Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Κυριακή 10 Ιουλίου 2016
Unfavorable Results After Free Tissue Transfer to Head and Neck
Publication date: Available online 9 July 2016
Source:Clinics in Plastic Surgery
Author(s): Marika Kuuskeri, Anne C. O'Neill, Stefan O.P. Hofer
Teaser
The purpose of the current article is to provide an overview of the functional and aesthetic unfavorable results of head and neck reconstruction, and provide suggestions on how to address these issues. Understanding the consequences of an unsuccessful reconstruction provides the foundation for proper planning and personalized approach to reconstruction of lost structures.from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/29NZraK
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Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis
Abstract
To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19–1.85), age (SMD, −0·10; 95% CI, −0.17–−0.03), obesity (OR, 1·54; 95% CI, 1·25–1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32–2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77–2·39), operative time (SMD, 0·49; 95% CI, 0·19–0·78), drain usage (OR, 0·36; 95% CI, 0·18–0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37–1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09–2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30–1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA.
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Relationship between maceration and wound healing on diabetic foot ulcers in Indonesia: a prospective study
Abstract
The aim of this study was to clarify the relationship between maceration and wound healing. A prospective longitudinal design was used in this study. The wound condition determined the type of dressings used and the dressing change frequency. A total of 62 participants with diabetic foot ulcers (70 wounds) were divided into two groups: non-macerated (n = 52) and macerated wounds (n = 18). Each group was evaluated weekly using the Bates–Jensen Wound Assessment Tool, with follow-ups until week 4. The Mann–Whitney U test showed that the changes in the wound area in week 1 were faster in the non-macerated group than the macerated group (P = 0·02). The Pearson correlation analysis showed a moderate correlation between maceration and wound healing from enrolment until week 4 (P = 0·002). After week 4, the Kaplan–Meier analysis showed that the non-macerated wounds healed significantly faster than the macerated wounds (log-rank test = 19·378, P = 0·000). The Cox regression analysis confirmed that maceration was a significant and independent predictor of wound healing in this study (adjusted hazard ratio, 0·324; 95% CI, 0·131–0·799; P = 0·014). The results of this study demonstrated that there is a relationship between maceration and wound healing. Changes in the wound area can help predict the healing of wounds with maceration in clinical settings.
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An Optimized Protocol for Packaging Pseudotyped Integrase Defective Lentivirus
Background: A number of integrase defective lentiviral (IDLV) packaging systems have been developed to produce integration deficient lentiviruses for gene delivery and epichromosomal expression. However, despite their growing demand, a comparative study to systemically evaluate the performance efficiency of different mutants on virus packaging and gene expression has not been done. Results: Site-directed mutagenesis was used to generate five integrasedeficient mutants for non-integrative lentiviral packaging (NILVP). The five mutants were then individually incorporated to make different integrase defective lentivirus plasmid packaging mix, keeping other packaging factors constant. CD511B-1, a lentivectorexpressing GFP from an EF1 promoter, was packaged with each of the five different lentivirus packaging mix to make pseudotypedviral particles. The performance and packaging efficiency of each of the integrase deficient mutants was evaluated based on GFP expression in HT1080 cells, while the wild type lentivirus packaging mix was used as a control. Of the five integrase mutant candidates, one with the highestGFP transgene expression level was chosen for further characterization. The non-integrative nature of this candidate was confirmed by quantitative polymerase chain reaction and characterized using both dividing and non-dividing cells. Finally, a detailed standard protocol for NILVP using this integrase defective mutant was developed. Conclusions: An efficient lentiviral packaging system for producing on-integrative lentivirus was established. This system is compatible with most existing lentivectors and can be used to transduce both dividing and non-dividing cells.
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Patterns of care for patients with advanced soft tissue sarcoma: experience from Australian sarcoma services
Background: There is a paucity of data on the current management of patients with advanced soft tissue sarcoma (STS) in the Australian health care setting. This study utilised the Australian sarcoma database to evaluate the patterns of care delivered to patients with advanced STS at Australian sarcoma services. Methods: Prospectively collected data from six sarcoma centres in Australia were sourced to identify patients diagnosed with advanced STS between 1 January 2010 and 31 December 2012. Descriptive statistics were analysed for patient demographics, clinicopathological characteristics and treatment patterns. Overall survival was estimated using the Kaplan–Meier product limit method. Results: Of 253 patients with advanced STS, four major STS subtypes were identified: undifferentiated pleomorphic sarcoma (23 %), leiomyosarcoma (17 %), liposarcoma (14 %), and synovial sarcoma (8 %); with the rest grouped as "other STS" (38 %). Approximately one-third of patients received palliative systemic therapy with the most common first-line therapy being doxorubicin alone (50 %). A small percentage of patients participated in clinical trials (20 %). Palliative radiotherapy was utilised mostly for treatment of symptomatic distant metastases and one-third of patients underwent metastasectomy, most commonly for pulmonary metastases. The median overall survival (OS) in this series was 18 months and no significant difference in OS was observed across different STS histological subtypes. Conclusions: This is the first detailed study outlining patterns of care for Australian patients with advanced STS managed at sarcoma services. These data highlight a particular area of weakness in the lack of clinical trials for sarcoma patients and also serve as an important reference point for understanding how practice may change over time as treatment options evolve.
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In vitro characterization of pralidoxime transport and acetylcholinesterase reactivation across MDCK cells and stem cell-derived human brain microvascular endothelial cells (BC1-hBMECs)
Background: Current therapies for organophosphate poisoning involve administration of oximes, such as pralidoxime (2-PAM), that reactivate the enzyme acetylcholinesterase. Studies in animal models have shown a low concentration in the brain following systemic injection. Methods: To assess 2-PAM transport, we studied transwell permeability in three Madin-Darby canine kidney (MDCKII) cell lines and stem cell-derived human brain microvascular endothelial cells (BC1-hBMECs). To determine whether 2-PAM is a substrate for common brain efflux pumps, experiments were performed in the MDCKII-MDR1 cell line, transfected to overexpress the P-gp efflux pump, and the MDCKII-FLuc-ABCG2 cell line, transfected to overexpress the BCRP efflux pump. To determine how transcellular transport influences enzyme reactivation, we developed a modified transwell assay where the inhibited acetylcholinesterase enzyme, substrate, and reporter are introduced into the basolateral chamber. Enzymatic activity was inhibited using paraoxon and parathion. Results: The permeability of 2-PAM is about 2 × 10 −6 cm s −1 in MDCK cells and about 1 × 10 −6 cm s −1 in BC1-hBMECs. Permeability is not influenced by pre-treatment with atropine. In addition, 2-PAM is not a substrate for the P-gp or BCRP efflux pumps. Conclusions: The low permeability explains poor brain penetration of 2-PAM and therefore the slow enzyme reactivation. This elucidates one of the reasons for the necessity of sustained intravascular (IV) infusion in response to organophosphate poisoning.
