Hemicyanine based ratiometric fluorescence probe for mapping lysosomal pH during heat stroke in living cells

Chem. Commun., 2018, Accepted Manuscript
DOI: 10.1039/C8CC02330A, Communication

Open Access

  This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.

Luling Wu, Yang Wang, Tony D. James, Nengqin Jia, Chusen Huang
Heat stroke is a lethal condition, which can cause dysfunction in central nervous system, multi-organ damage and even death. However, there is still limited knowledge of detailed mechanism about the...
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Minimum pupil in pupillary response to light and myopia affect disk halo size: a cross-sectional study

Objectives

To evaluate the relationship between pupillary response to light, myopia and disk halo size.

Design

Cross-sectional study.

Setting

Single refractive surgery centre.

Participants

In this study, 197 right eyes of 197 patients between 20 and 35 years of age were evaluated for disk halo size and pupillary response to light with a vision monitor.

Primary and secondary outcome measures

Halo radius, age, spherical equivalent (SE), axial length (AL), initial diameter, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, velocity of dilation, maximum pupil, minimum pupil, average pupil and dark pupil.

Results

Significant associations were found between disk halo size and SE (r=–0.219, P=0.002), AL (r=0.152, P=0.033) and minimum pupil (r=0.149, P=0.037). There were no associations between disk halo size and initial diameter, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, velocity of dilation, maximum pupil, average pupil, dark pupil and age (P>0.05). A significant difference in disk halo size was detected between the low-moderate and high myopia (SE< –6 D) groups (P=0.002) and between the small and large (minimum pupil≥4 mm) minimum pupil size groups (P=0.014).

Conclusions

Patients with a high SE and large minimum pupil size (minimum pupil ≥4 mm) suffered more disability glare than those with a low SE and small minimum pupil size.

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Fruit and vegetable intake and body adiposity among populations in Eastern Canada: the Atlantic Partnership for Tomorrows Health Study

Objectives

The prevalence of obesity among populations in the Atlantic provinces is the highest in Canada. Some studies suggest that adequate fruit and vegetable consumption may help body weight management. We assessed the associations between fruit and vegetable intake with body adiposity among individuals who participated in the baseline survey of the Atlantic Partnership for Tomorrow's Health (Atlantic PATH) cohort study.

Methods

We carried out a cross-sectional analysis among 26 340 individuals (7979 men and 18 361 women) aged 35–69 years who were recruited in the baseline survey of the Atlantic PATH study. Data on fruit and vegetable intake, sociodemographic and behavioural factors, chronic disease, anthropometric measurements and body composition were included in the analysis.

Results

In the multivariable regression analyses, 1 SD increment of total fruit and vegetable intake was inversely associated with body mass index (–0.12 kg/m²; 95% CI –0.19 to –0.05), waist circumference (–0.40 cm; 95% CI –0.58 to –0.23), percentage fat mass (–0.30%; 95% CI –0.44 to –0.17) and fat mass index (–0.14 kg/m²; 95% CI –0.19 to –0.08). Fruit intake, but not vegetable intake, was consistently inversely associated with anthropometric indices, fat mass, obesity and abdominal obesity.

Conclusions

Fruit and vegetable consumption was inversely associated with body adiposity among the participant population in Atlantic Canada. This association was primarily attributable to fruit intake. Longitudinal studies and randomised trials are warranted to confirm these observations and investigate the underlying mechanisms.

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The Collaborative IPD of Sleep and Stillbirth (Cribss): is maternal going-to-sleep position a risk factor for late stillbirth and does maternal sleep position interact with fetal vulnerability? An individual participant data meta-analysis study protocol

Introduction

Accumulating evidence has shown an association between maternal supine going-to-sleep position and stillbirth in late pregnancy. Advising women not to go-to-sleep on their back can potentially reduce late stillbirth rate by 9%. However, the association between maternal right-sided going-to-sleep position and stillbirth is inconsistent across studies. Furthermore, individual studies are underpowered to investigate interactions between maternal going-to-sleep position and fetal vulnerability, which is potentially important for producing clear and tailored public health messages on safe going-to-sleep position. We will use individual participant data (IPD) from existing studies to assess whether right-side and supine going-to-sleep positions are independent risk factors for late stillbirth and to test the interaction between going-to-sleep position and fetal vulnerability.

Methods and analysis

An IPD meta-analysis approach will be used using the Cochrane Collaboration-endorsed methodology. We will identify case–control and prospective cohort studies and randomised trials which collected maternal going-to-sleep position data and pregnancy outcome data that included stillbirth. The primary outcome is stillbirth. A one stage procedure meta-analysis, stratified by study with adjustment of a priori confounders will be carried out.

Ethics and dissemination

The IPD meta-analysis has obtained central ethics approval from the New Zealand Health and Disability Ethics Committee, ref: NTX/06/05/054/AM06. Individual studies should also have ethical approval from relevant local ethics committees. Interpretation of the results will be discussed with consumer representatives. Results of the study will be published in peer-reviewed journals and presented at international conferences.

PROSPERO registration number

CRD42017047703.

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Refugee maternal and perinatal health in Ontario, Canada: a retrospective population-based study

Objectives

Immigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes.

Design

This is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data.

Setting and participants

Refugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014.

Primary outcomes

Numerous adverse maternal and perinatal health outcomes.

Results

Refugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers.

Conclusions

Refugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further refining refugee status based on migration experiences.

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Role of iodine-containing multivitamins during pregnancy for childrens brain function: protocol of an ongoing randomised controlled trial: the SWIDDICH study

Introduction

Iodine is essential for normal brain development. Moderate and severe fetal iodine deficiency results in substantial to serious developmental delay in children. Mild iodine deficiency in pregnancy is associated with neurodevelopmental deficits in the offspring, but evidence from randomised trials is lacking. The aim of the Swedish Iodine in Pregnancy and Development in Children study is to determine the effect of daily supplementation with 150 µg iodine during pregnancy on the offspring's neuropsychological development up to 14 years of age.

Methods and analysis

Thyroid healthy pregnant women (n=1275: age range 18–40 years) at ≤12 weeks gestation will be randomly assigned to receive multivitamin supplements containing 150 µg iodine or non-iodine-containing multivitamin daily throughout pregnancy. As a primary outcome, IQ will be measured in the offspring at 7 years (Wechsler Intelligence Scale for Children-V). As secondary outcomes, IQ will be measured at 3.5 and 14 years, psychomotor development at 18 months and 7 years, and behaviour at 3.5, 7 and 14 years. Iodine status (urinary iodine concentration) will be measured during pregnancy and in the offspring at 3.5, 7 and 14 years. Thyroid function (thyroid hormones, thyroglobulin), and deiodinase type 2 polymorphisms will be measured during pregnancy and in the offspring at 7 and 14 years. Structural MRI or other relevant structural or functional brain imaging procedures will be performed in a subgroup of children at 7 and 14 years. Background and socioeconomic information will be collected at all follow-up times.

Ethics and dissemination

This study is approved by the Ethics Committee in Göteborg, Sweden (Diary numbers: 431-12 approved 18 June 2012 (pregnancy part) and 1089-16 approved 8 February 2017 (children follow-up)). According to Swedish regulations, dietary supplements are governed by the National Food Agency and not by the Medical Product Agency. Therefore, there is no requirement for a monitoring committee and the National Food Agency does not perform any audits of trial conduct. The trial will be conducted in accordance with the Declaration of Helsinki. The participating sites will be contacted regarding important protocol changes, both orally and in writing, and the trial registry database will be updated accordingly. Study results will be presented at relevant conferences, and submitted to peer-reviewed journals with open access in the fields of endocrinology, paediatrics and nutrition. After the appropriate embargo period, the results will be communicated to participants, healthcare professionals at the maternal healthcare centres, the public and other relevant groups, such as the national guideline group for thyroid and pregnancy and the National Food Agency.

Trial registration number

NCT02378246; Pre-results.

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Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America

Objective

To determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period.

Design

Prospective population-based surveillance study.

Setting

Healthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay).

Participants

2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015.

Main outcome measures

Incidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years.

Results

Median age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70).

Conclusions

We found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed.

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IndEcho study: cohort study investigating birth size, childhood growth and young adult cardiovascular risk factors as predictors of midlife myocardial structure and function in South Asians

Introduction

South Asians have high rates of cardiovascular disease (CVD) and its risk factors (hypertension, diabetes, dyslipidaemia and central obesity). Left ventricular (LV) hypertrophy and dysfunction are features of these disorders and important predictors of CVD mortality. Lower birth and infant weight and greater childhood weight gain are associated with increased adult CVD mortality, but there are few data on their relationship to LV function. The IndEcho study will examine associations of birth size, growth during infancy, childhood and adolescence and CVD risk factors in young adulthood with midlife cardiac structure and function in South Asian Indians.

