Effects of glycolic acid peeling on the cutaneous manifestation of generalized acanthosis nigricans caused by FGFR3 mutation: A report of one sporadic and two familial cases

http://ift.tt/2t8PoCE

Case of autoimmune autonomic ganglionopathy manifesting anhidrosis

Abstract

Autoimmune autonomic ganglionopathy (AAG), clinically characterized by gastrointestinal dysmotility, orthostatic hypotension and tonic pupils, is an idiopathic acquired disorder of the autonomic nervous system elicited by antibodies against ganglionic acetylcholine receptor (gAChR). We encountered a 60-year-old man who presented with severe anhidrosis, difficulty in thermoregulation, orthostatic hypotension, gastrointestinal dysmotility, tonic pupils and ptosis. Histologically, an anhidrotic skin sample was normal. Routine laboratory examinations of blood, urine and cerebrospinal fluid returned no abnormal findings. Serological examination revealed antibodies against α3 and β4 subunits of gAChR. The diagnosis was AAG. As sudomotor dysfunction reflects ganglionic neuropathy in AAG, we concluded that his anhidrosis was attributable to AAG. Anhidrosis is an important clue for the diagnosis of AAG, a rare neurological disorder.

http://ift.tt/2szgx4O

Isotretinoin and tattooing: a cautionary tale

http://ift.tt/2rmxLhD

Impact of use of chemical fertiliser on farm households’ risk behaviour and food security in Ethiopia

http://ift.tt/2rCu1Yo

More than meets the eye : from fetal microchimerism to forensic applications

http://ift.tt/2s7Jp2r

An integral equation approach to the prediction of the capacitance and inductance of a via through-hole

http://ift.tt/2rCOk8p

Real-world, single-centre experience of apremilast for the treatment of moderate to severe psoriasis

http://ift.tt/2rCX7qy

Randomised controlled trial of a baked egg intervention in young children allergic to raw egg but not baked egg

Consumption of baked egg by raw egg allergic children is associated with immune changes suggesting development of tolerance. However, causation has not been tested using a double blind randomized controlled tr...

http://ift.tt/2szfrWQ

The extended bundle of the tensor veli palatini: Anatomic consideration of the dilating mechanism of the Eustachian tube

The aim of this study was to analyze the topographical structures of the muscles surrounding the Eustachian tube.

http://ift.tt/2rmLNQf

Metaplastic breast carcinoma with chondroid differentiation: a rare variant of infiltrative carcinoma in a 38-year-old woman

Metaplastic breast carcinoma (MBC) is a rare type of invasive breast carcinoma, and chondroid differentiation is even rarer. Here we report a case of MBC with extensive chondroid differentiation in a 38-year-old woman who presented with a lump in her left breast. Ultrasound findings were most compatible with those of giant fibroadenoma. A histopathological examination revealed a malignant lesion comprising neoplastic epithelial cells arranged in solid nests, with large areas of chondroid differentiation. Neoplastic chondroid cells exhibited a positive reaction for S-100, patchy positive reaction for pan-cytokeratin (AE1/AE3) and negative reaction for epithelial membrane antigen. Both carcinomatous and chondroid cells exhibited p53 overexpression. Sentinel lymph node biopsy revealed no tumorous involvement.

http://ift.tt/2shgNSV

It's a cod! Finding Nemo (impacted fishbone) in the emergency department

A 23-year-old woman presented to the emergency department (ED) with a sensation of a 'fish bone' stuck in her throat after eating cod. On physical examination, while she reported an uncomfortable sensation in her throat, no airway compromise was evident. Clinical examination, including ear, nose and throat (ENT) and oropharyngeal assessment, was unremarkable. A linear opacity consistent with a fishbone was visualised on a soft tissue lateral neck X-ray anterior to the vertebral body of C4–6. One attempt to visualise the fishbone on direct laryngoscopy failed in the ED. The fishbone was later removed the next day via direct visualisation with a flexible endoscope in the operating theatre by the ENT surgical team. The patient's recovery was uneventful.

http://ift.tt/2rx8Vja

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: An observational study in 29 countries.

BACKGROUND: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING: Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES: The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS: A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg-1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P

http://ift.tt/2tt9Uxn

Women awaken faster than men after electroencephalogram-monitored propofol sedation for colonoscopy: A prospective observational study.

BACKGROUND: Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. OBJECTIVE: Sex-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. DESIGN: A prospective observational study. SETTING: An academic teaching hospital of Hannover Medical School. PATIENTS: A total of 219 patients (108 women and 111 men) scheduled for colonoscopy. INTERVENTION: Propofol sedation using electroencephalogram monitoring during a constant level of sedation depth (D0 to D2) performed by trained nurses or physicians after a body-weight-adjusted loading dose. MAIN OUTCOME MEASURES: The primary end-point was the presence of sex-specific differences in awakening time (time from end of sedation to eye-opening and complete orientation); secondary outcome parameters analysed were total dose of propofol, sedation-associated complications (bradycardia, hypotension, hypoxaemia and apnoea), patient cooperation and patient satisfaction. Multivariate analysis was performed to correct confounding factors such as age and BMI. RESULTS: Women awakened significantly faster than men, with a time to eye-opening of 7.3 +/- 3.7 versus 8.4 +/- 3.4 min (P = 0.005) and time until complete orientation of 9.1 +/- 3.9 versus 10.4 +/- 13.7 min (P = 0.008). The propofol dosage was not significantly different, with some trend towards more propofol per kg body weight in women (3.98 +/- 1.81 mg versus 3.72 +/- 1.75 mg, P = 0.232). CONCLUSION: The effect of sex aspects should be considered when propofol is used as sedation for gastrointestinal endoscopy. That includes adequate dosing for women as well as caution regarding potential overdosing of male patients. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT02687568). (C) 2017 European Society of Anaesthesiology

http://ift.tt/2sveg9X

Rocuronium is more hepatotoxic than succinylcholine in vitro.

BACKGROUND: The development of liver failure is a major problem in critically ill patients. The hepatotoxicity of many drugs, as one important reason for liver failure, is poorly screened for in human models. Rocuronium and succinylcholine are neuromuscular blocking agents used for tracheal intubation and for rapid-sequence induction. OBJECTIVE: We used an in-vitro test with a permanent cell line and compared rocuronium and succinylcholine for hepatotoxicity. DESIGN: In-vitro study. SETTING: A basic science laboratory, University Hospital Rostock, Germany. MATERIAL/(PATIENTS): The basic test compound is the permanent human liver cell line HepG2/C3A. In a standardised microtitre plate assay the toxicity of different concentrations of rocuronium, succinylcholine and plasma control was tested. INTERVENTIONS: After two incubation periods of 3 days, the viability of cells (XTT test, lactate dehydrogenase release and trypan blue staining), micro-albumin synthesis and the cytochrome 1A2 activity (metabolism of ethoxyresorufin) were measured. MAIN OUTCOME MEASURES: Differences between rocuronium and succinylcholine were assessed using the Kruskal-Wallis one-way test and two-tailed Mann-Whitney U test. RESULTS: Rocuronium, but not succinylcholine, led to a significant dose-dependent decrease of viability, albumin synthesis and cytochrome 1A2 activity of test cells. CONCLUSION: An in-vitro test with a cell line showed hepatotoxicity of rocuronium that was dose-dependent. Further studies are needed to investigate the underlying mechanisms of the effects of rocuronium on hepatic cellular integrity. TRIAL REGISTRATION: Not suitable. (C) 2017 European Society of Anaesthesiology

http://ift.tt/2tt7QoR

Adjuvants for Animal Vaccines

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2sgRHU7

Update on the supraclavicular flap.

Purpose of review: The purpose of this study is to describe the supraclavicular flap and its utility in head and neck reconstruction in the context of recent studies. Recent findings: Current literature regarding the supraclavicular flap has described its expanded uses in a variety of head and neck reconstructive settings. Its reliability and limited morbidity have been well demonstrated, and it has been cited as a reasonable alternative to other reconstructive options including, in some situations, free tissue transfer. Summary: The supraclavicular flap has shown dependability in reconstruction of defects in the head and neck, and it warrants consideration among reconstructive surgeons, especially for circumstances in which free tissue or other pedicled flaps are less than ideal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2sFiix7

In Response.

No abstract available

http://ift.tt/2rC7POa

Wind of Change or Siren Song?.

No abstract available

http://ift.tt/2s7qdSL

In Response.

No abstract available

http://ift.tt/2rCcwHF

In Response.

No abstract available

http://ift.tt/2s7sgpy

Intraperitoneal Instillation of Local Anesthetics: Is This a Suitable Alternative for Postcesarean Pain Relief Without Toxicity Profiling?.

No abstract available

http://ift.tt/2rCeh7R

Evaluation of the Temple Touch Pro, a Novel Noninvasive Core-Temperature Monitoring System.

BACKGROUND: The Temple Touch Pro (TTP) is a novel system that estimates core temperature from skin over the temporal artery. We tested the hypothesis that this noninvasive system estimates core temperature to an accuracy within 0.5[masculine ordinal indicator]C. METHODS: Core temperature was continuously monitored in 50 adult and pediatric surgical patients by positioning the sensor patch of a TTP over one temporal artery. The sensor consists of a thermistor array near the skin surface, another set of thermistors above an insulator, and a second insulator between the upper unit and the environment. The sensor measures skin temperature and heat flux, from which the monitor unit estimates core temperature from a proprietary algorithm. Reference core temperature was measured from the esophagus or nasopharynx. We conducted agreement analysis between the TTP and the reference core temperature measurements using the 95% Bland-Altman limits of agreement for repeated measurement data. The proportion of all differences that were within 0.5[masculine ordinal indicator]C and repeat measures concordance correlation coefficient (CCC) were estimated as well. RESULTS: TTP and the reference core temperature measurements agreed well in both adults and pediatric patients. Bland-Altman plots showed no evidence of systematic bias or variability over the temperature from 35.2[masculine ordinal indicator]C to 37.8[masculine ordinal indicator]C. The estimated 95% lower and upper limits of agreement were -0.57[masculine ordinal indicator]C (95% confidence interval [CI], -0.76 to -0.41) and 0.57[masculine ordinal indicator]C (95% CI, 0.44 to 0.71), indicating good agreement between the 2 methods. Ninety-four percentage (95% CI, 87% to 99%) of the TTP temperatures were within 0.5[masculine ordinal indicator]C of the reference temperature. Good agreement was also supported by an estimated repeated measures CCC of 0.82 (95% CI, 0.66 to 0.91). The TTP core temperature measurements also agreed well with nasopharyngeal reference temperatures. CONCLUSIONS: The noninvasive TTP system is sufficiently accurate and reliable for routine intraoperative core temperature monitoring. (C) 2017 International Anesthesia Research Society

http://ift.tt/2s7dOOl

Update on the supraclavicular flap.