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First record of the glass octopus Vitreledonella richardi (Cephalopoda: Vitreledonellidae) from the Arabian Sea
Background: Arabian Sea considered as one of the richest region of oceanic cephalopods. On conflicting information related to species diversity is still scare.ResultThis work presents the first report of a paralarvae of glass octopus Vitreledonella richardi from the Arabian Sea. A single specimen was collected during dusk by Isaacs-Kidd midwater trawl net on 28 February 2015. (Horizon of 150 m at 09° 52′ 30″ N; 73° 37′ 22″ E, bottom depth: 2005 m). A description of the specimen is provided. Conclusion: Record of this rare squid, from Arabian Sea is an addition to the cephalopod fauna of India.
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Farewell to life on land – thoracic strength as a new indicator to determine paleoecology in secondary aquatic mammals
Abstract
Habitat shifts from land to water have occurred independently in several mammal lineages. However, because we do not know completely about the relationship between skeletal morphology and function, both reliable life reconstructions of each extinct taxon and the timing of those shifts in locomotor strategies are yet to be fully understood. We estimated the strengths of rib cages against vertical compression in 26 extant and four extinct mammal specimens including cetartiodactyls, paenungulates, and carnivorans, representing 11 terrestrial, six semi-aquatic, and nine obligate aquatic taxa. Our analyses of extant taxa showed that strengths were high among terrestrial/semi-aquatic mammals, whose rib cages are subjected to vertical compression during the support on land, whereas strengths were low among obligate aquatic mammals, whose rib cages are not subjected to antigravity force in the water. We therefore propose rib strength as a new index to estimate the ability of an animal to be supported on land while being supported by either the forelimbs or thoracic region. According to our analyses of extinct taxa, this ability to be supported on land was rejected for a basal cetacean (Cetartiodactyla: Ambulocetus) and two desmostylians (Paenungulata: Paleoparadoxia and Neoparadoxia). However, this ability was not rejected for one desmostylian species (Desmostylus). Further study of the ribs of extant/extinct semi-aquatic taxa may help in understanding the ecological shifts in these groups.
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Reality Training: Severe head wound behind home plate
Incident Date: June 23, 2016
Department: Athletic trainers and Paramedics Plus, the standby medical service for the Oakland A's
What happened: Home plate umpire Paul Emmel was hit in the head when Angels' pinch-hitter Jefry Marte lost control of his bat. Emmel immediately fell to the ground. When he removed his hat, blood cascaded into the sand. The sound of the bat hitting Emmel's head was startling to players, and the blood streaming out of a laceration was surely just as frightening for television viewers.
Read more about the incident and watch the video of the injury.
Discussion points: Control of severe bleeding, patient assessment and working in a high-visibility venue
As you watch the video ask yourself or discuss with your partner, company or squad the following questions:
1. Many EMS agencies provide standby services for athletes at all levels of competition. What are some of the challenges unique to athletic event standby and how are you specifically prepared to meet those challenges"
2. What is your treatment plan for controlling severe bleeding from a significant head laceration" Does your agency stock hemostatic gauze" Could it have been used on this patient"
3. What other injuries should you consider after an official or athlete has sustained a significant blow to the head, such as contact from the swing of a baseball bat" How do those potential injuries change your treatment plan for the patient, including your transport destination"
4. How has your department prepared to cooperate with athletic trainers" Have you completed joint training sessions and agreed upon protocols for athletic-specific injuries such as spinal cord injury, traumatic brain injury, and head, face or neck injuries sustained from contact with bats, balls and skate blades"
Athlete standby, especially at professional sporting events, is one of the most coveted assignments for EMS crews. Paramedics are rarely called upon for assistance, but when they are, it is because a significant, potentially life-threatening injury has halted play. In these critical moments, with thousands of fans in the stadium and perhaps millions more watching on television or online, paramedics must be prepared to respond with the highest level of competence and professionalism.
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RESEARCH ON MIDWIFERY STUDENT’S ETHICAL SUSCEPTIBILITY ON PATIENT CARE PRACTICES
2016-07-10T18-38-49Z
Source: Journal of Contemporary Medicine
Yasemin AYDIN, Yurdanur Dikmen, Sare Cansu Kalkan.
Objective: Objective of this research is examining last grade students ethical susceptibility includes their susceptibility towards ethics, ethical codes and ethical dilemmas who are candidates to midwifery profession. Method: The research which is planned as descriptive one was carried out with intern students who study at Health College Midwifery Department of a public university between January-February 2016. Sample of the research contains 52 volunteer students. Questionnaire form which comprise of two parts was used in order to collect data. Students characteristics and opinions about ethics are asked in the first part. Ethical Susceptibility Questionnaire Findings: Students average age is 22.36±1.75. That are detected that 48.1 percent of students do not know occupational ethic codes, and 40.4 percent of students stated that ethics education does not suffice in curriculum, and 63.5 percent of students need ethics education. 57.7 percent of students stated that they experienced ethical problems during internship, and 46 percent of students who experienced ethical problems stated that they could not solve the ethical problems that they have faced. It is detected that students total point of ethical susceptibility is 86.81±20.86 (between 30-210 points). Results and Suggestions: It is found out that midwifery students ethical susceptibility is at medium level. It can be suggested that their curriculum before graduation should be enhanced in terms of augmentation of candidate midwifery students ethical susceptibility and recognition and providing a solution of ethical problems.
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The ability of orthodontists and oral/maxillofacial surgeons to predict eruption of lower third molar
Background: The aim of this study was to evaluate the ability of oral/maxillofacial surgeons (OMFSs) and orthodontists to predict third molar eruption by examining a simple panoramic radiograph in cases where full spontaneous eruption occurred. Methods: Panoramic radiographs of 17 patients, 13–16 years of age, were obtained just after orthodontic treatment (T1), when the third molars were intraosseous. The radiographs at T1 were presented to 28 OMFSs and 28 orthodontists—who were asked to give a prognosis for the lower third molars on both sides (n = 34). The full spontaneous eruption of all third molars was clinically observed when patients were older than 18 years (T2). These teeth were clinically asymptomatic at T1 and T2. Results: OMFSs decided by extractions in 49.6 % of cases while orthodontists in 37.8 % (p < 0.001), when the radiographs were examined at T1. Agreement between OMFSs and orthodontists was excellent (Kappa = 0.76, p < 0.0001), as well as intragroup agreement for both OMFSs (Kappa = 0.83) and orthodontists (Kappa = 0.96). Conclusions: Despite a remarkable agreement for third molar prognosis, orthodontists and OMFSs were unable to predict lower third molar eruption by examining a simple panoramic radiograph. Both indicated extractions of a considerable number of spontaneously erupted asymptomatic teeth.
