A Tale of 3 Trials: ACCORD, SPRINT, and SPS3. What Happened?

Within the last several years, the National Institutes of Health has supported three randomized clinical trials to determine whether lower than usually recommended goals for treatment of hypertension would have greater benefit for prevention of cardiovascular disease and stroke. These were the ACCCORD, SPRINT, and Secondary Prevention of Small Subcortical Strokes (SPS3) Trials. Together they enrolled 17,114 participants. Results for all three have been reported. The trials differ from each other in their inclusion criteria, target blood pressures for the lower goal (intensive treatment), but are similar in many respects. The results with regard to their primary outcome were different: not significant for ACCORD and SPS3, but definitely significant for SPRINT. Subgroup analysis revealed differences and similarities. When viewed together and with recent large observational studies, they support a conclusion that a systolic pressure in the range of 125–135 mm Hg range is likely to be optimal on treatment for most hypertensive patients.

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Editorial_Board

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Interrelationships Among Various Measures of Central Artery Stiffness

BACKGROUND

A number of different techniques and methodologies have been applied to quantify stiffness of arteries. Because measures of arterial stiffness differ in regards to measurement locations as well as properties, it is not clear how well these measures that are supposed to reflect the same arterial wall properties are related.

METHODS

Interrelationships between different measures of arterial stiffness were evaluated in 50 apparently healthy subjects varying in age.

RESULTS

Significant relations ranging from mild to strong were observed among measures of arterial stiffness while some measures were not significantly associated. Cardio-ankle vascular index (CAVI) was significantly associated with carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV). Ultrasound-derived measures of arterial stiffness (e.g., compliance, distensibility) were weakly or not significantly related to pulse wave velocity (PWV) measures. The limits of agreement between each of arterial stiffness measures based on the Bland–Altman analyses indicate that there were close agreements (CI = 1.12–1.52) between CAVI, cfPWV, and baPWV. However, agreements between PWV measures and ultrasound-derived measures were mild to moderate. β-stiffness index demonstrated large 95% CIs with other measures. When associations between relative changes in various measures of arterial stiffness in response to isometric handgrip exercise were evaluated, the general trend of associations was similar to the relations observed at rest. β-stiffness index was not related to most measures of arterial stiffness.

CONCLUSION

These results suggest that the techniques used to assess arterial stiffness may not be interchangeable in clinical and research settings and that comparisons of findings obtained with different arterial stiffness measures should be conducted with caution.

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Importance of Calibration Method in Central Blood Pressure for Cardiac Structural Abnormalities

BACKGROUND

Central blood pressure (CBP) independently predicts cardiovascular risk, but calibration methods may affect accuracy of central systolic blood pressure (CSBP). Standard central systolic blood pressure (Stan-CSBP) from peripheral waveforms is usually derived with calibration using brachial SBP and diastolic BP (DBP). However, calibration using oscillometric mean arterial pressure (MAP) and DBP (MAP-CSBP) is purported to provide more accurate representation of true invasive CSBP. This study sought to determine which derived CSBP could more accurately discriminate cardiac structural abnormalities.

METHODS

A total of 349 community-based patients with risk factors (71±5years, 161 males) had CSBP measured by brachial oscillometry (Mobil-O-Graph, IEM GmbH, Stolberg, Germany) using 2 calibration methods: MAP-CSBP and Stan-CSBP. Left ventricular hypertrophy (LVH) and left atrial dilatation (LAD) were measured based on standard guidelines.

RESULTS

MAP-CSBP was higher than Stan-CSBP (149±20 vs. 128±15mm Hg, P < 0.0001). Although they were modestly correlated (rho = 0.74, P < 0.001), the Bland–Altman plot demonstrated a large bias (21mm Hg) and limits of agreement (24mm Hg). In receiver operating characteristic (ROC) curve analyses, MAP-CSBP significantly better discriminated LVH compared with Stan-CSBP (area under the curve (AUC) 0.66 vs. 0.59, P = 0.0063) and brachial SBP (0.62, P = 0.027). Continuous net reclassification improvement (NRI) (P < 0.001) and integrated discrimination improvement (IDI) (P < 0.001) corroborated superior discrimination of LVH by MAP-CSBP. Similarly, MAP-CSBP better distinguished LAD than Stan-CSBP (AUC 0.63 vs. 0.56, P = 0.005) and conventional brachial SBP (0.58, P = 0.006), whereas Stan-CSBP provided no better discrimination than conventional brachial BP (P = 0.09).

CONCLUSIONS

CSBP is calibration dependent and when oscillometric MAP and DBP are used, the derived CSBP is a better discriminator for cardiac structural abnormalities.

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Higher Blood Pressure Partially Links Greater Adiposity to Reduced Brain White Matter Integrity

BACKGROUND

Adiposity and elevated blood pressure (BP) are associated with brain structure abnormalities, but whether these effects are independent is unknown. We tested whether associations between adiposity and white matter integrity were explained by elevated BP.

METHODS

A sample of 209 middle-aged adults underwent diffusion tensor imaging to quantify indirect metrics of white matter structural integrity. These included putative markers of global white matter integrity (fractional anisotropy (FA)), axonal integrity (axial diffusivity), and myelin integrity (radial diffusivity). Participants were either normotensive or prehypertensive.

RESULTS

After adjusting for age and sex, regression analyses showed that waist circumference was associated with FA (β = –0.15, P < 0.05) and axial diffusivity (β = –0.24, P < 0.001), and mean arterial pressure (MAP) was associated with FA (β = –0.21, P < 0.05). Direct and indirect effect analyses showed that waist circumference was indirectly associated with whole brain FA through MAP (β = –0.06), and directly related to whole brain axial diffusivity, independent of MAP (β = –0.24). Examination of specific white matter tracts yielded similar results; waist circumference was indirectly related to FA through MAP and radial diffusivity, and directly related to axial diffusivity, independent of MAP. Supplemental analyses using body mass index, systolic BP, and diastolic BP also yielded similar results.

CONCLUSION

These findings suggest at least 2 mechanisms explain the adiposity and white matter association: one pathway through elevated BP impacting global white matter integrity and reducing integrity of the myelin sheath, and at least one other adiposity-specific pathway decreasing axonal integrity.

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The Impact of Left Ventricular Mass on Diastolic Blood Pressure Targets for Patients With Coronary Artery Disease

BACKGROUND

Defining the optimal diastolic blood pressure (DBP) for patients with hypertension and coronary artery disease (CAD) is an ongoing challenge in part because of the concern that low DBP may have adverse cardiac effects (the J curve hypothesis).

METHODS

Left ventricular mass (LV mass) was measured on the echocardiogram of individuals (N = 92) with CAD who had coronary blood flow (CBF) in the left anterior descending (LAD) artery estimated from artery diameter and DBP distal to coronary stenosis.

RESULTS

CBF approached 0 in a small but defined proportion of persons at DBP of 70mm Hg. CBF was significantly lower in persons with higher LV mass (above the median of 83g/m²) when DBP was ≥75mm Hg. Higher electrocardiogram QRS voltage (sum of S V1 and R in V6), in the absence of LV hypertrophy (LVH), identified persons with significantly lower CBF at DBP ≥ 80mm Hg. In multivariate analysis, LV mass was a significant CBF determinant after adjusting for DBP and CAD severity. LV mass has a major impact on CBF when DBP is >70mm Hg, while DBP is the primary determinant of CBF when DBP is ≤70mm Hg. Multivariate analysis confirmed a significant interaction between LV mass and DBP.

CONCLUSIONS

DBP ≤ 70mm Hg is associated with a progressively greater proportion in whom CBF in the LAD approaches 0. For DBP > 70mm Hg, persons with higher LV mass, even in the absence of LVH, have lower CBF, suggesting LV mass is an important consideration when DBP is reduced in patients with CAD.

