A Swelling-Suppressed Si/SiOx Nanosphere Lithium Storage Material Fabricated by Graphene Envelopment

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC02957D, Communication

Hyun Dong Yoo, Eunjun Park, Hyekyoung Kim, Juhye Bae, Hankwon Chang, HeeDong Jang, Hansu Kim
Swelling-suppressed, Si nanocrystals-embedded SiO_x nanospheres lithium storage material was prepared by graphene envelopment. The free void spaces formed between the graphene envelope and Si/SiO_x nanospheres effectively accommodated the volume changes...
The content of this RSS Feed (c) The Royal Society of Chemistry

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Subchronic oral administration of crude khat extract (Catha edulis forsk) induces schizophernic-like symptoms in mice

Chewing fresh leaves of the khat plant (Catha edulis forsk) is a deep rooted and widespread habit in East Africa and the Middle East. Although a body of knowledge exists about the adverse effects of khat on healt...

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Buyang Huanwu Decoction attenuates H2O2-induced apoptosis by inhibiting reactive oxygen species-mediated mitochondrial dysfunction pathway in human umbilical vein endothelial cells

Apoptosis of endothelial cells caused by reactive oxygen species plays an important role in ischemia/reperfusion injury after cerebral infarction. Buyang Huanwu Decoction (BYHWD) has been used to treat stroke ...

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Amomum cardamomum L. ethyl acetate fraction protects against carbon tetrachloride-induced liver injury via an antioxidant mechanism in rats

Medicinal herb-derived drug development has become important in the relief of liver pathology. Amomun cardamomum is traditionally used therapeutically in Korea to treat various human ailments including dyspepsia,...

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Smartphones Diagnose Hospital’s Pneumatic Tube System

Lots of hospitals around the world use pneumatic tube systems to move meds, blood products, patient samples, usually without any problems. But problems can arise, as was the case at the University of Virginia Health System where blood samples sometimes arrived damaged. Specifically, many red blood cells in some samples were damaged as though they were subject to significant force. To understand what happened, a clinical chemistry postdoc and a professor of Pathology sent a couple of  retired smartphones through different routes of the tube system. Smartphones have accelerometers that can fairly accurately estimate the G forces they're subjected to and the researchers used readily available apps to obtain the data. Moreover, they used one phone to video record blood samples as they were being shuttled through the system.

The results of the study published in journal Clinical Chemistry clearly pointed to one path, the longest within the pneumatic tube system, that subjected the samples to unacceptable force levels. Clinicians at the hospital now know to avoid this pathway and we're guessing that there are engineers looking into slowing down the capsule speed.

As a side note, none of the phones suffered any substantial damage, a curious fact that may be useful to some clinicians.

Study in Clinical Chemistry: Smartphones Can Monitor Medical Center Pneumatic Tube Systems…

Via: University of Virginia…

The post Smartphones Diagnose Hospital's Pneumatic Tube System appeared first on Medgadget.

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Public use of tourniquets, bleeding control kits

Although large scale multiple casualty incidents such as the Boston Marathon bombing and the San Bernardino shooting capture the nation's attention smaller scale MCIs are much more common. The National Association of State EMS Officials provides one definition of an MCI as any incident "which generates more patients at one time than locally available resources can manage using routine procedures [1]. Using that definition, researchers estimate the yearly incident rate in the United States is about 13.0 MCIs per 100,000 population [2].

Hemorrhage is the second leading cause of death for patients injured in the prehospital environment, accounting for 30-40 percent of all mortality [3]. Many of the patients who hemorrhage do so after suffering vascular injuries in one or more extremities. The annual incidence of extremity vascular injuries in the United States ranges from a low of 12.4 injuries at a rural trauma center in Missouri [4] to a high of 55 lower extremity injuries at a high-volume urban trauma center in Houston [5]. In a study of isolated penetrating injuries to the extremities, 57 percent of the patients who died had injuries that might have been amenable to tourniquet application [6].

There is little debate about the value of rapid hemorrhage control for improving outcomes in critically injured trauma patients. The American College of Surgeons Committee on Trauma has stated that bleeding must be controlled by prehospital providers as quickly as possible.

For maximum efficiency, health care providers must apply tourniquets before the patient has developed shock [7]. During Operation Iraqi Freedom, tourniquets applied in the field and before the onset of shock were strongly associated with survival [8].

Unfortunately, in cases of severe bleeding, trained professionals may not always arrive in time to prevent exsanguination. Researchers in Austria and Germany found that when traumatic injury occurs, bystanders with varying levels of first aid training are often present on scene before EMS arrives [9].

In addition, these bystanders often attempt to provide hemorrhage control for patients suffering from an exsanguinating injury. Although prior first aid training increased the probability of successful hemorrhage control by the bystander, the lack of first aid training did not prevent bystanders from attempting to control bleeding and a significant percentage were successful.

Can the public help
A central question is whether these bystanders who are present on the scene and are willing to help control severe bleeding can become part of a trauma chain of survival. There is very little data in support of this position. However, studies involving a cardiac arrest chain of survival demonstrate that trained bystanders can safely and effectively use defibrillators to resuscitate victims of out-of-hospital cardiac arrest [10-14]. Even sixth graders with no previous medical training can achieve performance goals similar to those achieved by trained medical responders [15].

Similarly, is it reasonable to think ordinary citizens would be able to safely and effectively apply tourniquets when indicated before the arrival of EMS personnel. Limited available evidence suggests it is.

During a simulated explosion, one in five people with no medical training were able to correctly apply a commercially available tourniquet to a manikin's leg in less than 60 seconds [16]. Providing instructions on a notecard with the tourniquet more than doubled the rate of successful placements.

During the Boston Marathon bombing, 29 patients with life-threatening limb exsanguination had 27 improvised tourniquets applied in the field [17]. EMS personnel applied one-third of those tourniquets and non-EMS personnel or an unknown person applied the remainder.

In a 10-year evaluation of isolated penetrating or blunt extremity injury requiring either arterial revascularization or limb amputation at Boston Medical Center, only 2 percent of patients had a tourniquet applied before arriving at the trauma center and all were improvised tourniquets applied by police officers or bystanders [18]. An additional 2 percent of patients had a tourniquet applied by emergency department staff within one hour of arrival. While a very small number of patients without a tourniquet exsanguinated, no patient with a tourniquet died.

During a seven-year period, researchers at Boston Medical Center identified 11 patients who had an improvised tourniquet applied in the field by EMS [19]. Only one patient died, however, that patient was in cardiac arrest when EMS arrived on the scene. Of the 10 patients who survived, all had complete neurologic function in the affected extremity despite having the tourniquet in place for as long as 167 minutes (mean 75 +\- 38 minutes).

One concern about bystander application of a tourniquet is whether the bystander will be able to apply the device tightly enough to be effective. Indeed, a manikin study involving non-medical trained bystanders found that 70 percent of the incorrectly placed tourniquets were judged to be too loose [16]. However, a battlefield evaluation found that although morbidity remained high with partially ineffective tourniquet application (persistent distal pulses), mortality actually improved when compared to totally ineffective tourniquets (continued bleeding) [20]. This suggests that even when tourniquets are not tight enough to be totally effective, they may still be better than no tourniquet at all.

Hemorrhage-control training courses for the lay rescuer
The American College of Surgeons convened a special committee to identify changes necessary to improve survival following active shooter and MCIs [21]. One of the major themes to emerge from these series of meetings, known as the Hartford Consensus, is that the public will act as responders to provide aid before the arrival of professional rescuers.

Another major theme of the Hartford Consensus, which was the focus of the second Hartford Consensus Conference, is the value of a comprehensive educational program for all members of this trauma chain of survival. Critical to this concept and the focus of third Hartford Consensus Conference, is educational campaigns targeting members of the general public, which should include training on how to apply direct pressure, how to use hemostatic dressings, and how to apply tourniquets [22].

In response to the Hartford consensus, the EMS Education Department of the Denver Paramedic Division, in cooperation with the Prehospital Trauma Life Support committee of the National Association of EMTs developed training program targeting ordinary citizens [23]. The 2.5-hour Bleeding Control for the Injured course combines didactic lectures with hands-on training to teach the lay rescuer important life-saving skills such as hemorrhage control and how to open an airway [24].

Also in response to the Hartford Consensus, the White House launched the "Stop the Bleed" campaign [25]. This campaign hopes to provide public awareness to the simple steps that anyone can take to slow life-threatening bleeding. The campaign also promotes the placement of Bleeding Control Kits in public spaces that would allow members of the general public access to life-saving supplies, similar to public access defibrillation programs.

In 2015, the Harvard School of Public Education and the Harvard School of Government began a bleeding control pilot program at Charlotte Douglas International Airport [26]. The team placed bleeding control kits inside of each AED cabinet in the airport. Each kit contained pressure dressings, hemostatic dressings, tourniquets, and personal protective gloves. After training the airport emergency staff on the contents, use and location of the kits, the pilot team in conjunction with airport police, conducted three active shooter scenarios. After-action reporting indicated the responders were able to locate and appropriately use the kits in a simulated incident.

Bystander action is a result of competence from training
The military experience has demonstrated that complications associated with tourniquet use are rare, even when the tourniquet is improvised. The limited civilian data supports the safety of the tourniquets

Bystanders are often present on the scene of a traumatic injury before professional rescuers. In some cases, bystander care may mean the difference between whether the patient survives or not. Experience with CPR and AEDs has demonstrated that bystanders will attempt to intervene especially if they are trained and have easy access to the equipment.

Bystanders who self-report a feeling of competence to provide emergency first aid are more likely to help victims of traumatic injury [27]. That feeling of competence is positively correlated to first aid training. Those with first aid training feel competent to provide care before EMS arrives on the scene to take over [28].

With untrained bystanders as part of the definition of a first responder, the Office of Health Affairs at the Department of Homeland Security recommends the availability of both tourniquets and hemostatic agents in the early management of severe bleeding [7]. Lay rescuers play a vital role in providing immediate bleeding control while awaiting the arrival of traditional first responders [29].