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Taxonomic characterization of a brackish water, bloom-forming Peridiniopsis species (Peridiniales, Dinophyceae) from Iraq
Background: The occurrence of a small brackish water bloom-forming dinoflagellate belonging to the genus Peridiniopsis is reported for the first time from the Shatt Al-Arab River in Iraq. Based on the study of cell morphology, this taxon was attributed to the recently described Peridiniopsis minima, recorded so far only from the Jiulongjiang River, China. Results: The description of P. minima was extended to include some previously unreported details of the thecal surface, apical pore complex, and sulcus structure using light and scanning electron microscopy. Cells of this species from Iraq were oval to rhombic in shape and slightly dorso-ventrally compressed, with distinct red eyespot and endosymbiont nucleus. Cells were covered by a thin theca with the Kofoidian plate formula Po, X, 3′, 1a, 6″, 5c, 5 s, 5′′′, 2′′′′. Complementing the original description of the species, five plates were discerned in the composition of the sulcal area, and the presence of small median sulcal plate was confirmed. Conclusion: The finding of P. minima in the waters of Shatt Al-Arab River represents a new addition to the Iraqi aquatic microflora. Our observations of this dinoflagellate in brackish waters of the Shatt Al-Arab River system extend the known range of salinity tolerance for this species.
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Biancolina japonica Ishimaru 1996: first record of this burrowing amphipod from Australia and a review of host use in the genus Biancolina (Amphipoda: Peracarida: Crustacea)
Background: Biancolina Della Valle (Monograpie 20:1893) are minute amphipods that bore tunnels into algal tissue. Their global distribution and diversity are poorly known due to their small size and concealed habit. Results: Biancolina japonica Ishimaru (J Crust Biol 16:395–405, 1996) is reported from Bare Island, Botany Bay, New South Wales, Australia and is only the second species of Biancolina recorded in Australian waters following B. australis Nicholls (Rec South Aust Mus 6:309–334, 1939). B. japonica is found exclusively on species of Sargassum where it burrows into algal tissues to feed. Conclusions: We report Biancolina japonica Ishimaru (J Crust Biol 16:395–405, 1996), previously known only from Japan, for the first time in Australian waters. A review of the known algal hosts of all eight species of Biancolina indicates high levels of feeding specialisation on brown algae from the order Fucales.
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Considerations in surgical versus non-surgical management of HPV positive oropharyngeal cancer
Given the marked difference in clinical presentation and treatment response based on human papilloma virus (HPV) status, HPV-associated oropharyngeal squamous cell carcinoma is now viewed as a distinct biologic and clinical entity. HPV-associated oropharyngeal squamous cell carcinoma has increased by nearly 7.5 % per year, from approximately 16 % in the early 1980′s to nearly 70 % today, and is believed will continue to increase dramatically in the coming years. Currently, a myriad of treatment options exist for these patients as many active clinical trials are underway which aim to identify the most appropriate interventions for this unique group of patients. This review aims to provide considerations between surgical and non-surgical management for HPV-associated oropharyngeal squamous cell carcinoma.
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Perception of peer physical examination in two Australian osteopathy programs
Background: Peer physical examination (PPE) is an efficient and practical educational approach whereby students can practise their examination skills on each other before commencing clinical practice with actual patients. Little is known about the use of PPE in osteopathy education. Methods: Students in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) completed the Examining Fellow Students and the Peer Physical Examination questionnaires prior to, and at the completion of, their first 12-week teaching session. Descriptive statistics were generated for each questionnaire. The McNemar and sign tests were used to evaluate differences between each questionnaire administration. Logistic regression was used to evaluate the influence of demographics on responses to both questionnaires. Results: Results showed that students in both programs were generally willing to examine non-sensitive areas both before and after the 12-week teaching session. Students' were less apprehensive about PPE at the end of the teaching session, and this was reinforced by results for previous exposure to PPE in other courses. Consistent with previous studies, unwillingness to participate in PPE was associated with being female, being born outside Australia, holding religious beliefs, and being older. Conclusions: This is the first study to explore students' perceptions of PPE in this cohort and provides a basis for further work, including evaluating longer term changes in student perception of PPE, and whether these perceptions extend to practising manual therapy techniques. This study demonstrates that perceptions about PPE reported in medicine and other disciplines, namely that unwillingness to participate in PPE is associated with being female, being born outside Australia, holding religious beliefs, and being older, also apply to osteopathy. These findings are significant for all manual therapy students who spend a substantial portion of their course developing skills in PPE and practising manual therapy techniques. They highlight the need for curriculum development that acknowledges the importance of good practice in PPE, including discussions about body image, feedback skills training for educators, and providing detailed information to students about what to expect in practical skills classes before they commence their course.
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Acquisition and consolidation of novel morphology in human neocortex: a neuromagnetic study
Source:Cortex
Author(s): Alina Leminen, Lilli Kimppa, Miika M. Leminen, Minna Lehtonen, Jyrki P. Mäkelä, Yury Shtyrov
Research into neurobiological mechanisms of morphosyntactic processing of language has suggested specialised systems for decomposition and storage, which are used flexibly during the processing of complex polymorphemic words (such as those formed through affixation, e.g., boy+s = noun + plural marker or boy+ish = noun plus attenuator). However, neural underpinnings of acquisition of novel morphology are still unknown. We implicitly trained our participants with new derivational affixes through a word-picture association task and investigated the neural processes underlying formation of neural memory traces for new affixes. The participants' brain activity was recorded using magnetoencephalography (MEG), as they passively listened to the newly trained and untrained suffixes combined with real word and pseudoword stems. The MEG recording was repeated after a night's sleep using the same stimuli, to test the effects of overnight consolidation. The newly trained suffixes combined with real stems elicited stronger source activity in the left inferior frontal gyrus (LIFG) at ∼50 ms after the suffix onset than untrained suffixes, suggesting memory trace formation for the newly learned suffixes already on the same day. The following day, the suffix learning effect spread to the left superior temporal (STG) gyrus where it was again manifest as a response enhancement, particularly at ∼200–300 ms after the suffix onset, which might reflect an additional effect of overnight consolidation. Overall, the results demonstrate the rapid and dynamic processes of both immediate build-up and longer-term consolidation of neocortical memory traces for novel morphology, taking place after a short period of exposure to novel morphology and involving fronto-temporal perisylvian language circuitry.
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Real and Illusory Issues in the Illusion Debate (Why two things are sometimes better than one): Commentary on Kopiske et al. (2016)
Source:Cortex
Author(s): Robert L. Whitwell, Melvyn A. Goodale
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Epidemiological studies of burn patients in a burn center in Ghana: any clues for prevention?
Background: Burn injuries are a serious problem worldwide, with most occurrences in low- and middle-income countries. Depending on the extent of injury, burn victims are faced with the challenges of fitting into society due to complications such as extensive scarring and contractures. The current study seeks to determine whether epidemiological studies of burn patients can provide guidelines to enhance burn prevention among the Ghanaian population. Methods: Data from the Burns Registry of the Burns Intensive Care Unit (BICU) of Komfo Anokye Teaching Hospital (KATH) was obtained. Data on sex, age, aetiology, % total body surface area (TBSA), and admission outcomes from May 1, 2009, to April 30, 2013, were retrieved for a total of 487 patients during this period. Results: Data on burn admissions comprising 263 (54.0 %) males and 224 (46.0 %) females were obtained from the Burns Registry. Children 0–10 years were the most affected age group. The yearly mean % TBSA ranged from 24.74 % to 35.07 %. The majority of burns was caused by scalding. Mortality rates ranged from 8.4 % to 32.0 % during the period under review. Conclusions: The study shows that children of 10 years old and below are the most affected group; this may be due to inattention to these children by parents/caretakers. Safety and safe working environments should be provided at home and workplaces, and promotion of education on burn prevention should be intensified.
