Source:Annals of Allergy, Asthma & Immunology
Author(s): Philip Hei Li, Annette Wagner, Ryszard Rutkowski, Krzysztof Rutkowski
http://ift.tt/2oRUUq2
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Παρασκευή 28 Απριλίου 2017
Vaccine allergy
Source:Annals of Allergy, Asthma & Immunology
Author(s): Philip Hei Li, Annette Wagner, Ryszard Rutkowski, Krzysztof Rutkowski
http://ift.tt/2oRUUq2
Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis
Publication date: Available online 27 April 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jessica W. Hui, Jason Ong, James J. Herdegen, Hajwa Kim, Christopher D. Codispoti, Vahid Kalantari, Mary C. Tobin, Robert P. Schleimer, Pete S. Batra, Phillip S. LoSavio, Mahboobeh Mahdavinia
BackgroundIt is widely known that patients with chronic rhinosinusitis (CRS) commonly experience sleep disruption. Many of these patients have the associated diagnosis of obstructive sleep apnea (OSA). However, little is known about the risk factors for developing OSA in the CRS population.ObjectiveTo identify the risk factors for OSA in CRS to determine who should be screened for OSA among patients with CRS.MethodsWe evaluated a large cohort of patients with confirmed diagnostic criteria for CRS. Patient medical records were reviewed to identify those with OSA confirmed by overnight polysomnography. Records were further reviewed for demographic information (age, sex, race, and ethnicity), body mass index, and medical history, including the presence of nasal polyps, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, and eczema. The number of endoscopic sinus operations, duration of CRS, presence of subjective smell loss, and computed tomography Lund-Mackay score were also ascertained.ResultsA total of 916 patients with CRS were included in the study. Implementation of a multivariable regression model for identifying adjusted risk factors revealed that African American patients had a significantly higher risk for OSA than white patients, with an adjusted odds ratio of 1.98 (95% confidence interval, 1.19–3.29). Furthermore, patients with CRS without nasal polyps were at higher risk for OSA, with an odds ratio of 1.63 (95% confidence interval, 1.02–2.61) compared with patients with CRS with nasal polyps.ConclusionAfrican American patients with CRS were at higher risk for OSA compared with white patients, and this patient group needs to be screened for OSA.
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Systemic reaction to timothy grass pollen sublingual immunotherapy
Source:Annals of Allergy, Asthma & Immunology
Author(s): Anita Wasan, Anil Nanda
http://ift.tt/2oRX8pv
Cariogenic properties of Streptococcus mutans clinical isolates with sortase defects
Source:Archives of Oral Biology, Volume 81
Author(s): Jinthana Lapirattanakul, Yukiko Takashima, Pornpen Tantivitayakul, Thaniya Maudcheingka, Pattarawadee Leelataweewud, Kazuhiko Nakano, Michiyo Matsumoto-Nakano
ObjectiveIn Streptococcus mutans, a Gram-positive pathogen of dental caries, several surface proteins are anchored by the activity of sortase enzyme. Although various reports have shown that constructed S. mutans mutants deficient of sortase as well as laboratory reference strains with a sortase gene mutation have low cariogenic potential, no known studies have investigated clinical isolates with sortase defects. Here, we examined the cariogenic properties of S. mutans clinical isolates with sortase defects as well as caries status in humans harboring such defective isolates.DesignSortase-defective clinical isolates were evaluated for biofilm formation, sucrose-dependent adhesion, stress-induced dextran-dependent aggregation, acid production, and acid tolerance. Additionally, caries indices of subjects possessing such defective isolates were determined.ResultsOur in vitro results indicated that biofilm with a lower quantity was formed by sortase-defective as compared to non-defective isolates. Moreover, impairments of sucrose-dependent adhesion and stress-induced dextran-dependent aggregation were found among the isolates with defects, whereas no alterations were seen in regard to acid production or tolerance. Furthermore, glucan-binding protein C, a surface protein anchored by sortase activity, was predominantly detected in culture supernatants of all sortase-defective S. mutans isolates. Although the sortase-defective isolates showed lower cariogenic potential because of a reduction in some cariogenic properties, deft/DMFT indices revealed that all subjects harboring those isolates had caries experience.ConclusionsOur findings suggest the impairment of cariogenic properties in S. mutans clinical isolates with sortase defects, though the detection of these defective isolates seemed not to imply low caries risk in the subjects harboring them.
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The effects of fluoride, strontium, theobromine and their combinations on caries lesion rehardening and fluoridation
Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Frank Lippert
ObjectiveThe aim was to investigate the effects of fluoride, strontium, theobromine and their combinations on caries lesion rehardening and fluoridation (EFU) under pH cycling conditions.DesignHuman enamel specimens were demineralized at 37°C for 24h using a pH 5.0 solution containing 50mM lactic acid and 0.2% Carbopol 907 which was 50% saturated with respect to hydroxyapatite. Lesions were assigned to nine treatment groups (n=16) based on Knoop surface microhardness indentation length.Treatmentaqueous solutions were: placebo, 11.9mM sodium fluoride (F), 23.8mM sodium fluoride (2×F), 1.1mM strontium chloride hexahydrate (Sr), 1.1mM F theobromine, Sr+theobromine, F+Sr, F+theobromine, F+Sr+theobromine. Lesions were pH cycled for 5d (daily protocol: 3×1min-treatment; 2×60min-demineralization; 4×60min & overnight-artificial saliva). Knoop indentation length was measured again and%surface microhardness recovery (%SMHr) calculated. EFU was determined using the acid-etch technique. Data were analysed using ANOVA.ResultsModel showed fluoride dose-response for both variables (2×F>F>placebo). For%SMHr, F+Sr+/−theobromine resulted in more rehardening than F, however less than 2×F. F+theobromine was similar to F. For EFU, F+Sr was inferior to F, F+theobromine and F+Sr+theobromine which were similar and inferior to 2×F. In absence of fluoride, Sr, theobromine or Sr+theobromine were virtually indistinguishable from placebo and inferior to F.ConclusionsIt can be concluded that a) strontium aids rehardening but not EFU and only in presence of fluoride; b) theobromine does not appear to offer any anti-caries benefits in this model; c) there are no synergistic effects between strontium and theobromine in the presence or absence of fluoride.
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Lymphoepithelioma-like carcinoma of the upper urinary tract
Abstract
In this report, we summarized the clinicopathologic features of ten cases of lymphoepithelioma-like carcinoma (LELC) of the upper urinary tract (ureter n = 6; renal pelvis n = 4), a rare variant of urothelial cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. The initial diagnosis was made on radical nephrectomy in five cases, nephroureterectomy in three cases, and ureterectomy in two others. Four patients had pathologic stage T1 (n = 2) or T2 (n = 2) tumors, and six patients had stage pT3 disease. Microscopically, all tumors contained pure (n = 3) or predominant (n = 7) LELC, which composed 60 to 80% of the entire tumor. Non-LELC tumor component was adenocarcinoma (n = 2), spindle cell carcinoma (n = 1), or high-grade conventional urothelial carcinoma (n = 4). The LELC component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. Immunohistochemical staining showed LELC to be positive for cytokeratin AE1/AE3, CK7, CK34ßE12 (rare cells), CK5/6 (rare cells), and CK20 (rare cells); rare cells were p40 positive. GATA 3 was positive in all cases in a variable proportion of cells (20–80%). Lymphoid markers showed a polyclonal proliferation of predominant T cells admixed with B cells. In situ hybridization for the HPV genome was negative in all ten cases. Survival analysis showed no differences between LELC and conventional upper urinary tract urothelial carcinoma, pT classification being the only significant prognostic parameter. Morphologic recognition and distinction from other (non-)neoplastic lesions with prominent lymphoid stroma are critical for its clinical management.
http://ift.tt/2pHL66Z
Adaptation of the vertical vestibulo-ocular reflex in cats during low-frequency vertical rotation
Source:Auris Nasus Larynx
Author(s): Hiroaki Fushiki, Motoyoshi Maruyama, Hideo Shojaku
ObjectiveWe examined plastic changes in the vestibulo-ocular reflex (VOR) during low-frequency vertical head rotation, a condition under which otolith inputs from the vestibular system are essential for VOR generation.MethodsFor adaptive conditioning of the vertical VOR, 0.02Hz sinusoidal pitch rotation for one hour about the earth's horizontal axis was synchronized with out-of-phase vertical visual stimulation from a random dot pattern.ResultsA vertical VOR was well evoked when the upright animal rotated around the earth-horizontal axis (EHA) at low frequency due to the changing gravity stimulus and dynamic stimulation of the otoliths. After adaptive conditioning, the amplitude of the vertical VOR increased by an average of 32.1%.ConclusionOur observations showing plasticity in the otolithic contribution to the VOR may provide a new strategy for visual-vestibular mismatch training in patients with otolithic disorders. This low-frequency vertical head rotation protocol also provides a model for investigating the mechanisms underlying the adaptation of VORs mediated by otolith activation.
http://ift.tt/2qgW6oG
The effect of terrain on entheseal changes in the lower limbs
Abstract
One of the main factors involved in entheseal changes (EC) aetiology may be related to the physiological limits of biomechanical loading fixed during bone development, such that higher load during childhood and the adolescent growth spurt leads to a lower frequency of EC during adulthood. In this sense, it is possible that ECs may be related to overloading beyond an individual's normal physiological limits as established during childhood and adolescence.
This meta-analysis tested this aetiological possibility by studying the influence of terrain on the entheses of the lower extremities. The hypothesis is that individuals who inhabited rugged terrain have lower EC than those living in flat terrain. This is because biomechanical loads associated with rugged terrain will lead to a higher normal capacity (defined during skeletal development) mitigating the probability of overloading compared to those living in flat terrain who will therefore have a higher frequency of ECs. To test this, papers reporting EC frequencies in the lower limbs were analysed alongside the local terrain. Terrain was defined into two categories: flat or rugged based on altimetry profile, i.e. the average elevation gains and losses along four specific paths (North-South, East-West, Northwest-Southeast, Southwest-Northeast). Odds ratios were calculated to compare rugged and flat terrain.
The overall results are consistent with the hypothesis that overloading is a factor in EC aetiology. However, when the analysis is conducted by sex and side, this general trend does not always occur. Limitations such as the lack of standardized age ranges could be affecting the outcome, i.e. older individuals have a higher frequency of ECs. The findings of this analysis suggest that the theoretical assumptions associated with the cause of ECs require further testing and evaluation.
http://ift.tt/2oHlsiD
Adaptation of the vertical vestibulo-ocular reflex in cats during low-frequency vertical rotation
We examined plastic changes in the vestibulo-ocular reflex (VOR) during low-frequency vertical head rotation, a condition under which otolith inputs from the vestibular system are essential for VOR generation.
http://ift.tt/2oHbXzZ
Innate Immune Gene Transcript Level Associated with the Infection of Macrophages with Ectromelia Virus in Two Different Mouse Strains
Viral Immunology , Vol. 0, No. 0.
http://ift.tt/2qgfYs7
High Rate of Hepatitis B Virus Surface Antigenemia Among People Living with HIV/AIDS in Kakuri, Kaduna State, North West Nigeria
Viral Immunology , Vol. 0, No. 0.
http://ift.tt/2pdP99q
Visual analogue scale (VAS) as a monitoring tool for daily changes in asthma symptoms in adolescents: a prospective study
Success in asthma management hinges on patients' competency to detect and respond to ever-changing symptom severity. Thus, it is crucial to have reliable, simple, and sustainable methods of symptom monitoring ...
http://ift.tt/2oGjGON
Targeting Circulating Leukocytes and Pyroptosis during Ex Vivo Lung Perfusion Improves Lung Preservation.