Methods and analysis

We propose to study approximately 3000 men and women aged 43–50 years from two birth cohorts established in 1969–1973: the New Delhi Birth Cohort (n=1508) and Vellore Birth Cohort (n=2156). They had serial measurements of weight and height from birth to early adulthood. CVD risk markers (body composition, blood pressure, glucose tolerance and lipids) and lifestyle characteristics (tobacco and alcohol consumption, physical activity, socioeconomic status) were assessed at age ~30 years. Clinical measurements in IndEcho will include anthropometry, blood pressure, biochemistry (glucose, fasting insulin and lipids, urinary albumin/creatinine ratio) and body composition by dual energy X-ray absorptiometry and bioelectrical impedance. Outcomes are LV mass and indices of LV systolic and diastolic function assessed by two-dimensional and Doppler echocardiography, carotid intimal-media thickness and ECG indicators of ischaemia. Regression and conditional growth models, adjusted for potential confounders, will be used to study associations of childhood and young adult exposures with these cardiovascular outcomes.

Ethics and dissemination

The study has been approved by the Health Ministry Steering Committee, Government of India and institutional ethics committees of participating centres in India and the University of Southampton, UK. Results will be disseminated through scientific meetings and peer-reviewed journals.

Trial registration number

ISRCTN13432279; Pre-results.

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Associations between preoperative Oxford hip and knee scores and costs and quality of life of patients undergoing primary total joint replacement in the NHS England: an observational study

Objectives

To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS).

Design

Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases.

Setting

UK secondary care.

Participants

Men and women undergoing primary THR or TKR. The Hospital Episode Statistics data linked to patient-reported outcome measures included 602 176 patients undergoing hip or knee replacement who were followed up for up to 6 years. The Knee Arthroplasty Trial included 2217 patients undergoing TKR who were followed up for 12 years. The Clinical Outcomes in Arthroplasty Study cohort included 806 patients undergoing THR and 484 patients undergoing TKR who were observed for 1 year.

Outcome measures

EQ-5D-3L quality of life before and after surgery, costs of primary arthroplasty, costs of revision arthroplasty and the costs of hospital readmissions and ambulatory costs in the year before and up to 12 years after joint replacement.

Results

Average postoperative utility for patients at the 5th percentile of the OHS/OKS distribution was 0.61/0.5 for THR/TKR and 0.89/0.85 for patients at the 95th percentile. The difference between postoperative and preoperative EQ-5D utility was highest for patients with preoperative OHS/OKS lower than 10. However, postoperative EQ-5D utility was higher than preoperative utility for all patients with OHS≤46 and those with OKS≤44. In contrast, costs were generally higher for patients with low preoperative OHS/OKS than those with high OHS/OKS. For example, costs of hospital readmissions within 12 months after primary THR/TKR were £740/£888 for patients at the 5th percentile compared with £314/£404 at the 95th percentile of the OHS/OKS distribution.

Conclusions

Our findings suggest that costs and quality of life associated with total joint replacement vary systematically with preoperative symptoms measured by OHS/OKS.

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Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? Results from a multicentre trial in Israel

Objective

To assess the cost-effectiveness of an enhanced transtheoretical model of behaviour change in conjunction with physiotherapy compared with standard care (physiotherapy) in patients with chronic lower back pain (CLBP).

Design

Cost-utility and cost-effectiveness analyses alongside a multicentre controlled trial from a healthcare perspective with a 1-year time horizon.

Setting

The trial was conducted in eight centres within the Sharon district in Israel.

Participants

220 participants aged between 25 and 55 years who suffered from CLBP for a minimum of 3 months were recruited.

Interventions

The intervention used a model of behaviour change that sought to increase the adherence and implementation of physical activity in conjunction with physiotherapy. The control arm received standard care in the form of physiotherapy.

Primary and secondary measures

The primary outcome was the incremental cost per quality-adjusted life year (QALY) of the intervention arm compared with standard care. The secondary outcome was the incremental cost per Roland-Morris Disability Questionnaire point.

Results

The cost per QALY point estimate was 10 645 New Israeli shekels (NIS) (£1737.11). There was an 88% chance the intervention was cost-effective at NIS50 000 per QALY threshold. Excluding training costs, the intervention dominated the control arm, resulting in fewer physiotherapy and physician visits while improving outcomes.

Conclusions

The enhanced transtheoretical model intervention appears to be a very cost-effective intervention leading to improved outcomes for low cost. Given limitations within this study, there is justification for examining the intervention within a larger, long-term randomised controlled trial.

Trial registration number

NCT01631344; Pre-results.

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Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomised controlled trial

Objective

Fractured neck of femur is a severely painful condition with significant mortality and morbidity. We investigated whether early and continuous use of femoral nerve block can improve pain on movement and mobility after surgery in older participants with fragility neck of femur fracture.

Design

Prospective single-centre, randomised controlled pragmatic trial.

Setting

Secondary care, acute National Health Service Trust, UK.

Participants

Participants admitted with a history and examination suggesting fractured neck of femur.

Intervention

Immediate continuous femoral nerve block via catheter or standard analgesia.

Outcome measures

Primary outcome measures were Cumulative Dynamic Pain score and Cumulated Ambulation Score from surgery until day 3 postoperatively. Secondary outcome measures included pain scores at rest, cumulative side effects (nausea and constipation), quality of life (measured by EuroQOL 5 D instrument (EQ-5D) score) at day 3 and day 30, and rehabilitation outcome (measured by mobility score).

Results

141 participants were recruited, with 23 excluded. No significant difference was detected between Cumulative Dynamic Pain Score (standard care (n=56) vs intervention (n=55) 20 (IQR 15–24) vs 20 (15–23), p=0.51) or Cumulated Ambulation Score (standard care vs intervention 6 (5–9) vs 7 (5–10), p=0.76). There were no statistically different differences in secondary outcomes except cumulative pain at rest: 5 (0.5–6.5) in the standard care group and 2 (0–5) in the intervention group (p=0.043).

Conclusions

Early application of continuous femoral nerve block compared with standard systemic analgesia did not result in improved dynamic pain score or superior postoperative ambulation. This technique may provide superior pain relief at rest. Continuous femoral nerve block did not delay initial control of pain or mobilisation after surgery.

Trial registration number

ISRCTN92946117; Pre-results.

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Using machine learning techniques to develop forecasting algorithms for postoperative complications: protocol for a retrospective study

Introduction

Mortality and morbidity following surgery are pressing public health concerns in the USA. Traditional prediction models for postoperative adverse outcomes demonstrate good discrimination at the population level, but the ability to forecast an individual patient's trajectory in real time remains poor. We propose to apply machine learning techniques to perioperative time-series data to develop algorithms for predicting adverse perioperative outcomes.

Methods and analysis

This study will include all adult patients who had surgery at our tertiary care hospital over a 4-year period. Patient history, laboratory values, minute-by-minute intraoperative vital signs and medications administered will be extracted from the electronic medical record. Outcomes will include in-hospital mortality, postoperative acute kidney injury and postoperative respiratory failure. Forecasting algorithms for each of these outcomes will be constructed using density-based logistic regression after employing a Nadaraya-Watson kernel density estimator. Time-series variables will be analysed using first and second-order feature extraction, shapelet methods and convolutional neural networks. The algorithms will be validated through measurement of precision and recall.

Ethics and dissemination

This study has been approved by the Human Research Protection Office at Washington University in St Louis. The successful development of these forecasting algorithms will allow perioperative healthcare clinicians to predict more accurately an individual patient's risk for specific adverse perioperative outcomes in real time. Knowledge of a patient's dynamic risk profile may allow clinicians to make targeted changes in the care plan that will alter the patient's outcome trajectory. This hypothesis will be tested in a future randomised controlled trial.

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What attributions do Australian high-performing general practices make for their success? Applying the clinical microsystems framework: a qualitative study

Objectives

To identify the success attributions of high-performing Australian general practices and the enablers and barriers they envisage for practices wishing to emulate them.

Design

Qualitative study using semi-structured interviews and content analysis of the data. Responses were recorded, transcribed verbatim and coded according to success characteristics of high-performing clinical microsystems.

Setting

Primary healthcare with the participating general practices representing all Australian states and territories, and representing metropolitan and rural locations.

Participants

Twenty-two general practices identified as high performing via a number of success criteria. The 52 participants were 19 general practitioners, 18 practice managers and 15 practice nurses.

Results

Participants most frequently attributed success to the interdependence of the team members, patient-focused care and leadership of the practice. They most often signalled practice leadership, team interdependence and staff focus as enablers that other organisations would need to emulate their success. They most frequently identified barriers that might be encountered in the form of potential deficits or limitations in practice leadership, staff focus and mesosystem support.

Conclusions

Practice leaders need to empower their teams to take action through providing inclusive leadership that facilitates team interdependence. Mesosystem support for quality improvement in general practice should focus on enabling this leadership and team building, thereby ensuring improvement efforts are converted into effective healthcare provision.

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Reoperation after breast-conserving surgery for cancer in Australia: statewide cohort study of linked hospital data

Objectives

To investigate between-hospital variation in the probability of reoperation within 90 days of initial breast-conserving surgery (BCS), and the contribution of health system-level and other factors.

Design

Population-based, retrospective cohort study.

Setting

New South Wales (NSW), Australia.

Participants

Linked administrative hospitalisation data were used to define a cohort of adult women undergoing initial BCS for breast cancer in NSW between 1 July 2002 and 31 December 2013.

Primary outcome measures

Multilevel, cross-classified models with patients clustered within hospitals and residential areas were used to examine factors associated with any reoperation, and either re-excision or mastectomy, within 90 days.

