Active Surveillance und die moderne Diagnostik des Prostatatkarzinoms

Zusammenfassung

Hintergrund

Ein Teil der Prostatakarzinome wird in der primären Prostatabiopsie nicht detektiert, sodass bei weiterbestehendem Verdacht eine erneute Biopsie erfolgen muss. Neben der Problematik der Falsch-negativ-Rate in der systematischen Biopsie, besteht eine hohe Missklassifikationsrate, insbesondere das Tumorgrading betreffend. Dadurch kann es zu einer verspäteten Diagnose aggressiverer Tumoreigenschaften und im ungünstigsten Falle zu einem Versäumnis kurativer Ansätze kommen. Aufgrund dieser Problematik bestehen zahlreiche Ansätze, die Therapieentscheidung und Überwachung durch den Einsatz moderner Bildgebung und genetischer Biomarker zu optimieren

Ziel

Der Beitrag vermittelt eine Übersicht über die Active-Surveillance(AS)-Definitionen, die Problematik der Prostatakarzinomdetektion und genaue Grading-Abschätzung in der systematischen transrektalen Biopsie und den Einsatz der multiparametrischen MRT (mpMRT), der gezielten MRT- Fusionsbiopsie und genetischer Biomarker als potenzielle Lösungsansätze sowie deren Integration im klinischen Alltag.

Material und Methoden

Aktuelle Literatur wurde recherchiert und im Kontext mit eigenen Erfahrungen ausgewertet.

Ergebnisse

Die mpMRT sowie die gezielte MRT-Fusionsbiopsie sind dem aktuellen Standard der systematischen Biopsie in der Detektion des klinisch signifikanten Prostatakarzinoms überlegen. Besonders deutlich zeigt sich dies im Falle der Wiederholungsbiopsie des anterioren Prostatakarzinoms, einer persistierend suspekten PSA-Dynamik und Einschluss und Monitoring von AS-Patienten. Auch die Kombination mit weiteren neuartigen Prädiktoren sind weitere vielversprechende Ansätze.

Schlussfolgerung

Der potenzielle diagnostische Mehrwert kann ausschließlich durch eine interdisziplinäre Verknüpfung der zunehmend komplexeren diagnostischen Schritte erreicht werden. Effektive Lösungen im Rahmen der interdisziplinären Zusammenarbeit von Radiologen und Urologen auf Niveau der Fachgesellschaften sind notwendig, um Fragen bezüglich des Zeitaufwands und der Ressourcenverteilung mit den Leistungserstattern zu adressieren.

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Issue Information ‐ TOC

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Corrigendum

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In this Issue: Graphical Abstracts

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Issue Information ‐ Cover and Editorial Board

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Expanding unilateral cochlear implantation criteria for adults with bilateral acquired severe sensorineural hearing loss

Abstract

Objectives

To report on a retrospective cohort study on the effects of expanding inclusion criteria for application of cochlear implants (CIs) on the performance 1-year post-implantation.

Methods

Based on pre-implantation audiometric thresholds and aided speech recognition scores, the data of 164 CI recipients were divided into a group of patients that fulfilled conservative criteria (mean hearing loss at 0.5, 1 and 2 kHz > 85 dB HL and phoneme scores with hearing aids < 30%), and the remaining group of patients that felt outside this conservative criterion. Speech recognition scores (in quiet) and quality of life (using the NCIQ) of both groups, measured at 1-year post-implantation, were compared.

Results

The group that felt outside the conservative criterion showed a higher phoneme score at 1-year post-implantation compared to the conservative group, suggesting that relaxed criteria have a positive influence on the speech recognition results with CI. With respect to quality of life, both groups significantly improved 1-year post-implantation. The conservative group showed a higher benefit on the advanced perception domain of the NCIQ. Based on their worse pre-implantation hearing, this was expected.

Conclusions

The data suggest that relaxation of CI indication positively affects the speech recognition performance of patients with severe hearing loss. Both groups of patients showed a positive effect of CI on the quality of life. This benefit relates to communication skills and the subjective day-to-day functioning in society.

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Management of cutaneous T‐cell lymphomas: Established and emergent therapies

Abstract

Cutaneous T‐cell lymphoma is an uncommon group of non‐Hodgkin's lymphoma primarily affecting the skin. It is comprised of a variety of entities with different clinical behaviours and prognosis. Mycosis fungoides is the commonest subtype, and Sézary syndrome is a much rarer form of cutaneous T‐cell lymphoma. At this stage, control rather than cure is the goal of therapy, with particular emphasis placed on preserving quality of life. Our review of the efficacy, safety profile and accessibility of treatment modalities for mycosis fungoides/Sézary syndrome is a tailored guide for the clinician treating these rare conditions.

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Assessment of the efficacy and safety of platelet poor plasma gel as autologous dermal filler for facial rejuvenation

Summary

Background

The popularity of dermal fillers has grown rapidly in the last few years for facial rejuvenation. Plasma gel is an autologous gelatinous material that is prepared from the patient's own platelet poor plasma.

Objective

To evaluate the clinical efficacy and safety of plasma gel injection as a dermal filler for facial rejuvenation.

Patients and Methods

The current study was carried out on 52 females presented with facial aging divided into two groups: Group A included 34 females with facial wrinkles, and Group B included 18 females with tear trough deformity. After taking written informed consent, they received two sessions of plasma gel injections at 2‐week interval and followed up monthly for 3 months. They were assessed clinically before treatment sessions and at the end of follow‐up period.

Results

Both studied groups showed immediate significant clinical improvement after plasma gel injection that maintained till the end of follow‐up period. This finding was confirmed by significant reduction in the mean values of Wrinkle Severity Rating Scale (WSRS) in Group A and Tear Trough Rating Scale (TTRS) in group B, and significant improvement of skin homogeneity and texture in both groups. In general, the reported side effects were minimal and transient.

Conclusion

Autologous platelet poor plasma gel injection seems to be a cost‐effective, safe, well‐tolerated, and minimally invasive technique producing significant aesthetic correction of facial wrinkles and tear trough deformity.

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Thrombosis of abdominal aorta precipitating fatal subarachnoid haemorrhage

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Pharyngocutaneous fistula caused by dried 'Kombu (edible seaweed) after total laryngectomy

The most common early complication after total laryngectomy is pharyngocutaneous fistula (PCF). However, there are no reports of PCF after total laryngectomy caused by 'Kombu' (edible seaweed) as a foreign body in the digestive tract. A 68-year-old Japanese man had undergone total laryngectomy 5 years previously. He presented with PCF, neck swelling and pain. Video endoscopy showed that a dark green foreign body obstructed the digestive tract. PCF was successfully treated via emergency surgery comprising abscess drainage, foreign body removal and fistula closure. The foreign body was kombu. Clinicians who perform total laryngectomy should know the potential dangers of consuming hygroscopic food items that can cause bolus obstruction of the upper digestive tract and pharyngeal abscess and perforation.

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Comprehensive review of acute oesophageal necrosis

Acute oesophageal necrosis, also known as 'black oesophagus', is a rare condition characterised by the black discolouration of the oesophageal mucosa on endoscopy and involves the distal oesophagus in majority of cases but may also extend proximally. A number of conditions are found to be associated with it and it is thought to occur due to a combination of hypovolaemia and inadequate oesophageal protective mucosal barrier function. Gastric secretions may have a direct effect on the oesophageal mucosa. We present a case of a woman who presented with haematemesis and significant hypotension after a session of haemodialysis. Black oesophagus was confirmed on esophagogastroduodenoscopy. She was given two units of packed red blood cells and one unit of platelets, and started on a pantoprazole infusion. However, despite rigorous attempts at resuscitation the patient failed to recover.

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Temporal bone involvement of IgG4-related disease: a rare condition misleading to petrous apicitis causing lateral rectus palsy

IgG4-related disease (IgG4-RD) of temporal bone is rare and clinical manifestation mimics infection. A 19-year-old female presented with progressive left earache and intermittent left nasal obstruction. Then, she rapidly developed left lateral rectus palsy. The physical examination revealed mild redness of left tympanic membrane and a small nasal polyp from the left middle meatus. CT scan showed left petrous apicitis and enhancing sinonasal mucosa. Therefore, Gradenigo's syndrome was first considered. The empirical intravenous antibiotic was immediately prescribed and surgery was performed. The intraoperative pale soft tissue mass in middle ear and polyp in the left nasal cavity were sent for pathological examination and found positive immunohistochemical stains for IgG4 in plasma cells. Systemic corticosteroid, the first-line treatment, was started and her symptoms were finally recovery.

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Endoscopic control of gastric emptying after administration of intravenous erythromycin in an awake patient scheduled for urgent rigid bronchoscopy

Certain interventional pulmonology procedures such as the placement of a tracheal stent or resection of stenosing tracheal tumours require rigid bronchoscopy under general anaesthesia. Unlike an endotracheal tube with a cuff, the rigid bronchoscope only partially protects the airway from bronchoaspiration. For this reason, this procedure is performed on an elective basis in fasted patients. We describe the case of a 60-year-old man with acute respiratory distress requiring emergent rigid bronchoscopy following distal migration of a tracheal stent. One hour before the procedure, the patient had eaten a full meal. Gastric emptying was accelerated by perfusion of intravenous erythromycin and verified by endoscopy with a small diameter gastric endoscope under local anaesthesia. This 1 min procedure was very well tolerated by the patient and allowed to verify with certainty that the stomach was empty. The urgent rigid bronchoscopy for stent retrieval could then be performed safely without any risk of bronchoaspiration.

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Case of autoimmune polyglandular syndrome type 2: how we uncovered the diagnosis

A 24-year-old man with no significant medical history presented to the medical clinic with vomiting and giddiness for 2 days, loss of appetite for 1 month and progressive fatigability for the preceding 4 months. On examination, he was found to be hypotensive and was admitted to the hospital for work-up. Considering his abnormal labs and physical findings, he was worked up and was diagnosed with primary adrenal insufficiency. On further work-up for the aetiology of his Addison's disease, he was found to have concurrent autoimmune thyroiditis and vitiligo. A final diagnosis of autoimmune polyglandular syndrome type 2 was made. The patient was started on hormone replacement therapy and reported improvement of symptoms on 3-month follow-up visit.

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Uncommon presentation of medication-related osteonecrosis of the mandible in a patient with metastatic prostate cancer

An 82-year-old man with a background of prostate carcinoma and bony metastases presented with bilateral discharging neck fistulae. Two years prior to presentation, the patient had been treated with intravenous zoledronic acid for 1 year as part of chemotherapy. Intraoral examination revealed extensive bilateral medication-related osteonecrosis, with orocutaneous fistulae within the neck. Treatment comprised removal of loose necrotic bone sequestrae, debridement of the fistulae and long-term administration of antibiotics, vitamin E and pentoxifylline. Four weeks later, the orocutaneous fistulae had healed.

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Unusual complication of an Alaskan cruise: thinking outside the box

A 69-year-old man with a medical history of hypertension and diabetes presented with altered mental status once he returned from a 14-day Alaskan cruise. An extensive workup for stroke was negative. His physical examination was normal without any focal motor deficits, but he had developed memory loss and paresthesia. He admitted to eating a lot of fish when he was in Alaska. The whole-blood mercury level was found to be elevated. He was managed conservatively and his symptoms resolved completely in a few days. This led to a diagnosis of organic mercury toxicity.

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Arterioportal fistula after partial gastrectomy treated with coil embolisation

Arterioportal fistulas are a rare complication of abdominal interventions. They can remain asymptomatic for a long time and manifest with symptoms of portal hypertension. We present the case of a 65-year-old man admitted to the emergency room with increasing fatigue and melena. He had a history of partial gastrectomy with Billroth II reconstruction 40 years earlier for peptic ulcer perforation. On physical examination, he was pale and presented a machinery-type murmur in the epigastric area. Blood tests revealed iron deficiency anaemia of 5.6 g/dL. During hospitalisation, he required several blood transfusions and maintained melenas. An abdominal CT angiography showed a fusiform aneurysm of the left gastric artery draining to the venous portal-splenic confluent. He was successfully treated with transarterial coil embolisation of the left gastric artery aneurysm. The correct diagnosis of arterioportal fistulas can be very challenging, whereas the standard treatment with coil embolisation offers a low morbidity resolution of symptoms.

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Rare mimic of recurrent anaphylaxis

The distinction between true anaphylaxis and conditions that mimic it can be challenging. We present the unique case of a 23-year-old woman treated for recurrent episodes of anaphylaxis over the course of 11 years and the subsequent discovery of an unlikely condition. We also discuss our approach in managing cases where an anaphylactic mimic is suspected.