References

1. National Association of State EMS Officials. (2012). Extended definition document NEMSIS/NHTSA 2.2.1 data dictionary. Retrieved from http://ift.tt/1WuVN6w.
2. Schenk, E., Wijetunge, G., Mann, N. C., Lerner, E. B., Longthorne, A., & Dawson, D. (2014). Epidemiology of mass casualty incidents in the United States. Prehospital Emergency Care, 18(3), 408–416. doi:10.3109/10903127.2014.882999
3. Kauvar, D. S., Lefering, R., & Wade, C. E. (2006). Impact of hemorrhage on trauma outcome: An overview of epidemiology, clinical presentations, and therapeutic considerations. The Journal of Trauma, Injury, Infection, and Critical Care, 60(6), S3-S11. doi:10.1097/01.ta.0000199961.02677.19
4. Humphrey, P. W., Nichols, W. K., & Silver, D. (1994). Rural vascular trauma: A twenty-year review. Annals of Vascular Surgery, 8(2), 179-185.
5. Feliciano, D. V., Herskowitz, K., O'Gorman, R. B., Cruse, P. A., Brandt, M. L., Burch, J. M., & Mattox, K. L. (1988). Management of vascular injuries in the lower extremities. Journal of Trauma, 28(3), 319-328.
6. Dorlac, W. C., DeBakey, M. E., Holcomb, J. B., Fagan, S. P., Kwong, K. L., Dorlac, G. R., Schreiber, M. A., Persse, D. E., Moore, F. A., & Mattox, K. L. (2005). Mortality from isolated civilian penetrating extremity injury. Journal of Trauma, 59(1), 217-222.
7. Department of Homeland Security. (2015). First responder guide for improving survivability in improvised explosive device and/or active shooter incidents. Retrieved from http://ift.tt/1TUxsDG
8. Kragh, J. F. Jr., Walters, T. J., Baer, D. G., Fox, C. J., Wade, C. E., Salinas, J., & Holcomb, J. B. (2009). Survival with emergency tourniquet use to stop bleeding in major limb trauma. Annals of Surgery, 249(1), 1–7. doi:10.1097/SLA.0b013e31818842ba
9. Pelinka, L. E., Thierbach, A. R., Reuter, S., & Mauritz, W. (2004). Bystander trauma care – effect of the level of training. Resuscitation, 61(3), 289-296. doi:10.1016/j.resuscitation.2004.01.012
10. MacDonald, R. D., Mottley, J. L., & Weinstein, C. (2002). Impact of prompt defibrillation on cardiac arrest at a major international airport. Prehospital Emergency Care, 6(1), 1-5. doi:10.1080/10903120290938689
11. O'Rourke, M. F., Donaldson, E. E., & Geddes, J. S. (1997). An airline cardiac arrest program. Circulation, 96(9), 2849-2853. doi:10.1161/01.CIR.96.9.2849
12. Page, R. L., Joglar, J. A., Kowal, R. C., Zagrodzky, J. D., Nelson, L. L., Ramaswamy, K., Barbera, S. J., Hamdan, M. H., & McKenas, D. K. (2000). Use of automated external defibrillators by a U.S. airline. New England Journal of Medicine, 343(17), 1210-1216. doi:10.1056/NEJM200010263431702
13. Valenzuela, T. D., Roe, D. J., Nichol, G., Clark, L. L., Spaite, D. W., & Hardman, R. G. (2000). Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. New England Journal of Medicine, 343(17), 1206-1209. doi:10.1056/NEJM200010263431701
14. Wassertheil, J., Keane, G., Fisher, N., & Leditschke, J. F. (2000). Cardiac arrest outcomes at the Melbourne Cricket Ground and Shrine of Remembrance using a tiered response strategy — a forerunner to public access defibrillation. Resuscitation, 44(2), 97-104. doi:10.1016/S0300-9572(99)00168-9
15. Gundry, J. W., Comess, K. A., DeRook, F. A., Jorgenson, D., & Bardy, G. H. (1999). Comparison of naïve sixth-grade children with trained professionals in the use of an automated external defibrillator. Circulation, 100(16), 1703-1707. doi:10.1161/01.CIR.100.16.1703
16. Goolsby, C., Branting, A., Chen, E., Mack, E., & Olsen, C. (2015). Just-in-time to save lives: A pilot study of layperson tourniquet application. Academic Emergency Medicine, 22(9), 1113-1117. doi:10.1111/acem.12742
17. King, D. R., Larentzakis, A., & Ramly, E. P. (2015). Tourniquet use at the Boston Marathon bombing: Lost in translation. Journal of Trauma and Acute Care Surgery, 78(3), 594-599. doi:10.1097/TA.0000000000000561
18. Kalish, J., Burke, P., Feldman, J., Agarwal, S., Glantz, A., Moyer, P., Serino, R., & Hirsch, E. (2008). The return of tourniquets. Original research evaluates the effectiveness of prehospital tourniquets for civilian penetrating extremity injuries. Journal of the Emergency Medical Services, 33(8), 44–54. doi:10.1016/S0197-2510(08)70289-4
19. Bulger, E. M., Snyder, D., Schoelles, K., Gotschall, C., Dawson, D., Lang, E., Sanddal, N. D., Butler, F. K., Fallat, M., Taillac, P., White, L., Salomone, J. P., Seifarth, W., Betzner, M. J., Johannigman, J., & McSwain, N. Jr. (2014). An evidence-based prehospital guideline for external hemorrhage control: American College of Surgeons Committee on Trauma. Prehospital Emergency Care, 18(2), 163-173. doi:10.3109/10903127.2014.896962
20. Kragh, J. F., Walters, T. J., Baer, D. G., Fox, C. J., Wade, C. E., Salinas, J., & Holcomb, J. B. (2008). Practical use of emergency tourniquets to stop bleeding in major limb trauma. Journal of Trauma Injury, Infection, and Critical Care, 64(Suppl 2), S38–S49. doi:10.1097/TA.0b013e31816086b1
21. Jacobs, L. M., Wade, D., McSwain, N. E., Butler, F. K., Fabbri, W., Eastman, A., Conn, A., & Burns, K. J.. (2014). Hartford consensus: A call to action for THREAT, a medical disaster preparedness concept. Journal of the American College of Surgeons, 218(3), 467–475. doi:10.1016/j.jamcollsurg.2013.12.009
22. Jacobs, L. M. Jr., & the Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass-Casualty and Active Shooter Events. (2016). The Hartford consensus IV: A call for increased national resilience. Bulletin of the American College of Surgeons, 101(3), 17-24.
23. Pons, P. T., Jerome, J., McMullen, J., Manson, J., Robinson, J., & Chapleau, W. (2015). The Hartford consensus on active shooters: Implementing the continuum of prehospital trauma response. The Journal of Emergency Medicine, 49(6), 878–885. doi:10.1016/j.jemermed.2015.09.013
24. National Association of EMTs. (2016). Bleeding control for the injured. Retrieved from http://ift.tt/1WuWgWp
25. The White House, Office of the Press Secretary. (2015). Fact Sheet: Bystander: "Stop the Bleed" broad private sector support for effort to save lives and build resilience. Retrieved from http://ift.tt/1TUx3kI
26. National Preparedness Leadership Initiative. (2015). Public access bleeding control: An implementation strategy. Retrieved from http://ift.tt/1WuVUyS
27. Thierbach, A. R., Pelinka, L. E., Reuter, S., & Mauritz, W. (2004). Comparison of bystander trauma care for moderate versus severe injury. Resuscitation, 60(3), 271-277. doi:10.1016/j.resuscitation.2003.11.008
28. Steele, J. A. (1994). The effects of first aid training on public awareness of the management of a seriously injured patient. Journal of the Royal Society of Health, 114(2), 67–68. doi:10.1177/146642409411400204
29. Jacobs, L. M. Jr., & the Joint Committee to Create a National Policy to Enhance Survivability from Intentional Mass-Casualty and Active Shooter Events. (2015). The Hartford consensus III: Implementation of bleeding control – if you see something, do something. Bulletin of the American College of Surgeons, 100(7), 20-26.

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Bystander CPR: A key link in the chain of survival

With 359,000 people suffering out-of-hospital cardiac arrests in 2013, death by cardiac disease continues to be the number one killer in the United States [1]. Significant research in cardiac resuscitation has been ongoing since the 1950s, with time, effort and money examining the multiple variables affecting survival rates.

One component of the cardiac chain of survival, bystander CPR, appears to play a major role in the increase of survival to discharge rates in cardiac arrest. It is critical that EMS agencies play their part in strengthening this part of the resuscitation strategy in order to improve community health.

In 1988 the phrase "chain of survival" was coined to describe a series of events that if strung together and performed in a timely manner, would greatly improve the chances of survival from sudden cardiac arrest in the out of hospital setting [2]. These events include:

• Early access to the emergency cardiac care system by recognizing sudden cardiact arrest quickly and calling 911
• Early CPR by those nearest to the sudden cardiac arrest, bystanders
• Early defibrillation of ventricular arrhythmias
• Early advanced level care by trained professionals

Throughout the 1990s focus was placed on the back end of the chain of survival, i.e. the medications and procedures being done by paramedics and emergency department staff to improve survival rates. However, by the 2000s attention turned toward the improvement of the front end of the chain, specifically how to improve the incidence of bystander-provided CPR at the moment of collapse.

It was already known by the mid-1980s that early CPR by members of the public, performed before the arrival of trained responders, improved sudden cardiac arrest survival rates [3]. Yet the numbers of bystanders trained in CPR remains low and range considerably from one community to the next. Rates of 15 to 30 percent of sudden cardiac arrest receiving bystander CPR have been reported [4, 5]. Southern states, especially in areas with higher proportions of Hispanic and African American populations and lower median incomes have lower rates of CPR training [6].

Why are bystander CPR rates so low"
There have been a number of theories as to why bystander CPR rates have remained historically low, including fear of cross infection, fear of liability, the complexity of traditional CPR instruction that included mouth-to-mouth breathing techniques, and ultimately a lack of confidence in performing correctly in real life situations [7].

Regardless of the cause, it is essential to increase the percentage of sudden cardiac arrest patients who receive prearrival CPR, as a cost effective and efficacious method to improve survival to discharge rates.

Expanding CPR training opportunities
Up until the late 2000s, CPR courses taught to bystanders took several hours to complete, were costly and resource intensive, creating a barrier to readily accessible training opportunities. With the 2010 American Heart Association guideline recommendation that compressions-only CPR training may be more effective in training bystanders, organizations around the nation made an effort to train large numbers of bystanders in this technique. Without the extra burden of having to teach manual ventilation techniques and focusing on high-quality chest compressions practice, the time frame for training shortened considerably. Research has supported that change; studies comparing compressions only CPR versus "standard CPR" by nonprofessional bystanders showed a higher survival rate for sudden cardiac arrest patients who received compression only CPR [8,9].