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Estimation of the physical properties of neurons and glial cells using dielectrophoresis crossover frequency
Abstract
We successfully determine the ranges of dielectric permittivity, cytoplasm conductivity, and specific membrane capacitance of mouse hippocampal neuronal and glial cells using dielectrophoresis (DEP) crossover frequency (CF). This methodology is based on the simulation of CF directly from the governing equation of a dielectric model of mammalian cells, as well as the measurements of DEP CFs of mammalian cells in different suspension media with different conductivities, based on a simple experimental setup. Relationships between the properties of cells and DEP CF, as demonstrated by theoretical analysis, enable the simultaneous estimation of three properties by a straightforward fitting procedure based on experimentally measured CFs. We verify the effectiveness and accuracy of this approach for primary mouse hippocampal neurons and glial cells, whose dielectric properties, previously, have not been accurately determined. The estimated neuronal properties significantly narrow the value ranges available from the literature. Additionally, the estimated glial cell properties are a valuable addition to the scarce information currently available about this type of cell. This methodology is applicable to any type of cultured cell that can be subjected to both positive and negative dielectrophoresis.
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A regularized full reference tissue model for PET neuroreceptor mapping
Source:NeuroImage, Volume 139
Author(s): Joseph B. Mandeville, Christin Y.M. Sander, Hsiao-Ying Wey, Jacob M. Hooker, Hanne D. Hansen, Claus Svarer, Gitte M. Knudsen, Bruce R. Rosen
The full reference tissue model (FRTM) is a PET analysis framework that includes both free and specifically bound compartments within tissues, together with rate constants defining association and dissociation from the specifically bound compartment. The simplified reference tissue model (SRTM) assumes instantaneous exchange between tissue compartments, and this "1-tissue" approximation reduces the number of parameters and enables more robust mapping of non-displaceable binding potentials. Simulations based upon FRTM have shown that SRTM exhibits biases that are spatially dependent, because biases depend upon binding potentials. In this work, we describe a regularized model (rFRTM) that employs a global estimate of the dissociation rate constant from the specifically bound compartment (k4). The model provides an internal calibration for optimizing k4 through the reference-region outflow rate k2′, a model parameter that should be a global constant but varies regionally in SRTM. Estimates of k4 by rFRTM are presented for four PET radioligands. We show that SRTM introduces bias in parameter estimates by assuming an infinite value for k4, and that rFRTM ameliorates bias with an appropriate choice of k4. Theoretical considerations and simulations demonstrate that rFRTM reduces bias in non-displaceable binding potentials. A two-parameter reduction of the model (rFRTM2) provides robust mapping at a voxel-wise level. With a structure similar to SRTM, the model is easily implemented and can be applied as a PET reference region analysis that reduces parameter bias without substantially altering parameter variance.
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A regularized full reference tissue model for PET neuroreceptor mapping
Source:NeuroImage, Volume 139
Author(s): Joseph B. Mandeville, Christin Y.M. Sander, Hsiao-Ying Wey, Jacob M. Hooker, Hanne D. Hansen, Claus Svarer, Gitte M. Knudsen, Bruce R. Rosen
The full reference tissue model (FRTM) is a PET analysis framework that includes both free and specifically bound compartments within tissues, together with rate constants defining association and dissociation from the specifically bound compartment. The simplified reference tissue model (SRTM) assumes instantaneous exchange between tissue compartments, and this "1-tissue" approximation reduces the number of parameters and enables more robust mapping of non-displaceable binding potentials. Simulations based upon FRTM have shown that SRTM exhibits biases that are spatially dependent, because biases depend upon binding potentials. In this work, we describe a regularized model (rFRTM) that employs a global estimate of the dissociation rate constant from the specifically bound compartment (k4). The model provides an internal calibration for optimizing k4 through the reference-region outflow rate k2′, a model parameter that should be a global constant but varies regionally in SRTM. Estimates of k4 by rFRTM are presented for four PET radioligands. We show that SRTM introduces bias in parameter estimates by assuming an infinite value for k4, and that rFRTM ameliorates bias with an appropriate choice of k4. Theoretical considerations and simulations demonstrate that rFRTM reduces bias in non-displaceable binding potentials. A two-parameter reduction of the model (rFRTM2) provides robust mapping at a voxel-wise level. With a structure similar to SRTM, the model is easily implemented and can be applied as a PET reference region analysis that reduces parameter bias without substantially altering parameter variance.
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Bayesian electromagnetic spatio-temporal imaging of extended sources with Markov Random Field and temporal basis expansion
Source:NeuroImage, Volume 139
Author(s): Ke Liu, Zhu Liang Yu, Wei Wu, Zhenghui Gu, Yuanqing Li, Srikantan Nagarajan
Estimating the locations and spatial extents of brain sources poses a long-standing challenge for electroencephalography and magnetoencephalography (E/MEG) source imaging. In the present work, a novel source imaging method, Bayesian Electromagnetic Spatio-Temporal Imaging of Extended Sources (BESTIES), which is built upon a Bayesian framework that determines the spatio-temporal smoothness of source activities in a fully data-driven fashion, is proposed to address this challenge. In particular, a Markov Random Field (MRF), which can precisely capture local cortical interactions, is employed to characterize the spatial smoothness of source activities, the temporal dynamics of which are modeled by a set of temporal basis functions (TBFs). Crucially, all of the unknowns in the MRF and TBF models are learned from the data. To accomplish model inference efficiently on high-resolution source spaces, a scalable algorithm is developed to approximate the posterior distribution of the source activities, which is based on the variational Bayesian inference and convex analysis. The performance of BESTIES is assessed using both simulated and actual human E/MEG data. Compared with L2-norm constrained methods, BESTIES is superior in reconstructing extended sources with less spatial diffusion and less localization error. By virtue of the MRF, BESTIES also overcomes the drawback of over-focal estimates in sparse constrained methods.
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Effects of aging on low luminance contrast processing in humans
Publication date: 1 October 2016
Source:NeuroImage, Volume 139
Author(s): Emmanuelle Bellot, Véronique Coizet, Jan Warnking, Kenneth Knoblauch, Elena Moro, Michel Dojat
Luminance contrast is a fundamental visual cue. Using a dedicated neuroimaging framework, we sought to characterize typical Blood Oxygen Level Dependent (BOLD) responses in two subcortical regions, the superior colliculus (SC) and the lateral geniculate nucleus (LGN), and V1, the primary visual cortex area, and how they change over the lifespan. For imaging subcortical activity related to luminance contrast modulation, specific measurements were introduced to rule out possible signal contamination by cardiovascular activity and vascular alterations with age that could hamper the BOLD signal interpretation. Clearly, BOLD responses increased in these three regions with luminance contrast, with a statistically significant diminution in LGN and V1 for older compared to younger participants, while basal perfusion remained unchanged. Additionally, perceptual responses, as assessed with psychophysical experiments, were highly correlated to BOLD measures in the three studied regions. Taken together, fMRI and psychophysics results indicate an alteration of luminance contrast processing with normal aging. Based on this knowledge we can better recognize when age-related brain changes vary from these expectations especially during neurodegenerative diseases progression where the functioning of subcortical structures is altered. The proposed fMRI-physchophysics methodology allows performing such investigation.