Purpose of review: The purpose of this study is to describe the supraclavicular flap and its utility in head and neck reconstruction in the context of recent studies. Recent findings: Current literature regarding the supraclavicular flap has described its expanded uses in a variety of head and neck reconstructive settings. Its reliability and limited morbidity have been well demonstrated, and it has been cited as a reasonable alternative to other reconstructive options including, in some situations, free tissue transfer. Summary: The supraclavicular flap has shown dependability in reconstruction of defects in the head and neck, and it warrants consideration among reconstructive surgeons, especially for circumstances in which free tissue or other pedicled flaps are less than ideal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2sFiix7

Langerhans und Merkel: a nervous epidermal dispute

http://ift.tt/2rmnsd8

Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: a retrospective case -control study

Eustachian tube (ET) dysfunction can be very difficult to diagnose accurately. Our aim is to determine whether a newly developed sonotubometric test using clicks can reliably detect ET opening during swallowin...

http://ift.tt/2sgJZtn

Clinical performance validation of PITX2 DNA methylation as prognostic biomarker in patients with head and neck squamous cell carcinoma

by Verena Sailer, Heidrun Gevensleben, Joern Dietrich, Diane Goltz, Glen Kristiansen, Friedrich Bootz, Dimo Dietrich

Background

Despite advances in combined modality therapy, outcomes in head and neck squamous cell cancer (HNSCC) remain dismal with five-year overall survival rates of less than 50%. Prognostic biomarkers are urgently needed to identify patients with a high risk of death after initial curative treatment. Methylation status of the paired-like homeodomain transcription factor 2 (PITX2) has recently emerged as a powerful prognostic biomarker in various cancers. In the present study, the clinical performance of PITX2 methylation was validated in a HNSCC cohort by means of an independent analytical platform (Infinium HumanMethylation450 BeadChip, Illumina, Inc.).

Methods

A total of 528 HNSCC patients from The Cancer Genome Atlas (TCGA) were included in the study. Death was defined as primary endpoint. PITX2 methylation was correlated with overall survival and clinicopathological parameters.

Results

PITX2 methylation was significantly associated with sex, tumor site, p16 status, and grade. In univariate Cox proportional hazards analysis, PITX2 hypermethylation analyzed as continuous and dichotomized variable was significantly associated with prolonged overall survival of HNSCC patients (continuous: hazard ratio (HR) = 0.19 [95%CI: 0.04–0.88], p = 0.034; dichotomized: HR = 0.52 [95%CI: 0.33–0.84], p = 0.007). In multivariate Cox analysis including established clinicopathological parameters, PITX2 promoter methylation was confirmed as prognostic factor (HR = 0.28 [95%CI: 0.09–0.84], p = 0.023).

Conclusion

Using an independent analytical platform, PITX2 methylation was validated as a prognostic biomarker in HNSCC patients, identifying patients that potentially benefit from intensified surveillance and/or administration of adjuvant/neodjuvant treatment, i.e. immunotherapy.

http://ift.tt/2sfqAcl

Choosing Sunscreen For Your Kids

 

On this episode of MomDocs, Dr. Carrie Coughlin, pediatric dermatologist, joins us to discuss SPF and the ingredients. When choosing sunscreen for your child, there are a few factors to consider.

The post Choosing Sunscreen For Your Kids appeared first on ChildrensMD.

http://ift.tt/2sy11WO

Low-Dose Childhood Radiation Effects to the Thyroid Follow a Linear Dose–Response Trend and Persist Even 45+ Years After Exposure

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 235-236.


http://ift.tt/2syfn9w

Persistent Hyperthyroidism Is Associated with Increased Mortality

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 214-217.


http://ift.tt/2t7vckB

Patients with Toxic Nodular Goiter and Graves’ Disease Are at Increased Risk for All-Cause and Cardiovascular Mortality

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 218-220.


http://ift.tt/2sxS9k2

Delaying Surgery by More Than 1 Year for Selected Patients with Papillary Thyroid Microcarcinoma Does Not Compromise Outcomes

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 241-243.


http://ift.tt/2t7KqGk

Thyroid Cancer Incidence and Mortality Are Increasing

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 221-223.


http://ift.tt/2sxFsWf

Does Core Needle Biopsy Have A Role in the Evaluation of Thyroid Nodules with Indeterminate Cytology?

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 232-234.


http://ift.tt/2t7xgJh

Levothyroxine Does Not Lower Hypothyroidism Symptoms in Older Adults with Mild Subclinical Hypothyroidism

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 224-228.


http://ift.tt/2sxLvdI

Thyroid Hormone Receptor Alpha Resistance Causes Variability in the Severity but Not the Nature of Clinical Features

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 237-240.


http://ift.tt/2t7tU9k

High-Intensity Focused Ultrasound Is Useful in the Treatment of Symptomatic Benign Thyroid Nodules

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 229-231.


http://ift.tt/2sxqdg5

Thyroid Tumor Board: The Pathologic Criteria of Poorly Differentiated Thyroid Cancer Can Be Difficult to Distinguish From Differentiated Thyroid Carcinoma

Clinical Thyroidology Jun 2017, Vol. 29, No. 6: 244-246.


http://ift.tt/2t7Kq9i

Clinical performance validation of PITX2 DNA methylation as prognostic biomarker in patients with head and neck squamous cell carcinoma

by Verena Sailer, Heidrun Gevensleben, Joern Dietrich, Diane Goltz, Glen Kristiansen, Friedrich Bootz, Dimo Dietrich

Background

Despite advances in combined modality therapy, outcomes in head and neck squamous cell cancer (HNSCC) remain dismal with five-year overall survival rates of less than 50%. Prognostic biomarkers are urgently needed to identify patients with a high risk of death after initial curative treatment. Methylation status of the paired-like homeodomain transcription factor 2 (PITX2) has recently emerged as a powerful prognostic biomarker in various cancers. In the present study, the clinical performance of PITX2 methylation was validated in a HNSCC cohort by means of an independent analytical platform (Infinium HumanMethylation450 BeadChip, Illumina, Inc.).

Methods

A total of 528 HNSCC patients from The Cancer Genome Atlas (TCGA) were included in the study. Death was defined as primary endpoint. PITX2 methylation was correlated with overall survival and clinicopathological parameters.

Results

PITX2 methylation was significantly associated with sex, tumor site, p16 status, and grade. In univariate Cox proportional hazards analysis, PITX2 hypermethylation analyzed as continuous and dichotomized variable was significantly associated with prolonged overall survival of HNSCC patients (continuous: hazard ratio (HR) = 0.19 [95%CI: 0.04–0.88], p = 0.034; dichotomized: HR = 0.52 [95%CI: 0.33–0.84], p = 0.007). In multivariate Cox analysis including established clinicopathological parameters, PITX2 promoter methylation was confirmed as prognostic factor (HR = 0.28 [95%CI: 0.09–0.84], p = 0.023).

Conclusion

Using an independent analytical platform, PITX2 methylation was validated as a prognostic biomarker in HNSCC patients, identifying patients that potentially benefit from intensified surveillance and/or administration of adjuvant/neodjuvant treatment, i.e. immunotherapy.

http://ift.tt/2sfqAcl

Steroid Delivery to the Frontal Sinus Opening With a Bioabsorbable Implant vs. a Bioabsorbable Nasal Dressing

Condition:   Chronic Rhinosinusitis (Diagnosis)
Interventions:   Device: Bioabsorbable steroid releasing sinus implant;   Device: Bioabsorbable nasal dressing impregnated with steroid
Sponsor:   University of Rochester
Not yet recruiting - verified June 2017

http://ift.tt/2rwoFmv

Submucosa/Mucosal Pharyngeal Flap Trial

Condition:   Velopharyngeal Insufficiency
Interventions:   Procedure: Mucosa/submucosa Pharyngeal Flap;   Procedure: Standard of Care Pharyngeal Flap
Sponsor:   Lawson Health Research Institute
Not yet recruiting - verified June 2017

http://ift.tt/2sfYJZB

Clinical Study of Concurrent Radiotherapy With Concurrent Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma

Conditions:   Gastrointestinal Toxicity;   Blood / Bone Marrow Toxicity
Interventions:   Drug: Lobaplatin;   Device: linear accelerator
Sponsor:   Fifth Affiliated Hospital, Sun Yat-Sen University
Recruiting - verified June 2017

http://ift.tt/2rvRhw6

Autologous Muscle Derived Cells for Gastro-Intestinal Repair (AMDC-GIR) for Tongue Dysphagia

Condition:   Oropharyngeal Dysphagia
Intervention:   Drug: Autologous Muscle Derived Cells for Gastro-Intestinal Repair (AMDC-GIR)
Sponsors:   Peter Belafsky, MD;   Cook MyoSite
Recruiting - verified June 2017

http://ift.tt/2sfPWGV

Thyroid High-Impact Articles

FREE ACCESS through June 29, 2017.
Read now:

Latest Impact Factor: 5.515
The Official Journal of: American Thyroid Association

Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why?
R. Michael Tuttle, Bryan Haugen, Nancy D. Perrier 

Racial Disparities in Differentiated Thyroid Cancer: Have We Bridged the Gap?
Syed A. Shah, Mohamed A. Adam, Samantha M. Thomas, Randall P. Scheri, Michael T. Stang, Julie A. Sosa, Sanziana A. Roman

Serial Neck Ultrasonographic Evaluation of Changes in Papillary Thyroid Carcinoma During Pregnancy
Hye-Seon Oh, Won Gu Kim, Suyeon Park, Mijin Kim, Hyemi Kwon, Min Ji Jeon, Jeong Hyun Lee, Jung Hwan Baek, Dong Eun Song, Tae Yong Kim, Young Kee Shong, Won Bae Kim

Identification of Three Novel Fusion Oncogenes, SQSTM1/NTRK3, AFAP1L2/RET, and PPFIBP2/RET, in Thyroid Cancers of Young Patients in Fukushima
Keita Iyama, Michiko Matsuse, Norisato Mitsutake, Tatiana Rogounovitch, Vladimir Saenko, Keiji Suzuki, Mai Ashizawa, Chiyo Ookouchi, Satoshi Suzuki, Hiroshi Mizunuma, Toshihiko Fukushima, Shinichi Suzuki, Shunichi Yamashita

Postoperative Outcomes in Graves' Disease Patients: Results from the Nationwide Inpatient Sample Database
Gustavo A. Rubio, Tulay Koru-Sengul, Tanaz M. Vaghaiwalla, Punam P. Parikh, Josefina C. Farra, John I. Lew

Changes in Hepatic TRβ Protein Expression, Lipogenic Gene Expression, and Long-Chain Acylcarnitine Levels During Chronic Hyperthyroidism and Triiodothyronine Withdrawal in a Mouse Model
Kenji Ohba, Rohit Anthony Sinha, Brijesh Kumar Singh, Liliana Felicia Iannucci, Jin Zhou, Jean-Paul Kovalik, Xiao-Hui Liao, Samuel Refetoff, Judy Chia Ghee Sng, Melvin Khee-Shing Leow, Paul Michael Yen

The post Thyroid High-Impact Articles appeared first on American Thyroid Association.

http://ift.tt/2t6OgiW

Clinical Thyroidology for the Public – Highlighted Article

From Clinical Thyroidology for the Public: Exposure to radiation occurs with many imaging studies (like CT scans) and medical treatments (like radiation therapy for cancer). When radiation exposure involves the head and neck areas directly, the thyroid is exposed and there is an increased risk for the development of thyroid cancer in the future. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

Feedback & Suggestions

The post Clinical Thyroidology for the Public – Highlighted Article appeared first on American Thyroid Association.

http://ift.tt/2rAP4KZ

Roadmap for the clinical application of the basophil activation test in food allergy

Abstract

The diagnosis of IgE-mediated food allergy based solely on the clinical history and the documentation of specific IgE to whole allergen extract or single allergens is often ambiguous, requiring oral food challenges (OFC), with the attendant risk and inconvenience to the patient, to confirm the diagnosis of food allergy. This is a considerable proportion of patients assessed in Allergy clinics. The basophil activation test (BAT) has emerged as having superior specificity and comparable sensitivity to diagnose food allergy, when compared with skin prick test and specific IgE. BAT, therefore, may reduce the number of OFC required for accurate diagnosis, particularly positive OFC. BAT can also be used to monitor resolution of food allergy and the clinical response to immunomodulatory treatments. Given the practicalities involved in the performance of BAT, we propose that it be applied for selected cases where the history, skin prick test and/or specific IgE are not definitive for the diagnosis of food allergy. In the cases that the BAT is positive, food allergy is sufficiently confirmed without OFC; in the cases that BAT is negative or the patient has non-responder basophils, OFC may still be indicated. However, broad clinical application of BAT demands further standardisation of the laboratory procedure and of the flow cytometry data analyses, as well as clinical validation of BAT as a diagnostic test for multiple target allergens and confirmation of its feasibility and cost-effectiveness in multiple settings.