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Paramedian chest wall dermoid cyst

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Endophthalmitis with bilateral deafness from disseminated Streptococcus suis infection

Streptococcus suis is a Gram-positive cocci bacterium that are found mainly in pigs and can be transmitted to human through pigs or pork exposure. The disease is mainly found among occupations involving swine contact in western countries whereas in Asia the disease is usually contracted through raw pork consumption. In this case report, we present a case of a middle-aged Thai man who acquired the infection from raw pork consumption. He presented with endogenous endophthalmitis with infective spondylodiscitis, sepsis and meningitis and later developed blindness of the right eye and permanent bilateral hearing loss disseminated from S. suis infection. Our report suggests that S. suis infection be considered as a causative factor in patient presenting with established clinical symptoms and predisposing factors. Cultural habit of eating raw pork should be taken into account especially in Asian countries.

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A pigmented and eroded lesion on the buttock

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Global rosacea treatment guidelines and expert consensus points: The differences

Summary

Background

Rosacea is a highly prevalent, chronic inflammatory disease. The treatment of rosacea remains a challenge to dermatologists. Therapies include skin care, medications, lasers, and various combinations of these modalities. The appropriate treatment depends on clinical types and patient's various clinical symptoms.

Purpose

The purpose of this study was to review and compare current therapies for rosacea of all severities from four different guidelines.

Methodology

We searched PubMed using the keywords "rosacea," "treatment" AND ["erythema rosacea" OR "papulopustular rosacea" OR "ocular rosacea" OR "phymatous rosacea"]. We selected randomized controlled trials, observational studies, controlled clinical trials, and clinical trials. We indentified further studies (including the guidelines) by hand‐searching relevant publications and included those that met the inclusion criteria.

Results

The total number of records identified was 421. We limited our search to the specific abovementioned study types. Twenty‐five of these studies met with our inclusion criteria. An additional five manuscripts were selected using the abovementioned method, and four guidelines were included in this review.

Conclusion

Diagnosing and choosing the appropriate treatment options of rosacea according to guidelines is the basis of scientific criteria. More large‐scale randomized controlled clinical trials on new treatment methods, new drugs, or new dosage forms provide a new guideline for future rosacea treatment. Although there are some differences in the treatment of rosacea, it is generally based on anti‐demodex, anti‐inflammatory, and anti‐angiogenesis.

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Inverse association between statin use and head and neck cancer: A population‐based case‐control study in Han population

Abstract

Background

This case‐control study aimed to find the relationship between prior statin use and head and neck cancer occurrence using a large population‐based database.

Methods

This study used claims data from the Taiwan Longitudinal Health Insurance Database. We included 5515 patients with head and neck cancer as cases and 5515 propensity score‐matched patients without head and neck cancer as controls. Conditional logistic regressions were performed to investigate the relationship between head and neck cancer and prior statin exposure.

Results

Of the 11 030 total sampled patients, 16.95% had previously received prescriptions for statins. In addition, statin exposure was found in 15.99% of cases and 17.91% of controls. The logistic regression also revealed that the adjusted odds ratio of prior statin exposure for cases was 0.86 (95% confidence interval: 0.77‐0.95) compared to propensity score‐matched controls.

Conclusion

This study found an inverse association between statin usage and head and neck cancer occurrence.

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Positive pressure device treatment for Menière’s disease: an overview of the current evidence and a meta-analysis

Abstract

Objective

The objective was to critically assess the current evidence investigating the efficacy of using a positive pressure device in patients with definite or probable Menière's disease.

Methods

We performed a systematic literature search in MEDLINE, EMBASE and PsycINFO up to February 2018. We included both systematic reviews and primary literature [randomized controlled trials (RCTs)] investigating positive pressure treatment, in patients (≥ 18 years of age), with Menière's disease. We assessed the internal validity of systematic reviews using the AMSTAR tool and risk of bias of primary studies using the Cochrane Risk of bias tool. We performed a meta-analysis for each outcome based on the identified studies. The overall certainty of evidence for the outcomes was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

Results

The search for systematic reviews identified four relevant reviews. These all included the same four RCTs. An updated search identified one additional RCT. In total, five RCTs were included in the data synthesis. Our data synthesis showed no effect of positive pressure treatment on primary nor secondary outcomes. No serious adverse events were reported. The overall certainty of evidence ranged from very low to low, due to the serious risk of bias and imprecision.

Conclusion

The current available evidence does not support positive pressure device treatment in patients with Menière's disease. However, the limitations of the current literature hinder the possibility of any solid conclusion. There remains a need for randomized controlled trials of high quality to fully access the utility of this treatment.

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Coblator-Assisted Endoscopic Transnasal Resection of a Large Nasopharyngeal Pleomorphic Adenoma

Background. Pleomorphic adenomas occurring in the adult nasopharynx are rare, with our literature search identifying only 11 previous English-language reports. We document the unusual case of a large nasopharyngeal pleomorphic adenoma that was resected using radiofrequency coblation via an endoscopic transnasal approach. Methods. A 39-year-old male presented with worsening nasal congestion, intermittent otalgia, and a progressive change in voice. Flexible nasendoscopy showed a large homogeneous mass occupying the postnasal space, and computed tomography confirmed a 28 × 31 × 22 mm nasopharyngeal tumour. The biopsy-proven benign tumour was locally dissected using a coblator-assisted transnasal approach. Results. Histology confirmed complete excision of a myoepithelial-rich pleomorphic adenoma. The patient was symptom-free postoperatively, and no signs of recurrence were seen at one-year follow-up. Conclusions. This is a useful addition to the existing literature on surgical procedures used to treat benign pathology in the nasopharynx. The minimally invasive technique was well tolerated and had favourable patient outcomes.

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First-line therapy-stratified survival in BRAF-mutant melanoma: a retrospective multicenter analysis

Abstract

Background

Inhibition of the mitogen-activated protein kinase (MAPK) pathway as well as programmed death 1 receptor (PD-1) blockade was shown to prolong overall survival (OS) in patients with advanced B-Raf proto-oncogene (BRAF)-mutant melanoma. However, due to the lack of head-to-head trials, it remains unclear if one of these therapeutic approaches should be preferred in first-line therapy. Here, we present a retrospective analysis comparing anti-PD-1 monotherapy with BRAF/MAPK/ERK kinase (MEK) combined inhibition used as first-line agents in a real-world clinical setting.

Patients and methods

Clinical data, routine blood counts and lactate dehydrogenase (LDH) levels of 301 patients with unresectable or metastatic melanoma harboring an activating mutation in BRAF (V600E/K) were included. Of these, 106 received anti-PD-1 antibodies, while 195 patients were treated with a selective BRAF inhibitor combined with an MEK inhibitor as palliative first-line therapy. Patients were sub-grouped according to previously described predictive and prognostic markers.

Results

OS was significantly longer in patients receiving anti-PD-1 monotherapy compared to patients receiving combined MAPK inhibitors. Subsequent therapies were comparable among these groups. The difference in OS was less pronounced in patients with high LDH levels and visceral metastatic spread.

Conclusion

First-line treatment with a PD-1 blocking antibody might be associated with longer OS than first-line inhibition of the MAPK pathway in patients with advanced melanoma harboring mutant BRAF. These hypothesis-generating data need to be confirmed or rejected in prospective, randomized trials.

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Expression of a soluble IL-10 receptor enhances the therapeutic effects of a papillomavirus-associated antitumor vaccine in a murine model

Abstract

The presence of IL-10, produced either by tumor cells or immunosuppressive cells, is frequently associated with a poor prognosis for cancer progression. It may also negatively impact anticancer treatments, such as immunotherapies, that otherwise would promote the activation of cytotoxic T cells capable of detecting and destroying malignant cells. In the present study, we evaluated a new adjuvant approach for anticancer immunotherapy using a plasmid vector encoding a soluble form of the IL-10 receptor (pIL-10R). pIL-10R was coadministered to mice with a DNA vaccine encoding the type 16 human papillomavirus (HPV-16) E7 oncoprotein genetically fused with glycoprotein D of herpes simplex virus (HSV) (pgDE7h). Immunization regimens based on the coadministration of pIL-10R and pgDE7h enhanced the antitumor immunity elicited in mice injected with TC-1 cells, which express HPV-16 oncoproteins. The administration of the DNA vaccines by in vivo electroporation further enhanced the anticancer effects of the vaccines, leading to the activation of tumor-infiltrating polyfunctional E7-specific cytotoxic CD8⁺ T cells and control of the expansion of immunosuppressive cells. In addition, the combination of immunotherapy and pIL-10R allowed the control of tumors in more advanced growth stages that otherwise would not be treatable by the pgDE7h vaccine. In conclusion, the proposed treatment involving the expression of IL-10R enhanced the antitumor protective immunity induced by pgDE7h administration and may contribute to the development of more efficient clinical interventions against HPV-induced tumors.

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Effects of septorhinoplasty on smell perception

Abstract

Purpose

To assess whether significant changes in smell perception occur after septorhinoplasty, and evaluate whether septum deviation, allergic rhinitis, and surgical technique affect postoperative smell perception.

Methods

Thirty-four patients (> 18 years old) awaiting septorhinoplasty were included, while those with previous severe hyposmia or anosmia were excluded. The participants self-assessed their smell perception using a 100-mm visual analogue scale (VAS), where 0 mm indicated the inability to smell and 100 mm indicated normal smell perception. The University of Pennsylvania Smell Identification Test (UPSIT) was applied before the procedure, and 4 and 12 weeks after surgery.

Results

The UPSIT score showed no significant changes at 4 (p = 0.59; 95% CI − 0.35 to + 2) or 12 weeks (p = 0.16; 95% CI − 1.13 to + 0.66). A comparison of the VAS scores before and 4 weeks after surgery (p = 0.62; 95% CI − 0.63 to + 0.39) yielded similar results. However, the average VAS scores improved 12 weeks after surgery (p = 0.007; 95% CI + 0.22 to + 1.30). Olfactory function, measured using the UPSIT, was not influenced by open or closed surgical techniques (p ≥ 0.10), the presence or absence of rhinitis (p ≥ 0.15), or obstructive septum deviation (p ≥ 0.38). Twelve weeks after surgery, self-evaluated smell perception was better in patients who underwent a closed procedure rather than an open procedure (p = 0.006; 95% CI: −1.39 to −0.37).

Conclusion

A validated test demonstrates that septorhinoplasty does not compromise smell perception 4 and 12 weeks after surgery. However, it might improve smell perception by the self-report observation.

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Core Concept: Multimessenger astronomy probes deep-space events with an arsenal of lenses [Astronomy]

On September 22, 2017, four billion years into its journey through space, a ghostly particle hit the ice under Earth's South Pole. This rare event was picked up by IceCube, the largest neutrino detector on the planet, triggering a worldwide alert. In response, telescopes on the ground and in orbit...

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Signaling pathway of globo-series glycosphingolipids and {beta}1,3-galactosyltransferase V ({beta}3GalT5) in breast cancer [Biochemistry]

The globo-series glycosphingolipids (GSLs) SSEA3, SSEA4, and Globo-H specifically expressed on cancer cells are found to correlate with tumor progression and metastasis, but the functional roles of these GSLs and the key enzyme β1,3-galactosyltransferase V (β3GalT5) that converts Gb4 to SSEA3 remain largely unclear. Here we show that the expression...

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Correction for Hassall et al., Climate-induced phenological shifts in a Batesian mimicry complex [Correction]

EVOLUTION Correction for "Climate-induced phenological shifts in a Batesian mimicry complex," by Christopher Hassall, Jac Billington, and Thomas N. Sherratt, which was first published December 3, 2018; 10.1073/pnas.1813367115 (Proc Natl Acad Sci USA 116:929–933). Fig. 3. Trends in the number of high-fidelity model-mimic pairs in which (A) the model emerges...

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Correction for Street et al., Coevolution of cultural intelligence, extended life history, sociality, and brain size in primates [Correction]

COLLOQUIUM Correction for "Coevolution of cultural intelligence, extended life history, sociality, and brain size in primates," by Sally E. Street, Ana F. Navarrete, Simon M. Reader, and Kevin N. Laland, which was first published July 25, 2017; 10.1073/pnas.1620734114 (Proc Natl Acad Sci USA 114:7908–7914). The authors wish to note the...

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Functional diversity of motoneurons in the oculomotor system [Neuroscience]

Extraocular muscles contain two types of muscle fibers according to their innervation pattern: singly innervated muscle fibers (SIFs), similar to most skeletal muscle fibers, and multiply innervated muscle fibers (MIFs). Morphological studies have revealed that SIF and MIF motoneurons are segregated anatomically and receive different proportions of certain afferents, suggesting...

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Inhibition of EZH2 prevents fibrosis and restores normal angiogenesis in scleroderma [Medical Sciences]

Scleroderma (SSc) is a complex disease that involves activation of the immune system, vascular complications, and tissue fibrosis. The histone methyltransferase enhancer of zeste homolog 2 (EZH2) mediates trimethylation of lysine 27 of histone 3 (H3K27me3), which acts as a repressive epigenetic mark. Both EZH2 and H3K27me3 were elevated in...