Graphical abstract
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Psychiatric comorbidities and use of milnacipran in patients with chronic dizziness.
Psychiatric comorbidities and use of milnacipran in patients with chronic dizziness.
J Vestib Res. 2016 Jul 2;26(3):335-40
Authors: Horii A, Imai T, Kitahara T, Uno A, Morita Y, Takahashi K, Inohara H
Abstract
BACKGROUND: Psychiatric comorbidities are an important issue in the treatment of chronic dizziness patients.
OBJECTIVE: To test the correlation between psychiatric status and subjective handicaps and to examine the effects of milnacipran on handicaps.
METHODS: Hospital anxiety and depression scale (HADS) and handicaps were assessed by a questionnaire before and eight weeks after milnacipran treatment (50 mg/day) in 29 consecutive patients with chronic dizziness. Effects of milnaciplan were compared with fluvoxamine (200 mg/day).
RESULTS: A significant correlation was found between anxious and depressive scale scores and also between HADS and handicaps. Duration of symptoms was longer in the anxious/depressive group (HADS≧13) than in the non-anxious/depressive group. Handicaps and HADS were significantly decreased after treatment only in the anxious/depressive group. There were no overall differences in drug effects between milnaciplan and fluvoxamine. However, the rate of patients with a post/pre ratio of handicaps <80% was higher in milnaciplan group compared with the fluvoxamine group.
CONCLUSIONS: Not only anxiety disorders but also depression should be considered as comorbid psychiatric disorders in patients with chronic dizziness. Dizzy patients with psychiatric comorbidities have a longer duration of symptoms and more handicaps than those without psychiatric disorders. Milnacipran may be chosen as a treatment for patients with chronic dizziness with comorbid psychiatric disorders in case of and insufficient response to SSRIs.
PMID: 27392838 [PubMed - in process]
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Vestibulo-ocular reflex dynamics with head-impulses discriminates spinocerebellar ataxias types 1, 2 and 3 and Friedreich ataxia.
Vestibulo-ocular reflex dynamics with head-impulses discriminates spinocerebellar ataxias types 1, 2 and 3 and Friedreich ataxia.
J Vestib Res. 2016 Jul 2;26(3):327-34
Authors: Luis L, Costa J, Muñoz E, de Carvalho M, Carmona S, Schneider E, Gordon CR, Valls-Solé J
Abstract
OBJECTIVE: Although the diagnosis of inherited ataxias is ultimately genetic, this usually means an extensive and expensive process. This justifies the search for distinct clinical signs that may potentially help orient molecular diagnosis.
METHODS: We explored the vestibulo-ocular reflex (VOR) with the video Head Impulse Test in patients diagnosed with spinocerebellar ataxia (SCA) type 3 (n = 15), type 1 (n = 4) and type 2 (n = 4), Friedreich's ataxia (FA) (n = 9) and healthy controls (n = 40). We estimated the latency, regression (VORr) and instantaneous VOR gain at 40, 60 and 80 ms (VOR40, VOR60 and VOR80), and determined the latency, peak-velocity and occurrence rate of catch-up saccades triggered with head-impulses.
RESULTS: VOR latency was higher in FA (p < 0.001) and SCA3 (p = 0.02) as compared to controls, discriminating FA from other ataxic patients with an overall diagnostic accuracy of 88%. VORr, VOR40 and VOR60 were significantly lower in FA and SCA3 (p < 0.01). VOR80 was only significantly lower than controls in SCA3 (p < 0.01), discriminating these from other ataxic patients with an overall diagnostic accuracy of 78%. Covert saccades were only triggered in SCA3 but with low occurrence rate and peak velocity (11.1 ± 28.5% and 77.50 ± 15.30°/s) whereas overt saccades were present in all groups. VORr gain showed a negative correlation with disease severity evaluated with SARA (Spearman r = -0.46, p = 0.01).
CONCLUSIONS: vHIT provides phenotypic information that differentiates these autosomal ataxias and can serve as a strategy to orient genetic diagnosis. A correlation between VOR and SARA raises the possibility of using VOR gain as a neurophysiologic biomarker for disease severity.
PMID: 27392837 [PubMed - in process]
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Posturographic profile of patients with persistent postural-perceptual dizziness on the sensory organization test.
Posturographic profile of patients with persistent postural-perceptual dizziness on the sensory organization test.
J Vestib Res. 2016 Jul 2;26(3):319-26
Authors: Söhsten E, Bittar RS, Staab JP
Abstract
BACKGROUND/OBJECTIVE: Persistent postural-perceptual dizziness (PPPD) was defined by expert consensus for the forthcoming International Classification of Diseases, 11th edition. Its diagnostic criteria were derived from phobic postural vertigo and chronic subjective dizziness. Two key symptoms are postural unsteadiness and visually induced dizziness. We observed that patients with PPPD tended to perform poorly on multiple conditions of the EquiTest® Sensory Organization Test (SOT) and sought to investigate this phenomenon systematically.
METHODS: We examined cross-sectional, pair-wise group differences in mean scores from SOT conditions 1-6 and composite scores among 20 patients with PPPD, 15 patients recovered from acute vestibular syndromes, and 15 normal individuals (all female, 43 ± 9 years old). We also compared proportions of patients in each group with abnormal sensory analyses, and poor performance across multiple conditions.
RESULTS: Patients with PPPD had significantly lower mean scores than normal individuals on conditions 2-6 and the composite, and lower than recovered patients on conditions 2-3. Recovered patients had significantly lower mean scores than normal individuals on conditions 4-6 and the composite. Patients with PPPD had the greatest likelihood of abnormal sensory analyses.
CONCLUSIONS: Patients with PPPD had difficulties with postural control across multiple sensory challenges, consistent with postulated neurophysiologic mechanisms of this condition.
PMID: 27392836 [PubMed - in process]
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About the pathophysiology of acute unilateral vestibular deficit - vestibular neuritis (VN) or peripheral vestibulopathy (PVP)?
About the pathophysiology of acute unilateral vestibular deficit - vestibular neuritis (VN) or peripheral vestibulopathy (PVP)?
J Vestib Res. 2016 Jul 2;26(3):311-7
Authors: Uffer DS, Hegemann SC
Abstract
OBJECTIVE: To determine whether patients with acute unilateral peripheral vestibulopathy (PVP), often called "vestibular neuritis/neuronitis or neuropathy" (VN) have a vestibular lesion pattern consistent with the distribution of the neurological afferents.
BACKGROUND: Much is known about the clinical nature of PVP, however less so about its etiology and pathogenesis. Due to the frequency with which VN is used to describe the syndrome, an inflammation of the vestibular nerve or of one of its branches is often assumed to be the cause of PVP, though there is insufficient data so far to support this assumption.