Self-instructional kits have been created by the AHA and other training organizations that allows video-driven instruction to occur any time, and in any space [10]. School district CPR programs have used these kits to train middle and high school students during class, with the intent of having the students bring the kits home and train family members. This has resulted in a large number of citizens being trained in CPR at a modest cost [11, 12].

Internet-based CPR training has also drawn attention. A small study indicated that students who viewed an animation of CPR being done on a manikin performed ventilations and chest compressions just as well as students who received one hour of instructor-led training [13].

Widespread adoption of dispatch-assisted CPR training
Despite increasing access to CPR training, it is still likely that at the temporal moment of sudden cardiac arrest, the person closest to the victim is capable of performing hands-only CPR. 911 telecommunicators can provide just in time, over-the-phone guidance for individuals who are willing to provide CPR. Multiple studies have shown the efficacy of dispatch CPR instructions in improving sudden cardiac arrest survival rates [14, 15].

Providing reassurance to the would-be lay rescuer
The AHA has recommended that bystanders be educated on the virtually nonexistent risk of disease transmission during CPR. Information about relevant Good Samaritan laws should be provided, and worksites and public spaces should have basic personal protective equipment such as gloves and pocket masks co-located with public access automated external defibrillators [16].

The role of EMS agencies
As the first professionally trained link in the chain of survival, EMS agencies can play a critical role in training its community members in CPR and AED use. Examples include:

• Sponsoring large-scale, one-day events such as Save-A-Life Saturday
• Training middle school health teachers how to teach compression-only CPR to their students and providing training equipment when needed [17]
• Implementing dispatch-assisted CPR protocols within the 911 call center
• Advocating for legislative changes that encourage or mandate CPR training in public schools
• Work with government officials and other stakeholders to place AEDs in public areas and locations where the likelihood of SCA is higher
• Publically recognize bystanders who make the effort to perform CPR at the temporal moment of SCA

SCA is a public health disease that responds to carefully planned interventions based on evidence. Given the growing body of evidence that shows the benefit of bystander CPR, EMS agencies can take the lead to improve their community's ability to respond when seconds truly count.

References

1. American Heart Association. Cardiac Arrest Statistics. http://ift.tt/1RWfAJJ retrieved 20 April 2016.

2. Newman M (1989). "The chain of survival concept takes hold". JEMS 14: 11–13.

3. Ritter G et al. The effect of bystander CPR on survival of out-of-hospital cardiac arrest victims. Am Heart J. 1985 Nov;110(5):932-7.

4. De Maio VJ et al. Ontario Prehospital Advanced Life Support (OPALS) Study Group. CPR-only survivors of out-of-hospital cardiac arrest: implications for out-of-hospital care and cardiac arrest research methodology. Ann Emerg Med. 2001; 37: 602–608.

5. Lateef F, Anantharaman V. Bystander cardiopulmonary resuscitation in prehospital cardiac arrest patients in Singapore. Prehosp Emerg Care. 2001; 5: 387–390.

6. Anderson ML et al. Rates of cardiopulmonary resuscitation training in the United States. JAMA Intern Med. 2014 Feb 1;174(2):194-201.

7. Swor R et al. CPR training and CPR performance: do CPR-trained bystanders perform CPR" Acad Emerg Med. 2006; 13: 596–601.

8. Hüpfl M, Selig FS, Nafele P. Chest Compression-Only CPR: A Meta-Analysis. Lancet. 2010 Nov 6; 376(9752): 1552–1557.

9. Dias JA et al. Simplified dispatch-assisted CPR instructions outperform standard protocol. Resuscitation. 2007; 72: 108–114.

10. American Heart Association. CPRanytime.org website. www.cpranytime.org.

11. Isbye DL, Meyhoff CS, Lippert FK, Rasmussen LS. Skill retention in adults and in children 3 months after basic life support training using a simple personal resuscitation manikin. Resuscitation. 2007;74:296–302

12. Lorem T, Palm A, Wik L. Impact of a self-instruction CPR kit on 7th graders' and adults' skills and CPR performance. Resuscitation. 2008;79:103–108

13. Choa M-H, Park I-C, Chung HS, Yoon YS, Kim S-H, Yoo SK. Internet-based animation for instruction in cardiopulmonary resuscitation. J Telemed Telecare. 2006; 12 (suppl 3): 31–33.

14. Hallstrom AP, Cobb LA, Johnson E, Copass MK. Dispatcher assisted CPR: implementation and potential benefit: a 12-year study. Resuscitation. 2003;57: 123–129.

15. Dias JA et al. Simplified dispatch-assisted CPR instructions outperform standard protocol. Resuscitation. 2007; 72: 108–114.

16. Abella BS et al. AHA Scientific Statement: Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation. Circulation. 2008; 117: 704-709.

17. Daubs B. Local students and Save Lives Sonoma take CPR lessons to heart. The Healdsburg Tribune, 19 February 2014. http://ift.tt/1WuVI2Q retrieved 5/5/16.

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National EMS Week: Budgeting for PTSD

By Allison G. S. Knox, M.A., EMT-B, faculty member at American Military University

Post-traumatic stress disorder (PTSD) has received a lot of public attention in recent years as American service members returned from deployments in Iraq and Afghanistan. The struggles of these military personnel returning with PTSD have shed light on the issues and challenges of this often debilitating disorder. It is nothing short of a terrible illness for the ways it hijacks the lives of individuals.

In recognition of National EMS Week from May 15 to 21, it is important to understand how PTSD affects emergency medical technicians (EMTs), paramedics, and other members of the first responder community.

[Related: Today, Tomorrow, or Next Year" Coping with PTSD in EMS]

Responding to emergency medical calls can be traumatic; individuals working in such an environment are often profoundly affected by it. But what is often misunderstood is that even scenes that are not particularly gruesome can also have a lasting effect on responders. ​

​Full story: National EMS Week: Budgeting for PTSD

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Recurrence of hyperprolactinemia following dopamine agonist withdrawal and possible predictive factors of recurrence in prolactinomas

Abstract

Background

The optimal duration of cabergoline (CAB) treatment of prolactinomas that minimizes recurrences is not well established. 2011 Endocrine Society Guidelines suggested that withdrawal may be safely undertaken after 2 years in patients achieving normoprolactinemia and tumor reduction.

Materials

We analyzed 74 patients (mean age = 46.9 ± 14.4, M/F = 19/55, macro/micro = 18/56) bearing a prolactinoma divided in 3 groups: group A (23) treated for 3 years, group B (23) for a period between 3 and 5 years, and group C (28) for a period >5 years. CAB therapy was interrupted according to Endocrine Society Guidelines. Prolactin (PRL) levels were measured 3, 6, 12 and 24 months after withdrawal. Recurrence was defined with PRL levels ≥30 ng/ml.

Results

Groups did not differ in pretreatment PRL levels (123.2 ± 112.1, 120.9 ± 123.8, 176.6 ± 154.0), pituitary deficit (4, 17, 17 %), mean CAB weekly dose (0.7 ± 0.4, 0.6 ± 0.3, 0.7 ± 0.4) and PRL levels before withdrawal (17.1 ± 19.6, 11.4 ± 8.8, 13.8 ± 13.5). Recurrence occurred within 12 months in 34 patients (45.9 %), without significant differences among groups. Neuroradiological evaluation showed a significantly higher presence of macroadenoma in group C (13, 17 and 39 %, respectively). Recurrence rate of hyperprolactinemia did not depend on sex, tumor size or CAB dose but it was significantly correlated with PRL levels at diagnosis and before withdrawal (p = 0.03). Finally, patients with pituitary deficit at diagnosis showed a significantly higher recurrence rate (p = 0.03).

Conclusions

The study provides additional evidence that prolonging therapy for more than 3 years does not reduce recurrence rate. In particular, recurrence risk was similar in micro- and macroadenomas, and higher in patients with pituitary deficits at diagnosis.

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Erratum to: A novel oxidative stress marker in migraine patients: dynamic thiol–disulphide homeostasis

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In this issue

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Cristacarpin promotes ER stress-mediated ROS generation leading to premature senescence by activation of p21 waf-1

Abstract

Stress-induced premature senescence (SIPS) is quite similar to replicative senescence that is committed by cells exposed to various stress conditions viz. ultraviolet radiation (DNA damage), hydrogen peroxide (oxidative stress), chemotherapeutic agents (cytotoxic threat), etc. Here, we report that cristacarpin, a natural product obtained from the stem bark of Erythrina suberosa, promotes endoplasmic reticulum (ER) stress, leading to sub-lethal reactive oxygen species (ROS) generation and which eventually terminates by triggering senescence in pancreatic and breast cancer cells through blocking the cell cycle in the G1 phase. The majority of cristacarpin-treated cells responded to conventional SA-β-gal stains; showed characteristic p21^waf1 upregulation along with enlarged and flattened morphology; and increased volume, granularity, and formation of heterochromatin foci—all of these features are the hallmarks of senescence. Inhibition of ROS generation by N-acetyl-l-cysteine (NAC) significantly reduced the expression of p21^waf1, confirming that the modulation in p21^waf1 by anti-proliferative cristacarpin was ROS dependent. Further, the elevation in p21^waf1 expression in PANC-1 and MCF-7 cells was consistent with the decrease in the expression of Cdk-2 and cyclinD1. Here, we provide evidence that cristacarpin promotes senescence in a p53-independent manner. Moreover, cristacarpin treatment induced p38MAPK, indicating the ROS-dependent activation of the MAP kinase pathway, and thus abrogates the tumor growth in mouse allograft tumor model.

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Correlation of clinical outcomes with bremsstrahlung and Y-90 PET/CT imaging findings following Y-90 radiosynoviorthesis: a prospective study

Abstract

Background

It is unclear how to predict which patients will respond to Y-90 radiosynoviorthesis. The aim of this study is to correlate clinical outcomes following Y-90 radiosynoviorthesis with bremsstrahlung and Y-90 PET/CT imaging findings.

Methods

Fifty-one joints underwent bremsstrahlung planar and Y-90 PET/CT imaging following Y-90 radiosynoviorthesis. The Y-90 distribution pattern on bremsstrahlung planar imaging was classified as diffuse or non-diffuse and compared with the intra or extra-articular location of activity on Y-90 PET/CT. Treatment response was assessed by patients and clinicians at 6 months. In patients who underwent bremsstrahlung SPECT, side-by-side comparison with PET was performed with image quality/resolution scored using a five-point-scale.

