A diagnostic algorithm for tuberculous pleurisy using the ELISPOT assay on peripheral blood and pleural effusion

10.1080/23744235.2016.1183816<br/>Min-Chul Kim

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A novel approach for apportionment between primary and secondary sources of airborne nitrated polycyclic aromatic hydrocarbons (NPAHs)

Publication date: August 2016
Source:Atmospheric Environment, Volume 138
Author(s): Yan Lin, Xinghua Qiu, Yiqiu Ma, Junxia Wang, Yusheng Wu, Limin Zeng, Min Hu, Tong Zhu, Yifang Zhu
Nitrated polycyclic aromatic hydrocarbons (NPAHs) are strong environmental mutagens and carcinogens originating from both primary emissions and secondary reactions in the atmosphere. The sources and the toxicity of different NPAH species could vary greatly; therefore a specie-specific source apportionment is essential to evaluate their health risks and to formulate controlling regulations. However, few studies have reported source apportionment of NPAHs species to date. In this study, we developed an easy-to-perform method for the apportionment of primary versus secondary sources of airborne NPAHs based on the relationship between NPAHs and NO2. After log-transformation of both NPAHs and NO2 concentrations, a slope of β between these two variables was obtained by the linear regression. When β is significantly smaller than 1, it indicates primary emissions while β significantly greater than 1 suggests secondary formation. We have validated this method with data previously collected in Beijing. A good correlation, with R value of 0.57, was observed between results produced by this new method and by Positive Matrix Factorization (PMF). The correlation could be further improved (R = 0.71) if the gas/particle partition of NPAHs is taken into consideration. This developed method enables the source apportionment for individual NPAHs species and could be used to validate the results of other receptor models.

Graphical abstract

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Individual particles of cryoconite deposited on the mountain glaciers of the Tibetan Plateau: Insights into chemical composition and sources

Publication date: August 2016
Source:Atmospheric Environment, Volume 138
Author(s): Zhiwen Dong, Dahe Qin, Shichang Kang, Yajun Liu, Yang Li, Jie Huang, Xiang Qin
Cryoconite deposited on mountain glacier surfaces is significant for understanding regional atmospheric environments, which could influence the albedo and energy balance of the glacier basins, and maintain the glacial microbiology system. Field observations were conducted on the glaciers of western China, including Laohugou Glacier No.12 (LHG), Tanggula Dongkemadi Glacier (TGL), Zhadang Glacier (ZD), and Baishui Glacier No.1 in the Yulong Mountains (YL), as well as Urumqi Glacier No.1 in the Tianshan Mountains (TS) for comparison with locations in the Tibetan Plateau, in addition to laboratory TEM-EDX analysis of the individual cryoconite particles filtered on lacey carbon (LC) and calcium-coated carbon (Ca-C) TEM grids. This work provided information on the morphology and chemical composition, as well as a unique record of the particle's physical state, of cryoconite deposition on the Tibetan Plateau. The result showed that there is a large difference in the cryoconite particle composition between various locations on the Tibetan Plateau. In total, mineral dust particles were dominant (>50%) in the cryoconite at all locations. However, more anthropogenic particles (e.g., black carbon (BC) and fly ash) were found in YL (38%) and ZD (22%) in the Ca-C grids in the southern locations. In TGL, many NaCl and MCS particles (>10%), as well as few BC and biological particles (<5%), were found in cryoconite in addition to mineral dust. In TS, the cryoconite is composed primarily of mineral dust, as well as BC (<5%). Compared with other sites, the LHG cryoconite shows a more complex composition of atmospheric deposition with sufficient NaCl, BC, fly ash and biological particles (6% in LC grid). The higher ratio of anthropogenic particles in the southern Tibetan Plateau is likely caused by atmospheric pollutant transport from the south Asia to the Tibetan Plateau. Cryoconite in the northern locations (e.g., TGL, LHG, and TS) with higher dust and salt particle ratio are influenced by large deserts in central Asia. Therefore, the transport and deposition of cryoconite is of great significance for understanding regional atmospheric environment and circulation. Large amounts of biological, NaCl and MCS particles were observed in the cryoconite, implying that in addition to dust and BC, many types of light absorbing impurities (LAI) together could influence the glacier albedo change and induce ice melting in the mountain glaciers of the Tibetan Plateau. Moreover, a high BC concentration in the south (e.g., YL and ZD) could significantly change the albedo of snow and ice, at a greater rate than dust, causing significant melting of the glaciers under global warming.



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Emission characteristics of carboxylates in PM2.5 from incense burning with the effect of light on acetate

Publication date: August 2016
Source:Atmospheric Environment, Volume 138
Author(s): Su-Ching Kuo, Ying I. Tsai, Khajornsak Sopajaree
Incense burning produces potentially harmful particulate matter. In this study we investigated the emissions of PM2.5 and gaseous acetic acid from four brands of traditional incense; Liao and Shang Lao Shan (SLS), sold in Taiwan, and Thai Yellow (Thai Y) and Thai Black (Thai B), sold in Thailand. Additionally, photochemical reactions of PM2.5 carboxylates emitted from incense burning were studied via a simulated light experiment. The average PM2.5 mass emission factor of each incense type was inversely correlated with the ash production of that incense. The Thailand incense carboxylate emissions were markedly higher than the Taiwan incense. Acetate accounted for 87.46% of total carboxylate emissions, with acetate emitted from the Thailand incense 1.26 times higher than from the Taiwan incense. Phthalate was detected in the PM2.5, indicating the presence of plasticizer. Concentrations of PM2.5 acetate, formate, pyruvate, glutarate, succinate, fumarate and tartarate were reduced in simulated light (51.5%–97.1% of those under dark), indicating that these seven types of carboxylate are easily photodegradable. In contrast, malonate, maleate, oxalate and phthalate concentrations in light were 1.17–1.84 times higher than in darkness, indicating photochemical reactions contribute to the formation of these species. The formation of the low-molecular weight dicarboxylates oxalate and malonate was most noticeable. Acetic acid, highly irritating to the respiratory system and skin, was present at high levels for all four incense types, as shown by the gaseous acetic acid/PM2.5 acetate ratios of 1.03–3.61. Burning incense indoors can generate high concentrations of PM2.5 acetate that increases the risks of respiratory and contact irritation, particularly when burning the Thailand incense. Moreover, burning incense in poorly ventilated, dimly lit indoor areas (e.g., temples and homes) can markedly increase the risk of irritation because the gaseous acetic acid is not degraded as it would be in light.