Background: The role of the circulating leukocytes in lungs and their relationship with circulating proinflammatory cytokines during ischemia-reperfusion injury is not well understood. Using ex vivo lung perfusion (EVLP) to investigate the pathophysiology of isolated lungs, we aimed to identify a therapeutic target to optimize lung preservation leading to successful lung transplantation. Methods: Rat heart-lung blocks were placed on EVLP for 4 hours with or without a leukocyte-depleting filter (LF). Following EVLP, lung grafts were transplanted, and posttransplant outcomes were compared. Results: Lung function was significantly better in lung grafts on EVLP with a LF than in lungs on EVLP without a LF. The interleukin (IL)-6 levels in the lung grafts and EVLP perfusate were also significantly lower after EVLP with a LF. Interestingly, IL-6 levels in the perfusate did not increase after the lungs were removed from the EVLP circuit, indicating that the cells trapped by the LF were not secreting IL-6. The trapped cells were analyzed with flow cytometry to detect apoptosis and pyroptosis; 26% were pyroptotic (Caspase-1-positive). After transplantation, there was better graft function and less inflammatory response if a LF was used or a caspase-1 inhibitor was administered during EVLP. Conclusions: Our data demonstrated that circulating leukocytes derived from donor lungs, and not circulating proinflammatory cytokines substantially impaired the quality of lung grafts through Caspase-1 induced pyroptotic cell death during EVLP. Removing these cells with a LF and/or inhibiting pyroptosis of the cells can be a new therapeutic approach leading to long-term success following lung transplantation. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2pq1WEr
http://ift.tt/2pq1WEr
Chronic AMR in Liver Transplant: Validation of the 1-Year cAMR score's Ability to Determine Long-Term Outcome.
Background: A proposed chronic antibody-mediated rejection (AMR) score has recently predicted 50%10-year death censored allograft loss in patients with Donor Specific Alloantibodies (DSA) Mean Florescence Intensity (MFI) >10 000 and requires confirmation in patients with lower MFI (1000-10 000). Methods: All patients who underwent liver transplantation (LT) from 1/00-4/09, had DSA (MFI >=1000) in serum 10-14 months post-LT, and had a protocolized liver biopsy were evaluated (n=230). The previously proposed chronic AMR (cAMR) score was used to risk-stratify putative chronic AMR in DSA+ patients with MFI from 1000-10 000. Results: The MFI distribution of DSA+ recipients were as follows: 66% had MFI 1000-4999, 14% had MFI 5000-10 000 and 20% had MFI >10 000. The cAMR score distribution on 1-year protocol liver biopsy was found to be: 41% had a score 27.5. MFI correlated with 1-year cAMR category (27.5, 29% vs. 42% when MFI was 1000-10 000 vs. MFI >10 000; p=0.047). In patients with a cAMR score 13 (p=0.004) in DSA+ patients with MFI 1000-10 000. DSA MFI>10 000 vs. MFI 1000-10 000 at 1-year was also more likely to persist at 5-years (95% vs. 68%; p
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http://ift.tt/2qf3VOR
High tacrolimus clearance is a risk factor for acute rejection in the early phase after renal transplantation.
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A Short Term Comparison of Cartilage with Temporalis Fascia Graft Tympanoplasty in Paediatric and Adolescent Population
Abstract
To compare the anatomic and functional outcomes of the cartilage and temporalis fascia graft materials in type 1 tympanoplasty in paediatric and adolescent population. A total of 55 patients aged <18 years who required type 1 tympanoplasty were selected. 30 patients underwent cartilage palisade tympanoplasty and 25 using temporalis fascia grafts. The age, the side of the operated ear, the operative technique, pre- and post operative pure tone and impedance audiological results, and the status of the graft were noted. Graft was considered taken up if there was successful closure of tympanic membrane perforation. At the end of 6 months, the graft take rate for cartilage was 90% and for temporalis fascia it was 80% (p > 0.05). ABG closure ratio in cartilage group was 58.54 ± 23.10% and in temporalis fascia group was 56.46 ± 27.4% (p > 0.05). Pre operatively all patients had type B tympanogram in both the groups. While post operatively either type A or C curve was seen in 80% patients of cartilage and 68% patients of temporalis fascia group. Hearing outcomes and graft success rates were high in both fascia and cartilage graft groups but not significantly different.
http://ift.tt/2ptn9zp
Surgical Outcome of Mastoid Cavity Obliteration Using Postauricular Composite Bone with Periosteum Flap
Abstract
This study was aimed to evaluate surgical outcome of patients undergoing obliteration of mastoid cavity with postauricular composite osteo-periosteal flap. This interventional study was carried out on 100 patients having unsafe CSOM from Nov. 2012 to Oct. 2014 who underwent canal wall down mastoidectomy with tympanoplasty and obliteration of cavity using composite osteo-periosteal flap. The primary outcome measure was control of suppuration and creation of dry, low-maintenance mastoid cavity, which was assessed using Merchant et al. grading system. At the end of 1 year follow-up, 89% patients had Grade 0 summary score while Grade 3 which was considered as failure of control of infection was not obtained in any patient during the entire follow-up period. Mastoid cavity obliteration using composite osteo-periosteal flap is an effective technique to avoid cavity problems.
http://ift.tt/2ppo55z
Cardiovascular risk in patients with rheumatoid arthritis
Abstract
Substantial epidemiologic data have shown an increased risk of cardiovascular (CV) disease in rheumatoid arthritis (RA) patients. Traditional CV risk factors may partly contribute to CV disease in RA; however, current evidence underlines the important role of inflammation in the pathogenesis of atherosclerosis and amplification of CV risk. Interplays between inflammation and lipid metabolism in the development of atherosclerosis have been established by recent scientific advances. Atherosclerosis is currently viewed as an inflammatory disease, and modifications of lipoproteins during inflammation accelerate atherogenesis. The role of inflammation in the increased CV risk in RA has been further demonstrated by the CV protective effect of methotrexate and TNF antagonists, particularly in patients responding to these treatments. The management of CV risk in RA should include the use of effective disease-modifying anti-rheumatic drugs to control disease activity and the treatment of traditional CV risk factors.
http://ift.tt/2qnH5AF
Eosinophilic Otitis Media: the Aftermath of Eosinophil Extracellular Trap Cell Death
Abstract
Purpose of Review
Eosinophilic otitis media (EOM) is a refractory disease characterized by the accumulation of eosinophils in middle ear effusion and mucosa. We summarize current knowledge regarding the clinical characteristics and management of EOM. Although eosinophil activation in inflamed foci is involved in the pathogenesis of EOM, little is known about the fate of the eosinophils and aftermath of their cell death. We discuss the possibility that eosinophils undergo non-apoptotic cell death that worsens tissue damage and increases effusion viscosity.
Recent Findings
Unlike chronic otitis media, EOM is strongly associated with an allergic background. Corticosteroids are currently the only effective pharmacological treatment, and surgical intervention is often required. Mucosal eosinophils infiltrate extensively into the middle ear cavity where they are stimulated by locally produced activators including interleukin-5 and eotaxin. The eosinophils undergo cytolysis in the effusion, which represents a major fate of activated eosinophils in vivo. Recent data revealed cytolysis could be renamed as extracellular trap cell death (ETosis). ETosis represents suicidal cell death involving total cell degranulation and development of sticky chromatin structures (extracellular traps (ETs)). The characteristics of eosinophil- and neutrophil-derived ET polymers might contribute to the difference in viscosity of secretions between EOM and common chronic otitis media.
Summary
The extracellular products remaining after eosinophil ETosis are an important aspect of EOM pathology. The concept of ETosis also has novel implications for potential therapeutic modalities in various eosinophilic disorders.
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Bioprinting of Biomimetic Skin containing Melanocytes
Abstract
This study reports a three-dimensional (3D) bioprinting technique that is capable of producing a full-thickness skin model containing pigmentation. Multiple layers of fibroblasts (FB)-containing collagen hydrogel precursor were printed and crosslinked through neutralization using sodium bicarbonate, constituting the dermal layer. Melanocytes (MC) and keratinocytes (KC) were sequentially printed on top of the dermal layer to induce skin pigmentation upon subsequent air-liquid interface culture. Histological analysis was performed not only to confirm the formation of distinct skin layers, but also to identify the presence of pigmentation. The bioprinted skin structure showed the dermal and epidermal layers as well as the terminal differentiation of the KC that formed the stratum corneum. Moreover, the MC-containing epidermal layer showed freckle-like pigmentations at the dermal-epidermal junction, without the use of external ultraviolet light or chemical stimuli. The presented method offers the capability of producing engineered ephelides in biomimetic skin, thus rendering 3D bioprinting techniques as productive on-demand options for the creation of skin models available for therapeutic or research use.
This article is protected by copyright. All rights reserved.
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Genetics and other factors in the aetiology of female pattern hair loss
Abstract
Pattern hair loss is the most common form of hair loss in both women and men. Male pattern hair loss, also termed male androgenetic alopecia (M-AGA), is an androgen-dependent trait that is predominantly genetically determined. Androgen-mediated mechanisms are probably involved in FPHL in some women but the evidence is less strong than in M-AGA; and other non-androgenic pathways, including environmental influences, may contribute to the aetiology. Genome-wide association studies (GWASs) have identified several genetic loci for M-AGA and have provided better insight into the underlying biology. However, the role of heritable factors in female pattern hair loss (FPHL) is largely unknown. Recently published studies have been restricted to candidate gene approaches and could not clearly identify any susceptibility locus/gene for FPHL but suggest the aetiology differs substantially from that of M-AGA. Hypotheses about possible pathomechanisms of FPHL as well as the results of the genetic studies performed to date are summarized.
This article is protected by copyright. All rights reserved.
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Syndecan-1 regulates dendritic cell migration in cutaneous hypersensitivity to haptens
Abstract
In human dendritic cells (DC), we previously demonstrated in vitro that syndecan-1 (SDC1) is downregulated during maturation correlating with enhanced motility.
We investigated the effects of SDC1 on DC migration in vivo during TNCB(2,4,6-trinitro-1-chlorobenzene)-induced cutaneous hypersensitivity reaction (CHS) in mice.
