One-lung ventilation using a bronchial blocker tube for a large tracheal carcinoma resection

Successful one-lung ventilation using a bronchial blocker tube for a large tracheal carcinoma resection

από Xuelian Zhao, Jianfeng Fu, Xuan Zhou, Shasha Zhang στο Journal of Clinical Anesthesia

Μετάφραση άρθρου

The informed consent was obtained from the patient. A 57-year old woman was diagnosed as a trachea adenoid cystic carcinoma. A large tumor was found in the upper tracheal under fiber bronchoscopy (FBO), which the lower edge of the tumor was about 3cm proximal to the carina and the tumor size was about 4cm, obstructing the tracheal lumen by 92%. The gap at the narrowest intraluminal point was about 0.5cm (Fig.1A, B). Abnormal FEV 1% FVC: 22.07 and PaO2: 6.5kPa were detected by pulmonary function test and arterial blood gas test on room air respectively.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

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Issue Information - Journal Info page

No abstract is available for this article.

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Issue Information - TOC

No abstract is available for this article.

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CYCORE: Cyberinfrastructure for Comparative Effectiveness Research - Feasibility Trial

Conditions:   Advanced Cancers;   Colorectal Cancer;   Head And Neck Cancer;   Cancer Survivors
Interventions:   Device: Smart phone;   Device: Accelerometers;   Device: Blood Pressure Monitor;   Other: Telephone Surveys;   Other: Home Visit;   Device: Home Health Hub and Modem;   Device: Carbon Monoxide (CO) Monitor;   Device: Heat Rate Monitor;   Device: Global Positioning System (GPS) Device;   Other: Surveys;   Device: Weight Scale;   Device: Fitbit Monitor;   Behavioral: At-Home Exercise Program;   Behavioral: Physical Fitness Tests;   Behavioral: Questionnaires;   Behavioral: Lean Body Mass Assessment
Sponsors:   M.D. Anderson Cancer Center;   National Cancer Institute (NCI)
Recruiting - verified April 2017

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Survey Study and Records Review of Treatment Outcomes in Freeman-Sheldon Syndrome

Conditions:   Freeman-Sheldon Syndrome;   Arthrogryposis Distal Type 2A;   Whistling Face Syndrome;   Craniocarpotarsal Dysplasia;   Craniocarpotarsal Dystrophy;   Freeman-Sheldon Syndrome Variant;   Sheldon-Hall Syndrome;   Arthrogryposis Distal Type 2B;   Gordon Syndrome;   Arthrogryposis Distal Type 3;   Arthrogryposis Distal Type 1;   Arthrogryposis, Distal, Type 1A;   Arthrogryposis Distal Type 1B;   Arthrogryposis, Distal;   Craniofacial Abnormalities;   Arthrogryposis
Interventions:   Other: PTSD Checklist-Civilian (PCL-C);   Other: Modified Flanagan Quality of Life Scale;   Other: Center for Epidemiologic Studies Depression Scale (CES-D);   Other: Functional Enquiry (or Review of Systems) Form;   Other: Study of Therapeutic Outcomes and Practices in Freeman-Sheldon Syndrome (STOP-FSS) Questionnaire;   Other: FSRG Semi-Structured Quality of Life Interview (FSRG SSQLI);   Other: Medical Records Review
Sponsor:   Freeman-Sheldon Research Group, Inc.
Recruiting - verified April 2017

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Neue Therapieoption bei Acne vulgaris

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Narben effektiv behandeln

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Mit Nadeln gegen Narben

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Haartransplantation

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Neue Optionen der Teamarbeit in Kommunen

Eine Versorgung chronisch Kranker über alle Sektoren und Betreuungsbereiche hinweg ist in Deutschland meist noch Utopie. Doch mancherorts gibt es Keimzellen für neue Modelle mit Vorbildcharakter.

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Dermatokosmetika bei Akne: Was ist empfehlenswert?

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ADK aktiv bei dermatologischen Fortbildungen

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Tagung Dermatologische Praxis 2017

Bei der Dermatologischen Praxis in Frankenthal konnten die Teilnehmer wieder aus einer Vielzahl an unterschiedlichen Veranstaltungen mit über 70 Referenten auswählen. Ein Schwerpunkt war am Samstag die Behandlung der Akne. Ebenfalls am Samstag hatten die Besucher auch Gelegenheit, sich in einem Workshop der Arbeitsgemeinschaft Ästhetische Dermatologie und Kosmetologie (ADK) aus erster Hand über wichtige Themen der ästhetischen Medizin zu informieren.

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Zytologie in der dermatologischen Praxis

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Mustervorlage für Hygieneplan

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Atopisches Ekzem: Proaktiv behandeln!

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Wasserlöslicher Nagellack

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Nicht invasives Lifting

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Inhaltsverzeichnis

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Die Adhärenz junger Akne-Patienten verbessern — aber wie?

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Pigmentverändungen vorbeugen

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Sterbegeld muss versteuert werden

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Lichttherapie gegen Juckreiz: UV-B nicht mit UV-A kombinieren!

Bei Patienten mit Psoriasis oder atopischem Ekzem bringt es für den Juckreiz offenbar nichts, eine Phototherapie mit UV-B-Strahlen durch einen UV-A-Anteil zu ergänzen. Angesichts möglicher kumulativer Nebenwirkungen empfehlen Schweizer Forscher, die Indikation für den UV-A-Zusatz restriktiv zu stellen.

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„Es klappt ja doch mit Familie!“

Beruf und Familie — das funktioniert auch in eigener Praxis. Vielleicht sogar besser als im Krankenhaus. Diese Erkenntnis konnten junge Ärzte vom „Tag der Chancen" in Thüringen im März mitnehmen.

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„Ganzkörper-Lichttherapie oft zu früh abgesetzt“

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Chirurgische Prävention hereditärer gastrointestinaler Tumordispositionen

Zusammenfassung

Hintergrund

Tumorerkrankungen stellen die zweithäufigste Todesursache in der industrialisierten Welt dar. Das zunehmende Verständnis der molekularen Ätiopathogenese von Tumoren und des Einflusses auf die klinische Heterogenität und das Therapieansprechen hat zu einer Präzisierung onkologischer Strategien geführt. Hereditäre Dispositionssyndrome werden aufgrund fehlender Awareness hierzulande nur zu einem kleinen Anteil durch klinische und konsekutive molekulargenetische Testung identifiziert. In Anbetracht des weitreichenden Benefits für Betroffene und deren Familien wären systematische molekulargenetische Untersuchungen bei allen gastrointestinalen Tumoren sinnvoll.

Methode

Eine Recherche und Auswertung aktueller Literatur wurden durchgeführt.

Ergebnisse und Schlussfolgerungen

Durch Identifikation von Mutationsträgern eröffnen sich zahlreiche Optionen für Präventionsstrategien. Diese reichen von einer Änderung der Lifestyle-Faktoren über eine medikamentöse Prävention bis hin zu risikoreduzierenden prophylaktischen Operationen. Allerdings muss hierbei das syndrombezogene Risiko des Auftretens der Tumorerkrankung (Penetranz) unter Berücksichtigung des Gens oder evtl. des genauen Genlokus und des Geschlechts (Gender) sowie des Alters mit der Morbidität jeder Maßnahme genau abgewogen werden. Es ist die Rolle der Behandler unterschiedlicher Disziplinen, über die Möglichkeiten und Grenzen präventiver Maßnahmen so zu beraten, dass Betroffene eine informierte Entscheidung treffen können. In dieser Übersichtsarbeit werden der aktuelle Stand präventiver Optionen in der Behandlung hereditärer Tumorerkrankungen des Gastrointestinaltrakts dargestellt und Konsequenzen für das klinische Management diskutiert.

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Dysregulated homeostasis of target tissues or autoantigens - a novel principle in autoimmunity

Publication date: Available online 11 April 2017
Source:Autoimmunity Reviews
Author(s): Frank Petersen, Xiaoyang Yue, Gabriela Riemekasten, Xinhua Yu
Monogenic autoimmune disorders provide a powerful tool for our understanding of the principles of autoimmunity due to the obvious impact of a single gene on the disease. So far, approximately 100 single gene defects causing murine monogenic autoimmune disorders have been reported and the functional characterization of these genes will provide significant progress in understanding the nature of autoimmunity. According to their function, genes leading to monogenic autoimmune disorders can be categorized into two groups. An expectable first group contains genes involved in the homeostasis of the immune system, including homeostasis of immune organs and immune cells. Intriguingly, the second group consists of genes functionally involved in the homeostasis of target tissues or autoantigens. According to our novel hypothesis, we propose that autoimmunity represents a consequence of a dysregulated homeostasis of the immune system and/or its targets including autoantigens and target tissues. In this review we refer to both aspects of homeostasis in autoimmunity with a highlight on the role of the homeostasis of target tissues and antoantigens.



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Primary Extracranial Meningioma: A Rare Location

Abstract

Meningiomas are benign extraaxial tumors of the central nervous system (CNS). Extracranial meningiomas are extremely rare (2%) and can develop as a direct extension from a primary intracranial meningioma or as true primary extracranial meningioma originating from ectopic arachnoid cells. Only eight cases of primary meningioma in the jaw have been reported to date. Extracranial meningiomas are frequently misdiagnosed, resulting in inappropriate clinical management. The aim of this article was to describe the case of a man with an asymptomatic swelling in the right retromolar area over a period of 2 months. Cone beam computed tomography was performed to determine the extension and involvement of the adjacent structures. Histopathological findings and immunohistochemical analysis aided in the diagnosis of primary extracranial meningioma in the mandible and several aspects of this unusual neoplasm are reviewed. The treatment of choice was a partial resection of the mandible and reconstruction with autogenous iliac tricortical bone. Five years after surgery, the patient remains free of disease.

http://ift.tt/2p41Emb

Correlation of frontal sinus recess anatomy with ethnicity, gender, and pathology

Research on frontal sinus cells has been conflicting regarding relationship between frontal sinus cells and frontal sinus disease. There are no published studies regarding gender differences in frontal sinus disease. No comparisons between African Americans and Caucasians and frontal sinus disease have been published. This study attempts to define the above relationships as well as the relationship between number and types of cells and disease.

http://ift.tt/2nCq4WA

Abrasion and blunt tissue trauma study of a novel flexible robotic system in the porcine model

The objective of this study was to determine if a flexible robotic system caused increased tissue reaction when accessing the oropharynx and hypopharynx compared to intubation controls in only 2 scenarios: high speed tissue impact and multiple unit insertions and retractions. The data obtained were submitted as part of the entirety of information submitted for FDA approval.

http://ift.tt/2o2kp7z

Improving resident familiarity with the translabyrinthine approach to the internal auditory canal

To increase otolaryngology resident experience with drilling and dissection of the internal auditory canal (IAC) via a translabyrinthine approach.

http://ift.tt/2nClV4U

Assessing cumulative acute toxicity of chemoradiotherapy in head and neck cancer with or without induction chemotherapy

To compare cumulative acute toxicity in head and neck cancer patients treated with concurrent chemoradiotherapy alone (CCRT) versus induction chemotherapy (IC) followed by CCRT (I/CCRT).

http://ift.tt/2o2qbWK

Successful one-lung ventilation using a bronchial blocker tube for a large tracheal carcinoma resection

The informed consent was obtained from the patient. A 57-year old woman was diagnosed as a trachea adenoid cystic carcinoma. A large tumor was found in the upper tracheal under fiber bronchoscopy (FBO), which the lower edge of the tumor was about 3cm proximal to the carina and the tumor size was about 4cm, obstructing the tracheal lumen by 92%. The gap at the narrowest intraluminal point was about 0.5cm (Fig.1A, B). Abnormal FEV 1% FVC: 22.07 and PaO2: 6.5kPa were detected by pulmonary function test and arterial blood gas test on room air respectively.

http://ift.tt/2owUhWj

Clinical Thyroidology for the Public – Highlighted Article

From Clinical Thyroidology for the Public: Hyperthyroidism, or an overactive thyroid, is a common disorder with an estimated lifetime risk of 2-5% in the general population. Read More….