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Prediabetes and Diabetes Are Associated With Arterial Stiffness in Older Adults: The ARIC Study

BACKGROUND

To determine whether prediabetes and diabetes in older adults are associated with arterial stiffness measured in central and peripheral arteries and to examine characteristics that modify these associations.

METHODS

Cohort members attending the 5th exam (2011–2013) of the Atherosclerosis Risk in Communities (ARIC) study had pulse wave velocity (PWV) measures performed at the carotid-femoral (cfPWV), brachial-ankle (baPWV), and femoral-ankle (faPWV) segments. Fasting glucose ≥126mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or currently taking diabetes medication defined diabetes. Fasting glucose 100–125mg/dl or HbA1c 5.7%–6.4% among those without diabetes defined prediabetes. Cross-sectional associations were modeled using multivariable linear regression.

RESULTS

Among 4,279 eligible participants with cfPWV measures (mean age 75 years), 22% were African–American, 25.5% had diabetes, and 54.7% had prediabetes. Compared to those with normal glucose, cfPWV was 95.8cm/s higher (stiffer) on average for those with diabetes (for reference: being 1 year older was associated with 14.4cm/s higher cfPWV). Similar findings were seen for diabetes and baPWV, although attenuated. Interestingly, faPWV was 17.6cm/s lower for those with diabetes compared to normal glucose. There was a significant positive association between baPWV and prediabetes. Among those with diabetes, cfPWV was higher for those with albuminuria, reduced kidney function, duration of diabetes ≥10 years, and elevated HbA1c (HbA1c ≥7).

CONCLUSION

Among older adults, diabetes is associated with higher central arterial stiffness and lower peripheral arterial stiffness, and prediabetes is associated with higher baPWV. Cross-sectionally, the magnitude of the effect of diabetes on central stiffness is equivalent to 6 years of arterial aging.

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Attenuated Heart Rate Recovery After Exercise Testing and Risk of Incident Hypertension in Men

BACKGROUND

Although attenuated heart rate recovery (HRR) and reduced heart rate (HR) reserve to maximal exercise testing are associated with adverse cardiovascular outcomes, their relation to incident hypertension in healthy normotensive populations is unclear. We examined the hypothesis that both attenuated HRR and reduced HR reserve to exercise testing are associated with incident hypertension in men.

METHODS

A total of 1,855 participants were selected comprising of healthy, initially normotensive men who underwent peak or symptom-limited treadmill testing at baseline. HRR was calculated as the difference between peak HR during exercise testing and the HR at 2 minutes after exercise cessation. HR reserve was calculated as the percentage of HR reserve (peak HR – resting HR)/(220 – age – resting HR) x 100.

RESULTS

During an average 4-year follow-up, 179 (9.6%) men developed hypertension. Incident hypertension was associated with HRR quartiles (Q1 (<42 (bpm)) 12.5%, Q2 (43–49 bpm) 8.5%, Q3 (50–56 bpm) 9.3%, and Q4 (>57 bpm) 8.3%; P = 0.05 for trend). The relative risk (RR) of the incident hypertension in the slowest HRR quartile vs. the fastest HRR quartile was 1.78 (95% confidence interval (CI): 1.14–2.78) after adjustment for confounders. Every 1 bpm increment in HRR was associated with a 2% (RR 0.98, 95% CI: 0.97–0.99) lower risk of incident hypertension after adjusting for potential confounders. In contrast, reduced HR reserve did not predict the risk of incident hypertension.

CONCLUSIONS

Slow HRR after exercise testing is independently associated with the development of hypertension in healthy normotensive men.

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Blood Pressure Variability and Prediction of Target Organ Damage in Patients With Uncomplicated Hypertension

BACKGROUND

The average of multiple blood pressure (BP) readings (mean BP) independently predicts target organ damage (TOD). Observational studies have also shown an independent relationship between BP variability (BPV) and TOD, but there is limited longitudinal data. This study aimed to determine the effects of changes in mean BP levels compared with BPV on left ventricular mass index (LVMI) and aortic pulse wave velocity (aPWV).

METHODS

Mean BP levels (research-protocol clinic BP (clinic BP), 24-hour ambulatory BP, and 7-day home BP) and BPV were assessed in 286 patients with uncomplicated hypertension (mean age 64±8 SD years, 53% women) over 12 months. Reading-to-reading BPV (from 24-hour ambulatory BP) and day-to-day BPV (from 7-day home BP) were assessed at baseline and 12 months, and visit-to-visit BPV (clinic BP) was assessed from 5 visits over 12 months. LVMI was measured by 3D echocardiography and aPWV with applanation tonometry.

RESULTS

The strongest predictors of the changes in LVMI (LVMI) were the changes in mean 24-hour systolic BPs (SBPs) (P < 0.02). Similarly, the strongest predictors of the changes in aPWV (aPWV) were the changes in mean 24-hour ambulatory SBPs (P < 0.01) and the changes in mean clinic SBP (P < 0.001). However, none of the changes in BPV were independently associated with LVMI or aPWV (P > 0.05 for all).

CONCLUSIONS

Changes in mean BP levels, but not BPV, were most relevant to changes in TOD in patients with uncomplicated hypertension. Thus, from this point of view, BPV appears to have limited clinical utility in this patient population.

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Accuracy of patient-specific template-guided vs. free-hand fluoroscopically controlled pedicle screw placement in the thoracic and lumbar spine: a randomized cadaveric study

Abstract

Purpose

Dorsal spinal instrumentation with pedicle screw constructs is considered the gold standard for numerous spinal pathologies. Screw misplacement is biomechanically disadvantageous and may create severe complications. The aim of this study was to assess the accuracy of patient-specific template-guided pedicle screw placement in the thoracic and lumbar spine compared to the free-hand technique with fluoroscopy.

Methods

Patient-specific targeting guides were used for pedicle screw placement from Th2–L5 in three cadaveric specimens by three surgeons with different experience levels. Instrumentation for each side and level was randomized (template-guided vs. free-hand). Accuracy was assessed by computed tomography (CT), considering perforations of <2 mm as acceptable (safe zone). Time efficiency, radiation exposure and dependencies on surgical experience were compared between the two techniques.

Results

96 screws were inserted with an equal distribution of 48 screws (50 %) in each group. 58 % (n = 28) of template-guided (without fluoroscopy) vs. 44 % (n = 21) of free-hand screws (with fluoroscopy) were fully contained within the pedicle (p = 0.153). 97.9 % (n = 47) of template-guided vs. 81.3 % (n = 39) of free-hand screws were within the 2 mm safe zone (p = 0.008). The mean time for instrumentation per level was 01:14 ± 00:37 for the template-guided vs. 01:40 ± 00:59 min for the free-hand technique (p = 0.013), respectively. Increased radiation exposure was highly associated with lesser experience of the surgeon with the free-hand technique.

Conclusions

In a cadaver model, template-guided pedicle screw placement is faster considering intraoperative instrumentation time, has a higher accuracy particularly in the thoracic spine and creates less intraoperative radiation exposure compared to the free-hand technique.

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Optimizing the process of fertility preservation in pediatric female cancer patients – a multidisciplinary program

Abstract

Background

Current evidence indicates sub-optimal incidence of fertility preservation (FP) in eligible patients. We present herein our designated multidisciplinary program for FP in pediatric and adolescent population and present our data on FP in female patients.

Methods

Pediatric patients (age 0–18) who were candidate for highly gonadotoxic treatments were referred to FP program for a multidisciplinary discussion and gonadal risk-assessment followed by either oocyte cryopreservation or ovarian cryopreservation (OCP) for female patients, and sperm banking for male patients. The OCP protocol consists of aspiration of oocytes from small antral follicles and in-vitro maturation followed by cryopreservation, as well as ovarian tissue cryopreservation.