Results

Of 34 458 women undergoing BCS, 29.1% underwent reoperation within 90 days, half of which were mastectomies. Overall, the probability of reoperation decreased slightly over time. However, there were divergent patterns by reoperation type; the probability of re-excision increased alongside a concomitant decrease in the probability of mastectomy. Significant between-hospital variation was observed. Non-metropolitan location and surgery at low-volume hospitals were associated with a higher overall probability of reoperation, and of mastectomy specifically, after accounting for patient-level factors, calendar year and area-level socioeconomic status. The magnitude of association with geographical location and surgical volume decreased over time.

Conclusions

Reoperation rates within 90 days of BCS varied significantly between hospitals. For women undergoing mastectomy after BCS, this represents a dramatic change in clinical course. Multilevel modelling suggests unwarranted clinical variation may be an issue, likely due to disparities in access to multidisciplinary breast cancer care and preoperative diagnostic procedures. However, the observed reduction in disparities over time is encouraging and indicates that guidelines and policy initiatives have the potential to improve regional breast cancer care.

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Effect of intratracheal dexmedetomidine administration on recovery from general anaesthesia after gynaecological laparoscopic surgery: a randomised double-blinded study

Objectives

To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery.

Design

Prospective, randomised, double-blinded, controlled trial.

Setting

A general hospital, Guangdong Province, China.

Participants

All patients who underwent elective laparoscopic gynaecological surgery, aged 18–60 years old, 40–80 kg in weight, American Society of Anesthesiologists class I–II were eligible. Patients were excluded if they had respiratory disease, heart disorders which might represent risk factors of potential complications of Dex such as bradycardia, heart block, coronary heart disease, uncontrolled hypertension or the long-term use of sedative drugs.

Intervention

Patients were randomly allocated to either receive intratracheal Dex (DT), intravenous Dex (DV) or intravenous saline (CON, n=30, respectively). In the DT and DV groups, Dex (0.5 µg/kg) was diluted and mixed in 1 or 20 mL of saline, respectively, and injected via the intratracheal or intravenous route 30 min before the completion of the surgery.

Outcome measures

The primary outcome was the coughing extent among the three groups. Secondary outcomes included awareness time, extubation time, postoperative visual analogue scale and Steward recovery score.

Results

Compared with the CON group, the extent of coughing was significantly reduced in both the DV group and the DT group. Furthermore, the mean time to awareness (13.4 (4.3) vs 8.8 (2.9), p<0.001) and the extubation time (14.3 (4.3) vs 8.4 (3.6), p<0.001) were reduced in the DT group. Patients in the DT group also experienced better early recovery quality and less pain than those in the CON group. Furthermore, intratracheal Dex administration contributed to improved stability in haemodynamics with no significant side effects.

Conclusions

Intratracheal Dex administration may avoid untoward laryngeal responses for patients emerging from general anaesthesia after gynaecological laparoscopy.

Trial registration number

ChiCTR-IOR-15007611.

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Behaviours preceding suicides at railway and underground locations: a multimethodological qualitative approach

Objectives

Suicides by train have devastating consequences for families, the rail industry, staff dealing with the aftermath of such incidents and potential witnesses. To reduce suicides and suicide attempts by rail, it is important to learn how safe interventions can be made. However, very little is known about how to identify someone who may be about to make a suicide attempt at a railway location (including underground/subways). The current research employed a novel way of understanding what behaviours might immediately precede a suicide or suicide attempt at these locations.

Design and methods

A qualitative thematic approach was used for three parallel studies. Data were gathered from several sources, including interviews with individuals who survived a rail suicide attempt (n=9), CCTV footage of individuals who died by rail suicide (n=16) and qualitative survey data providing views from rail staff (n=79).

Results

Our research suggests that there are several behaviours that people may carry out before a suicide or suicide attempt at a rail location, including station hopping and platform switching, limiting contact with others, positioning themselves at the end of the track where the train/tube approaches, allowing trains to pass by and carrying out repetitive behaviours.

Conclusions

There are several behaviours that may be identifiable in the moments leading up to a suicide or suicide attempt on the railways which may present opportunities for intervention. These findings have implications for several stakeholders, including rail providers, transport police and other organisations focused on suicide prevention.

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Complications in breast augmentation with textured versus smooth breast implants: a systematic review protocol

Introduction

Breast augmentation is one of the most popular aesthetic plastic surgeries worldwide. There are various types of breast implants, and these can be categorised into different broad groups based on their content, shape or surface, to name a few. When looking at the surface of the shell, they can be categorised into two main kinds: textured and smooth implants. To our knowledge, a literature review and meta-analysis of the complications of these two types of implants when used for aesthetic breast augmentation has yet to be written.

Methods and analysis

The PubMed, EMBASE and Cochrane electronic databases will be searched from their inception to 1 October 2017. Only cohort studies, case series, case–control studies and randomised controlled trials will be included. Identification of the articles for inclusion will be carried out by two independent researchers, and data will be extracted from these studies for analysis. This protocol defines the inclusion and exclusion criteria, as well as the primary and secondary outcomes. Statistical data analysis will be conducted in Review Manager V.5.3 from Cochrane Collaboration. The methodological quality of the included studies will also be assessed.

Ethics and dissemination

This review will analyse secondary data collected from studies which are not linked to any specific individual. Once completed, the conclusions of the review could prove to be a valuable resource for plastic surgeons to conduct aesthetic implant procedures. The review will be submitted for publication in a peer-reviewed journal and presented at various national and international conferences.

PROSPERO registration number

CRD42017078727.

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Metabolic syndrome and its components with neuron-specific enolase: a cross-sectional study in large health check-up population in China

Objective

This study was aimed at investigating the relationship between neuron-specific enolase (NSE) and components of metabolic syndrome (MS).

Design

Cross-sectional study.

Setting

Chinese health check-up population.

Participants

40 684 health check-up people were enrolled in this study from year 2014 to 2016.

Main outcome measures

OR and coefficient for MS.

Results

The percentage of abnormal NSE and MS was 26.85% and 8.85%, respectively. There were significant differences in sex, body mass index, drinking habit, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), blood pressure and MS between low-NSE and high-NSE groups. In logistic regression analysis, elevated NSE was present in MS, higher body mass index, hypertriglyceridaemia, hypertension and low-HDL groups. Stepwise linear analysis showed a negative correlation between NSE and fasting blood glucose (FBG) (<6.0 mmol/L), and a positive correlation between NSE and TGs (<20 mmol/L), systolic blood pressure (75–200 mm Hg), HDL-C (0.75–2.50 mmol/L), diastolic blood pressure (<70 mm Hg) and FBG (6.00–20.00 mmol/L). Furthermore, MS was positively correlated with NSE within the range of 2.00–7.50 ng/mL, but had a negative correlation with NSE within the range of 7.50–23.00 ng/mL.

Conclusion

There are associations between NSE with MS and its components. The result suggests that NSE may be a potential predictor of MS. Further research could be conducted in discussing the potential mechanism involved.

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Fatigue in patients with chronic obstructive pulmonary disease: protocol of the Dutch multicentre, longitudinal, observational FAntasTIGUE study

Introduction

Fatigue is the second most common symptom in patients with chronic obstructive pulmonary disease (COPD). Despite its high prevalence, fatigue is often ignored in daily practice. For this reason, little is known about the underlying determinants of fatigue in patients with COPD. The primary objectives of this study are to chart the course of fatigue in patients with COPD, to identify the physical, systemic, psychological and behavioural factors that precipitate and perpetuate fatigue in patients with COPD, to evaluate the impact of exacerbation-related hospitalisations on fatigue and to better understand the association between fatigue and 2-year all-cause hospitalisation and mortality in patients with COPD. The secondary aim is to identify diurnal differences in fatigue by using ecological momentary assessment (EMA). This manuscript describes the protocol of the FAntasTIGUE study and gives an overview of the possible strengths, weaknesses and clinical implications.

Methods and analysis

A 2-year longitudinal, observational study, enrolling 400 patients with clinically stable COPD has been designed. Fatigue, the primary outcome, will be measured by the subjective fatigue subscale of the Checklist Individual Strength (CIS-Fatigue). The secondary outcome is the day-to-day/diurnal fatigue, registered in a subsample (n=60) by EMA. CIS-Fatigue and EMA will be evaluated at baseline, and at 4, 8 and 12 months. The precipitating and perpetuating factors of fatigue (physical, psychological, behavioural and systemic) will be assessed at baseline and at 12 months. Additional assessments will be conducted following hospitalisation due to an exacerbation of COPD that occurs between baseline and 12 months. Finally, at 18 and 24 months the participants will be followed up on their fatigue, number of exacerbations, exacerbation-related hospitalisation and survival.

Ethics and dissemination

This protocol was approved by the Medical research Ethics Committees United, Nieuwegein, the Netherlands (NL60484.100.17).

Trial registration number

NTR6933; Pre-results.

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Rate of adherence to urate-lowering therapy among patients with gout: a systematic review and meta-analysis

Introduction

Reported adherence to urate-lowering therapy (ULT) in gout varies widely (17%–83.5%). Variability may partly be due to different adherence measurement methods. This review aimed to quantify ULT adherence in adult patients with gout.