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

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CD11b regulates antibody class switching via induction of AID

Publication date: July 2017
Source:Molecular Immunology, Volume 87
Author(s): Seohyun Park, Hyunsub Sim, Hye-In Kim, Daecheol Jeong, Guang Wu, Soo Young Cho, Young Seek Lee, Hyung-Joo Kwon, Keunwook Lee
The integrin CD11b, which is encoded by the integrin subunit alpha M (ITGAM), is primarily expressed on the surface of innate immune cells. Genetic variations in ITGAM are among the strongest risk factors for systemic lupus erythematosus, an autoimmune disease characterized by the presence of autoantibodies. However, the regulatory function of CD11b in the antibody responses remains unclear. Here, we report the induction of CD11b in activated B2 B cells and define its unexpected role in immunoglobulin heavy chain class switch recombination (CSR). LPS-activated B cells lacking CD11b yielded fewer IgG subtypes such as IgG1 and IgG2a in vitro, and immunization-dependent CSR and affinity maturation of antibodies were severely impaired in CD11b-deficient mice. Notably, we observed the reduced expression of activation-induced cytidine deaminase (AID), an enzyme that initiates CSR and somatic hypermutation, and ectopic expression of AID was sufficient to rescue the defective CSR of CD11b-deficient B cells. LPS-induced phosphorylation of NF-κB p65 and IκBα was attenuated in CD11b-deficient B cells, and hyperactivation of IκB kinase 2 restored the defective AID expression and CSR, which implied that CD11b regulates the NF-κB-dependent induction of AID. Overall, our experimental evidence emphasized the function of CD11b in antibody responses and the role of CD11b as a vital regulator of CSR.



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Positive feedback effect of PGE2 on cyclooxygenase-2 expression is mediated by inhibition of Akt phosphorylation in human follicular dendritic cell-like cells

Publication date: July 2017
Source:Molecular Immunology, Volume 87
Author(s): Jongseon Choe, Yongdae Yoon, Jini Kim, Yu-Jin Jung
Prostaglandins (PGs) are bioactive lipid mediators generated from the phospholipids of cell membrane in response to various inflammatory signals. To understand the potential role of PGs in PG production itself during immune inflammatory responses, we examined the effect of PGE2, PGF2α, and beraprost on COX-2 expression using follicular dendritic cell (FDC)-like HK cells isolated from human tonsils. Those three PGs specifically augmented COX-2 protein expression in a dose-dependent manner after 4 or 8h of treatment. The enhancing effect was also reflected in the actual production of PGs and the viable cell recovery of germinal center B-cells. To investigate the underlying molecular mechanism, we examined the impact of PI3K inhibitors on PG-induced COX-2 expression. Interestingly, COX-2 induction by PGE2 and beraprost, but not PGF2α, was enhanced by wortmannin and LY294002. In line with this result, Akt phosphorylation was inhibited by PGE2 and beraprost but not by PGF2α. The distinct effect of PGE2 and beraprost from PGF2α was reproduced in Akt-knockdowned HK cells. Our current findings imply that PGE2 and PGI2 stimulate COX-2 expression in FDC by inhibiting Akt phosphorylation. Additional studies are warranted to determine the potential role of Akt as a therapeutic target in patients with inflammatory disorders.



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Dithranol

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Lichtschutz bei Xeroderma pigmentosum

Zusammenfassung

Xeroderma pigmentosum ist eine seltene autosomal-rezessiv vererbte Genodermatose, die durch Mutationen in Genen, verantwortlich für die Reparatur UV-induzierter DNA-Schäden, verursacht wird. Die Erkrankung ist charakterisiert durch erhöhte UV-Lichtsensitivität und eine Poikilodermie, Augenbeteiligung und bei manchen Patienten durch ausgeprägte Sonnenbrände und neurologische Mitbeteiligung. Es besteht ein erhöhtes Risiko für die Entwicklung von Augen- und Hauttumoren an sonnenexponierten Arealen. Derzeit besteht keine kurative Therapie. Als protektive Maßnahme wird ein absoluter Lichtschutz vor allen UV-Strahlungen dringend empfohlen.

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Lichtschutzfaktor 50+

Zusammenfassung

Der Nutzen von Sonnenschutzmitteln mit Lichtschutzfaktoren (LSF) jenseits 50 ist umstritten. Um eine Irreführung des Konsumenten zu vermeiden, sind mehrere Länder bereits dazu übergegangen, LSF über 50 nicht mehr auf Sonnenschutzmitteln zu deklarieren. Argumente gegen hohe LSF sind das Risiko eines unausgewogenen Schutzes, der die Gefahr von Schäden durch längerwellige ultraviolette Strahlung erhöhen könnte; Vermittlung eines falschen Sicherheitsgefühls, das zur zeitlichen Ausdehnung der Sonnenexposition verleiten könnte; gesundheitliche Risiken durch höhere Konzentration an Filtersubstanzen und die nur marginal höhere Lichtblockade. Demgegenüber steht die Erkenntnis, dass der funktionelle LSF von Sonnenschutzmitteln in der praktischen Anwendung ohnehin weit hinter dem deklarierten LSF zurückbleibt und daher der Einsatz von höheren LSF bei sensitiven Individuen und starker UV-Belastung durchaus Sinn machen könnte.

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Erratum zu: Orale Schleimhautalteration – was ist die Ursache?

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Nasenmuschelchirurgie

Zusammenfassung

Die Nase bildet die ersten 8 cm des oberen Respirationstrakts und dient neben der Luftzufuhr der Reinigung, Befeuchtung und Temperierung der Atemluft. Dies wird als Konditionierung bezeichnet. Diffusor und Beschleuniger der Atemluft ist die Nasenklappenregion, gebildet aus dem Kopf der unteren Nasenmuschel, Anteilen des knorpeligen Septums und des Lateralknorpels. Voraussetzungen sind regelrechte mukoziliäre Clearance und ausreichender Luftdurchtritt. Die Hypertrophie der unteren Nasenmuscheln ist eine der häufigsten Ursachen symptomatischer Nasenatmungsbehinderungen. Rhinometrische Verfahren stellen bei unklaren Fällen die erweiterte Diagnostik dar. Neben der konservativen Therapie einer allergischen oder vasomotorischen Rhinitis mittels spezifischer Immuntherapie bzw. topischer Kortikoide gibt es diverse interventionelle Verfahren zur Verkleinerung des Muschelgewebes bei einem hohen Maß an Schonung der respiratorischen Schleimhaut.

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Abrasion and blunt tissue trauma study of a novel flexible robotic system in the porcine model

Publication date: Available online 11 April 2017
Source:American Journal of Otolaryngology
Author(s): Michael Z. Lerner, Michael Tricoli, Marshall Strome
ObjectivesThe objective of this study was to determine if a flexible robotic system caused increased tissue reaction when accessing the oropharynx and hypopharynx compared to intubation controls in only 2 scenarios: high speed tissue impact and multiple unit insertions and retractions. The data obtained were submitted as part of the entirety of information submitted for FDA approval.MethodsThis study consisted of 5 groups of Yorkshire pigs (2 animals per group). On Day 0, all animals were intubated. For group 1 (control), a second endotracheal tube was advanced to just above the vocal cords. In abrasion groups 2 and 3, the flexible robotic system was advanced against the oropharyngeal and hypopharyngeal tissues, respectively. In blunt trauma groups 4 and 5, the flexible robotic system was advanced at maximum speed (22mm/s) to collide with oropharyngeal and hypopharyngeal tissues, respectively. Pre- and post-procedure endoscopic assessments of tissue reaction were performed daily for 4 days. An independent reviewer graded tissue reaction using a 0–3 point scale.ResultsTissue reaction scores at each observation time point for all test groups were less than or equal to control scores except for one instance of moderate scoring (2 out of 3) on Day 2 for an animal in the blunt trauma group where reaction was likely intubation-related rather than device impact related. Otherwise, all flexible robotic system-treated animal scores were less than 1 by Day 4.ConclusionsIn this limited study, the flexrobotic system afforded surgical access to the oropharynx and hypopharynx without an increased level of abrasion or tissue trauma when compared to intubation alone.



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Immune-mediated cytokine storm and its role in severe dengue

Abstract

Dengue remains one of the most important mosquito-borne diseases worldwide. Infection with one of the serologically related dengue viruses (DENVs) can lead to a wide range of clinical manifestations and severity. Severe dengue is characterized by plasma leakage and abnormal bleeding that can lead to shock and death. There is currently no specific treatment for severe dengue due to gaps in understanding of the underlying mechanisms. The transient period of vascular leakage is usually followed by a rapid recovery and is suggestive of the effects of short-lived biological mediators. Both the innate and the adaptive immune systems are activated in severe dengue and contribute to the cytokine production. We discuss the immunological events elicited during a DENV infection and identify candidate cytokines that may play a key role in the severe manifestations of dengue and possible interventions.

http://ift.tt/2opOL7F

Primary Extracranial Meningioma: A Rare Location

Abstract

Meningiomas are benign extraaxial tumors of the central nervous system (CNS). Extracranial meningiomas are extremely rare (2%) and can develop as a direct extension from a primary intracranial meningioma or as true primary extracranial meningioma originating from ectopic arachnoid cells. Only eight cases of primary meningioma in the jaw have been reported to date. Extracranial meningiomas are frequently misdiagnosed, resulting in inappropriate clinical management. The aim of this article was to describe the case of a man with an asymptomatic swelling in the right retromolar area over a period of 2 months. Cone beam computed tomography was performed to determine the extension and involvement of the adjacent structures. Histopathological findings and immunohistochemical analysis aided in the diagnosis of primary extracranial meningioma in the mandible and several aspects of this unusual neoplasm are reviewed. The treatment of choice was a partial resection of the mandible and reconstruction with autogenous iliac tricortical bone. Five years after surgery, the patient remains free of disease.

http://ift.tt/2p41Emb

The state of asthma epidemiology: an overview of systematic reviews and their quality

Recently, we have published an overview of systematic reviews in allergy epidemiology and identified asthma as the most commonly reviewed allergic disease. Building on this work, we aimed to investigate the qu...

http://ift.tt/2pqCHjV

Tumor-associated myeloid cells as guiding forces of cancer cell stemness

Abstract

Due to their ability to differentiate into various cell types and to support tissue regeneration, stem cells simultaneously became the holy grail of regenerative medicine and the evil obstacle in cancer therapy. Several studies have investigated niche-related conditions that favor stemness properties and increasingly emphasized their association with an inflammatory environment. Tumor-associated macrophages (TAMs) and myeloid-derived suppressor cells (MDSCs) are major orchestrators of cancer-related inflammation, able to dynamically express different polarized inflammatory programs that promote tumor outgrowth, including tumor angiogenesis, immunosuppression, tissue remodeling and metastasis formation. In addition, these myeloid populations support cancer cell stemness, favoring tumor maintenance and progression, as well as resistance to anticancer treatments. Here, we discuss inflammatory circuits and molecules expressed by TAMs and MDSCs as guiding forces of cancer cell stemness.

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IDO and galectin-3 hamper the ex vivo generation of clinical grade tumor-specific T cells for adoptive cell therapy in metastatic melanoma

Abstract

Adoptive T cell transfer (ACT) with ex vivo-expanded tumor-reactive T cells proved to be successful for the treatment of metastatic melanoma patients. Mixed lymphocyte tumor cell cultures (MLTC) can be used to generate tumor-specific T cells for ACT; however, in a number of cases tumor-reactive T cell, expansion is far from optimal. We hypothesized that this is due to tumor intrinsic and extrinsic factors and aimed to identify and manipulate these factors so to optimize our clinical, GMP-compliant MLTC protocol. We found that the tumor cell produced IDO and/or galectin-3, and the accumulation of CD4⁺CD25^hiFoxP3⁺ T cells suppressed the expansion of tumor-specific T cells in the MLTC. Strategies to eliminate CD4⁺CD25^hiFoxP3⁺ T cells during culture required the depletion of the whole CD4⁺ T cell population and were found to be undesirable. Blocking of IDO and galectin-3 was feasible and resulted in improved efficiency of the MLTC. Implementation of these findings in clinical protocols for ex vivo expansion of tumor-reactive T cells holds promise for an increased therapeutic potential of adoptive cell transfer treatments with tumor-specific T cells.

http://ift.tt/2p3IVa9

Consistent and powerful graph-based change-point test for high-dimensional data [Statistics]

A change-point detection is proposed by using a Bayesian-type statistic based on the shortest Hamiltonian path, and the change-point is estimated by using ratio cut. A permutation procedure is applied to approximate the significance of Bayesian-type statistics. The change-point test is proven to be consistent, and an error probability in...