Results

The establishment of a designated FP program resulted in a significant increase in referral and subsequent FP procedures of all eligible patients. Sixty-two female patients were referred for FP discussion during a period of 36 months; 41 underwent OCP; 11 underwent oocyte cryopreservation and six were declined due to parental decision. The median age was 13.2y (range 18 months-18y). Thirty-two (51.6 %) were chemotherapy-naïve. Seventeen patients (27 %) had sarcoma, 16 patients (26 %) had acute leukemia. The mean number of mature oocytes that were eventually vitrified was significantly higher in chemotherapy-naïve patients compared with chemotherapy-exposed patients (mean 12 oocytes (1–42) versus 2 (0–7)).

Conclusion

Multidisciplinary programs that encompass experts of all relevant fields, skilled laboratory resources and a facilitated path appear to maximize the yield. We observed a considerable higher referral rates following launching a designated program and earlier OCP in chemo-naïve patients that culminated in a better fertility preservation procedure.

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Novel Femur Window Chamber Model for Long-Term Optical Access to Bone Marrow Compartment

The biological complexity of bone marrow is driven by the diverse array of hematopoietic and non-hematopoietic cells that orchestrate intricate biological activities, such as immune and tumor regulation, as well as hematopoiesis.  Observing and tracking the complex cellular interactions and activities within the bone marrow niche are limited by currently available techniques, such as blood counts and histology, which use a "snapshot" of static evidence to infer such dynamics in vivo.

Researchers from the Princess Margaret Cancer Centre, University of Toronto, have developed a novel pre-clinical technique to visualize and quantitate the in vivo activities of bone marrow cells in real-time using a femur window chamber model.  This new model, intended to complement current standard methods, was used in conjunction with intravital multiphoton fluorescence microscopy, a powerful technique for imaging living tissue.  The researchers describe the protocol for surgical implantation of the window chamber in the murine femur and demonstrate the use of this approach for imaging and tracking neutrophils within the femur vasculature.  In this case, the femur window chamber model enabled the dynamic imaging of three constituents of the femoral bone marrow: neutrophils, vasculature, and collagen matrix.

The current model provides valuable proof of principle that serial visualization and quantification of immune cell movement and regulation is feasible within the highly complex bone marrow compartment.  Long-term optical access to the bone marrow niche is an important advancement that has future applications in studying stem cells transplantation, hematopoiesis and immune regulation in various pathologies, including cancer.

Study in journal JOVE: Femur Window Chamber Model for In Vivo Cell Tracking in the Murine Bone Marrow

Flashbacks: Transparent Cranial Window Implant for Brain Monitoring, Laser Therapy; Transparent Skull Implant for Repeat Brain Laser Therapy

This post Novel Femur Window Chamber Model for Long-Term Optical Access to Bone Marrow Compartment appeared first on Medgadget.

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NovelRNA-binding activity of NQO1promotes SERPINA1 mRNA translation

Publication date: Available online 8 August 2016
Source:Free Radical Biology and Medicine
Author(s): Andrea Di Francesco, Clara Di Germanio, Amaresh C. Panda, Phu Huynh, Robert Peaden, Ignacio Navas-Enamorado, Paul Bastian, Elin Lehrmann, Alberto Diaz-Ruiz, David Ross, David Siegel, Jennifer L. Martindale, Michel Bernier, Myriam Gorospe, Kotb Abdelmohsen, Rafael de Cabo
NAD(P)H:quinone oxidoreductase (NQO1) is essential for cell defense against reactive oxidative species, cancer, and metabolic stress. Recently, NQO1 was found in ribonucleoprotein (RNP) complexes, but NQO1-interacting mRNAs and the functional impact of such interactions are not known. Here, we used ribonucleoprotein immunoprecipitation (RIP) and microarray analysis to identify comprehensively the subset of NQO1 target mRNAs in human hepatoma HepG2 cells. One of its main targets, SERPINA1 mRNA, encodes the serine protease inhibitor α−1-antitrypsin, A1AT, which is associated with disorders including obesity-related metabolic inflammation, chronic obstructive pulmonary disease (COPD), liver cirrhosis and hepatocellular carcinoma. Biotin pulldown analysis indicated that NQO1 can bind the 3' untranslated region (UTR) and the coding region (CR) of SERPINA1 mRNA. NQO1 did not affect SERPINA1 mRNA levels; instead, it enhanced the translation of SERPINA1 mRNA, as NQO1 silencing decreased the size of polysomes forming on SERPINA1 mRNA and lowered the abundance of A1AT. Luciferase reporter analysis further indicated that NQO1 regulates SERPINA1 mRNA translation through the SERPINA1 3'UTR. Accordingly, NQO1-KO mice had reduced hepatic and serum levels of A1AT and increased activity of neutrophil elastase (NE), one of the main targets of A1AT. We propose that this novel mechanism of action of NQO1 as RNA-binding protein may help to explain its pleiotropic biological effects.



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Hormetic Shifting of Redox Environment by Pro-Oxidative Resveratrol Protects Cells Against Stress

Publication date: Available online 8 August 2016
Source:Free Radical Biology and Medicine
Author(s): Annabell Plauth, Anne Geikowski, Susanne Cichon, Sylvia J. Wowro, Linda Liedgens, Morten Rousseau, Christopher Weidner, Luise Fuhr, Magdalena Kliem, Gail Jenkins, Silvina Lotito, Linda J. Wainwright, Sascha Sauer
Resveratrol has gained tremendous interest owing to multiple reported health-beneficial effects. However, the underlying key mechanism of action of resveratrol remained largely controversial. Here, we demonstrate that under physiologically relevant conditions major biological effects of resveratrol can be attributed to the generation of oxidation products such as reactive oxygen species (ROS). At low hormetic concentrations (< 50 µM), treatment with resveratrol increased cell viability in a set of representative cell models, whereas application of quenchers of ROS completely truncated these beneficial effects. Notably, application of resveratrol led to mild, Nrf2-specific cellular gene expression reprogramming. For example, in primary human epidermal keratinocytes this resulted in a 1.3-fold increase of endogenous metabolites such as glutathione (GSH) and subsequently in a quantitative reduction of the cellular redox environment by 2.61 mV mmol GSH per g protein. After external application of oxidative stress by using 0.8% (v/v) ethanol, endogenous generation of ROS was consequently reduced by 24% in resveratrol pre-treated cells. In contrast to the common perception that resveratrol acts mainly as a chemical antioxidant or as a target protein-specific ligand, we propose that effects from resveratrol treatment are essentially based on oxidative triggering of cells. In relevant physiological microenvironments this effect can lead to hormetic shifting of cellular defence towards a more reductive state to improve resilience to oxidative stress in a manner that can be exactly defined by the redox-environment of the cell.

Graphical abstract

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Neuroendokrine Neoplasien des Mediastinums

Zusammenfassung

Primäre neuroendokrine Tumoren (NET) des Mediastinums sind selten, wobei neuroendokrine Neoplasien des Thymus die häufigsten darstellen. Insgesamt machen sie 5 % aller Tumoren des Mediastinums und Thymus aus. Die WHO-Klassifikation aus dem Jahr 2015 unterteilt NET des Thymus in 3 Gruppen: niedriggradig maligne (typisches Karzinoid), mäßiggradig maligne (atypisches Karzinoid) und hochgradig maligne NET (großzelliges neuroendokrines Karzinom, kleinzelliges Karzinom). Bei dieser Einteilungsänderung der mediastinalen/thymischen NET in 3 Malignitätsgrade wurde die Nomenklatur an die der Lunge angepasst, während die histologischen Kriterien der eigentlichen Entitäten gleich geblieben sind. NET treten typischerweise bei Erwachsenen mittleren Alters, vorwiegend bei Männern auf. Etwa 30 % sind asymptomatisch, wobei die restlichen durch Symptomatik des lokalen Tumorwachstums, Fernmetastasen und/oder endokrine Symptomatik gekennzeichnet sind. Karzinoide können auch als Teil des MEN1-Syndroms (multiple endokrine Neoplasie) auftreten. Zum Zeitpunkt der Diagnose präsentieren sie sich häufig mit regionalen Lymphknoten oder Fernmetastasen, wobei Lunge und Knochen die primären Absiedelungsgebiete darstellen. Die wesentlichen Parameter der Diagnostik neuroendokriner Tumoren umfassen die Zellmorphologie sowie das Vorliegen und die Anzahl von Mitosen und/oder Nekrosen. Patienten mit typischen Karzinoiden zeigen die beste Prognose, während sie bei atypischen Karzinoiden sowie großzelligen neuroendokrinen Tumoren bereits schlechter ist und kleinzellige Karzinome mit einem durchschnittlichen Überleben von 14 Monaten die schlechteste Prognose aufweisen.

