Clinical characteristics and follow-up results of 12 cases of paradoxical embolism

Publication date: June 2017
Source:Data in Brief, Volume 12
Author(s): Hong-liang Zhang, Zhi-hong Liu, Qin Luo, Yong Wang, Zhi-hui Zhao, Chang-ming Xiong
This article contains the clinical characteristics of the paradoxical embolized patients and the following up results. Data included are related to the article "Paradoxical embolism: Experiences from a single center" (Zhang Hong-liang, Liu Zhi-hong, Luo Qin, Wang Yong, Zhao Zhi-hui, Xiong Chang-ming, in press) [1]. The data are obtained from the hospital records and telephone interview.



http://ift.tt/2nlTIw3

Data on the effects of anti-cancer drug of resveratrol in breast cancer cells, MDA-MB-231 cells

Publication date: June 2017
Source:Data in Brief, Volume 12
Author(s): Eunmi Park
The data here is related to the article, "Curcumin enhances poly (ADP-ribose) polymerase inhibitor sensitivity to chemotherapy in breast cancer cells" (Y.E Choi, and E. Park, 2015) [1]. The article shows that curcumin, as a natural bioactive compound, enhanced DNA damage response and induced cell death in MDA-MB-231 cells [1]. This data includes that breast cancer cells, MDA-MB-231 respond to DNA damage after UV irradiation, post to resveratrol treatment. The data shows that resveratrol treatment results in reduction of S-phase cell cycle and induction of γ-H2AX, which is a hallmark of DNA damage after UV irradiation in breast cancer cells, MDA-MB-231. Moreover, resveratrol sensitizes breast cancer cells to respond to UV treatment as a natural bioactive compound.



http://ift.tt/2nVRDtz

Data on subgroup specific baseline characteristics and serum sphingosine-1-phosphate concentrations in the Study of Health in Pomerania

Publication date: June 2017
Source:Data in Brief, Volume 12
Author(s): Eileen Moritz, Danilo Wegner, Stefan Groß, Martin Bahls, Marcus Dörr, Stephan B. Felix, Till Ittermann, Stefan Oswald, Matthias Nauck, Nele Friedrich, Rainer H. Böger, Günter Daum, Edzard Schwedhelm, Bernhard H. Rauch
In this data article, we provide subgroup specific baseline characteristics and serum sphingosine-1-phosphate (S1P) concentrations for healthy individuals within the Study of Health in Pomerania (SHIP)-TREND cohort. After exclusion of subjects with cardiovascular disease, diabetes mellitus, hypertension, metabolic syndrome, elevated liver enzymes and/or chronic kidney disease stadium III or IV, four subgroups were defined according to different limits for body mass index (BMI), alterations in blood lipid levels and smoking status. Tables show respective clinical and laboratory parameters stratified by gender. Serum S1P concentrations are also stratified by age groups. The data presented herein is related to the research article entitled "Reference intervals for serum sphingosine-1-phosphate in the population-based Study of Health in Pomerania" (E. Moritz, D. Wegner, S. Groß, M. Bahls, M. Dörr, S.B. Felix, T. Ittermann, S. Oswald, M. Nauck, N. Friedrich, R.H. Böger, G. Daum, E. Schwedhelm, B.H. Rauch, Clin Chim Acta. 468 (2017) 25–31) [1].



http://ift.tt/2nm46DY

Genome organization: Zooming in on nuclear organization

Two studies report new methods for studying the 3D genome — one captures three-way contacts and the other calculates 3D structures of genomes in single cells.

http://ift.tt/2n7P7LY

Disease genomics: Transitioning from association to causation with eQTLs

http://ift.tt/2nDIZzh

Regulatory elements: A boost to RNA processing

http://ift.tt/2n7JXQh

Functional variomics and network perturbation: connecting genotype to phenotype in cancer

The abundance and heterogeneity of mutations in cancer create challenges for understanding their effects, but such functional characterization will be crucial for optimizing clinical care. In this Review, the authors discuss diverse computational tools and systems biology experimental strategies for elucidating the functional effects of cancer mutations, including consequences on gene regulation, protein structure and local and global perturbations of molecular interaction networks.