Methods

This analysis examined studies in PubMed, Web of Science, CNKI Scholar and WanFang databases from inception to January 2017. Papers were selected by inclusion and exclusion criteria in the context. Random-effect meta-analysis estimated adherence.

Results

22 studies were found by the inclusion criteria, which involved 1 37 699 patients with gout. Four ways to define adherence were reported. Meta-analysis revealed that the overall adherence rate was 47% (95% CI 42% to 52%, I²=99.7%). Adherence rate to ULT was 42% (95% CI 37% to 47%, I²=99.8%) for prescription claims, 71% (95% CI 63% to 79%) for pill count, 66% (95% CI 50% to 81%, I²=86.3%) for self-report and 63% (95% CI 42% to 83%, I²=82.9%) for interview, respectively. The influential factor on adherence rate was country of origin.

Conclusions

Among adult patients with gout, overall adherence rate to ULT was as low as 47%, which suggested that clinicians should pay more attention to medication adherence in patients with gout to effectively improve adherence to ULT.

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Detection of Echinococcus multilocularis in domestic dogs of Shiqu County in the summer herding

Abstract

Alveolar echinococcosis (AE) is one of the most serious parasitic zoonosis in Asia. Shiqu County is the most important endemic area of AE in China. Our primary objective is to find out the risk factors for Echinococcus multilocularis infection in domestic dogs in Shiqu County during the summer herding period. A total of 120 fecal samples were collected from 60 ranchers in October 2016. Nested PCR (nPCR) was performed to amplify regions of the mitochondrial12S rRNA gene of E. multilocularis. The results showed that the infection rates of AE in dogs from Qiwu, Yiniu, Changshaganma, Derongma, Mengyi, and Xiazha villages were 5, 5, 10, 20, 10, and 5%, respectively. It should be stressed that the infected dogs will shed eggs through feces and may have a habit of preying on rodents, the intermediate host of the parasite, and become re-infected. This investigation confirmed the presence of E. multilocularis infection in dogs in Shiqu and revealed the risk factors associated with the infection during summer herding.

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A new kernel development algorithm for edge detection using singular value ratios

Abstract

The perceptual quality of an image is very sensitive to the degradation of the edge information which is usually caused by many video signal applications such as super-resolution and denoising. Hence, it is very important to detect and enhance the edge information of the image. In this research work, new sets of kernels for edge detection using ratios of singular values of an image are proposed, which results in more detailed detection of edges in the original image. The parameters, which are the elements of kernel matrices and the threshold value used for producing binary image after convolving the kernels with the image of the proposed method, are optimised to achieve more detailed edge detection of the image. The experimental results show that more detailed edges are detected by the proposed method compared to the conventional edge detection techniques.

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Quantification of Histidine-Rich Protein 3 of Plasmodium falciparum

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy, Ahead of Print.


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Quantification of Histidine-Rich Protein 3 of Plasmodium falciparum

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy, Ahead of Print.


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Development of DNA aptamers targeting low-molecular-weight amyloid-[small beta] peptide aggregates in vitro

Chem. Commun., 2018, Accepted Manuscript
DOI: 10.1039/C8CC02256A, Communication

Madhuri Chakravarty, Hadi AlShamaileh, He Huang, Rudi K Tannenberg,, Suxiang Chen, Simon Worrall, Peter R Dodd, Rakesh Naduvile Veedu
We have developed a novel functional nucleic acid aptamer to amyloid-[small beta] peptide 1-40 (A[small beta]1-40) and investigated its potential to detect A[small beta] peptide fragments in neuropathologically confirmed Alzheimer brain hippocampus tissues...
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Effect of a rest-pause vs. traditional squat on electromyography and lifting volume in trained women

Abstract

Purpose

Rest-pause (4 s unloaded rest between repetitions) single session training effects on lifting volume, and muscle activity via electromyography (EMG) are currently vague in the literature and can benefit strength and conditioning professionals for resistance training program design. This study compared differences in volume lifted and muscle activity between a rest-pause vs. traditional protocol.

Methods

Trained females (N = 13) completed both a rest-pause and traditional squat protocol consisting of four sets to movement failure at 80% pretest 1 repetition maximum load with 2-min rest between sets. Total volume and muscle activity of the vastus lateralis, vastus medialis, rectus femoris, and gluteus maximus were measured on both training days. Differences in muscle activity were viewed as a percent change (%∆).

Results

A paired samples t test indicated total volume lifted was higher in the rest-pause compared to the traditional protocol (2532 vs. 2036 kg; p < .05). Furthermore, paired samples t tests showed muscle activity %∆ of the gluteus maximus was greater in the traditional protocol compared to the rest-pause protocol (p < .05). No other muscle activity differences were observed in the remaining muscles.

Conclusions

The rest-pause allows for greater volume lifted via increased repetitions compared to a traditional protocol in trained women. The rest-pause method may be superior to a traditional method of training during a hypertrophy mesocycle, where a primary focus is total volume lifted. Furthermore, %∆ muscle activity in the GM will be greater while performing a traditional back squat protocol in comparison to a rest-pause.

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Implications of non-accidental trauma on resource utilization and outcomes

Abstract

Purpose

The purpose was to compare the resource utilization and outcomes between patients with suspected (SUSP) and confirmed (CONF) non-accidental trauma (NAT).

Methods

The institutional trauma registry was reviewed for patients aged 0–18 years presenting from 2007 to 2012 with a diagnosis of suspicion for NAT. Patients with suspected and confirmed NAT were compared.

Results

There were 281 patients included. CONF presented with a higher heart rate (142 ± 27 vs 128 ± 23 bpm, p < 0.01), lower systolic blood pressure (100 ± 18 vs 105 ± 16 mm Hg, p = 0.03), and higher Injury Severity Score (15 ± 11 vs 9 ± 5, p < 0.01). SUSP received fewer consultations (1.6 ± 0.7 vs 2.4 ± 1.1, 95% CI − 0.58 to − 0.09, p < 0.01) and had a shorter length of stay (1.6 ± 1.3 vs 7.8 ± 9.8 days, 95% CI − 4.58 to − 0.72, p < 0.01). SUSP were more often discharged home (OR 94.22, 95% CI: 21.26–417.476, p < 0.01). CONF had a higher mortality rate (8.2 vs 0%, p < 0.01).

Conclusions

Patients with confirmed NAT present with more severe injuries and require more hospital resources compared to patients in whom NAT is suspected and ruled out.

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Toxins, Vol. 10, Pages 152: Bovine Peripheral Blood Mononuclear Cells Are More Sensitive to Deoxynivalenol Than Those Derived from Poultry and Swine

Toxins, Vol. 10, Pages 152: Bovine Peripheral Blood Mononuclear Cells Are More Sensitive to Deoxynivalenol Than Those Derived from Poultry and Swine

Toxins doi: 10.3390/toxins10040152

Authors: Barbara Novak Eleni Vatzia Alexandra Springler Alix Pierron Wilhelm Gerner Nicole Reisinger Sabine Hessenberger Gerd Schatzmayr Elisabeth Mayer

Deoxynivalenol (DON) is one of the most prevalent mycotoxins, contaminating cereals and cereal-derived products. Its derivative deepoxy-deoxynivalenol (DOM-1) is produced by certain bacteria, which either occur naturally or are supplemented in feed additive. DON-induced impairments in protein synthesis are particularly problematic for highly proliferating immune cells. This study provides the first comparison of the effects of DON and DOM-1 on the concanavalin A-induced proliferation of porcine, chicken, and bovine peripheral blood mononuclear cells (PBMCs). Therefore, isolated PBMCs were treated with DON (0.01–3.37 µM) and DOM-1 (1.39–357 µM) separately, and proliferation was measured using a bromodeoxyuridine (BrdU) assay. Although pigs are considered highly sensitive to DON, the present study revealed a substantially higher sensitivity of bovine (IC50 = 0.314 µM) PBMCs compared to chicken (IC50 = 0.691 µM) and porcine (IC50 = 0.693 µM) PBMCs. Analyses on the proliferation of bovine T-cell subsets showed that all major subsets, namely, CD4+, CD8β+, and γδ T cells, were affected to a similar extent. In contrast, DOM-1 did not affect bovine PBMCs, but reduced the proliferation of chicken and porcine PBMCs at the highest tested concentration (357 µM). Results confirm the necessity of feed additives containing DON-to-DOM-1-transforming bacteria and highlights species-specific differences in the DON sensitivity of immune cells.

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Asymmetric Tyrosination of Spindle Microtubules Facilitates Selfish Inheritance

Publication date: Available online 10 April 2018
Source:Trends in Cell Biology
Author(s): Shikha Laloraya
Meiotic drive is an enigmatic process that results from biased segregation of selfish genetic elements that enhance their own transmission and drive evolution. During asymmetric female meiotic divisions, selfish elements segregate preferentially towards the egg rather than polar bodies. Recent findings demonstrate that asymmetric spindle tyrosination helps selfish elements to cheat.