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Lymphome des Mediastinums

Zusammenfassung

Lymphominfiltrate im Mediastinum stellen eine Herausforderung für die behandelnden Ärzte und auch für die pathologische Diagnostik dar. Klinisch handelt es sich häufig um eine Notfallsituation, zur Diagnostik gelangen in die Pathologie zumeist nur recht kleine Stanzbiopsate. Das bei Weitem häufigste maligne Lymphom im Mediastinum ist das klassische Hodgkin-Lymphom, zumeist handelt es sich um den Subtyp der nodulären Sklerose. Bei sehr ausgeprägten sklerotischen Veränderungen können das Auffinden und auch die immunhistochemische Typisierung der Hodgkin- und Reed-Sternberg-Zellen schwierig sein. Vom klassischen Hodgkin-Lymphom muss das mediastinale großzellige B‑Zell-Lymphom abgegrenzt werden, das auch anders behandelt wird. Dieses zeichnet sich durch den Nachweis von Blastenrasen aus, die immunhistochemisch einen kräftigen B‑Zell-Phänotyp zeigen (CD20 und CD79a), aber häufig auch CD30 exprimieren können. Die enge biologische Verwandtschaft von klassischen Hodgkin-Lymphomen und mediastinalen großzelligen B‑Zell-Lymphomen kommt auch dadurch zum Ausdruck, dass es Lymphominfiltrate mit intermediären Eigenschaften (sog. mediastinale Grauzonenlymphome) gibt. Diese sollten deshalb erkannt und diagnostiziert werden, weil sie mit einer etwas schlechteren Prognose assoziiert sind. Eine seltene Lymphomentität stellt das extranodale thymische Marginalzonenlymphom vom Mucosa-associated-lymphoid-tissue(MALT)-Typ dar, das mit Autoimmunerkrankungen vergesellschaftet sein kann. T‑lymphoblastische Lymphome bzw. Leukämien treten bei Kindern und jungen Erwachsenen auf, sind eine schnell wachsende Vorläuferzellneoplasie und müssen differenzialdiagnostisch von Thymomen, aber auch von normalen oder hyperplastischen Thymi abgegrenzt werden.

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Electrochemical Detection of Single Cancer and Healthy Cell Collisions on a Microelectrode

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC04515D, Communication

Jeffrey E Dick
The electrochemical detection of single cancer cells and healthy cells is reported. Detection was achieved by monitoring the consumption of a single cell's contents upon its collisions with a microelectrode...
The content of this RSS Feed (c) The Royal Society of Chemistry

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A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation

Background and Aim. The efficacy of supplementation treatment with two multispecies probiotic formulates on subjects diagnosed with IBS-C and the assessment of their gut microbiota were investigated. Methods. A randomized, double-blind, three-arm parallel group trial was carried out on 150 IBS-C subjects divided into three groups (F_1, F_2, and F_3). Each group received a daily oral administration of probiotic mixtures (for 60 days) F_1 or F_2 or placebo F_3, respectively. Fecal microbiological analyses were performed by species-specific qPCR to assess the different amount of probiotics. Results. The percentage of responders for each symptom was higher in the probiotic groups when compared to placebo group during the treatment period () and was maintained quite similar during the follow-up period (). Fecal analysis demonstrated that probiotics of the formulations increased during the times of treatment only in fecal DNA from subjects treated with F_1 and F_2 and not with F_3, and the same level was maintained during the follow-up period. Conclusions. Multispecies probiotic supplementations are effective in IBS-C subjects and induce a different assessment in the composition of intestinal microbiota. This clinical study is registered with the clinical study registration number ISRCTN15032219.

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Lanreotide Autogel in the Treatment of Idiopathic Refractory Diarrhea: Results of an Exploratory, Controlled, Before and After, Open-label, Multicenter, Prospective Clinical Trial

Publication date: Available online 8 August 2016
Source:Clinical Therapeutics
Author(s): Raf Bisschops, Vincent De Ruyter, Gauthier Demolin, Didier Baert, Tom Moreels, Piet Pattyn, Hans Verhelst, Luc Lepoutre, Joris Arts, Philip Caenepeel, Patrick Ooghe, Thierry Codden, Pascal Maisonobe, Elke Petrens, Jan Tack
PurposeChronic idiopathic diarrhea is the passage of loose stools >3 times daily, or a stool weight >200 g/d, persisting for >4 weeks without clear clinical cause. Patients refractory to standard anti-diarrhetics have limited treatment options. Somatostatin analogues have the ability to reduce gastrointestinal secretions and motility. This study evaluated the efficacy and safety of lanreotide Autogel^* 120 mg in chronic idiopathic diarrhea.MethodsOther anti-diarrhetics were not allowed during the study and were stopped at screening. Patients received lanreotide Autogel 120 mg at baseline and day 28. Stool frequency and consistency (Bristol Stool Scale) were recorded; quality of life (QoL) was assessed using the 36-item Short Form Health Survey and irritable bowel syndrome QoL questionnaires; adverse events were monitored. The primary outcome was the proportion of patients with a reduction of ≥50% or normalization to a mean of ≤3 stools/d at day 28.FindingsThirty-three patients with >3 stools/d at baseline were included; mean (SD) age was 55.2 (16.4) years. Fourteen patients (42.4%) had a response to lanreotide Autogel at day 28 and 17 (51.5%) at day 56. Mean (SD) number of stools decreased significantly from 5.7 (2.2) at baseline to 3.7 (2.2) at day 56 overall (n = 32; P < 0.001). Significant and clinically meaningful improvements in disease-specific QoL were found in the overall populations. No new safety signals emerged.ImplicationsLanreotide Autogel 120 mg decreased symptoms in these patients with chronic idiopathic refractory diarrhea, and meaningfully improved QoL. These finding have to be confirmed in further clinical trials. ClinicalTrials.gov Identification: NCT00891371; Eudract CT 2009-009356-20



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Co-immobilization of Palm and DNase I for the development of an effective anti-infective coating for catheter surfaces

Publication date: Available online 8 August 2016
Source:Acta Biomaterialia
Author(s): Diana Alves, Andreia Magalhães, Daria Grzywacz, Damian Neubauer, Wojciech Kamysz, Maria Olívia Pereira
Biomaterial-associated infections, in particular, catheter-associated infections (CAI) are a major problem in clinical practice due to their ability to resist antimicrobial treatment and the host immune system. This study aimed to co-immobilize the antimicrobial lipopeptide Palm and the enzyme DNase I to introduce both antimicrobial and anti-adhesive functionalities to polydimethylsiloxane (PDMS) material, using dopamine chemistry. Surface characterization confirmed the immobilization of both compounds and no leaching of Palm from the surfaces for up to 5 days. Co-immobilization of both agents resulted in a bifunctional coating with excellent surface antimicrobial and anti-biofilm properties against both Staphylococcus aureus and Pseudomonas aeruginosa. The modified surfaces demonstrated superior biocompatibility. To better discriminate co-adhesion of both species on modified surfaces, PNA FISH (Fluorescence in situ hybridization using peptide nucleic acid probes) was employed, and results showed that P. aeruginosa was the dominant organism, with S. aureus adhering afterwards on P. aeruginosa agglomerates. Furthermore, Palm immobilization exhibited no propensity to develop bacterial resistance, as opposite to the immobilization of an antibiotic. The overall results highlighted that co-immobilization of Palm and DNase I holds great potential to be applied in the development of catheters.Statement of SignificanceCatheter-associated infections (CAI) are the most common hospital-acquired infections worldwide. Several coating strategies have been proposed to fight these infections but most of them present some important limitations, including the emergence of resistant bacteria and toxicity concerns. The present work describes a two-step polydopamine-based surface modification strategy to successfully co-immobilize an antimicrobial peptide (Palm) and an enzyme targeting an important component of biofilm matrix (DNase I). This immobilization approach imparted polydimethylsiloxane surfaces with both anti-adhesive and antimicrobial properties against the adhesion of relevant bacteria as single and dual-species, with excellent stability and biocompatible and anti-biofilm properties, holding, therefore, great potential in the development of catheters able to prevent CAI.