http://ift.tt/2nDRrOJ

Lichenoid folliculitis, a unifying concept

Abstract

Skin diseases presenting with keratotic papules, atrophy, cicatricial alopecia, and/or "lichenoid" histopathologic changes have been described under at least 30 names. This family of diseases contains two subgroups, largely based on clinical features: keratosis pilaris atrophicans (KPA; including keratosis pilaris atrophicans faciei/ulerythema ophryogenes, atrophoderma vermiculata , and keratosis follicularis spinulosa decalvans); and the lichen planopilaris (LPP) subgroup (including LPP, frontal fibrosing alopecia, Graham-Little-Piccardi-Lassueur Syndrome, and fibrosing alopecia in a pattern distribution). An interface dermatitis with lichenoid inflammation is characteristic of the LPP group of disorders, but the literature provides scant information about the histopathology of the KPA group. Our experience has been that the two subgroups show a unifying histologic similarity as well as considerable clinical overlap. Since these conditions overlap clinically and histologically, we propose that the term lichenoid folliculitis (LF) be used to refer to this group of diseases, thus simplifying cumbersome nomenclature and highlighting the possibility of shared pathogenesis and treatment options.

http://ift.tt/2nDni26

Clinical Thyroidology High-Impact Articles

FREE ACCESS through April 7, 2017.
Read Now:

Multimodality Treatment with Surgery, External-Beam Radiation, and Chemotherapy Improves Survival for Selected Patients with Anaplastic Thyroid Cancer
Masha J. Livhits, Michael W. Yeh

Active Surveillance of Small, Low-Risk Papillary Thyroid Cancers Can Be a Safe Alternative to Surgery in Selected Patients
Angela M. Leung

Pregnancy Has Little Effect on the Progression of Differentiated Thyroid Cancer in Women with an Excellent, Indeterminate, or Biochemically Incomplete Risk Classification Status
Charles H. Emerson

Large NIFTP Have a Very Low Risk of Recurrence
Jerome M. Hershman

The post Clinical Thyroidology High-Impact Articles appeared first on American Thyroid Association.

http://ift.tt/2nqztPz

Sex steroids and the GH axis: Implications for the management of hypopituitarism

Publication date: Available online 14 March 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Vita Birzniece, Ken K.Y. Ho
Growth hormone (GH) regulates somatic growth, substrate metabolism and body composition. Sex hormones exert profound effect on the secretion and action of GH. Estrogens stimulate the secretion of GH, but inhibit the action of GH on the liver, an effect that occurs when administered orally. Estrogens suppress GH receptor signaling by stimulating the expression proteins that inhibit cytokine receptor signaling. This effect of estrogens is avoided when physiological doses of estrogens are administered via a non-oral route. Estrogen-like compounds, such as selective estrogen receptor modulators, possess dual properties of inhibiting the secretion as well as the action of GH. In contrast, androgens stimulate GH secretion, driving IGF-1 production. In the periphery, androgens enhance the action of GH. The differential effects of estrogens and androgens influence the dose of GH replacement in patients with hypopituitarism on concomitant treatment with sex steroids. Where possible, a non-oral route of estrogen replacement is recommended for optimizing cost-benefit of GH replacement in women with GH deficiency. Adequate androgen replacement in conjunction with GH replacement is required to achieve the full anabolic effect in men with hypopituitarism.



http://ift.tt/2nqOoco

Narrow neovaginal width in a transgender patient due to short interramic distance

Abstract

Vaginoplasty is one of the core procedures for transgender patients. A neovaginal cavity is created between the prostate and rectum. The width of the introitus is determined by the distance between the inferior pubic rami. A 32-year-old transgender patient underwent vaginoplasty. Surgery was uneventful. When starting the dilation regimen, insertion of the usual stent was impossible since the neovagina had restricted width. A CT scan of the pelvis showed that the interramic distance, at 3.0 cm below the lower border of bony structure of the symphysis pubis, was only 3.2 cm. If a transgender patient presents with short stature, a short interramic distance may be expected. Preoperative radiological imaging should be considered. Surgeons should be equipped with adequate-size stents for postoperative dilation regimen.

Level of Evidence: Level V, risk / prognostic study

http://ift.tt/2mEYdVm

Prevalence of transverse upper labial crease

Abstract

Background

The presence or hyperactivity of the depressor septi nasi muscle has been proposed to cause a visible crease in the upper labial region that is esthetically disturbing to patients. The objective of this paper was to determine how often an upper labial crease is evident in women and to find a straightforward treatment. Muscular creases can be ameliorated with botulinum toxin. However, weakening the depressor septi nasi muscles with botulinum toxin did not eradicate existing upper labial creases at rest or during facial animation. Therefore, we proposed that a complex interplay exists between the upper labial muscles, and we sought to determine which of these muscles are responsible for the existence of the upper labial crease.