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Solution to the 50-year-old Okazaki-fragment problem [Biochemistry]

The antiparallel structure of double-stranded DNA, together with the known 5′→3′ directionality of DNA polymerases, necessitates that the two DNA strands are replicated in opposite directions. The leading strand is synthesized in the same direction as the replication fork, whereas the lagging strand is replicated in the opposite direction. In...

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Plasma lipidome reveals critical illness and recovery from human Ebola virus disease [Systems Biology]

Ebola virus disease (EVD) often leads to severe and fatal outcomes in humans with early supportive care increasing the chances of survival. Profiling the human plasma lipidome provides insight into critical illness as well as diseased states, as lipids have essential roles as membrane structural components, signaling molecules, and energy...

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Male reproductive tract cilia beat to a different drummer [Cell Biology]

From early embryonic development through adulthood, cilia play crucial roles in unicellular to multicellular organisms. Current taxonomy classifies cilia as two types: motile (conventional) and nonmotile. Motile cilia possess the classic 9 + 2 organization of microtubules, typical of multiciliated epithelia and spermatozoon flagellum, whereas nonmotile cilia characteristically lack the...

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Klebsiella oxytoca enterotoxins tilimycin and tilivalline have distinct host DNA-damaging and microtubule-stabilizing activities [Microbiology]

Establishing causal links between bacterial metabolites and human intestinal disease is a significant challenge. This study reveals the molecular basis of antibiotic-associated hemorrhagic colitis (AAHC) caused by intestinal resident Klebsiella oxytoca. Colitogenic strains produce the nonribosomal peptides tilivalline and tilimycin. Here, we verify that these enterotoxins are present in the...

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Musical pleasure and musical emotions [Commentary]

In a pharmacological study published in PNAS, Ferreri et al. (1) present evidence that enhancing or inhibiting dopamine signaling using levodopa or risperidone modulates the pleasure experienced while listening to music. This result is the latest development in an already remarkable series of studies by the groups of Robert Zatorre...

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Uterine double-conditional inactivation of Smad2 and Smad3 in mice causes endometrial dysregulation, infertility, and uterine cancer [Physiology]

SMAD2 and SMAD3 are downstream proteins in the transforming growth factor-β (TGF β) signaling pathway that translocate signals from the cell membrane to the nucleus, bind DNA, and control the expression of target genes. While SMAD2/3 have important roles in the ovary, we do not fully understand the roles of...

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Tumor-suppressive signaling in the uterus [Physiology]

Endometrial cancer is the most common gynecologic cancer, with 63,230 new cases and 11,350 deaths in the United States in 2018 (1). The resulting fertility loss and the life-threatening potential of uterine cancer are devastating. Unfortunately, the etiology of endometrial cancer remains poorly defined, hampering the design of effective diagnostic...

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Infiltration of CD8+ T cells into tumor cell clusters in triple-negative breast cancer [Immunology and Inflammation]

Infiltration of CD8+ T lymphocytes into solid tumors is associated with good prognosis in various types of cancer, including triple-negative breast cancer (TNBC). However, the mechanisms underlying different infiltration levels are largely unknown. Here, we have characterized the spatial profile of CD8+ T cells around tumor cell clusters (tightly connected...

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Metabolic plasticity meets gene regulation [Systems Biology]

Tumor metabolism has been investigated as an exploitable avenue for treatment in the last several years. The link between tumor and metabolism traces its origin to a seminal observation by Otto Warburg, almost a century ago, that cancer cells, regardless of oxygen availability, convert most intracellular glucose to lactate—that is,...

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Recruitment of APOL1 kidney disease risk variants to lipid droplets attenuates cell toxicity [Medical Sciences]

Two coding variants in the apolipoprotein L1 (APOL1) gene (termed G1 and G2) are strongly associated with increased risk of nondiabetic kidney disease in people of recent African ancestry. The mechanisms by which the risk variants cause kidney damage, although not well-understood, are believed to involve injury to glomerular podocytes....

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Quantitative zeptomolar imaging of miRNA cancer markers with nanoparticle assemblies [Chemistry]

Multiplexed detection of small noncoding RNAs responsible for posttranscriptional regulation of gene expression, known as miRNAs, is essential for understanding and controlling cell development. However, the lifetimes of miRNAs are short and their concentrations are low, which inhibits the development of miRNA-based methods, diagnostics, and treatment of many diseases. Here...

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Dopamine neuron-derived IGF-1 controls dopamine neuron firing, skill learning, and exploration [Neuroscience]

Midbrain dopamine neurons, which can be regulated by neuropeptides and hormones, play a fundamental role in controlling cognitive processes, reward mechanisms, and motor functions. The hormonal actions of insulin-like growth factor 1 (IGF-1) produced by the liver have been well described, but the role of neuronally derived IGF-1 remains largely...

https://ift.tt/2TgQD2z

Multiple interactive memory representations underlie the induction of false memory [Psychological and Cognitive Sciences]

Theoretical and computational models such as transfer-appropriate processing (TAP) and global matching models have emphasized the encoding–retrieval interaction of memory representations in generating false memories, but relevant neural mechanisms are still poorly understood. By manipulating the sensory modalities (visual and auditory) at different processing stages (learning and test) in the...

https://ift.tt/2IClpPf

Structural, functional, and behavioral insights of dopamine dysfunction revealed by a deletion in SLC6A3 [Neuroscience]

The human dopamine (DA) transporter (hDAT) mediates clearance of DA. Genetic variants in hDAT have been associated with DA dysfunction, a complication associated with several brain disorders, including autism spectrum disorder (ASD). Here, we investigated the structural and behavioral bases of an ASD-associated in-frame deletion in hDAT at N336 (∆N336)....

https://ift.tt/2TlzPHG

IMRT Combined With Toripalimab in Unresectable Locally Recurrent Nasopharyngeal Carcinoma.

Conditions:   Nasopharyngeal Carcinoma;   Nasopharyngeal Neoplasms;   Nasopharyngeal Diseases;   Head and Neck Neoplasm
Interventions:   Drug: Tolipalimab;   Radiation: Reirradiation
Sponsor:   Sun Yat-sen University
Not yet recruiting

https://ift.tt/2BSw7M2

Experimental Pain Reporting Accuracy and Clinical Post-operative Pain

Conditions:   Surgical Procedure, Unspecified;   Pain, Postoperative;   ENT Disease
Intervention:   Device: pain reporting accuracy
Sponsors:   Carmel Medical Center;   University of Haifa
Not yet recruiting

https://ift.tt/2UbDmpi

A Dose Escalation Study of PF‑06939999 in Participants With Advanced or Metastatic Solid Tumors.

Conditions:   Advanced Solid Tumors;   Metastatic Solid Tumors
Intervention:   Drug: PF-06939999
Sponsor:   Pfizer
Not yet recruiting

https://ift.tt/2BTUs45

Nivolumab and BMS986205 in Treating Patients With Stage II-IV Squamous Cell Cancer of the Head and Neck

Conditions:   Lip;   Oral Cavity Squamous Cell Carcinoma;   Pharynx;   Larynx;   Squamous Cell Carcinoma
Interventions:   Biological: Nivolumab;   Biological: IDO1 Inhibitor BMS-986205;   Procedure: Therapeutic Conventional Surgery;   Other: Questionnaire Administration
Sponsor:   Thomas Jefferson University
Not yet recruiting

https://ift.tt/2U8lcoj

Serial Epstein-Barr Virus DNA Surveillance in Nasopharyngeal Carcinoma Patients

Condition:   Nasopharyngeal Carcinoma
Intervention:   Diagnostic Test: Plasma EBV DNA
Sponsor:   Sun Yat-sen University
Not yet recruiting

https://ift.tt/2BTUokR

Study of TQB2450 in Patients With Recurrent or Metastatic Squamous Cell Cancer of the Head and Neck（R/M SCCHN）

Condition:   Squamous Cell Carcinoma of the Head and Neck
Interventions:   Drug: TQB2450+cisplatin or carboplatin + 5-Fluorouracil (5-FU);   Drug: placebo+cisplatin or carboplatin + 5-Fluorouracil (5-FU)
Sponsor:   Chia Tai Tianqing Pharmaceutical Group Co., Ltd.
Not yet recruiting

https://ift.tt/2U5q2ms

On efficient Bayesian inference for models with stochastic volatility

Sakaria, DK; Griffin, JE; (2017) On efficient Bayesian inference for models with stochastic volatility. Econometrics and Statistics , 3 pp. 23-33. 10.1016/j.ecosta.2016.08.002 . Green open access

https://ift.tt/2NuuXuF

Trauma induced acute kidney injury

Perkins, ZB; Captur, G; Bird, R; Gleeson, L; Singer, B; O'Brien, B; (2019) Trauma induced acute kidney injury. PLoS One , 14 (1) , Article e0211001. 10.1371/journal.pone.0211001 . Green open access

https://ift.tt/2GNjQMF

Assessing the impact of artistic and cultural activities on the health and well-being of forcibly displaced people using participatory action research

Clini, C; Thomson, LJM; Chatterjee, HJ; (2019) Assessing the impact of artistic and cultural activities on the health and well-being of forcibly displaced people using participatory action research. BMJ Open , 9 (2) , Article e025465. 10.1136/bmjopen-2018-025465 . Green open access

https://ift.tt/2NtbOsW

Monitoring neovascularization and integration of decellularized human scaffolds using photoacoustic imaging

Ogunlade, O; Ho, J; Kalber, T; Hynds, R; Zhang, E; Janes, SM; Birchall, M; ... Beard, P; + view all Ogunlade, O; Ho, J; Kalber, T; Hynds, R; Zhang, E; Janes, SM; Birchall, M; Butler, C; Beard, P; - view fewer (2019) Monitoring neovascularization and integration of decellularized human scaffolds using photoacoustic imaging. Photoacoustics , 13 pp. 76-84. 10.1016/j.pacs.2019.01.001 . (In press). Green open access

https://ift.tt/2GMw1tl

Planning for Public Transport: Applying European Good Practice to UK Regions?

Hamiduddin, I; Hickman, R; (2018) Planning for Public Transport: Applying European Good Practice to UK Regions? In: Ferm, J and Tomaney, J, (eds.) Planning Practice: Critical Perspectives from the UK. (pp. 250-265). Routledge: New York, NY, USA.

https://ift.tt/2NBKetP

Y-linked iDmrt1 paralogue (iDMY) in the Eastern spiny lobster, Sagmariasus verreauxi: The first invertebrate sex-linked Dmrt

Chandler, JC; Fitzgibbon, QP; Smith, G; Elizur, A; Ventura, T; (2017) Y-linked iDmrt1 paralogue (iDMY) in the Eastern spiny lobster, Sagmariasus verreauxi: The first invertebrate sex-linked Dmrt. Developmental Biology , 430 (2) pp. 337-345. 10.1016/j.ydbio.2017.08.031 . Green open access

https://ift.tt/2GLuUKo

Structural Toxicity: Hypertrophy Models of Human Pluripotent Stem Cell-Derived Cardiomyocytes

Kriston-Vizi, J; Harding, SE; Földes, G; (2017) Structural Toxicity: Hypertrophy Models of Human Pluripotent Stem Cell-Derived Cardiomyocytes. In: Clements, M and Roquemore, L, (eds.) Stem Cell-Derived Models in Toxicology. (pp. 271-291). Humana Press: New York, NY, USA. Green open access

https://ift.tt/2NuuNn3

Meet the pagans: on the misuse of 'Beowulf' in 'Andreas'

North, R; (2018) Meet the pagans: on the misuse of 'Beowulf' in 'Andreas'. In: Magennis, H and Cesario, M, (eds.) Aspects of knowledge: Preserving and reinventing traditions of learning in the Middle Ages. (pp. 185-209). Manchester University Press: Manchester, UK.

https://ift.tt/2GJ9ZaZ

Phase 1 dose-finding and pharmacokinetic study of eribulin-liposomal formulation in patients with solid tumours

Evans, TRJ; Dean, E; Molife, LR; Lopez, J; Ranson, M; El-Khouly, F; Zubairi, I; ... Kristeleit, R; + view all Evans, TRJ; Dean, E; Molife, LR; Lopez, J; Ranson, M; El-Khouly, F; Zubairi, I; Savulsky, C; Reyderman, L; Jia, Y; Sweeting, L; Greystoke, A; Barriuso, J; Kristeleit, R; - view fewer (2019) Phase 1 dose-finding and pharmacokinetic study of eribulin-liposomal formulation in patients with solid tumours. British Journal of Cancer , 120 pp. 379-386. 10.1038/s41416-019-0377-x . Green open access

https://ift.tt/2GLhA8L

Cholangiocarcinoma is associated with a raised enhanced liver fibrosis (ELF) score independent of primary sclerosing cholangitis