Graphical abstract

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Mutations in CIT , encoding citron rho-interacting serine/threonine kinase, cause severe primary microcephaly in humans

Abstract

Primary microcephaly is a clinical phenotype in which the head circumference is significantly reduced at birth due to abnormal brain development, primarily at the cortical level. Despite the marked genetic heterogeneity, most primary microcephaly-linked genes converge on mitosis regulation. Two consanguineous families segregating the phenotype of severe primary microcephaly, spasticity and failure to thrive had overlapping autozygomes in which exome sequencing identified homozygous splicing variants in CIT that segregate with the phenotype within each family. CIT encodes citron, an effector of the Rho signaling that is required for cytokinesis specifically in proliferating neuroprogenitors, as well as for postnatal brain development. In agreement with the critical role assigned to the kinase domain in effecting these biological roles, we show that both splicing variants predict variable disruption of this domain. The striking phenotypic overlap between CIT-mutated individuals and the knockout mice and rats that are specifically deficient in the kinase domain supports the proposed causal link between CIT mutation and primary microcephaly in humans.

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Accuracy of Fine Needle Aspiration Cytology (FNAC) in comparison to histopathological examination for the diagnosis of thyroid swellings

2016-08-09T09-16-35Z
Source: International Journal of Medical Science and Public Health
Divyesh Goswami, Preeti Agrawal, Princy Shinde.
Background: Fine needle aspiration cytology (FNAC) is simple, readily available, reliable, time saving and minimally invasive procedure. And because of that it is widely accepted as a diagnostic tool in recent years. histopathological examination of surgically excised thyroid swelling is also one of the accurate way to determine the pathology. However, it requires preparation and long procedure like anaesthesia, hospitalization and sometime even over treatment. Objectives: Primary objective of this study was to evaluate the result of FNAC in diagnosis of various thyroid lesions and correlate the result of FNAC with Histopathological examination in diagnosis of various thyroid lesions. Materials and Methods: A prospective study carried out for duration of two years. Data collected were detailed history of participants, general physical examination and local examination. Investigations like Thyroid function test, Fine needle aspiration cytology and whenever it was possible histopathological examination was done. Correlation of FNAC with histopathological examination was done in those patients. Results: Out of total 150 recruited patients 132 (82%) were female. Common age group of presentation was 21 to 40 years of age with > 60% were presented during this period. Non neoplastic non inflammatory lesions were common (76.67%) with common lesion were colloid goitre (36.67%), benign cystic lesion (10.67%), and adenomatous goitre (10.67%). 15 (10%) cases diagnosed as inflammatory lesion and 15 (10%) were neoplastic lesions. While 5 lesions were remain undiagnosed. Out of 60 correlated cases of FNAC with histopathological examination four were incorrectly diagnosed. The sensitivity of the FNAC found out 85.71% and specificity 96%. While positive predictive value (PPV) was 85.71 % and negative predictive value was 96%. Conclusion: the FNAC could be consider as primary investigational tool for diagnosis and to differentiate thyroid lesions and so for the selection of patients for surgery.


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Gold(I)-Catalyzed Reaction of Ferrocene and Propargylic Esters: Synthesis of Functionalized Ferrocene Derivatives

The reaction of propargylic esters with ferrocene in the presence of gold catalysts provided ferrocene derivatives containing a functionalized vinyl moiety. This ferrocene C-H bond functionalization takes place with complete regio- and stereoselectivity. The reaction is proposed to proceed through an electrophilic substitution in which a vinylgold carbene intermediate arising from a 1,2-rearrangement of the starting propargylic ester would behave as the electrophilic counterpart.

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A Halogen Bonding 1,3-Disubstituted Ferrocene Receptor for Selective Recognition and Redox Sensing of Azide

A neutral redox-active acyclic halogen bonding (XB) receptor with a ferrocene core functionalised at the 1,3-positions of a cyclopentadienyl ring with iodotriazole motifs is prepared. Owing to favourable host-guest size-complementarity, the receptor was found to be selective for azide over a diverse range of anions with different geometries. Voltammetric studies revealed the unique ability of the XB ferrocene receptor to selectively sense azide via a significant cathodic shift of its ferrocene/ferrocenium redox couple. Notably, much weaker binding of azide was observed for the hydrogen bonding 1,3-bis-prototriazole ferrocene receptor analogue, which also displayed a poorer electrochemical response suggesting that halogen bonding interactions play crucial roles in the selective binding and sensing of azide.

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Asymmetrical 1,3-bis-(heteroazolyl)benzene platinum complexes with tunable second-order nonlinear optical properties

A series of cyclometalated platinum(II) complexes bearing asymmetrical 1,3-bis-(heteroazolyl)benzene ligands, as chloro or phenylacetylene derivatives, have been synthetized and characterized. The N^C^N proligands, (benzoxazolyl) (benzothiazolyl)benzene in complex 1 and related compounds, and (benzoxazolyl)(benzimidazolyl)benzene in complex 2, have been synthesized by a two-step procedure including a Pd-catalysed C-H bond activation reaction. Electronic absorption, luminescence and second-order nonlinear optical properties of the novel complexes have been investigated experimentally and theoretically (TD-DFT) calculations, and compared to that of the known 1,3-bis-(benzoxazolyl)benzene platinum complex for which the nonlinear optical response have been studied for the first time. All complexes exhibit green luminescence in dichloromethane solution at room temperature, and the nature of the heteroazolyl ligand and/or the substituent at the central phenyl ring has no significant impact on the emission signatures. In contrast, the functionalization of the terdentate ligands and the nature of the ancillary ligand (chloride or phenylacetylide) allow modulating the nonlinear optical activity.

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Band Gaps and Photocurrent Responses of Bulk and Thin-film Coordination Polymers Based on 3,6-di(1H-imidazol-1-yl)-9H-carbazole

Based on a novel rigid N-donor, 3,6-di(1H-imidazol-1-yl)-9H-carbazole (L), two CPs formulated as CdL(L1)3DMF (H2L1 = 4,4'-carbonyldibenzoic acid, DMF = N,N'-dimethylformamide) (1) and Cu2L2(SO4) (2) have been solvothermally synthesized and structurally characterized by single-crystal X-ray diffraction. CP 1 exhibits a two-dimensional (2D) structure, and CP 2 shows a one-dimensional (1D) chain. The two CPs exhibit different quasi-reversible redox properties and they possess very weak photoluminescence properties. Density functional theory (DFT) calculation and experiment results show that CP 1 has wider band gap than CP 2. Notably, CP 2 produces higher photocurrent density than CP 1 upon the visible light illumination, which is also in agreement with their Nyquist plots and MottSchottky curves. The thin-film CP 1 has been obtained via physical exfoliation in methanol, and it shows more active electrochemical behavior and enhanced photoresponse than bulk CP 1.