Findings

Bremsstrahlung planar images were classified as diffuse in 33/51 (65 %) and non-diffuse in 18/51 (35 %) scans. There was no association between treatment response and the bremsstrahlung planar imaging pattern. PET/CT confirmed an intra-articular location in all 33/33 (100 %) diffuse scans and an extra-articular location in 3/18 (17 %) non-diffuse scans. Of the three joints with extra-articular activity, none had any treatment response. Excluding these three joints, there remained no association between the bremsstrahlung planar imaging pattern and treatment response. Of the 42 joints imaged with SPECT, PET image quality/resolution was classified as superior in 40 (95 %). In one patient with extra-articular activity on PET/CT, SPECT/CT was unable to definitively localise the activity to the intra or extra-articular space.

Conclusions

The distribution pattern on bremsstrahlung planar imaging did not correlate with clinical outcome following Y-90 radiosynoviorthesis in our study population. However, in patients with non-diffuse planar imaging patterns, Y-90 PET/CT should be considered to exclude extra-articular activity with PET providing superior image quality compared to SPECT.

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Muscle Dysmorphia Symptomatology and Associated Psychological Features in Bodybuilders and Non-Bodybuilder Resistance Trainers: A Systematic Review and Meta-Analysis

Abstract

Background

Muscle dysmorphia (MD) is associated with a self-perceived lack of size and muscularity, and is characterized by a preoccupation with and pursuit of a hyper-mesomorphic body. MD symptoms may hypothetically be more prevalent in bodybuilders (BBs) than in non-bodybuilder resistance trainers (NBBRTs).

Objective

Our objective was to compare MD symptomatology in BBs versus NBBRTs and identify psychological and other characteristics associated with MD in these groups.

Methods

We searched relevant databases from earliest record to February 2015 for studies examining MD symptoms in BBs and/or NBBRTs. Included studies needed to assess MD using a psychometrically validated assessment tool. Study quality was evaluated using an adapted version of the validated Downs and Black tool. We calculated between-group standardized mean difference (effect sizes [ESs]) and 95 % confidence intervals (CIs) for each MD subscale, and performed meta-analysis when five or more studies used the same MD tool. We also extracted data describing psychological or other characteristics associated with MD.

Results

Of the 2135 studies initially identified, 31 analyzing data on 5880 participants (BBs: n = 1895, NBBRTs: n = 3523, controls: n = 462) were eligible for inclusion, though study quality was generally poor–moderate (range 7–19/22). Most participants were male (90 %). Eight different MD assessment tools were used. Meta-analysis for five studies all using the Muscle Dysmorphia Inventory (MDI) revealed there was a medium to large pooled ES for greater MD symptomatology in BBs than in NBBRTs on all MDI subscales (ES 0.53–1.12; p ≤ 0.01). Competitive BBs scored higher than non-competitive BBs (ES 1.21, 95 % CI 0.82–1.60; p < 0.001). MD symptoms were associated with anxiety (r 0.32–0.42; p ≤ 0.01), social physique anxiety (r 0.26–0.75; p < 0.01), depression (r 0.23–0.53; p ≤ 0.01), neuroticism (r 0.38; p < 0.001), and perfectionism (r 0.35; p < 0.05) and were inversely associated with self-concept (r –0.32 to –0.36; p < 0.01) and self-esteem (r –0.42 to –0.47; p < 0.01).

Conclusions

MD symptomatology was greater in BBs than in NBBRTs. Anxiety and social physique anxiety, depression, neuroticism, and perfectionism were positively associated with MD, while self-concept and self-esteem were negatively associated. It remains unclear whether these characteristics are exacerbated by bodybuilding, or whether individuals with these characteristics are attracted to the bodybuilding context.

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Author’s Reply to Will G. Hopkins: “Submaximal, Perceptually Regulated Exercise Testing Predicts Maximal Oxygen Uptake: A Meta-Analysis Study”

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Comment on: “Submaximal, Perceptually Regulated Exercise Testing Predicts Maximal Oxygen Uptake: A Meta-Analysis Study”

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Multi-Dimensional Interacting Constraints on Physical Activity Behaviours in the Finnish Population

Abstract

Finnish sports organisations, local and federal government, and healthcare organisations have widely adopted the World Health Organization and national recommendations for physical activity for different age groups. However, studies have indicated that only 46 % of 3-year-old preschool children, approximately 50 % of primary school students (7–12 years), 10–17 % of secondary school students (13–15 years) and 16 % of Finnish adults (20–54 years) attain those recommendations. In Finland there are 33,620 built sports facilities and over 9000 sport clubs, meaning there are many possibilities for physical activity, yet people are still rather inactive. In this paper we argue that availability of facilities, although an important element, is not enough to promote physical activity. It is possible that the current built physical environmental design does not fulfil people's needs regarding participation in physical activity. More emphasis should be placed on the design and operation of the facilities to develop new affordances for physical activity.

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Spontan aufgetretener, livider Knoten im Bauchnabel

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Pathogenese der Psoriasis vulgaris

Zusammenfassung

Psoriasis ist eine entzündliche, T‑Zell-mediierte Autoimmunkrankheit der Haut und Gelenke, unter der 2–4 % der Erwachsenen und 0,1–1 % der Kinder und Jugendlichen leiden. Genetische Suszeptibilität, Umweltfaktoren und Prozesse des angeborenen Immunsystems initiieren die Pathogenese der Psoriasis, die schließlich in eine adaptive Immunantwort mündet. Die T‑Zell-Antwort wird von epidermalen CD8⁺-T-Zellen und dermalen CD4⁺-T-Zellen orchestriert, die vorzugsweise Interleukin-17 (IL‑17) produzieren. Forschungsergebnisse der letzten 15 Jahre haben zelluläre und molekulare Mechanismen sowie beteiligte Zytokine wie Tumornekrosefaktor (TNF) oder IL‑23 identifiziert, die alle an der psoriatischen Entzündung beteiligt sind. Dieses Wissen konnte translational genutzt wurden, sodass uns verschiedene antipsoriatisch wirksame kleine Moleküle und Biologika für den klinischen Einsatz zur Verfügung stehen. In diesem Beitrag stellen wir die aktuellen Grundlagen der Psoriasispathogenese im Kontext moderner Therapien dar.

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Public use of tourniquets, bleeding control kits

Bystander application of a tourniquet to 'Stop the Bleed' may mean the difference between life and death for a patient with severe hemorrhage

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Bystander CPR: A key link in the chain of survival

EMS agencies should promote public involvement in cardiopulmonary resuscitation and AED use to improve community health

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The use of a modified abbé island flap to reconstruct primary lip defects of over 80 %

Abstract

Background

Lip reconstruction for defects greater than 80 % present a challenge in maintaining acceptable oral function and good aesthetic results. Abbé flaps offer an excellent reconstructive option but are limited to defects under 65 %.

Methods

We describe a two-stage "modified Abbé island flap" technique whereby a full-thickness myocutaneous flap is combined with a modified Karapandzic flap, allowing for reconstruction of total and near total lip defects.

Results

Six patients underwent successful two-stage lower and upper lip reconstruction with this technique. Oral competence and satisfactory aesthetic outcomes were achieved in all six cases. There were no complications. Although microstomia was noted to a certain extent, we argue this impact to be less than the morbidity of a free flap that lacks sphincteric function.

Conclusion

The "Modified Abbé Island Flap" can be used to reconstruct near-total lip defects using locally innervated, well-vascularized tissues that recreate the oral sphincter and restore oral competence. The combination of the conventional Abbé flap with a modified Karapandzic flap provides reliable results and significantly reduces operating time.

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Kigelia africana (Lam.) Benth. (Sausage tree): Phytochemistry and pharmacological review of a quintessential African traditional medicinal plant

Publication date: 2 August 2016
Source:Journal of Ethnopharmacology, Volume 189
Author(s): Idris Bello, Mustapha W. Shehu, Mustapha Musa, Mohd. Zaini Asmawi, Roziahanim Mahmud
Ethnopharmacological relevanceKigelia africana is a quintessential African herbal medicinal plant with a pan-African distribution and immense indigenous medicinal and non-medicinal applications. The plant is use traditionally as a remedy for numerous disease such as use wounds healing, rheumatism, psoriasis, diarrhea and stomach ailments. It is also use as an aphrodisiac and for skin care.Aim of the reviewThe present review aims to compile an up-to-date review of the progress made in the continuous pharmacological and phytochemistry investigation of K. africana and the corresponding commercial and pharmaceutical application of these findings with the ultimate objective of providing a guide for future research on this plant.MethodThe scholarly information needed for this paper were predominantly sourced from the electronic search engines such as Google, Google scholar; publishing sites such as Elsevier, scienceDirect, BMC, PubMed; other scientific database sites for chemicals such as ChemSpider, PubChem, and also from online books.ResultsPharmacological investigations conducted confirm the anti-inflammatory, analgesic, antioxidant and anticancer activity of the extract of different parts of the plant. Bioactive constituents are found to be present in all parts of the plant. So far, approximately 150 compounds have been characterized from different part of the plant. Iridoids, naphthoquinones, flavonoids, terpenes and phenylethanoglycosides are the major class of compounds isolated. Novel compounds with potent antioxidant, antimicrobial and anticancer effect such as verbascoside, verminoside and pinnatal among others, have been identified. Commercial trade of K. africana has boosted in the las few decades. Its effect in the maintenance of skin has been recognized resulting in a handful of skin formulations in the market.ConclusionsThe pharmaceutical potentials of K. africana has been recognized and have witness a surge in research interest. However, till date, many of its traditional medicinal uses has not been investigated scientifically. Further probing of the existential researches on its pharmacological activity is recommended with the end-goal of unravelling the pharmacodynamics, pharmacokinetics, clinical relevance and possible toxicity and side effects of both the extract and the active ingredients isolated.