Saffioti, F; Roccarina, D; Vesterhus, M; Hov, JR; Rosenberg, W; Pinzani, M; Pereira, SP; ... Thorburn, D; + view all Saffioti, F; Roccarina, D; Vesterhus, M; Hov, JR; Rosenberg, W; Pinzani, M; Pereira, SP; Boberg, KM; Thorburn, D; - view fewer (2019) Cholangiocarcinoma is associated with a raised enhanced liver fibrosis (ELF) score independent of primary sclerosing cholangitis. European Journal of Clinical Investigation , Article e13088. 10.1111/eci.13088 . (In press).

https://ift.tt/2NsN6ZO

MRI for patients with cardiac implantable electronic devices: simplifying complexity with a 'one-stop' service model

Bhuva, AN; Feuchter, P; Hawkins, A; Cash, L; Boubertakh, R; Evanson, J; Schilling, R; ... Manisty, CH; + view all Bhuva, AN; Feuchter, P; Hawkins, A; Cash, L; Boubertakh, R; Evanson, J; Schilling, R; Lowe, M; Moon, JC; Manisty, CH; - view fewer (2019) MRI for patients with cardiac implantable electronic devices: simplifying complexity with a 'one-stop' service model. BMJ Quality and Safety 10.1136/bmjqs-2018-009079 . (In press). Green open access

https://ift.tt/2GReVL1

Integrating Estuarine, Coastal and Inner Shelf Sediment Systems in a Common Conceptual Framework as a Basis for Participatory Shoreline Management

French, JR; Burningham, H; Thornhill, GD; Nicholls, RJ; (2016) Integrating Estuarine, Coastal and Inner Shelf Sediment Systems in a Common Conceptual Framework as a Basis for Participatory Shoreline Management. In: Meadows, ME and Lin, JC, (eds.) Geomorphology and Society. (pp. 245-277). Springer Japan: Tokyo, Japan. Green open access

https://ift.tt/2Nuup85

'Creative Little Scientists' Project: Mapping and Comparative Assessment of Early Years Science Education Policy and Practice

Stylianidou, F; Glauert, E; Rossis, D; Havu-Nuutinen, S; (2016) 'Creative Little Scientists' Project: Mapping and Comparative Assessment of Early Years Science Education Policy and Practice. In: Papadouris, N and Hadjigeorgiou, A and Constantinou, CP, (eds.) Insights from Research in Science Teaching and Learning: Selected Papers from the ESERA 2013 Conference. (pp. pp. 201-220). Springer: Cham, Switzerland. Green open access

https://ift.tt/2GKMIp4

Investigating the Nasal Cycle Using Unilateral Peak Nasal Inspiratory Flow and Acoustic Rhinometry Minimal Cross-Sectional Area Measurements

Tan, M; Whitcroft, KL; Mehta, N; Schilder, A; Leung, TS; Andrews, P; (2019) Investigating the Nasal Cycle Using Unilateral Peak Nasal Inspiratory Flow and Acoustic Rhinometry Minimal Cross-Sectional Area Measurements. Clinical Otolaryngology 10.1111/coa.13313 . (In press).

https://ift.tt/2NsMK5q

Optimal management of bio-based energy supply chains under parametric uncertainty through a data-driven decision-support framework

Medina-González, S; Shokry, A; Silvente, J; Lupera, G; Espuña, A; (2018) Optimal management of bio-based energy supply chains under parametric uncertainty through a data-driven decision-support framework. Computers and Industrial Engineering 10.1016/j.cie.2018.12.008 . (In press). Green open access

https://ift.tt/2NsNcRa

Towards an 'information technocracy'? Discourses of London's post-referendum real estate markets

Livingstone, ND; (2019) Towards an 'information technocracy'? Discourses of London's post-referendum real estate markets. In: Raco, M and Savini, F, (eds.) Planning and Knowledge: How New Forms of Technocracy are Shaping Contemporary Cities. Policy Press: Bristol. (In press).

https://ift.tt/2GPXD0C

Accidents Waiting to Happen

Forty, J; (2019) Accidents Waiting to Happen. Architectural Review (1458) pp. 96-97.

https://ift.tt/2Nw6IMz

The current landscape of European registries for rare endocrine conditions

Ali, SR; Bryce, J; Cools, M; Korbonits, M; Beun, JG; Taruscio, D; Danne, T; ... Ahmed, SF; + view all Ali, SR; Bryce, J; Cools, M; Korbonits, M; Beun, JG; Taruscio, D; Danne, T; Dattani, M; Dekkers, OM; Linglart, A; Netchine, I; Nordenstrom, A; Patocs, A; Persani, L; Reisch, N; Smythe, A; Sumnik, Z; Visser, WE; Hiort, O; Pereira, AM; Ahmed, SF; - view fewer (2019) The current landscape of European registries for rare endocrine conditions. European Journal of Endocrinology , 180 (1) pp. 89-98. 10.1530/EJE-18-0861 . Green open access

https://ift.tt/2GPXr1o

STEM Education as “Trojan Horse”: Deconstructed and Reinvented for All

Bencze, L; Reiss, MJ; Sharma, A; Weinstein, M; (2018) STEM Education as "Trojan Horse": Deconstructed and Reinvented for All. In: Bryan, L and Tobin, K, (eds.) 13 Questions: Reframing Education's Conversation: Science. (pp. 69-87). Peter Lang: New York, NY, USA. Green open access

https://ift.tt/2Nuu5pT

Varro and Italy: the de Lingua Latina and the Gauls

Arena, V; (2019) Varro and Italy: the de Lingua Latina and the Gauls. In: Aberson, M and Biella, MC and Wullschleger, M, (eds.) Nos sumus Romani qui fuimus ante: Memory of Ancient Italy. Peter Lang (In press).

https://ift.tt/2GPXbzs

The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study

Abstract

Purpose

To assess the impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients, we conducted retrospective before-after study in a tertiary teaching hospital.

Methods

We examined all adult patients admitted ICU after an elective operation for head and neck cancer, or esophageal cancer from February 2014 to January 2017. From February 2014 to July 2015, patients were administered hypotonic fluid (sodium; 35 mmol/L) as the National Institute for Health and Care Excellence (NICE) have recommended. From August 2015 to January 2017, patients were administered isotonic fluid (sodium; 140 mmol/L). We defined the incidence of delirium as the primary outcome. The delirium was defined as the Intensive Care Delirium Screening Checklist during the ICU stay ≥ 4. A propensity score-matched model was used to adjust confounders.

Results

As postoperative intravenous maintenance fluid, hypotonic fluid was administered to 119 patients and isotonic fluid was administered to 92 patients. Among those total cohorts, the incidence of postoperative delirium in the hypotonic group was 21.8%, which was significantly higher than that (9.8%) in the isotonic group (p = 0.019). After propensity score matching, we selected 77 patients in each group. The incidence of delirium during the ICU stay in the hypotonic group was 26.0%, which was significantly higher than the incidence of 11.7% in the isotonic group (p = 0.023).

Conclusions

In this study, the use of postoperative hypotonic maintenance fluid was associated with a higher risk of postoperative delirium than that when isotonic maintenance fluid was used.

https://ift.tt/2GKZpjv

Experimental research on the therapeutic effect of MMR vaccine to juvenile-onset recurrent respiratory papillomatosis

Abstract

Objective

To evaluate the efficacy of MMR vaccine in the treatment of juvenile-onset recurrent respiratory papillomatosis as adjuvant therapy by experimental research.

Methods

Thirty-one children with RRP were enrolled and assigned randomly to intervention group or control group. Fifteen subjects in intervention group were treated with local application MMR vaccine on the lesion after surgery; sixteen subjects in the control group were treated with surgical excision alone. The quantity of virus of positive specimens was measured by fluorescence quantitative polymerase chain reaction.

Results

After treatment with MMR vaccine, viral load of intervention group was (9.56 ± 11.03) × 10⁸  copies/ml, that of control group was (22.01 ± 17.78) × 10⁸ copies/ml, and there was significant difference between the two groups (P = 0.040).

Conclusions

Local application MMR vaccine as adjuvant therapy can reduce HPV viral load significantly. It is suggested that the MMR vaccine may inhibit replication of HPV DNA, but the curative effect needs further confirmation.

https://ift.tt/2NsUT9S

Bilateral Syphilitic Optic Neuropathy with Secondary Autoimmune Optic Neuropathy and Poor Visual Outcome

We describe the case of a 65-year-old man who suffered progressive visual loss despite appropriate treatment of ocular syphilis. Our patient initially presented with a unilateral 6th nerve palsy and associated double vision, which self-resolved over 6 months. His ophthalmic examination was otherwise normal. 12 months after the initial complaint, he represented with dyschromatopsia, reduced visual acuity, tonic pupils, and optic nerve atrophy. He tested positive for syphilis and was admitted for treatment of neurosyphilis with high-dose benzylpenicillin. Despite treatment, at a 4-month review his visual acuity remained poor and progression of optic nerve atrophy was noted alongside the development of bilateral central scotomas. Further testing was congruent with a diagnosis of autoimmune optic retinopathy. We propose this to be secondary to his syphilitic infection. Syphilis is known as the "great mimicker," and despite being quite treatable, this case highlights ongoing complexity in the diagnosis and management of syphilis, unfortunately with a poor visual outcome.
Case Rep Ophthalmol 2019;10:81–88

https://ift.tt/2T0sVbz

The ubiquitin-like modifier FAT10 is required for normal IFN-γ production by activated CD8+ T cells

Publication date: April 2019

Source: Molecular Immunology, Volume 108

Author(s): Mei Min Mah, Michael Basler, Marcus Groettrup

Abstract

FAT10 is the only ubiquitin-like modifier which directly targets its substrate proteins for rapid degradation by the proteasome. While the conjugation and proteasomal targeting of FAT10 are fairly well understood, the biological functions of FAT10 have remained largely elusive. Here we have investigated the role of FAT10 in cytokine responses in mice upon viral infection. We used lymphocytic choriomeningitis virus (LCMV) infection of mice to induce the IFN-γ and TNF-α-dependent expression of FAT10. We found that TCR-stimulated splenocytes derived from LCMV-infected FAT10^−/− mice secreted less IFN-γ and expressed less mRNA for IL-12 p40 but secreted more IFN-α and IFN-β compared to FAT10^+/− mice. The reduction in IFN-γ secretion could be assigned to CD8⁺ T cells. Nevertheless, LCMV viral clearance was similar in FAT10^−/− as compared to FAT10^+/− mice. Since FAT10 has previously been reported to promote influenza A virus (IAV) replication in vitro we have studied the effect of FAT10 deficiency during IAV infection in mice. Unexpectedly, IAV titers and disease symptoms were not changed in FAT10^−/− mice even though the Fat10 mRNA was rapidly induced in the lung upon IAV infection. In conclusion, we find that FAT10 fine-tunes the balance of interferons during viral infection by lowering the production of type I and enhancing type II interferons.

https://ift.tt/2ICkaQf

Otorhinolaryngological manifestations and delayed diagnosis in Kawasaki Disease

Publication date: Available online 26 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): M. Rouault, A. Coudert, R. Hermann, Y. Gillet, E. Truy, S. Ayari-Khalfallah

Abstract

Objectives

Kawasaki disease (KD) is a febrile multisystemic vasculitis of unknown etiology whose coronary prognosis is improved by early diagnosis and management. The objective of this study was to describe ENT manifestations encountered and to look for a delayed diagnosis associated with these manifestations.

Methods

A retrospective descriptive single-center study was conducted in Lyon between January 2009 and December 2017. All children treated for Kawasaki disease were included in the study. Clinical, biological and cardiac ultrasound data were collected. According to the diagnosis made at the first medical visit, children were classified into two groups: diagnosis of ENT spectrum or non-ENT diagnosis. The diagnostic times were compared by a Student test.

Results

142 patients were included: 64 in the ENT diagnostic group, 78 in the non-ENT diagnostic group. When the initial diagnosis was of ENT spectrum, the diagnostic time of KD was significantly longer: 8.51 days vs 5.77 days - (p <0.01). The total duration of fever was also longer - 10.92 vs 8.32 days – (p = 0.013) - and the frequency of antibiotics intake more important - 92.2% vs 46.2% - (p <0.01). Four children underwent surgery in the ENT diagnostic group: two retro-pharyngeal abscesses, one paracentesis and one cervicectomy.

Conclusions

ENT manifestations are frequently at the forefront of KD and constitute a misleading clinical picture responsible for delayed diagnosis and potentially inappropriate medico-surgical management. It is necessary to provide more education to practitioners for earlier recognition of Kawasaki disease.

https://ift.tt/2To2wEd

Radiation Exposure during Videofluoroscopic Swallowing Studies in Young Children

Publication date: Available online 25 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Eun Jae Ko, In Young Sung, Kyoung Hyo Choi, Yong Gyu Kwon, Jisun Yoon, Taehoon Kim

Abstract

Objectives

Swallowing difficulties are best assessed by videofluoroscopic swallowing studies (VFSS). However, limiting radiation exposure is important, especially in young children. The purpose was to evaluate radiation dose in young children during VFSS, and to investigate factors associated with it.