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Iranian homograft heart valves: assessment of durability and late outcome

Abstract

Durability and the rate of complications of homograft heart valves, adjusted for patient-related contributors and surgical techniques, rely mainly on the quality of allografts which in turn are mirrored in the donor characteristics and most importantly recovery and processing procedures. Aimed to assess the quality, a study was conducted to figure out the durability and late outcome following homograft replacement with valved conduits procured by the Iranian Tissue Bank. Retrospectively, the pre-implantation, perioperative and follow-up data of 400 non-consecutive recipients of cryopreserved heart valves (222 pulmonary and 178 aortic) from 2006 to 2015 were collected and analyzed in terms of variables reflecting late outcome including adverse events and durability. In the context of durability, the event of interest was defined as the need for homograft replacement and homograft-related death. The mean follow-up time (SD) of study entrants (male/female ratio, 1.4) was 49.8 (36.3) months. Median age at the time of implantation was 11 years. Total 10-years mortality was 21 % (84/400), including 66.7 % early (30-days mortality: 56/84) and 33.3 % late (28/84). Overall late complication rate was 2 %. Median survival time was 120 months (95 % CI 83.3–156.6). The pulmonary valves appeared to be more durable (P value <0.001) and survival probabilities in small sized grafts were lower (P value 0.008). One-, five-, and ten-year graft survival was 82, 76 and 73 %, respectively. The evidences suggest that the homografts function satisfactory with low rate of late complications; nevertheless, more emphasis should be given to make long-term durability comparable.

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Clinical Q & A: Translating Therapeutic Temperature Management from Theory to Practice

Therapeutic Hypothermia and Temperature Management , Vol. 0, No. 0.


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Tactical Medics Group - Tactical Casualty Care programs

Tactical Medics Group LLC is a Texas based tactical medical training company that is a woman owned small business, veteran run organization. This NAEMT Authorized Training Center specializes in NAEMT's full spectrum of Tactical Casualty Care programs, such as TCCC, TCCC-AC, TECC, LFR-TCC. These "Hybrid" courses are designed to bring these historically 'Death by Power Point" ...

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Implicit motor sequence learning in schizophrenia and in old age: reduced performance only in the third session

Abstract

Although there still is conflicting evidence whether schizophrenia is a neurodegenerative disease, cognitive changes in schizophrenia resemble those observed during normal aging. In contrast to extensively demonstrated deficits in explicit learning, it remains unclear whether implicit sequence learning is impaired in schizophrenia and normal aging. Implicit sequence learning was investigated using a computerized drawing task, the 'implicit pattern learning task (IPLT)' in 30 stable patients with schizophrenia, 30 age-matched controls and 30 elderly subjects on two consecutive days and after 1 week (sessions 1, 2 and 3). Fixed sequence trials were intermixed with random trials, and sequence learning was assessed by subtraction of the response time in fixed sequence trials from random trials. Separate analyses of response times and movement accuracy (i.e., directional errors) were performed. Explicit sequence knowledge was assessed using three different awareness tasks. All groups learned equally during sessions 1 and 2. In session 3, control subjects showed significantly larger learning scores than patients with schizophrenia (p = .012) and elderly subjects (p = .021). This group difference is mainly expressed in movement time and directional errors. Patients with schizophrenia demonstrated less subjective sequence awareness, and both patients with schizophrenia and elderly subjects had less explicit sequence recall. Explicit recall was positively correlated with task performance in all groups. After a short 24 h interval, all subjects showed similar improvements in implicit sequence learning. However, no benefit of prior task exposure 1 week later was observed in patients with schizophrenia and elderly subjects compared to controls. As patients with schizophrenia and elderly both display less explicit sequence recall, the control group superiority after 1 week could be explained by an explicit learning component. The few patients with schizophrenia and elderly subjects who had some sequence recall could possibly utilize this explicit knowledge to improve their task performance but did this by distinct mechanisms.

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Patients’ Perspective of Medication Adherence in Chronic Conditions: A Qualitative Study

Abstract

Introduction

About 50% of patients do not take their long-term therapy for chronic conditions as prescribed. Many studies have centered on patients' adherence to a specific treatment or single conditions, but few have taken all chronic conditions into consideration from a patient's perspective. This study aims to explore factors that impact on drug compliance and to identify strategies to improve this from the perspective of patients with at least one chronic condition.

Methods

Patients were recruited by healthcare professionals from a hospital pharmacy, four community pharmacies, patient associations, and a primary care center in Barcelona. Five focus groups were conducted (N = 36). Conversations were audiotaped and transcribed verbatim to allow qualitative analysis.

Results

Study subjects were aged 39–90 years (mean 65 years) and the mean number of comorbidities per patient was 2.3 (range 1–7). The main modifiers of therapeutic conduct were: patients' health beliefs, patient–prescriber relationships, and patients' motivation and perception of illness control. Study participants wanted greater participation in decision-making concerning their health and increased education about their illness and medication. They also wanted individualized healthcare that took their preferences and personal and emotional issues into account.

Conclusion

Our results highlight how the patient–prescriber's relationship and factors such as health beliefs, motivation and perception of illness control impact on medication adherence in chronic patients. Future interventions to optimize adherence to treatment should focus on shared decision-making and more extensive health education.

Funding

Celgene Corporation.

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A Novel Plasmid, pSx1, Harboring a New Tn1696 Derivative from Extensively Drug-Resistant Shewanella xiamenensis Encoding OXA-416

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


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Is Thyroglobulin Level by Liquid Chromatography Tandem-Mass Spectrometry Always Reliable for Follow-Up of DTC After Thyroidectomy: A Report on Two Patients

Thyroid , Vol. 0, No. 0.


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Hypermetabolism on 18F-Fluorodeoxyglucose Positron Emission Tomography Scan Does Not Influence the Interpretation of Thyroid Cytopathology, and Nodules with a SUVmax

Thyroid , Vol. 0, No. 0.


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Iodine Content in Milk Alternatives

Thyroid , Vol. 0, No. 0.


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Liquid Drug and Dietary Supplement Products by PharmaTech: Recall - Risk of Product Contamination

Audience: Pediatrics, Pharmacy, Family Practice, Consumer Including drug products: Aller-chlor Antihistamine Diocto Syrup Docusate Sodium Ninjacof Ninjacof A Senexion Liquid Senna Syrup Sennazon Syrup Virtrate-2 Virtrate-K Including dietary...

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Maternal high-fat diet during pregnancy can affect baby's gut microbes

A new study by researchers at Baylor College of Medicine found that, "babies born to mothers who consumed a high-fat diet during pregnancy had a gut microbiome that was distinctly different from the one in babies of mothers on a non-high-fat diet". Noteably, researchers found that, "the micro...

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New Model Sheds Light on Secondary Bacterial Pneumonia

Washington, DC – August 9, 2016 – For years, researchers have known that the bacteria Staphylococcus aureus (S. aureus) can trigger severe, sometimes deadly secondary bacterial pneumonia, in some people who are subsequently infected with influenza A virus, but scientists have not known exactly h...

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Mcr-1 Gene Isolated from Human for the First Time in Brazil

Washington, DC – August 8, 2016 – For the first time in Brazil, a particular antibiotic resistance mechanism conferring resistance to the important antibiotic, colistin, has been detected in a human. It was in a strain of Escherichia coli that was isolated from a diabetic patient's foot infectio...