We show that DC in SDC1-deficient mice migrated faster and at a higher rate to lymph nodes draining the hapten-painted skin. Adoptive transfer of SDC1-deficient hapten- and fluorochrome-labelled DC into wild type (WT) mice led to increased and faster migration of DC to paracortical lymph nodes, and to a stronger CHS compared to WT DC. In SDC1-/- mice, CCR7 remains longer on the DC surface within the first 15 min maturation (or: after LPS-induced maturation). In addition, a time-dependent up-regulation of CCL2, CCL3, VCAM1 and talin was found during maturation in SDC1-/- DC. However, no difference in T cell stimulating capacity of SDC1-deficient DC was found compared to WT DC. Mechanistically, SDC1-deficient DC showed enhanced migration towards CCL21 and CCL19. This may result from functional overexpression of CCR7 in SDC1-/- DC. Increased and accelerated migration of otherwise functionally intact SDC1-deficient DC leads to an exacerbated CHS. Based on our results, we conclude that SDC1 on DC negatively regulates DC migration.
This article is protected by copyright. All rights reserved.
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Tetrodotoxin, Epinephrine, and Chemical Permeation Enhancer Combinations in Peripheral Nerve Blockade.
BACKGROUND: Chemical permeation enhancers (CPEs) have the potential to improve nerve blockade by site 1 sodium channel blockers such as tetrodotoxin (TTX). Here, we investigated the efficacy and toxicity of CPE-enhanced nerve blockade across a range of TTX concentrations using 2 CPEs (sodium octyl sulfate and octyl trimethyl ammonium bromide). We also tested the hypothesis that CPEs could be used to reduce the concentrations of TTX and/or of a second adjuvant drug (in this case, epinephrine) needed to achieve prolonged local anesthesia METHODS: Sprague-Dawley rats were injected at the sciatic nerve with combinations of TTX and CPEs, with and without epinephrine. Sensory and motor nerve blockade were assessed using a modified hot plate test and a weight-bearing test, respectively. Systemic and local toxicities of the different combinations were assessed. RESULTS: Addition of increasing concentrations of TTX to fixed concentrations of CPEs produced a marked concentration-dependent improvement in the rate of successful nerve blocks and in nerve block duration. CPEs did not affect systemic toxicity. At some concentrations, the addition of sodium octyl sulfate increased the duration of block from TTX plus epinephrine, and epinephrine increased that from TTX plus CPEs. The addition of epinephrine did not cause an increase in local toxicity, and it markedly reduced systemic toxicity. CONCLUSIONS: CPEs can prolong the duration of nerve blockade across a range of concentrations of TTX. CPEs could also be used to reduce the concentration of epinephrine needed to achieve a given degree of nerve block. CPEs may be useful in enhancing nerve blockade from site 1 sodium channel blockers. (C) 2017 International Anesthesia Research Society
http://ift.tt/2qnocxM
http://ift.tt/2qnocxM
Measuring and Improving the Quality of Preprocedural Assessments.
BACKGROUND: Preprocedural assessments are used by anesthesia providers to optimize perioperative care for patients undergoing invasive procedures. When these assessments are performed in advance by providers who are not caring for the patient during the procedure, there is an additional layer of complexity in ensuring that the workup meets the needs of the primary anesthesia care team. In this study, anesthesia providers were asked to rate the quality of preprocedural assessments prepared by other providers to evaluate anesthesia care team satisfaction. METHODS: Quality ratings for preprocedural assessments were collected from anesthesia providers on the day of surgery using an electronic quality assurance tool from January 9, 2014 to October 21, 2014. Users could rate assessments as "exemplary," "satisfactory," or "unsatisfactory." Free text comments could be entered for any of the quality ratings chosen. A reviewer trained in clinical anesthesia categorized all comments as "positive," "constructive," or "neutral" and conducted in-depth chart reviews triggered by 67 "constructive" comments submitted during the first 3 months of data collection to further subcategorize perceived deficiencies in the preprocedural assessments. In May 2014, providers were asked to participate in a midpoint survey and provide general feedback about the preprocedural process and evaluations. RESULTS: 37,611 procedures requiring anesthesia were analyzed. Of the 17,522 (46.6%) cases with a rated preprocedural assessment, anesthesia providers rated 3828 (21.8%) as "exemplary," 13,454 (76.8%) as "satisfactory," and 240 (1.4%) as "unsatisfactory." The monthly proportion of "unsatisfactory" ratings ranged from 3.1% to 0% over the study period, whereas the midpoint survey showed that anesthesia providers estimated that the number of unsatisfactory evaluations was 11.5%. Preprocedural evaluations performed on inpatients received significantly better ratings than evaluations performed on outpatients by the preadmission testing clinic or phone program (P
http://ift.tt/2pu1s1X
http://ift.tt/2pu1s1X
Optimizing Anesthesia-Related Waste Disposal in the Operating Room: A Brief Report.
Misappropriation of noncontaminated waste into regulated medical waste (RMW) containers is a source of added expense to health care facilities. The operating room is a significant contributor to RMW waste production. This study sought to determine whether disposing of anesthesia-related waste in standard waste receptacles before patient entry into the operating room would produce a reduction in RMW. A median of 0.35 kg of waste was collected from 51 cases sampled, with a potential annual reduction of 13,800 kg of RMW to the host institution, and a cost savings of $2200. (C) 2017 International Anesthesia Research Society
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http://ift.tt/2ptMr0b
Analysis of Production, Impact, and Scientific Collaboration on Difficult Airway Through the Web of Science and Scopus (1981-2013).
BACKGROUND: Bibliometrics, the statistical analysis of written publications, is an increasingly popular approach to the assessment of scientific activity. Bibliometrics allows researchers to assess the impact of a field, or research area, and has been used to make decisions regarding research funding. Through bibliometric analysis, we hypothesized that a bibliometric analysis of difficult airway research would demonstrate a growth in authors and articles over time. METHODS: Using the Web of Science (WoS) and Scopus databases, we conducted a search of published manuscripts on the difficult airway from January 1981 to December 2013. After removal of duplicates, we identified 2412 articles. We then analyzed the articles as a group to assess indicators of productivity, collaboration, and impact over this time period. RESULTS: We found an increase in productivity over the study period, with 37 manuscripts published between 1981 and 1990, and 1268 between 2001 and 2010 (P 9% for both WoS and Scopus, and CAGR for anesthesiology as a whole =0.64% in WoS, and =3.30% in Scopus. Furthermore, we found a positive correlation between the number of papers published per author and the number of coauthored manuscripts (P
http://ift.tt/2ptGLU3
http://ift.tt/2ptGLU3
A Prospective, Randomized, Clinical Trial on the Effects of a Valveless Trocar on Respiratory Mechanics During Robotic Radical Cystectomy: A Pilot Study.
BACKGROUND: Prolonged pneumoperitoneum and Trendelenburg positioning for robot-assisted radical cystectomy (RARC) are essential for optimizing visualization of the operative field, although they worsen hemodynamic and respiratory function. Our hypothesis is that the use of a valveless trocar (VT) may improve respiratory mechanics. METHODS: In this prospective, 2-arm parallel trial, patients ASA II to III undergoing RARC were randomly assigned into 2 groups: in the VT group, the capnoperitoneum was maintained with a VT; in the control group, the capnoperitoneum was maintained with a standard trocar (ST group). Inspiratory plateau pressure (Pplat), static compliance (Cstat), minute volume (MV), tidal volume (Vt), and carbon dioxide (CO2) elimination rate were recorded at these times: 15 minutes after anesthesia induction (T0), 10 minutes (T1) and 60 minutes (T2) after first robot docking, 10 minutes before first undocking (T3), 10 minutes (T4) and 60 minutes (T5) after second docking, 10 minutes before second undocking (T6), and 10 minutes before extubation (T7). The primary end point of the study was the assessment of Pplat mean value from T1 to T6. RESULTS: A total of 56 patients were evaluated: 28 patients in the VT group and 28 in the ST group. VT group had lower Pplat (means and standard error, VT group 30 [0.66] vs ST group 34 [0.66] cm H2O, with estimated mean difference and 95% confidence, -4.1 [-5.9 to -2.2], P
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http://ift.tt/2qngSm0
Arterial Pressure and the Rate of Elimination of Crystalloid Fluid.
Excretion of crystalloid fluid is slow during general anesthesia. The distribution and elimination of buffered Ringer's solution were analyzed to determine whether the rate of elimination correlates with a hemodynamic factor, consciousness, patient posture, or the type of general anesthesia. Data were derived from 4 separately published studies in which 30 volunteers and 48 anesthetized patients had received 0.833 (1 series 0.667) mL/kg/min of lactated or acetated Ringer's solution over 30 minutes. Frequent measurements of the blood hemoglobin and mean urinary excretion were used as input in a kinetic analysis according to a 2-volume model and covariates, using microconstants and mixed-effects modeling software. The results show that rate of elimination of crystalloid fluid decreased with the mean arterial pressure (MAP) and patient age, but was unaffected by consciousness and inhalational or intravenous anesthesia. The elimination rate constant was 6.5 (95% confidence interval, 5.2-7.9) x 10-3 x (MAP/mean MAP)5.2 x (Age/mean Age)-1.5. The mean MAP for the 2108 data points was 81.3 mm Hg and the mean age was 40 years. The central fluid space that was expanded by infused fluid (Vc, plasma volume) increased with body weight but decreased with general anesthesia and with reductions of MAP. Simulations revealed a more than 10-fold difference in the excreted fluid volume after a theoretical 30-minute infusion, depending on whether the MAP was 50 or 100 mm Hg. In conclusion, the rate of elimination of crystalloid fluid decreased in proportion to MAP but was independent of general anesthesia and moderate-sized surgery. (C) 2017 International Anesthesia Research Society
http://ift.tt/2ptGKzt
http://ift.tt/2ptGKzt
Outlier Practice Patterns in Mohs Micrographic Surgery
This analysis of publicly available Medicare Part B claims data studies outlier physician practices in Mohs micrographic surgery and the associated factors.
http://ift.tt/2oFLPpb
http://ift.tt/2oFLPpb
Protective multimodal analgesia with etoricoxib and spinal anesthesia in inguinal hernia repair: a randomized controlled trial
Abstract
Background
Inguinal hernia repair is a common procedure, and can be performed under spinal anesthesia. Although adequate analgesia is crucial to postoperative recovery, the optimal protective analgesic regimen remains to be established.
Purpose
To investigate the effects of preoperative etoricoxib within a protective multimodal analgesic regimen with respect to pain control following open inguinal hernia repair.
Methods
Sixty adult patients undergoing open inguinal hernia repair participated in a single-center, randomized, double-blinded, placebo-controlled trial in a general academic medical center. The intervention group (n = 30) received 120 mg of oral etoricoxib 1 h preoperatively, and 10–12 mg bupivacaine with 25 μg fentanyl as spinal anesthesia. The control group (n = 30) received oral placebo 1 h preoperatively, and spinal anesthesia as above. Postoperative Visual Analog Scale pain scores at rest and on active straight leg raise were recorded and analyzed.
Results
Resting pain scores were significantly lower in the intervention than the control group at 16 h, 24 h, and on discharge (3.00 vs. 4.35; 1.57 vs. 4.00; 1.24 vs. 3.76, respectively; p < 0.05). Pain scores on active straight leg raise were significantly lower in the intervention than the control group at 16 h, 24 h, and on discharge (3.85 vs. 5.59, p < 0.01; 2.84 vs. 4.90, p < 0.05; 3.55 vs. 5.32, p < 0.05, respectively).