Methods

Children with swallowing difficulty who underwent VFSS from February 2012 to July 2014 were recruited. Dose area product (DAP) and screening time were offered by the fluoroscopy machine, and effective dose was calculated from the DAP using a conversion coefficient published by the National Radiological Protection Board (NRPB-R262). The age, gender, height, weight, body mass index (BMI), body surface area (BSA), underlying disease of the subject children, and results of VFSS were investigated.

Results

In 89 children (mean age 1.57±2.17, 55 boys and 34 girls), mean effective dose was 0.29±0.20 mSv, mean DAP was 2.41±1.65 Gy cm², and mean screening time was 2.24±0.99 minutes. The effective dose correlated with the screening time (r=0.598, p<0.001), age (r=0.210, p=0.049), height (r=0.521, p<0.001), weight (r=0.461, p<0.001), and BSA (r=0.493, p<0.001). There was no such correlation with gender, BMI, underlying disease, or the results of VFSS.

Conclusion

s: The effective dose during VFSS (0.29 mSv) in young children, which is affected by screening time, age, and body size, is considerably lower than the pediatric radiation exposure limit of 1mSv per year. However more than 4 VFSS annually would exceed this limit. Our findings will help physicians to reduce the radiation exposure and provide a useful references for future pediatric VFSS guidelines.

https://ift.tt/2IDPLBb

F-BAR domain only protein 1 (FCHO1) deficiency is a novel cause of combined immune deficiency in humans

Publication date: Available online 26 February 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Enrica Calzoni, Craig D. Platt, Sevgi Keles, Hye Sun Kuehn, Sarah Beaussant-Cohen, Yu Zhang, Julia Pazmandi, Gaetana Lanzi, Francesca Pala, Azzeddine Tahiat, Hasibe Artac, Raul Jimenez Heredia, Jasmin Dmytrus, Ismail Reisli, Vedat Uygun, Dilara Uygun, Aysen Bingol, Erdem Basaran, Kamel Djenouhat, Nafissa Benhalla

https://ift.tt/2EvPLik

Aberrant natural killer (NK) cell activation and dysfunction among ART-treated HIV-infected adults in an African cohort

Publication date: Available online 26 February 2019

Source: Clinical Immunology

Author(s): Rose Nabatanzi, Lois Bayigga, Stephen Cose, Sarah Rowland-Jones, Glenda Canderan, Moses Joloba, Damalie Nakanjako

Abstract

Background

We examined NK cell phenotypes and functions after seven years of ART and undetectable viral loads (<50 copies/ml) with restored CD4 T-cell counts (≥500 cells/μl) and age-matched healthy-HIV-uninfected individuals from the same community.

Methods

Using flow-cytometry NK cell phenotypes were described using lineage markers (CD56^+/-CD16^+/−). NK cell activation was determined by expression of activation receptors (NKG2D, NKp44 and NKp46) and activation marker CD69. NK cell function was determined by CD107a, granzyme-b, and IFN-gamma production.

Results

CD56 dim and CD56 bright NK cells were lower among ART-treated-HIV-infected than among age-matched-HIV-negative individuals; p = 0.0016 and p = 0.05 respectively. Production of CD107a (P = 0.004) and Granzyme-B (P = 0.005) was lower among ART-treated-HIV-infected relative to the healthy-HIV-uninfected individuals. NKG2D and NKp46 were lower, while CD69 expression was higher among ART-treated-HIV-infected than healthy-HIV-uninfected individuals.

Conclusion

NK cell activation and dysfunction persisted despite seven years of suppressive ART with "normalization" of peripheral CD4 counts.

https://ift.tt/2EenjAp

Initial safety analysis of a randomized phase II trial of nelipepimut-S + GM-CSF and trastuzumab compared to trastuzumab alone to prevent recurrence in breast cancer patients with HER2 low-expressing tumors

Publication date: Available online 25 February 2019

Source: Clinical Immunology

Author(s): Clifton G. Travis, M. Peace Kaitlin, P. Holmes Jarrod, J. Vreeland Timothy, F. Hale Diane, S. Herbert Garth, K. Litton Jennifer, K. Murthy Rashmi, Lukas Jason, E. People George, A. Mittendorf Elizabeth

Abstract

The development of HER2-targeted therapy has decreased recurrence rates and improved survival, transforming the natural history of HER2-positive breast cancer. However only a minority of breast cancer patients benefit as these agents are not used in patients with tumors expressing low levels of HER2. Preclinical data suggests a synergistic action of HER2-targeted vaccination with trastuzumab. We report the initial safety interim analysis of a phase II trial that enrolled patients with HER2 low-expressing (IHC 1+/2+) breast cancer who were clinically disease-free after standard therapy. Patients were randomized to receive the HER2-peptide vaccine nelipepimut-S + GM-CSF with trastuzumab (vaccine arm) or trastuzumab + GM-CSF (control arm) and were followed for recurrence. A planned analysis that occurred after enrollment of 150 patients showed no significant differences in toxicity between the two arms, including cardiac toxicity. The clinical efficacy of this combination will be reported 6 months after the final patient was enrolled.

https://ift.tt/2T3FXoT

Just enough: An introduction

Ingleby, M; Randalls, S; (2019) Just enough: An introduction. In: Ingleby, M and Randalls, S, (eds.) Just Enough: The History, Culture and Politics of Sufficiency. (pp. 3-12). Palgrave Macmillan: London, UK.

https://ift.tt/2VoXrZB

The enhanced liver fibrosis (ELF) test in diagnosis and management of liver fibrosis

Day, JW; Rosenberg, WM; (2018) The enhanced liver fibrosis (ELF) test in diagnosis and management of liver fibrosis. British Journal of Hospital Medicine , 79 (12) pp. 694-699. 10.12968/hmed.2018.79.12.694 .

https://ift.tt/2Eybwhy

In Control with No Control: Perceptions and Reality of Windows 10 Home Edition Update Features

Morris, J; Becker, I; Parkin, S; (2019) In Control with No Control: Perceptions and Reality of Windows 10 Home Edition Update Features. In: Proceedings of Workshop on Usable Security (USEC) 2019. NDSS Symposium: San Diego, CA, USA.

https://ift.tt/2ViVFJf

Targeting miR-34a/Pdgfra interactions partially corrects alveologenesis in experimental bronchopulmonary dysplasia

Ruiz-Camp, J; Quantius, J; Lignelli, E; Arndt, PF; Palumbo, F; Nardiello, C; Surate Solaligue, DE; ... Morty, RE; + view all Ruiz-Camp, J; Quantius, J; Lignelli, E; Arndt, PF; Palumbo, F; Nardiello, C; Surate Solaligue, DE; Sakkas, E; Mižíková, I; Rodríguez-Castillo, JA; Vadász, I; Richardson, WD; Ahlbrecht, K; Herold, S; Seeger, W; Morty, RE; - view fewer (2019) Targeting miR-34a/Pdgfra interactions partially corrects alveologenesis in experimental bronchopulmonary dysplasia. EMBO Molecular Medicine , 11 (2) , Article e9448. 10.15252/emmm.201809448 . Green open access

https://ift.tt/2EyM2AI

A discussion of statistical methods to characterize early growth and its impact on bone mineral content later in childhood

Crozier, SR; Johnson, W; Cole, TJ; Macdonald-Wallis, C; Muniz-Terrera, G; Inskip, HM; Tilling, K; (2019) A discussion of statistical methods to characterize early growth and its impact on bone mineral content later in childhood. Annals of Human Biology 10.1080/03014460.2019.1574896 . (In press).

https://ift.tt/2VoXmoL

Living related renal transplantation from grandparental donors to paediatric recipients

Scanes, M; Tanton, J; Knapp, K; Copley, A; Gaymer, C; Boyle, S; Hayes, WN; ... Marks, SD; + view all Scanes, M; Tanton, J; Knapp, K; Copley, A; Gaymer, C; Boyle, S; Hayes, WN; Kessaris, N; Mamode, N; Marks, SD; - view fewer (2017) Living related renal transplantation from grandparental donors to paediatric recipients. Presented at: 9th Congress of the International Pediatric Transplant Association (IPTA 2017), Barcelona, Spain. Green open access

https://ift.tt/2Ez1tci

Developing digital scholars: from the ivory tower to the Twittersphere

Hicks, A; (2016) Developing digital scholars: from the ivory tower to the Twittersphere. In: Mackenzie, A and Martin, L, (eds.) Developing Digital Scholarship: Emerging practices in academic libraries. (pp. 157-172). Facet Publishing: London, UK. Green open access

https://ift.tt/2VkMUyk

Health and social care practitioners' understanding of the problems of people with dementia‐related visual processing impairment

McIntyre, A; Harding, E; Yong, KXX; Sullivan, MP; Gilhooly, M; Gilhooly, K; Woodbridge, R; McIntyre, A; Harding, E; Yong, KXX; Sullivan, MP; Gilhooly, M; Gilhooly, K; Woodbridge, R; Crutch, S; - view fewer (2019) Health and social care practitioners' understanding of the problems of people with dementia‐related visual processing impairment. Health & Social Care in the Community 10.1111/hsc.12715 . (In press). Green open access

https://ift.tt/2Ez1nBs

The to-infinitival perfect: A study of decline

Bowie, J; Wallis, S; (2016) The to-infinitival perfect: A study of decline. In: Werner, V and Seoane, E and Suárez-Gómez, C, (eds.) Re-assessing the Present Perfect. (pp. 43-94). De Gruyter Mouton: Berlin, Germany. Green open access

https://ift.tt/2VkMzf2

உலகம் சமூக ஊடகங்களை எப்படி மாற்றியிருக்கிறது

Miller, D; Costa, E; Haynes, N; McDonald, T; Nicolescu, R; Sinanan, J; Spyer, J; ... Wang, X; + view all Miller, D; Costa, E; Haynes, N; McDonald, T; Nicolescu, R; Sinanan, J; Spyer, J; Venkatraman, S; Wang, X; Wang, X; - view fewer (2019) உலகம் சமூக ஊடகங்களை எப்படி மாற்றியிருக்கிறது (Priya K. Murthy, Trans.). UCL Press: London, UK. Green open access

https://ift.tt/2EyM23G

Social Semiotic Multimodality

Jewitt, C; Henriksen, B; (2016) Social Semiotic Multimodality. In: Klug, NM and Stöckl, H, (eds.) Handbuch Sprache im multimodalen Kontext = Handbook of Language in Multimodal Contexts. (pp. 145-164). De Gruyter: Berlin, Germany. Green open access

https://ift.tt/2VlKn7a

Pre-surgical Caregiver Burden and Anxiety Are Associated with Post-Surgery Cortisol over the Day in Caregivers of Coronary Artery Bypass Graft Surgery Patients

Singh Solorzano, C; Steptoe, A; Leigh, E; Kidd, T; Jahangiri, M; Poole, L; (2019) Pre-surgical Caregiver Burden and Anxiety Are Associated with Post-Surgery Cortisol over the Day in Caregivers of Coronary Artery Bypass Graft Surgery Patients. International Journal of Behavioral Medicine 10.1007/s12529-019-09775-6 . (In press). Green open access

https://ift.tt/2ExbR45

Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study

Richards, M; Sizer, A; Sharma, N; Rawle, MJ; Davis, D; Kuh, D; James, S-N; Identifying the lifetime cognitive and socioeconomic antecedents of cognitive state: seven decades of follow-up in a British birth cohort study. BMJ Open (In press).

https://ift.tt/2VlOgc6

Nietzsche and Freud: The 'I' and Its Drives

Gardner, S; (2015) Nietzsche and Freud: The 'I' and Its Drives. In: Constâncio, J and Mayer Branco, MJ and Ryan, B, (eds.) Nietzsche and the Problem of Subjectivity. (pp. 367-393). De Gruyter: Berlin, Germany. Green open access

https://ift.tt/2ExbGpr

The association between maternal-child physical activity levels at the transition to formal schooling: cross-sectional and prospective data from the Southampton Women’s Survey

Hesketh, KR; Brage, S; Cooper, C; Godfrey, KM; Harvey, NC; Inskip, HM; Robinson, SM; Hesketh, KR; Brage, S; Cooper, C; Godfrey, KM; Harvey, NC; Inskip, HM; Robinson, SM; Van Sluijs, EMF; - view fewer (2019) The association between maternal-child physical activity levels at the transition to formal schooling: cross-sectional and prospective data from the Southampton Women's Survey. International Journal of Behavioral Nutrition and Physical Activity , 16 (1) , Article 23. 10.1186/s12966-019-0782-9 . Green open access

https://ift.tt/2VkvAcT

Determinants of energy futures - a scenario discovery method applied to cost and carbon emission futures for South American electricity infrastructure

Moksnes, N; Rozenberg, J; Broad, O; Taliotis, C; Howells, M; Rogner, H; (2019) Determinants of energy futures - a scenario discovery method applied to cost and carbon emission futures for South American electricity infrastructure. Environmental Research Communications 10.1088/2515-7620/ab06de . (In press). Green open access

https://ift.tt/2ExbwOR

Paediatric renal transplantation: moving forward in the field

Mamode, N; Marks, SD; (2017) Paediatric renal transplantation: moving forward in the field. Pediatric Nephrology , 32 (11) pp. 2003-2004. 10.1007/s00467-017-3760-y . Green open access

https://ift.tt/2VkM5Wg

The changing treatment landscape for MDR/XDR-TB - can current clinical trials revolutionise and inform a brave new world?