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IJMS, Vol. 19, Pages 1150: Localization Microscopy of Actin Cytoskeleton in Human Platelets

IJMS, Vol. 19, Pages 1150: Localization Microscopy of Actin Cytoskeleton in Human Platelets

International Journal of Molecular Sciences doi: 10.3390/ijms19041150

Authors: Sandra Mayr Fabian Hauser Anja Peterbauer Andreas Tauscher Christoph Naderer Markus Axmann Birgit Plochberger Jaroslaw Jacak

Here, we measure the actin cytoskeleton arrangement of different morphological states of human platelets using a new protocol for photo-switching of rhodamine class fluorophores. A new medium composition was established for imaging the cytoskeleton using Alexa Fluor 488 conjugated to phalloidin. Morphological states of platelets bound to a glass substrate are visualized and quantified by two-dimensional localization microscopy at nanoscopic resolution. Marker-less drift correction yields localization of individual Alexa 488 conjugated to phalloidin with a positional accuracy of 12 nm.

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Down-Regulated miR-125a-5p Promotes the Reprogramming of Glucose Metabolism and Cell Malignancy by Increasing Levels of CD147 in Thyroid Cancer

Thyroid, Ahead of Print.


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Dependence of cell adhesion on extracellular matrix materials formed on pore bridge boundaries by nanopore opening and closing geometry

Analyst, 2018, Accepted Manuscript
DOI: 10.1039/C8AN00429C, Paper

SUEON KIM, Dong Yeol Han, Zhenzhong Chen, Won Gu Lee
In this study, we report experimental results for characterization of the growth and formation of pore bridge materials that modified the adhesion structures of cells cultured on nanomembranes with opening...
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Down-Regulated miR-125a-5p Promotes the Reprogramming of Glucose Metabolism and Cell Malignancy by Increasing Levels of CD147 in Thyroid Cancer

Thyroid, Ahead of Print.


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Mild Blast Injury Produces Acute Changes in Basal Intracellular Calcium Levels and Activity Patterns in Mouse Hippocampal Neurons

Journal of Neurotrauma, Ahead of Print.


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Letter in response to Google DeepMind and healthcare in an age of algorithms

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Reply

Publication date: Available online 10 April 2018
Source:The Journal of Emergency Medicine
Author(s): Brit Long, Drew Long, Alex Koyfman




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Self-templated fabrication of FeMnO3 nanoparticles-filled polypyrrole nanotubes for peroxidase mimicking with a synergistic effect and their sensitive colorimetric detection of glutathione

Chem. Commun., 2018, Accepted Manuscript
DOI: 10.1039/C8CC01574K, Communication

Maoqiang Chi, Sihui Chen, Mengxiao Zhong, Ce Wang, Xiaofeng Lu
A self-templated approach has been developed for the preparation of FeMnO3 nanoparticles filled in the hollow core of polypyrrole (PPy) nanotubes by an in situ polymerization process accompanied with the...
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Self-Templated Synthesis of Heavily Nitrogen-Doped Hollow Carbon Spheres

Chem. Commun., 2018, Accepted Manuscript
DOI: 10.1039/C8CC00415C, Communication

jie lin, Wei Zhao, Meng Qian, Kun Liu, Jijian Xu, Fu Qiang Huang
Nitrogen-doped hollow carbon spheres with well-defined shape, uniform diameter, and high doping concentration (11 at%) are synthesized via space-confined thermal decomposition of a single source precursor zinc carbodiimide, which can...
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Heparin-induced tau filaments are structurally heterogeneous and differ from Alzheimer's disease filaments

Chem. Commun., 2018, Accepted Manuscript
DOI: 10.1039/C8CC01355A, Communication

Yann Fichou, Michael Vigers, Andrew K Goring, Neil A Eschmann, Songi Han
Alzheimer's disease (AD) is characterized by the presence of tau filaments in the brain whose structure was recently solved. The formation of AD filaments is routinely modeled in-vitro by mixing...
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One-step isothermal detection of multiple KRAS mutations by forming SNP specific hairpins on a gold nanoshell

Analyst, 2018, Accepted Manuscript
DOI: 10.1039/C8AN00525G, Communication

Chan Ho Chung, joong Hyun kim
We developed a one-step isothermal method for typing mutiple KRAS mutations using designed set of primers to form a hairpin on a gold nanoshell upon being ligated by a SNP...
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IJMS, Vol. 19, Pages 1148: Deoxyribonucleic Acid Damage and Repair: Capitalizing on Our Understanding of the Mechanisms of Maintaining Genomic Integrity for Therapeutic Purposes

IJMS, Vol. 19, Pages 1148: Deoxyribonucleic Acid Damage and Repair: Capitalizing on Our Understanding of the Mechanisms of Maintaining Genomic Integrity for Therapeutic Purposes

International Journal of Molecular Sciences doi: 10.3390/ijms19041148

Authors: Jolene Helena Anna Joubert Simone Grobbelaar Elsie Nolte Marcel Nel Michael Pepper Magdalena Coetzee Anne Mercier

Deoxyribonucleic acid (DNA) is the self-replicating hereditary material that provides a blueprint which, in collaboration with environmental influences, produces a structural and functional phenotype. As DNA coordinates and directs differentiation, growth, survival, and reproduction, it is responsible for life and the continuation of our species. Genome integrity requires the maintenance of DNA stability for the correct preservation of genetic information. This is facilitated by accurate DNA replication and precise DNA repair. DNA damage may arise from a wide range of both endogenous and exogenous sources but may be repaired through highly specific mechanisms. The most common mechanisms include mismatch, base excision, nucleotide excision, and double-strand DNA (dsDNA) break repair. Concurrent with regulation of the cell cycle, these mechanisms are precisely executed to ensure full restoration of damaged DNA. Failure or inaccuracy in DNA repair contributes to genome instability and loss of genetic information which may lead to mutations resulting in disease or loss of life. A detailed understanding of the mechanisms of DNA damage and its repair provides insight into disease pathogeneses and may facilitate diagnosis and the development of targeted therapies.

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IJMS, Vol. 19, Pages 1149: The Role, Involvement and Function(s) of Interleukin-35 and Interleukin-37 in Disease Pathogenesis

IJMS, Vol. 19, Pages 1149: The Role, Involvement and Function(s) of Interleukin-35 and Interleukin-37 in Disease Pathogenesis

International Journal of Molecular Sciences doi: 10.3390/ijms19041149

Authors: Ramatu Omenesa Bello Voon Chin Mohammad Abd Rachman Isnadi Roslaini Abd Majid Maizaton Atmadini Abdullah Tze Lee Zainul Amiruddin Zakaria Mohd Hussain Rusliza Basir

The recently identified cytokines—interleukin (IL)-35 and interleukin (IL)-37—have been described for their anti-inflammatory and immune-modulating actions in numerous inflammatory diseases, auto-immune disorders, malignancies, infectious diseases and sepsis. Either cytokine has been reported to be reduced and in some cases elevated and consequently contributed towards disease pathogenesis. In view of the recent advances in utilizing cytokine profiles for the development of biological macromolecules, beneficial in the management of certain intractable immune-mediated disorders, these recently characterized cytokines (IL-35 and IL-37) offer potential as reasonable targets for the discovery of novel immune-modulating anti-inflammatory therapies. A detailed comprehension of their sophisticated regulatory mechanisms and patterns of expression may provide unique opportunities for clinical application as highly selective and target specific therapeutic agents. This review seeks to summarize the recent advancements in discerning the dynamics, mechanisms, immunoregulatory and anti-inflammatory actions of IL-35 and IL-37 as they relate to disease pathogenesis.

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Simple and label-free pathogen enrichment via homobifunctional imidoesters using a microfluidic (SLIM) system for ultrasensitive pathogen detection in various clinical specimens

Publication date: 15 July 2018
Source:Biosensors and Bioelectronics, Volume 111
Author(s): Choong Eun Jin, Bonhan Koo, Eun Yeong Lee, Ji Yeun Kim, Sung-Han Kim, Yong Shin
Diseases caused by pathogenic microorganisms including bacteria and viruses can cause serious medical issues including death and result in huge economic losses. Despite the myriad of recent advances in the rapid and accurate detection of pathogens, large volume clinical samples with a low concentration of pathogens continue to present challenges for diagnosis and surveillance. We here report a simple and label-free approach via homobifunctional imidoesters (HIs) with a microfluidic platform (SLIM) to efficiently enrich and extract pathogens at low concentrations from clinical samples. The SLIM system consists of an assembled double microfluidic chip for streamlining large volume processing and HIs for capturing pathogens and isolating nucleic acids by both electrostatic and covalent interaction without a chaotropic detergent or bulky instruments. The SLIM system significantly increases the enrichment and extraction rate of pathogens (up to 80% at 10 CFU (colony forming unit) in a 1 mL volume within 50 min). We demonstrated its clinical utility in large sample volumes from 46 clinical specimens including environmental swabs, saliva, and blood plasma. The SLIM system showed higher sensitivity with these samples and could detect pathogens that were below the threshold of detection with other methods. Finally, by combining our SLIM approach with an isothermal optical sensor, pathogens could be detected at a very high sensitivity in blood plasma samples within 80 min via enrichment, extraction and detection steps. Our SLIM system thus provides a simple, reliable, cost-effective and ultrasensitive pathogen diagnosis platform for use with large volume clinical samples and would thus have significant utility for various infectious diseases.