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Ion mobility spectrometry nuisance alarm threshold analysis for illicit narcotics based on environmental background and a ROC-curve approach

Analyst, 2016, Accepted Manuscript
DOI: 10.1039/C6AN00844E, Paper

Thomas P Forbes, Marcela Najarro
The discriminative potential of an ion mobility spectrometer (IMS) for trace detection of illicit narcotics relative to environmental background was investigated with a receiver operating characteristic (ROC) curve framework. The...
The content of this RSS Feed (c) The Royal Society of Chemistry

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Implication of different clinical and pathological variables in patients with differentiated thyroid cancer on successful ablation for 3700 MBq 131 I: a single Egyptian institutional experience over 14 years

Abstract

Objective

Is to investigate possible factors predicting success of ablation for 3700 MBq radioactive iodine 131 in patients with differentiated thyroid cancer (DTC) following near total thyroidectomy.

Methods

This retrospective study enrolled 272 patients between 2000 and 2014. The success or failure of ablation was assessed 6 months after given the dose and our criteria for complete successful remnant ablation defined as: Negative ¹³¹I whole body scan with no residual functioning thyroid tissue or distant functioning metastases and stimulated thyroglobulin (Tg) level less than 2 ng/ml. Different clinical and pathological factors, such as age, gender, tumor histology, grade and variants, size of primary malignant lesion, stage, and risk assessment according to the American (ATA) and European Thyroid Association (ETA) guidelines, associated pathology, tumor mutifocality, lymph node (LN) metastases and their number, invasiveness of the tumor (capsular invasion of the nodule, extra-thyroidal extension, and vascular invasion), baseline stimulated Tg level, and pre-ablative diagnostic scan were assessed.

Results

There were 185 successful ablations (68 %). The baseline-stimulated Tg measured before the ablation was the only independent predictor of ablation success in multivariate analysis (P < 0.0001) with odds ratio (OR) of 2.64 (95 % CI: 1.54–4.54) and the optimal cutoff for this was 3.8 ng/mL. On the univariate analysis, LN metastases was predictor of ablation failure (P value = 0.03).

Conclusion

Baseline-stimulated Tg level is clinically important and had a significant predictive value for successful ablation; therefore, higher pre-ablation Tg should potentially be incorporated in the decision making for ¹³¹I dosage or other treatment. In accordance with other studies, this is also applicable to cervical lymph nodal involvement and thyroid capsule invasion.

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Prediction of all-cause death using 11 C-hydroxyephedrine positron emission tomography in Japanese patients with left ventricular dysfunction

Abstract

Objectives

The aim of this study was to determine whether ¹¹C-hydroxyephedrine (¹¹C-HED) can predict adverse events including all-cause death in Japanese patients with left ventricular (LV) dysfunction.

Background

Although ¹¹C-HED PET has been used to assess cardiac sympathetic innervation in various disease conditions, data on their prognostic value are limited.

Methods

Sixty patients (mean LVEF, 42 ± 14 %) with LV dysfunction (42 ischemic and 18 non-ischemic heart disease) underwent ¹¹C-HED PET. Myocardial retention was calculated for ¹¹C-HED PET as a measure of cardiac sympathetic neuronal integrity. Statistical analysis was performed using Cox proportional hazards regression and log-rank test.

Results

Thirteen deaths (7 cardiac and 6 non-cardiac deaths) occurred during a mean follow-up period of 33 ± 23 months. The patients with death were associated with significantly lower ¹¹C-HED retention (7.1 ± 2.1 vs 9.0 ± 2.4, p = 0.015) than those without death. The hazard ratio for global ¹¹C-HED retention per unit (/min) was 0.762 (p = 0.039), which remained significant in multivariate analysis. When the patients were divided into the high (≥8.5) and low (<8.5) ¹¹C-HED retention groups, the low ¹¹C-HED retention group was associated with significantly poorer survival than the high ¹¹C-HED retention group (p = 0.004).

Conclusion

The low global ¹¹C-HED retention is a marker of poor overall survival in patients with LV dysfunction in this study.

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Feminist Perspectives on Family Relationships: Part 3

Abstract

In Part 3 of the three-part collection on feminism and families, we revisit the 13 articles that appeared in two previous issues of Sex Roles, and then present the six additional articles published in the current issue. We address the ways in which these articles examine feminist perspectives on family relationships from various interdisciplinary lenses and the ways in which all the articles link various intersections among gender, race, ethnicity, social class, sexual orientation, and embodiment to deal with key feminist family topics such as motherhood and fatherhood, work and family, families and violence, emotion work and household labor, and the interplay between private experiences and public institutions. We position these articles so as to highlight diverse feminist theoretical perspectives and methodological orientations, and we address the innovations these articles contribute to the scholarship on feminism and families.

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Is radioiodine administration in patients with papillary thyroid multifocal microcarcinoma unnecessary?