Graphical abstract

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Treatment for diabetic ulcer wounds using a fern tannin optimized hydrogel formulation with antibacterial and antioxidative properties

Publication date: 2 August 2016
Source:Journal of Ethnopharmacology, Volume 189
Author(s): Jordan Chia-Yung Lai, How-Yee Lai, Nalamolu Koteswara Rao, Shiow-Fern Ng
Ethnopharmacological relevanceBlechnum orientale Linn. (B. orientale) is a fern traditionally used by the natives as a poultice to treat wounds, boils, ulcers, blisters, abscesses, and sores on the skin.Aim of the studyTo investigate the wound healing ability of a concentrated extract of B. orientale in a hydrogel formulation in healing diabetic ulcer wounds.Materials and methodsThe water extract from the leaves of B. orientale was separated from the crude methanolic extract and subjected to flash column chromatography techniques to produce concentrated fractions. These fractions were tested for phytochemical composition, tannin content, antioxidative and antibacterial activity. The bioactive fraction was formulated into a sodium carboxymethylcellulose hydrogel. The extract-loaded hydrogels were then characterized and tested on excision ulcer wounds of streptozotocin-induced diabetic rats. Wound size was measured for 14 days. Histopathological studies were conducted on the healed wound tissues to observe for epithelisation, fibroblast proliferation and angiogenesis. All possible mean values were subjected to statistical analysis using One-way ANOVA and post-hoc with Tukey's T-test (P<0.05).ResultsOne fraction exhibited strong antioxidative and antibacterial activity. The fraction was also highly saturated with tannins, particularly condensed tannins. Fraction W5–1 exhibited stronger antioxidant activity compared to three standards (α-Tocopherol, BHT and Trolox-C). Antibacterial activity was also present, and notably bactericidal towards Methicillin-resistant Staphylococcus aureus (MRSA) at 0.25mg/ml. The extract-loaded hydrogels exhibited shear-thinning properties, with high moisture retention ability. The bioactive fraction at 4% w/w was shown to be able to close diabetic wounds by Day 12 on average. Other groups, including controls, only exhibited wound closure by Day 14 (or not at all). Histopathological studies had also shown that extract-treated wounds exhibited re-epithelisation, higher fibroblast proliferation, collagen synthesis, and angiogenesis.ConclusionThe ethnopharmacological effects of using B. orientale as a topical treatment for external wounds was validated and was also significantly effective in treating diabetic ulcer wounds. Thus, B. orientale extract hydrogel may be presented as a potential treatment for diabetic ulcer wounds.

Graphical abstract

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Sulfate conjugation of daphnetin by the human cytosolic sulfotransferases

Publication date: 2 August 2016
Source:Journal of Ethnopharmacology, Volume 189
Author(s): Zhengyang Han, Yuecheng Xi, Lijun Luo, Chunyang Zhou, Katsuhisa Kurogi, Yoichi Sakakibara, Masahito Suiko, Ming-Cheh Liu
Ethnopharmacological relevanceIn Turkey, daphnetin-containing Daphne oleoides is used as a folk medicine for treating rheumatic pain and lumbago. A daphnetin-containing traditional Chinese medicine tablet, named Zushima-Pian, is available in China for treating rheumatoid arthritis. The present study aimed to investigate the metabolism of daphnetin through sulfation in cultured human cells and to identify the human cytosolic sulfotransferase(s) (SULT(s)) that is(are) capable of mediating the sulfation of daphnetin.Materials and methodsCultured HepG2 human hepatoma cells and Caco-2 human colon carcinoma cells were labeled with [³⁵S]sulfate in the presence of different concentrations of daphnetin. Thirteen known human SULTs, previously expressed and purified, as well as cytosols of human kidney, liver, lung, and small intestine, were examined for daphnetin-sulfating activity using an established sulfotransferase assay.Results[³⁵S]sulfated daphnetin was found to be generated and released by HepG2 cells and Caco-2 cells labeled with [³⁵S] sulfate in the presence of daphnetin. Among the 13 known human SULTs, SULT1A1, SULT1A2, SULT1A3, SULT1B1, and SULT1C4 displayed significant sulfating activity toward daphnetin. Of the four human organ samples later tested, small intestine and liver cytosols displayed considerably higher daphnetin-sulfating activity than those of lung and kidney.ConclusionThe results derived from the present study showed unequivocally that daphnetin could be sulfated in cultured human cells and by purified human SULT enzymes as well as human organ cytosols. The information obtained provided a basis for further studies on the metabolism of daphnetin through sulfation in vivo.

Graphical abstract

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CMV endometritis in a non- immunosuppressed patient presenting as recurrent pyometra- A case report

2016-05-31T08-38-46Z
Source: Journal of Interdisciplinary Histopathology
Dr. Geetha Vasudevan, Dr Pavithra Prabhakar, Dr. Shephali Sharma.
Cytomegalovirus infection of the female genital tract is a rare entity. We present a case of 70 year old woman who came with recurrent pyometra, but was otherwise in good health. Hysterectomy was done and the endometrium showed occasional stromal cells with karyomegaly and intranuclear eosinophilic inclusions consistent with cytomegaloviral infection and dense lymphoplasmacytic infiltrate. This was an incidental finding in an otherwise immunocompetent nonpregnant woman, hence being reported for its rarity and uncommon presentation. Keywords: cytomegalovirus, inclusions, endometrium.


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The relation between illness perceptions and psychiatric morbidity among patients with vitiligo, in Al-Madinah, Saudi Arabia

2016-05-31T08-35-39Z
Source: International Journal of Medical Science and Public Health
Mokhtar Mahfouz Shatla, Israa Abdulhadi AlSofyani, Samira Waslullah Almitairi, Ahmad Saud Alrahili, Amani Wasal Alsolami.
Background: Vitiligo is a prevalent macular skin depigmentation that can impose significant psychiatric morbidity in terms of depression and anxiety. Patients with vitiligo, as well as other chronic diseases, react to their illness by developing their own beliefs and perceptions that might affect their health and well-being. Objective: This study aimed to assess the rate of depression and anxiety among patients with vitiligo, and to evaluate the relation between patients perceptions regarding vitiligo and the increased likelihood of depression and anxiety. Materials and Methods: This cross-sectional study included consecutive adult patients with vitiligo who attended the Laser and Skin Clinic in King Fahd Hospital, in Al-Madinah, Saudi Arabia. Participants were invited to respond to the Arabic versions of the Hospital Anxiety and Depression Scale (HADS), and the Revised-Illness Perceptions Questionnaire (IPQ-R). Patients sociodemographic characteristics were recorded. Results: Out of 132 patients, 49 (37.1%) had depression and 56 (42.4%) had anxiety. Pearsons correlation showed significant association between depression and anxiety, and various dimensions of the patients poor illness perceptions (P

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Aging-mediated neuromuscular instability and delayed choice reaction time

2016-05-31T08-35-39Z
Source: International Journal of Medical Science and Public Health
Nitin Ashok John, Kuppusamy Saranya, Yerrabeli Dhanalakshmi, Jyoti John.
Background: Normal aging phenomenon is associated with cognitive decline, without any associated pathologies, over the lifespan of an adult. The fluid abilities; attention, processing speed, and executive functions are notably affected, which can hamper the everyday life. Reaction time (RT) test assesses all these abilities. Physical activity has been postulated to have a beneficial effect in the prevention of cognitive decline with aging. Objective: To study the effect of aging on the choice auditory and visual RT in healthy adults and in those performing aerobic exercise. Materials and Methods: The present cross-sectional study was carried out in the Physiology Department, IGMC, Nagpur. Twenty healthy adults and 20 aerobic exercisers were recruited in 3 groups of different age groups; Group 1: 3140 years, Group 2: 4150 years, and Group 3: 5160 yearseach group comprising 20 individuals. RT both with low- and high-frequency sound and with red, green, and indigo color was assessed. Statistical analysis was done using One-way ANOVA. Post-hoc analysis was done by TukeyKrammer test. Statistical value of p

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Evaluation of Weekly Iron and Folic Acid Supplementation Programme for adolescents in rural schools of Kannur, North Kerala, India: A cross-sectional study

2016-05-31T08-35-39Z
Source: International Journal of Medical Science and Public Health
Sarada AK, Thilak SA.
Background: Iron deficiency is the major cause for anemia and widespread nutritional deficiency disorder in India. In 2013, Ministry of Health and Family Welfare has launched the Weekly Iron and Folic Acid Supplementation (WIFS) Programme to reduce the prevalence and severity of nutritional anemia in adolescent population. Since it is a relatively new program, we conducted this survey to evaluate current status of the program implementation in the schools, Kannur, India. Objective: To evaluate the current status of WIFS Programme implementation in the schools of Kannur, north Kerala, India. Materials and Methods: It was a cross-sectional study carried out in schools under the rural field practice area of Community Medicine Department, Kannur Medical College, Kannur. Two schools were selected randomly for the data collection and a sample of 524 students and 39 teachers were studied for a period of 1 month. A pretested, semi-structured, self-administered questionnaire was administered and descriptive statistics and associations were analyzed. Results: Out of the 524 students, 50.4% were males and 49.6% females, 77.3% of them had not consumed iron and folic acid (IFA) tablets regularlymain reasons were feeling healthy and parents resistance. Awareness about anemia and its symptoms was good but significant difference existed between the schools. Twenty-three percent had side effects after IFA tablets intake and common side effect was stomach pain. All 39 teachers opined WIFS Programme was useful and 90% teachers counseled the students. Fifty percent teachers told they faced resistance from parents. Conclusion: Awareness about anemia was good but WIFS implementation in schools was not regular. There is a need to strengthen the program by giving proper training to the teachers and by giving health education to the parents and students about the benefits of WIFS.


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Evaluation of primary retroperitoneal masses by computed tomography scan

2016-05-31T08-35-39Z
Source: International Journal of Medical Science and Public Health
Anantkumar Chaudhari, Purvi D Desai, Mahesh K Vadel, Kumarbhargav Kaptan.
Background: Retroperitoneum is one of the largest spaces in the body where the primary and metastatic tumors grow silently to large sizes before the clinical signs and symptoms appear. Though retroperitoneal masses are rare with reported incidence of 0.3% to 3.0%, majority of them are malignant. Early and accurate diagnosis is crucial. Of the many diagnostic modalities, radiological investigation such as computed tomography (CT) is the modality of choice for the primary evaluation. Objective: To evaluate the usefulness of CT scan in evaluation of the retroperitoneal masses. Materials and Methods: Total 30 cases of retroperitoneal mass were studied by CT scan using oral and intravenous contrast in the Department of Radiodiagnosis and Imaging, Government Medical College and New Civil Hospital, Surat, Gujarat, India, from July 2010 to July 2013. Result: Of the 30 cases, 17 were male and 13 were female patients. A total of 63.3% of the lesions were malignant and 36.6% of the lesions were benign. Retroperitoneal lymphoid masses were the most common. Conclusion: CT scan is safe, simple, minimally invasive, and a cost-effective method in the diagnosis of primary retroperitoneal masses. It is highly effective in determining the exact location, extension, metastatic lymphadenopathy, vascular invasion, and distant metastases with fair accuracy. It is a vital guide in the procedures such as guided FNAC and biopsy. It provides important clues for the final diagnosis. Thus, CT is the modality of choice in the evaluation of retroperitoneal masses. However, differentiating the malignant lesions and metastatic lymph nodes from each other is difficult on CT features alone.