Conclusion
The addition of etoricoxib to spinal anesthesia as a multimodal protective regimen can improve pain control after inguinal hernia repair. The optimal dose and applicability to other operations remains to be established.
http://ift.tt/2qfyZek
A lateral paracarotid approach for ultrasound-guided stellate ganglion block with a linear probe
Abstract
Recent reports suggest that ultrasound-guided stellate ganglion block (SGB) is safer and more accurate than classic SGB by the using the surface anatomical landmark. However, previous reports concern the classic paratracheal approach using a small specialized curved probe, which may not be appropriate in some patients. The authors have attempted several approaches, including paratracheal, trans-thyroidal, lateral paracarotid, and lateral approaches, to find a safe and suitable method for real-time ultrasound-guided SGB using a standard high-frequency linear probe. A total of 27 injections were performed on 27 patients with sensorineural hearing loss. The lateral paracarotid out-of-plane and lateral in-plane approaches were identified as the easiest and safest methods among the four tested. In this report, we describe a new lateral paracarotid approach for ultrasound-guided SGB. An ipsilateral paratracheal short-axis transverse scan was acquired at the C6 level with a linear probe (6–13 MHz). The probe was moved laterally, scanning the thyroid, carotid artery, internal jugular vein, longus colli muscle, and the transverse process of the C6, placing the carotid artery in the middle of the view. Light pressure was applied to the probe postero-medially to displace the carotid artery medially and completely compress the internal jugular vein. The needle was inserted out-of-plane between the lateral margin of the carotid artery and Chassaignac's tubercle, traversing the collapsed internal jugular vein, and targeted between the longus colli muscle and the prevertebral fascia. A total of 4 ml of 0.2% ropivacaine was injected for each procedure after a negative aspiration test. Successful blockade was confirmed with the onset of Horner's sign. All 27 injections resulted in successful blockade with Horner's sign presenting within 5 min after injection. Side effects were minor and caused minimal discomfort; they included hoarseness and a foreign body sensation. No hematomas formed after any injections. We suggest that this new lateral paracarotid approach, with out-of plane needle insertion at the C6 tubercle under transverse scan, is a convenient and safe method for performing real-time ultrasound-guided SGB, as it provides a wide, safe space for needle passage without risking thyroid or esophageal injury.
http://ift.tt/2oFq8oV
Comparison of the incidences of hyponatremia in adult postoperative critically ill patients receiving intravenous maintenance fluids with 140 mmol/L or 35 mmol/L of sodium: retrospective before/after observational study
Abstract
Purpose
The purpose of this study was to compare the incidences of hyponatremia in adult postoperative critically ill patients receiving isotonic and hypotonic maintenance fluids.
Methods
In this single-center retrospective before/after observational study, we included patients who had undergone an elective operation for esophageal cancer or for head and neck cancer and who received postoperative intensive care for >48 h from August 2014 to July 2016. In those patients, sodium-poor solution (35 mmol/L of sodium; Na35) had been administered as maintenance fluid until July 2015. From August 2015, the protocol for postoperative maintenance fluid was revised to the use of isotonic fluid (140 mmol/L of sodium; Na140). The primary outcome was the incidence of hyponatremia (<135 mmol/L) until the morning of postoperative day (POD) 2.
Results
We included 179 patients (Na35: 87 patients, Na140: 92 patients) in the current study. The mean volume of fluid received from ICU admission to POD 2 was not significantly different between the two groups (3291 vs 3337 mL, p = 0.84). The incidence of postoperative hyponatremia was 16.3% (15/92) in the Na140 cohort, which was significantly lower than that of 52.9% (46/87) in the Na35 group (odds ratio = 0.17, 95% confidence interval 0.09–0.35, p < 0.001]. The incidences of hypernatremia, defined as serum sodium concentration >145 mmol/L, were not significantly different between the two groups.
Conclusion
In this study, the use of intravenous maintenance fluid with 35 mmol/L of sodium was significantly associated with an increased risk of hyponatremia compared to that with 140 mmol/L of sodium in adult postoperative critically ill patients.
http://ift.tt/2qfcDtz
Paravertebral block catheter breakage by electrocautery during thoracic surgery
Abstract
Advantages of thoracic paravertebral analgesia (TPA) include placement of the catheter closer to the surgical field; however, the catheter can become damaged during the operation. We experienced a case of intraoperative TPA catheter breakage that prompted us to perform an experiment to investigate possible causes. A 50-year-old male underwent a thoracoscopic lower lobectomy under general anesthesia with TPA via an intercostal approach. Following surgery, it was discovered that the catheter had become occluded, as well as cut and fused, so we reopened the incision and removed the residual catheter. From that experience, we performed an experiment to examine electrocautery-induced damage in normal (Portex™, Smith's Medical), radiopaque (Perifix SoftTip™, BBraun), and reinforced (Perifix FX™, BBraun) epidural catheters (n = 8 each). Chicken meat was penetrated by each catheter and then cut by electrocautery. In the normal group, breakage occurred in 8 and occlusion in 6 of the catheters, and in the radiopaque group breakage occurred in 8 and occlusion in 7. In contrast, breakage occurred in only 3 and occlusion in none in the reinforced group, with the 5 without breakage remaining connected only by the spring coil. Furthermore, in 7 of the reinforced catheters, electric arc-induced thermal damage was observed at the tip of the catheter. A TPA catheter for thoracic surgery should be inserted via the median approach, or it should be inserted after surgery to avoid catheter damage during surgery.
http://ift.tt/2oFALYT
An update on the management of postoperative nausea and vomiting
Abstract
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients' risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period. A combination of prophylactic antiemetic drugs should be administered to patients with moderate-to-high risk of developing PONV in order to facilitate the recovery process. Optimal management of perioperative pain using opioid-sparing multimodal analgesic techniques and preventing PONV using prophylactic antiemetics are key elements for achieving an enhanced recovery after surgery. Strategies that include reductions of the baseline risk (e.g., adequate hydration, use of opioid-sparing analgesic techniques) as well as a multimodal antiemetic regimen will improve the likelihood of preventing both PONV and PDNV.
http://ift.tt/2qfeHS7
APHAB-Scores zur individuellen Beurteilung des Nutzens von Hörgeräteversorgungen
Zusammenfassung
Hintergrund
Der APHAB (Abbreviated Profile of Hearing Aid Benefit) ist ein Frageninventar, das mit seinen Unterskalen die subjektive Hörbeeinträchtigung in 4 unterschiedlichen Situationen misst. Ziel der vorliegenden Studie an einem sehr großen Kollektiv ist zu zeigen, wie sich die Antworten in den 4 Subskalen vor und nach einer Hörgeräteversorgung (HGV) verteilen und welcher Nutzen („benefit") sich für die Patienten ergibt. Diese Ergebnisse werden anhand der vorhandenen Literatur diskutiert.
Patienten und Methoden
Zwischen April 2013 und März 2016 wurden 35.000 APHAB-Fragebögen aus 9 Kassenärztlichen Vereinigungen ausgewertet. Für alle Unterskalen wurde der durchschnittliche APHAB-Wert vor und nach einer HGV sowie der Nutzen bestimmt und grafisch ausgewertet.
Ergebnisse
Die Ergebnisse der subjektiven Bewertungen der Hörbeeinträchtigung im APHAB vor und nach einer HGV sowie der daraus resultierende Hörgerätenutzen wurden mittels Perzentilverteilungen und Boxplots dargestellt und statistisch ausgewertet. Die Interquartilbereiche vor und nach einer HGV überlappten sich in allen APHAB-Subskalen nicht. In 3 Skalen (EC, BN, RV) lag der Median einer durchschnittlichen Hörverbesserung durch Hörgeräte bei knapp 30 Prozentpunkten, in der AV-Skala war dieser Wert leicht negativ.
Schlussfolgerung
Durch die Perzentilverteilungen dieser Untersuchung lassen sich die subjektive Beeinträchtigung eines individuellen Hörvermögens vor und nach einer HGV sowie deren Nutzen auf der Basis einer Grundgesamtheit mit sehr großer Fallzahl einordnen. Zudem wird dargestellt, warum die Darstellung von Boxplots und der daraus abgeleitete durchschnittliche Nutzen einer HGV grundsätzlich problematisch sind.
http://ift.tt/2qeMhL1
Counting the Cuts in Mohs Surgery: A Way to Improve Care and Reduce Costs
In an analysis of Medicare billing data submitted by more than 2,300 United States physicians, researchers have calculated the average number of surgical slices, or cuts, made during Mohs micrographic surgery (MMS), a procedure that progressively removes thin layers of cancerous skin tissue in a way that minimizes damage to healthy skin and the risks of leaving cancerous tissue behind.
http://ift.tt/2oFH1A6
High prevalence of antibodies reacting to mimotopes of Simian virus 40 large T antigen, the oncoprotein, in serum samples of patients affected by non-Hodgkin lymphoma
Abstract
A new immunological investigation was carried out to study the association between non-Hodgkin lymphoma and Simian virus 40 (SV40). To this end, a new indirect ELISA was employed with two mimotopes from SV40 large T antigen (Tag), the viral oncoprotein, to analyse for specific reactions to antibodies in sera from non-Hodgkin lymphoma patients and controls, represented by healthy subjects (HS) and breast carcinoma (BC) patients. This study allowed us to assay a new sera collection from non-Hodgkin lymphoma patients (NHL, n = 254). To verify the association between NHL and SV40 Tag, two totally independent cohorts were analysed: NHL1 n = 150 and NHL2 n = 104. The epidemiological survey included sera from HS1, n = 150; HS2, n = 104 and BC, n = 78. This new indirect ELISA revealed that antibodies against SV40 Tag mimotopes are detectable in NHL1 and NHL2 sera with a prevalence of 37 and 36%, respectively. The prevalence of SV40-antibodies detected in both NHL1 and NHL2 cohorts differs statistically from controls, at 19% for HS1 (p < 0.01), HS2 (p < 0.05) and BC patients (p < 0.05). This study, carried out with an immunological assay with specific Tag oncoprotein mimotopes of Simian virus 40, reports the presence of IgG antibodies against the large Tumour antigen in non-Hodgkin lymphomas for the first time. Our immunological data with two independent NHL cohorts show a statistically significant association between Simian virus 40 Tag and non-Hodgkin lymphoma. These results suggest that SV40-positive non-Hodgkin lymphomas could be treated differently from those tested SV40-negative.