Summary

Radioiodine (RAI) has played a crucial role in differentiated thyroid cancer treatment for more than 60years. However, the use of RAI administration in patients with papillary thyroid microcarcinoma (even multifocal) is now being widely discussed and often not recommended. In accordance with European consensus, and contrary to the American Thyroid Association (ATA) guidelines, we recently performed RAI thyroid remnant ablation in a patient with differentiated papillary multifocal microcarcinoma. The post-therapeutic whole-body scan and SPECT/CT revealed the real and unexpected extent of disease, with metastases to upper mediastinal lymph nodes. This finding led to the patient's upstaging from stage I to stage IVa according to the American Joint Committee on Cancer/International Union Against Cancer criteria.

Learning points

¹³¹I is a combined beta–gamma emitter, thus allowing not only residual thyroid tissue ablation but also metastatic tissue imaging.

RAI remnant ablation omission also means post-treatment whole-body scan omission, which may lead to disease underestimation, due to incorrect nodal and metastatic staging.

RAI should be considered also in "low-risk" patients, especially when the lymph node involvement is not reliably documented.

Lower administered RAI activity (30mCi, 1.1GBq) may be a workable compromise in low-risk patients, not indicated for RAI remnant ablation according to ATA guidelines.

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A multidisciplinary approach to clitoral reconstruction after female genital mutilation: the crucial role of counselling

Objectives: Female genital mutilation (FGM) is becoming more widely seen in the West, due to immigration and population movement. Health services are being confronted with the need to provide care for women with FGM. One of the more recent trends is the provision of clitoral reconstruction. It remains unclear, however, what constitutes good practice with regard to this type of surgery. Methods: Based on a keynote presentation about reconstructive clitoral surgery, we briefly discuss the possible consequences of FGM and the findings from recent publications on clitoral reconstruction. Recognising individual differences in women, we suggest a multidisciplinary counselling model to provide appropriate care for women requesting clitoral reconstruction. Results: The literature shows that FGM influences physical, mental and sexual health. Clitoral reconstructive, surgery can lead to an increase in sexual satisfaction and orgasm in some, but not all, women. A multidisciplinary approach would enable a more satisfactory and individually tailored approach to care. The multidisciplinary team should consist of a midwife, a gynaecological surgeon, a psychologist-psychotherapist, a sexologist and a social worker. Comprehensive health counselling should be the common thread in this model of care. Our proposed care pathway starts with taking a thorough history, followed by medical, psychological and sexological consultations. Conclusions: Women with FGM requesting clitoral reconstruction might primarily be looking to improve their sexual life, to recover their identity and to reduce pain. Surgery may not always be the right answer. Thorough counselling that includes medical, psychological and sexual advice is therefore necessary as part of a multidisciplinary approach.

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Urgent chemotherapy in hematological patients in the ICU

Purpose of review : Over the past decades, survival of critically ill hematological patients has dramatically improved, and these patients are more frequently referred to the ICU for intensive treatment, including a rising need for administering anticancer-therapy in this setting. Recent findings : The scarce literature on this subject provides evidence for feasibility of administering chemotherapy in the ICU, with expected ICU survival of 60-70%, and one in three patients surviving at least 1 year after discharge. We summarize the recent evidence concerning outcome, dosing and indications of chemotherapy in the ICU, and provide practical guidelines for some special oncological situations. Summary : Anticancer-therapy in the ICU is feasible and no longer futile as long as it is initiated in a selected, well-informed patient population with reasonable prognostic expectations. Accurate recognition of organ failure and early referral to the ICU for both supportive care and timely administration of chemotherapy is recommended before the development of multisystem organ failure.

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Pharmacokinetic variability and exposures of fluconazole, anidulafungin, and caspofungin in intensive care unit patients: data from multinational Defining Antibiotic Levels in Intensive care unit (DALI) patients study

Introduction: The objective of the study was to describe the pharmacokinetics (PK) of fluconazole, anidulafungin, and caspofungin in critically ill patients and to compare with previously published data. We also sought to determine whether contemporary fluconazole doses achieved PK/pharmacodynamic (PD; PK/PD) targets in this cohort of intensive care unit patients. Methods: The Defining Antibiotic Levels in Intensive care unit patients (DALI) study was a prospective, multicenter point-prevalence PK study. Sixty-eight intensive care units across Europe participated. Inclusion criteria were met by critically ill patients administered fluconazole (n = 15), anidulafungin (n = 9), and caspofungin (n = 7). Three blood samples (peak, mid-dose, and trough) were collected for PK/PD analysis. PK analysis was performed by using a noncompartmental approach. Results: The mean age, weight, and Acute Physiology and Chronic Health Evaluation (APACHE) II scores of the included patients were 58 years, 84 kg, and 22, respectively. Fluconazole, caspofungin, and anidulafungin showed large interindividual variability in this study. In patients receiving fluconazole, 33% did not attain the PK/PD target, ratio of free drug area under the concentration-time curve from 0 to 24 hours to minimum inhibitory concentration (fAUC(0- 24)/ MIC) >= 100. The fluconazole dose, described in milligrams per kilogram, was found to be significantly associated with achievement of fAUC(0- 24)/ MIC >= 100 (P = 0.0003). Conclusions: Considerable interindividual variability was observed for fluconazole, anidulafungin, and caspofungin. A large proportion of the patients (33%) receiving fluconazole did not attain the PK/PD target, which might be related to inadequate dosing. For anidulafungin and caspofungin, dose optimization also appears necessary to minimize variability.