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Chinese cave {delta}18O records do not represent northern East Asian summer monsoon rainfall [Physical Sciences]

In a recent study, Goldsmith et al. reconstructed the Holocene lake-level history of Lake Dali in Inner Mongolia from fossil beach ridges and assume it reflected East Asian summer monsoon (EASM) rainfall (1). In addition, they note a good correlation between the lake fluctuations and Chinese speleothem δ18O records, and...

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Quantification of circulating Mycobacterium tuberculosis antigen peptides allows rapid diagnosis of active disease and treatment monitoring [Engineering]

Tuberculosis (TB) is a major global health threat, resulting in an urgent unmet need for a rapid, non–sputum-based quantitative test to detect active Mycobacterium tuberculosis (Mtb) infections in clinically diverse populations and quickly assess Mtb treatment responses for emerging drug-resistant strains. We have identified Mtb-specific peptide fragments and developed a...

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Reply to Liu et al.: East Asian summer monsoon rainfall dominates Lake Dali lake area changes [Physical Sciences]

We thank Liu et al. (1) for their comments on our paper (2). The first point of Liu et al. (1) is that the Lake Dali Early Holocene highstand could reflect increased winter precipitation and/or glacier melt rather than monsoon rainfall. First, modern winter precipitation contributes <10% annual precipitation (2,...

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MYO6 is targeted by Salmonella virulence effectors to trigger PI3-kinase signaling and pathogen invasion into host cells [Cell Biology]

To establish infections, Salmonella injects virulence effectors that hijack the host actin cytoskeleton and phosphoinositide signaling to drive pathogen invasion. How effectors reprogram the cytoskeleton network remains unclear. By reconstituting the activities of the Salmonella effector SopE, we recapitulated Rho GTPase-driven actin polymerization at model phospholipid membrane bilayers in cell-free...

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Y chromosome’s roles in sex differences in disease [Immunology and Inflammation]

In PNAS, Krementsov et al. (1) report that if you are a male mouse and catch the flu, the severity of your illness may depend on the type of Y chromosome (ChrY) that you have. In this study, influenza A virus was administered to consomic ChrY mouse strains in which...

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Complement modulation in the retinal pigment epithelium rescues photoreceptor degeneration in a mouse model of Stargardt disease [Medical Sciences]

Recessive Stargardt macular degeneration (STGD1) is caused by mutations in the gene for the ABCA4 transporter in photoreceptor outer segments. STGD1 patients and Abca4−/− (STGD1) mice exhibit buildup of bisretinoid-containing lipofuscin pigments in the retinal pigment epithelium (RPE), increased oxidative stress, augmented complement activation and slow degeneration of photoreceptors. A...

http://ift.tt/2owlSqS

Design of energy-transducing artificial cells [Biophysics and Computational Biology]

A sustainable society requires sources of renewable energy that are efficient, cost-effective, and robust. Achieving such energy sources represents a significant challenge that requires the development of novel technologies, including the creation of materials that control physical and chemical transformations at a molecular level. Photosynthesis performs solar energy conversion using...

http://ift.tt/2nBz8Lh

Structural reconstruction of protein ancestry [Biophysics and Computational Biology]

Ancestral protein reconstruction allows the resurrection and characterization of ancient proteins based on computational analyses of sequences of modern-day proteins. Unfortunately, many protein families are highly divergent and not suitable for sequence-based reconstruction approaches. This limitation is exemplified by the antigen receptors of jawed vertebrates (B- and T-cell receptors), heterodimers...

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Rapid evolution of resistance to parasitism in biological control [Agricultural Sciences]

A growing awareness of human dependence on the natural capital of ecosystem services has highlighted the importance of such services to the sustainable management of both natural and production ecosystems. Biological control is an ecosystem service in which a pest, pathogen, or weed is effectively controlled through an ecological interaction...

http://ift.tt/2p4twq3

In situ characterization of cofacial Co(IV) centers in Co4O4 cubane: Modeling the high-valent active site in oxygen-evolving catalysts [Chemistry]

The Co4O4 cubane is a representative structural model of oxidic cobalt oxygen-evolving catalysts (Co-OECs). The Co-OECs are active when residing at two oxidation levels above an all-Co(III) resting state. This doubly oxidized Co(IV)2 state may be captured in a Co(III)2(IV)2 cubane. We demonstrate that the Co(III)2(IV)2 cubane may be electrochemically...

http://ift.tt/2p2m1mz

Toward neuroprotective treatments of Parkinson’s disease [Neuroscience]

Parkinson's disease (PD) is, after Alzheimer's disease, the second most-common neurodegenerative disorder affecting 1–2% of the global population over the age of 65 (1, 2). Aging being a primary risk factor for PD (3), its economic burden on our society in terms of medical care will escalate with our aging...

http://ift.tt/2nBDfr0

Deficiency of transcription factor RelB perturbs myeloid and DC development by hematopoietic-extrinsic mechanisms [Immunology and Inflammation]

RelB is an NF-κB family transcription factor activated in the noncanonical pathway downstream of NF-κB–inducing kinase (NIK) and TNF receptor family members including lymphotoxin-β receptor (LTβR) and CD40. Early analysis suggested that RelB is required for classical dendritic cell (cDC) development based on a severe reduction of cDCs in Relb−/−...

http://ift.tt/2p4BzTR

Preventing acquisition of HIV is the only path to an AIDS-free generation [Population Biology]

The article by Medlock et al. (1) reminds us that HIV infection is still the epidemic of our times. Currently, 36.7 million persons are living with HIV, and annual deaths from HIV are still upward of 1 million persons per year (aidsinfo.unaids.org). Because a wide variety of studies have demonstrated...

http://ift.tt/2p4FH6u

KETCH1 imports HYL1 to nucleus for miRNA biogenesis in Arabidopsis [Plant Biology]

MicroRNA (miRNA) is processed from primary transcripts with hairpin structures (pri-miRNAs) by microprocessors in the nucleus. How cytoplasmic-borne microprocessor components are transported into the nucleus to fulfill their functions remains poorly understood. Here, we report KETCH1 (karyopherin enabling the transport of the cytoplasmic HYL1) as a partner of hyponastic leaves...

http://ift.tt/2owsghM

Pore translocation of knotted DNA rings [Biophysics and Computational Biology]

We use an accurate coarse-grained model for DNA and stochastic molecular dynamics simulations to study the pore translocation of 10-kbp–long DNA rings that are knotted. By monitoring various topological and physical observables we find that there is not one, as previously assumed, but rather two qualitatively different modes of knot...

http://ift.tt/2nBPXpt

In This Issue [This Week in PNAS]

Early Antarctic ice age dynamics Antarctica. Image courtesy of Wikimedia Commons/Dave Pape. The extent of Antarctic ice sheets oscillated widely on astronomical time scales throughout the Oligocene and Early Miocene Epochs, approximately 34 to 17 million years ago, when comparably large ice sheets had not yet developed in the Arctic....

http://ift.tt/2nBLwuQ

Statistical significance of seasonal warming/cooling trends [Earth, Atmospheric, and Planetary Sciences]

The question whether a seasonal climate trend (e.g., the increase of summer temperatures in Antarctica in the last decades) is of anthropogenic or natural origin is of great importance for mitigation and adaption measures alike. The conventional significance analysis assumes that (i) the seasonal climate trends can be quantified by...

http://ift.tt/2p4yWRZ

Transcription factor Etv5 is essential for the maintenance of alveolar type II cells [Cell Biology]

Alveolar type II (AT2) cell dysfunction contributes to a number of significant human pathologies including respiratory distress syndrome, lung adenocarcinoma, and debilitating fibrotic diseases, but the critical transcription factors that maintain AT2 cell identity are unknown. Here we show that the E26 transformation-specific (ETS) family transcription factor Etv5 is essential...

http://ift.tt/2p2DtHj

Strategic siting and regional grid interconnections key to low-carbon futures in African countries [Sustainability Science]

Recent forecasts suggest that African countries must triple their current electricity generation by 2030. Our multicriteria assessment of wind and solar potential for large regions of Africa shows how economically competitive and low-environmental–impact renewable resources can significantly contribute to meeting this demand. We created the Multicriteria Analysis for Planning Renewable...

http://ift.tt/2nBuzAJ

Using cone beam CT to assess the upper airway after surgery in children with sleep disordered breathing symptoms and maxillary-mandibular disproportions: a clinical pilot

Abstract

Background

The surgical excision of anatomic obstructions such as adenoids, palatine or lingual tonsils are commonly performed in children with sleep disordered breathing (SDB). Imaging studies measuring airway changes post-surgery in the SDB pediatric population are scarce, rarely addresses the nasal cavity, and are based on global measures (e.g. volume) that do not represent the complexity of the upper airway anatomy. The purpose of this pilot is to test the feasibility in using cone beam CT (CBCT) to analyze the nasal and pharyngeal airway space post-surgery using meaningful methods of analyses, and correlating imaging findings with clinical outcomes in children with SDB symptoms and maxillary-mandibular disproportion.

Methods

Twelve non-syndromic children with SDB symptoms and jaw disproportions were evaluated by interdisciplinary airway team before and after upper airway surgery. CBCT and OSA-18 quality of life questionnaire pre and post-operatively were completed. Conventional and new airway variables were measured based on 3D models of the upper airways and correlated with OSA-18. Conventional measures include volume, surface area, and cross-sectional area. New airway measures include constriction and patency; point-based analyses.

Results

Eight females and four males were 8.8 ± 2 years with mean BMI of 18.7 ± 3. OSA-18 improved, median (lower quartile-upper quartile) from 64.2 (54.7–79.5) to 37.6 (28.7–43) postoperatively, p < 0.001. The median of all airway measures improved however with very wide range. Subjects with the smallest amounts of constriction relief and/or gain in airway patency presented with least improvement in OSA-18. New airway measures show strong correlation with changes in OSA-18 (ρ = 0.44 to 0.71) whereas conventional measures showed very weak correlation (ρ = −0.04 to 0.37).