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Antiatherogenic Effect of Camellia japonica Fruit Extract in High Fat Diet-Fed Rats

Hypercholesterolemia is a well-known etiological factor for cardiovascular disease and a common symptom of most types of metabolic disorders. Camellia japonica is a traditional garden plant, and its flower and seed have been used as a base oil of traditional cosmetics in East Asia. The present study was carried out to evaluate the effect of C. japonica fruit extracts (CJF) in a high fat diet- (HFD-) induced hypercholesterolemic rat model. CJF was administered orally at three different doses: 100, 400, and 800 mg·kg−1·day−1 (CJF 100, 400, and 800, resp.). Our results showed that CJF possessed strong cholesterol-lowering potency as indicated by the decrease in serum total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL), accompanied by an increase in serum high-density lipoprotein (HDL). Furthermore, CJF reduced serum lipid peroxidation by suppressing the formation of thiobarbituric acid reactive substance. In addition, oil red O (ORO) staining of rat arteries showed decreased lipid-positive staining in the CJF-treated groups compared to the control HFD group. Taken together, these results suggest that CJF could be a potent herbal therapeutic option and source of a functional food for the prevention and treatment of atherosclerosis and other diseases associated with hypercholesterolemia.

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Inductive Effect of Palmatine on Apoptosis in RAW 264.7 Cells

Osteoporosis is a serious public health problem characterized by low bone density and deterioration of the bone microarchitecture. Current treatment options target either osteoclast resorption or osteoblast formation. It has been reported that berberine, a close structural analog of palmatine, inhibited bone loss in an osteoporosis model. In this study, osseous metabolism was observed in vitro with osteoclast bone resorbing cells. We proved that mouse preosteoclastic cell line (RAW 264.7) has a higher sensitivity to palmatine than mouse osteoblastic cell line (MC3T3-E1); the cell survival rates significantly decreased at 40 μM palmatine. The level, a metabolic product of nitric monoxide (NO), and iNOS mRNA expression, an osteoclast with NO induced enzyme, also increased with higher dosage of palmatine. Furthermore, it was recognized that the cell viability decrease from palmatine was caused by apoptosis rather than necrosis. Additionally, osteoclast apoptosis from palmatine did not occur when iNOS was inhibited with -nitro-L-arginine methyl ester hydrochloride (pan NOS inhibitor). These results indicate that palmatine plays an important role in osteoclast apoptosis via the NOS system. Hence, palmatine could be considered as a viable pharmaceutical candidate for osteoporosis bone resorption inhibitor.

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IJMS, Vol. 17, Pages 700: Pesticides Drive Stochastic Changes in the Chemoreception and Neurotransmission System of Marine Ectoparasites

Scientific efforts to elucidate the mechanisms of chemical communication between organisms in marine environments are increasing. This study applied novel molecular technology to outline the effects of two xenobiotic drugs, deltamethrin (DM) and azamethiphos (AZA), on the neurotransmission system of the copepod ectoparasite Caligus rogercresseyi. Transcriptome sequencing and bioinformatics analyses were conducted to evaluate treatment effects on the glutamatergic synaptic pathway of the parasite, which is closely related to chemoreception and neurotransmission. After drug treatment with DM or AZA, stochastic mRNA expression patterns of glutamatergic synapse pathway components were observed. Both DM and AZA promoted a down-regulation of the glutamate-ammonia ligase, and DM activated a metabotropic glutamate receptor that is a suggested inhibitor of neurotransmission. Furthermore, the delousing drugs drove complex rearrangements in the distribution of mapped reads for specific metabotropic glutamate receptor domains. This study introduces a novel methodological approach that produces high-quality results from transcriptomic data. Using this approach, DM and AZA were found to alter the expression of numerous mRNAs tightly linked to the glutamatergic signaling pathway. These data suggest possible new targets for xenobiotic drugs that play key roles in the delousing effects of antiparasitics in sea lice.

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Effect of gold nanoparticles on thermal gradient generation and thermotaxis of E. coli cells in microfluidic device

Abstract

Bacteria responds to changing chemical and thermal environment by moving towards or away from a particular location. In this report, we looked into thermal gradient generation and response of E. coli DH5α cells to thermal gradient in the presence and in the absence of spherical gold nanoparticles (size: 15 to 22 nm) in a static microfluidic environment using a polydimethylsiloxane (PDMS) made microfluidic device. A PDMS-agarose based microfluidic device for generating thermal gradient has been developed and the thermal gradient generation in the device has been validated with the numerical simulation. Our studies revealed that the presence of gold nanoparticles, AuNPs (0.649 μg/mL) has no effect on the thermal gradient generation. The E. coli DH5α cells have been treated with AuNPs of two different concentrations (0.649 μg/mL and 0.008 μg/mL). The thermotaxis behavior of cells in the presence of AuNPs has been studied and compared to the thermotaxis of E.coli DH5α cells in the absence of AuNPs. In case of thermotaxis, in the absence of the AuNPs, the E. coli DH5α cells showed better thermotaxis towards lower temperature range, whereas in the presence of AuNPs (0.649 μg/mL and 0.008 μg/mL) thermotaxis of the E. coli DH5α cells has been inhibited. The results show that the spherical AuNPs intervenes in the themotaxis of E. coli DH5α cells and inhibits the cell migration. The reason for the failure in thermotaxis response mechanism may be due to decreased F-type ATP synthase activity and collapse of membrane potential by AuNPs, which, in turn, leads to decreased ATP levels. This has been hypothesized since both thermotaxis and chemotaxis follows the same response mechanism for migration in which ATP plays critical role.

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A H2S Donor GYY4137 Exacerbates Cisplatin-Induced Nephrotoxicity in Mice

Accumulating evidence demonstrated that hydrogen sulfide (H2S) is highly involved in inflammation, oxidative stress, and apoptosis and contributes to the pathogenesis of kidney diseases. However, the role of H2S in cisplatin nephrotoxicity is still debatable. Here we investigated the effect of GYY4137, a novel slow-releasing H2S donor, on cisplatin nephrotoxicity in mice. Male C57BL/6 mice were pretreated with GYY4137 for 72 h prior to cisplatin injection. After cisplatin treatment for 72 h, mice developed obvious renal dysfunction and kidney injury as evidenced by elevated blood urea nitrogen (BUN) and histological damage. Consistently, these mice also showed increased proinflammatory cytokines such as TNF-α, IL-6, and IL-1β in circulation and/or kidney tissues. Meanwhile, circulating thiobarbituric aid-reactive substances (TBARS) and renal apoptotic indices including caspase-3, Bak, and Bax were all elevated. However, application of GYY4137 further aggravated renal dysfunction and kidney structural injury in line with promoted inflammation, oxidative stress, and apoptotic response following cisplatin treatment. Taken together, our results suggested that GYY4137 exacerbated cisplatin-induced nephrotoxicity in mice possibly through promoting inflammation, oxidative stress, and apoptotic response.

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Cardiorenal Involvement in Metabolic Syndrome Induced by Cola Drinking in Rats: Proinflammatory Cytokines and Impaired Antioxidative Protection

We report experimental evidence confirming renal histopathology, proinflammatory mediators, and oxidative metabolism induced by cola drinking. Male Wistar rats drank ad libitum regular cola (C, ) or tap water (W, ). Measures. Body weight, nutritional data, plasma glucose, cholesterol fractions, TG, urea, creatinine, coenzyme Q10, SBP, and echocardiograms (0 mo and 6 mo). At 6 months euthanasia was performed. Kidneys were processed for histopathology and immunohistochemistry (semiquantitative). Compared with W, C rats showed (I) overweight (+8%, ), hyperglycemia (+11%, ), hypertriglyceridemia (2-fold, ), higher AIP (2-fold, ), and lower Q10 level (−55%, ); (II) increased LV diastolic diameter (+9%, ) and volume (systolic +24%, ), posterior wall thinning (−8%, ), and larger cardiac output (+24%, ); (III) glomerulosclerosis (+21%, ), histopathology (+13%, ), higher tubular expression of IL-6 (7-fold, ), and TNFα (4-fold, ). (IV) Correlations were found for LV dimensions with IL-6 (74%, ) and TNFα (52%, ) and fully abolished after TG and Q10 control. Chronic cola drinking induced cardiac remodeling associated with increase in proinflammatory cytokines and renal damage. Hypertriglyceridemia and oxidative stress were key factors. Hypertriglyceridemic lipotoxicity in the context of defective antioxidant/anti-inflammatory protection due to low Q10 level might play a key role in cardiorenal disorder induced by chronic cola drinking in rats.

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Physical measurements of Chinese children in Hong Kong—A pilot study in preschools and kindergartens

Normal growth is essential to a developing child. Most syndromes with dysmorphic features demonstrate recognizable patterns of disproportionate growth, thus physical measurements are an important aspect of patient evaluation. Delineating the abnormal growth pattern depends greatly on the accuracy of the normal range. However, the currently available reference data are restricted in terms of ethnicity and geographical location, hence may not be applicable to all children worldwide. In Hong Kong, reference data are limited only to the neonatal period. The aim of our pilot study is to obtain a set of region-specific physical measurement data for Chinese children in Hong Kong. Two to six year olds were recruited from preschools and kindergartens in different regions of Hong Kong. Twenty-six parameters found in previous publications were measured with minor modifications. Three medical personnel trained by a clinical geneticist obtained these parameters. Satisfactory inter-rater reliability was achieved in a training cohort prior to the study. Raw measurement data collected were normalized and fitted into growth curves modeled by LMS method. We recruited 448 children (55.6% male) between 2 and 6 years old from five preschools and kindergartens. Growth curves with essential percentile lines were drawn. Significant differences were identified in 11 parameters when compared with Caucasian children, including canthal distances and facial width/height. Our current pilot study presents the first local- and ethnicity-specific data on physical measurements of 2–6 year olds. Our findings highlighted the substantial ethnic variability in physical measurements and the need for an ethnic-specific reference for Chinese children. © 2016 Wiley Periodicals, Inc.