METHODS: We conducted a retrospective study of 25 patients who had presented to our clinic with PVP and had all vestibular receptor organs tested shortly after start of symptoms. We analysed their vestibular lesion patterns in order to determine whether they were consistent with the neuritis hypothesis (NH).
RESULTS: The lesion patterns varied conspicuously. 76% did not follow an innervation pattern, thereby contradicting the NH and only 24% had a lesion pattern that either definitely (16%) or probably (8%) supported the NH.
CONCLUSION: These results should remind us to be careful before jumping to quick conclusions about the pathogenetic nature of PVP. With any reason to question VN as the only cause of PVP, we should reconsider the treatment approach to PVP. If the cause probably or even possibly lies inside the vestibular labyrinth, an intratympanic steroid injection might prove to be a more effective measure, even in first-line treatment. If the etiology is unsure, a combination of systemic and intratympanic steroid treatment may be adequate.
PMID: 27392835 [PubMed - in process]
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The repeatability of oVEMP in response to low-frequency vibration against the vertex and forehead.
The repeatability of oVEMP in response to low-frequency vibration against the vertex and forehead.
J Vestib Res. 2016 Jul 2;26(3):303-9
Authors: Holmeslet B, Klaksvik J, Goplen F, Bugten V, Foss OA
Abstract
BACKGROUND: The measurement of ocular Vestibular Evoked Myogenic Potentials (oVEMP) is a novel method for investigating vestibular function. Stimulus and recording techniques vary in the literature. A standardized test procedure is desirable in order to ensure repeatable results.
OBJECTIVE: To investigate the magnitude and repeatability of the asymmetry ratio (AR) of oVEMPs in response to low-frequency bone conducted vibration (BCV) applied to the forehead and vertex in a healthy population.
METHODS: 20 healthy subjects were tested three times by stimulating with 125 Hz BCV at the forehead and the vertex. The first two tests were performed with the subject remaining in the examining room and the electrodes in place. After a short break, a third test was performed with a new set of electrodes. The AR was calculated for each test based on the evoked oVEMPs responses from the left and the right side. The AR magnitude, variance and repeatability coefficients were evaluated to determine which of the two stimulus sites is best suited in clinical use.
RESULTS: Stimulation at the forehead resulted in a statistically significant lower median AR compared to the vertex. The forehead had lower repeatability coefficients, and statistically significantly lower variances.
CONCLUSIONS: This study indicates that the forehead is a better stimulation site than the vertex for low-frequency BCV in clinical use.
PMID: 27392834 [PubMed - in process]
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The development of the ICF vestibular environmental scale.
The development of the ICF vestibular environmental scale.
J Vestib Res. 2016 Jul 2;26(3):297-302
Authors: Whitney SL, Alghadir A, Alghwiri A, Alshebber KM, Alshehri M, Furman JM, Mueller M, Grill E
Abstract
UNLABELLED: People with vestibular disorders report changes in symptoms based on their environment with many situations increasing their symptoms. The purpose of this paper was to utilize the International Classification of Functioning Disability and Health (ICF) from the World Health Organization (WHO) to describe common environmental triggers for dizziness in persons living with balance and vestibular disorders. A multi-centre cross-sectional study was conducted with four different centres on three different continents, including patients from the United States (Pittsburgh), Germany (Munich), Jordan (Amman) and Saudi Arabia (Riyadh).
SUBJECTS: Three hundred eighty one persons with vestibular disorders participated.
METHODS: A 9-item questionnaire (the Vestibular Environmental Scale) was developed from existing ICF items, which were compared to Dizziness Handicap Inventory (DHI) scores. Sixty-five percent of participants reported that "quick movements in the vicinity" increased symptoms, "crowds" at 45%, and "design of buildings, e.g. narrow hallways, stairs, elevators" at 42%. The "crowds" item was a good positive predictor of psychogenic vertigo (OR 1.8, 95% Confidence Interval 1.03-3.16), while "food" (OR 0.47, 95% Confidence Interval 0.17-1.29) and "light" (OR 0.41 95% Confidence Interval 0.23-0.75) were negative predictors of psychogenic vertigo. There also was a positive correlation between the number of triggers and DHI score (Spearman correlation coefficient 0.47, p < 0.0001). Sixty-eight percent of the subjects reported an increase in symptoms with between 1 and 4 environmental triggers. In our cross cultural sample, environmental triggers affect dizziness in persons living with balance and vestibular disorders. The use of items from the ICF of the WHO may help to promote cross cultural sharing of information in persons with dizziness.
PMID: 27392833 [PubMed - in process]
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Yellowstone Caldera/Bacterial Mat
Bacterial mats, golden brown in color, seen at the outer edges of a geothermal vent/geyser. Cyanobacteria grow around 163 F or lower. Yellowstone National Park.
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Floor swab organism/Swarming
Floor swab was done for a science project. One of the organisms seen was mucoid, opaque in color and had finger like projections (swarming) after growth on TSA at 37 degree's C for 48 hrs.
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Serratia marcescens/
Serratia marcescensgrown on TSA for 48 hrs. at 37 degree's C then held at room temp for 24 hrs. Serratia marcescens is circular, mucoid and has a red to oragne pigment due to the production of prodigiosin. Usually the red coloration dose best at reduced temperatures so after initial grown at ...
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Fiber-reinforced interim fixed dental prostheses: A clinical protocol
Publication date: Available online 9 July 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Barry D. Hammond, Jeffrey A. Hodd
Repairing or refabricating interim fixed dental prostheses can be a source of frustration in terms of lost productivity and inconvenience to the patient. The technique for reinforcing interim fixed dental prosthetic restorations described here will provide added strength and durability. The technique can be used either indirectly or for the direct intraoral fabrication of the interim prosthesis, thereby yielding predictable and esthetic results.
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Evaluation of patient experience and satisfaction with CAD/CAM-fabricated complete dentures: A retrospective survey study
Publication date: Available online 9 July 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Paola C. Saponaro, Burak Yilmaz, William Johnston, Reza H. Heshmati, Edwin A. McGlumphy
Statement of problemReports of sound, evidence-based treatment outcomes of computer-aided design/computer-aided manufacture (CAD/CAM) of complete dentures (CD) are lacking in publication databases.PurposeThe purpose of this retrospective survey study was to assess patient preferences and satisfaction when treated with digitally fabricated CDs, by using a questionnaire.Material and methodsA total of 50 patients who received digital CDs were included in this study. A 10-item questionnaire was sent to the patients in order to assess their satisfaction with their digital CD experience. The items, or statements listed, were concerned with patient satisfaction and also the treatment technique and final outcome. Results of patient satisfaction questions were evaluated using descriptive statistics, means, and medians. All statistical tests were performed using commercially available software. Responses to the questionnaire provided by patients were analyzed using the Mantel-Haenszel chi-squared test (α=.05).ResultsThe questionnaire was sent to 50 patients, and the total patient response rate after treatment intervention was 38% (n=19). Data obtained from questionnaire responses revealed that patients were generally pleased and satisfied with digital CDs. The chi-squared test results revealed no statistically significant differences (P=.180) in the ratings of experienced CD wearers. However, 70% of experienced CD patients agreed that their new digital CDs were "better" than their previous set of CDs. In all categories evaluated, patients gave positive responses regarding their digital CDs.ConclusionsResults of this questionnaire-driven study suggest that ratings from experienced CD wearers rehabilitated with CAD/CAM-fabricated CDs did not differ significantly from their previous ratings of conventional CDs, but overall, their satisfaction ratings of their digital CDs tended to be positive.