Conclusions

Using point-based analyses, new airway measures better explained changes in clinical symptoms compared to conventional measures. Airway patency gained by at least 150% and constriction relief by at least 15% showed marked improvement in OSA-18 by 40–55%, after surgery in the tested cohort.

http://ift.tt/2on24pi

Rigid versus semi-rigid bis(imidazole) ligands in the assembly of two Co(II) coordination polymers: structural variability, electrochemical properties and photocatalytic behavior

The hydrothermal reactions of 1,2,4,5-cyclohexanetetracarboxylic acid (H4L) with CoCl2 center dot 2H(2)O and rigid or semi-rigid bis(imidazole) ligands were able to generate two Co(II) coordination polymers (CPs), {[Co-5(L)(2)(1,4-bimb)( mu(3)-OH)(2)(H2O)(8)]center dot 2H(2)O}(n) (1), {[Co(L)(0.5)(1,4-bib)]center dot H2O}(n) (2) (1,4-bimb = 1,4-bis(imidazol-1-ylmethyl) benzene, 1,4-bib = 1,4-bis(1H-imidazol-1-yl) benzene). CPs 1 and 2 were structurally characterized by elemental analysis, IR spectroscopy, X-ray powder diffraction and single crystal X-ray diffraction. CP 1 features a 3D 3,3,4,4,5-connected framework with an unprecedented {4(2).8.10(2).12}{4(3).6.8(6)}(2){4(3)}(2){4(6)}(2){6(2).8}(2) topology, which represents the first example of CPs with such a topology. CP 2 possesses a three-fold interpenetration 3D framework with mog topology. The distinct structures of the two CPs may result from diverse coordination modes of the (L)(4-) ligands and different structural characteristics of rigid or semi-rigid N-donor ligands. The thermal stabilities, photoluminescence properties and electrochemical behavior in the solid state for CPs 1 and 2 have been investigated. The photophysical studies indicated that CPs 1 and 2 are potential semiconductive materials. Moreover, both CPs 1 and 2 show high photocatalytic efficiency for the degradation of methylene blue (MB) under UV light irradiation and exhibit good stability and recyclability. A possible photocatalytic mechanism is speculated by introducing t-butyl alcohol (TBA) as a widely used (OH)-O-center dot scavenger.

http://ift.tt/2p1ZnKQ

Ruthenium(II) bipyridine complexes: from synthesis and crystal structures to electrochemical and cytotoxicity investigation

Complexes 1-4, [Ru(L)(bpy)(2)]PF6, where bpy=2,2-bipyridine; HL=3-methylpyridine-2-carboxylic acid (HL1), 6-methylpyridine-2-carboxylic acid (HL2), 5-bromopyridine-2-carboxylic acid (HL3) and 6-bromopyridine-2-carboxylic acid (HL4), were synthesized and characterized. The electrochemical character of the complexes was investigated by cyclic voltammetry revealing two reversible reduction waves in the negative range of potentials, most likely due to a reduction of the bipyridine moiety. Cytotoxicity studies by MTT assay for 72h of drug action revealed that 2-4 exhibited moderate activity in cervical human tumor cells (HeLa). Complex 2 exhibited low activity in colon cancer LS-174 cells (180 +/- 10), while all complexes were devoid of activity in lung cancer A549 and non-tumor MRC-5 cells, up to 200M. Combinational studies of the most active complex 2, with pharmacological modulators of cell redox status, L-buthionine-sulfoximine (L-BSO) or N-acetyl-L-cysteine (NAC), showed that when L-BSO potentiated, 2 induced a sub-G1 peak of the cell cycle in the HeLa cell line. UV-vis and cyclic voltammetry were performed in order to investigate the binding mode of 2 to DNA and suggested intercalation for the complex-DNA interaction. [GRAPHICS]

http://ift.tt/2p42e2Z

Serum periostin relates to type-2 inflammation and lung function in asthma; data from the large population-based cohort Swedish GA(2)LEN

Abstract

Background

Periostin has been suggested as a novel, phenotype-specific biomarker for asthma driven by type-2 inflammation. However, large studies examining relationships between circulating periostin and patient characteristics are lacking and the suitability of periostin as a biomarker in asthma remains unclear.

Aim

To examine circulating periostin in healthy controls and subjects with asthma from the general population with different severity and treatment profiles, both with and without chronic rhinosinusitis (CRS), in relation to other biomarkers and clinical characteristics.

Methods

Serum periostin was examined by ELISA in 1091 subjects aged 17-76 from the Swedish GA(2)LEN study, which included 460 asthmatics with/without chronic rhinosinusitis (CRS), 97 individuals with CRS only, and 203 healthy controls. Clinical tests included measurement of lung function, FeNO, IgE, urinary eosinophil derived neurotoxin (U-EDN) and serum eosinophil cationic protein (S-ECP), as well as completion of questionnaires regarding respiratory symptoms, medication and quality of life.

Results

Although median periostin values showed no differences when comparing disease groups with healthy controls, multiple regression analyses revealed that periostin was positively associated with higher FeNO, U-EDN and total IgE. In patients with asthma, an inverse relationship with lung function was also observed. Current smoking was associated with decreased periostin levels, whereas increased age and lower BMI related to higher periostin levels in subjects both with and without asthma.

Conclusion

We confirm associations between periostin and markers of type-2 inflammation, as well as lung function, and identify novel constitutional factors of importance to the use of periostin as a phenotype-specific biomarker in asthma.

This article is protected by copyright. All rights reserved.

http://ift.tt/2nB5Ts1

Primary Extracranial Meningioma: A Rare Location

Abstract

Meningiomas are benign extraaxial tumors of the central nervous system (CNS). Extracranial meningiomas are extremely rare (2%) and can develop as a direct extension from a primary intracranial meningioma or as true primary extracranial meningioma originating from ectopic arachnoid cells. Only eight cases of primary meningioma in the jaw have been reported to date. Extracranial meningiomas are frequently misdiagnosed, resulting in inappropriate clinical management. The aim of this article was to describe the case of a man with an asymptomatic swelling in the right retromolar area over a period of 2 months. Cone beam computed tomography was performed to determine the extension and involvement of the adjacent structures. Histopathological findings and immunohistochemical analysis aided in the diagnosis of primary extracranial meningioma in the mandible and several aspects of this unusual neoplasm are reviewed. The treatment of choice was a partial resection of the mandible and reconstruction with autogenous iliac tricortical bone. Five years after surgery, the patient remains free of disease.

http://ift.tt/2p41Emb

Atorvastatin-Diltiazem Combination Induced Rhabdomyolysis Leading to Diagnosis of Hypothyroidism

Statins and hypothyroidism, independently, can rarely cause rhabdomyolysis. The combination of them especially with concurrent intake of drugs such as diltiazem increases the risk of rhabdomyolysis. Hashimoto's encephalopathy is a rare condition associated with Hashimoto's thyroiditis and some patients with that can present with a stroke like picture. An elderly male who has been on atorvastatin for three years and on diltiazem for a week presented with sudden onset inability to walk and confusion. On examination muscle tenderness was noticed and creatine kinase levels indicated rhabdomyolysis which we attributed to atorvastatin. Patient developed a seizure and myoclonus of masseters. Considering this, his confusion and his neutrophilia and high C-reactive protein levels, empirical antibiotics with dexamethasone were started and the patient responded to that. His cerebrospinal fluid and blood culture reports that arrived later did not show sepsis. After going home also his CK (creatine kinase) levels remained high; TSH (thyroid-stimulating hormone) level test was done and hypothyroidism was diagnosed. His antithyroid peroxidase antibody levels were also very high. We retrospectively think he had Hashimoto's encephalopathy as well. His lipid profile and TSH and CK values returned to normal in that order after a few months of levothyroxine therapy.

http://ift.tt/2p3BaBc

Survival outcomes for cutaneous angiosarcoma of the scalp versus face

ABSTRACT

Background

The primary purpose of this study was to examine whether angiosarcoma outcomes differ for the scalp and face.

Methods

We conducted a retrospective outcomes analysis of 50 patients with cutaneous angiosarcoma treated by curative intent identified from the Princess Margaret Cancer Centre Registry (from 1958 to 2014).

Results

Median survival was 26 months (95% confidence interval [CI], 17.6–34.6) and median follow-up 29 months. For the scalp and face, respectively, the 5-year locoregional control rate was 9% and 53% (p = .04); the recurrence-free survival (RFS) rate was 5% and 27% (p = .017); and the overall survival (OS) rate was 9% and 26% (p = .017). Scalp lesions were larger, more likely to be multifocal, and presented more rapidly once noticed. In multivariate Cox proportional hazards analysis, scalp location was independently prognostic for mortality (hazard ratio [HR], 2.10; 95% CI, 1.03–4.28; p = .04).

Conclusion

Scalp angiosarcoma has worse survival than angiosarcoma of the face. Scalp angiosarcoma tends to be larger at presentation, which may be because it is not noticed until more advanced. © 2017 Wiley Periodicals, Inc. Head Neck, 2017

http://ift.tt/2nARooi

Media Advisory: Maryland’s Top Cancer Scientists Discuss Research on Tracking and Treating Cancer

At the annual "Research Matters" conference on Wednesday, April 12, scientists at Maryland's two academic cancer centers will meet to discuss how scientists are using advanced imaging methods to develop better ways pinpoint and track cancer cells — down to the microscopic level — and precisely target each cell with anti-cancer drugs.

http://ift.tt/2ppN7R7

Procedural review in European fundamental rights cases: introduction

The analyses provided in this volume show at once the potential and the limitations of procedural review as a suitable approach for European Courts having to decide on fundamental rights cases. The question arises as to what form of procedural review would be the most appropriate for the European Courts to apply. The comparative analysis of case law shows that a great variety of approaches can be conceived. Hence there is no straightforward and easy answer to the main research question of this book, which is to what extent and how the 'argument from procedure' can be used in fundamental rights case law of the European Courts in a legitimate and practical manner.

http://ift.tt/2nZJQXm

Lifestyle related behaviours and body composition indicators in a sample of European children : a cluster analysis approach

http://ift.tt/2nALmUM

Communicating creativity on YouTube : what and for whom?

This article addresses non-professional users' expressions of everyday creativity on YouTube, adopting the idea that making entails connecting on different levels. By combining different materials and ideas into a video and sharing it within the social context of the platform, uploaders can connect with its enormous audience. In our first study, we explore patterns in the elements that are used when creating a video. We also question whether these pattern combinations are aimed at different types of viewers. Our results show that videos with self-made content that display various skills are mainly targeted at viewers situated close to the uploader (e.g., family, friends). Yet, videos that incorporate instances of popular culture, either as a whole (e.g., a pop concert recording) or in part (e.g., remixed with other content), are directed at a much broader audience. In our second study, we question whether these self-made videos convey a message about uploaders' personality traits commonly linked to creative behavior. We found that independent observers are able to accurately predict the uploaders' actual openness to experience, a trait marked as the substrate of creativity. Next, we discuss our results in light of a pessimistic view of today's democratized culture. We show that uploaders appear to have a tacit knowledge of what kind of videos are interesting for what type of viewers. We conclude that, despite the lowered barriers to the production and dissemination of video, YouTube viewers are still able to identify variations in the personality trait most commonly associated to creativity.

http://ift.tt/2nZUA8p

Measuring Cell Free DNA During the Course of Treatment for Esophageal Cancer as a Marker of Response and Recurrence

Conditions:   Esophageal Neoplasm;   Esophageal Neoplasms Malignancy Unspecified;   Esophageal Neoplasms Malignant;   Cancer of Esophagus;   Cancer of the Esophagus;   Esophageal Cancer;   Esophagus Cancer;   Neoplasm, Esophageal
Intervention:   Other: Blood and Tissue Collection
Sponsor:   Mayo Clinic
Not yet recruiting - verified April 2017

http://ift.tt/2nZRzoz

Oropharyngeal Tumor Induction Chemotherapy and Response-stratified Locoregional Therapy Trial in Order to Minimize Long-term Adverse Events

Conditions:   HPV-Related Squamous Cell Carcinoma;   HNSCC
Interventions:   Drug: nab-paclitaxel;   Drug: Carboplatin;   Drug: Nivolumab;   Drug: Cisplatin;   Drug: Hydroxyurea;   Drug: 5-FU;   Drug: Dexamethasone;   Drug: Famotidine;   Drug: Diphenhydramine;   Drug: Paclitaxel;   Procedure: Transoral robotic surgery (TORS);   Radiation: Adjuvant RT;   Radiation: Chemoradiotherapy
Sponsor:   University of Chicago
Not yet recruiting - verified April 2017

http://ift.tt/2oUG5Hw

Giant perforated marginal ulcer after laparoscopic Roux-en-Y gastric bypass

Perforation of a marginal ulcer (MU) is a complication of Roux-en-Y gastric bypass that can be life-threatening. We report a case of a perforated MU that presented 7 months after surgery with several interesting points for discussion. Firstly, the presentation of the ulcer was cryptic with unreliable investigations. Secondly, the ulcer presented again even after anastomotic revision surgery. Finally, the ulcer and the sepsis associated with perforation presented after months of poor nutritional intake with profound hypoalbuminaemia. Perforated MUs causing malnutrition pose clinicians with the difficult decision of which operation to offer; patch repair, revision of the anastomosis or reversal surgery. This case illustrates that primary reversal surgery for a perforated recurrent MU may be the most appropriate surgical management in this clinical situation.

http://ift.tt/2ovq7CX

Fluorescence in a cryptococcoma following administration of 5-aminolevulinic acid hydrochloride (Gliolan)

A 54-year-old man presented with two episodes of dysarthria and left facial droop. Both episodes resolved by the time of examination. MRI of the brain revealed a right frontotemporal, heterogeneously enhancing mass with surrounding vasogenic oedema, suggestive of a high-grade primary brain neoplasm. The patient was administered preoperative 5-aminolevulinic acid hydrochloride (Gliolan), and fluorescence-guided resection of the lesion was undertaken. Cryptococcus gattii infection was diagnosed from the specimen and the patient was given appropriate antifungal treatment. This is the first reported case of Gliolan-mediated fluorescence in a fungal abscess and highlights one of the potential pitfalls in fluorescence-guided surgery.

http://ift.tt/2ppxdGi

Topical delivery of anthramycin I. Influence of neat solvents

Haque, T; Rahman, KM; Thurston, DE; Hadgraft, J; Lane, ME; (2017) Topical delivery of anthramycin I. Influence of neat solvents. European Journal of Pharmaceutical Sciences 10.1016/j.ejps.2017.03.043 . (In press).

http://ift.tt/2p1qIwK

Hydroxypyridinone and 5-Aminolaevulinic Acid Conjugates for Photodynamic Therapy.