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A sensitive signal-on photoelectrochemical sensor for tetracycline determination using visible-light-driven flower-like CN/BiOBr composites

Publication date: 15 July 2018
Source:Biosensors and Bioelectronics, Volume 111
Author(s): Pengcheng Yan, Desheng Jiang, Yuhui Tian, Li Xu, Junchao Qian, Henan Li, Jiexiang Xia, Huaming Li
As a broad-spectrum antibiotic, tetracycline (TC) is widely used in agricultural purposes and human therapy. More attention is paid to TC as a serious threat to human health, including the fast spreading of antibiotic resistance gene and the serious toxicity to aquatic organisms. Therefore, the timely and accurate determination of TC residues is an urgent task to protect the safety of human. Herein, an effective and facile photoelectrochemical sensor platform based on carbon nitride/bismuth oxyhalide (CN/BiOBr) composites can be constructed for monitoring TC. The flower-like CN/BiOBr composites are prepared via a simple one-pot ethylene glycol-assisted solvothermal process with the addition of ionic liquid 1-hexadecyl-3-methylimidazolium bromide ([C16mim]Br). In view of matched energy band positions of CN and BiOBr, the addition of CN can reduce the recombination of photogenerated electron-hole pairs and improve the efficiency of visible light utilization, leading to enhancing photoelectrochemical response of BiOBr. Under light excitation, the photocurrent of CN/BiOBr composites is drastically improved, which is 6 times as much as that of pure BiOBr. Considering the superior photoelectrochemical performance, a photoelectrochemical sensor for monitoring TC has been developed, displaying linearly enhanced photocurrent with increasing the TC concentration. Two linear relationships received are from 8.0 to 4.0 × 10² ng mL⁻¹, and 4.0 × 10² to 5.2 × 10³ ng mL⁻¹, respectively. The detection limit is 3.8 ng mL⁻¹. The photoelectrochemical sensor exhibits a series of benefits including excellent stability, a wide linear range, a low detection limit and good anti-interference ability. Therefore, this work may offer great promises in providing a universal and efficient photoelectrochemical sensor for the tetracycline detection, and pave the way of constructing more materials used in photoelectrochemical detection field.

Graphical abstract

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One-by-one imprinting in two eccentric layers of hollow core-shells: Sequential electroanalysis of anti-HIV drugs

Publication date: 15 July 2018
Source:Biosensors and Bioelectronics, Volume 111
Author(s): Kislay Singh, Swadha Jaiswal, Richa Singh, Sana Fatma, Bhim Bali Prasad
Double layered one-by-one imprinted hollow core-shells@ pencil graphite electrode was fabricated for sequential sensing of anti-HIV drugs. For this, two eccentric layers were developed on the surface of vinylated silica nanospheres to obtain double layered one-by-one imprinted solid core-shells. This yielded hollow core-shells on treatment with hydrofluoric acid. The modified hollow core-shells (single layered dual imprinted) evolved competitive diffusion of probe/analyte molecules. However, the corresponding double layered one-by-one imprinted hollow core-shells (outer layer imprinted with Zidovudine, and inner layer with Lamivudine) were found relatively better owing to their bilateral diffusions into molecular cavities, without any competition. The entire work is based on differential pulse anodic stripping voltammetry at double layered one-by-one imprinted hollow core-shells. This resulted in indirect detection of electro inactive targets with limits of detection as low as 0.91 and 0.12 (aqueous sample), 0.94 and 0.13 (blood serum), and 0.99 and 0.20 ng mL^-1 (pharmaceutics) for lamivudine and zidovudine, respectively in anti-HIV drug combination.



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Suggestions Offered to Reduce Physician Frustration With EHRs

TUESDAY, April 10, 2018 -- Changes can be implemented to help reduce physician frustration with electronic health records (EHRs), according to an article published in Medical Economics. In order to help physicians become more efficient and reduce...

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New Staging System Predicts CKD Progression in Children

TUESDAY, April 10, 2018 -- A new staging system can help better predict the length of time until a child with chronic kidney disease (CKD) will progress to end-stage renal disease (ESRD), according to a study published online April 10 in the...

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Polycystic Ovary Syndrome Tied to Risk of Mental Health Issues

TUESDAY, April 10, 2018 -- Polycystic ovary syndrome (PCOS) is associated with higher risk of psychiatric conditions, according to a study published online April 10 in the Journal of Clinical Endocrinology & Metabolism. Thomas R. Berni, from...

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Considerable Differences in Burden of Disease at State Level

TUESDAY, April 10, 2018 -- There are considerable differences in the burden of disease at the state level, according to a study published in the April 10 issue of the Journal of the American Medical Association. Ali H. Mokdad, Ph.D., from the...

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The epidemiology of Helicobacter pylori infection in Europe and the impact of lifestyle on its natural evolution toward stomach cancer after infection: A systematic review

Helicobacter, EarlyView.


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Disruption of NSD1 in head and neck cancer promotes favorable chemotherapeutic responses linked to hypomethylation

Human papillomavirus (HPV) negative head and neck squamous cell carcinoma (HNSCC) represents a distinct classification of cancer with poor expected outcomes. Of the 11 genes recurrently mutated in HNSCC, we identify a singular and substantial survival advantage for mutations in the gene encoding Nuclear Set Domain Containing Protein 1 (NSD1), a histone methyltransferase altered in approximately 10% of patients. This effect, a 55% decrease in risk of death in NSD1-mutated versus non-mutated patients, can be validated in an independent cohort. NSD1 alterations are strongly associated with widespread genome hypomethylation in the same tumors, to a degree not observed for any other mutated gene. To address whether NSD1 plays a causal role in these associations, we use CRISPR-Cas9 to disrupt NSD1 in HNSCC cell lines and find that this leads to substantial CpG hypomethylation and sensitivity to cisplatin, a standard chemotherapy in head and neck cancer, with a 40 - 50% decrease in IC50. Such results are reinforced by a survey of 1,001 cancer cell lines, in which loss-of-function NSD1 mutations have an average 23% decrease in cisplatin IC50 compared to cell lines with wild type NSD1. This study identifies a favorable subtype of head and neck cancer linked to NSD1 mutation, hypomethylation and cisplatin sensitivity.

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Targeting NAD+/PARP DNA repair pathway as a novel therapeutic approach to SDHB-mutated cluster I pheochromocytoma and paraganglioma

Purpose: Cluster I pheochromocytomas and paragangliomas (PCPGs) tend to develop malignant transformation, tumor recurrence, and multiplicity. Transcriptomic profiling suggests that cluster I PCPGs and other related tumors exhibit distinctive changes in the tricarboxylic acid (TCA) cycle, the hypoxia signaling pathway, mitochondrial electron transport chain, and methylation status, suggesting that therapeutic regimen might be optimized by targeting these signature molecular pathways. Experimental Design: In the present study, we investigated the molecular signatures in clinical specimens from cluster I PCPGs in comparison to cluster II PCPGs that are related to kinase signaling and often present as benign tumors. Results: We found that cluster I PCPGs develop dependency to mitochondrial complex I, evidenced by the upregulation of complex I components and enhanced NADH dehydrogenation. Alteration in mitochondrial function resulted in strengthened NAD+ metabolism, here considered as a key mechanism of chemoresistance, particularly, of succinate dehydrogenase subunit B (SDHB)-mutated cluster I PCPGs via the PARP1/BER DNA repair pathway. Combining a PARP inhibitor with temozolomide, a conventional chemotherapeutic agent, not only improved cytotoxicity but also reduced metastatic lesions, with prolonged overall survival of mice with SDHB knockdown PCPG allograft. Conclusions: In summary, our findings provide novel insights into an effective strategy for targeting cluster I PCPGs, especially those with SDHB mutations.

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Discovery of a glucocorticoid receptor (GR) activity signature using selective GR antagonism in ER-negative breast cancer

Purpose: Although high glucocorticoid receptor (GR) expression in early-stage estrogen receptor (ER)-negative breast cancer (BC) is associated with shortened relapse-free survival (RFS), how associated GR transcriptional activity contributes to aggressive BC behavior is not well understood. Using potent GR antagonists and primary tumor gene expression data, we sought to identify a tumor-relevant gene signature based on GR activity that would be more predictive than GR expression alone. Experimental Design: Global gene expression and GR ChIP-sequencing were performed to identify GR-regulated genes inhibited by two chemically distinct GR antagonists, mifepristone and CORT108297. Differentially expressed genes from MDA-MB-231 cells were cross-evaluated with significantly expressed genes in GR-high versus GR-low ER-negative primary BCs. The resulting subset of GR targeted genes was analyzed in two independent ER-negative BC cohorts to derive and then validate the GR activity signature (GRsig). Results: Gene expression pathway analysis of glucocorticoid-regulated genes (inhibited by GR antagonism) revealed cell survival and invasion functions. GR ChIP-seq analysis demonstrated that GR antagonists decreased GR chromatin association for a subset of genes. A GRsig comprised of n=74 GR activation-associated genes (also reversed by GR antagonists) was derived from an adjuvant chemotherapy-treated Discovery cohort and found to predicted probability of relapse in a separate Validation cohort (HR=1.9; p= 0.012). Conclusions: The GRsig discovered herein identifies high-risk ER-negative/GR-positive BCs most likely to relapse despite administration of adjuvant chemotherapy. Because GR antagonism can reverse expression of these genes, we propose that addition of a GR antagonist to chemotherapy may improve outcome of these high-risk patients.