Honeyborne, I; Lipman, M; Zumla, A; McHugh, TD; (2019) The changing treatment landscape for MDR/XDR-TB - can current clinical trials revolutionise and inform a brave new world? International Journal of Infectious Diseases 10.1016/j.ijid.2019.02.006 . (In press). Green open access

https://ift.tt/2Exw7CP

Standardization of pediatric uroradiological terms: a multidisciplinary European glossary

Vivier, P-H; Augdal, TA; Avni, FE; Bacchetta, J; Beetz, R; Bjerre, AK; Blickman, J; ... Riccabona, M; + view all Vivier, P-H; Augdal, TA; Avni, FE; Bacchetta, J; Beetz, R; Bjerre, AK; Blickman, J; Cochat, P; Coppo, R; Damasio, B; Darge, K; El-Ghoneimi, A; Hoebeke, P; Läckgren, G; Leclair, M-D; Lobo, M-L; Manzoni, G; Marks, SD; Mattioli, G; Mentzel, H-J; Mouriquand, P; Nevéus, T; Ntoulia, A; Ording-Muller, L-S; Oswald, J; Papadopoulou, F; Porcellini, G; Ring, E; Rösch, W; Teixeira, AF; Riccabona, M; - view fewer (2018) Standardization of pediatric uroradiological terms: a multidisciplinary European glossary. Pediatric Radiology , 48 (2) pp. 291-303. 10.1007/s00247-017-4006-7 . Green open access

https://ift.tt/2VnQwzQ

Inflammatory demyelination without astrocyte loss in MOG antibody-positive NMOSD

Wang, JJ; Jaunmuktane, Z; Mummery, C; Brandner, S; Leary, S; Trip, SA; (2016) Inflammatory demyelination without astrocyte loss in MOG antibody-positive NMOSD. Neurology , 87 (2) pp. 229-231. 10.1212/WNL.0000000000002844 .

https://ift.tt/2ExvYiL

Atlanto-occipital dislocation in a patient presenting with out-of-hospital cardiac arrest: a case report and literature review

Atlanto-occipital dislocation is a rare and severe injury of the upper spine associated with a very poor prognosis.

https://ift.tt/2SZvA5u

Effects of deoxynivalenol, 3-acetyl-deoxynivalenol and 15-acetyl-deoxynivalenol on parameters associated with oxidative stress in HepG2 cells

Abstract

This work studied the effect of deoxynivalenol (DON) and two of its acetylated analogs (3-ADON, 15-ADON) on first indicators of oxidative stress status, namely production of reactive oxygen species (ROS) and induction of lipid peroxidation (LPO), in HepG2 cells. HepG2 cells were exposed to different concentrations of the three toxins, either alone or in combinations, for 24, 48, and 72 h. Results of cytotoxicity obtained in HepG2 cells were correlated with the detection of ROS and LPO. This effect was inversely correlated with ROS while directly correlated with LPO for the assayed mycotoxins in individual treatment. Combinations of two toxins containing 15-ADON yielded highest values, while for two-toxin combinations with 3-ADON, the effects were minor. A combination of all three mycotoxins alleviated ROS production and the highest levels in LPO were detected, in association to a final breakdown of adaption of ROS early produced by HepG2. In conclusion, parameters of stress evaluation presented in this study (ROS and LPO), revealed increases in HepG2 cells exposed to DON, 3-ADON, and 15-ADON either individually or combined.

https://ift.tt/2UanhAm

Partial Trisomy of Chromosome 13 with a Novel Translocation (8 ; 13) and Unique Clinical Presentation in a Palestinian Infant

Partial trisomy 13 is a rare syndrome that usually culminates in death within the first six months of the infant's life. We present a rare case of partial trisomy 13q with exclusive clinical manifestations. The full-term male baby was born by normal vaginal delivery, his birth weight was 3500 grams, and head circumference was 30 cm. He had dysmorphic features in the form of microcephaly, trigonocephaly, depressed nose bridge, hypotelorism, long philtrum, high arch palate, left-sided inguinal hernia, hydrocele, and laryngomalacia. He was operated for pyloric stenosis at the age of 28 days. He also had left-sided severe pelvic-ureteral junction stenosis which was repaired by nephrostomy followed by pyeloplasty. Furthermore, he had right-sided vesicoureteral reflux grade III, right-sided hydronephrosis, small ventricular septum defect, small atrial septum defect, left lung lower lobe sequestration, and craniosynostosis of metopic suture. The baby had global developmental delay and failure to thrive. Cytogenetic study showed a 46,XY, der(8)t(8;13)(p23;q14) karyotype, emphasizing a partial trisomy 13q syndrome with a concomitant partial monosomy in 8p. The baby passed away, in the intensive care unit, at the age of 7 months due to respiratory failure resulting from recurrent chest infections. This is the first reported case of a partial trisomy 13q associated with chromosome 8 with unique clinical presentations. Cytogenetic study for both parents is recommended in order to pinpoint the origin of the translocation and to provide the proper counseling for the family.

https://ift.tt/2SsjWuO

Occlusal height difference between maxillary central and lateral incisors: should aesthetic perception influence bracket placement?

Abstract

Background

The aim of this study was to verify anecdotal evidence that the maxillary central-to-lateral occlusal height difference (OHD) of more than 0.5 mm is a feature displayed in the majority of media and to discuss its implications for individualized orthodontic treatment planning.

Methods

Photographs of smiling female models were collected from a variety of printed advertisements and allocated to 3 groups (n = 30 each): 1 dental, 2 fashion and 3 orthodontics. Group 4 used female patient images from orthodontic textbooks, assuming an OHD of 0.5 mm between maxillary central and lateral incisors. OHD was assessed by measuring the incisor height on the photographs and using average values to establish height differences.

Results

The average maxillary central-to-lateral incisor OHD differences were 1.39 mm (dental literature), 1.34 mm (fashion advertisements), 1.23 mm (orthodontics) and 0.62 mm (orthodontic textbooks) respectively. The differences between the advertisement groups were not significant (P >  0.05), but for orthodontic textbooks they were (P <  0.001).

Conclusions

Advertisers seem to prefer greater maxillary central-to-lateral OHD compared to commonly used bracket placement protocols. Therefore, discussing OHD at start of treatment is recommended; modification of commonly used bracket placement protocols may be helpful to achieve desired aesthetic outcome.

https://ift.tt/2BTh5W5

ICD-10-Symptom-Rating-Fragebogen zur Beurteilung psychischer Komorbiditäten bei Patienten mit chronischem Tinnitus

Zusammenfassung

Hintergrund

Psychische Komorbiditäten bei Tinnituspatienten sind häufig und ihre Diagnostik ist wichtig für Interventionen und Therapieerfolg. Hierbei ist die Auswahl geeigneter Fragebögen entscheidend. Ziel dieser Studie war es, das ICD-10-Symptom-Rating (ISR) für die Diagnostik psychologischer Komorbiditäten zu untersuchen.

Methode

In der vorliegende Studie wurden Tinnitusbelastung und psychische Komorbidität bei n = 311 Patienten mit chronischem Tinnitus untersucht, die eine 7‑tägige multimodale tinnitusspezifische Intensivtherapie absolvierten. Zur Messung der Tinnitusbelastung wurde die deutsche Version des Tinnitus-Fragebogens (TF) eingesetzt. Psychische Komorbidität wurde mit dem ISR (Gesamtbelastung, depressives Syndrom, Angstsyndrom, Zwangssyndrom, somatoformes Syndrom, Essstörungssyndrom), Perceived Stress Questionnaire (PSQ: Gesamtwert für subjektive Stressbelastung, „Anspannung", „Sorgen", „Freude" und „Anforderungen") sowie der Allgemeinen Depressionsskala (ADS) gemessen.

Ergebnisse

Bei 65 % der Patienten bestanden psychische Komorbiditäten. Die Gesamtwerte des TF, ISR, PSQ und ADS zeigten signifikante Verbesserungen nach der Therapie. Zu Beginn der Therapie fanden sich signifikante Korrelationen der eingesetzten Messinstrumente, d. h., die Tinnitusbelastung konnte durch ISR-Gesamtbelastung, -Zwangssyndrom und PSQ-Anspannung vorhergesagt werden. Nach der Therapie wurde die – nun verringerte – Tinnitusbelastung zusätzlich durch die ISR-Unterskalen „Depression" und „Esstörungssyndrom" vorhergesagt.

Schlussfolgerung

Der ISR ist zur Erfassung komorbider psychischer Belastung bei Patienten mit chronischem Tinnitus und zur Erfassung kurzfristiger Therapieeffekte geeignet. Bei der Therapie des chronischen Tinnitus sollten stressassoziierte Anspannung, depressives Erleben und dysfunktionales Coping, z. B. über maladaptives Essverhalten, berücksichtigt werden.

https://ift.tt/2EgX9wZ

Statistics make their “official entry” in the European Annals of Otorhinolaryngology Head & Neck Diseases

Publication date: Available online 26 February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): Q. Lisan, C. Martin, O. Laccourreye

https://ift.tt/2H7xg5P

Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on cervical lymphatic malformation in adults and children: Diagnosis

Publication date: Available online 25 February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): J. Lerat, A. Bisdorff-Bresson, M. Borsic, C. Chopinet, V. Couloignier, N. Fakhry, P. Fayoux, F. Jegoux, A. Larralde, N. Leboulanger, R. Nicollas, S. Pondaven Letourmy, SFORL work group

Abstract

Objectives

The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for the diagnosis of cervical lymphatic malformation in adults and children.

Methods

A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group, and finalized in a coordination meeting. Guidelines were graded A, B, C or expert opinion, by decreasing level of evidence.

Results

The SFORL recommends that complete ENT examination should be performed to identify lesions at high risk of complication or associated with poor prognosis. In case of diagnostic doubt, especially in latero-cervical or oral floor lesions, fine-needle aspiration cytology should be performed before therapeutic decision-making. One or more validated classifications should be used to assess treatment efficacy and monitor progression. The reliability of antenatal diagnosis should be ensured by associating MRI to ultrasound. In antenatal diagnosis, the locoregional extension of the cervical lymphatic malformation should be evaluated accurately for prognosis, and associated malformations should be screened for, to guide treatment options.

https://ift.tt/2tDZFIM

Dermoscopic phenotype of pseudoxanthoma elasticum skin lesions: a study of 16 patients

Abstract

Pseudoxanthoma elasticum (PXE) is an autosomal recessive metabolic disorder due to mutations in the ABCC6 gene on chromosome 16. Clinical manifestations of PXE are first observed in the skin which number among the criteria for diagnosis. Their identification can be problematic and might be easier diagnosed with help of dermoscopy (DS). PXE skin lesions are well described clinically in the literature, but only few case reports describe their DS features.

This article is protected by copyright. All rights reserved.

https://ift.tt/2BV2gCo

Analysis of Serum Metabolite Profiles in Syphilis Patients by Untargeted Metabolomics

Abstract

Background

Global metabolomics analysis can provide substantial information on energy metabolism, physiology, possible diagnostic biomarkers and intervention strategies for pathogens.

Objective

To gain a better understanding of the mechanisms of syphilis and analysis of serum metabolite profiles in syphilis patients.

Methods

we conducted an untargeted metabolomics analysis of serum from 20 syphilis patients and 20 healthy controls.

Results

A total of 2,890 molecular features were extracted from each sample, and the peak intensity of each feature was obtained. Distinct differential metabolites were identified by principal component analysis, partial least squares discriminant analysis, and hierarchical clustering analysis. Furthermore, five metabolites were identified as significantly different by Student's T‐test, including trimethylamine N‐oxide, L‐arginine, lysoPC(18:0), betaine, and acetylcarnitine. KEGG analysis showed that these differential metabolites were in various pathways, including Chagas disease, fatty acid biosynthesis, primary bile acid biosynthesis, Salmonella infection, ABC transporters, glycerophospholipid metabolism, and choline metabolism. Among them, trimethylamine N‐oxide was 3.922 times in patients with syphilis than healthy controls.