Battah, S; Hider, RC; MacRobert, AJ; Dobbin, PS; Zhou, T; (2017) Hydroxypyridinone and 5-Aminolaevulinic Acid Conjugates for Photodynamic Therapy. J Med Chem 10.1021/acs.jmedchem.7b00346 . (In press).

http://ift.tt/2nZM7SF

Characterization of Transcriptional Changes in ERG Rearrangement-Positive Prostate Cancer Identifies the Regulation of Metabolic Sensors Such as Neuropeptide Y

Massoner, P; Kugler, KG; Unterberger, K; Kuner, R; Mueller, LAJ; Fälth, M; Schäfer, G; Massoner, P; Kugler, KG; Unterberger, K; Kuner, R; Mueller, LAJ; Fälth, M; Schäfer, G; Seifarth, C; Ecker, S; Verdorfer, I; Graber, A; Sültmann, H; Klocker, H; - view fewer (2013) Characterization of Transcriptional Changes in ERG Rearrangement-Positive Prostate Cancer Identifies the Regulation of Metabolic Sensors Such as Neuropeptide Y. PLOS One , 8 (2) , Article e55207. 10.1371/journal.pone.0055207 . Green open access

http://ift.tt/2p1nklF

Omega-3 polyunsaturated fatty acids selectively inhibit growth in neoplastic oral keratinocytes by differentially activating ERK1/2

Nikolakopoulou, Z; Nteliopoulos, G; Michael-Titus, AT; Parkinson, EK; (2013) Omega-3 polyunsaturated fatty acids selectively inhibit growth in neoplastic oral keratinocytes by differentially activating ERK1/2. Carcinogenesis , 34 (12) pp. 2716-2725. 10.1093/carcin/bgt257 . Green open access

http://ift.tt/2nZKrbr

Local delivery of novel MRTF/SRF inhibitors prevents scar tissue formation in a preclinical model of fibrosis

Yu-Wai-Man, C; Spencer-Dene, B; Lee, RMH; Hutchings, K; Lisabeth, EM; Treisman, R; Bailly, M; Yu-Wai-Man, C; Spencer-Dene, B; Lee, RMH; Hutchings, K; Lisabeth, EM; Treisman, R; Bailly, M; Larsen, SD; Neubig, RR; Khaw, PT; - view fewer (2017) Local delivery of novel MRTF/SRF inhibitors prevents scar tissue formation in a preclinical model of fibrosis. Scientific Reports , 7 p. 518. 10.1038/s41598-017-00212-w . Green open access

http://ift.tt/2p1vREU

Quality of clinical practice guidelines in delirium: a systematic appraisal

Bush, SH; Marchington, KL; Agar, M; Davis, DHJ; Sikora, L; Tsang, TWY; (2017) Quality of clinical practice guidelines in delirium: a systematic appraisal. BMJ Open , 7 (3) , Article e013809. 10.1136/bmjopen-2016-013809 . Green open access

http://ift.tt/2nZGYdd

High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda

Olupot-Olupot, P; Engoru, C; Uyoga, S; Muhindo, R; Macharia, A; Kiguli, S; Opoka, RO; Olupot-Olupot, P; Engoru, C; Uyoga, S; Muhindo, R; Macharia, A; Kiguli, S; Opoka, RO; Akech, S; Ndila, C; Nyeko, R; Mtove, G; Nteziyaremye, J; Chebet, M; George, EC; Babiker, AG; Gibb, DM; Williams, TN; Maitland, K; - view fewer (2017) High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda. Clinical Infectious Diseases , 64 (7) pp. 939-946. 10.1093/cid/cix003 . Green open access

http://ift.tt/2p1zcE1

Importance of bulk states for the electronic structure of semiconductor surfaces: implications for finite slabs

Sagisaka, K; Nara, J; Bowler, D; (2017) Importance of bulk states for the electronic structure of semiconductor surfaces: implications for finite slabs. Journal of Physics: Condensed Matter , 29 (14) , Article 145502. 10.1088/1361-648X/aa5f91 .

http://ift.tt/2nZIoEB

Regression DCM for fMRI

Frässle, S; Lomakina, EI; Razi, A; Friston, KJ; Buhmann, JM; Stephan, KE; (2017) Regression DCM for fMRI. Neuroimage 10.1016/j.neuroimage.2017.02.090 . (In press). Green open access

http://ift.tt/2p1gDjy

Delayed diagnosis of Townes‑Brocks syndrome with multicystic kidneys and renal failure caused by a novel SALL1 nonsense mutation: A case report

Lin, FJ; Lu, W; Gale, D; Yao, Y; Zou, R; Bian, F; Jiang, GR; (2016) Delayed diagnosis of Townes‑Brocks syndrome with multicystic kidneys and renal failure caused by a novel SALL1 nonsense mutation: A case report. Experimental and Therapeutic Medicine , 11 (4) pp. 1249-1252. 10.3892/etm.2016.3035 . Green open access

http://ift.tt/2nZBrDi

A silicon-based surface code quantum computer

O'Gorman, J; Nickerson, NH; Ross, P; Morton, JJL; Benjamin, SC; (2016) A silicon-based surface code quantum computer. npj Quantum Information , 2 , Article 15019. 10.1038/npjqi.2015.19 . Green open access

http://ift.tt/2p1oWMl

Self-report and behavioural measures of impulsivity as predictors of impulsive behaviour and psychopathology in male prisoners

Huddy, V; Kitchenham, N; Roberts, A; Jarrett, M; Phillip, P; Forrester, A; Campbell, C; Huddy, V; Kitchenham, N; Roberts, A; Jarrett, M; Phillip, P; Forrester, A; Campbell, C; Byrne, M; Valmaggia, L; - view fewer (2017) Self-report and behavioural measures of impulsivity as predictors of impulsive behaviour and psychopathology in male prisoners. Personality and Individual Differences , 113 pp. 173-177. 10.1016/j.paid.2017.03.010 .

http://ift.tt/2nZAvPp

Genotype List String: a grammar for describing HLA and KIR genotyping results in a text string

Milius, RP; Mack, SJ; Hollenbach, JA; Pollack, J; Heuer, ML; Gragert, L; Spellman, S; Milius, RP; Mack, SJ; Hollenbach, JA; Pollack, J; Heuer, ML; Gragert, L; Spellman, S; Guethlein, LA; Trachtenberg, EA; Cooley, S; Bochtler, W; Mueller, CR; Robinson, J; Marsh, SGE; Maiers, M; - view fewer (2013) Genotype List String: a grammar for describing HLA and KIR genotyping results in a text string. Tissue Antigens , 82 (2) pp. 106-112. 10.1111/tan.12150 . Green open access

http://ift.tt/2p1joRE

Statistics for LA-ICP-MS based fission track dating

Vermeesch, P; (2017) Statistics for LA-ICP-MS based fission track dating. Chemical Geology 10.1016/j.chemgeo.2017.03.002 . (In press).

http://ift.tt/2nZHeJ7

A study of methanol and silicon monoxide production through episodic explosions of grain mantles in the Central Molecular Zone

Coutens, A; Rawlings, JMC; Viti, S; Williams, DA; (2017) A study of methanol and silicon monoxide production through episodic explosions of grain mantles in the Central Molecular Zone. Monthly Notices of the Royal Astronomical Society , 467 (1) pp. 737-746. 10.1093/mnras/stx119 . Green open access

http://ift.tt/2p1nfyn

Translators' end-revision processing patterns and maxims: a think-aloud protocol study

Shih, CYY; (2013) Translators' end-revision processing patterns and maxims: a think-aloud protocol study. Arab World English Journal , 4 (3) pp. 31-44. Green open access

http://ift.tt/2nZsJVS

Fifty Years of Migration, Fifty Years of Waiting: Turkey, Germany and the European Union

Mandel, R; (2013) Fifty Years of Migration, Fifty Years of Waiting: Turkey, Germany and the European Union. German Politics and Society , 31 (2) 10.3167/gps.2013.310206 .

http://ift.tt/2p1oSw5

Critical appraisal of implant connections and veneering materials

Petridis, H; (2015) Critical appraisal of implant connections and veneering materials. International Journal of Prosthodontics , 28 (3) p. 313. 10.11607/ijp.2015.3.YPE .

http://ift.tt/2nZNAbk

Chemical routes to discharging graphenides

Hodge, SA; Buckley, DJ; Yau, HC; Skipper, NT; Howard, CA; Shaffer, MSP; (2017) Chemical routes to discharging graphenides. Nanoscale (9) pp. 3150-3158. 10.1039/c6nr10004j .

http://ift.tt/2p1qw0u

De Supportive and Palliative Care Indicators Tool (SPICT) als prognostische tool op de acute G-dienst

http://ift.tt/2p1stKi

Etty Hillesum’s reaction to the persecution of her people

http://ift.tt/2p3pv5o

Perspectives of research on Etty Hillesum’s writings

http://ift.tt/2p1vx9r

The Ethics and Religious Philosophy of Etty Hillesum

http://ift.tt/2p3ekJF

The Inner Coherion of Jeremiah 34:8-22, on the Liberation of the Slaves during the Siege of Jerusalem, and its Relation to Deuteronomy 15

http://ift.tt/2p13uXO

Late Quaternary climatic control of Lake Baikal (Russia) turbidite systems: Implications for turbidite systems worldwide

Lake Baikal (Russia) contains a variety of turbidite systems in different tectonic and depositional settings that provide tests for the role of Quaternary climatic change on turbidite system growth. During Pleistocene glacial climates, all types of systems exhibit increased sediment supply (high sedimentation rates, high net sand percent, thick sand turbidites) and progradation. During Holocene interglacial climate, all systems exhibit reduced sediment supply and retreat. Seismic profiles from the large Selenga Fan and small Tompuda Fan show (1) maximum fan growth during the late Pleistocene glacial melt time, where lobes and large channels reached the distal outer fan, and (2) fan retreat during the transition to the fully developed Holocene interglacial climate. For example, the Selenga Fan surface lobes backstepped ∼55 km from the distal outer fan to the distal inner fan, and the large outer fan surface channel (∼750 m wide, ∼20 m levee relief) evolved to a smaller surface channel (∼450 m wide, ∼13 m levee relief) that extended only to the end of the inner fan. These results show that Quaternary climate controls the growth of the Lake Baikal turbidite systems in a setting where there are no significant water-level changes, which often are cited as the main control on turbidite system growth. The Lake Baikal and other marine turbidite systems suggest that climatic control of sediment supply, unrelated to sea-level lowering and tectonic effects, may have been a much more important control for turbidite systems than previously believed, not only during the Pleistocene, but perhaps also for ancient systems.