This article is protected by copyright. All rights reserved.

http://ift.tt/2t77B3r

A novel frameshift mutation in the XPC gene in a Moroccan patient: a case report

Xeroderma pigmentosum is an autosomal recessive inherited disease. The diagnosis is essentially based on clinical findings and the family history. This genodermatosis is genetically heterogeneous; to date, nin...

http://ift.tt/2stzGUP

Patch testing in psoriasis patients: results of a 30-year retrospective study

Abstract

Psoriasis and allergic contact dermatitis (ACD) are common, chronic T-lymphocyte mediated conditions. Although psoriasis patients are commonly referred for patch testing, there are conflicting views on the relationship between contact allergy and psoriasis. Previous studies have suggested ACD is less common in psoriasis¹ and that psoriatics are more difficult to sensitize^1,2,3.

This article is protected by copyright. All rights reserved

http://ift.tt/2sxm7oi

Outcomes of radiation therapy for advanced T3/T4 non-melanoma cutaneous squamous cell and basal cell carcinoma

Abstract

Non-melanoma cutaneous squamous and basal cell carcinoma (NMSC) is common, and most patients present with early stage (T1/T2) NMSC, which has an excellent prognosis. However, a minority of NMSC patients present with an advanced stage (T3/T4) primary tumor, which may be surgically unresectable but potentially curable with radiation therapy (RT). Because advanced NMSC is rare, studies^1-5 examining the outcomes of RT for patients with T3/T4 tumors are limited. As the outcomes of RT in this patient cohort are unclear, this study was undertaken to examine survival in a large cohort of patients treated at our institution and to explore variables associated with survival outcomes.

This article is protected by copyright. All rights reserved.

http://ift.tt/2t6Mjmu

Atopic dermatitis and risk of hypertension, type-2 diabetes, myocardial infarction and stroke in a cross-sectional analysis from the Canadian Partnership for Tomorrow Project

Abstract

Background

Atopic dermatitis (AD) has been associated with cardiovascular risk factors and diseases, but epidemiologic studies to date have found conflicting results.

Objectives

We aimed to determine the associations of AD with hypertension, type-2 diabetes (T2D), myocardial infarction (MI) and stroke.

Methods

We conducted a cross-sectional analysis of baseline data from the Canadian Partnership for Tomorrow Project which includes Canadian residents aged 30-74 living in British Columbia, Alberta, Ontario, Quebec and the Atlantic Provinces. We excluded participants with incomplete data on AD, hypertension, T2D, MI or stroke, who had type-1 or gestational diabetes or who developed any of the outcomes at an age prior to a diagnosis of AD, leaving 259,119 participants in our analysis. We used logistic regression to calculate age and sex- and multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) between AD and subsequent hypertension, T2D, MI and stroke.

Results

AD was reported by 21,379 (8.4%) participants. A total of 52,787 cases of hypertension, 12,739 cases of T2D, 4,390 cases of MI and 2,235 cases of stroke were reported by participants at enrollment. In the multivariable-adjusted model, AD was associated with decreased odds (OR, 95% CI) of hypertension (0.87, 0.83-0.90), T2D (0.78, 0.71-0.84), MI (0.87, 0.75-1.00) and stroke (0.79, 0.66-0.95).

Conclusions

We did not find evidence of a positive association between AD and subsequent hypertension, T2D, MI or stroke; AD was inversely associated with these outcomes in our study. Given our findings and the conflicting literature, AD is likely not a major risk factor for cardiovascular disease.

This article is protected by copyright. All rights reserved.

http://ift.tt/2t6Rbbt

Ig-seq: Deep sequencing of the variable region of Atlantic salmon IgM heavy chain transcripts

Publication date: August 2017
Source:Molecular Immunology, Volume 88
Author(s): Aleksei Krasnov, Sven Martin Jørgensen, Sergey Afanasyev
Immunoglobulin M plays a key role in systemic protection of Atlantic salmon against pathogens. Until recent, studies have focused on antigen-specific antibodies and little is known about the IgM repertoire: its size, developmental changes and responses to antigens. We report the development of deep sequencing protocol to characterize the repertoire of IgM heavy chain variable region. Its structure and changes were examined at the early stages of life and after infection with virus of cardiac myopathy. Clonotypes are identified by the V and J gene segments and amino acid sequences of CDR3, which determine the contribution of the heavy chain to the antigen binding properties. A major fraction of transcripts are functional while the rest are either sterile (transcribed from noncoding parts of Ig loci) or include stop codons. Despite marked difference in frequencies of combinations of V and J genes, the size of repertoire is large. The IgM diversity steadily increases after hatch followed with temporal reduction during smoltification and recovery after seawater transfer. Most clonotypes are present only in one fish. However multiple transcripts in uninfected fish are produced exclusively from a small fraction of shared clonotypes. While only 4.7% of clonotypes are detected in three and more fish, they comprise 35% of transcripts. Increased frequencies of most abundant clonotypes were detected in the head kidney and blood at ten weeks after viral infection and all were shared. Occurrence of the same clonotypes in multiple individuals can be explained with either their simple structure or exposure to common antigens. Complexity of CDR3 assessed by contents of non complementary nucleotides is slightly lower in shared clonotypes but difference is small. High nucleotide diversity of CDR3 with identical amino acid sequences suggests selection.



http://ift.tt/2su2rk8

A novel immune-related gene HDD1 of silkworm Bombyx mori is involved in bacterial response

Publication date: August 2017
Source:Molecular Immunology, Volume 88
Author(s): Kui Zhang, Guangzhao Pan, Yuzu Zhao, Xiangwei Hao, Chongyang Li, Li Shen, Rui Zhang, Jingjing Su, Hongjuan Cui
Insects have evolved an effective immune system to respond to various challenges. In this study, a novel immune-related gene, called BmHDD1, was first charactered in silkworm, Bombyx mori. BmHDD1 contained an ORF of 837bp and encoding a deduced protein of 278 amino acids. BmHDD1 was specifically expressed in hemocytes, and highly expressed at the molting and metamorphosis stages under normal physiological conditions. Our results suggested that BmHDD1 was mainly generated by hemocytes and secreted into hemolymph. Our results also showed that the expression level of BmHDD1 was significantly increased after 20E injection, which indicated that BmHDD1 might be regulated by ecdysone. More importantly, BmHDD1 was dramatically induced after injected with different types of PAMPs or bacteria, either in hemocytes or fat body. Those results suggested that BmHDD1 plays a role in developing and immunity system in silkworm, Bombyx mori.



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The young Van Dyck’s fingerprint: a technical approach to assess the authenticity of a disputed painting

The painting Saint Jerome, part of the collection of the Maagdenhuis Museum (Antwerp, Belgium), is attributed to the young Anthony van Dyck (1613–1621) with reservations. The painting displays remarkable compositional and iconographic similarities with two early Van Dyck works (1618–1620) now in Museum Boijmans van Beuningen (Rotterdam) and Nationalmuseum (Stockholm). Despite these similarities, previous art historical research did not result in a clear attribution to this master. In this study, the work's authenticity as a young Van Dyck painting was assessed from a technical perspective by employing a twofold approach. First, technical information on Van Dyck's materials and techniques, here identified as his fingerprint, were defined based on a literature review. Second, the materials and techniques of the questioned Saint Jerome painting were characterized by using complementary imaging techniques: infrared reflectography, X-ray radiography and macro X-ray fluorescence scanning. The insights from this non-invasive research were supplemented with analysis of a limited number of cross-sections by means of field emission scanning electron microscopy coupled with energy dispersive X-ray spectroscopy. The results demonstrated that the questioned painting's materials and techniques deviate from Van Dyck's fingerprint, thus making the authorship of this master very unlikely.

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Reduction in the Age-Adjusted Prevalence of Hearing Impairment in the United States

In Reply We thank Dr Fuller-Thomson for her suggestion. Prior publications have found associations between hearing impairment (HI) and blood lead levels (BLL) and cadmium. If associations exist, it is unknown what proportion of HI in the population may be attributable to lead and/or cadmium or other heavy metals. Heavy metal exposures co-occur with other factors that increase HI risk, including noisy occupations (eg, manufacturing, construction, transportation), smoking, and lower socioeconomic status, hence BLL could be a proxy for other characteristics.

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The Reduction in the Age-Adjusted Prevalence of Hearing Impairment in the United States An Unexpected Dividend of Phasing Out Leaded Gasoline?

In their article, "Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years," Hoffman and colleagues concluded that there was a 25% reduction in high-frequency hearing impairment and a 30% reduction in speech frequency hearing impairment in respondents' worse ear between the 1999 to 2004 cycle of the National Health and Nutrition Examination Survey (NHANES) and the 2011 to 2012 NHANES cycle. I hypothesize that this beneficial trend may be partially owing to the phasing out of leaded gasoline which resulted in an 87% decline in the geometric mean blood lead levels (BLL) in American adults from 13.1 μg/dL in the late 1970s to 1.64 μg/dL by the year 2000.

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A Supraclavicular Mass

A man presented with a 6-year history of a painless lump in the supraclavicular region; palpation detected a smooth, soft, and fluctuant mass, and computed tomography revealed a poorly circumscribed, heterogeneous, and cystic mass near the sternocleidomastoid muscle. What is your diagnosis?

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Foreign Body in a Premature Infant

This case examines the unique challenges of treating airway obstruction in neonates and describes an innovative technique of foreign body removal.

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Somatization and the Review of Systems

This cohort study examines the association between patient responses on a form used for review of systems and somatization.

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Comprehensive Hearing Aid Intervention at a Free Subspecialty Clinic

This observational cohort study describes the structure, feasibility, and outcomes of a free subspecialty clinic providing hearing aids to develop a paradigm for other programs interested in implementing similar projects.

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TCGA study of liver cancer reveals potential targets for therapy

Only two drugs are FDA-approved for liver cancer. This study of hepatocellular carcinoma found genetic alterations in tumors—including mutations in tumor-suppressing genes and high expression of immune checkpoint genes—that could be targets for drugs that already exist.