http://ift.tt/2qn1YvW
Stretchable electronic platform for soft and smart contact lens applications
A smart contact lens, envisioned to correct or improve vision, entails the integration of several electronic components such as: Si chips, a power source and an electro-optic module. All of them being interconnected by non-conventional electrical layouts in a fully stretchable platform. Such a platform must be designed with strict geometrical requirements and material limitations, to attain compulsory characteristics such as: biocompatibility, oxygen/light transparency, and being imperceptible by the human eye. To favor fabrication throughput, our approach encompasses the development of the thermoplastic platform on a planar manner, in order to thermoform it afterwards into a curvilinear spherical shape by means of metallic molds. Thermoforming induces mechanical stress resulting in distributed strain regions (mainly localized at the edges), which directly affects the integrity of the components. For this reason, here we present a finite element model FEM (using COMSOL) of the thermoforming step corroborated by experimental data, in order to analyze the strain development on the lens surface making emphasis on the wrinkle formation at the edge. The thermoplastic was modelled in the static domain, in 2D-axial symmetry and 3D spaces with defined contact to the molds and free boundary conditions elsewhere. The thermoforming process was performed at several temperatures (i.e. from 80 °C to 140 °C) for two 100 μm-thick thermoplastic carriers (i.e. polyethylene terephthalate – PET and polyurethane PUT) using molds of 8 mm of radius. The measured strain and shape after the thermoforming were in good agreement with the FEM models, showing compressive hoop strains in the order of -10±2% at the border of the lens (radius of 6.5 mm), and close to zero radial strain. Non-axial symmetrical crumpling and wrinkles at the border were found out for temperatures below 100°C and radii bigger than 5 mm, and were reproduced and analyze with 3D FEM models. Finally, the output trends of the modelling were employed as guidelines to design and optimize "horse shoe" meander interconnections to increase the robustness and reliability of the whole system. Such modeling and designing approach could be applied for diverse types of thermoforming steps of soft materials (i.e. thermoplastic polymers) in order to enhance the mechanical integrity and proper component location.
http://ift.tt/2pc4iZ7
Material aspects of a-SiN:H based 2D direct X-ray sensor array
The possibility of creating an 2D X-ray sensor array on the base of a-SiN:H thin films without switching elements and an X-ray conversion layer is presented in this report. The behavior of a-SiN:H Thin-Film Diode under X-ray irradiation its limitations, and ways of increasing longterm stability and sensitivity of the sensor are discussed.
http://ift.tt/2oPTQCY
Salinity effects on competition between cryptic species of the nematode Rhabditis (Pellioditis) marina
Behind the morphological similarity of many species, a substantial hidden genetic diversity can be found. This hidden or cryptic diversity leads to a significantly higher biodiversity in ecosystems than previously regarded and is important for estimating total diversity on earth. It has been well documented in the marine nematode, Rhabditis (Pellioditis) marina (Derycke et al., 2008), where several cryptic species occur sympatrically (Pm I, Pm II, Pm III and Pm IV). This coexistence challenges traditional ecological competition theory, stating that competition will be most severe between closely related species, rendering coexistence unlikely. Niche partitioning, where species coexistence is explained by differences in phenotype is a possible way to achieve such coexistence. Closely related sympatric species, despite only minor differences in morphology, can display different preferences for abiotic conditions. So if cryptic species differ in their response to ecological heterogeneities, their coexistence may be facilitated and the outcome of competition will depend on fluctuations in the abiotic environment. Studying these preferences and more broadly the ecology of cryptic species can lead to a better insight in the origin of cryptic speciation and the geographical distribution of these cryptic species. Rhabditis (Pellioditis) marina is a common bacterivore associated with decomposing macro-algae in the littoral zone of coastal and estuarine environments. One of the possible factors shaping the distribution patterns and coexistence of the cryptic species is salinity, one of the most conspicuous environmental factors causing heterogeneity in tidal environments. The effect of salinity on the coexistence of cryptic species was studied in a lab experiment, where population structure between competition cultures (with equal abundances of four cryptic species together) and monospecific cultures (where the four cryptic species can not affect each other's population development) was compared at two different salinities. The results showed an effect of competition and salinity on the population structure with (1) an increased time-averaged abundance of Pm III at the low salinity in monospecific cultures, (2) a negative effect of competition on the abundance of two cryptic species (Pm II and Pm IV) and (3) stronger competition at lower salinity. Lower salinity has mostly an intensifying effect on the outcome of the competitive interactions and besides competition, complete exclusion (Pm IV) and facilitative interactions occurred (Pm I and Pm III at high salinity). These results show that changes in the abiotic environment (in casu salinity) can shift the outcome of competition between and hence the possibility of the coexistence of different cryptic species of Rhabditis (Pellioditis) marina.
http://ift.tt/2qn2NEY
Editorial
Swaab, PA; Editorial. The Journal of the Sylvia Townsend Warner Society 10.14324/111.444.stw.2017.00 . Green open access
http://ift.tt/2qeHCFY
The archive, the auteur and the unfilmed film: Reflections on Dreyer’s and von Trier’s Medea
Thomson, C; The archive, the auteur and the unfilmed film: Reflections on Dreyer's and von Trier's Medea. Journal of Scandinavian Cinema (In press).
http://ift.tt/2pbKchr
Being a barrister
Halsall, SJ; (2017) Being a barrister. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2qezl4Y
Evidence for early life in Earth’s oldest hydrothermal vent precipitates
Dodd, MS; Papineau, D; Greene, T; Slack, JF; Rittner, M; Pirajno, F; O'Neil, J; Dodd, MS; Papineau, D; Greene, T; Slack, JF; Rittner, M; Pirajno, F; O'Neil, J; Little, CTS; - view fewer (2017) Evidence for early life in Earth's oldest hydrothermal vent precipitates. Nature , 546 pp. 60-64. 10.1038/nature21377 .
http://ift.tt/2pbEdcw
Computational modelling of structural, dynamical and electronic properties of multicomponent silicate glasses
Konstantinou, K; (2017) Computational modelling of structural, dynamical and electronic properties of multicomponent silicate glasses. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2pbP8Tw
Unified Tracking and Shape Estimation for Concentric Tube Robots
Vandini, A; Bergeles, C; Glocker, B; Giataganas, P; Yang, GZ; (2017) Unified Tracking and Shape Estimation for Concentric Tube Robots. IEEE Transactions on Robotics 10.1109/TRO.2017.2690977 . (In press). Green open access
http://ift.tt/2qezw08
Education in Interwar Rural England: Community, Schooling and Voluntarism
Kirke, A; (2017) Education in Interwar Rural England: Community, Schooling and Voluntarism. Doctoral thesis, UCL (University College London).
http://ift.tt/2pbGkNk
The use of evidence in English local public health decision-making: a systematic scoping review
Kneale, D; Rojas-Garcia, A; Raine, R; Thomas, J; (2017) The use of evidence in English local public health decision-making: a systematic scoping review. Implementation Science , 12 , Article 53. 10.1186/s13012-017-0577-9 . Green open access
http://ift.tt/2pbLFEs
London’s traditional markets: managing change and conflict in complex urban spaces
Kim, S-H; (2017) London's traditional markets: managing change and conflict in complex urban spaces. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2qeSUtJ
Patient Experiences of Swallowing Exercises After Head and Neck Cancer: A Qualitative Study Examining Barriers and Facilitators Using Behaviour Change Theory
Govender, R; Wood, CE; Taylor, SA; Smith, CH; Barratt, H; Gardner, B; (2017) Patient Experiences of Swallowing Exercises After Head and Neck Cancer: A Qualitative Study Examining Barriers and Facilitators Using Behaviour Change Theory. Dysphagia 10.1007/s00455-017-9799-x . (In press). Green open access
http://ift.tt/2pbV2UH
Modulating the stress response in critical illness
Khaliq, W; (2017) Modulating the stress response in critical illness. Doctoral thesis, UCL (University College London).
http://ift.tt/2qes6db
History, Violence and Collective Memory: Implications for Mental Health in Ecuador
Capella, M; Jadhav, SS; Moncrieff, J; (2017) History, Violence and Collective Memory: Implications for Mental Health in Ecuador. Transcultural Psychiatry (In press). Green open access
http://ift.tt/2pbHwjQ
The role of magnetospheric plasma instabilities in auroral and substorm dynamics
Kalmoni, NME; (2017) The role of magnetospheric plasma instabilities in auroral and substorm dynamics. Doctoral thesis, UCL (University College London).
http://ift.tt/2qetgFo
New laboratory edge illumination x-ray phase contrast imaging set-ups
Kallon, GKN; (2017) New laboratory edge illumination x-ray phase contrast imaging set-ups. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2qexTiO
Public financing of innovation: new questions
Mazzucato, M; Semieniuk, G; (2017) Public financing of innovation: new questions. Oxford Review of Economic Policy , 33 (1) pp. 24-48. 10.1093/oxrep/grw036 . Green open access
http://ift.tt/2pc7Ni7
Effects of task complexity, glossing, and working memory capacity on L2 reading and L2 learning
Jung, J; (2017) Effects of task complexity, glossing, and working memory capacity on L2 reading and L2 learning. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2qesAQJ
Immigrant Arrival and Tuberculosis among Large Immigrant- and Refugee-Receiving Countries, 2005-2009.
White, Z; Painter, J; Douglas, P; Abubakar, I; Njoo, H; Archibald, C; Halverson, J; White, Z; Painter, J; Douglas, P; Abubakar, I; Njoo, H; Archibald, C; Halverson, J; Robson, J; Posey, DL; - view fewer (2017) Immigrant Arrival and Tuberculosis among Large Immigrant- and Refugee-Receiving Countries, 2005-2009. Tuberc Res Treat , 2017 , Article 8567893. 10.1155/2017/8567893 . Green open access
http://ift.tt/2qeOxz4
Variations in crowding, saccadic precision, and spatial localization reveal the shared topology of spatial vision
Greenwood, JA; Szinte, M; Sayim, B; Cavanagh, P; (2017) Variations in crowding, saccadic precision, and spatial localization reveal the shared topology of spatial vision. Proceedings of the National Academy of Sciences , 114 (17) E3573-E3582. 10.1073/pnas.1615504114 . Green open access
http://ift.tt/2pbM3CZ
Tech City: exploring the operation and governance of inner east London’s digital cluster
Jones, EM; (2017) Tech City: exploring the operation and governance of inner east London's digital cluster. Doctoral thesis, UCL (University College London).