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PET/RM simultánea vs. PET/TC en oncología. Una revisión sistemática

Publication date: Available online 8 August 2016
Source:Revista Española de Medicina Nuclear e Imagen Molecular
Author(s): C. Riola-Parada, L. García-Cañamaque, V. Pérez-Dueñas, M. Garcerant-Tafur, J.L. Carreras-Delgado
ObjetivoEl objetivo de esta revisión fue evaluar la capacidad diagnóstica de la PET/RM simultánea en oncología, comparándola con la de la PET/TC, basándonos en la evidencia disponible.Material y métodosSe realizó una búsqueda sistemática en las bases de datos Medline y Embase hasta el 21 de enero de 2016, para identificar artículos clínicos originales que realizasen un análisis comparativo entre PET/RM simultánea y PET/TC en pacientes oncológicos.ResultadosSe obtuvo un total de 57 artículos, distribuidos por enfermedades del siguiente modo: carcinoma de cabeza y cuello (5), pulmón y nódulos pulmonares (13), carcinoma colorrectal (1), lesiones hepáticas (2), incidentalomas abdominales (1), tumores neuroendocrinos (2), carcinoma de tiroides (2), carcinoma de mama (3), tumores ginecológicos (2), carcinoma de próstata (4), linfoma (2), mieloma múltiple (1), metástasis óseas (3), tumores intracraneales (2), oncología pediátrica (1) y neoplasias diversas (13). En la mayoría de las enfermedades oncológicas, el rendimiento diagnóstico de la PET/RM simultánea fue similar o incluso superior al de la PET/TC. Sin embargo, la PET/TC fue superior en la detección de pequeños nódulos pulmonares.ConclusiónLa PET/RM simultánea en oncología es factible, obteniendo resultados al menos equiparables a los de la PET/TC, con menor exposición a radiaciones ionizantes. No obstante, la evidencia disponible aún es limitada, y son necesarios estudios que incluyan a un mayor número de pacientes y neoplasias para establecer las indicaciones de la PET/RM e identificar los protocolos adecuados a cada enfermedad.ObjectiveThe aim of this review was to evaluate the diagnostic performance of simultaneous PET/MRI in oncology compared with that of PET/CT, based upon the available evidence.Material and methodsA systematic search was performed in the Medline and Embase databases to identify original clinical articles published up to 21 January 2016, in order to compare simultaneous PET/MRI and PET/CT in oncology patients.ResultsA total of 57 articles were obtained that included various diseases: head and neck cancer (5), lung cancer and lung nodules (13), colorectal cancer (1), liver lesions (2), abdominal incidentalomas (1), neuroendocrine tumours (2), thyroid carcinoma (2), breast cancer (3), gynaecological cancer (2), prostate cancer (4), lymphoma (2), multiple myeloma (1), bone metastases (3), intracranial tumours (2), paediatric oncology (1) and various tumours (13). Diagnostic performance of simultaneous PET/MRI was similar or even better to that of PET/CT in most oncological diseases. However, PET/CT was superior for small lung nodule detection.ConclusionSimultaneous PET/MRI in oncology is feasible, performing at least equally as well as PET/CT, with lower radiation exposure. However, available evidence is still limited. Studies including more patients and tumours are needed to establish PET/MRI indications and to identify appropriate protocols for each disease.



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Handheld Device Images Children’s Retinas In High Resolution for First Time

Scientists at Duke University have developed the first device that can be used to reliably image the retinas of young children. While imaging the eyes of adults is routine, children are more challenging because patience and cooperation are a required part of an eye exam. Bulky stationary devices that demand a few minutes of focus are simply not designed for young kids.

The Duke team's handheld probe overcomes many of the limitations of stationary devices while performing scanning laser ophthalmoscopy and optical coherence tomography. Using the device, ophthalmologists are able to visualize the parafoveal photoreceptor structure down to individual cells in children as young as 14 months.

The probe weighs only 3.3 ounces (94 grams) and is small and convenient enough to easily place over the eyes of kids under anesthesia. There are no adaptive optics used, which are typically mirrors that can rapidly change their shape, allowing the system to be as compact as it is.

Some details according to Duke University's announcement:

A new type of smaller scanning mirror recently reached a point where it could replace larger, older models. A new design using converging rather than collimated light cut the telescoping length of the device by a third. Custom lenses detailing curvature, thickness and glass type were custom designed by first author Francesco LaRocca and specially fabricated. And a mechanical design to hold and integrate the components was designed by Derek Nankivil—who, with LaRocca, recently graduated with their PhDs from Duke-and fabricated in a machine shop on Duke's campus.

The new device was then given to clinicians for testing on adults, which proved that it was capable of getting accurate photoreceptor density information. It was also used for research imaging in children who were already having an eye exam under anesthesia.

Study in Nature Photonics: In vivo cellular-resolution retinal imaging in infants and children using an ultracompact handheld probe…

Via: Duke…

This post Handheld Device Images Children's Retinas In High Resolution for First Time appeared first on Medgadget.

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Performance evaluation of a rapid whole-blood immunoassay for the detection of IgG antibodies against Helicobacter pylori in daily clinical practice

A growing number of rapid Helicobacter pylori antibody tests are commercially available now, however, some of these tests are often used without sufficient evaluation. The aim of this study was to evaluate the pe...

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Development of a fast and low-cost qPCR assay for diagnosis of acute gas pharyngitis

Group A streptococci (GAS) are the most common bacterial cause of acute pharyngitis and account for 15–30 % of cases of acute pharyngitis in children and 5–10 % of cases in adults. In this study, a real-time q...

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Comparative study of different carbon-supported Fe 2 O 3 -Pt catalysts for oxygen reduction reaction

Abstract

One of the challenges in electrocatalysis is the adequate dispersion of the catalyst on an appropriate porous support matrix, being up to now the most commonly used the carbon-based supports. To overcome this challenge, carbon supports must first be functionalized to guide the catalyst's nucleation, thereby, improving the dispersion and allowing the use of smaller amount of the catalyst material to achieve a higher electrochemically active surface area. This study present the effect of functionalized Vulcan carbon XC72 (FVC) and functionalized Black Pearl carbon (FBPC) as supports on the catalytic activity of decorated Fe₂O₃ with Pt. Both carbons were functionalized with HNO₃ and subsequently treated with ethanolamine. Fe₂O₃ nanoparticles were synthesized by chemical reduction and decorated with platinum by epitaxial growth. Pt and Fe₂O₃ structural phases were identified by XRD and XPS; the Pt content was measured by XPS, and results showed to a high Pt content in Fe₂O₃-Pt/FBPC. TEM micrographs reveal nanoparticles with an average size of 2 nm in both supported catalysts. The Fe₂O₃-Pt/FVC catalyst presents the highest specific activity and mass activity, 0.21 mA cm⁻²_Pt and 140 mA mg_Pt⁻¹, respectively, associated to the appropriate distribution of platinum on the Fe₂O₃ nanoparticles.

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Biochar enhances the cadmium tolerance in spinach ( Spinacia oleracea ) through modification of Cd uptake and physiological and biochemical attributes

Abstract

Cadmium (Cd) has no known role in plant biology and is toxic to plants and animals. The Cd mainly accumulated in agricultural soils through anthropogenic activities, such as sewage water irrigation and phosphorus fertilization. Biochar (BC) has been proposed as an amendment to reduce metal toxicity in plants. The objective of this study was to evaluate the role of BC (cotton stick at a rate of 0, 3, and 5 %) on Cd uptake and the photosynthetic, physiological, and biochemical responses of spinach (Spinacia oleracea) grown in Cd-spiked soil (0, 25, 50, 75, and 100 mg Cd kg⁻¹ soil). The results showed that Cd toxicity decreased growth, photosynthetic pigments, gas exchange characteristics, and amino acid and protein contents in 52-day-old spinach seedlings. The Cd treatments increased the concentrations of Cd, sugar, ascorbic acid, and malondialdehyde (MDA) in plants. The application of BC ameliorated the harmful effects of Cd in spinach plants. Under Cd stress, BC application increased the growth, photosynthesis, and protein contents and decreased Cd concentrations and MDA contents in plants. The maximum BC-mediated increase in dry biomass was about 25 % with 5 % BC application in control plants. It is concluded that BC could ameliorate Cd toxic effects in spinach through changing the physiological and biochemical attributes under Cd stress.