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Influence of implant abutment material on the color of different ceramic crown systems
Publication date: Available online 9 July 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Doğu Ömür Dede, Arzu Armağanci, Gözlem Ceylan, Ersan Çelik, Soner Çankaya, Burak Yilmaz
Statement of problemCeramics are widely used for anterior restorations; however, clinical color reproduction still constitutes a challenge particularly when the ceramic crowns are used on titanium implant abutments.PurposeThe purpose of this in vitro study was to investigate the effect of implant abutment material on the color of different ceramic material systems.Material and methodsForty disks (11×1.5 mm, shade A2) were fabricated from medium-opacity (mo) and high-translucency (ht) lithium disilicate (IPS e.max) blocks, an aluminous ceramic (VITA In-Ceram Alumina), and a zirconia (Zirkonzahn) ceramic system. Disks were fabricated to represent 3 different implant abutments (zirconia, gold-palladium, and titanium) and dentin (composite resin, A2 shade) as background (11×2 mm). Disk-shaped composite resin specimens in A2 shade were fabricated to represent the cement layer. The color measurements of ceramic specimens were made on composite resin abutment materials using a spectrophotometer. CIELab color coordinates were recorded, and the color coordinates measured on composite resin background served as the control group. Color differences (ΔE00) between the control and test groups were calculated. The data were analyzed with 2-way analysis of variance (ANOVA) and compared with the Tukey HSD test (α=.05).ResultsThe ceramics system, abutment material, and their interaction were significant for ΔE00 values (P<.001). Clinically unacceptable results (ΔE00>2.25) were observed for lithium disilicate ceramics on titanium abutments (2.46-2.50). The ΔE00 values of lithium disilicate ceramics for gold-palladium and titanium abutments were significantly higher than for other groups (P<.05).ConclusionThe color results (ΔE00>2.25) of an implant-supported lithium disilicate ceramic restoration may be clinically unacceptable if it is fabricated over a titanium abutment. Zirconia may be a more suitable abutment material for implant-supported ceramic restorations.
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An alternative impression technique for mobile teeth
Publication date: Available online 9 July 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Evangelia Lampraki, Konstantinos M. Chochlidakis, Evangelos Rossopoulos, Carlo Ercoli
The impression technique described combines elastomeric impression materials and irreversible hydrocolloid to make an accurate preliminary impression of extremely mobile and misaligned teeth. Upon setting, the materials are removed from the mouth in 3 different directions and reassembled extraorally. This technique provides an alternative, easy, accurate, and safe way to make a preliminary impression of mobile, periodontally involved teeth.
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Short message service (SMS) texting as a method of communication during on call: prevalence and experience of medical staff in a large acute NHS Trust in the UK
Publication date: Available online 9 July 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): J. Matharu, B. Hale, M. Ammar, P.A. Brennan
With the widespread use of smartphones, text messaging has become an accepted form of communication for both social and professional use in medicine. To our knowledge no published studies have assessed the prevalence and use of short message service (SMS) texting by doctors on call. We have used an online questionnaire to seek information from doctors in a large NHS Trust in the UK about their use of texting while on call, what they use it for, and whether they send images relevant to patients' care. We received 302 responses (43% response rate), of whom 166 (55%) used SMS while on call. There was a significant association between SMS and age group (p=0.005), with the 20-30-year-old group using it much more than the other age groups. Doctors in the surgical specialties used it significantly less than those in other speciality groups (p<0 .001). Texting while on call was deemed to be safe and reliable (p<0.001). Eighteen clinicians (11%) admitted to routinely sending images of patients by text, despite some being identifiable. Texting was mainly used to update colleagues on patients' progress and give information about times of ward rounds and meetings. With the increasing use of texting in healthcare, much of which seems to be unregulated, further work and detailed guidance is required on what information may be given to ensure confidentiality and that SMS is a safe and acceptable method of communication to use when on call.
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Ambulance destroyed after intersection collision
Surveillance video shows a car drive past a stop sign and into a Twin Township Ambulance on June 23, 2016. The broadside collision completely destroyed the patient care compartment.
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Ambulance destroyed after intersection collision
Surveillance video shows a car drive past a stop sign and into a Twin Township Ambulance on June 23, 2016. The broadside collision completely destroyed the patient care compartment.
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Ambulance destroyed after intersection collision
Surveillance video shows a car drive past a stop sign and into a Twin Township Ambulance on June 23, 2016. The broadside collision completely destroyed the patient care compartment.
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High-throughput proteome dynamics for discovery of key proteins in sentinel species: Unsuspected vitellogenins diversity in the crustacean Gammarus fossarum
Publication date: Available online 9 July 2016
Source:Journal of Proteomics
Author(s): Judith Trapp, Jean Armengaud, Jean-Charles Gaillard, Olivier Pible, Arnaud Chaumot, Olivier Geffard
In environmental science, omics-based approaches are widely used for the identification of gene products related to stress response. However, when dealing with non-model species, functional prediction of genes is challenging. Indeed, functional predictions are often obtained by sequence similarity searches and functional data from phylogenetically distant organisms, which can lead to inaccurate predictions due to quite different evolutionary scenarios. In oviparous females, vitellogenin production is vital for embryonic development, ensuring population viability. Its abnormal presence in fish male organisms is commonly employed as a biomarker of exposure to xenoestrogens, named endocrine disruptors. Here, in the freshwater amphipod Gammarus fossarum, we identified vitellogenin proteins by means of a proteome temporal dynamics analysis during oogenesis and embryogenesis. This exhaustive approach allows several functional molecular hypotheses in the oogenesis process to be drawn. Moreover, we revealed an unsuspected diversity of molecular players involved in yolk formation as eight proteins originating from different families of the large lipid transfer protein superfamily were identified as "true vitellogenins".Biological significanceIn non-model species, next generation sequencing technologies development enables quickly deciphering gene and protein sequences but accuracy of associated functional prediction remains to be established. Here, in the crustacean Gammarus fossarum, a key sentinel species in freshwater biomonitoring, we identified key molecular players involved in the female reproduction by studying the proteome dynamics of ovaries and embryos. An unsuspected diversity of vitellogenin proteins was evidenced. These proteins being vital for offspring development, their high diversity may be advantageous for the organism's reproduction. Phylogenetic analysis showed that some forms are true vitellogenin orthologs while others are included in the apolipoprotein family, a paralogous group from the vitellogenin family. Among crustaceans, Gammarus fossarum is the first documented case where diverse protein families are involved in the yolk formation process.
Graphical abstract
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Ambulance destroyed after intersection collision
Surveillance video shows a car drive past a stop sign and into a Twin Township Ambulance on June 23, 2016. The broadside collision completely destroyed the patient care compartment.