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Sialylation: an Avenue to Target Cancer Cells

Abstract

Tumorigenesis and metastasis are frequently associated with altered structure and expression of oligosaccharides on cell surface glycoproteins and glycolipids. The expression of sialylated glycoconjugates has been shown to change during development, differentiation, disease and oncogenic transformation. Abnormal sialylation in cancer cell is a distinctive feature associated with malignant properties including invasiveness and metastatic potential. The alterations in sialylation is accompanied by changes in sialic acid, sialidase activity, sialyltransferase (ST) activity or sialoproteins. The present review summarizes the reports on alterations of sialic acid, linkage specific STs and sialoproteins, sialidase activity together with different subtypes of ST and sialidases mRNA expressions in various cancers like lung, breast, oral, cervical, ovarian, pancreatic etc. Sialic acids are widely distributed in nature as terminal sugars of oligosaccharides attached to proteins or lipids. The increase shedding of sialic acid observed in malignant tumors may be due to different types of sialidases. The amount of sialic acid is governed by levels of sialidases and STs. Various types of STs are also involved in formation of different types sialylated tumor associated carbohydrate antigens which plays important role in metastasis. The alterations associated with sialylation aids in early diagnosis, prognosis and post treatment monitoring in various cancers. Recently newer drugs targeting different interplays of sialylation have been developed, which might have profound effect in inhibiting sialylation and thus cancer metastasis and infiltration.

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Mutation Scanning of D1705 and D1709 in the RNAse IIIb Domain of MicroRNA Processing Enzyme Dicer in Cutaneous Melanoma

Abstract

Since the discovery of microRNAs (miRNAs) there have been performed several studies showing perturbations in the expression of miRNAs and the miRNA expression machinery in cutaneous melanoma. Dicer, a pivotal cytosolic enzyme of miRNA maturation has shown to be affected by both somatic and germline mutations in a variety of cancers. Recent studies have shown that recurrent somatic mutations of Dicer frequently affect the metal-ion-binding sites D1709 and D1705 of its RNase IIIb domain, therefore called hot spot mutations. The present study investigates metal-ion-binding sites D1709 and D1705 of the Dicer RNase IIIb domain in cutaneous melanomas and melanoma metastasis by Sanger sequencing. All investigated samples showed wildtype sequence and no single mutation was detected. The miRNA processing enzyme Dicer of melanoma and melanoma metastasis does not appear to be affected by mutation in the metal-ion-binding sites D1709 and D1705 of its RNase IIIb domain.

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Immunohistochemical Analysis of E-Cadherin, p53 and Inhibin-α Expression in Hydatidiform Mole and Hydropic Abortion

Abstract

The purpose of this study was to investigate the role of E-cadherin, p53, and inhibin-α immunostaining in the differential diagnosis of hydropic abortion (HA), partial hydatidiform mole (PHM), and complete hydatidiform mole (CHM). E-cadherin, p53, and inhibin-α protein expression patterns were investigated immunohistochemically using paraffin -embedded tissue sections from histologically diagnosed cases of HA (n = 23), PHM (n = 24), and CHM (n = 23). Expression patterns of these markers were scored semi-quantitatively according to the staining intensity, percentage of positive cells, and immunoreactivity score. Classification of cases was established on histologic criteria and supported by the molecular genotyping. Immunostaining allowed the identification of specific cell types with E-cadherin, p53, and inhibin-α expression in all cases. E-cadherin expression was detected on the cell surface of villous cytotrophoblasts. We observed a marked decline in the expression of E-cadherin from HAs to PHMs to CHMs. The p53-positive reaction was restricted to the nucleus of villous cytotrophoblasts. Significantly increased p53 expression was observed in CHMs, compared with HAs and PHMs. The expression of inhibin-α was localised in the cytoplasm of villous syncytiotrophoblasts, and the expression of this marker was significantly higher in PHMs and CHMs than HAs. In conclusion, immunohistochemical analysis of E-cadherin, p53, and inhibin-α expression could serve as a useful adjunct to conventional methods in the differential diagnosis of HA, PHM, and CHM.

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Study on the Association Between miRNA-202 Expression and Drug Sensitivity in Multiple Myeloma Cells

Abstract

An increasing amount of experimental evidence has shown that miRNAs play a causal role in hematologic tumorigenesis. In this study, we characterized the role of miR-202 in multiple myeloma (MM) drug sensitivity. The potential binding site of miR-202 and B cell-activating factor (BAFF) was confirmed by luciferase reporter assay. MM cells were transfected with miR-202 mimics and inhibitor. Cells growth was measured by WST-1 cell proliferation assay and Annexin V-FLUOS apoptosis assay. BAFF and miR-202 mRNA levels were measured by real-time PCR. Meanwhile, BAFF, Bcl-2 family survival proteins and MAPK pathway proteins were measured by Western blot. It was found that miR-202 was functioned as a modulator of BAFF expression. miR-202 over-expression sensitized MM cells to bortezomib (Bort) but less to Thalidomide (Thal) and dexamethasone (Dex). miR-202 mimics in combination with Bort inhibited MM cell survival more effectively as compared with Bort treatment alone. Our study also provided experimental evidence that JNK/SAPK signaling pathway was involved in the regulatory effect of miR-202 on drug resistance of MM cells. These results suggest that the regulatory mechanism of miR-202 expression may be a promising target for fine-tuning anti-myeloma therapy.

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Clinical Performance of APTIMA Human Papillomavirus (HPV) 16 18/45 mRNA Genotyping Testing for the Detection of Cervical Intraepithelial Neoplasia 3 (CIN3) or Cancer in a Select Group of Chinese Women

Abstract

HPV type was evaluated in a select group of Chinese women that were positive with hybrid capture, and correlations were performed between the pathology found, the type of virus and a semiquantitation from the hybrid capture results. Totally 394 referred high-risk-HPV-positive women evaluated by Hybrid Capture 2 (HC-2) assay were enrolled. Before colposcopy, cervical specimens were collected from all participants and suspended into PreservCytcollection medium (Hologic Inc., Marlborough, MA), and tested with the APTIMA HPV16 18/45 mRNA assay. Colposcopy and diagnostic biopsies were done on all participants. Viral load was assessed by HC2 assay. Totally 55 women were diagnosed as CIN 3 plus cancer (≥CIN3), and the prevalence of HPV16/18/45 was 65.5 % (95 % confidence interval [CI], 52.9–78.0 %) among these ≥CIN3 women. Compared with the group with positive HC2 but negative HPV16/18/45, the odds ratio (OR) to identify ≥CIN3 was 6.3 (95 % CI, 3.2–12.3) for HPV16 and 3.2 (95 % CI, 1.4–7.2) for HPV18/45. When using ≥CIN3 as an endpoint, the sensitivity and specificity was 65.5 % (95 % CI, 52.9–78.0 %) and 72.0 % (95 % CI, 67.2–76.8 %). In the case of HPV16/18/45 negative, no high HPV load had a statistically significant increased risk for the prevalence of ≥CIN3. HPV16, 18 and 45 infection is a major cause for ≥CIN3 in Chinese women. Women with positive HPV16/18/45 should be referred to colposcopy immediately. HPV load was not suitable for the further triaged of the HPV16/18/45 negative cases.

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Serum Sialyl-Tn (STN) as a Tumor Marker in Patients with Endometrial Cancer

Abstract

There are no potential tumor markers validated for prognosis of endometrial cancer. However, sialyl Tn (STN) is a carbohydrate antigen that is associated with the production of mucin, which reportedly plays important roles in carcinogenesis. Although STN expression in endometrial cancer has been investigated, its prognostic value remains controversial and no studies have investigated serum STN levels in large case series. In this study, we investigated diagnostic and prognostic applications of serum STN for endometrial cancer. Between January 2006 and December 2012, serum STN levels were examined prospectively in patients with endometrial cancer. A total of 146 patients (stage I, 98; stage II, 15; stage III, 17; stage IV, 16) were treated for endometrial cancer. The median age was 60 years (28–83). Subsequently 29 patients (19.9%) relapsed at the time of the last follow-up and the median follow-up time was 44 months (1–83). Elevated serum STN levels were identified in 36 patients (24.7%) and were associated with histological grade (p = 0.02) and lymph node metastasis (p = 0.006). Elevated serum STN levels were not related to histological types, clinical stages, myometrial invasions, distant metastases, age, menopausal status, body mass index, or relapse. Among the 36 patients with elevated serum STN levels, 33 (91.7%) achieved remission and serum STN levels returned to the normal range. Seven patients (21.2%) with elevated serum STN levels at baseline relapsed and their serum STN levels were again elevated. Serum STN levels are a potential prognostic indicator for endometrial cancer.

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Loss of Protein Tyrosine Phosphatase Receptor J Expression Predicts an Aggressive Clinical Course in Patients with Esophageal Squamous Cell Carcinoma

Abstract

Protein Tyrosine Phosphatase Receptor J (PTPRJ) has been reported to be a tumor suppressor in various human cancers. The aim of this study was to investigate the clinical significance of PTPRJ in ESCC patients and its effects on biological behaviors of ESCC cells. PTPRJ expression, at mRNA and protein levels, were respectively detected by quantitative real-time PCR, western blot and immunohistochemistry, based on 106 newly diagnosed ESCC patients. The associations between PTPRJ expression and clinicopathological characteristics of ESCC patients were statistically analyzed. Then, the effects of PTPRJ in migration and invasion were determined by wound healing and transwell assays based on ESCC cell line transfected with siRNA or expression vector of PTPRJ. Expression of PTPRJ at mRNA and protein levels were both significantly lower in ESCC tissues than those in normal esophageal mucosa. Immunohistochemistry showed that PTPRJ protein was localized in the cytoplasm of cancer cells in ESCC tissues. In addition, PTPRJ downregulation was found to be closely correlated with advanced tumor stage (P = 0.01) and poor differentiation (P = 0.03). Moreover, knockdown of PTPRJ in KYSE510 cells could significantly promote cell migration and invasion (both P < 0.05), which were reversed by the restoration of PTPRJ expression in vitro (both P < 0.05). Our data offer the convincing evidence that loss of PTPRJ expression may predict an aggressive clinical course in ESCC patients. PTPRJ may function as a tumor suppressor and play an important role in the regulation of ESCC cell motility, suggesting its potentials as a therapeutic agent for human ESCC.