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Adjuvant Human Papillomavirus Vaccination for Secondary Prevention

This systematic review evaluates literature regarding human papillomavirus vaccination for secondary disease prevention after treatment of virus-related clinical disease.

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Support for the Diagnosis of CHARGE Syndrome—Reply

In Reply We appreciate the comments by Martin et al regarding our work and wish to respond to the excellent points that they raised.

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The 10 Commandments of Management for Acute Upper Airway Obstruction

This Viewpoint recommends 10 commandments or rules to follow when managing an acute upper airway obstruction in an infant or child.

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Slowly Enlarging Neck Mass

A man had an enlarging, nontender, neck mass at the angle of the mandible; computed tomography showed a heterogeneous mass adjacent to the tail of the left parotid, and pathologic findings revealed an encapsulated soft nodule within the specimen. What is your diagnosis?

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Learning Curves for Transoral Robotic Surgery for Oropharynx Carcinoma

This study assesses learning curves for 3 oncologic transoral robotic surgery specialists and assesses the number of cases needed to identify the learning phase.

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With Experience Comes Wisdom

What a pleasure it is to be able to comment on the Viewpoint by Grundfast et al, "The 10 Commandments of Management for Acute Upper Airway Obstruction in Infants and Children." Having just finished Michael Lewis's book The Undoing Project, which tells the story of Daniel Kahneman, Amos Tversky, and the birth of a new form of behavioral psychology and decision analysis, I am, of course, concerned about the inherent biases in trusting at face value the words of a senior statesman just because he looks and acts the part. Do we hold with heuristic beliefs that with an author's age and experience comes wisdom? I am now "trained" not to ask "who the author is" but "what has he or she actually done" before I trust the narrator that speaks to me.

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Otolaryngology Resident Duty Hour Restrictions and Outcomes

This study analyses the association of otolaryngology duty hour restrictions with surgery-specific outcomes, including complications following thyroid and parathyroid procedures performed before and after duty hour reform.

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Slow-Growing Infiltrative Sinonasal Mass

A man in his 50s was seen for a 6-month history of swelling involving the nasal bridge and right eye and intermittent ipsilateral epistaxis; endoscopy demonstrated a right-sided exophytic mass visible between the middle turbinate and nasal septum. What is your diagnosis?

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Definition of Close Surgical Margins in SCC of the Oral Tongue

This study evaluates specimens of squamous cell carcinoma of the oral tongue and compares close resection margins of less than 5.0 mm vs less than or equal to 2.2 mm for determination of risk for local recurrence as a positive margin.

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Conservative Treatment of Isolated Cricoid Cartilage Fractures From Blunt Trauma

This case series examines the conservative treatment of laryngotracheal traumas.

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Lingual Tonsillectomy for Treatment of Pediatric Obstructive Sleep Apnea

This meta-analysis evaluates the therapeutic outcomes of lingual tonsillectomy for treatment of pediatric obstructive sleep apnea.

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June 2017 Issue Highlights

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Traumatic Facial Injuries Among Elderly Nursing Home Residents

This population-based study estimates the incidence of facial trauma among elderly nursing home residents and details mechanisms of injury, injury characteristics, and patient demographic data.

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Inaugural Symposium on Advanced Surgical Techniques in Adult Airway Reconstruction

This report communicates the findings of the North American Airway Collaborative Symposium on Advanced Surgical Techniques in Adult Airway Reconstruction.

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Association of Body Mass Index in Head and Neck Reconstructive Surgery

This cohort study examines whether elevated body mass index is an independent risk factor for perioperative and postoperative infections after free tissue transfer in patients undergoing head and neck reconstructive surgery.

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A Young Man With Proptosis Causing Decreased Visual Acuity

A teenage boy had deteriorating vision and swelling in his right eye, right ear pain, and forehead tenderness; endoscopy revealed a fleshy, red soft-tissue mass in the superior nasal cavity. What is your diagnosis?

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Transoral Robotic Surgery and Long-term Outcomes and Costs

This cross-sectional analysis investigates the association of transoral robotic surgery with short- and long-term outcomes and costs in surgically treated patients with oropharyngeal cancer.

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Trismus and Swelling on the Side of the Face

A woman presented with mild to moderate trismus and swelling on the left side of the face of a few months' duration; physical examination was remarkable for left-sided facial swelling, and no deficits of the facial or trigeminal nerves were detected. What is your diagnosis?

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Long-term Surveillance Following Intralesional Steroid Injection for Benign Vocal Fold Lesions

This cohort study reports the findings of a long-term surveillance following intralesional steroid injection for benign vocal fold lesions.

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Head and Neck Squamous Cell Carcinoma Therapy With a WEE1 Inhibitor

This study maps the cellular response to the WEE1 inhibitor and explores the contributions of p53 to its effect.

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Gerechtelijke achterstand: de piñata van de wetgever

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How to Build a Supervised Autonomous System for Robot-Enhanced Therapy for Children with Autism Spectrum Disorder

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Removal of sensor tilt noise in fluxgate gradiometer survey data by applying one-dimensional wavelet filtering

Archaeological prospection with magnetometer instruments is performed in a wide range of field configurations, ranging from single probe setups to mobile arrays that allow combining multiple sensors. The latter type, whereby instruments are mounted onto a cart system, are particularly prone to motion‐induced noise. Sensor tilt, for example, causes in‐line noise that can obscure magnetic variations present. To remediate these effects, image processing techniques are the most frequently applied. However, while efficient in producing more levelled data plots, these procedures are often associated with a smoothing penalty whereby low‐intensity or small‐scale anomalies are masked. We propose a one‐dimensional signal processing approach, based on discrete wavelet analysis. By selecting wavelets that correspond to the motion‐induced noise patterns, such effects can be targeted more precisely, reducing the risk of feature masking or artefact creation. Evaluation of the proposed procedure on three fluxgate gradiometer datasets collected with a hand‐propelled push‐cart system, proved it a valid and more dedicated method to reduce the impact of motion induced noise in magnetometry data collected with cart mounted array setups.

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Enuresis: practical guidelines for primary care

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Supervised autonomy for online learning in human-robot interaction

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Establishing Biodiversity Damage resulting from GMOs

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Is old news no news? The impact of self-disclosure by organizations in crisis

This study examines the impact of self-disclosing incriminating information in the context of organizational crises. Study one indicates that when an organization self-discloses a crisis, participants devote less attention to subsequent negative publicity and any attention this information receives has less impact on the organizational post crisis reputation. An interaction between crisis timing strategy and crisis involvement in study two suggests that if an organization self-discloses a crisis, both participants' attention to negative publicity and the impact of this attention on post-crisis reputation are low, irrespective of crisis involvement. If an organization does not self disclose a crisis, however, crisis involvement affects consumers' attention to negative publicity but not the impact of this attention on the organizational post-crisis reputation. These findings offer an important indication that organizations in crisis should self-disclose potentially incriminating information. (C) 2016 Elsevier Inc. All rights reserved.

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Desmopressin (melt) therapy in children with monosymptomatic nocturnal enuresis and nocturnal polyuria results in improved neuropsychological functioning and sleep

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Comparison of Overall Resource Consumption of Biosolids Management System Processes Using Exergetic Life Cycle Assessment

This study focused on the evaluation of biosolids management systems (BMS) from a natural resource consumption point of view. Additionally, the environmental impact of the facilities was benchmarked using Life Cycle Assessment (LCA) to provide a comprehensive assessment. This is the first study to apply a Cumulative Exergy Extraction from the Natural Environment (CEENE) method for an in-depth resource use assessment of BMS where two full-scale BMS and seven system variations were analyzed. CEENE allows better system evaluation and understanding of how much benefit is achievable from the products generated by BMS, which have valorization potential. LCA results showed that environmental burden is mostly from the intense electricity consumption. The CEENE analysis further revealed that the environmental burden is due to the high consumption of fossil and nuclear-based natural resources. Using Cumulative Degree of Perfection, higher resource-use efficiency, 53%, was observed in the PTA-2 where alkaline stabilization rather than anaerobic digestion is employed. However, an anaerobic digestion process is favorable over alkaline stabilization, with 35% lower overall natural resource use. The most significant reduction of the resource footprint occurred when the output biogas was valorized in a combined heat and power system.

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Effect of liquid hot water pre-treatment on sugarcane press mud methane yield

Sugarcane press mud was pretreated by liquid hot water (LHW) at different temperatures (140–210 °C) and pre-treatment times (5–20 min) in order to assess the effects on the chemical oxygen demand (COD) solubilisation, inhibitors formation and methane yield. The experimental results showed that a high degree of biomass solubilisation was possible using LHW. Higher methane yields were obtained at lower severities (log(Ro) = 2.17–2.77) with (i) mild temperatures (140–150 °C) and long contact times (12.5 min, 20 min) or (ii) mild temperatures (175 °C) with short contact time (2 min). The highest increase in methane yield (up to 63%) compared to the untreated press mud was found at 150 °C for 20 min. At temperatures of 200 °C and 210 °C, low methane efficiency was attributed to the possible formation of refractory compounds through the Maillard reaction.

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Environmental sustainability assessment of food waste valorization options

Food waste can be valorized through different technologies, such as anaerobic digestion, incineration, and animal feed production. In this study we analyzed the environmental performance of two food waste valorization scenarios from a company of the retail sector in Belgium, through exergy analysis, exergetic life cycle assessment (ELCA), and a traditional life cycle assessment (LCA). In scenario 1 all food waste was considered to be valorized in an anaerobic digestion (producing electricity, heat, digestate and sorting the packaging material to be used as fuel for cement industry), while in scenario 2 a bread fraction was valorized to produce animal feed and a non-bread fraction was valorized in an anaerobic digestion (producing the same products on scenario 1, but in lower amounts). Scenario 2 was 10% more efficient than scenario 1 in the exergy analysis. For the ELCA and the single score LCA, scenario 2 presented lower environmental impacts than scenario 1 (32% and 26% lower, respectively). These results were mainly due to the avoided products from traditional supply chain (animal feed produced from agricultural products) and lower exergy loss at the feed production plant. Nevertheless, the high dry matter content of the bread waste played an important role on these results, therefore it should be pointed out that valorizing food waste to animal feed seems to be a better option only for the fractions of food waste with low water content (as bread waste).

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Consequences of Coexistence Policies on the Environment: A Different View

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Effective roughness modelling as a tool for soil moisture retrieval from C-and L-band SAR

Soil moisture retrieval from Synthetic Aperture Radar (SAR) using state-of-the-art backscatter models is not fully operational at present, mainly due to difficulties involved in the parameterisation of soil surface roughness. Recently, increasing interest has been drawn to the use of calibrated or effective roughness parameters, as they circumvent issues known to the parameterisation of field measured roughness. This paper analyses effective roughness parameters derived from C- and L-band SAR observations over a large number of agricultural seedbed sites in Europe. It shows that parameters may largely differ between SAR acquisitions, as they are related to the observed backscatter coefficients and variations in the local incidence angle. Therefore, a statistical model is developed that allows for estimating effective roughness parameters from microwave backscatter observations. Subsequently, these parameters can be propagated through the Integral Equation Model (IEM) for soil moisture retrieval. It is shown that fairly accurate soil moisture results are obtained both at C- and L-band, with an RMSE ranging between 4 vol% and 6.5 vol%.