Methods

A total of 100 consecutive female volunteers who visited a plastic surgery clinic were prospectively examined. The presence and localization of the upper labial crease were assessed at rest and during animation prompted with the "smile test" and during snuffling. Additionally, the appearance and symmetry of the upper labial crease were assessed and correlated with the type of smile to identify the dominant muscles involved.

Results

In total, 38% of women older than 40 years presented with an upper labial crease at rest, and 70% presented with a crease during animation. Only one third of the women were aware that they had such a crease when they smiled. When the crease was present, it was bilateral in 98% of the women. When it was asymmetrical, which was the case for 10% of women, the fold was longer, shorter, or less visible on one half of the upper lip. The localization was highly variable and ranged from the base of the columella to the caudal third of the upper lip. When an upper labial crease was present at rest and/or during facial animation, it was associated with a type B smile, i.e., the "canine" smile, due a dominant levator labii superioris muscle.

Conclusions

This study showed that upper labial creases are present more often than women are aware of them. The injection of botulinum toxin into the levator labii superioris muscles can eradicate an upper labial crease.

Level of Evidence: Level IV, risk / prognostic study.

http://ift.tt/2okLEL5

Health assessment instruments for people with intellectual disabilities—A systematic review

Publication date: May 2017
Source:Research in Developmental Disabilities, Volume 64
Author(s): E.J. Bakker-van Gijssel, P.L.B.J. Lucassen, T.C Olde Hartman, L. van Son, W.J.J. Assendelft, H.M.J. van Schrojenstein Lantman-de Valk
BackgroundPeople with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems.AimThe aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality.MethodsWe conducted an electronic literature search of papers published between January 2000 and May 2016. After a two-phase selection process (kappa: 0.81 and 0.77) we collected data from the 29 included peer-reviewed articles on the following four domains; development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content (i.e. ID-related health problems, prevention and health promotion topics) and effectiveness of the instruments.Results/ConclusionsWe distinguished 20 different health assessment instruments. Limited information was found on the development of the instruments as well as on their clinimetric properties. The content of the instruments was rather diverse. The included papers agreed that health assessment instruments are effective. However, only three instruments evaluated effectiveness in a randomised controlled trial. Patients with ID, carers and general practitioners (GPs) generally appreciated the health assessment instruments.ImplicationTwo instruments, "Stay well and healthy −Health risk appraisal (SWH-HRA)"and the "Comprehensive Health Assessment Programme (CHAP)", appeared to have the highest quality. These instruments can be used to construct a health assessment instrument for people with ID that meets scientific standards.



http://ift.tt/2nVctsL

SIGUEME: Technology-based intervention for low-functioning autism to train skills to work with visual signifiers and concepts

Publication date: May 2017
Source:Research in Developmental Disabilities, Volume 64
Author(s): María Vélez-Coto, María José Rodríguez-Fórtiz, María Luisa Rodriguez-Almendros, Marcelino Cabrera-Cuevas, Carlos Rodríguez-Domínguez, Tomás Ruiz-López, Ángeles Burgos-Pulido, Inmaculada Garrido-Jiménez, Juan Martos-Pérez
BackgroundPeople with low-functioning ASD and other disabilities often find it difficult to understand the symbols traditionally used in educational materials during the learning process. Technology-based interventions are becoming increasingly common, helping children with cognitive disabilities to perform academic tasks and improve their abilities and knowledge. Such children often find it difficult to perform certain tasks contained in educational materials since they lack necessary skills such as abstract reasoning. In order to help these children, the authors designed and created SIGUEME to train attention and the perceptual and visual cognitive skills required to work with and understand graphic materials and objects.MethodsA pre-test/post-test design was implemented to test SIGUEME. Seventy-four children with low-functioning ASD (age=13.47, SD=8.74) were trained with SIGUEME over twenty-five sessions and compared with twenty-eight children (age=12.61, SD=2.85) who had not received any intervention.ResultsThere was a statistically significant improvement in the experimental group in Attention (W=−5.497, p<0.001). There was also a significant change in Association and Categorization (W=2.721, p=0.007) and Interaction (W=−3.287, p=0.001).ConclusionsSIGUEME is an effective tool for improving attention, categorization and interaction in low-functioning children with ASD. It is also a useful and powerful instrument for teachers, parents and educators by increasing the child's motivation and autonomy.



http://ift.tt/2n84AwB

Targeted physical activity messages for parents of children with disabilities: A qualitative investigation of parents' informational needs and preferences