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Biopsychological structure of Yin-Yang using Cloninger’s Temperament model and Carver and White’s BIS/BAS scale

Introduction. The purpose of this study was to examine the psychological structure of Yin-Yang based on the Sasang Personality Questionnaire (SPQ) in relation to Carver and White's Behavior Inhibition/Behavior Activation System (BIS/BAS) Scale and Cloninger's temperament model of the West. Methods. A total of 188 university students were classified as high (30%), middle (40%), and low (30%) groups based on their SPQ score and their differences in Cloninger's temperaments and BIS/BAS subscales were analyzed using analysis of covariance after controlling the sex. Correlation among SPQ, Cloninger's four temperaments and BIS/BAS subscales was also examined. Results. Significant differences in BAS (F = 11.703, p

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Symbiotic essential amino acids provisioning in the American cockroach, Periplaneta americana (Linnaeus) under various dietary conditions

Insect gut microbes have been shown to provide nutrients such as essential amino acids (EAAs) to their hosts. How this symbiotic nutrient provisioning tracks with the host's demand is not well understood. In this study, we investigated microbial essential amino acid (EAA) provisioning in omnivorous American cockroaches (Periplaneta americana), fed low-quality (LQD) and comparatively higher-quality dog food (DF) diets using carbon stable isotope ratios of EAAs (δ13CEAA). We assessed non-dietary EAA input, quantified as isotopic offsets (Δ13C) between cockroach (δ13CCockroach EAA) and dietary (δ13CDietary EAA) EAAs, and subsequently determined biosynthetic origins of non-dietary EAAs in cockroaches using 13C-fingerprinting with dietary and representative bacterial and fungal δ13CEAA. Investigation of biosynthetic origins of de novo non-dietary EAAs indicated bacterial origins of EAA in cockroach appendage samples, and a mixture of fungal and bacterial EAA origins in gut filtrate samples for both LQD and DF-fed groups. We attribute the bacteria-derived EAAs in cockroach appendages to provisioning by the fat body residing obligate endosymbiont, Blattabacterium and gut-residing bacteria. The mixed signatures of gut filtrate samples are attributed to the presence of unassimilated dietary, as well as gut microbial (bacterial and fungal) EAAs. This study highlights the potential impacts of dietary quality on symbiotic EAA provisioning and the need for further studies investigating the interplay between host EAA demands, host dietary quality and symbiotic EAA provisioning in response to dietary sufficiency or deficiency.

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Premature feather loss among common tern chicks in Ontario: the return of an enigmatic developmental anomaly

In July 2014, we observed premature feather loss (PFL) among non-sibling, common tern Sterna hirundo chicks between two and four weeks of age at Gull Island in northern Lake Ontario, Canada. Rarely observed in wild birds, to our knowledge PFL has not been recorded in terns since 1974, despite the subsequent banding of hundreds of thousands of tern chicks across North America alone. The prevalence, 5% of chicks (9/167), and extent of feather loss we report is more extreme than in previous reports for common terns but was not accompanied by other aberrant developmental or physical deformities. Complete feather loss from all body areas (wing, tail, head and body) occurred over a period of a few days but all affected chicks appeared vigorous and quickly began to grow replacement feathers. All but one chick (recovered dead and submitted for post-mortem) most likely fledged 10–20 days after normal fledging age. We found no evidence of feather dystrophy or concurrent developmental abnormalities unusual among affected chicks. Thus, the PFL we observed among common terns in 2014 was largely of unknown origin. There was striking temporal association between the onset of PFL and persistent strong southwesterly winds that caused extensive mixing of near-shore surface water with cool, deep lake waters. One hypothesis is that PFL may have been caused by unidentified pathogens or toxins welling up from these deep waters along the shoreline but current data are insufficient to test this. PFL was not observed among common terns at Gull Island in 2015, although we did observe similar feather loss in a herring gull Larus argentatus chick in that year. Comparison with sporadic records of PFL in other seabirds suggests that PFL may be a rare, but non-specific, response to a range of potential stressors. PFL is now known for gulls, penguins and terns.

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Transcranial sonography findings related to depression in parkinsonian disorders: cross-sectional study in 126 patients

Background. Transcranial sonography (TCS) has emerged as a potential diagnostic tool for Parkinson's disease. Recent research has suggested that abnormal echogenicity of substantia nigra, raphe nuclei and third ventricle is associated with increased risk of depression among these patients. We sought to reproduce these findings in an ongoing larger study of patients with parkinsonian syndromes. Methods. A total of 126 patients with parkinsonian symptoms underwent the Hamilton Depression Scale, and TCS of the substantia nigra (SN) (n = 126), the raphe nuclei (RN) (n = 80) and the third ventricle (n = 57). We then calculated the correlation between depression and hyper-echogenic SN, hypo-echogenic RN and a wider third ventricle. Results. In patients with PD we found no significant difference of the SN between non-depressed and depressed patients (46% vs. 22%; p = 0.18). Non-depressed patients with other parkinsonisms more often had hyperechogenicity of the SN than depressed patients (51% vs. 0%; p = 0.01). We found no relation between depression and the echogenicity of the RN or the width of the third ventricle. Conclusions. In patients with parkinsonian syndromes, we found no association between depression and hyper-echogenic SN, hypo-echogenic RN or a wider third ventricle, as determined by transcranial sonography.

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Foraging loads of red wood ants: Formica aquilonia (Hymenoptera: Formicidae) in relation to tree characteristics and stand age

Background. Foraging efficiency is critical in determining the success of organisms and may be affected by a range of factors, including resource distance and quality. For social insects such as ants, outcomes must be considered at the level of both the individual and the colony. It is important to understand whether anthropogenic disturbances, such as forestry, affect foraging loads, independent of effects on the quality and distribution of resources. We asked if ants harvest greater loads from more distant and higher quality resources, how individual efforts scale to the colony level, and whether worker loads are affected by stand age. Methods. First, we performed a fine-scale study examining the effect of distance and resource quality (tree diameter and species) on harvesting of honeydew by red wood ants, Formica aquilonia, in terms of crop load per worker ant and numbers of workers walking up and down each tree (ant activity) (study 1). Second, we modelled what the combination of load and worker number responses meant for colony-level foraging loads. Third, at a larger scale, we asked whether the relationship between worker load and resource quality and distance depended on stand age (study 2). Results. Study 1 revealed that seventy percent of ants descending trees carried honeydew, and the percentage of workers that were honeydew harvesters was not related to tree species or diameter, but increased weakly with distance. Distance positively affected load mass in both studies 1 and 2, while diameter had weak negative effects on load. Relationships between load and distance and diameter did not differ among stands of different ages. Our model showed that colony-level loads declined much more rapidly with distance for small diameter than large diameter trees. Discussion. We suggest that a negative relationship between diameter and honeydew load detected in study 1 might be a result of crowding on large diameter trees close to nests, while the increase in honeydew load with distance may result from resource depletion close to nests. At the colony level, our model suggests that very little honeydew was harvested from more distant trees if they were small, but that more distant larger trees continued to contribute substantially to colony harvest. Although forestry alters the activity and foraging success of red wood ants, study 2 showed that it does not alter the fundamental rules determining the allocation of foraging effort.