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Resistance mechanisms to targeted therapies in ROS1+ and ALK+ non-small cell lung cancer

Purpose: Experimental Design: Results: Conclusions:

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A First-in-Human Phase 1 Study of LY3023414, an Oral PI3K/mTOR Dual Inhibitor, in Patients with Advanced Cancer

Purpose: The phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway is frequently aberrated in cancer. LY3023414 is a potent and selective ATP competitive inhibitor of class I PI3K isoforms, mTOR, and DNA-PK. Here we report the dose escalation results of the first-in-human phase I study of LY3023414.  Experimental Design: A 3+3 dose escalation for QD and BID oral dosing of LY3023414 was followed by an expansion cohort for CYP3A4 drug-drug interaction (DDI) assessment. The primary objective was to determine the recommended phase 2 dose (RP2D). Additional objectives included safety, pharmacokinetics (PK)/pharmacodynamics, and antitumor activity. Results: Forty-seven patients with solid tumors received LY3023414 at QD (20-450 mg) or BID dosing (150-250 mg). Dose-limiting toxicities were observed at 450 mg QD (thrombocytopenia, hypotension, hyperkalemia) in 3/3 patients, 250 mg BID dosing (hypophosphatemia, fatigue, mucositis) in 3/4 patients, and in 1/15 patients at 200 BID mg (nausea). Common related AEs included nausea (38%), fatigue (34%), and vomiting (32%) and were mostly mild or moderate. LY3023414 pharmacokinetics demonstrated dose-dependent increase in exposure with ≥ 90% target inhibition at doses ≥150 mg. DDI analysis demonstrated LY3023414 to be a weak inhibitor of CYP3A4. Durable partial response was observed in an endometrial cancer patient harboring PIK3R1 and PTEN truncating mutations and 13 additional patients (28%) had decrease in their target lesions by up to 30%.  Conclusions: LY3023414 has a tolerable safety profile and single agent activity in patients with advanced cancers. The RP2D of LY3023414 monotherapy is 200 mg BID based on safety, tolerability, and PK/Pharmacodynamic data.

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Patterns of Care of Breast Cancer Patients in a Rural Cancer Center in Western India

Abstract

Breast cancer is an emerging public health problem in low- and middle-income countries. The main objective is to describe the clinical characteristics and patterns of care of breast cancer patients diagnosed and treated in a rural cancer hospital in Barshi, Western India. The results from a cross-sectional study of 99 consecutive breast cancer patients diagnosed and treated between February 2012 and November 2014 in Nargis Dutt Memorial Cancer Hospital is reported. The case records of the patients were scrutinized and reviewed to abstract data on their clinical characteristics, diagnostic, and treatment details. The mean age at diagnosis of the patients was 52.8 ± 11.6 years; 83.5% of women were married, and 60.6% were illiterate. Sixty percent of patients had tumors measuring 5 cm or less. Almost half of the patients (46.4%) had stage I or II A disease and a third (36.0%) had axillary lymph node metastasis. Estrogen, progesterone, and human epidermal growth factor receptor2 receptor status were investigated in 41 (41.4%) of patients only. The median interval between diagnosis and initiation of treatment was 11 days. Modified radical mastectomy was done in 91% of patients, and nearly a third of patients who were prescribed chemotherapy did not complete treatment. The rural-based tertiary cancer care center has made treatment more accessible to breast cancer patients and has reduced the interval between diagnosis and treatment initiation. However, there are still many challenges like non-compliance to and incomplete treatments and poor follow-up that need to be addressed.

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IJMS, Vol. 19, Pages 1147: Multifaceted Role of Pneumolysin in the Pathogenesis of Myocardial Injury in Community-Acquired Pneumonia

IJMS, Vol. 19, Pages 1147: Multifaceted Role of Pneumolysin in the Pathogenesis of Myocardial Injury in Community-Acquired Pneumonia

International Journal of Molecular Sciences doi: 10.3390/ijms19041147

Authors: Ronald Anderson Jan Nel Charles Feldman

Pneumolysin (PLY), a member of the family of Gram-positive bacterial, cholesterol-dependent, β-barrel pore-forming cytolysins, is the major protein virulence factor of the dangerous respiratory pathogen, Streptococcus pneumoniae (pneumococcus). PLY plays a major role in the pathogenesis of community-acquired pneumonia (CAP), promoting colonization and invasion of the upper and lower respiratory tracts respectively, as well as extra-pulmonary dissemination of the pneumococcus. Notwithstanding its role in causing acute lung injury in severe CAP, PLY has also been implicated in the development of potentially fatal acute and delayed-onset cardiovascular events, which are now recognized as being fairly common complications of this condition. This review is focused firstly on updating mechanisms involved in the immunopathogenesis of PLY-mediated myocardial damage, specifically the direct cardiotoxic and immunosuppressive activities, as well as the indirect pro-inflammatory/pro-thrombotic activities of the toxin. Secondly, on PLY-targeted therapeutic strategies including, among others, macrolide antibiotics, natural product antagonists, cholesterol-containing liposomes, and fully humanized monoclonal antibodies, as well as on vaccine-based preventive strategies. These sections are preceded by overviews of CAP in general, the role of the pneumococcus as the causative pathogen, the occurrence and types of CAP-associated cardiac complication, and the structure and biological activities of PLY.

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Enhanced lymphodepletion is insufficient to replace exogenous IL-2 or IL-15 therapy in augmenting the efficacy of adoptively transferred effector CD8+ T cells

Effector CD8+ T cells conditioned with IL-12 during activation mediate enhanced antitumor efficacy after adoptive transfer into lymphodepleted hosts; this is due in part to improved IL-7 responsiveness. Therefore, we hypothesized that increasing the intensity or type of lymphodepletion would deplete more IL-7-consuming host cells and improve the persistence and antitumor activity of IL-12-conditioned CD8+ T cells. Using cyclophosphamide (CTX), fludarabine (FLU), and total body irradiation (TBI, 6 Gy) either individually or in combination, we found that combined lymphodepletion best enhanced T cell engraftment in mice. This improvement was strongly related to the extent of leukopenia, as post-transfer levels of donor T cells inversely correlated to host cell counts after lymphodepletion. Despite the improvement in engraftment seen with combination lymphodepletion, dual-agent lymphodepletion did not augment the antitumor efficacy of donor T cells compared to TBI alone. Similarly, IL-7 supplementation after TBI and transfer of tumor-reactive T cells failed to improve persistence or anti-tumor immunity. However, IL-15 or IL-2 supplementation greatly augmented the persistence and antitumor efficacy of donor tumor-reactive T cells. Our results indicate that the amount of host IL-7 induced after single agent lymphodepletion is sufficient to potentiate the expansion and antitumor activity of donor T cells, and that the efficacy of future regimens may be improved by providing post-transfer support with IL-2 or IL-15.

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Local Control for Clinical Stage I Non-small Cell Lung Cancer Treated with Five Fraction Stereotactic Body Radiation Therapy is Not Associated with Treatment Schedule

Publication date: Available online 10 April 2018
Source:Practical Radiation Oncology
Author(s): Pamela Samson, Sana Rehman, Aditya Juloori, Todd DeWees, Michael Roach, Jeffrey Bradley, Gregory M.M. Videtic, Kevin Stephans, Clifford Robinson
PurposeClinical concern remains regarding the relationship between consecutive (QD) versus non-consecutive (QoD) lung SBRT treatment schedules and outcomes for clinical Stage I NSCLC. We examined a multi-institutional series of patients receiving five fraction lung SBRT to compare the local failure rates and overall survival between patients receiving QD versus QoD treatment.Methods and MaterialsLung SBRT databases from two high-volume institutions were combined, and patients receiving five fraction SBRT for a solitary Stage I NSCLC were identified. QD treatment was defined as completing SBRT in ≤7days, while QoD treatment was defined as completing treatment in >7days. To control for patient characteristics between the two institutions, a 1:1 propensity matched analysis was performed. Multivariable logistic regression was performed to identify variables independently associated with local failure, and Cox proportional hazards modeling to identify variables independently associated with increased mortality.ResultsFrom 2005–2016, 245 clinical Stage I NSCLC patients receiving five fraction SBRT were identified. 117 (47.8%) patients received QD treatment and 128 (52.2%) patients received QoD treatment. On propensity matched analysis, no association was seen between QD treatment and local failure (Odds Ratio for QD treatment 0.48, 95% CI 0.12–1.99, p=0.5). On multivariable logistic regression central tumors were independently associated with increased likelihood of local recurrence (OR 5.2, 95% CI 1.11–24.2, p=0.04). Kaplan–Meier analysis identified no difference in median overall survival between QD versus QoD treatments (38.0months versus 38.0months, log-rank p=0.7), respectively. QD treatment was not associated with an increased mortality hazard (HR 1.08, 95% CI 0.67–1.75, p=0.75).ConclusionsThis analysis demonstrated no association between QD versus QoD treatment scheduling and local control or overall survival for early stage NSCLC.