Conclusion

Trimethylamine N‐oxide may be used as an indicator to distinguish between syphilis patients and healthy controls. The changes in these metabolites suggest that T. pallidum affects the normal metabolic activity of host cells, providing some clues for elucidating the pathogenesis of T. pallidum.

This article is protected by copyright. All rights reserved.

https://ift.tt/2U82tJJ

Reply reply to the comments on “The increasing incidence of frontal fibrosing alopecia. In search of triggering factors.”

Abstract

We read with interest the opinion of Harries and Holmes¹ about our publication.² We have the impression that the authors may have confused the difference between an editorial and a commentary and misunderstood the strict standards and rules of a peer‐reviewed journal. As the authors of this critique provide no substantial discussion about the merit of our publication, we are addressing the issues raised in their text.

This article is protected by copyright. All rights reserved.

https://ift.tt/2BVsLYm

Re: The increasing incidence of frontal fibrosing alopecia. In search of triggering factors

Abstract

It was with disappointment we discovered on reading the commentary by Rudnicka and Rakowska [1] that the authors had used this editorial vehicle, usually so helpful in providing insightful critique of the latest research by experts in their field, to present their own unpublished data on dietary habits in frontal fibrosing alopecia (FFA). As clinicians, we rely on our ability to critically appraise the evidence presented in the literature to determine the most appropriate advice for our patients. Introducing these data in this way undermines the peer review process and does not allow critical reading as we have no clear idea of the methodology used.

This article is protected by copyright. All rights reserved.

https://ift.tt/2U8NsHA

Different presentations of linear IgA disease in a father and daughter

Abstract

Linear IgA bullous disease (LABD) is a subepidermal blistering disease from the deposition of IgA in the basement membrane zone (BMZ). Two main forms of the disease are described: chronic bullous dermatitis of childhood (CBDC) and adult linear IgA bullous dermatitis (A‐LABD), with different clinical presentation and prognosis.¹ We present LABD in a daughter with CBDC and a good response to treatment, and her father with A‐LABD and a chronic course.

This article is protected by copyright. All rights reserved.

https://ift.tt/2BToqFn

Successful treatment of progressive mucinous histiocytosis with multilayer CO2‐laser ablation

Abstract

Progressive mucinous histiocytosis (PMH) is a very rare, benign form of non‐Langerhans' cell histiocytosis of the skin. Patients show characteristic 2‐10 mm sized red‐brown and flesh colored, non‐pruritic papules, particularly on the back of the hands and the extensor sides of the forearms. Up to date seventeen respectively fifteen hereditary cases in seven respectively eight² families and five sporadic cases have been reported. Pathogenetically, a lysosomal storage disease of histiocytes, as well as proliferation and accumulation of histiocytes to a yet undetected stimulus are considered.

This article is protected by copyright. All rights reserved.

https://ift.tt/2U8NnDM

A novel moisturizer with high sun protection factor improves cutaneous barrier function and the visible appearance of rosacea‐prone skin

Summary

Background

Consensus guidelines advocate general skincare for rosacea patients.

Objectives

Two independent studies were performed to assess whether a tinted daily SPF‐30 facial moisturizer (DFM30) improves barrier function of dry skin and the efficacy and tolerability of DFM30 on rosacea‐prone skin.

Methods

In study 1, electrical capacitance (EC) and transepidermal water loss (TEWL) were measured at baseline, 2, 4, 8, and 24 hours after a single application of DFM30 and on a control site in 21 healthy females with dry skin. Study 2 evaluated 33 females with mild to moderate rosacea and nontransient erythema. Efficacy and tolerability after once‐daily DFM30 were assessed using a chromameter, image analysis of photographs, and trained rater and patient evaluations up to day 22.

Results

In study 1, EC showed statistically significant increases at 2, 4, and 8 hours, and TEWL showed statistically significant decreases 2, 4, 8, and 24 hours after DFM30 application to healthy females compared to baseline. In study 2, covering skin redness improved significantly after DFM30 application on day 1; 33.3% showed improved covering skin redness compared to baseline. Patients reported significantly less redness on day 8 than day 3. Feelings of dryness and tightness/tension were lower 30 minutes after first application. Feeling of dryness was lower than baseline after 3 days, 1 and 3 weeks. Image analysis suggested redness was significantly lower on day 22 compared to baseline. Chromameter readings showed significantly lower erythema on the cheek compared to baseline. All patients stated that DFM30 relieves and neutralizes visible redness who also indicated that they would purchase DFM30, and the product was well tolerated.

Conclusions

These studies show that DFM30 is suitable as part of the skincare regimens advocated by ROSacea COnsensus (ROSCO) for rosacea patients. DFM30 is an effective moisturizer that improves cutaneous barrier function and the appearance of rosacea‐prone skin.

https://ift.tt/2Ex3DJm

Trotula de Ruggiero: The Magistra mulier sapiens and her medical dermatology treatises

Summary

Trotula de Ruggiero is supposed to be one of the first female physician of the history, or at least the first who practiced, taught, and wrote medical texts inside the illustrious medieval Medical School of Salerno around the XI‐XII centuries. Here we retrace the steps of her fascinating history from historical cues to legendary anecdotes, through the analysis of the medical texts which were ascribed to her in the Middle Ages and that were very popular around Europe for several centuries, prevalently dealing with all the aspects of women's medical problems, with a focus on dermatology, cosmetic science, and obstetrics/gynecology.

https://ift.tt/2VkLm7C

A systematic review of hearing and vestibular function in carriers of the Pro51Ser mutation in the COCH gene

Abstract

Background and objectives

The Pro51Ser (P51S) COCH mutation is characterized by a late-onset bilateral sensorineural hearing loss (SNHL) and progressive vestibular deterioration. The aim of this study was to carry out a systematic review of all reported hearing and vestibular function data in P51S COCH mutation carriers and its correlation with age.

Materials and methods

Scientific databases including Medline, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, ISI Web of Knowledge, and Web of Science were searched to accumulate information about hearing outcome and vestibular function. Eleven genotype–phenotype correlation studies of the P51S COCH variant were identified and analyzed.

Results

The SNHL starts at the age of 32.8 years. The Annual Threshold Deterioration is 3 decibel hearing loss (dB HL) per year (1–24 dB HL/year). Profound SNHL was observed at 76 years on average (60–84 years). 136 individual vestibular measurements were collected from 86 carriers. The onset of the vestibular dysfunction was estimated around 34 years (34–40 years), and vestibular deterioration rates were higher than those of the SNHL, with complete bilateral loss observed between 49 and 60 years.

Conclusion

Both audiometric and vestibular data were processed with much different methodologies and pre-symptomatic P51S carriers were systematically underrepresented. Further delineation of this correlation would benefit cross-sectional and longitudinal study involving all (pre-symptomatic and symptomatic) P51S carriers.

https://ift.tt/2IALHS1

Cost analysis of office-based transnasal esophagoscopy

Abstract

Purpose

Although office-based transnasal esophagoscopy has been investigated extensively, a cost analysis is still lacking. We performed a cost analysis combined with feasibility study for two diagnostic processes: patients with globus pharyngeus and/or dysphagia, and hypopharyngeal carcinoma.

Methods

Prospective cohort study.

Results

Forty-one procedures were performed, of which 35 were fully completed. The procedure was well tolerated with mild complaints such as nasal or pharyngeal pain and burping. Four complications occurred: two minor epistaxis and two vasovagal reactions. In patients with globus pharyngeus and/or dysphagia, transnasal esophagoscopy resulted in a cost saving of €94.43 (p 0.026) per procedure, compared to our regular diagnostic process. In patients with suspicion of hypopharyngeal carcinoma, cost savings were €831.41 (p 0.000) per case.

Conclusions

Cost analysis showed that office-based transnasal esophagoscopy can provide significant cost savings for the current standard of care. Furthermore, this procedure resulted in good patient acceptability and few complications.

https://ift.tt/2TkJAG4

Isotretinoin and Hidradenitis Suppurativa

Abstract

We read with great interest the article by Gallagher et al.¹, in which eight patients with severe acne vulgaris, who were treated with Isotretinoin, developed painful nodules in their axillae and groins consistent with Hidradenitis Suppurativa (HS). These observations prompted that systemic Isotretinoin may cause flares of HS, particularly in young, thin males.

This article is protected by copyright. All rights reserved.

https://ift.tt/2GK2ZKH

Hidradenitis Suppurativa and Diabetes: Big Data Bias Masks a True Association

Abstract

Phan et al present an updated meta‐analysis of the association between Hidradenitis Suppurativa (HS) and Type 2 Diabetes Mellitus (DM) which demonstrates a statistically significant elevation in the odds ratio (OR) for DM in HS Patients compared with healthy controls (OR=2.17 95% CI 1.85‐2.55 p<0.001). They astutely highlight that the risk difference of 0.4% between HS patients and controls (16.1% vs 15.7%) implies that this result is clinically non‐significant, quite at odds with clinical experience, data from existing studies and the remainder of the article discussing the importance of DM awareness in HS patients and possible mechanistic links between DM and HS. The reason for this statistical‐common sense disconnect is the lack of acknowledgement of external bias in Phan's analysis. Whilst the methodology is sound, it does not eliminate all bias and residual confounding despite the high reported I2 (which as a point estimate is misleading in the setting of large heterogeneity). Although weighting of studies addresses 'within study variance' and heterogeneity (I2) assesses methodological (internal) heterogeneity, no consideration of external biases (including population bias and outcome bias) is provided by a statistical program, it requires the use of common sense on behalf of the statistician and authors often by plotting and visualising the data. We replicated Phan et al's analysis with the additional step of assessing studies for external bias and threats to generalisability. Visualisation of data in a L'Abbe plot demonstrates lack of clustering on the x axis‐ indicating violation of the assumption of one underlying baseline risk.

This article is protected by copyright. All rights reserved.

https://ift.tt/2Nr4n5F

Epidemiology and Dermatological Comorbidity of Seborrhoeic Dermatitis – Population‐based Study in 161,000 Employees

Summary

Background

Seborrhoeic dermatitis (SD) is a common but epidemiologically poorly researched chronic skin disease.

Objectives

To characterise the prevalence and dermatological comorbidity of SD in Germany.

Methods

In the course of voluntary company skin checks, full body examinations were carried out in more than 500 companies by experienced dermatologists and documented electronically.

Results

161,269 participants were included (55.5% male, mean age 43.2+10.9 years). SD was identified in 3.2% (men: 4.6%, women 1.4%). A significant difference was found between age groups (2.0% in < 35; 3.6% in 35‐64; 4.4% ≥ 65 years). Most frequent concomitant skin conditions were: folliculitis (17.0%, 95% CI 15.9‐18.1), onychomycosis (9.1%, 95% CI 8.3‐10.0), tinea pedis (7.1%, 95% CI 6.3‐7.8), rosacea (4.1%, 95% CI 3.6‐4.7), acne (4.0%, 95% CI 3.4‐4.5) and psoriasis (2.7%, 95% CI 2.3‐3.2).

Regression analysis revealed the following relative dermatological comorbidity when controlling for age and gender: folliculitis (OR 2.1, 95% CI 2.0‐2.3), contact dermatitis (OR 1.8, 95% CI 1.1‐2.8), intertriginous dermatitis (OR 1.8, 95% CI 1.4‐2.2), rosacea (OR 1.6, 95% CI 1.4‐1.8), acne (OR 1.4, 95% CI 1.2‐1.7), pyoderma (OR 1.4, 95% CI 1.1‐1.8), tinea corporis (OR 1.4, 95% CI 1.0‐2.0), pityriasis versicolor (OR 1.3, 95% CI 1.0‐1.7) and psoriasis (OR 1.2, 95% CI 1.0‐1.4).

Conclusions

SD is a common disease which is more prevalent in men and older people and has an increased rate of dermatological comorbidity. However, absolute differences in prevalence of comorbidities are mostly small and negligible. Nevertheless, the findings underline the necessity of integrated, complete dermatological diagnostics and therapy.

This article is protected by copyright. All rights reserved.

https://ift.tt/2ID8n4g

Antipruritic effects of transient heat‐stimulation on histaminergic and non‐histaminergic itch

Abstract

Background

Chronic itch is notoriously difficult to treat. Counter‐stimuli are able to inhibit itch, but this principle is difficult to apply in clinical practice, and the mechanisms behind counter‐stimulation‐induced itch suppression in humans are unclear.

Objectives

1) To analyse the stimulus‐response effects of transient heat stimuli on histaminergic and non‐histaminergic itch; 2) to investigate whether the antipruritic effect depends on homotopic (peripheral mediation) versus heterotopic (central mediation) counter‐stimulation relative to the itch provocation site.

