mei Liang, Keith Eilerman, L. Jeffrey Medeiros, Russell K. Brynes, Carlos Bueso-Ramos
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Hepatocyte nuclear factor 1 coordinates multiple processes in a model of intestinal epithelial cell function
Publication date: Available online 6 February 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): Rui Yang, Jenny L. Kerschner, Ann Harris
Mutations in hepatocyte nuclear factor 1 transcription factors (HNF1α/β) are associated with diabetes. These factors are well studied in the liver, pancreas and kidney, where they direct tissue-specific gene regulation. However, they also have an important role in the biology of many other tissues, including the intestine. We investigated the transcriptional network governed by HNF1 in an intestinal epithelial cell line (Caco2). We used chromatin immunoprecipitation followed by direct sequencing (ChIP-seq) to identify HNF1 binding sites genome-wide. Direct targets of HNF1 were validated using conventional ChIP assays and confirmed by siRNA-mediated depletion of HNF1, followed by RT-qPCR. Gene ontology process enrichment analysis of the HNF1 targets identified multiple processes with a role in intestinal epithelial cell function, including properties of the cell membrane, cellular response to hormones, and regulation of biosynthetic processes. Approximately 50% of HNF1 binding sites were also occupied by other members of the intestinal transcriptional network, including hepatocyte nuclear factor 4A (HNF4A), caudal type homeobox 2 (CDX2), and forkhead box A2 (FOXA2). Depletion of HNF1 in Caco2 cells increases FOXA2 abundance and decreases levels of CDX2, illustrating the coordinated activities of the network. These data suggest that HNF1 plays an important role in regulating intestinal epithelial cell function, both directly and through interactions with other intestinal transcription factors.
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VEMPs in central neurological disorders
Source:Clinical Neurophysiology
Author(s): Franca Deriu, Edoardo R. de Natale, Immacolata Magnano, Francesca Ginatempo
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