http://ift.tt/2qet9d4
An Evaluation of the Methods Used in the Estimation of Sex
Harrison, DL; (2017) An Evaluation of the Methods Used in the Estimation of Sex. Doctoral thesis, (UCL) University College London. Green open access
http://ift.tt/2pbKLYw
MAGE-A4ᶜ¹º³²T for Multi-Tumor
Conditions: Bladder Cancer; Melanoma; Head and Neck Cancer; Ovarian Cancer; Non-Small Cell Lung Cancer; Esophageal Cancer; Gastric Cancer
Intervention: Genetic: Autologous genetically modified MAGE-A4ᶜ¹º³²T cells
Sponsor: Adaptimmune
Not yet recruiting - verified April 2017
http://ift.tt/2qeEPfT
Intervention: Genetic: Autologous genetically modified MAGE-A4ᶜ¹º³²T cells
Sponsor: Adaptimmune
Not yet recruiting - verified April 2017
http://ift.tt/2qeEPfT
Radiotherapy Assessments During Intervention ANd Treatment (RADIANT)
Conditions: Radiation Therapy; Cancer; Cancer of Anus; Cancer of Bladder; Cancer of Cervix; Cancer of Colon; Cancer of Rectum; Cancer of Esophagus; Cancer of Gallbladder; Cancer of Liver; Cancer of Ovary; Cancer of Pancreas; Cancer of Prostate; Cancer of Kidney and Renal Pelvis; Cancer of Stomach; Cancer of Testis; Cancer of Uterus; Cancer of Uterus and Cervix; Cancer of Kidney
Intervention:
Sponsors: Robert Terbrueggen; National Cancer Institute (NCI)
Recruiting - verified April 2017
http://ift.tt/2oPNx2g
Intervention:
Sponsors: Robert Terbrueggen; National Cancer Institute (NCI)
Recruiting - verified April 2017
http://ift.tt/2oPNx2g
Interest of MRI in Preoperative Staging for the Laryngeal and Hypopharyngeal Cancer
Conditions: Hypopharyngeal Carcinoma; Laryngeal Carcinoma
Intervention: Other: Pharyngo laryngeal MRI
Sponsor: Hospices Civils de Lyon
Not yet recruiting - verified March 2017
http://ift.tt/2pbHEjw
Intervention: Other: Pharyngo laryngeal MRI
Sponsor: Hospices Civils de Lyon
Not yet recruiting - verified March 2017
http://ift.tt/2pbHEjw
Metabolic engineering of micronutrients in crop plants
Micronutrient deficiency is a widespread phenomenon, most prevalent in developing countries. Being causally linked to the occurrence of a range of diseases, it affects billions of people worldwide. Enhancing the content of micronutrients in crop products through biotechnology is a promising technique to fight micronutrient malnutrition worldwide. Micronutrient fortification of food products has been implemented in a number of Western countries, but remains inaccessible for poor rural populations in a major part of the developing world. Moreover, evidence of the negative impacts of this practice on human health, at least for some vitamins, is accumulating. Biofortification of crop plants-the enhancement of vitamins and minerals through plant biotechnology-is a promising alternative or complement in the battle against micronutrient deficiencies. Owing to a growing knowledge about vitamin metabolism, as well as mineral uptake and reallocation in plants, it is today possible to enhance micronutrient levels in crop plants, offering a sustainable solution to populations with a suboptimal micronutrient intake.
http://ift.tt/2qexJb9
Methods matter: a meta-regression on the determinants of willingness-to-pay studies on biofortified foods
Following the growing evidence on biofortification as a cost-effective micronutrient strategy, various researchers have elicited consumers' willingness to pay (WTP) for biofortified crops in an effort to justify and determine their adoption. This review presents a meta-analysis of WTP studies on biofortified foods, either developed through conventional breeding or using genetic modification technology. On the basis of 122 estimates from 23 studies (9507 respondents), consumers are generally willing to pay 21.3% more for biofortified crops. Because WTP estimates are often determined through different valuation methods and procedures, a meta-regression was carried out to examine the role of potential determinants. Aside from contextual factors, such as type of food crop, target nutrient, and region (but not breeding technique), various methodological factors significantly influence premiums, including the type of respondent, nature of the study, study environment, participation fee, and provided information. The findings allow researchers to better anticipate potential methodological biases when examining WTP for (biofortified) foods, while it gives policy makers a broad understanding of the potential demand for different biofortified crops in various settings.
http://ift.tt/2oEzotD
The socioeconomics of genetically modified biofortified crops: a systematic review and meta-analysis
Building upon the growing interest and research on genetically modified (GM) biofortification, its socioeconomic potential has been increasingly examined. We conducted two systematic reviews and meta-analyses to provide comprehensive evidence of consumers' willingness to pay (11 economic valuation studies, 64 estimates) and cost-effectiveness/benefits (five economic evaluation studies, 30 estimates). Worldwide, consumers were willing to pay 23.9% more for GM biofortified food crops. Aside from crop and design-related differences, information provision was deemed crucial. Positive information (nutrition and GM benefits) is associated with the highest consumer willingness to pay, compared with negative, objective, and conflicting GM information, especially when negative information was mentioned last. This health intervention would reduce the aggregated micronutrient deficiency burden in Asia (15.6 million disability-adjusted life years (DALYs)) by 12.5-51.4%, at a low cost of USD 7.9-27.8 per DALY in a pessimistic and optimistic scenario, respectively. Given that GM biofortified crops could tackle hidden hunger in a cost-effective and well-accepted way, its implementation is worth pursuing. A case study on folate biofortification further elaborates on the importance of socioeconomic research and the determinants of their market potential.
http://ift.tt/2qeDRk3
Precipitation and extended defect formation in silicon
The impact of self-interstitials and strain on the critical size for nucleation of incoherent precipitates is well-known. A factor that has been neglected so far is the incorporation of intrinsic point defects of the host matrix in the precipitate itself. It is shown that this can have an important impact both on the critical r size and on the precipitated phase. The theoretical results are illustrated for the case of oxygen precipitation in silicon. The growing precipitate can also cause the nucleation of extended lattice defects such as dislocations and stacking faults in the surrounding matrix. A model is presented to predict stacking fault r nucleation.
http://ift.tt/2qeGCBQ
Analysis of transient photoconductivity in CdSe:Cu:Cl thin films
A number of interesting transient phenomena, occurring in CdSe: Cu: Cl thin films, exhibiting superlinear photoconductivity, are described: the typical S-shaped current rise, the exponential decay, the inversely proportional dependence of rise time on illumination level, the illumination independent decay time, the influence of bias illumination and pulse frequency on the current rise and decay curves, and the possibility to influence the rise and decay time through the application of a potential to a field-plate. A simple, analytical model for these transients, based on the crude two-level model for superlinear photoconductors, is developed. The model explains the observed behaviour qualitatively and, to a certain degree, even quantitatively. Using this model, the value of the electron capture cross section of the sensitizing centres is estimated from the experimental results. The resulting value of 1.9 x 10(-19) cm2 falls in the range of the values reported elsewhere.
http://ift.tt/2oErctq
{beta}hCG-secreting osteosarcoma
A 35-year-old woman presented to our institution with tender, right knee swelling. Radiological and pathological work-up revealed metastatic osteosarcoma. Prior to the initiation of chemotherapy, she underwent a routine urine pregnancy test and was surprised with a positive result. Serum beta human chorionic gonadotropin (βhCG) levels were also consistently positive and rising. No gestational sac was seen at transvaginal ultrasound. The paraneoplastic ectopic secretion of βhCG has been well described in gestational trophoblastic and gonadal tumours but has very rarely been associated with other tumour types. This patient's βhCG level was reflective of osteosarcoma activity and normalised with response to chemotherapy. The prognostic implications of βhCG expression in more diverse tumours is unclear; however, where raised, it can be used to monitor disease activity.
http://ift.tt/2oSxotS
Towards improved design and evaluation of epileptic seizure predictors
Abstract—Objective: Key issues in the epilepsy seizure prediction research are (1) the reproducibility of results (2) the inability to compare multiple approaches directly. To overcome these problems, the Seizure Prediction Challenge was organized on Kaggle.com. It aimed at establishing benchmarks on a dataset with predefined train, validation and test sets. Our main objective is to analyse the competition format, and to propose improvements, which would facilitate a better comparison of algorithms. The second objective is to present a novel deep learning approach to seizure prediction and compare it to other commonly used methods using patient centered metrics. Methods: We used the competition's datasets to illustrate the effects of data contamination. Having better data partitions, we compared three types of models in terms of different objectives. Results: We found that correct selection of test samples is crucial when evaluating the performance of seizure forecasting models. Moreover, we showed that models, which achieve state-of-the-art performance with respect to commonly used AUC, sensitivity and specificity metrics, may not yet be suitable for practical usage because of low precision scores. Conclusion: Correlation between validation and test datasets used in the competition limited its scientific value. Significance: Our findings provide guidelines which allow for a more objective evaluation of seizure prediction models.
http://ift.tt/2pFRziP
On the strongest form of a theorem of Whitney for Hamiltonian cycles in plane triangulations
In this article, we investigate hamiltonian cycles in plane triangulations. The aim of the article is to find the strongest possible form of Whitney's theorem about hamiltonian triangulations in terms of the decomposition tree defined by separating triangles. We will decide on the existence of nonhamiltonian triangulations with given decomposition trees for all trees except trees with exactly one vertex with degree k{4,5} and all other degrees at most 3. For these cases, we show that it is sufficient to decide on the existence of nonhamiltonian triangulations with decomposition tree K-1,K- 4 or K-1,K- 5. We also give computational results on the size of a possible minimal nonhamiltonian triangulation with these decomposition trees.
http://ift.tt/2pFRGur
Complex and detailed balancing of chemical reaction networks revisited
The characterization of the notions of complex and detailed balancing for mass action kinetics chemical reaction networks is revisited from the perspective of algebraic graph theory, in particular Kirchhoff's Matrix Tree theorem for directed weighted graphs. This yields an elucidation of previously obtained results, in particular with respect to the Wegscheider conditions, and a new necessary and sufficient condition for complex balancing, which can be verified constructively.
http://ift.tt/2pp1RAE
Incidence geometry from an algebraic graph theory point of view
The goal of this thesis is to apply techniques from algebraic graph theory to finite incidence geometry. The incidence geometries under consideration include projective spaces, polar spaces and near polygons. These geometries give rise to one or more graphs. By use of eigenvalue techniques, we obtain results on these graphs and on their substructures that are regular or extremal in some sense. The first chapter introduces the basic notions of geometries, such as projective and polar spaces. In the second chapter, we introduce the necessary concepts from algebraic graph theory, such as association schemes and distance-regular graphs, and the main techniques, including the fundamental contributions by Delsarte. Chapter 3 deals with the Grassmann association schemes, or more geometrically: with the projective geometries. Several examples of interesting subsets are given, and we can easily derive completely combinatorial properties of them. Chapter 4 discusses the association schemes from classical finite polar spaces. One of the main applications is obtaining bounds for the size of substructures known as partial m- systems. In one specific case, where the partial m-systems are partial spreads in the polar space H(2d − 1, q^2) with d odd, the bound is new and even tight. A variant of the famous Erdős-Ko-Rado problem is considered in Chapter 5, where we study sets of pairwise non-trivially intersecting maximal totally isotropic subspaces in polar spaces. A combination of geometric and algebraic techniques is used to obtain a classification of such sets of maximum size, except for one specific polar space, namely H(2d − 1, q^2) for odd rank d ≥ 5. Near polygons, including generalized polygons and dual polar spaces, are studied in the last chapter. Several results on substructures in these geometries are given. An inequality of Higman on the parameters of generalized quadrangles is generalized. Finally, it is proved that in a specific dual polar space, a highly regular substructure would yield a distance- regular graph, generalizing a result on hemisystems. The appendix consists of an alternative proof for one of the main results in the thesis, a list of open problems and a summary in Dutch.
http://ift.tt/2poWb9L
ERA ranking representability: the missing link between ordinal regression and multi-class classification
Can a multi-class classification model in some situations be simplified to an ordinal regression model without sacrificing performance? We try to answer this question from a theoretical point of view for one-versus-one multi-class ensembles. To that end, sufficient conditions are derived for which a one-versus-one ensemble becomes ranking representable, i.e. conditions for which the ensemble can be reduced to a ranking or ordinal regression model such that a similar performance on training data is measured. As performance measure, we use the area under the ROC curve (AUC) and its reformulation in terms of graphs. For the three-class case, this results in a new type of cycle transitivity for pairwise AUCs that can be verified by solving an integer quadratic program. Moreover, solving this integer quadratic program can be avoided, since its solution converges for an infinite data sample to a simple form, resulting in a deviation bound that becomes tighter with increasing sample size.