Methods

18 healthy subjects (8 females, 25.7±0.8 y.o.) participated. Itch was evoked on pre‐marked areas of the volar forearms, by either histamine (1% solution), or cowhage (35‐40 spicules). In addition to the itch provocations (Experiment 1), 5‐seconds homotopic heat stimuli of 32, 40, 45 or 50°C were applied. In Experiment 2, heat stimuli were applied either homotopically, intra‐segmentally (next to the provocation site), or extra‐segmentally (dorsal forearm). Itch intensity was evaluated throughout the procedures using a digital Visual Analog Scale.

Results

Homotopic counter‐stimuli inhibited histaminergic itch by 41.27% at 45°C (p<0.01), and by 76.66% at 50°C (p<0.0001). Cowhage‐induced itch was less prone to counter‐stimulation and was only significantly diminished at 50°C by 43.60% (p=0.009). Counter‐stimulations applied heterotopically were not able to significantly inhibit itch.

Conclusions

Itch pathway‐specific effects of counter‐stimuli were observed between homo‐ and heterotopic stimulation. Histaminergic itch was robustly inhibited by short‐term homotopic noxious heat stimuli for up to 10 minutes. Non‐histaminergic itch was only weakly inhibited. The inhibitory effects exerted by the short‐term heat stimuli only occurred following homotopical counter‐stimulation.

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Dermoscopic and reflectance confocal microscopic features of epidermodysplasia verruciformis

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Clonal change of methicillin‐resistant Staphylococcus aureus isolated from patients with impetigo in Kagawa, Japan

Abstract

Recently, the USA300 clone, which is a Panton–Valentine leukocidin (PVL)‐positive clonal complex 8‐staphylococcal cassette chromosome mec type IV (CC8‐IV) community‐acquired methicillin‐resistant Staphylococcus aureus (CA‐MRSA) strain, emerged in community and hospital settings in Japan. Hence, clonal types of CA‐MRSA strains are predicted to be changing. Nonetheless, long‐term surveillance of CA‐MRSA has not been conducted in Japan. Here, we investigated the transition and current status of CA‐MRSA strains isolated from outpatients with impetigo; the samples were collected between 2007 and 2016 in Kagawa, Japan. The detection rate (22.8%, 488/2139 strains) of MRSA slightly decreased in these 10 years. Molecular epidemiological analyses showed that the prevalence of the CC89‐II clone, which is a typical CA‐MRSA genotype of causative agents of impetigo, significantly decreased from 48.0% (48/100 strains) in 2007–2009 to 21.9% (16/73 strains) in 2013–2016. By contrast, a non‐USA300 CC8‐IV clone, which is a highly pathogenic CA‐MRSA/J clone, significantly increased in prevalence from 9.0% (9/100 strains) to 32.9% (24/73 strains). The prevalence of PVL‐positive CA‐MRSA strains increased annually from 2012 (0%) to 2015 (6.7%), whereas only one of these strains turned out to be the USA300 clone. Antibiotic susceptibility data revealed that the rates of resistance to gentamicin and clindamycin among CA‐MRSA strains decreased along with the decreased prevalence of the CC89‐II clone and increased prevalence of the CA‐MRSA/J clone. Our data strongly suggest that the clonal types and antibiotic susceptibility of CA‐MRSA isolated from patients with impetigo dramatically changed during the last 10 years in Japan.

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Shiunko and Chuoko, topical Kampo medicines, inhibit the expression of gehA encoding the extracellular lipase in Cutibacterium acnes

Abstract

Antimicrobial agents have been used for eradication of Cutibacterium (formerly Propionibacterium) acnes that is an exacerbation factor of the skin disease acne vulgaris. However, the use of antibiotics is associated with an increased risk of promoting the emergence of resistant bacteria and leading to skin dysbiosis. Traditional Japanese Kampo medicines, such as Keigairengyoto, are used to treat acne. However, there is incomplete understanding regarding their functional mechanism in treatment of acne. In this study, we examined the antimicrobial and anti‐lipase activity of the Kampo medicines used empirically for acne treatment. Three oral medicines, Keigairengyoto, Seijoboufuto and Jumihaidokuto, were found to inhibit the growth of C. acnes and decrease the lipase activity. Especially, Keigairengyoto caused remarkable decrease of bacterial lipase activity. Furthermore, topical medicines such as Shiunko and Chuoko significantly decreased the lipase activity in a dose‐dependent manner, without inhibiting C. acnes growth. The topical medicines were found to inhibit the expression of gehA, which codes for extracellular lipase. Our results indicate that Shiunko and Chuoko have potential as effective acne therapeutic agents, especially because they do not promote the emergence of antimicrobial‐resistant bacteria and skin dysbiosis.

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Acitretin‐induced curling of hair in a Korean male

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Unknown primary Merkel cell carcinoma responding well to first‐line treatment with avelumab

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Prevention of tumor progression in Stewart–Treves syndrome with a low dose of pazopanib

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Comparison of plasma and CSF Neurofilament-light in an MS trial

de Flon, P; Laurell, K; Sundström, P; Blennow, K; Söderström, L; Zetterberg, H; Gunnarsson, M; de Flon, P; Laurell, K; Sundström, P; Blennow, K; Söderström, L; Zetterberg, H; Gunnarsson, M; Svenningsson, A; - view fewer (2019) Comparison of plasma and CSF Neurofilament-light in an MS trial. Acta Neurologica Scandinavica 10.1111/ane.13078 . (In press).

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Foreword: OpenStreetMap Studies and Volunteered Geographical Information

Haklay, M; (2015) Foreword: OpenStreetMap Studies and Volunteered Geographical Information. In: Arsanjani, JJ and Zipf, A and Mooney, P and Helbich, M, (eds.) OpenStreetMap in GIScience: Experiences, Research, and Applications. (v-vii). Springer: Cham, Switzerland. Green open access

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Hepatic DNA damage in harbour porpoises (Phocoena phocoena) stranded along the English and Welsh coastlines

Acevedo-Whitehouse, K; Cole, KJ; Phillips, DH; Jepson, PD; Deaville, R; Arlt, VM; (2018) Hepatic DNA damage in harbour porpoises (Phocoena phocoena) stranded along the English and Welsh coastlines. Environmental and Molecular Mutagenesis , 59 (7) pp. 613-624. 10.1002/em.22205 . Green open access

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Beached bachelors: An extensive study on the largest recorded sperm whale Physeter macrocephalus mortality event in the North Sea

IJsseldijk, LL; van Neer, A; Deaville, R; Begeman, L; van de Bildt, M; van den Brand, JMA; Brownlow, A; ... Siebert, U; + view all IJsseldijk, LL; van Neer, A; Deaville, R; Begeman, L; van de Bildt, M; van den Brand, JMA; Brownlow, A; Czeck, R; Dabin, W; Ten Doeschate, M; Herder, V; Herr, H; IJzer, J; Jauniaux, T; Jensen, LF; Jepson, PD; Jo, WK; Lakemeyer, J; Lehnert, K; Leopold, MF; Osterhaus, A; Perkins, MW; Piatkowski, U; Prenger-Berninghoff, E; Pund, R; Wohlsein, P; Gröne, A; Siebert, U; - view fewer (2018) Beached bachelors: An extensive study on the largest recorded sperm whale Physeter macrocephalus mortality event in the North Sea. PLoS One , 13 (8) , Article e0201221. 10.1371/journal.pone.0201221 . Green open access

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Mixing of porpoise ecotypes in southwestern UK waters revealed by genetic profiling

Fontaine, MC; Thatcher, O; Ray, N; Piry, S; Brownlow, A; Davison, NJ; Jepson, P; ... Goodman, SJ; + view all Fontaine, MC; Thatcher, O; Ray, N; Piry, S; Brownlow, A; Davison, NJ; Jepson, P; Deaville, R; Goodman, SJ; - view fewer (2017) Mixing of porpoise ecotypes in southwestern UK waters revealed by genetic profiling. Royal Society Open Science , 4 (3) , Article 160992. 10.1098/rsos.160992 . Green open access

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Red Vienna, White Socialism, and the Blues: Ann Tizia Leitich’s America

Klautke, E; (2019) Red Vienna, White Socialism, and the Blues: Ann Tizia Leitich's America. [Review]. Central Europe 10.1080/14790963.2019.1583954 . (In press).

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Isolated teeth from La Ferrassie: Reassessment of the old collections, new remains, and their implications

Becam, G; Verna, C; Gómez-Robles, A; Gómez-Olivencia, A; Albessard, L; Arnaud, J; Frelat, MA; ... Balzeau, A; + view all Becam, G; Verna, C; Gómez-Robles, A; Gómez-Olivencia, A; Albessard, L; Arnaud, J; Frelat, MA; Madelaine, S; Schwab, C; Souday, C; Turq, A; Balzeau, A; - view fewer (2019) Isolated teeth from La Ferrassie: Reassessment of the old collections, new remains, and their implications. American Journal of Physical Anthropology 10.1002/ajpa.23798 . (In press).

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Impact Investing Innovation: Bringing Together Public, Private and Third Sectors to Create Greater Value: The Case of the Public Private Partnership Initiative for the New Public Hospital of Treviso

Addarii, F; Lipparini, F; Medda, F; (2018) Impact Investing Innovation: Bringing Together Public, Private and Third Sectors to Create Greater Value: The Case of the Public Private Partnership Initiative for the New Public Hospital of Treviso. In: La Torre, M and Calderini, M, (eds.) Social Impact Investing Beyond the SIB Evidence from the Market. (pp. 115-140). Palgrave Macmillan: Cham, Switzerland.

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An Optimized Method for the Proteomic Analysis of Low Volumes of Cell Culture Media and the Secretome: The Application and the Demonstration of Altered Protein Expression in iPSC-Derived Neuronal Cell Lines from Parkinson's Disease Patients

Heywood, W; (2019) An Optimized Method for the Proteomic Analysis of Low Volumes of Cell Culture Media and the Secretome: The Application and the Demonstration of Altered Protein Expression in iPSC-Derived Neuronal Cell Lines from Parkinson's Disease Patients. Journal of Proteome Research 10.1021/acs.jproteome.8b00831 . (In press).

https://ift.tt/2tCT5SH

Anarchist Education

Suissa, J; (2018) Anarchist Education. In: Levy, C and Adams, M, (eds.) The Palgrave Handbook of Anarchism. (pp. 511-529). Palgrave MacMillan: Cham, Switzerland.

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Multi-cluster technology learning in times: A transport sector case study with TIAM-UCL

Anandarajah, G; McDowall, W; (2015) Multi-cluster technology learning in times: A transport sector case study with TIAM-UCL. In: Giannakidis, G and Labriet, M and Ó Gallachóir, B and Tosato, G, (eds.) Informing Energy and Climate Policies Using Energy Systems Models Insights from Scenario Analysis: Increasing the Evidence Base. (pp. 261-278). Springer: Cham, Switzerland. Green open access

https://ift.tt/2tCT1Cr

Ethnic Heterogeneity, Ethnic and National Identity, and Social Cohesion in England

Wiertz, D; Bennett, MR; Parameshwaran, M; (2015) Ethnic Heterogeneity, Ethnic and National Identity, and Social Cohesion in England. In: Koopmans, R and Lancee, B and Schaeffer, M, (eds.) Social Cohesion and Immigration in Europe and North America: Mechanisms, Conditions, and Causality. (pp. 123-142). Routledge: London, UK. Green open access

https://ift.tt/2H3zTFu

Investigative practice into sudden death in epilepsy: A global survey

Kinney, MO; McCluskey, G; Friedman, D; Walker, MC; Sander, JW; Shankar, R; (2019) Investigative practice into sudden death in epilepsy: A global survey. Acta Neurologica Scandinavica 10.1111/ane.13080 . (In press).

https://ift.tt/2tFk9AK

Stronger Together: Personality, Intelligence and the Assessment of Career Potential

Leutner, F; Chamorro-Premuzic, T; (2018) Stronger Together: Personality, Intelligence and the Assessment of Career Potential. Journal of Artificial Intelligence Research , 6 (4) , Article 49. 10.3390/jintelligence6040049 . Green open access

https://ift.tt/2H3zNh6

Embracing diversity in the early years and primary classroom: a cross-cultural perspective

Ang, L; Flewitt, R; (2015) Embracing diversity in the early years and primary classroom: a cross-cultural perspective. In: Wyse, D and Davis, R and Jones, P and Rogers, S, (eds.) Exploring Education and Childhood: From current certainties to new visions. (pp. 145-159). Routledge: London, UK. Green open access

https://ift.tt/2tClyYN

Exploring second language writers' pausing and revision behaviours: A mixed methods study

Revesz, AJ; Michel, M; Lee, M; (2019) Exploring second language writers' pausing and revision behaviours: A mixed methods study. Studies in Second Language Acquisition (In press).

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