Publication date: May 2017
Source:Research in Developmental Disabilities, Volume 64
Author(s): R.L. Bassett-Gunter, R.J. Ruscitti, A.E. Latimer-Cheung, J.L. Fraser-Thomas
Background and aimPhysical activity (PA) has myriad benefits for children with disabilities (CWD). Information and messaging campaigns can promote PA among CWD. The overall purpose of the study was to gain an understanding of the development of PA information and messages targeting parents of CWD. The specific objectives were to identify parents' preferences regarding PA information and messaging content and preferred methods and sources of communication.MethodFocus groups were conducted with parents of CWD (N=28). Qualitative data were collected and transcribed. Inductive content analyses were employed to identify key themes.ResultsThree key thematic areas were identified: 1) Preferred content (e.g., targeted information, self-regulatory strategies, inclusive images), 2) Challenges (e.g., lack of information and language clarity), 3) Preferred sources (e.g., other parents, reliable organizations, central information hub).Conclusions and implicationsParents' needs and preferences regarding PA information could be incorporated into campaigns to enhance parent PA support and PA among CWD. Stakeholders (e.g., PA organizations, programs and practitioners) can employ these strategies in campaigns and resources targeting parents of CWD. Research is necessary to empirically develop and evaluate PA information and messaging campaigns targeting parents of CWD.



http://ift.tt/2nUSeeI

Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders

Publication date: May 2017
Source:Research in Developmental Disabilities, Volume 64
Author(s): Bram B. Sizoo, Erik Kuiper
Anxiety and depression co-occur in 50–70% of adults with autism spectrum disorder (ASD) but treatment methods for these comorbid problems have not been systematically studied. Recently, two ASD-tailored protocols were published: mindfulness based stress reduction (MBSR) and cognitive behavioural therapy (CBT). We wanted to investigate if both methods are equally effective in reducing anxiety and depression symptoms among adults with ASD. 59 adults with ASD and anxiety or depression scores above 7 on the Hospital Anxiety and Depression Scale, gave informed consent to participate; 27 followed the CBT protocol, and 32 the MBSR treatment protocol. Anxiety and depression scores, autism symptoms, rumination, and global mood were registered at the start, at the end of the 13-week treatment period, and at 3-months follow-up. Irrational beliefs and mindful attention awareness were used as process measures during treatment and at follow-up. Results indicate that both MBSR and CBT are associated with a reduction in anxiety and depressive symptoms among adults with ASD, with a sustained effect at follow-up, but without a main effect for treatment group. A similar pattern was seen for the reduction of autistic symptoms, rumination and the improvement in global mood. There are some indications that MBSR may be preferred over CBT with respect to the treatment effect on anxiety when the scores on measures of irrational beliefs or positive global mood at baseline are high. Mindfulness and cognitive behavioral therapies are both promising treatment methods for reducing comorbid anxiety and depression in adults with ASD.



http://ift.tt/2n7R3oM

Motor learning paradigm and contextual interference in manual computer tasks in individuals with cerebral palsy

Publication date: May 2017
Source:Research in Developmental Disabilities, Volume 64
Author(s): Maria Tereza Artero Prado, Deborah Cristina Gonçalves Luiz Fernani, Talita Dias da Silva, Ana R.P. Smorenburg, Luiz Carlos de Abreu, Carlos Bandeira de Mello Monteiro
BackgroundCerebral palsy (CP) is a group of disorders of movement and posture that cause activity limitations. Due to the different motor problems these individuals encounter there is a need to offer rehabilitation programs that promote motor learning. Additionally, the understanding of the learning patterns of these individuals can help us attend to their learning needs to maximize their learning efficiency.AimsThe present study aimed to add to the knowledge base in regards to motor learning and the contextual interference (CI) effect.Methods and proceduresThe study included 40 individuals with CP and 40 typically developing (TD) participants matched for age and gender with the CP group. Both groups were divided into 2 subgroups regarding the practice schedule (random or constant practice) of a manual maze test on the computer. The participants who performed in the constant practice schedule performed the same standard maze 30 times, while participants in the random practice schedule performed a total of 30 trials on 5 mazes with a different spatial layout including the standard maze. After 5min of rest, retention was studied with a task in which all participants performed the standard maze. To examine the transfer effect, all participants also performed a maze with a new layout. Time of completion was registered in seconds for each trial.Outcomes and resultsThe results showed that the performance was lower in individuals with CP compared to typically developing individuals. In addition, only the participants with CP showed a contextual interference effect, with performance after the random practice schedule being superior compared to participants who practiced with a constant practice schedule.Conclusions and implicationsOverall performance was lower in individuals with CP compared to individuals with TD. Additionally, both TD individuals and individuals with CP showed the contextual interference effect in the transfer phase, with the execution of random practice leading to better performance than constant practice. These findings provide important information to assist clinicians in developing rehabilitation programs for children with CP.