http://ift.tt/2pG4pxt
On the way of integrating evacuation approaches
With the growing pressure on available urban space and the construction of more and more complex building infrastructures, the navigational task for building users is getting increasingly difficult. As people react more impulsive under stressful situations, emergencies can exacerbate way finding problems. Additionally, leadership and familiarity with the (topological structure of a) building can influence the ease of finding appropriate evacuation routes. In research, two separate and distinctive techniques for modelling evacuation paths have been developed: evacuation simulation modelling through complex computer simulations and 3D network modelling based on graph theory. Taking into account a global user perspective, the 3D network modelling approach has the advantage to preserve a close connection with the semantic building structure. Following this approach, existing three dimensional evacuation routing algorithms tend to use Dijkstra's shortest path algorithm. However, as more factors, compared to path length, influence evacuation situations, literature acknowledges a void in representing more realistic, complete and accurate emergency situations. This paper presents a first step in creating such integral algorithm by implementing capacity constraints based on user flow control on a 3D geometric network model. In the future additional topics such as zonal partitioning can be added to the algorithm, moving to an integration of both evacuation approaches.
http://ift.tt/2pp1TbU
An efficient algorithm for the single-source shortest path problem in graph theory
The Single-Source Shortest Path problem (SSSP), known as the basis of many application areas, is a fundamental matter in graph theory. In this paper, a new efficient algorithm named Li-Qi (LQ) is proposed for SSSP to find a simple path of minimum total weights from a designated source vertex-to each vertex. The algorithm is based on the ideas of the queue and the relaxation, The main differences between this strategy with the Breadth-first search and the Bellman-Ford algorithm are that the vertices may be queued more than once and only the source vertex and relaxed vertices are queued; the algorithm terminates when the queue is empty. Experimental evaluation on different sizes of the generated graphs validates that the proposed algorithm far outperforms the simplest implementation of the Dijkstra's algorithm and surpasses the Bellman-Ford algorithm by about 2 times.
http://ift.tt/2pFLPW9
The High Cost of Surviving Acute Respiratory Distress Syndrome
According to a new multicenter study, nearly half of previously employed adult survivors of acute respiratory distress syndrome were jobless one year after hospital discharge, and are estimated to have lost an average of $27,000 in earnings.
http://ift.tt/2qeswmz
Response to strigolactone treatment in chrysanthemum axillary buds is influenced by auxin transport inhibition and sucrose availability
Axillary bud outgrowth is regulated by both environmental cues and internal plant hormone signaling. Central to this regulation is the balance between auxins, cytokinins, and strigolactones. Auxins are transported basipetally and inhibit the axillary bud outgrowth indirectly by either restricting auxin export from the axillary buds to the stem (canalization model) or inducing strigolactone biosynthesis and limiting cytokinin levels (second messenger model). Both models have supporting evidence and are not mutually exclusive. In this study, we used a modified split-plate bioassay to apply different plant growth regulators to isolated stem segments of chrysanthemum and measure their effect on axillary bud growth. Results showed axillary bud outgrowth in the bioassay within 5 days after nodal stem excision. Treatments with apical auxin (IAA) inhibited bud outgrowth which was counteracted by treatments with basal cytokinins (TDZ, zeatin, 2-ip). Treatments with basal strigolactone (GR24) could inhibit axillary bud growth without an apical auxin treatment. GR24 inhibition of axillary buds could be counteracted with auxin transport inhibitors (TIBA and NPA). Treatments with sucrose in the medium resulted in stronger axillary bud growth, which could be inhibited with apical auxin treatment but not with basal strigolactone treatment. These observations provide support for both the canalization model and the second messenger model with, on the one hand, the influence of auxin transport on strigolactone inhibition of axillary buds and, on the other hand, the inhibition of axillary bud growth by strigolactone without an apical auxin source. The inability of GR24 to inhibit bud growth in a sucrose treatment raises an interesting question about the role of strigolactone and sucrose in axillary bud outgrowth and calls for further investigation.
http://ift.tt/2pta6xY
Kinetic model construction using chemoinformatics
Kinetic models of chemical processes not only provide an alternative to costly experiments; they also have the potential to accelerate the pace of innovation in developing new chemical processes or in improving existing ones. Kinetic models are most powerful when they reflect the underlying chemistry by incorporating elementary pathways between individual molecules. The downside of this high level of detail is that the complexity and size of the models also steadily increase, such that the models eventually become too difficult to be manually constructed. Instead, computers are programmed to automate the construction of these models, and make use of graph theory to translate chemical entities such as molecules and reactions into computer-understandable representations. This work studies the use of automated methods to construct kinetic models. More particularly, the need to account for the three-dimensional arrangement of atoms in molecules and reactions of kinetic models is investigated and illustrated by two case studies. First of all, the thermal rearrangement of two monoterpenoids, cis- and trans-2-pinanol, is studied. A kinetic model that accounts for the differences in reactivity and selectivity of both pinanol diastereomers is proposed. Secondly, a kinetic model for the pyrolysis of the fuel "JP-10" is constructed and highlights the use of state-of-the-art techniques for the automated estimation of thermochemistry of polycyclic molecules. A new code is developed for the automated construction of kinetic models and takes advantage of the advances made in the field of chemo-informatics to tackle fundamental issues of previous approaches. Novel algorithms are developed for three important aspects of automated construction of kinetic models: the estimation of symmetry of molecules and reactions, the incorporation of stereochemistry in kinetic models, and the estimation of thermochemical and kinetic data using scalable structure-property methods. Finally, the application of the code is illustrated by the automated construction of a kinetic model for alkylsulfide pyrolysis.
http://ift.tt/2oPwUnm
An investigation into the genetic architecture of multiple system atrophy and familial Parkinson's disease
Federoff, MC; (2017) An investigation into the genetic architecture of multiple system atrophy and familial Parkinson's disease. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2pbaxfL
Levels of Schwann cell c-Jun control nerve development and response to injury
Fazal, SV; (2017) Levels of Schwann cell c-Jun control nerve development and response to injury. Doctoral thesis, UCL (University College London).
http://ift.tt/2oSEUVs
A Search for Prions and Analyses of Genomic Rearrangements in Fission Yeast Cells
Ellis, DA; (2017) A Search for Prions and Analyses of Genomic Rearrangements in Fission Yeast Cells. Doctoral thesis, UCL (University College London).
http://ift.tt/2pb4hEs
Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis
Lang, L; Clifford, A; Wei, L; Zhang, D; Leung, D; Augustine, G; Danat, IM; Lang, L; Clifford, A; Wei, L; Zhang, D; Leung, D; Augustine, G; Danat, IM; Zhou, W; Copeland, JR; Anstey, KJ; Chen, R; - view fewer (2017) Prevalence and determinants of undetected dementia in the community: a systematic literature review and a meta-analysis. BMJ Open , 7 (2) , Article e011146. 10.1136/bmjopen-2016-011146 . Green open access
http://ift.tt/2oSzV7d
Recovering History Education’s Forgotten Past : Diversity and Change in Professional Discourse in England, 1944-1962
Edwards, C; (2017) Recovering History Education's Forgotten Past : Diversity and Change in Professional Discourse in England, 1944-1962. Doctoral thesis, UCL (University College London).
http://ift.tt/2paUhv6
CD161+ T cells in Immune Regulation
Duurland, CL; (2017) CD161+ T cells in Immune Regulation. Doctoral thesis, UCL (University College London).
http://ift.tt/2oSxaTn
The use of hypercapnic challenge blood oxygen level dependent (BOLD) MRI for the investigation of childhood steno-occlusive arteriopathy
Dlamini, N; (2017) The use of hypercapnic challenge blood oxygen level dependent (BOLD) MRI for the investigation of childhood steno-occlusive arteriopathy. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2paZT8L
Analysis and targeting of Core Binding Factor (CBF) Complex in precursor B-ALL
Deltcheva, E; (2017) Analysis and targeting of Core Binding Factor (CBF) Complex in precursor B-ALL. Doctoral thesis, UCL (University College London).
http://ift.tt/2oSyXYK
A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study
Gilmartin-Thomas, JF-M; Smith, F; Wolfe, R; Jani, Y; (2017) A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study. International Journal of Nursing Studies , 72 pp. 15-23. 10.1016/j.ijnurstu.2017.03.008 .
http://ift.tt/2pb1tY9
Organosilica Nanoparticles with an Intrinsic Secondary Amine: An Efficient and Reusable Adsorbent for Dyes
Chen, F; Zhao, E; Kim, T; Wang, J; Hableel, G; Reardon, PJT; Ananthakrishna, SJ; Chen, F; Zhao, E; Kim, T; Wang, J; Hableel, G; Reardon, PJT; Ananthakrishna, SJ; Wang, T; Arconada-Alvarez, S; Knowles, JC; Jokerst, JV; - view fewer (2017) Organosilica Nanoparticles with an Intrinsic Secondary Amine: An Efficient and Reusable Adsorbent for Dyes. Applied Materials Interfaces 10.1021/acsami.7b04181 . (In press).
http://ift.tt/2oSkkES
New methods for testing phylogenetic niche conservatism with an application to the Squamates of Madagascar
de Almeida Afonso Abranches Nunes, LG; (2017) New methods for testing phylogenetic niche conservatism with an application to the Squamates of Madagascar. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2paYOhc
Principles and Practices for Involving Teenagers in Decision-Making about their Care and Treatment: A prospective participant-observation study to inform policy and practice
Day, ER; (2017) Principles and Practices for Involving Teenagers in Decision-Making about their Care and Treatment: A prospective participant-observation study to inform policy and practice. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2oSoNHH
Drug Use And Opioid Substitution Treatment In Pregnancy: Evidence From Electronic Health Records
Davies, HR; (2017) Drug Use And Opioid Substitution Treatment In Pregnancy: Evidence From Electronic Health Records. Doctoral thesis, UCL (University College London).
http://ift.tt/2paYLSy
Quantum-orbit analysis of laser-matter interactions in intense orthogonally polarised fields
Das, T; (2017) Quantum-orbit analysis of laser-matter interactions in intense orthogonally polarised fields. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2oSp9hk
Numerical Optimisation Problems in Finance
Cui, Y; (2017) Numerical Optimisation Problems in Finance. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2paNjX8
The regulation of arsenic metabolism in Rhizobium sp.str. NT-26
Corsini Madeira, P; (2017) The regulation of arsenic metabolism in Rhizobium sp.str. NT-26. Doctoral thesis, UCL (University College London). Green open access
http://ift.tt/2oSx9ih
The Psychogenesis of Terrorism
Corner, EJ; (2017) The Psychogenesis of Terrorism. Doctoral thesis, UCL (University College London).