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Femoral and vertebral strength improvements in postmenopausal women with osteoporosis treated with denosumab

In the randomized, placebo-controlled FREEDOM study of women aged 60 to 90 years with postmenopausal osteoporosis, treatment with denosumab once every 6 months for 36 months significantly reduced hip and new vertebral fracture risk by 40% and 68%, respectively. To gain further insight into this efficacy, we performed a nonlinear finite element analysis (FEA) of hip and spine quantitative computed tomography (QCT) scans to estimate hip and spine strength in a subset of FREEDOM subjects (n=48 placebo; n=51 denosumab) at baseline, 12, 24, and 36 months. We found that, compared with baseline, the finite element estimates of hip strength increased from 12 months (5.3%; p<0.0001) and through 36 months (8.6%; p<0.0001) in the denosumab group. For the placebo group, hip strength did not change at 12 months and decreased at 36 months (-5.6%; p<0.0001). Similar changes were observed at the spine: strength increased by 18.2% at 36 months for the denosumab group (p<0.0001) and decreased by -4.2% for the placebo group (p=0.002). At 36 months, hip and spine strength increased for the denosumab group compared with the placebo group by 14.3% (p<0.0001) and 22.4% (p<0.0001), respectively. Further analysis of the finite element models indicated that strength associated with the trabecular bone was lost at the hip and spine in the placebo group, whereas strength associated with both the trabecular and cortical bone improved in the denosumab group. In conclusion, treatment with denosumab increased hip and spine strength as estimated by FEA of QCT scans compared with both baseline and placebo owing to positive treatment effects in both the trabecular and cortical bone compartments. These findings provide insight into the mechanism by which denosumab reduces fracture risk for postmenopausal women with osteoporosis.

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Effects of denosumab on fracture and bone mineral density by level of kidney function

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Bone size, volumetric bone density in relation to fat mass in healthy young men at age of peak bone mass

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Transperineal aggressive angiomyxoma

A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass, which she first noticed 6 months before and had progressively enlarged since then.

Radiological studies revealed a 14 cm lesion with translevator growth that displaced rather than invaded adjacent structures, with a peculiar whorled pattern on T2-weighted MRI, which enhanced following gadolinium administration. CT-guided biopsy was performed, and in conjunction with imaging features the diagnosis of an aggressive angiomyxoma was assumed and confirmed following surgical excision.

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Urethrocutaneous fistula mimicking vesicocutaneous fistula: a rare entity

Urethral fistulas arising from the anterior urethra usually open on the ventral aspect and are located in the penile, scrotal or perineal region. A diabetic 65-year-old man presented with suprapubic urinary fistula that was communicating with a dorsally located internal urethral opening located in the bulbar region. Such unusual fistula has not been described before.

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Rapidly enlarging acquired capillary hemangioma of the eyelid

DESCRIPTIONCase description

Case 1: A 10-year-old female presented with a 2-week history of a small reddish mass on her right upper eyelid. Her past history was otherwise uneventful. Ocular examination and visual acuity were both normal. The right upper eyelid showed a small reddish mass measuring about 2x2 mm approximately 1 mm from the eyelashes and at the junction of the medial two thirds and lateral one third of the eyelid (figure 1, top panel). The patient was kept under observation as the mass was small, but it rapidly increased in size over the next 2 weeks (figure 1, middle panel). Complete surgical excision was performed after the stalk was clamped and the bleeding blood vessel at the base was cauterised, followed by closure of the skin with 6–0 silk. A cosmetically acceptable result was achieved after 2 weeks (figure 1, bottom panel).

Figure 1

(Top panel) Small reddish mass on...

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Alopecia neoplastica

Description

A woman in her 60s with a history of cutaneous melanoma status post wide local excision and negative sentinel lymph node biopsy more than one decade before presented with 3 weeks of worsening memory, word finding difficulty and changes in handwriting. Her family reported peculiar behaviour such as writing letters on top of (instead of next to) one another and using a hairbrush upside down. The patient also complained of new right leg pain, paraesthesias and a mild frontal headache. Dermatological exam was notable for a 2x2 cm smooth, round nodule on the right parietal scalp, which had been present for a few months and was notable for complete loss of the overlying hair (figure 1). MRI of the brain showed greater than 10 diffusely enhancing lesions suspicious for metastatic disease, with a dominant left parietal haemorrhagic lesion measuring approximately 2.8x2.9x2.2 cm (figure 2). Associated...

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Hereditary leiomyomatosis and renal cell cancer (HLRCC): cutaneous and renal manifestations requiring a multidisciplinary team approach

Cutaneous leiomyomasare rare tumours of smooth muscle origin associated with disorders such as hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome. HLRCC is an autosomal dominant syndrome caused by loss of function mutations in the fumarate hydratase gene. Sufferers of this disorder are predisposed to the development of tumours of the skin and/or uterus, with a further subset of HLRCC families at risk of renal cell carcinoma with papillary features. This syndrome is rare and carries with it a significant rate of mortality. A multidisciplinary approach to care is critical in the management of these patients and their families. The dermatologist can play a central role in this process, coordinating care between specialist medical and allied health teams.

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Issue Information

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Serum HE4 is correlated to prognostic factors and survival in patients with endometrial cancer

Abstract

The extent of surgery and the decision for adjuvant treatment in patients with endometrial cancer (EC) depend on the presence of risk factors for lymph node metastases and disease recurrence. Postoperative markers such as myometrial infiltration and specific mutations can select patients for adjuvant treatment but will not influence surgical planning. A biomarker stratifying patients into low-risk and high-risk groups before surgery could identify patients who benefit from more extensive surgery. Therefore, we evaluated the correlation of serum biomarker HE4 with clinical and recently identified prognostic pathological variables and survival. Patients treated for endometrial cancer between 1994 and 2014 were included. Serum HE4 concentration was measured in preoperatively obtained samples. A total of 88 patients were eligible for analysis. The majority (64%) was diagnosed with endometrioid-type adenocarcinoma. Serum HE4 concentration is significantly associated with stage of disease (p = 0.001), deep myometrial invasion (p < 0.001), exact depth of myometrial invasion (≥4 mm) (p = 0.01), tumour-free distance to serosa (≤7 mm) (p < 0.001), extensive lymph vascular space invasion (p = 0.04) and cervical involvement (p = 0.001). HE4 concentration and nodal involvement were correlated, although not significant (p = 0.17). Serum HE4 is an independent prognostic factor for recurrence-free survival (HR 5.12 per 10-fold increase in HE4, 95% CI 1.54–17.1) and overall survival (HR 7.48 per 10-fold increase in HE4, 95% CI 1.76–31.7). HE4 is a prognostic marker in endometrial cancer and is helpful in addition to other variables for the preoperative risk stratification of patients with endometrial cancer.

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Stervensbegeleiding tussen ethiek en wetgeving

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Het ethisch beleid in zorginstellingen : een juridische analyse met focus op levenseindezorg

De invoering van de Wet Patiëntenrechten, de Euthanasiewet en de Wet Palliatieve Zorg in 2002 heeft geleid tot een explosie van het levenseindebeleid in Belgische zorginstellingen. Een arsenaal aan richtlijnen, procedures en protocollen moeten zorgverleners een houvast bieden bij de toepassing van deze wetten. Heel wat voorzieningen wenden dit beleid aan om hun ethische visie op bepaalde zorgen op de werkvloer te implementeren. Dit proefschrift onderzoekt de toelaatbaarheid en grenzen van dergelijk beleid, alsook de rechten en plichten van de beheerder, het artsenkorps en de patiënten. Heikele vragen zoals 'mag een voorziening een van de wet afwijkend ethisch beleid voeren?', 'kan de overheid hierop controle uitvoeren?' 'en kan een instelling euthanasie verbieden?' worden kritisch bestudeerd. Ook worden maatregelen voorgesteld om de toegang van patiënten tot bij wet geregelde zorgen in België beter te beschermen.

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Het Vlaamse navormingslandschap palliatieve zorg voor huisartsen

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Dynamic Linear Panel Regression Models with Interactive Fixed Effects

Moon, HR; Weidner, M; (2017) Dynamic Linear Panel Regression Models with Interactive Fixed Effects. Econometric Theory , 33 (1) pp. 158-195. 10.1017/S0266466615000328 . Green open access

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Reperfusion, conditioning and the ongoing search for the holy grail

Yellon, RL; Bell, RM; (2017) Reperfusion, conditioning and the ongoing search for the holy grail. The British Journal of Cardiology , 24 (1) pp. 35-38. 10.5837/bjc.2017.008 .

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Delayed rhabdomyolysis with paclitaxel, ifosfamide, carboplatin, and etoposide regimen: a case report

High-dose chemotherapy with autologous stem cell rescue is commonly used for the treatment of relapsed germ cell tumors. We report the first case of delayed rhabdomyolysis with paclitaxel, ifosfamide, carbopla...

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Using cone beam CT to assess the upper airway after surgery in children with sleep disordered breathing symptoms and maxillary-mandibular disproportions: a clinical pilot

The surgical excision of anatomic obstructions such as adenoids, palatine or lingual tonsils are commonly performed in children with sleep disordered breathing (SDB). Imaging studies measuring airway changes p...

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B-FAHF-2 plus oral immunotherapy (OIT) is safer and more effective than OIT alone in a murine model of concurrent peanut/tree nut allergy

Abstract

Background

Concurrent sensitization to peanut (PN) and tree nuts (TN), the most dangerous food allergies, is common. Current oral immunotherapy (OIT) is not fully satisfactory.

Objective

To determine if the herbal formula B-FAHF-2 (BF2) ameliorates PN/TN OIT adverse reactions and enhances persistence of a tolerant state.

Methods

Concurrently sensitized peanut, walnut (WN) and cashew (CSH) allergic mice received 1 day PN/WN/CSH rush OIT plus 3 weeks of maintenance dosing, with or without 3-weeks prior and 3-weeks BF2 co-treatment. Anaphylactic symptom scores, core body temperatures, plasma histamine levels, basophil numbers, antigen-specific IgE, cytokine levels, and IL-4, INF-γ and Foxp3 gene promoter DNA methylation status, and their correlation with final challenge symptom scores were determined.

Results

BF2+OIT treated mice experienced significantly fewer and less severe adverse reactions than OIT only treated mice (p<0.01) during the one-day rush OIT buildup dose phase. Both OIT only and BF2+OIT mice showed significant desensitization (p<0.01 and 0.001 respectively) at one-week post therapy challenge; being greater in BF2+OIT mice. All sham treated and 91% of OIT treated mice experienced anaphylaxis whereas only 21% of BF2+OIT treated mice exhibited reactions during 5-6 weeks of dose escalation single PN and TN challenges. Greater and more persistent protection in BF2+OIT mice was associated with significantly lower plasma histamine and IgE levels, increased IFN- γ/IL-4 and IL-10/IL-4 ratios, DNA re-methylation at the IL-4 promoter and de-methylation at IFN-γ and Foxp3 promoters. Final challenge symptom scores were inversely correlated with IL-4 DNA methylation levels (p<0.0002), and positively correlated with IFN-γ and Foxp3 gene promoter methylation levels (p<0.0011) (p<0.0165).

Conclusions and clinical relevance

Combined BF2/OIT therapy was safer and produced longer post treatment protection, and more tolerance-prone immunological and epigenetic modifications than OIT alone. BF2/OIT may provide an additional OIT option for patients with concurrent peanut/ tree nut and other food allergies.

This article is protected by copyright. All rights reserved.

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Contents Vol. 78, 2016

ORL 2016;78:I-IV

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Acknowledgement to Reviewers

ORL 2016;78:361

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Sul neomodernismo italiano. Corporale di Paolo Volponi e Petrolio di Pier Paolo Pasolini

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Nuovi realismi: il caso italiano. Definizioni, questioni, prospettive, ed by S. Contarini, M. P. De Paulis-Dalambert, A. Tosatti, Transeuropa, Massa 2016

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EX VIVO COMPUTED TOMOGRAPHIC EVALUATION OF MORPHOLOGY VARIATIONS IN EQUINE CERVICAL VERTEBRAE

Diagnostic imaging is one of the pillars in the clinical workup of horses with clinical signs of cervical spinal disease. An improved awareness of morphologic variations in equine cervical vertebrae would be helpful for interpreting findings. The aim of this anatomic study was to describe CT variations in left-right symmetry and morphology of the cervical and cervicothoracic vertebrae in a sample of horses. Postmortem CT examinations of the cervical spine for horses without congenital growth disorders were prospectively and retrospectively recruited. A total of 78 horses (27 foals, 51 mature horses) were evaluated. Twenty-six horses (33.3%) had homologous changes in which a transposition of the caudal part of the transverse process (caudal ventral tubercle) of C6 toward the ventral aspect of the transverse process of C7 was present (n = 10 bilateral, n = 12 unilateral left-sided, n = 4 unilateral right-sided). There was one horse with occipito-atlantal malformation, two horses with rudimentary first ribs bilaterally, and one horse with bilateral transverse processes at Th1, representing homeotic (transitional) vertebral changes. Chi-square tests identified no significant differences in the number of conformational variations between the group of mature horses with or without clinical signs (P = 0.81) or between the group of mature horses and the group of foals (P = 0.72). Findings indicated that, in this sample of horses, the most frequently identified variations were homologous variations (transposition of the caudal part of the transverse process of C6-C7) in the caudal equine cervical vertebral column. Homeotic (transitional) variations at the cervicothoracic vertebral column were less common. (C) 2015 American College of Veterinary Radiology.