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Using the seasonal and temporal precipitation concentration index for characterizing the monthly rainfall distribution in Spain

The concentration of the rainfall in a year is an important aspect of the climate. An unbalanced distribution of rainfall evokes periods of rainfall excess and periods of drought which make plant and crop growth difficult. Rainfall concentration needs to be considered in the assessment and the prediction of soil losses by water erosion. A statistical derived index, known as the Precipitation Concentration Index is presented to be used in quantifying the relative distribution of the rainfall patterns. Based on the available data sets, two different calculation procedures were used for deriving the Precipitation Concentration Index (Seasonal and Temporal). The application of the two procedures on the rainfall data of two meteorological stations from different climatological regions revealed how the two methods can be used in quantifying the seasonal and temporal concentration of the rainfall. The rainfall data from meteorological stations situated in a central transect of Spain were used in this investigation. From the observed results, it can be concluded that in the Southern part of the transect, the concentration of the rainfall is not a seasonal effect (not strongly confined by a typical dry or wet period) but a temporal effect (bounded to the unreliable, unpredictable character of the rainfall).

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Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: a retrospective case -control study

Abstract

Background

Eustachian tube (ET) dysfunction can be very difficult to diagnose accurately. Our aim is to determine whether a newly developed sonotubometric test using clicks can reliably detect ET opening during swallowing in normal ET subjects, and patulous ET (PET) in subjects with ET dysfunction.

Methods

Sixteen subjects (19 normal ET ears and 6 PET ears) were individually placed in a sound-isolated audiometry booth and subjected to a 1000Hz click train stimulus, played through the nose. PET subjects were identified through the ET clinic at our institution, while healthy subjects were recruited. Transmission through the ET was recorded by a microphone in the ear ipsilateral to the presenting nostril, during no swallow and swallow states, and this was used to compute a power ratio (power in the frequency range of interest to the whole frequency range). The power transmission ratio both before and after the swallow was averaged, and represented the baseline (BaseR). The power transmission ratio during swallow represented the peak (PeakR). The same process was repeated in the absence of a stimulus to account for swallowing noise. Wilcoxon rank rum tests were performed to determine statistical significance.

Results

It was found that for healthy ET patients, the median difference between the PeakR and BaseR was 0.51 (p = 0.004). For the PET patients in this study, the median difference between the PeakR and the BaseR was 3.30 (p = 0.041). Comparing the baseline between groups revealed that PET patients had a median BaseR 1.05 higher than healthy ET patients. PET patients had a median PeakR of 3.84 higher than healthy ET patients. Both were deemed to be statistically significant (p = 0.003, p = 0.003 respectively). A significant difference was found between median PeakR for the stimulus and no-stimulus condition for the healthy ET group (0.59, p < 0.001) and for the PET group (4.39, p = 0.031), indicating that it was unlikely that swallowing noise caused false positive results.

Conclusion

The results of this study suggest that a novel click stimulus is capable of detecting ET opening during swallowing in healthy patients as well as highlighting PET in diseased subjects.

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Asbestos Exposure and Cancer Risk

A fact sheet about asbestos, asbestos-related diseases, and who to contact for more information.

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Cohort study of preoperative blood pressure and risk of 30-day mortality after elective non-cardiac surgery

Abstract

Background: Preoperative blood pressure (BP) thresholds associated with increased postoperative mortality remain unclear. We investigated the relationship between preoperative BP and 30-day mortality after elective non-cardiac surgery.Methods: We performed a cohort study of primary care data from the UK Clinical Practice Research Datalink (2004–13). Parsimonious and fully adjusted multivariable logistic regression models, including restricted cubic splines for numerical systolic and diastolic BP, for 30-day mortality were constructed. The full model included 29 perioperative risk factors, including age, sex, comorbidities, medications, and surgical risk scale. Sensitivity analyses were conducted for age (>65 vs <65 years old) and the timing of BP measurement.Results: A total of 251 567 adults were included, with 589 (0.23%) deaths within 30 days of surgery. After adjustment for all risk factors, preoperative low BP was consistently associated with statistically significant increases in the odds ratio (OR) of postoperative mortality. Statistically significant risk thresholds started at a preoperative systolic pressure of 119 mm Hg (adjusted OR 1.02 [95% confidence interval (CI) 1.01–1.02]) compared with the reference (120 mm Hg) and diastolic pressure of 63 mm Hg [OR 1.24 (95% CI 1.03–1.49)] compared with the reference (80 mm Hg). As BP decreased, the OR of mortality risk increased. Subgroup analysis demonstrated that the risk associated with low BP was confined to the elderly. Adjusted analyses identified that diastolic hypertension was associated with increased postoperative mortality in the whole cohort.Conclusions: In this large observational study we identified a significant dose-dependent association between low preoperative BP values and increased postoperative mortality in the elderly. In the whole population, elevated diastolic, not systolic, BP was associated with increased mortality.

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Les enjeux nouveaux de l'écopoétique

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Local Moufang sets

All known Moufang sets arise, in some way or another, from an algebraic structure which can be called `division' in some way. In this PhD dissertation, I made an attempt to develop a theory of local Moufang sets, which generalize Moufang sets in a way to allow constructing using the corresponding local algebraic structures. In the first of the two major parts of the dissertation, I develop the theory of local Moufang sets, while in the second part, some examples are constructed. The most general example constructed arises from a local Jordan pair (which corresponds to a local Jordan algebra), and one of the main theorems characterizes these local Moufang sets.

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Geometric design of curvature and widening of bicycle paths

For better cycling infrastructure and improved bicycle safety, upgraded guidelines and an advanced design classification system are required, which take into consideration the geometry of roads, the acting forces and the dimensions of the bicycle. The rise in the number of accidents, puts a question mark to the current bicycle classification systems in terms of bicycle safety. Currently, a universally accepted bicycle classification system does not exist. This study aims to provide a unique set of design parameters, developed by deriving various formulas related to the bike riding dynamics, which could be the basis for a new classification system. This study evaluates bicycle paths without conducting a real life experiment. This study would however prove fruitful for policy framework and bicycle safety in near future.

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Les ciels de Rolin. La spectaculaire et dérisoire beauté du monde

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Cardiomyopathy and anaesthesia

1A012A033J02

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14 Juillet : réinventer le mythe

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Maylis de Kerangal répond aux questions de Sara Buekens

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Are Family Firms Good Employers?

Family firms employ about 60 percent of the global workforce. While it is widely assumed that they are good employers, data about their conduct is mixed. In this study, we extend stewardship and agency theories to test competing propositions about the impact of family on employment practices using data from 14,961 private Belgian firms over a 19-year period. Higher investments, lower dividend payout, and higher risk tolerance indicate that family firms are better financial stewards of their companies than nonfamily firms. However, family firms are worse organizational stewards than nonfamily firms: They offer lower compensation, invest less in employee training, and exhibit higher voluntary turnover and lower labor productivity. Further, and contrary to earlier research, we find that financial practices in private family firms do not change over time, and that the deleterious influence of family on employment practices rises with both firm age and with heightened family involvement. Together, our findings suggest that a more nuanced understanding of stewardship and agency theory is needed to understand the impact of family on the governance of private firms.

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Mechanisms underlying induction of allergic sensitization by Pru p 3

Abstract

Background

Recently, the nature of the lipid-ligand of Pru p 3, one of the most common plant food allergens in Southern Europe, has been identified as a derivative of the alkaloid camptothecin bound to phytosphingosine. However, the origin of its immunological activity is still unknown.

Objective

We sought to evaluate the role of the Pru p 3 lipid- ligand in the immunogenic activity of Pru p 3.

Methods

In vitro cultures of different cell types (monocyte-derived dendritic cells (moDCs), PBMCs and epithelial and iNKT-hybridoma cell lines) have been used to determine the immunological capacity of the ligand, by measuring cell proliferation, maturation markers and cytokine production. To study the capacity of the lipid-ligand to promote sensitization to Pru p 3 in vivo, a mouse model of anaphylaxis to peach has been produced and changes in the humoral and basophil responses have been analyzed.

Results

The lipid-ligand of Pru p 3 induced maturation of moDCsc and proliferation of PBMCs. Its immunological activity resided in the phytosphingosine tail of the ligand. The adjuvant activity of the ligand was also confirmed in vivo, where the complex of Pru p 3-ligand induced higher levels of IgE than Pru p 3 alone. The immunological capacity of the Pru p 3 ligand was mediated by CD1d, as maturation of moDCs was inhibited by anti-CD1d antibodies and Pru p 3-ligand co-localized with CD1d on epithelial cells. Finally, Pru p 3-ligand presented by CD1d was able to interact with iNKTs.

Conclusions & Clinical Relevance

The Pru p 3 lipid-ligand could act as an adjuvant to promote sensitization to Pru p 3, through its recognition by CD1d receptors. This intrinsic adjuvant activity of the accompanying lipid cargo could be a general essential feature of the mechanism underlying the phenomenon of allergenicity.

This article is protected by copyright. All rights reserved.

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Validity of the Assessment of Population Health and Use of Health Care in a National Health Interview Survey

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Tracking HCV protease population diversity during transmission and susceptibility of founder populations to antiviral therapy

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3-Chlorotyrosine formation in ready-to-eat vegetables due to hypochlorite treatment and its dietary exposure and risk assessment

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Expanding the Host Range of Hepatitis C Virus through Viral Adaptation

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Graag meer welzijnsnuances in het pensioendebat: Een derde van de Belgische en Nederlandse oudere werknemers ervaart werken als een onvrijwillige keuze

Aan de hand van de Europese SHARE (Survey of Health, Ageing and Retirement in Europe) dataset evalueren we de gevolgen van een beleid dat aanzet tot langer werken (vooral via het beperken van de mogelijkheden om vervroegd uit te treden). We stellen vast dat dit beleid er voor zorgt dat mensen later op pensioen gaan en we willen nagaan welke de welzijnseffecten zijn van dit langer werken. Welzijnseffecten worden meestal niet in rekening genomen in het pensioendebat. We zien welzijn als een breed begrip dat vraagt om aandacht voor verschillende levensdomeinen en dus verder kijkt dan louter financiële overwegingen (bijvoorbeeld ook kijken naar mentale en fysieke gezondheid, sociale relaties, …). De vrijwilligheid van keuzes is een belangrijke determinant voor dit algemeen welzijn. Daarom maken we een onderscheid tussen vrijwillig en onvrijwillig werkenden. We bekijken naast België ook Nederland waar het pensioenbeleid het uittreden al langer geleden beperkte. In beide landen ervaart zowat een derde van de werkende vijftigplussers zijn arbeidssituatie als onvrijwillig. Deze groep rapporteert gemiddeld een significant lagere levenstevredenheidsscore dan de groep vrijwillig werkenden. Deze vaststelling vraagt om meer welzijnsnuances in het pensioendebat en om meer aandacht voor een flankerend beleid gericht op 'werkbaar werk' voor ouderen.