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Feasibility and benefits of group-based exercise in residential aged care adults: a pilot study for the GrACE programme

The objective of the study was to examine the feasibility and benefits of a group resistance training exercise programme for improving muscle function in institutionalised older adults. A feasibility and acceptability study was designed for a residential aged care (RAC) facility, based on the Gold Coast, Australia. Thirty-seven adults, mean age 86.8 ± 6.1 years (30 females) living in a RAC facility. Participants were allocated into an exercise (n = 20) or control (n = 17) group. The exercise group, the Group Aged Care Exercise (GrACE) programme, performed 12 weeks of twice weekly resistance exercises. Feasibility was measured via recruitment rate, measurement (physiological and surveys) completion rate, loss-to-follow-up, exercise session adherence, adverse events, and ratings of burden and acceptability. Muscle function was assessed using gait speed, sit-to-stand and handgrip strength assessments. All intervention participants completed pre- and post-assessments, and the exercise intervention, with 85% (n = 17) of the group attending ≥ 18 of the 24 sessions and 15% (n = 3) attending all sessions. Acceptability was 100% with exercise participants, and staff who had been involved with the programme strongly agreed that the participants "Benefited from the programme." There were no adverse events reported by any participants during the exercise sessions. When compared to the control group, the exercise group experienced significant improvements in gait speed (F(4.078) = 8.265, p = 0.007), sit to stand performance (F(3.24) = 11.033, p = 0.002) and handgrip strength (F(3.697) = 26.359, p

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Idiopathic intracranial hypertension occurred after spinal surgery: report of two rare cases and systematic review of the literature

Abstract

Background

Idiopathic intracranial hypertension (IIH) is a relatively rare syndrome of increased intracranial pressure of unknown etiology. It is characterized by cerebrospinal fluid (CSF) opening pressure more than 250 mmH₂O, with normal cranial imaging and CSF content. IIH occurred after spinal surgery is extremely rare.

Methods

We present two IIH cases occurred after spinal surgery and conduct a systematic review of articles reporting IIH occurred after spinal surgery.

Results

The first patient underwent a posterior decompression and fixation for cervical fractures. IIH symptoms appeared 3 days postoperatively and gradually resolved with appropriate medication. The second patient underwent posterior spinal fusion with segmental instrumentation for congenital scoliosis. IIH symptoms appeared 5 days postoperatively and the patient died due to the irreversible intracranial hypertension although underwent intensive care and treatment. The literature review revealed that there were only five cases of IIH occurred after spinal surgery reported till date.

Conclusions

IIH occurred after spinal surgery is relatively rare; the diagnosis is based upon exclusion of other diseases. IIH should be kept in mind in patients underwent spinal surgery as it could develop into irreversible intracranial hypertension.

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Proline and α-Methylproline as Chiral Auxiliaries for the Synthesis of Enantiopure Bis-Cyclometalated Iridium(III) Complexes

A convenient proline- and α-methylproline-mediated method for the synthesis of enantiomerically pure bis-cyclometalated iridium(III) complexes is reported. The reactions of l-proline or l-α-methylproline with [Ir(µ-Cl)(C^N)₂]₂ (C^N = cyclometalating 2-phenylpyridine, 2-phenylbenzoxazole, or 2-phenylbenzothiazole ligand) afforded diastereomeric mixtures of intermediate prolinatoiridium(III) complexes from which the Λ-(S) diastereomers were isolated with excellent diastereomeric purity by washing, precipitation, or crystallization. A subsequent trifluoroacetic acid (TFA) induced substitution of the prolinate ligands with 2,2′-bipyridine with the retention of configuration provided the chiral-only-at-metal complexes with >99 % ee.

Proline and α-methylproline are very suitable chiral auxiliaries for the synthesis of enantiopure bis-cyclometalated iridium(III) complexes in a straightforward and convenient fashion without the tedious chromatographic separation of the intermediate diastereomers.

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Urinary metabolomic profiling of asthmatics can be related to clinical characteristics

Abstract

Metabolomics has been increasingly explored to achieve an improved understanding of asthma. In the current observational and exploratory study, the first to have examined the relationship between oxidative stress extension, eosinophilic inflammation and disease severity in asthmatic patients, metabolomics (using target aliphatic aldehydes and alkanes) was carried out using solid phase microextraction (SPME) followed by comprehensive two-dimensional gas chromatography coupled to mass spectrometry with a high resolution time of flight analyzer (GC×GC-ToFMS). We were able to demonstrate that metabolomics can give valuable insights into asthma mechanisms once lipidic peroxidation assessed by urinary metabolomics is related to clinical characteristics of non-obese asthmatics such as disease severity, lung function, and eosinophilic inflammation.

Nevertheless, considering our sample size, the obtained results require further validation using a much larger sample cohort.

This article is protected by copyright. All rights reserved.