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The practice of laparoscopic liver surgery in Belgium: a national survey

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Musculoskeletal Disease in Aged Horses and Its Management

Musculoskeletal disorders are the most prevalent health problem in aging horses. They are not life threatening, but are painful and an important welfare issue. Chronic joint disease (osteoarthritis) and chronic laminitis are the most prevalent. Treating osteoarthritis in the elderly horse is similar to treating performance horses, but aims at providing a stable situation with optimal comfort. Immediate medical treatment of flare-ups, long-term pain management, and adaptation of exercise and living conditions are the mainstays of treatment. Laminitis in the geriatric horse is related often to pituitary pars intermedia dysfunction, which may be treated with additional pergolide.

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Moving towards the goals of FP2020 : classifying contraceptives

With the renewed focus on family planning, a clear and transparent understanding is needed for the consistent classification of contraceptives, especially in the commonly used modern/traditional system. The World Health Organization Department of Reproductive Health and Research and the United States Agency for International Development (USAID) therefore convened a technical consultation in January 2015 to address issues related to classifying contraceptives. The consultation defined modern contraceptive methods as having a sound basis in reproductive biology, a precise protocol for correct use and evidence of efficacy under various conditions based on appropriately designed studies. Methods in country programs like Fertility Awareness Based Methods [such as Standard Days Method (SDM) and TwoDay Method], Lactational Amenorrhea Method (LAM) and emergency contraception should be reported as modern. Herbs, charms and vaginal douching are not counted as contraceptive methods as they have no scientific basis in preventing pregnancy nor are in country programs. More research is needed on defining and measuring use of emergency contraceptive methods, to reflect their contribution to reducing unmet need. The ideal contraceptive classification system should be simple, easy to use, clear and consistent, with greater parsimony. Measurement challenges remain but should not be the driving force to determine what methods are counted or reported as modern or not. Family planning programs should consider multiple attributes of contraceptive methods (e.g., level of effectiveness, need for program support, duration of labeled use, hormonal or nonhormonal) to ensure they provide a variety of methods to meet the needs of women and men.

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The unique peptidome: Taxon-specific tryptic peptides as biomarkers for targeted metaproteomics

The Unique Peptide Finder (http://ift.tt/29N7iBK) is an interactive web application to quickly hunt for tryptic peptides that are unique to a particular species, genus or any other taxon. Biodiversity within the target taxon is represented by a set of proteomes selected from a monthly updated list of complete and non-redundant UniProt proteomes, supplemented with proprietary proteomes loaded into persistent local browser storage. The software computes and visualizes pan and core peptidomes as unions and intersections of tryptic peptides occurring in the selected proteomes. In addition, it also computes and displays unique peptidomes as the set of all tryptic peptides that occur in all selected proteomes but not in any UniProt record not assigned to the target taxon. As a result, the unique peptides can serve as robust biomarkers for the target taxon, e.g. in targeted metaproteomics studies. Computations are extremely fast since they are underpinned by the Unipept database, the Lowest Common Ancestor algorithm implemented in Unipept and modern web technologies that facilitate in-browser data storage and parallel processing.

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Female genital mutilation : a literature review of the current status of legislation and policies in 27 African countries and Yemen

This article discusses the results of a literature review that has assessed the impact of Female Genital Mutilation (FGM) legislation in 28 countries (27 in Africa and Yemen) where FGM is concentrated. Evidence on the impact of FGM legislation was available on prevalence of FGM; changes in societal attitudes and perceptions of FGM; knowledge and awareness of FGM legislation and consequences, and the impact on medicalization. While the majority of countries have adopted legal frameworks prohibiting FGM, these measures have been ineffective in preventing and/or in accelerating the abandonment of the practice. Anti-FGM laws have had an impact on prevalence in only two countries where strict enforcement of legal measures has been complemented by robust monitoring, coupled with robust advocacy efforts in communities. Owing to poor enforcement and lax penalties, legal measures have had a limited impact on medicalization. Similarly, legal frameworks have had a limited impact on societal attitudes and perceptions of FGM, with evidence suggesting rigid enforcement of FGM laws has in some instances been counterproductive. Although evidence suggests legislation has not influenced the decline in FGM in the majority of countries, legal frameworks are nevertheless key components of a comprehensive response to the elimination and abandonment of the practice, and need to be complemented by measures that address the underlying socio-cultural causes that are the root of this practice.

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A global social contract to reduce maternal mortality : the human rights arguments and the case of Uganda

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Reproductive health research meeting

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A COMPARISON OF EXPERIMENTAL AND NUMERICAL BEHAVIOUR CHARACTERISTICS OF A SHIP ENTERING A LOCK USING BENCHMARK TEST DATA

This paper discusses several papers that were presented at the 3rd International Conference on Ship Manoeuvring in Shallow and Confined Water, which had a non-exclusive focus on Ship Behaviour in Locks. For this conference, experimental model test data obtained at Flanders Hydraulics Research had been made public and researchers were encouraged to compare numerical with experimental results [1]. Data of benchmark tests carried out both with self-propelled and captive models were used by researchers for comparison with various numerical tools. The objective of this paper is to give a selected overview of how accurately numerical tools are presently able to predict the hydrodynamic forces that occur on ships approaching locks. Based on this, the paper concludes that experiments and numerical tools complement each other.

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Kids save lives : ERC position statement on school children education in CPR : 'Hands that help: training children is training for life'

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Challenges with ship model tests in shallow water waves

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Achievement and maintenance of high quality resuscitation skills : Automated Learning with an Interactive Virtual Environment (ALIVE)

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Studies claiming efficacy of CPR training interventions: which skills should be assessed and how should data be reported to allow comparison?

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Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest

Introduction : In the 2010 Guidelines on Cardiopulmonary Resuscitation the relationship between compression rate and depth is considered to be a knowledge gap. In order to characterise this relationship, we performed an observational study in out-of-hospital cardiac arrest patients. We hypothesized that faster chest compressions are associated with decreased depth. Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation according to 2005 Guidelines, chest compression rate and depth were recorded using an accelerometer on a Zoll E-series monitor-defibrillator providing feedback for compressions <4 cm deep and <80/min. Compression depth was compared for rates <80/min, 80-120/min and >120/min. Multilevel models with repeated measurements of compression depth and rate, nested within patients, were used with depth as a continuous and as a categorical variable. A difference in depth ≥0.5 cm was considered clinically significant. Results are reported as means and standard error. Results and discussion : One hundred and thirty-three consecutive patients were analysed (213409 compressions). Of all compressions 2% were <80/min, 62% between 80-120/min and 36% >120/min, 36 % were <4 cm deep, 45% between 4 and 5 cm, 19% >5cm. Compression depth for rates 80-120/min was 4.6 (±0.003) cm compared to 3.9 (±0.003) cm for compressions >120/min (mean difference 0.7 cm, P<0.001). In 77 out of 133 (58 %) patients a statistically significant lower depth was observed for rates >120/min compared to rates 80-120/min, in 40 out of 133 (30%) this difference was also clinically significant. Moreover, the multilevel models showed that the deepest compression occurred at a rate of 64/min, with progressively lower depths at higher rates. Age and sex of the patient had no additional effect on depth. Conclusions : This study showed an association between higher compression rates and lower compression depths. To avoid superficial compressions, feedback devices should alert rescuers when compression rates become excessively high.

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The long-term outcome after severe trauma of children in Flanders (Belgium): a population-based cohort study using the International Classification of Functioning-related outcome score

Important long-term health problems have been described after severe paediatric trauma. The International Classification of Functioning (ICF) was developed as a universal framework to describe that health. We evaluated outcome in children after 'severe' trauma (defined as: hospitalised >48 h) by means of a questionnaire based on this ICF construct (IROS). Questionnaires were sent to children; one year after this trauma and to 'control' children without any previous 'severe' trauma. We created propensity score-matched pairs (n=133) and evaluated differences in health perception. IROS characteristics were investigated by means of Item Response Theory models. We then estimated the health state of each individual based on his/her response pattern (factor score z01) and investigated the effect of selected covariates with simple linear regression. Significant odds ratios for differences between matched groups (p<0.05) were observed for among others emotional problems, mobility, societal life and family burden, but not for chronic pain. Children in the trauma group showed, e.g. significant more physician (estimated relative risk R' 1.7) and psychologist (R' 3.5) visits. IROS primarily provides information from medium to high health burden levels and factor scores ranged from 0.41 (lowest) to 0.967 (highest burden). A significant impact on health burden could only be proven for the 'state at discharge' (p=0.015), although there was a tendency towards worse factor scores for children that were older, had a higher Injury Severity Score or after traffic injury. In conclusion, we showed that the burden of health problems for children and families after severe trauma is still high and physical, as well as psychosocial in nature. The health state at discharge seems to predict long-term outcome, which might be of importance in view of, e. g. trajectory assistance. IROS may provide an improved scoring system to evaluate outcome after (paediatric) injury or critical illness.

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Alcohol septal ablation to overcome shock

A 69-year-old man, known with hypertrophic obstructive cardiomyopathy (HOCM), was referred to our hospital because of progressive hypoxaemia and sepsis after admission for respiratory infection. Once at the emergency department, cardiopulmonary resuscitation, intubation and mechanical ventilation were necessary. Despite vasopressors and colloids the patient remained haemodynamically unstable. Because of the conviction that the distributive shock, caused by sepsis, was worsened by an associated obstructive shock related to the HOCM, an alcohol septal ablation (ASA) was attempted in these acute circumstances. Immediately after the ASA the gradient over the left ventricular outflow tract disappeared and the mean arterial pressure and oxygenation increased. Despite his cardiovascular recuperation the patient died a couple of days later. Nevertheless we achieved an improvement of the haemodynamic situation of this patient with HOCM by performing an urgent ASA.

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Effect of intravenous sildenafil on right and left ventricular function in pigs

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Media art and the resurrection of an image: motion and sculpturing

Can the photographic image be remediated in other media? Starting from this question, this article argues how 'un-plugged' media art experiments can create extensions of the photographic image by introducing a new setting in time or space. An analysis of flipbooks, based on the work of Volker Gerling, is given as an example of a vivifying extension in time that nonetheless underscores the nature of the photographic image. Next, an analysis of the life-sized sculptural installations and models of Hans Op de Beeck demonstrates how a spectator, in an encounter with a spatial extension, can participate in the resuscitation of a photographic image.

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Management of crush-related injuries after disasters

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Acute respiratory failure that complicates the resuscitation of pediatric patients with scald injuries

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Should semiautomatic defibrillators be used by emergency medical technicians in Belgium

Early external defibrillation is the single most effective intervention in patients with out-of-hospital cardiac arrest. Literature data indicate that instructing emergency medical technicians (EMTs) to use defibrillators is beneficial, provided the local emergency medical system is well organized. We tried to estimate the potential benefit of early defibrillation in some centres in Belgium by retrospectively analyzing the data from the Belgian Cardio-Pulmonary-Cerebral Resuscitation Registry collected between 1983 and 1987 in Belgian centres with a Mobile Intensive Care Unit (MICU). The data show that 2310 out of 3371 patients (69%) were first attended by the EMTs; on subsequent arrival of the MICU-teams, 584 of these 2310 patients i.e. 17% of the whole study population, presented with ventricular fibrillation. Analysis of estimated time factors in these 2310 patients revealed that the median time interval between collapse and start of resuscitation by EMTs was 8 min; the median time interval between collapse and start of MICU-resuscitation attempts was 16 min. The duration of EMT-resuscitation before MICU-arrival was probably more than 5 min and 10 min in 58% and 23% of the cases respectively. It is concluded that EMTs can be expected to reach a substantial number of ventricular fibrillation victims within a few minutes after the collapse and many minutes before arrival of the MICU. Therefore, training of EMTs in the use of semi-automatic defibrillators seems worthwhile in MICU-served regions in Belgium.