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Tuning a cellular lipid kinase activity adapts hepatitis C virus to replication in cell culture

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Successful Engraftment of Human Hepatocytes in uPA-SCID and FRG® KO Mice

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The impact of exposure to other countries on life satisfaction: an international application of the relative income hypothesis

The cause of international differences in life satisfaction is usually ascribed to differences in living standards. Yet, despite improving living standards in a lot of middle-income countries, significant differences in life satisfaction between middle- and high-income countries remain. This paper examines if there is an international comparison effect and assesses to what extent the relative income hypothesis can be applied to explain international differences in life satisfaction. We test this by analyzing how exposure to other countries impacts life satisfaction. It is hypothesized that higher exposure to other countries in low- and middle-income countries has a negative effect due to increased aspirations and relative deprivation, while the opposite holds true for rich countries. We draw on data from the World Value Survey, the World Bank and the KOF Globalization index to perform a multilevel analysis. The results suggest that an international comparison effect indeed exists and is capable of partially explaining international differences in life satisfaction. Additional analyses reveal that people in lower income classes, in all countries, are affected more by exposure to other countries, indicating that individual characteristics are important when assessing the impact of exposure on life satisfaction. We demonstrate the robustness of these findings by showing that both sub-indicators of exposure, informational flow and international contact, have an impact on life satisfaction that is similar to that of our overall exposure-index.

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Histamine Receptor 2 Modifies iNKT Cell Activity within the Inflamed Lung

Abstract

Background

Histamine is a key immunoregulatory mediator and can dampen proinflammatory responses via activation of histamine receptor 2 (H₂R). The aim of this study was to determine the role of H₂R in modulating lung inflammatory responses.

Methods

H₂R was blocked using famotidine or activated using dimaprit in both the ovalbumin (OVA) and house dust mite extract (HDM) murine models of respiratory inflammation. H₂R-deficient animals and CD1d/ H₂R-deficient animals were utilized to examine the CD1d presentation of lipid antigens (αGal-Cer or OCH) to invariant Natural Killer T (iNKT) cells.

Results

Famotidine treatment resulted in more severe airway disease in the OVA model, while dimaprit treatment significantly reduced disease severity. Both OVA and HDM-induced airway disease were more severe in H₂R-deficient animals. Flow cytometric analysis of lung tissue from H₂R-deficient animals revealed increased numbers of CD1d⁺ dendritic cells and increased numbers of iNKT cells. In vitro, αGal-Cer-stimulated iNKT cells from H₂R-deficient mice secreted higher levels of IL-4, IL-5 and GM-CSF. In vivo, αGal-Cer or OCH administration to the lung resulted in enhanced mucus secretion, inflammatory cell recruitment and cytokine production in H₂R-deficient or famotidine-treated animals, while dimaprit dampened the lung iNKT cell response to αGalCer. Removal of iNKT cells in H₂R-deficient (CD1d^-/-H₂R^-/-) animals normalized the lung response to HDM.

Conclusion

The deliberate activation of H₂R, or its downstream signaling molecules, may represent a novel therapeutic target for chronic lung inflammatory diseases, especially when CD1d-mediated presentation of lipid antigens to iNKT cells are contributing to the pathology.

This article is protected by copyright. All rights reserved.

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Is the atopic march related to confounding by genetics and early life environment? A systematic review of sibship and twin data

Abstract

A popular hypothesis known as the atopic march proposes a set of sequential allergy and respiratory disorders in early childhood contributes enormously to the burden of disease in developed countries. Although the concept of the atopic march has been refined and strengthened by many cross-sectional and longitudinal studies linking eczema as the initial manifestation with progression to hay fever and then asthma, there is yet no definitive proof that the atopic march is the primary causal factor in childhood allergic disease. This debate is mainly related to the controversy around potential confounding of these associations by genetic and environmental factors. Family studies are ideally suited to unravelling the role of these factors. While multiple reviews have synthesised evidence from studies investigating this question, no review to date has explored specific evidence generated by twin and sibling studies to understand the aetiology of atopic march diseases. Our aim was to conduct a systematic review of twin and sibling studies that examine the allergic phenotypes that form the atopic march, to determine whether such analyses of data from these studies attempt to control for the effect confounding by shared factors, and to report estimates the magnitude of associations between multiple phenotypes. Our review suggests that (1) genetics play a bigger role predisposing eczema to hay fever and eczema to asthma than environmental factors; and (2) the link between eczema, and asthma and hay fever is independent of shared early life environmental factors and genetics.

This article is protected by copyright. All rights reserved.

http://ift.tt/2rzwWRA

Editorial Board/Aims & Scope

Publication date: July 2017
Source:Oral Oncology, Volume 70





http://ift.tt/2ss6kq6

Postgastric bypass hypoglycaemia in a patient with end-stage renal disease: a diagnostic and management pitfall

Roux-en-Y gastric bypass (RYGB) surgery is currently one of the most popular procedures to aid weight loss. Hypoglycaemia associated with gastric bypass surgery is an underdiagnosed but life-threatening potential consequence of the surgical procedure. We present a case of a 44-year-old woman with end-stage renal disease presenting with refractory hypoglycaemia after 10 years of RYGB. Extensive history and work-up excluded medications, renal disease, insulinoma and dumping syndrome as the cause of hypoglycaemia. Dietary modifications or pharmacological trial of drugs did not ameliorate her symptoms with progressive worsening of hypoglycaemia leading to continuous dextrose infusion. Distal pancreatectomy was performed with subsequent resolution of hypoglycaemia. Surgical pathology results showed diffuse hyperplastic islet cells, confirming the diagnosis of postgastric bypass hypoglycaemia.

http://ift.tt/2sD5OFZ

Saddle-nose and bilateral cauliflower ear deformities with pyoderma gangrenosum-like ulcers, cavitary pulmonary lesions, digital gangrene and pulselessness in a young female

We report a young female who presented with saddle-nose and bilateral cauliflower ear deformities along with pyoderma gangrenosum-like ulcers, digital gangrene and pulselessness. Subsequently, she was found to have bilateral conductive hearing loss, a corneal opacity, mild aortic regurgitation and radiological evidence of cavitary changes in lungs and aortoarteritis. Our patient had a constellation of symptoms which posed a diagnostic challenge. Finally, a diagnosis of relapsing polychondritis with several unusual features was made. Overlap with Takayasu's arteritis and granulomatosis with polyangitis, which has been reported rarely in the literature, cannot be excluded.

http://ift.tt/2sw5Vn4

Renal cell carcinoma with isolated breast metastasis

Renal cell carcinoma (RCC) is a highly prevalent disease worldwide with many cases being metastasised to various organs during the time of initial presentation. Metastatic RCC to the breast is a rare entity and can mimic primary breast carcinoma. In this article, we present a 63-year-old Caucasian woman presented with a breast mass that was detected by screening mammography and found to have a biopsy proven grade-II clear RCC in the breast tissue. Despite the high incidence and prevalence of primary breast cancer, metastasis from extramammary should be suspected in patients with a prior history of other cancers. In this brief literature review, we also highlight the survival benefit from surgery and close follow-up in selected group of patients with metastatic, metachronous and solitary RCC.

http://ift.tt/2rk2A6v

Gamma-delta T-cell lymphoma of skin, eye and brain presenting with visual loss

A young man presented with rapid, predominantly right-sided visual loss with a background of multifocal skin lesions. Visual acuity was right hand movements, left 6/5 Snellen, deteriorating to 6/38. He showed panuveitis with bilateral multifocal retinal infiltrates and retinal vasculitis. Multifocal brain lesions were identified. Biopsy of both skin and vitreous showed atypical lymphocytes, and immunohistochemistry confirmed T-cell lymphoma of gamma–delta subtype. Management with the CODOX-M/IVAC polychemotherapy regimen achieved rapid response including resolution of intraocular changes and substantial improvement of visual acuity to right 6/7.5, left 6/6. However, he relapsed before planned stem cell transplantation. Salvage with the gemcitabine/dexamethasone/cisplatin regimen, although temporarily effective, was followed by further relapse including widespread brain involvement, and he succumbed 10 months after presentation.

http://ift.tt/2sCUHNb

Acute massive gastric dilatation causing ischaemic necrosis and perforation of the stomach

Acute massive gastric dilatation (AMGD) is a rare distinctive condition but associates with high morbidity and mortality. Though usually seen in patients with eating disorders, many aetiologies of AMGD have been described. The distension has been reported to cause gastric necrosis with or without perforation, usually within 1–2 days of an inciting event of AMGD.

We report the case of a 58-year-old male who presented with gastric perforation associated with AMGD 11 days after surgical relief of a proximal small bowel obstruction. The AMGD arose from a closed loop obstruction between a tumour at the gastro-oesophageal junction and a small bowel obstruction as a result of volvulus around a jejunal feeding tube.

To our knowledge, this is the first case of a closed loop obstruction of this aetiology reported in the literature, and the presentation of this patient's AMGD was notable for the delayed onset of gastric necrosis. The patient underwent an exploratory laparotomy and a partial gastrectomy to excise a portion of his perforated stomach. Surgeons should be aware of the possibility of delayed ischaemic gastric perforation in cases of AMGD.

http://ift.tt/2rjBfRW

Fingolimod-associated macular oedema

Description

A 54-year-old female with history of relapsing remitting multiple sclerosis (MS) was switched from interferon beta-1A (Avonex, Biogen) to fingolimod (Gilenya, Novartis) therapy after having two clinical relapses within 2 years while on treatment. As part of her treatment protocol, she was referred to the local ophthalmology unit for a baseline screen and periodic review thereafter. Three months into her treatment, she complained of blurring of vision in her right eyeA visual acuity assessment showed a reduction in best-corrected visual acuity (BCVA) from 6/6 to 6/12. An optical coherence tomography (OCT) scan showed evidence of oedema and cystic changes within her right macula (figure 1). She was diagnosed with fingolimod-associated macular oedema (FAME) and was started on topical steroids (prednisolone acetate 1% four times a day) and non-steroidal treatment to her right eye. The patient showed an initial response to treatment in the first month and was closely...

http://ift.tt/2sDiOLX

Phosphorus use efficiency of improved faba bean (Vicia faba) varieties in low-input agro-ecosystems

The use of phosphorus (P)-efficient legumes is a prerequisite for sustainable intensification of low-input agro-ecosystems. A study was undertaken in a farmer's field in the tropical highlands of Ethiopia to assess the agronomic performance, P acquisition efficiency (PAE), and P utilization efficiency (PUE) of six improved faba bean varieties (Vicia faba L. var. CS-20DK, Degaga, Gebelcho, Moti, Obse, Walki) without and with P application. Varieties showed significant variations in PUE, but P application had no significant effect on PUE. Variety Moti demonstrated highest PUE of 272 kg grain kg(-1) P, which was 1.6-fold higher than the lowest PUE (164 kg grain kg-1 P) of Gebelcho. PUE was significantly and positively correlated with grain yield (r = 0.542) and negatively correlated with shoot PAE (r = -0.541), indicating that PUE is important for grain yield. The results demonstrate that variations in grain and biomass yield of faba beans were largely due to differences in PUE and not due to PAE. Therefore, we argue that genetic resources of faba bean varieties showing optimal agronomic performance and high PUE in low-input agro-ecosystems should be better explored. Introduction of such varieties in low-input cereal-based cropping systems could improve and enhance P use efficiency at the system level.