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Viruses and bacteria in Th2 biased allergic airway disease

Abstract

Allergic airway diseases are typically characterized by a type 2-biased inflammation. Multiple distinct viruses and bacteria have been detected in the airways. Recently, it has been confirmed that the microbiome of allergic individuals differs from those of healthy subjects, showing a close relationship with the type 2 response in allergic airway disease. In this paper, we summarize recent findings on the prevalence of viruses and bacteria in type 2-biased airway diseases and on mechanisms employed by viruses and bacteria in propagating type 2 responses. The understanding of the microbial composition and post-infectious immune programming is critical for the reconstruction of the normal microflora and immune status in allergic airway diseases.

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Nanoplasmonic probe as a triple channel colorimetric sensor array for proteins discrimination

Analyst, 2016, Accepted Manuscript
DOI: 10.1039/C6AN00302H, Communication

Jinpeng Mao, Yuexiang Lu, Ning Chang, Jiaoe Yang, Jiacheng Yang, Sichun Zhang, Yueying Liu
The salt-induced aggregation, nanoparticles regrowth and self-assemble behaviors of gold nanoparticles (AuNPs) and DNA conjugate could be changed after interaction with different proteins, generating various color changes and unique fingerprint...
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Depth and time-dependent heterogeneity of microglia in mouse hippocampal slice cultures

Publication date: Available online 17 May 2016
Source:Neuroscience Research
Author(s): Yuka Kasahara, Ryuta Koyama, Yuji Ikegaya
Microglia are the brain-resident immune cells with the phagocytic capacity to engulf dead and living neurons in health and disease. However, the mechanisms underlying the neuron-microglia interaction remain elusive partly because proper in vitro systems are lacking. Specifically, the highly activated status of microglia with amoeboid morphology in primary culture is different from the 'resting' microglia with multiple processes in vivo. Here, we performed a detailed investigation of microglial properties in mouse hippocampal slice cultures, focusing on the changes in morphology in the activated state, finding a depth and time-dependent localization of in vivo-like microglia in slice cultures.



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Evidence in the eye of the beholder: about probiotics and VAP prevention

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Year in review in Intensive Care Medicine 2014, II: ARDS, airway management, ventilation, adjuvants in sepsis, hepatic failure, symptoms assessment and management, palliative care and support for families, prognostication, organ donation, outcome, organisation and research methodology

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A Photodegradable Hexaaza-Pentacene Molecule for Selective Dispersion of Large-Diameter Semiconducting Carbon Nanotubes

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC01558A, Communication

Jie Han, Qiyan Ji, Hongbo Li, Gang Li, Song Qiu, Hai-Bei Li, qichun Zhang, Hehua Jin, Qingwen Li, Jin Zhang
Harvesting high-purity semiconducting single-walled carbon nanotubes (s-SWCNTs) with removable dispersants remains challenge. In this work, we demonstrate that small heteroacene derivates may serve as a promising selective dispersant for sorting...
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Robotic Surgery Simulator: Elements to Build a Training Program

Publication date: Available online 17 May 2016
Source:Journal of Surgical Education
Author(s): Xavier Tillou, Sylvie Collon, Sandrine Martin-Francois, Arnaud Doerfler
ObjectiveFace, content, and construct validity of robotic surgery simulators were confirmed in the literature by several studies, but elements to build a training program are still lacking. The aim of our study was to validate a progressive training program and to assess according to prior surgical experience the amount of training needed with a robotic simulator to complete the program.DesignExercises using the Da Vinci Skill Simulator were chosen to ensure progressive learning. A new exercise could only be started if a minimal score of 80% was achieved in the prior one. The number of repetitions to achieve an exercise was not limited. We devised a "performance index" by calculating the ratio of the sum of scores for each exercise over the number of repetitions needed to complete the exercise with at least an 80% score.SettingThe study took place at the François Baclesse Cancer Center. Participants all work at the primary care university Hospital located next to the cancer center.ParticipantsA total of 32 surgeons participated in the study— 2 experienced surgeons, 8 junior and 8 senior residents in surgery, 6 registrars, and 6 attending surgeons.ResultsThere was no difference between junior and senior residents, whereas the registrars had better results (p < 0.0001). The registrars performed less exercise repetitions compared to the junior or senior residents (p = 0.012). Attending surgeons performed significantly more repetitions than registrars (p = 0.024), but they performed fewer repetitions than junior or senior residents with no statistical difference (p = 0.09). The registrars had a performance index of 50, which is the best result among all novice groups. Attending surgeons were between senior and junior residents with an index at 33.85.ConclusionChoice of basic exercises to manipulate different elements of the robotic surgery console in a specific and progressive order enables rapid progress. The level of prior experience in laparoscopic surgery affects outcomes. More advanced laparoscopic expertise seems to slow down learning, surgeons having to "unlearn" to acquire a new technique.



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Assessing Resident Cataract Surgery Outcomes Using Medicare Physician Quality Reporting System Measures

Publication date: Available online 17 May 2016
Source:Journal of Surgical Education
Author(s): Avni P. Finn, Sheila Borboli-Gerogiannis, Stacey Brauner, Han-Ying Peggy Chang, Sherleen Chen, Matthew Gardiner, Scott H. Greenstein, Carolyn Kloek, Joan W. Miller, Teresa C. Chen
ObjectivesTo assess resident cataract surgery outcomes at an academic teaching institution using 2 Physician Quality Reporting System (PQRS) cataract measures, which are intended to serve as a proxy for quality of surgical care.DesignA retrospective review comparing cataract surgery outcomes of resident and attending surgeries using 2 PQRS measures: (1) 20/40 or better best-corrected visual acuity following cataract surgery and (2) complications within 30 days following cataract surgery requiring additional surgical procedures.SettingAn academic ophthalmology center.ParticipantsA total of 2487 surgeries performed at the Massachusetts Eye and Ear Infirmary from January 1, 2011 to December 31, 2012 were included in this study.ResultsOf all 2487 cataract surgeries, 98.95% achieved a vision of at least 20/40 at or before 90 days, and only 0.64% required a return to the operating room for postoperative complications. Of resident surgeries, 98.9% (1370 of 1385) achieved 20/40 vision at or before 90 days follow-up. Of attending surgeries, 99.0% (1091 of 1102) achieved 20/40 vision at or before 90 days (p = 1.00). There were no statistically significant differences between resident and attending cases regarding postoperative complications needing a return to the operating room (i.e., 0.65%, or 9 of 1385 resident cases vs 0.64%, or 7 of 1102 attending cases; p = 1.00).ConclusionsUsing PQRS Medicare cataract surgery criteria, this study establishes new benchmarks for cataract surgery outcomes at a teaching institution and supplemental measure for assessing resident surgical performance. Excellent cataract outcomes were achieved at an academic teaching institution, with results exceeding Medicare thresholds of 50%. There appears to be no significant difference in supervised trainee and attending cataract surgeon outcomes using 2 PQRS measures currently used by Medicare to determine physician reimbursement and quality of care.