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The long-term sequelae of palliative radiotherapy to Lumbo-sacral spine using conventional PA-single portal technique

Publication date: Available online 10 April 2018
Source:Practical Radiation Oncology
Author(s): Kuan-Yin Hsiao, Hui-Chuan Wang, Steve H Fung, Waqar Haque, E Brian Butler, Bin S Teh




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[ASAP] Signal Smoothing with PLS Regression

Analytical Chemistry

DOI: 10.1021/acs.analchem.8b01194

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Multiple perioral homogenous blue macules

Clinical and Experimental Dermatology, EarlyView.


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Long‐term outcomes in oral cavity squamous cell carcinoma with adjuvant and salvage radiotherapy after surgery

The Laryngoscope, EarlyView.


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Multiple perioral homogenous blue macules

Clinical and Experimental Dermatology, EarlyView.


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Long‐term outcomes in oral cavity squamous cell carcinoma with adjuvant and salvage radiotherapy after surgery

The Laryngoscope, EarlyView.


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Current trends in the medical management of osteoradionecrosis using triple therapy

Publication date: Available online 9 April 2018
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): J. Dhanda, L. Rennie, R. Shaw
Recent guidelines from the National Institute for Health and Care Excellence (NICE) have suggested that the medical management of osteoradionecrosis (ORN) of the jaws should be used in clinical trials only, and some drugs and therapeutics committees have withdrawn funds for such prescriptions. With increased scrutiny on the use of these agents, the aims of this study were to ascertain current trends in the presentation and management of ORN, with particular focus on which agents are being used.



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Use of patient-reported outcome measures in oral and maxillofacial trauma surgery: a review

Publication date: Available online 9 April 2018
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): R. Ologunde, N.M.H. McLeod
In the UK, about one person/100/year sustains a facial injury, so trauma surgery accounts for a considerable part of the caseload in oral and maxillofacial surgery (OMFS). Patient-reported outcome measures (PROM) allow for patient-centred assessment of postoperative outcomes, but to our knowledge, most research in OMFS trauma does not currently include them. To investigate their use, we searched Medline to find relevant studies that reported outcomes from inception in January 1879 to August 2016. Those not in the English language and those that did not report operations were excluded. We retrieved 416 articles, of which 21 met the inclusion criteria (five randomised controlled trials and 16 cohort studies) yielding 16 outcome measures. Most of these had been devised by authors (eight studies), four studies reported use of the Geriatric Oral Health Assessment Index, and three the Nasal Obstruction Symptom Evaluation. Most were used in studies on mandibular surgery (n=13), followed by those on nasal and facial surgery (n=3 each). There is a great heterogeneity in the use of these assessments in OMF trauma. In view of their increasing importance compared with simpler objective measures that may not be relevant to the patients' own perception, more research is needed to establish which of them can be used to measure the QoL of patients treated for OMF trauma.



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Dentin dysplasia type I—A dental disease with genetic heterogeneity

Oral Diseases, EarlyView.


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Morphosyntactic abilities of toddlers with hearing impairment and normal hearing: evidence from a sentence‐repetition task

International Journal of Language &Communication Disorders, EarlyView.


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Pulsed dye laser treatment of rosacea using a novel 15 mm diameter treatment beam

Lasers in Surgery and Medicine, EarlyView.


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Editorial Board

Publication date: June 2018
Source:Biomaterials, Volume 168





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Laryngopharyngealer Reflux

Laryngo-Rhino-Otol 2018; 97: 238-245
DOI: 10.1055/s-0044-100794

Die Prävalenz von laryngopharyngealem Reflux (LPR) wird in der Allgemeinbevölkerung mit bis zu 31 % angegeben. Bei Patienten mit Stimmproblemen bzw. Kehlkopferkrankungen tritt ein LPR bei ca. 50 % der Patienten als Begleiterscheinung auf. Typische refluxbedingte Erkrankungen am Larynx sind eine chronische Laryngitis und das Kontaktgranulom. Nicht abschließend geklärt ist die Rolle des LPR bei der Genese des Stimmlippenkarzinoms. Für die Diagnose des LPR gibt es noch keine evidenzbasierten Daten, er kann jedoch üblicherweise klinisch aus der Kombination typischer Symptome (Heiserkeit, chronischer Hustenreiz/Räuspern, Globusgefühl/Dysphagie) und dem charakteristischen laryngoskopischen Bild (ein Schleimhauterythem bzw. eine Schleimhauthyperplasie mit Fältelung der Interarytenoidregion und ein Stimmlippenödem) gestellt werden. Gelegentlich wird eine LPR zusätzlich durch eine pharyngeale 24h-pH-Metrie-Untersuchung gesichert. Die Therapie des LPR umfasst mehrere Bereiche, wie z.B. diätetische Maßnahmen, die medikamentöse Therapie mit Protonenpumpeninhibitoren (PPIs) und ggf. eine chirurgische Intervention. Bei symptomatischen Patienten erfolgt oft eine Therapie mit PPIs, bei der der HNO-Arzt im engen Dialog mit dem Gastroenterologen steht.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Rhinoplastik

Laryngo-Rhino-Otol 2018; 97: 289-292
DOI: 10.1055/a-0549-3244

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Radiologisch basierte Therapie des Kehlkopfkrebses überprüft

Laryngo-Rhino-Otol 2018; 97: 231-232
DOI: 10.1055/s-0044-100272

Ko HC et al. Survival Outcomes for Patients With T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx. JAMA Otolaryngol Head Neck Surg 2017; 143: 1126–1133 Wie ist das Überleben von Patienten mit Kehlkopfkrebs im Stadium T3N0M0, die operativ oder mittels Radiotherapie behandelt wurden? Zur Klärung dieser Frage verglichen chinesische Wissenschaftler die retrospektiven Daten dieser Patienten über einen langfristigen Nachbeobachtungszeitraum.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Was bestimmt die Prognose von Patienten mit Störungen des Schluckvorganges?

Laryngo-Rhino-Otol 2018; 97: 232-234
DOI: 10.1055/s-0044-100285

Bock JM et al. Evaluation of the natural history of patients who aspirate. Laryngoscope 2017; 127: S1–S10 Die klinische Progression der Aspiration bis zu eventuellen pulmonalen Störungen ist nicht vollständig verstanden. Empfehlungen zur Ernährungsumstellung, Schwere von Penetration und Aspiration gemäß PAS sowie die Ätiologie der Dysphagie beeinflussen möglicherweise die Zeitspanne bis zum Auftreten des ersten pulmonalen Ereignisses sowie das Gesamtüberleben von Patienten mit VFS-dokumentierter, asymptomatischer Penetration und Aspiration.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Techniken der Stapedotomie

Laryngo-Rhino-Otol 2018; 97: 236-237
DOI: 10.1055/s-0044-102148

© Georg Thieme Verlag KG Stuttgart · New York

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Zum richtigen Umgang mit Bonusmeilen

Laryngo-Rhino-Otol 2018; 97: 274-275
DOI: 10.1055/s-0043-125169

© Georg Thieme Verlag KG Stuttgart · New York

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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 227-228
DOI: 10.1055/a-0549-3134

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Interne Validität des Acoustic Voice Quality Index Version 03.01 und des Acoustic Breathiness Index

Laryngo-Rhino-Otol
DOI: 10.1055/a-0596-7819

Hintergrund Akustische Messverfahren haben das Potential Heiserkeit und Behauchtheit objektiv zu messen und der Acoustic Voice Quality Index (AVQI) und der Acoustic Breathiness Index (ABI) zeigen gute Ergebnisse hinsichtlich Validität und Reliabilität. Das Ziel dieser Studie war die Überprüfung der internen Validität der aktuellen Version des AVQI 03.01 und des ABI im Deutschen. Hierzu wurde die Sensitivität gegenüber Stimmveränderungen im Heiserkeits- und Behauchtheitsgrad durch logopädische Stimmtherapie untersucht. Material und Methoden Insgesamt wurden 84 Stimmaufzeichnungen von fortlaufender Sprache und dem Vokal [a:] vor und nach einer Stimmtherapie verwendet. Alle Aufnahmen der 42 Probanden stammten von Stimmpatienten mit unterschiedlichen Schweregraden einer Dysphonie vor und nach einer konservativen Therapie. Alle Stimmen wurden von drei Stimmexperten nach dem RBH-System beurteilt. Ergebnisse Die Intra- Beurteiler Reliabilität ergab insgesamt eine hohe Reliabilität für Heiserkeit (Kappa Mittelwert = 0,76) und Behauchtheit (Kappa Mittelwert = 0,69). Die Inter- Beurteiler Reliabilität erreichte hingegen eine niedrigere Reliabilität für beide Stimmqualitätsaspekte, die zwischen Kappa = 0,27 und 0,29 lag. Für beide Messverfahren, AVQI und ABI, zeigte sich ein deutlicher Zusammenhang zwischen der Perzeption von Veränderungen der Stimmqualität vor und nach der Therapie und dem Messergebnis (Heiserkeit vs. AVQI: r = 0,715, p < 0,01 und Behauchtheit vs. ABI: r = 0,712, p < 0,01). Die Unterschiede waren auch nicht signifikant. Schlussfolgerung Die Resultate zeigten, dass AVQI Version 03.01 und ABI eine hohe interne Validität haben, um Stimmveränderungen nach Intervention zu erfassen. AVQI und ABI sind zwei valide und robuste Messinstrumente, die Heiserkeit und Behauchtheit objektiv messen können.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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