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Microfluidic Buffer Exchange for Interference-free Micro/Nanoparticle Cell Engineering
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Utility of Gleason pattern 4 morphologies detected on transrectal ultrasound (TRUS)-guided biopsies for prediction of upgrading or upstaging in Gleason score 3 + 4 = 7 prostate cancer
Abstract
Selected patients with Gleason score (GS) 3 + 4 = 7 prostate cancer (PCa) detected on transrectal ultrasound (TRUS)-guided biopsies may be considered for active surveillance (AS); however, a proportion of these will harbor more aggressive disease. The purpose of this study was to determine if morphologies of Gleason pattern 4 PCa may predict upgrading and/or upstaging after radical prostatectomy (RP). A database search for men with GS 3 + 4 = 7 PCa diagnosed on TRUS-guided biopsy that underwent RP between January 2010 and October 2015 identified 152 patients. Two blinded genitourinary pathologists independently reviewed the biopsies and assessed ill-defined glands (IDG), fused glands, small or large cribriform patterns, and glomerulations. Patient age, serum prostate-specific antigen (PSA), percentage (%) of biopsy sites involved by 3 + 4 = 7 PCa, and overall extent of pattern 4 were also recorded. GS and stage (presence or absence of extraprostatic extension [EPE]) were retrieved from RP reports. Data were compared using independent t tests and chi-square. Inter-observer agreement was calculated using Cohen's Kappa statistic. Percent of biopsy sites and extent of pattern 4 were compared to statistically significant morphologies using the Spearman correlation. 28.3 % (43/152) of patients were upgraded to GS >3 + 4 = 7 at RP (GS 4 + 3 = 7 [N = 17], GS 4 + 3 = 7 with tertiary pattern 5 [N = 25], and GS 4 + 5 = 9 [N = 1]) and 44.1 % (67/152) showed EPE after RP. PSA was associated with both upgrading (8.5 ± 5.4 vs. 6.9 ± 3.2 ng/mL, [p = 0.04]) and EPE (8.2 ± 4.6 vs. 6.7 ± 3.2 ng/mL, [p = 0.03]). IDG, fused glands, and glomerulations were not associated with upgrading or EPE (p > 0.05) with moderate to strong inter-observer agreement (K = 0.76–0.88). There was strong inter-observer agreement for small and large cribriform formations (K = 0.93 and 0.94, respectively) and both patterns were strongly associated with upgrading (p < 0.001) and EPE (p = 0.02) on RP. Strong associations were observed between increasing number of morphologies and both upgrading (p = 0.0.25) and EPE (p < 0.001). Overall extent of pattern 4 was associated with upgrading (p = 0.009) and EPE (p = 0.019) while percent of sites involved by GS 3 + 4 = 7 was only associated with EPE (p = 0.023). Cribriform morphology correlated to percentage of sites with 3 + 4 and overall extent of pattern 4 (rho = 0.25, p = 0.002, rho = 0.20, p = 0.015, respectively). Presence of cribriform morphology on TRUS-guided biopsy is strongly associated with upgrading and upstaging at RP and shows near-perfect inter-observer agreement whereas IDG, fused glands, and glomerulations were not useful. Cribriform morphology may be of importance when considering treatment plans for patients with intermediate risk PCa.
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Engineering Three-dimensional Epithelial Tissues Embedded within Extracellular Matrix
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Automated Lipid Bilayer Membrane Formation Using a Polydimethylsiloxane Thin Film
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Effects of bypass system on PCDD/F emission and chlorine circulation in cement kilns
Abstract
A bypass at the kiln inlet allows the effective reduction of alkali chloride cycles and thus perhaps affects the emission of PCDD/Fs. Effects of bypass system on PCDD/F emission and chlorine circulation were studied in two typical dry cement kilns with 5000 ton/day clinker capacity in China and named CK1 and CK2, respectively. Firstly, the emission level of PCDD/Fs with the operation of bypass system was estimated in CK1, to certify that bypass system has a perfect adaption to the cement kiln regarding the PCDD/F emission even with the refuse derived fuel (RDF) as the replacement of fuel. On the other hand, the operating conditions in the CK2 were scrutinised by monitoring the concentrations of SO2, NH3 and HCl. In addition, the characteristics of raw meal, clinker, bag filter ash and bypass ash were also investigated by Energy Dispersive Spectrometer (EDS), metal and chlorine analysis. The balance of chlorine showed that 18 % of the possible accumulated chlorine could be ejected from the cement kiln system when 2 % of kiln exhaust gas was extracted. Furthermore, the emission level of PCDD/Fs in the main flue gas also decreased from 0.037 ± 0.035 ng I-TEQ/Nm3 to 0.019 ± 0.007 ng I-TEQ/Nm3 with a reduction efficiency of 48.2 %. Most importantly, PCDD/F emission from the bypass system was proven to have rather minor effect on the total emission factor. The congener distributions of PCDD/Fs were also analysed in the flue gas and fly ash, before and after application of bypass system, to find cues to the formation mechanism.
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Somatic Hypermutation in Immunity and Cancer: Critical Analysis of Strand-Biased and Codon-Context Mutation Signatures
Publication date: Available online 10 July 2016
Source:DNA Repair
Author(s): Edward J. Steele
For 30 years two general mechanisms have competed to explain somatic hypermutation of immunoglobulin (Ig) genes. The first, the DNA-based model, is focussed only on DNA substrates. The modern form is the Neuberger "DNA Deamination Model" based on activation-induced cytidine deaminase (AID) and short-patch error-prone DNA repair by DNA Polymerase-η operating around AID C-to-U lesions. The other is an RNA-based mechanism or the "Reverse Transcriptase Model" of SHM which produces strand-biased mutations at A:T and G:C base pairs. This involves error-prone cDNA synthesis via an RNA-dependent DNA polymerase copying the Ig pre-mRNA template and integrating the now error-filled cDNA copy back into the normal chromosomal site. The modern form of this mechanism depends on AID dC-to-dU lesions and long tract error-prone cDNA synthesis of the transcribed strand by DNA Polymerase-η acting as a reverse transcriptase. The evidence for and against each mechanism is critically evaluated. The conclusion is that all the SHM molecular data gathered since 1980 supports directly or indirectly the RNA/RT-based mechanism. All the data and critical analyses are systematically laid out so the reader can evaluate this conclusion for themselves.Recently we have investigated whether similar RNA/RT-based mutator mechanisms explain how de novo mutations arise in somatic tissues (cancer genomes). The data analyses indeed suggest that cancers arise via dysregulated "Ig-like SHM responses" involving rogue DNA and RNA deaminations coupled to genome-wide RT events. Further, Robyn Lindley has recently shown that the strand-biased mutations in cancer genome genes are also in "codon-context." This has been termed Targeted Somatic Mutation (TSM) to highlight that mutations are far more targeted than previously thought in somatic tissues associated with disease. The TSM process implies an "in-frame DNA reader" whereby DNA and RNA deaminases at transcribed regions are guided in their mutagenic action, by the codon reading frame of the DNA.
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