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Can Rural Minimally Invasive Surgery Fellowships Provide Operative Experience Similar to Urban Programs?

Publication date: Available online 17 May 2016
Source:Journal of Surgical Education
Author(s): James Patrick Ryan, Andrew J. Borgert, Kara J. Kallies, Lea M. Carlson, Howard McCollister, Paul A. Severson, Shanu N. Kothari
ObjectiveOperative experience in rural fellowship programs is largely unknown. The 2 of the most rural minimally invasive surgery (MIS)/bariatric fellowships are located in the upper Midwest. We hypothesized that these 2 programs would offer a similar operative experience to other U.S. programs in more urban locations.DesignThe 2011 to 2012 and 2012 to 2013 fellowship case logs from 2 rural Midwest programs were compared with case logs from 23 U.S. MIS/bariatric programs. All rural Midwest fellowship graduates completed a survey describing their fellowship experience and current practice. Statistical analysis included Wilcoxon rank-sum test.SettingSetting included the 2 rural Midwest U.S. MIS/bariatric fellowship programs.ParticipantsGraduates from MIS/bariatric fellowship programs participated in the study.ResultsMean volumes for bariatric, foregut, abdominal wall, small intestine, and hepatobiliary cases for rural Midwest fellows vs. other U.S. programs were 123.8 ± 23.7 vs. 150.2 ± 49.2 (p = 0.20); 44.3 ± 19.4 vs. 66.3 ± 35.5 (p = 0.18); 48.3 ± 28.0 vs. 57.9 ± 27.8 (p = 0.58); 11.3 ± 1.9 vs. 12.0 ± 8.7 (p = 0.58); and 55.0 ± 34.8 vs. 48.1 ± 42.6 (p = 0.63), respectively. Mean endoscopy volume was significantly higher among rural Midwest fellows (451.0 ± 395.2 vs. 99.7 ± 83.4; p = 0.05). All rural Midwest fellows reported an adequate number of cases as operating surgeon during fellowship. A total of 60% of fellows currently practice in a rural area. In all, 87% and 13% reported that their fellowship training was extremely or somewhat beneficial to their current practice, respectively.ConclusionsRural MIS fellowship programs offer a similar operative experience to other U.S. programs. A greater volume of endoscopy cases was observed in rural Midwest fellowships.



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Repaying in Kind: Examination of the Reciprocity Effect in Faculty and Resident Evaluations

Publication date: Available online 17 May 2016
Source:Journal of Surgical Education
Author(s): Aimee K. Gardner, Daniel J. Scott
BackgroundAlthough the reciprocity hypothesis (that trainees have a tendency to modify evaluations based on the grades they receive from instructors) has been documented in other fields, very little work has examined this phenomenon in the surgical residency environment. The purpose of this study was to investigate the extent to which lenient-grading faculty receive higher evaluations from surgery residents.MethodsEvaluation data from 2 consecutive academic years were collected retrospectively at a large university-based General Surgery residency program. Monthly faculty evaluations of residents (15 items) and resident evaluations of faculty (8 items; 1 = never demonstrates, 10 = always demonstrates) were included. Correlation and regression analyses were conducted with SPSS version 22 (IBM; Chicago, IL).ResultsA total of 2274 faculty assessments and 1480 resident assessments were included in this study, representing 2 years of evaluations for 32 core faculty members responsible for completing all resident evaluations and 68 PGY1-5 general surgery residents. Faculty (63% men, 13.5 ± 9.8 years out of training) represented 5 different divisions (general surgery, surgical oncology, transplant, trauma critical care, and vascular) within the general surgery department. Faculty received an average of 71.1 ± 33.9 evaluations from residents over the course of 2 years. The average rating of faculty teaching by residents was 9.5 ± 0.4. Residents received an average of 21.8 ± 0.5 evaluations with average ratings of 4.2 ± 0.4. Correlation analyses indicated a positive relationship between the average rating received from residents and the number of years since faculty completed training (r = 0.44, p = 0.01). Additionally, a significant relationship emerged between ratings received from residents and ratings given to residents (r = 0.40, p = 0.04). Regression analyses indicated that when both variables (years since training, ratings given to residents) were included in the model, only ratings given to residents remained a significant predictor of evaluation ratings received from residents (F(1,32) = 4.40, p = 0.04), with an R² of 0.16. Sex or division affiliation did not account for any unique variance.ConclusionsThese findings suggest that a reciprocity effect exists between surgery faculty and resident evaluations. This effect warrants further exploration, such that efforts to mitigate the risks of providing inaccurate assessments may be developed. Providing trainees with accurate assessments is particularly important given the high-stakes use of these data for milestones, promotion, and graduation purposes, which currently do not account for this reciprocity effect.SummaryResults suggest that there is a reciprocity effect in the faculty and resident evaluation process.