http://ift.tt/2ruyC3E

A critical view on microplastic quantification in aquatic organisms

http://ift.tt/2s4pTUQ

Early and late outcomes after surgical management of congenital vascular rings.

http://ift.tt/2tpzzH8

Contemporary analysis and numerical simulation of revisited long-term creep tests on reinforced concrete beams from the Sixties

The stresses and deformations in concrete change over time as a result of the creep- and shrinkage deformations of concrete. Different material models are available in literature in order to predict this time-dependent behaviour. These material models mostly have been calibrated on large datasets of creep specimens. In order to verify the accuracy of the contemporary material models with respect to the prediction of the creep behaviour of reinforced concrete beams, a cross-sectional calculation tool which employs the age-adjusted effective modulus has been developed and used to analyse an original set of 4 year-long creep data on reinforced beams from the 1960's. Six commonly used material models for the prediction of creep and shrinkage are considered in the current investigation: CEB-FIP Model Code 1990–1999, fib Model Code 2010, the model of EN1992-1-1, model B3, the Gardner Lockmann 2000 model, and ACI 209. The data on reinforced beams relates to an experimental investigation in collaboration with six major research institutes in Belgium. From 1967 until 1972 thirty-two reinforced beams with different reinforcement ratios were subjected, up until 4.5 years, to different stress levels in a four point bending configuration with a span of 2.8 m. In this paper a comparison between the measurements and the calculated deflections and strains is reported. Further, the deflections were also predicted using the contemporary creep models in combination with the nonlinear creep correction factor provided in EN1992-1-1, since the maximum concrete stresses in the beams were outside the service stress range of each of the models. Correcting for the nonlinearity of the creep coefficient significantly improves the calculated deflections. The most accurate predictions of the deflections at early age were obtained by the model of fib Model Code 2010. The Gardner Lockmann 2000 model exhibits the highest accuracy with respect to deflections at the end of loading and with respect to the creep rate.

http://ift.tt/2srra8P

Self-anchored suspension bridges with prestressed concrete deck : Some historic examples

This paper deals with a challenging bridge type, which is not very well known i.e. self-anchored suspension bridges with prestressed concrete deck. Some of these bridges were built in the 1950's over a canal around the city of Ghent after a design by Prof. Daniël Vandepitte (1922–2016). Prof. Vandepitte, passed away at the age of 94 years and was a brilliant teacher in structural analysis. He was a successor of Prof. Gustave Magnel (1889–1955) in the field of structural analysis and he designed several remarkable bridges in the early 1950's before he was appointed at Ghent University.

http://ift.tt/2tpsxCh

Response of hydrological processes to input data in high alpine catchment : an assessment of the Yarkant River basin in China

Most studies of input data used in hydrological models have focused on flow; however, point discharge data negligibly reflect deviations in spatial input data. To study the effects of different input data sources on hydrological processes at the catchment scale, eight MIKE SHE models driven by station-based data (SBD) and remote sensing data (RSD) were implemented. The significant influences of input variables on water components were examined using an analysis of the variance model (ANOVA) with the hydrologic catchment response quantified based on different water components. The results suggest that compared with SBD, RSD precipitation resulted in greater differences in snow storage in the different elevation bands and RSD temperatures led to more snowpack areas with thinner depths. These changes in snowpack provided an appropriate interpretation of precipitation and temperature distinctions between RSD and SBD. For potential evapotranspiration (PET), the larger RSD value caused less plant transpiration because parameters were adjusted to satisfy the outflow. At the catchment scale, the spatiotemporal distributions of sensitive water components, which can be defined by the ANOVA model, indicate that this approach is rational for assessing the impacts of input data on hydrological processes.

http://ift.tt/2ss9dXH

Type B aortic dissection triggered by heart transplantation in a patient with Marfan syndrome

http://ift.tt/2tpiY6f

Analyzing runoff processes through conceptual hydrological modeling in the Upper Blue Nile Basin, Ethiopia

Understanding runoff processes in a basin is of paramount importance for the effective planning and management of water resources, in particular in data-scarce regions such as the Upper Blue Nile. Hydrological models representing the underlying hydrological processes can predict river discharges from ungauged catchments and allow for an understanding of the rainfall-runoff processes in those catchments. In this paper, such a conceptual process-based hydrological model is developed and applied to the upper Gumara and Gilgel Abay catchments (both located within the Upper Blue Nile Basin, the Lake Tana sub-basin) to study the runoff mechanisms and rainfall-runoff processes in the basin. Topography is considered as a proxy for the variability of most of the catchment characteristics. We divided the catchments into different runoff production areas using topographic criteria. Impermeable surfaces (rock outcrops and hard soil pans, common in the Upper Blue Nile Basin) were considered separately in the conceptual model. Based on model results, it can be inferred that about 65% of the runoff appears in the form of interflow in the Gumara study catchment, and baseflow constitutes the larger proportion of runoff (44-48%) in the Gilgel Abay catchment. Direct runoff represents a smaller fraction of the runoff in both catchments (18-19% for the Gumara, and 20% for the Gilgel Abay) and most of this direct runoff is generated through infiltration excess runoff mechanism from the impermeable rocks or hard soil pans. The study reveals that the hillslopes are recharge areas (sources of interflow and deep percolation) and direct runoff as saturated excess flow prevails from the flat slope areas. Overall, the model study suggests that identifying the catchments into different runoff production areas based on topography and including the impermeable rocky areas separately in the modeling process mimics the rainfall-runoff process in the Upper Blue Nile Basin well and yields a useful result for operational management of water resources in this data-scarce region.

http://ift.tt/2srNxei

Spatio-temporal sedimentation patterns in beaver ponds along the Chevral river, Ardennes, Belgium

http://ift.tt/2tpBfQQ

Studying denitrification by aerobic endospore-forming bacteria in soil

http://ift.tt/2ss7Rfy

Climate and vegetation water use efficiency at catchment scales

http://ift.tt/2tpDhRe

Spatial and temporal variations in surface water nitrate concentrations in a mixed land use catchment under humid temperate climatic conditions

http://ift.tt/2srT6cW

Effects of vertical resolution and map scale of digital elevation models on geomorphological parameters used in hydrology

The advent of digital elevation models (DEMs) has made it possible to objectively extract, calculate and store geomorphological parameters for hydrological modelling at several scales. For a grid-based DEM, the threshold area used to extract the channel network is analogous to the scale of the map produced. In addition to the map scale, the effects of the vertical resolution of the DEM on some frequently used geomorphological parameters in hydrology are examined using high-resolution DEMs of two natural and two artificial catchments. The vertical resolution was varied between 1 cm and 1 m, the most common vertical resolution of DEMs. At a fixed map scale, the mean absolute percentage error in the geomorphological parameters caused by a decrease in vertical resolution is within the range 0-5% for the medium-sized catchments and 0-10% for the small catchments studied. Although it is true that a change in vertical resolution may cause a change in the individual pixel slope, area and topographic index (area/slope), particularly in low relief terrain, their cumulative distributions do not show any significant change with the vertical resolution. The shape of the normalized width function is not very sensitive to the vertical resolution and the map scale. For small catchments order change may occur at different map scales for the different vertical resolution DEMs of the same catchment, causing a significant change in order-related parameters such as Horton ratios. It is suggested that the vertical resolution of the DEM of a catchment be considered satisfactory for most hydrological applications if the ratio of the average drop per pixel and vertical resolution is greater than unity. This ratio criterion could be used to define the minimum pixel area for reliable channel network definition for any given vertical resolution. The minimum pixel area places a lower bound on the horizontal resolution with which a channel network can be extracted from a DEM. These results could potentially be used to assess the adequacy for hydrological purposes of existing and proposed digital elevation databases.

http://ift.tt/2tpyIWN

Effects on vertical resolution and map scale of digital elevation models on geomorphological parameters used in hydrology

The advent of digital elevation models (DEMs) has made it possible to objectively extract, calculate and store geomorphological parameters for hydrological modelling at several scales. For a grid-based DEM, the threshold area used to extract the channel network is analogous to the scale of the map produced. In addition to the map scale, the effects of the vertical resolution of the DEM on some frequently used geomorphological parameters in hydrology are examined using high-resolution DEMs of two natural and two artificial catchments. The vertical resolution was varied between 1 cm and 1 m, the most common vertical resolution of DEMs. At a fixed map scale, the mean absolute percentage error in the geomorphological parameters caused by a decrease in vertical resolution is within the range 0-5% for the medium-sized catchments and 0-10% for the small catchments studied. Although it is true that a change in vertical resolution may cause a change in the individual pixel slope, area and topographic index (area/slope), particularly in low relief terrain, their cumulative distributions do not show any significant change with the vertical resolution. The shape of the normalized width function is not very sensitive to the vertical resolution and the map scale. For small catchments order change may occur at different map scales for the different vertical resolution DEMs of the same catchment, causing a significant change in order-related parameters such as Horton ratios. It is suggested that the vertical resolution of the DEM of a catchment be considered satisfactory for most hydrological applications if the ratio of the average drop per pixel and vertical resolution is greater than unity. This ratio criterion could be used to define the minimum pixel area for reliable channel network definition for any given vertical resolution. The minimum pixel area places a lower bound on the horizontal resolution with which a channel network can be extracted from a DEM. These results could potentially be used to assess the adequacy for hydrological purposes of existing and proposed digital elevation databases.

http://ift.tt/2srHqqi

Stream network morphology and storm response in humid catchments

Addressing scaling issues in hydrological modelling involves, among other things, the study of problems related to hydrological similarity between catchments of different scales. Recent research about catchment similarity relationships is based on distributed conceptual models of surface runoff production. In this type of hydrological modelling both infiltration excess and saturation excess runoff production mechanisms are considered. In many humid lowland areas overland flow is a rare phenomenon because of the specific conditions that prevail: moderate rainfall, high infiltration capacity and low relief. The complete drainage system in these regions consists of surface and subsurface components which have organized themselves in a given geological, geomorphological and climatic situation. A surface drainage network has developed through sapping erosion at the zone of groundwater exfiltration. The resulting hierarchical stream network is in equilibrium with large time-scale conditions and adjusts itself dynamically to the inter-year and seasonal meteorological fluctuations. Greater understanding of the interrelationships that underlie the storm response of catchments in humid lowland regions can be expected by focusing on stream network morphology as a function of topography, geology and climate. This paper applies the physically based mathematical model of stream network morphology, developed by De Vries (1977), to the Zwalmbeek catchment, Belgium. Based on this model and for different climatic conditions (expressed in terms of rainfall characteristics) the first-order stream spacing versus average water-table depth relationship is calculated. From field observations, digital elevation model derived channel network drainage densities and flood event analysis it is concluded that the 1% exceedance probability rainfall can be suggested as representative for the shaping climatic conditions in the catchment under study, The corresponding curves relating channel network characteristics, such as stream spacing, drainage density and channel geometry, to average water-table depth are basin descriptors and could be used for comparative studies (e.g. regional flood frequency analysis). The model further allows for the prediction of the expansion and shrinkage of the first-order channel network as a function of catchment wetness expressed in terms of the effective water-table depth.

http://ift.tt/2tpPoxr

Polydioxanone suture material in growing vascular anastomoses. Experimental study.