http://ift.tt/2pb5GuP
The effect of perioperative dexamethasone dosing on post-tonsillectomy hemorrhage risk
Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Yin Yiu, Justin B. Mahida, Jennifer N. Cooper, Nicole M. Elsey, Katherine J. Deans, Peter C. Minneci, Tyler B. Merrill, Joseph D. Tobias, Charles A. Elmaraghy
ObjectivesDexamethasone is currently recommended for routine prophylaxis against postoperative nausea and vomiting after tonsillectomy procedures. However, some studies have raised concern that dexamethasone use may lead to higher rates of post-tonsillectomy hemorrhage. Our objective was to determine whether higher doses of dexamethasone administered perioperatively during tonsillectomy procedures are associated with an increased risk of secondary post-tonsillectomy hemorrhage.MethodsWe conducted a retrospective review of 9843 patients who underwent tonsillectomy and received dexamethasone at our institution from January 2010 to October 2014. We compared the dose of dexamethasone administered to patients who did and did not develop secondary post-tonsillectomy hemorrhage using Mann Whitney U tests. Multivariable logistic regression models were used to evaluate the association between dexamethasone dose and post-tonsillectomy hemorrhage after adjustment for demographic and clinical characteristics.ResultsA total of 280 (2.8%) patients developed secondary post-tonsillectomy hemorrhage. Patients who developed hemorrhage tended to be older (median (interquartile range) 7 (4–11) vs. 5 (3–8) years), p < 0.001) and had undergone tonsillectomy more often for chronic tonsillitis but less often for tonsillar or adenotonsillar hypertrophy or sleep disturbances. Dexamethasone dose was significantly lower on average in patients who experienced secondary post-tonsillectomy hemorrhage (median (interquartile range) 0.19 (0.14, 0.23) mg/kg vs. 0.21 (0.17, 0.30), p < 0.001). Multivariable modeling demonstrated that the dose of dexamethasone was not significantly associated with post-tonsillectomy hemorrhage after adjustment for age.ConclusionsThere does not appear to be a dose-related increase in the risk of post-tonsillectomy hemorrhage for patients receiving dexamethasone during tonsillectomy procedures.
http://ift.tt/2oSBaTS
Foreign body aspiration in children: A study of children who lived or died following aspiration
Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Maha Mohammad, Mohammad Saleem, Mohamad Mahseeri, Imad Alabdallat, Ali Alomari, Ala' Za'atreh, Ibraheem Qudaisat, Abdulrahman Shudifat, Mohammad Nasri Alzoubi
Foreign body aspiration (FBA) is a preventable cause of mortality and morbidity in children. We conducted a chart review of children who presented to a university hospital due to FBA in the period 1999–2014. Children were either managed with bronchoscopy for removal of the foreign body or died due to FBA. A total of 103 children were seen due to FBA including 27 deaths. The majority of children were boys and were less than 3 years old. Most aspirated foreign bodies were food-related, mainly peanuts. The majority of children presented with acute choking incidents, a smaller number presented with recurrent chest infections, and few children's choking incidents were unwitnessed. X-ray had a high rate of false negatives and bronchoscopy was the gold standard technique for assessment and management. Aspiration of foreign bodies is a preventable, life-threatening condition that calls for increased parent education and awareness.
http://ift.tt/2oEa5YD
Giant Orbital Melanoma in a Heroin Abuser
Purpose: The aim of this report was to report a heroin abuser with nondiagnosed giant uveal melanoma infiltrating the orbit and prolapsing through the face. Methods: We conducted a case report of the patient with giant melanoma. Results: In March 2013, a 39-year-old male with bleeding from the right side of his face was taken to the Emergency Center of the University Hospital Bratislava by ambulance. The heroin abusing, homeless male who had never been treated before reported a 2-year history of a prolapsed, dark colored mass from his eye. Acute computed tomography confirmed a solid mass 20 × 20 cm prolapsing from the orbit. The patient rejected primary care, accepted only 1 transfusion and left the hospital. Two months later, he was admitted to the hospital due to anemia after many collapses. Liver metastasis was present. Surgical palliative therapy was not possible due to his general status. The patient started fractionated external radiotherapy with 8.0 Gy Co60. Histopathological examination of the biopsy specimen showed malignant melanoma of the epitheloid type G2–3. The patient died in December 2013. Conclusion: Extraorbital formation of a melanoma mass may progress to a giant volume, and without treatment, led to metastases in the liver and to death after 9 months in our patient with anemia.
Case Rep Ophthalmol 2017;8:288–293
http://ift.tt/2paU4Im
Case Rep Ophthalmol 2017;8:288–293
http://ift.tt/2paU4Im
Limbal Stem Cell-Sparing Corneoscleroplasty with Peripheral Intralamellar Tuck: A New Surgical Technique for Keratoglobus
Purpose: To describe the technique of limbal stem cell-sparing corneoscleroplasty for the management of advanced keratoglobus. Methods: A patient with bilateral advanced keratoglobus, with best-corrected visual acuity of 20/400 in the right eye and 20/200 in the left eye, underwent limbal stem cell-sparing corneoscleroplasty of the right eye. Initially, a 360-degree limbal incision with 200-μm depth was created, followed by a sublimbal tunnel dissection into the sclera, in order to conserve stem cells. Next, a limbus-to-limbus lamellar keratectomy at 200-μm depth was performed. Meanwhile, a donor corneoscleral button with preserved endothelium of the central 8 mm was fashioned. Prior to suturing the donor corneoscleral graft using a modified suturing technique to cover its scleral component, a full-thickness trephination of 8-mm diameter was completed in the central host cornea. Results: Reepithelialization occurred within the first week. No episodes of rejection, intraocular pressure spikes, or epithelial breakdown were observed postoperatively. At the 6-month follow-up, the patient had 20/70 best-corrected vision and a smooth cornea with regular astigmatism on topography. Conclusion: Limbal stem cell-sparing corneoscleroplasty is a single-step technique for restoring the structural integrity of the cornea in advanced keratoglobus while preserving the host limbal stem cells.
Case Rep Ophthalmol 2017;8:279–287
http://ift.tt/2oPqYLn
Case Rep Ophthalmol 2017;8:279–287
http://ift.tt/2oPqYLn
Branch Retinal Vein Occlusion, Macular Ischemia, and Intravitreal Anti-VEGF Therapy
Purpose: To report a case with ischemic macular edema (ME) due to an acute branch retinal vein occlusion (BRVO) which was treated with repeated intravitreal anti-VEGF injections. Methods: Retrospective case presentation. Results: A 66-year-old female patient was treated with repeated intravitreal anti-VEGF injections due to ischemic ME following an acute BRVO. Over a period of 2.5 years best corrected visual acuity increased from 0.06 to 0.6 (decimal notation) accompanied by a reduction in central retinal thickness from 546 to 292 µm. Overall 17 anti-VEGF injections were administered to treat repeated recurrence of ME. Macular ischemia did not worsen during this profound intravitreal anti-VEGF therapy. Conclusion: Intravitreal anti-VEGF therapy can be a beneficial treatment strategy even in ischemic ME following an acute BRVO.
Case Rep Ophthalmol 2017;8:271–278
http://ift.tt/2pbcLM3
Case Rep Ophthalmol 2017;8:271–278
http://ift.tt/2pbcLM3
Single Gene Encourages Growth of Intestinal Stem Cells, Supporting “Niche” Cells—and Cancer
A gene previously identified as critical for tumor growth in many human cancers also maintains intestinal stem cells and encourages the growth of cells that support them, according to results of a study led by Johns Hopkins researchers. The finding, reported in the Apr. 28 issue of Nature Communications, adds to evidence for the intimate link between stem cells and cancer, and advances prospects for regenerative medicine and cancer treatments.
http://ift.tt/2poBkU1
Environmental factors and hormones in the development of rheumatoid arthritis
Abstract
The etiopathogenesis of rheumatoid arthritis (RA) is partially understood. Genetic, environmental, and hormonal factors and their interactions are considered to play an important role on disease development. The relative contribution of environmental factors to RA development is probably larger than previously thought. The aim of this review is to appraise robust evidence about the role of environmental and hormonal risk factors for RA. We will discuss inhaled pollutants, nutritional habits, infectious, hormonal, and reproductive factors. As some of these factors are potentially modifiable, understanding their impact on RA development opens new opportunities for potential interventions and disease prevention.
http://ift.tt/2qc2Nvj
Future therapeutic targets in rheumatoid arthritis?
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent joint inflammation. Without adequate treatment, patients with RA will develop joint deformity and progressive functional impairment. With the implementation of treat-to-target strategies and availability of biologic therapies, the outcomes for patients with RA have significantly improved. However, the unmet need in the treatment of RA remains high as some patients do not respond sufficiently to the currently available agents, remission is not always achieved and refractory disease is not uncommon. With better understanding of the pathophysiology of RA, new therapeutic approaches are emerging. Apart from more selective Janus kinase inhibition, there is a great interest in the granulocyte macrophage-colony stimulating factor pathway, Bruton's tyrosine kinase pathway, phosphoinositide-3-kinase pathway, neural stimulation and dendritic cell-based therapeutics. In this review, we will discuss the therapeutic potential of these novel approaches.
http://ift.tt/2oQ6S4c
The meteorology of cytokine storms, and the clinical usefulness of this knowledge
Abstract
The term cytokine storm has become a popular descriptor of the dramatic harmful consequences of the rapid release of polypeptide mediators, or cytokines, that generate inflammatory responses. This occurs throughout the body in both non-infectious and infectious disease states, including the central nervous system. In infectious disease it has become a useful concept through which to appreciate that most infectious disease is not caused directly by a pathogen, but by an overexuberant innate immune response by the host to its presence. It is less widely known that in addition to these roles in disease pathogenesis these same cytokines are also the basis of innate immunity, and in lower concentrations have many essential physiological roles. Here we update this field, including what can be learned through the history of how these interlinking three aspects of biology and disease came to be appreciated. We argue that understanding cytokine storms in their various degrees of acuteness, severity and persistence is essential in order to grasp the pathophysiology of many diseases, and thus the basis of newer therapeutic approaches to treating them. This particularly applies to the neurodegenerative diseases.
http://ift.tt/2oPNaFY
The role of autoantibodies in the pathophysiology of rheumatoid arthritis
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation. The presence of autoantibodies in the sera of RA patients has provided many clues to the underlying disease pathophysiology. Based on the presence of several autoantibodies like rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), anti-carbamylated protein antibodies (anti-CarP), and more recently anti-acetylated protein antibodies RA can be subdivided into seropositive and seronegative disease. The formation of these autoantibodies is associated with both genetic and environmental risk factors for RA, like specific human leukocyte antigen (HLA) alleles and smoking. Autoantibodies can be detected many years before disease onset in a subset of patients, suggesting a sequence of events in which the first autoantibodies develop in predisposed hosts, before an inflammatory response ensues leading to clinically apparent arthritis. Research on the characteristics and effector functions of these autoantibodies might provide more insight in pathophysiological processes underlying arthritis in RA. Recent data suggests that ACPA might play a role in perpetuating inflammation once it has developed. Furthermore, pathophysiological mechanisms have been discovered supporting a direct link between the presence of ACPA and both bone erosions and pain in RA patients. In conclusion, investigating the possible pathogenic potential of autoantibodies might lead to improved understanding of the underlying pathophysiological processes in rheumatoid arthritis.
http://ift.tt/2oPNCDX
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