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Undergraduate Suture and Local Anesthetic Training in the United Kingdom

Publication date: Available online 17 May 2016
Source:Journal of Surgical Education
Author(s): Conor Jones, Rosalind Mole, Matthew Jones




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Comparison of the compact dry TC method with the standard method ISO 21149:2006 for determining aerobic colony counts in cosmetic emulsion

Abstract

Objective

Compact Dry TC, a rapid method kit for determining aerobic colony counts, has been developed by Nissui Pharmaceutical Co. for food application. These plates are presterilized and contain culture medium, a cold-soluble gelling agent and a color redox indicator for rapid enumeration. In the present study, the alternative method is compared with the standard method ISO 21149:2006 – Cosmetic - Microbiology - Enumeration and detection of aerobic mesophilic bacteria, for cosmetic emulsions application.

Methods

An oil-in-water (o/w) cosmetic emulsion was contaminated with a pool of bacterial strains (Escherichia coli ATCC 8739, Staphylococcus aureus ATCC 6538, Pseudomonas aeruginosa ATCC 9027). 1 mL samples were spread on agar as described in ISO 21149. The colonies were enumerated after 3 days of incubation. At the same time, 1.2 mL samples were spread on Compact Dry TC kits. The kit was incubated at 35 °C ± 1 °C for 48 h and the colonies were enumerated.

Accuracy determination was carried out using 6 replicates at 4 levels of concentrations (10, 50, 100, and 250 CFU/ml). The repeatability study was carried out using 12 replicates at 4 levels of concentrations (10, 50, 100, and 250 CFU/ml). Variations relative to the analyst and to the batch of emulsion have been investigated.

Results

The linear correlation coefficients of Compact Dry TC Kit enumeration with standard method ISO 21149:2006 was 0.9999. In comparison study, no apparent differences were noted between the Compact Dry TC Kit and the reference method ISO 21149, for the detection level of aerobic microorganisms. Relative accuracy, repeatability, and intermediate precision studies were acceptable.

In the repeatability study, the Shapiro-Wilk test has confirmed the normally distribution of the twelve assays. No significant variations in Compact Dry TC count results were observed with different analysts and different batches of emulsion.

Conclusion

The results showed that the two compared methods " Compact Dry TC" versus "Conventional pour plate" performed equally well. Demonstration was achieved that the Compact Dry TC method may constitute a useful alternative tool for rapid enumeration of aerobic mesophilic bacteria in cosmetic emulsions.

This article is protected by copyright. All rights reserved.

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Guizhi Fuling Wan, a Traditional Chinese Herbal Formula, Sensitizes Cisplatin-Resistant Human Ovarian Cancer Cells through Inactivation of the PI3K/AKT/mTOR Pathway

The aim of the study was to explore the possible mechanisms that Guizhi Fuling Wan (GFW) enhances the sensitivity of the SKOV3/DDP ovarian cancer cells and the resistant xenograft tumours to cisplatin. Rat medicated sera containing GFW were prepared by administering GFW to rats, and the primary bioactive constituents of the sera were gallic acid, paeonol, and paeoniflorin analysed by HPLC/QqQ MS. Cell counting kit-8 analysis was shown that coincubation of the sera with cisplatin/paclitaxel enhanced significantly the cytotoxic effect of cisplatin or paclitaxel in SKOV3/DDP cells. The presence of the rat medicated sera containing GFW resulted in an increase in rhodamine 123 accumulation by flow cytometric assays and a decrease in the protein levels of P-gp, phosphorylation of AKT at Ser473, and mTOR in a dose-dependent manner in SKOV3/DDP cells by western blot analysis, but the sera had no effect on the protein levels of PI3K p110α and total AKT. The low dose of GFW enhanced the anticancer efficacy of cisplatin and paclitaxel treatment in resistant SKOV3/DDP xenograft tumours. GFW could sensitize cisplatin-resistant SKOV3/DDP cells by inhibiting the protein level and function of P-gp, which may be medicated through inactivation of the PI3K/AKT/mTOR pathway.

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The role of hypothalamic NF-κB signaling in the response of the HPT-axis to acute inflammation in female mice

Endocrinology, Early Release.


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Glucagon-like peptide-2 requires a full-complement of Bmi-1 for its proliferative effects in the murine small intestine

Endocrinology, Early Release.


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Adiponectin exerts neurotrophic effects on dendritic arborization, spinogenesis and neurogenesis in the dentate gyrus in male mice

Endocrinology, Early Release.


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Cranberry extract inhibits in vitro and in vivo adhesion of F4 and F18+ E. coli to pig intestinal epithelium and reduces excretion in experimentally infected pigs

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High susceptibility rate for F4+ and F18+ enterotoxigenic Escherichia coli in Belgian pigs

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Evaluating recombinant secretory IgA stability upon a feed challenge experiment

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Immune suppression in calves after an oral infection with Escherichia coli O157:H7

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ETEC virulence factors modulate the intestinal immune system

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Heat-labile enterotoxin enhances small intestinal colonization with F18ac+ verotoxigenic E. coli in newly weaned piglets

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Letters of condolence: assessing attitudes and variability in practice amongst oncologists and palliative care doctors in Yorkshire

Jessica S Hayward, Oluwatobi Makinde and Naveen S Vasudev

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Definition and risk factors for chronicity following acute idiosyncratic drug-induced liver injury

Journal of Hepatology

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Negative effects on psychological health and quality of life of genuine irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease

Clinical Gastroenterology and Hepatology

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Targeted agents in GI radiotherapy: Clinical efficacy and side effects

Best Practice & Research Clinical Gastroenterology

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Self-identification and management of hand-foot syndrome (HFS): effect of a structured teaching program on patients receiving capecitabine-based chemotherapy for colon cancer

Supportive Care in Cancer

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Association of acute gastroesophageal reflux disease with esophageal histologic changes

JAMA

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Regulation of GLI underlies a role for BET bromodomains in pancreatic cancer growth and the tumor microenvironment

Clinical Cancer Research

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