We studied the growth of vascular anastomoses after use of absorbable suture material in 21 piglets. In six piglets, end-to-end anastomosis of the infrarenal aorta was performed with 5-0 continuous polypropylene suture; stenosis developed in two of these animals. In 15 piglets, continuous polydioxanone sutures were used for the anastomoses, and no stenosis developed. On the contrary, 14 of these anastomoses showed some degree of dilation at the anastomotic site. Burst testing to 300 mm Hg caused no disruption. On histologic examination, only scar tissue at media and intima with good degree of differentiation was noted. Growth of a vascular anastomosis after use of absorbable polydioxanone suture material seems to be perfectly possible without stricture formation. Because the growing process takes years instead of months in human beings, with obviously less stress at the anastomotic site, it is likely that dilatation at the level of the suture line will not occur in clinical use.

http://ift.tt/2srYGvw

Case 18-2017 — An 11-Year-Old Girl with Difficulty Eating after a Choking Incident

Presentation of Case. Dr. Lazaro V. Zayas (Psychiatry): An 11-year-old girl was seen in an outpatient clinic of this hospital because of difficulty eating solid food and associated weight loss after an acute choking incident. The patient had been in her usual health until 14 days before this…

http://ift.tt/2srFXAC

Proteome profiling of wheat shoots from different cultivars

Wheat is a cereal grain and one of the world's major food crops. Recent advances in wheat genome sequencing are by now facilitating its genomic and proteomic analyses. However, little is known about possible differences in total protein levels of hexaploid versus tetraploid wheat cultivars, and also knowledge of phosphorylated wheat proteins is still limited. Here, we performed a detailed analysis of the proteome of seedling leaves from two hexaploid wheat cultivars (Triticum aestivum L. Pavon 76 and USU-Apogee) and one tetraploid wheat (T. turgidum ssp. durum cv. Senatore Cappelli). Our shotgun proteomics data revealed that, whereas we observed some significant differences, overall a high similarity between hexaploid and tetraploid varieties with respect to protein abundance was observed. In addition, already at the seedling stage, a small set of proteins was differential between the small (USU-Apogee) and larger hexaploid wheat cultivars (Pavon 76), which could potentially act as growth predictors. Finally, the phosphosites identified in this study can be retrieved from the in-house developed plant PTM-Viewer (http://ift.tt/2d7K5je), making this the first searchable repository for phosphorylated wheat proteins. This paves the way for further in depth, quantitative (phospho) proteome-wide differential analyses upon a specific trigger or environmental change.

http://ift.tt/2rukho3

Learning to breathe : developmental phase transitions in oxygen status

Plants are developmentally disposed to significant changes in oxygen availability, but our understanding of the importance of hypoxia is almost entirely limited to stress biology. Differential patterns of the abundance of oxygen, nitric oxide ((NO)-N-center dot), and reactive oxygen species (ROS), as well as of redox potential, occur in organs and meristems, and examples are emerging in the literature of mechanistic relationships of these to development. We describe here the convergence of these cues in meristematic and reproductive tissues, and discuss the evidence for regulated hypoxic niches within which oxygen-, ROS-, (NO)-N-center dot-, and redox-dependent signalling curate developmental transitions in plants.

http://ift.tt/2ruwqJL

Adding a single state memory optimally accelerates symmetric linear maps

http://ift.tt/2sd4QNY

Arsenic release from foodstuffs upon food preparation

In this study the concentration of total arsenic (As) and arsenic species (inorganic As, arsenobetaine, dimethylarsinate, and methylarsonate) was monitored in different foodstuffs (rice, vegetables, algae, fish, crustacean; molluscs) before and after preparation using common kitchen practices. By measuring the water content of the foodstuff and by reporting arsenic concentrations on a dry weight base, we were able to distinguish between As release effects due to food preparation and As decrease clue to changes in. oisture content upon food preparation. Arsenic species were released to the broth during boiling, steaming, frying, or soaking of the food. Concentrations declined with maxima of 57% for total arsenic, 65% for inorganic As, and 32% for arsenobetaine. On the basis of a combination of our own results and literature data, we conclude that the extent of this release of arsenic species is species specific, with inorganic arsenic species being released most easily, followed by the small organic As species and the large organic As species.

http://ift.tt/2sdjHIq

Jewish villains and Basque heroes: ethnic identities and national narratives in Francisco Navarro Villoslada's Amaya o los vascos del siglo VIII

http://ift.tt/2ru8O88

Sensory evaluation of boar-taint-containing minced meat, dry-cured ham and dry fermented sausage by a trained expert panel and consumers

http://ift.tt/2sd8I1N

DNA adductomics to study the genotoxic effects of red meat consumption with and without added animal fat in rats

http://ift.tt/2rtvPIl

Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases

http://ift.tt/2sdcesI

Designing equilibrium modified atmosphere packages for fresh-cut vegetables subjected to changes in temperature

Storage temperature is never constant in the distribution chain of fresh foods. Due to the temperature dependence of respiration of fresh produce and O(2) permeability of a packaging film, fluctuating temperatures result in changes of the internal O(2) and CO(2) concentration of Equilibrium Modified Atmosphere (EMA) packaged fresh produce. Therefore, the design of EMA packages was improved by adding mathematical models describing the effect of temperature, O(2) and CO(2) levels on produce respiration. The influence of temperature on respiration was described by an Arrhenius type of equation while the influence of O(2) and CO(2) on respiration was modelled by a Michaelis-Menten kinetic for 10 types of fresh-cut produce. Compared to unprocessed vegetables a higher temperature dependence of cut/shredded produce was observed. An integrated mathematical model characterized the effect of produce type, produce weight, temperature, O(2) and CO(2) dependence of produce respiration,film type, package area and temperature dependence of film permeability for O(2) in order to predict the internal O(2) concentration of an EMA package which was designed for equilibrium concentration of 3 mL/100 mt O(2) at 7 degrees C. The model was validated by packaging 10 types of fresh-cut vegetables and comparing equilibrium O(2) levels with those predicted at six different temperatures between 2 and 15 degrees C.

http://ift.tt/2rtWS6f

Perioperative Antibiotic Prophylaxis to Prevent Surgical Site Infections in Solid Organ Transplantation.

Antibiotic prophylaxis in the perioperative period is the standard of care for nearly all surgical procedures and routinely prescribed during solid organ transplantation (SOT). The primary goal of perioperative antibiotic prophylaxis is to minimize postoperative surgical site infections (SSIs). SSIs are a significant issue in SOT. Depending on the organ transplanted, SSIs occur in 3 to 53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. SOT recipients are also at increased risk of developing SSIs with antimicrobial-resistant organisms. In this manuscript, we describe the epidemiology and risk factors for SSIs in SOT, and examine the available literature to guide the use of different regimens for perioperative antibiotic prophylaxis for each organ. We have further addressed specific situations that are unique to each organ transplant type, such as the use of extracorporeal membrane oxygenation in thoracic organ transplantation, as well as an approach to perioperative antibiotic prophylaxis in the setting of recipient and/or donor infection prior to transplantation. We provide potential approaches to the selection, dosing, and duration of perioperative antibiotic prophylaxis for each of these clinical situations. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2s44hb1

Anti-CD20 blocker Rituximab in Kidney Transplantation.

Rituximab is a chimeric anti-CD20 monoclonal protein used in various clinical scenarios in kidney transplant recipients. However, its evidence-based use there remains limited due to lack of controlled studies, limited sample size, short follow-up and poorly defined endpoints. Rituximab is indicated for CD20+ PTLD. It may be beneficial for treating recurrent MN and recurrent allograft ANCA vasculitis and possibly for recurrent FSGS. Rituximab, in combination with IVIG/PP, appears to decrease antibody level and increase the odds of transplantation in sensitized recipients. The role of Rituximab in ABOi transplant remains unclear, as similar outcomes are achieved without its use. Rituximab is not efficacious in ABMR/CAMR. Strict RCTs are necessary to elucidate its true role in these settings. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2ryCbBl

An Institution-Wide Rule-Based Protocol for Early Detection of Esophageal Intubation.

No abstract available

http://ift.tt/2ryP3Hp

Inguinal Hernia Surgery: Updates in Surgery series.

No abstract available

http://ift.tt/2s3ATSk

In Response.

No abstract available

http://ift.tt/2rypQNw

Real-Time Ultrasound-Guided Right Supraclavicular Approach to the Central Vein: An Alternative Option.

No abstract available

http://ift.tt/2s3Vndw

In Response.

No abstract available

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Development and Validation of a Risk Scale for Emergence Agitation After General Anesthesia in Children: A Prospective Observational Study.

BACKGROUND: Emergence agitation (EA) is a common complication in children after general anesthesia. The goal of this 2-phase study was (1) to develop a predictive model (EA risk scale) for the incidence of EA in children receiving sevoflurane anesthesia by performing a retrospective analysis of data from our previous study (phase 1) and (2) to determine the validity of the EA risk scale in a prospective observational cohort study (phase 2). METHODS: Using data collected from 120 patients in our previous study, logistic regression analysis was used to predict the incidence of EA in phase 1. The optimal combination of the predictors was determined by a stepwise selection procedure using Akaike information criterion. The [beta]-coefficient for the selected predictors was calculated, and scores for predictors determined. The predictive ability of the EA risk scale was assessed by a receiver operating characteristic (ROC) curve, and the area under the ROC curve (c-index) was calculated with a 95% confidence interval (CI). In phase 2, the validity of the EA risk scale was confirmed using another data set of 100 patients (who underwent minor surgery under general anesthesia). The ROC curve, the c-index, the best cutoff point, and the sensitivity and specificity at the point were calculated. In addition, we calculated the gray zone, which ranges between the two points where sensitivity and specificity, respectively, become 90%. RESULTS: In phase 1, the final model of the multivariable logistic regression analysis included the following 4 predictors: age (logarithm odds ratios [OR], -0.38; 95% CI, -0.81 to 0.00), Pediatric Anesthesia Behavior score (logarithm OR, 0.65; 95% CI, -0.09 to 1.40), anesthesia time (logarithm OR, 0.60; 95% CI, -0.18 to 1.19), and operative procedure (logarithm OR, 2.53; 95% CI, 1.30-3.75 for strabismus surgery and logarithm OR, 2.71; 95% CI, 0.99-4.45 for tonsillectomy). The EA risk scale included these 4 predictors and ranged from 1 to 23 points. In phase 2, the incidence of EA was 39%. The c-index of phase 1 was 0.84 (95% CI, 0.74-0.94), and the c-index of phase 2 was 0.81 (95% CI, 0.72-0.89). The best cutoff point for the EA risk scale was 11 (sensitivity = 87% and specificity = 61%). The gray zone ranged from 10 to 13 points, and included 38% of patients. CONCLUSIONS: We developed and validated an EA risk scale for children receiving sevoflurane anesthesia. In our validation cohort, this scale has excellent predictive performance (c-index > 0.8). The EA risk scale could be used to predict EA in children and adopt a preventive strategy for those at high risk. This score-based preventive approach should be studied prospectively to assess the safety and efficacy of such a strategy. (C) 2017 International Anesthesia Research Society

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