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Periphyton: an important regulator in optimizing soil phosphorus bioavailability in paddy fields

Abstract

Periphyton is ubiquitous in paddy field, but its importance in influencing the bioavailability of phosphorus (P) in paddy soil has been rarely recognized. A paddy field was simulated in a greenhouse to investigate how periphyton influences P bioavailability in paddy soil. Results showed that periphyton colonizing on paddy soil greatly reduced P content in paddy floodwater but increased P bioavailability of paddy soil. Specifically, all the contents of water-soluble P (WSP), readily desorbable P (RDP), algal-available P (AAP), and NaHCO₃-extractable P (Olsen-P) in paddy soil increased to an extent compared to the control (without periphyton) after fertilization. In particular, Olsen-P was the most increased P species, up to 216 mg kg⁻¹ after fertilization, accounting for nearly 60 % of total phosphorus (TP) in soil. The paddy periphyton captured P up to 1.4 mg g⁻¹ with Ca-P as the dominant P fraction and can be a potential crop fertilizer. These findings indicated that the presence of periphyton in paddy field benefited in improving P bioavailability for crops. This study provides valuable insights into the roles of periphyton in P bioavailability and migration in a paddy ecosystem and technical support for P regulation.

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Use of mixed solid waste as a soil amendment for saline-sodic soil remediation and oat seedling growth improvement

Abstract

Soil salinization has become a worldwide problem that imposes restrictions on crop production and food quality. This study utilizes a soil column experiment to address the potential of using mixed solid waste (vinegar residue, fly ash, and sewage sludge) as soil amendment to ameliorate saline-sodic soil and enhance crop growth. Mixed solid waste with vinegar residue content ranging from 60-90 %, sewage sludge of 8.7–30 %, and fly ash of 1.3–10 % was added to saline-sodic soil (electrical conductivity (EC_1:5) = 1.83 dS m⁻¹, sodium adsorption ratio (SAR_1:5) = 129.3 (mmol_c L⁻¹)^1/2, pH = 9.73) at rates of 0 (control), 130, 260, and 650 kg ha⁻¹. Results showed that the application of waste amendment significantly reduced SAR, while increasing soil soluble K⁺, Ca²⁺, and Mg²⁺, at a dose of 650 kg ha⁻¹. The wet stability of macro-aggregates (>1 mm) was improved 90.7–133.7 % when the application rate of amendment was greater than 260 kg ha⁻¹. The application of this amendment significantly reduced soil pH. Germination rates and plant heights of oats were improved with the increasing rate of application. There was a positive correlation between the percentage of vinegar residue and the K/Na ratio in the soil solutions and roots. These findings suggest that applying a mixed waste amendment (vinegar residue, fly ash, and sewage sludge) could be a cost-effective method for the reclamation of saline-sodic soil and the improvement of the growth of salt-tolerant plants.

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Photocatalytic performance of electrospun CNT/TiO 2 nanofibers in a simulated air purifier under visible light irradiation

Abstract

The photocatalytic treatment of gaseous benzene under visible light irradiation was developed using electrospun carbon nanotube/titanium dioxide (CNT/TiO₂) nanofibers as visible light active photocatalysts. The CNT/TiO₂ nanofibers were fabricated by electrospinning CNT/poly(vinyl pyrrolidone) (PVP) solution followed by the removal of PVP by calcination at 450 °C. The molar ratio of CNT/TiO₂ was fixed at 0.05:1 by weight, and the quantity of CNT/TiO₂ loaded in PVP solution varied between 30 and 60 % wt. CNT/TiO₂ nanofibers have high specific surface area (116 m²/g), significantly higher than that of TiO₂ nanofibers (44 m²/g). The photocatalytic performance of the CNT/TiO₂ nanofibers was investigated by decolorization of 1 × 10⁻⁵ M methylene blue (MB) dye (in water solution) and degradation of 100 ppm gaseous benzene under visible light irradiation. The 50-CNT/TiO₂ nanofibers (calcined CNT/TiO₂ nanofibers fabricated from a spinning solution of 50 % wt CNT/TiO₂ based on PVP) had higher MB degradation efficiency (58 %) than did other CNT/TiO₂ nanofibers and pristine TiO₂ nanofibers (15 %) under visible light irradiation. The photocatalytic degradation of gaseous benzene under visible light irradiation on filters made of 50-CNT/TiO₂ nanofibers was carried out in a simulated air purifier system. Similar to MB results, the degradation efficiency of gaseous benzene by 50-CNT/TiO₂ nanofibers (52 %) was higher than by other CNT/TiO₂ nanofibers and pristine TiO₂ nanofibers (18 %). The synergistic effects of the larger surface area and lower band gap energy of CNT/TiO₂ nanofibers were presented as strong adsorption ability and greater visible light adsorption. The CNT/TiO₂ nanofiber prepared in this study has potential for use in air purifiers to improve air treatment efficiency with less energy.

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Prevalence of bacterial resistance within an eco-agricultural system in Hangzhou, China

Abstract

The wide use of antibiotics in the animal husbandry and the relevant sustainable industries may promote the emergence of antibiotic-resistant bacteria (ARB), which constitutes a growing threat to human health. The objective of this study was to determine the abundance and diversity of sulfonamide- and tetracycline-resistant bacteria within an eco-agricultural system (EAS) in Hangzhou, China. We investigated samples at every link in the EAS, from livestock manure, to biogas residues and biogas slurry, to vegetable and ryegrass fields, to a fish pond. A combination of culture-based and 16S rRNA gene-based sequencing method was used in this study. Within the studied system, the average rate of bacterial resistance to sulfonamide (46.19 %) was much higher than that of tetracycline (8.51 %) (p < 0.01). There were 224 isolates that were enumerated and sequenced, 108 of which were identified to species level. The genera comprising the sulfamethoxazole-resistant (SMX^r) bacteria were generally different from those of tetracycline-resistant (TC^r) bacteria. Staphylococcus and Acinetobacter were the most dominant genera of SMX^r bacteria (19.30 % of the total resistant bacteria) and TC^r bacteria (14.04 % of the total resistant bacteria), respectively. Several strains of resistant opportunistic pathogens (e.g., Pantoea agglomerans) were detected in edible vegetable samples, which may exert a potential threat to both pig production and human health. In general, this study indicates that the EAS is an important reservoir of antibiotic-resistant bacteria, some of which may be pathogenic.

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Biosynthesised magnetic iron nanoparticles for sludge dewatering via Fenton process

Abstract

The magnetic iron nanoparticles (MFeNp) were biosynthesised using the extract of Cinnamomum tamala (bay leaf) and examined for its efficacy on sludge dewatering. The characteristics of MFeNp were studied using scanning electron microscope (SEM), transmission electron microscopy (TEM), x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and x-ray photoelectron spectrometer (XPS) techniques. The presence of polyphenolic compounds were confirmed by FTIR and XPS analysis. The reduction in capillary suction time (CST) (71.36 to 16.5 s) and specific resistance to filtration (SRF) (53.71 × 10¹¹ to 1.47 × 10¹¹ m/kg) values have indicated that the use of Fenton nanocatalyst enhanced the sludge dewaterability. The differential scanning calorimetry (DSC) analysis has shown that the mass of bound water in the treated sludge was decreased significantly from 1.45 to 0.92 kg H₂O/kg DS. The breakdown of extracellular polymeric substances (EPS) by the MFeNp leads to the significant reduction in proteins, polysaccharides, water content and heavy metals. The optimisation using response surface modelling (RSM) have shown that the maximum removal efficiency of water from the sludge was 85.9 % when the optimum pH (3) MFeNp dosage (50 mg/g DS) and H₂O₂ dosage (500 mg/g DS) were maintained. The experimental results and the statistical optimisation have suggested that MFeNp can be used as a potential nanocatalyst for the sludge dewaterability and hence it can be used for the agricultural purpose.

Graphical abstract

Schematic representation of sludge dewatering process

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