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miRNA Isolation from FFPET Specimen: A Technical Comparison of miRNA and Total RNA Isolation Methods

Abstract

MiRNA remain stable for detection and PCR-based amplification in FFPE tissue samples. Several miRNA extraction kits are available, however miRNA fraction, as part of total RNA can be isolated using total RNA purification methods, as well. Our primary aim was to compare four different miRNA and total RNA isolation methods from FFPE tissues. Further purposes were to evaluate quantitatively and qualitatively the yield of the isolated miRNA. MiRNAs were isolated from normal colorectal cancer FFPE specimens from the same patients. Two miRNA isolation kits (High Pure miRNA Isolation Kit, miRCURY™ RNA Isolation Kit) and two total RNA isolation kits were compared (High Pure RNA Paraffin Kit, MagNA Pure 96 Cellular RNA LV Kit). Quantity and quality were determined, expression analysis was performed by real-time PCR using qPCR Human Panel I + II (Exiqon) method detecting 742 human miRNAs in parallel. The yield of total RNA was found to be higher than miRNA purification protocols (in CRC: Ex: 0203 ± 0021 μg; HPm: 1,45 ± 0,8 μg; HPp: 21,36 ± 4,98 μg; MP: 8,6 ± 5,1 μg). MiRNAs were detected in lower relative quantity of total RNA compared to the miRNA kits. Higher number of miRNAs could be detected by the miRNA isolation kits in comparison to the total RNA isolation methods. (Ex: 497 ± 16; HPm: 542 ± 11; HPp: 332 ± 36; MP: 295 ± 74). Colon specific miRNAs (miR-21-5p;-34-5p) give satisfying results by miRNA isolation kits. Although miRNA can be detected also after total RNA isolation methods, for reliable and reproducible miRNA expression profiling the use of miRNA isolation kits are more suitable.

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Back-trajectory analysis of African dust outbreaks at a coastal city in southern Spain: Selection of starting heights and assessment of African and concurrent Mediterranean contributions

Publication date: September 2016
Source:Atmospheric Environment, Volume 140
Author(s): M. Cabello, J.A.G. Orza, C. Dueñas, E. Liger, E. Gordo, S. Cañete
The present study uses a back-trajectory analysis at multiple heights for better interpretation of the impact of the African dust outbreaks in the coastal Mediterranean city of Málaga (Spain), the southernmost large city in Europe. Throughout a 3-year period, 363 days were identified as dusty days by atmospheric transport models. During these events, PM10, SO2, O3, temperature, AOD and Ångström exponent showed statistically significant differences compared to days with no African dust. It was found that under African dust events, the study site was influenced by Mediterranean air masses at the lowermost heights and by Atlantic advections at high altitudes, while African air masses mostly reached Málaga at intermediate levels. Specifically, the lowest heights at which air masses reached the study site after having resided over Africa are confined into the 1000–2000 m range. The decoupling between the lowest heights and the ones for dust transport may explain the presence of aged air masses at the time of the African outbreak. Additionally, with the aim of studying the influence of the air mass origin and history on air quality, a new procedure based on Principal component analysis (PCA) is proposed to determine which altitudes are best suited as starting points for back-trajectory calculations, as they maximize the differences in residence time over different areas. Its application to Málaga identifies three altitudes (750, 2250 and 4500 m) and a subsequent analysis of back-trajectories for African dust days provided the main source areas over Africa as well as further insight on the Mediterranean contribution.



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Particulate hydroxy-PAH emissions from a residential wood log stove using different fuels and burning conditions

Publication date: September 2016
Source:Atmospheric Environment, Volume 140
Author(s): Rozanna Avagyan, Robin Nyström, Robert Lindgren, Christoffer Boman, Roger Westerholm
Hydroxylated polycyclic aromatic hydrocarbons are oxidation products of polycyclic aromatic hydrocarbons, but have not been studied as extensively as polycyclic aromatic hydrocarbons. Several studies have however shown that hydroxylated polycyclic aromatic hydrocarbons have toxic and carcinogenic properties. They have been detected in air samples in semi urban areas and combustion is assumed to be the primary source of those compounds. To better understand the formation and occurrence of particulate hydroxylated polycyclic aromatic hydrocarbons from residential wood log stove combustion, 9 hydroxylated polycyclic aromatic hydrocarbons and 2 hydroxy biphenyls were quantified in particles generated from four different types of wood logs (birch, spruce, pine, aspen) and two different combustion conditions (nominal and high burn rate). A previously developed method utilizing liquid chromatography – photo ionization tandem mass spectrometry and pressurized liquid extraction was used. Polycyclic aromatic hydrocarbons were analyzed along with hydroxylated polycyclic aromatic hydrocarbons. The hydroxylated polycyclic aromatic hydrocarbon emissions varied significantly across different wood types and burning conditions; the highest emissions for nominal burn rate were from spruce and for high burn rate from pine burning. Emissions from nominal burn rate corresponded on average to 15% of the emissions from high burn rate, with average emissions of 218 μg/MJfuel and 32.5 μg/MJfuel for high burn rate and nominal burn rate, respectively. Emissions of the measured hydroxylated polycyclic aromatic hydrocarbons corresponded on average to 28% of polycyclic aromatic hydrocarbons emissions.This study shows that wood combustion is a large emission source of hydroxylated polycyclic aromatic hydrocarbons and that not only combustion conditions, but also wood type influences the emissions of hydroxylated polycyclic aromatic hydrocarbons and polycyclic aromatic hydrocarbons. There are few studies that have determined hydroxylated polycyclic aromatic hydrocarbons in emissions from wood combustion, and it is therefore necessary to further investigate the formation, occurrence and distribution of these compounds as they are present in significant amounts in wood smoke particles.



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Vertical structure of foggy haze over the Beijing–Tianjin–Hebei area in January 2013

Publication date: August 2016
Source:Atmospheric Environment, Volume 139
Author(s): Feng Han, Jun Xu, Youjiang He, Hongyan Dang, Xuezhen Yang, Fan Meng
In January 2013, frequent episodes of intense air pollution occurred in the Beijing–Tianjin–Hebei area (BTH), China. Besides the occurrence of region-wide dry haze pollution, foggy haze conditions also developed across the region on numerous days, lasting into the afternoon. Synergistic analysis, using multisatellite datasets, air sounding and surface meteorological observations, indicated that there was a vertical overlap of fog and aerosol layers during the foggy haze episodes in the region. Fog appeared at a low level of the atmosphere. The altitude of the upper boundary of the fog differed across the region, but it was always below 1 km. The aerosol layer that closely contacted with the top of the underlying fog was rather dense, having a high concentration comparable to that during severe pollution on the ground. Above the dense aerosol layer, aerosol with a concentration equivalent to that of moderate pollution stretched up to an altitude of 2 km. Beyond that, a tenuous aerosol layer extended 5 km into the atmosphere. This overlapping of fog and haze layers frequently occurred across the region in January 2013. The occurrence of a foggy haze over BTH could worsen the regional air quality, and its appearance across this region would have notable effects on the radiation balance.



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Aromatic compound emissions from municipal solid waste landfill: Emission factors and their impact on air pollution

Publication date: August 2016
Source:Atmospheric Environment, Volume 139
Author(s): Yanjun Liu, Wenjing Lu, Hanwen Guo, Zhongyuan Ming, Chi Wang, Sai Xu, Yanting Liu, Hongtao Wang
Aromatic compounds (ACs) are major components of volatile organic compounds emitted from municipal solid waste (MSW) landfills. The ACs emissions from the working face of a landfill in Beijing were studied from 2014 to 2015 using a modified wind tunnel system. Emission factors (EFs) of fugitive ACs emissions from the working face of the landfill were proposed according to statistical analyses to cope with their uncertainty. And their impacts on air quality were assessed for the first time. Toluene was the dominant AC with an average emission rate of 38.8 ± 43.0 μg m⁻² s⁻¹ (at a sweeping velocity of 0.26 m s⁻¹). An increasing trend in AC emission rates was observed from 12:00 to 18:00 and then peaked at 21:00 (314.3 μg m⁻² s⁻¹). The probability density functions (PDFs) of AC emission rates could be classified into three distributions: Gaussian, log-normal, and logistic. EFs of ACs from the working face of the landfill were proposed according to the 95th percentile cumulative emission rates and the wind effects on ACs emissions. The annual ozone formation and secondary organic aerosol formation potential caused by AC emissions from landfills in Beijing were estimated to be 8.86 × 10⁵ kg year⁻¹ and 3.46 × 10⁴ kg year⁻¹, respectively. Toluene, m + p-xylene, and 1,3,5-trimethylbenzene were the most significant contributors to air pollution. Although ACs pollutions from landfills accounts for less percentage (∼0.1%) compared with other anthropogenic sources, their fugitive emissions which cannot be controlled efficiently deserve more attention and further investigation.



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Translational genomics for human diseases: toward a new era of precision medicine

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Systemische Therapien der Psoriasis und Psoriasisarthritis

Zusammenfassung

Die Psoriasis vulgaris ist eine der häufigsten chronischen Hauterkrankungen. Über 25 % der betroffenen Personen benötigen aufgrund der massiven Ausprägung der Symptome und/oder einer deutlichen Einschränkung der Lebensqualität eine wirksame systemische Therapie. Dank intensiverer Forschung und erfolgreicher Zusammenarbeit zwischen akademischen und industriellen Einrichtungen haben sich unsere Behandlungsmöglichkeiten für die Psoriasis in den letzten Jahren enorm erweitert. Insbesondere ermöglichen uns zielgerichtete Therapien eine personalisierte Medizin. Diese Übersichtsarbeit beschreibt das Spektrum der systemischen Therapien bei Psoriasis und Psoriasisarthritis und thematisiert Wirksamkeit, Sicherheit und Besonderheiten der einzelnen Substanzen.

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Pustulöse Psoriasis

Zusammenfassung

Eine Reihe pustulöser Hauterkrankungen teilen klinische, pathogenetische und epidemiologische Aspekte mit der Psoriasis vulgaris, und ihre Einordung als eigene klinische Entitäten oder Unterformen der Psoriasis ist weiterhin umstritten, was sich auch in der Vielzahl ihrer Bezeichnungen widerspiegelt. Hierzu gehören die generalisierte pustulöse Psoriasis mit ihren Sonderformen, die Acrodermatitis continua suppurativa, die akute Pustulosis palmoplantaris, die Psoriasis pustulosa palmoplantaris sowie pustulöse Varianten der vorwiegend durch TNF-Blocker getriggerten paradoxen psoriasiformen Dermatitis. In diesem Beitrag werden Erkenntnisse zu Epidemiologie, klinischem Bild, Pathogenese, Genetik und Therapie dieser pustulösen Hauterkrankungen dargestellt.

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