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Talus fracture in a 4-year-old child

Fracture of the talus is uncommon in childhood. We report a case of talar neck fracture that occurred in a 4-year-old girl. We present the radiological findings, the orthopaedic follow-up and the clinical outcome.

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Altered Fatty Acid Metabolism and Reduced Stearoyl-Coenzyme A Desaturase Activity in Asthma

Abstract

Background

Fatty acids and lipid mediator signaling play an important role in the pathogenesis of asthma, yet this area remains largely under-explored. The aims of this study were (i) to examine fatty acid levels and their metabolism in obese and non-obese asthma patients and (ii) to determine the functional effects of altered fatty acid metabolism in experimental models.

Methods

Medium- and long-chain fatty acid levels were quantified in serum from 161 human volunteers by LC/MS. Changes in stearoyl-coenzyme A desaturase (SCD) expression and activity was evaluated in the ovalbumin (OVA) and house dust mite (HDM) murine models. Primary human bronchial epithelial cells from asthma patients and controls were evaluated for SCD expression and activity.

Results

The serum desaturation index (an indirect measure of SCD) was significantly reduced in non-obese asthma patients and in the OVA murine model. SCD1 gene expression was significantly reduced within the lungs following OVA or HDM challenge. Inhibition of SCD in mice promoted airway hyperresponsiveness. SCD1 expression was suppressed in bronchial epithelial cells from asthma patients. IL-4 and IL-13 reduced epithelial cell SCD1 expression. Inhibition of SCD reduced surfactant protein C expression and suppressed rhinovirus-induced IP-10 secretion, which was associated with increased viral titers.

Conclusions

This is the first study to demonstrate decreased fatty acid desaturase activity in humans with asthma. Experimental models in mice and human epithelial cells suggest that inhibition of desaturase activity leads to airway hyperresponsiveness and reduced anti-viral defense. SCD may represent a new target for therapeutic intervention in asthma patients.

This article is protected by copyright. All rights reserved.

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Establishment and characterization of a clear cell odontogenic carcinoma cell line with EWSR1-ATF1 fusion gene

Publication date: June 2017
Source:Oral Oncology, Volume 69
Author(s): Satoko Kujiraoka, Takaaki Tsunematsu, Yukiko Sato, Maki Yoshida, Ayataka Ishikawa, Rei Tohyama, Michio Tanaka, Yutaka Kobayashi, Tomoyuki Kondo, Aya Ushio, Kunihiro Otsuka, Mie Kurosawa, Masako Saito, Akiko Yamada, Rieko Arakaki, Hirokazu Nagai, Hiromasa Nikai, Kengo Takeuchi, Toshitaka Nagao, Youji Miyamoto, Naozumi Ishimaru, Yasusei Kudo
ObjectiveClear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumor (MOT) characterized by sheets and lobules of vacuolated and clear cells. To understand the biology of CCOC, we established a new cell line, CCOC-T, with EWSR1-ATF1 fusion gene from a mandible tumor with distant metastasis and characterized this cell line.Materials and methodsTo detect the EWSR1-ATF1 fusion gene, we used three CCOC cases, including the present case, by RT-PCR and FISH analysis. We characterized established CCOC-T cells by checking cell growth, invasion and the expression of odontogenic factors and bone-related factors. Moreover, the gene expression profile of CCOC-T cells was examined by microarray analysis.ResultsHistologically, the primary tumor was comprised of cords and nests containing clear and squamoid cells separated by fibrous septa. In addition, ameloblastomatous islands with palisaded peripheral cells were observed, indicating probable odontogenic origin. This tumor expressed the fusion gene EWSR1-ATF1, which underlies the etiology of hyalinizing clear cell carcinoma (HCCC) and potentially that of CCOC. We found a breakpoint in the EWSR1-ATF1 fusion to be the same as that reported in HCCC. Established CCOC-T cells grew extremely slowly, but the cells showed highly invasive activity. Moreover, CCOC-T cells expressed bone-related molecules, odontogenic factors, and epithelial mesenchymal transition (EMT)-related molecules.ConclusionTo the best of our knowledge, this is the first report on the establishment of a CCOC cell line. CCOC-T cells serve as a useful in vitro model for understanding the pathogenesis and nature of MOT.



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Human papillomavirus genotypes and risk of head and neck cancers: Results from the HeNCe Life case-control study

Publication date: June 2017
Source:Oral Oncology, Volume 69
Author(s): Claudie Laprise, Sreenath Arekunnath Madathil, Nicolas F. Schlecht, Geneviève Castonguay, Denis Soulières, Phuc Felix Nguyen-Tan, Paul Allison, François Coutlée, Michael Hier, Marie-Claude Rousseau, Eduardo L. Franco, Belinda Nicolau
ObjectiveHuman papillomaviruses (HPV) are changing dramatically the epidemiologic landscape of head and neck cancers (HNCs). Their role in the aetiology of these cancers varies widely among HNCs subsites, sex and geographical regions worldwide. We describe HPV prevalence and its association with HNCs risk overall and by anatomical subsite in a sample of Canadians.Materials and methodsThe HeNCe Life study recruited 460 incident HNCs cases and 458 controls frequency-matched by age and sex from four Montreal hospitals in 2005–2013. We tested oral rinse and oral brush specimens for mucosal HPV genotypes. HPV positivity was categorized hierarchically as either negative, exclusively non-α-9 species types, α-9 types other than HPV16, and HPV16. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the associations between HPV and HNCs using unconditional logistic regression, controlling for confounders.ResultsThe prevalence of HPV infection among controls and cases was 14.5% and 41.2% in oral rinse and 3.1% and 24.4% in oral brush samples, respectively. HPV16 was the predominant genotype with an oral rinse and oral brush prevalence of 26.3% and 16.2% among cases and 2.4% and 0.2% among controls, respectively. HPV infection was associated with an increased risk of HNCs overall (OR=4.18; 95% CI, 2.94–5.95) and oropharyngeal cancer only (OR=10.3; 95% CI, 6.8–15.7). HNCs and oropharyngeal cancer were strongly associated with HPV16 (OR=18.1; 95% CI, 9.1–35.8, and OR=47.2; 95% CI, 23.1–96.6, respectively).ConclusionHPV infection, particularly HPV16, was associated with an increased HNCs risk, most strongly for oropharyngeal cancers.



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Clinical information modeling processes for semantic interoperability of electronic health records : systematic review and inductive analysis

Objective: This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. Material and Methods: Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. Results: Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. Discussion: Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. Conclusion: Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler.

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Prevalence, associated factors and management implications of left ventricular outflow tract obstruction in Takotsubo cardiomyopathy: a two-year, two-center experience

Background: Some patients with Takotsubo cardiomyopathy (TTC) develop cardiogenic shock due to left ventricular outflow tract (LVOT) obstruction -there is, however, a paucity of data regarding this condition. Methods: Prevalence, associated factors and management implications of LVOT obstruction in TTC was explored, based on two-year data from two Belgian heart centres. Results: A total of 32 patients with TTC were identified out of 3,272 patients presenting with troponin-positive acute coronary syndrome. In six patients diagnosed with TTC (19%), a significant LVOT obstruction was detected by transthoracic echocardiography. Patients with LVOT obstruction were older and had more often septal bulging, and presented more frequently in cardiogenic shock as compared to those without LVOT obstruction (P < 0.05). Moreover, all patients with LVOT obstruction showed systolic anterior motion (SAM) of the anterior mitral valve leaflet, which was associated with a higher grade of mitral regurgitation (2.2 +/- 0.7 vs. 1.0 +/- 0.6, P< 0.001). Adequate therapeutic management including fluid resuscitation, cessation of inotropic therapy, intravenous beta-blocker, and the use of intra-aortic balloon pump resulted in non-inferior survival in TTC patients with LVOT obstruction as compared to those without LVOT obstruction. Conclusions: TTC is complicated by LVOT obstruction in approximately 20% of cases. Older age, septal bulging, SAM-induced mitral regurgitation and hemodynamic instability are associated with this condition. Timely and accurate diagnosis of LVOT obstruction by echocardiography is key to successful management of these TTC patients with LVOT obstruction and results in a non-inferior outcome as compared to those patients without LVOT obstruction.

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Re-evaluating currently available data and suggestions for planning randomised controlled studies regarding the use of hydroxyethyl-starch in critically ill patients: a multidisciplinary statement

Introduction: Hydroxyethyl starch (HES) is a commonly used colloid in critically ill patients. However, its safety has been questioned in recent studies and meta-analyses. Methods: We re-evaluated prospective randomised controlled trials (RCT) from four meta-analyses published in 2013 that compared the effect of HES with crystalloids in critically ill patients, focusing on the adherence to 'presumably correct indication'. Regarding the definition of 'presumably correct indication', studies were checked for the following six criteria (maximum six points): short time interval from shock to randomisation (<6 h), restricted use for initial volume resuscitation, use of any consistent algorithm for haemodynamic stabilisation, reproducible indicators of hypovolaemia, maximum dose of HES, and exclusion of patients with pre-existing renal failure or renal replacement therapy. Results: Duration of fluid administration ranged from 90 min up to a maximum of 90 days. Four studies considered follow-up until 90-day mortality, three studies 28-/30-day mortality, whereas four studies reported only early mortality. Included studies showed a large heterogeneity of the indication score ranging between 1 and 4 points with a median (25%; 75% quartile) of 4 (2; 4). Conclusions: The most important question, whether or not HES may be harmful when it is limited to immediate haemodynamic stabilisation, cannot be answered yet in the absence of any study sufficiently addressing this question. In order to overcome the limitations of most of the previous studies, we now suggest an algorithm emphasising the strict indication of HES. Additionally, we give a list of suggestions that should be adequately considered in any prospective RCT in the field of acute volume resuscitation in critically ill patients.

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Achievement and maintenance of high quality resuscitation skills : Automated Learning with an Interactive Virtual Environment (ALIVE)

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Assessing basic life support skills without an instructor: is it possible?

Background : Current methods to assess Basic Life Support skills (BLS; chest compressions and ventilations) require the presence of an instructor. This is time-consuming and comports instructor bias. Since BLS skills testing is a routine activity, it is potentially suitable for automation. We developed a fully automated BLS testing station without instructor by using innovative software linked to a training manikin. The goal of our study was to investigate the feasibility of adequate testing (effectiveness) within the shortest period of time (efficiency). Methods : As part of a randomised controlled trial investigating different compression depth training strategies, 184 medicine students received an individual appointment for a retention test six months after training. An interactive FlashTM (Adobe Systems Inc., USA) user interface was developed, to guide the students through the testing procedure after login, while Skills StationTM software (Laerdal Medical, Norway) automatically recorded compressions and ventilations and their duration ("time on task"). In a subgroup of 29 students the room entrance and exit time was registered to assess efficiency. To obtain a qualitative insight of the effectiveness, student's perceptions about the instructional organisation and about the usability of the fully automated testing station were surveyed. Results : During testing there was incomplete data registration in two students and one student performed compressions only. The average time on task for the remaining 181 students was three minutes (SD 0.5). In the subgroup, the average overall time spent in the testing station was 7.5 minutes (SD 1.4). Mean scores were 5.3/6 (SD 0.5, range 4.0-6.0) for instructional organisation and 5.0/6 (SD 0.61, range 3.1-6.0) for usability. Students highly appreciated the automated testing procedure. Conclusions : Our automated testing station was an effective and efficient method to assess BLS skills in medicine students. Instructional organisation and usability were judged to be very good. This method enables future formative assessment and certification procedures to be carried out without instructor involvement. Trial registration B67020097543

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