http://ift.tt/2nUUqmq

IFC-EDITORIAL BOARD

Publication date: April 2017
Source:Research in Developmental Disabilities, Volume 63





http://ift.tt/2n86n4I

Psychometric properties of the Japanese version of the Adult Attention-deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS-J) and its short scale in accordance with DSM-5 diagnostic criteria

Publication date: April 2017
Source:Research in Developmental Disabilities, Volume 63
Author(s): Toshinobu Takeda, Yui Tsuji, Hiroshi Kurita
We developed the Japanese version of the Adult ADHD Self-Report Scale (ASRS-J) and report its psychometric properties. The ASRS-J and other questionnaires were administered to 48 adults with ADHD, 46 adults with non-ADHD psychiatric disorders, 96 non-clinical adults, and 894 university students. ADHD diagnoses were made using the Japanese semi-structured diagnostic interview for adult ADHD, which is compatible with the DSM-5. The ASRS-J, its subscales, and the short form, all had Cronbach's α values of around 0.80. Total scores on the ASRS-J and the ASRS-J-6 were highly correlated with readministration after a two-week interval. The total and 18 individual item scores in the ASRS-J were significantly higher in the ADHD group than the other three groups. ASRS-J scores were correlated with scores on the Japanese version of Conners' Adult ADHD Rating Scales-Self Report subscales (0.59≤r≤0.77), with one exception. ASRS-J scores were also correlated (albeit more weakly; r=0.38) with Beck Depression Inventory-II total scores. Employing optimal cut-offs, sensitivity, specificity, and positive and negative predictive values of the ASRS-J and ASRS-J-6 are all above 0.69. The ASRS-J and ASRS-J-6 showed acceptable psychometric properties, although further study is necessary.



http://ift.tt/2nUZqYv

A qualitative evaluation of caregivers’ experiences, understanding and outcomes following diagnosis of FASD

Publication date: April 2017
Source:Research in Developmental Disabilities, Volume 63
Author(s): Katrina Chamberlain, Natasha Reid, Judith Warner, Doug Shelton, Sharon Dawe
IntroductionThe effects of prenatal exposure to alcohol are wide-ranging and pervasive in nature. In response to growing concerns about the lifelong disabilities related to prenatal alcohol exposure, a fetal alcohol spectrum disorder (FASD) diagnostic clinic was established in 2012. This was the first multi-disciplinary service operating permanently within an Australian health service. The current study aimed to explore the lived experience of the diagnostic process for caregivers of children with FASD.MethodsTwelve caregivers were approached and ten participated in audiotaped interviews about caring for a child with FASD. Qualitative analysis was undertaken on transcribed interviews using NVivo 10 for thematic analysis.ResultsThe major themes that emerged were: a desire for future support for their child although uncertainty about how this support could be accessed; an understanding of FASD prior to assessment but a concerted concern that this condition was not recognised as a disability across educational and related settings; that a formal assessment process provided validation for caregiver concerns and that caregivers felt respected and understood by the clinical team during this process.DiscussionThese findings highlight the concerns of caregivers, emphasising both the importance of diagnostic services and the need for provision of further support beyond diagnosis for a child with FASD.What does this paper add?This study provides information on the lived experiences of caregivers who attended the first multi-disciplinary FASD assessment and diagnostic service in Australia. This study provides valuable insight into the ongoing difficulties that families are experiencing following diagnosis in the current Australian context.



http://ift.tt/2n86sFF

Alcohol, tobacco and cannabis use: Do students with mild-intellectual disability mimic students in the general population?

Publication date: April 2017
Source:Research in Developmental Disabilities, Volume 63
Author(s): Dibia Liz Pacoricona Alfaro, Virginie Ehlinger, Stanislas Spilka, Jim Ross, Mariane Sentenac, Emmanuelle Godeau
Education policies encourage inclusion of students with mild-intellectual disability (mild-ID) in community/school life. However, such policies potentially increase exposure to substance use.This article examines tobacco, alcohol and cannabis use among French students enrolled in special units for students with disabilities (ULIS) at mainstream junior high schools compared to those of general population of the equivalent age; and explores factors associated with substance use among ULIS students, known to present mostly mild-ID.In 2014, a questionnaire adapted from the international HBSC/WHO study was administered to 700 ULIS students (mean-age 14.2). Comparative data were gathered from 7023 junior high-school students (mean-age 13.6) in the general population.Among students <14 years-old, tobacco and alcohol use rates were similar between ULIS and general population. For students ≥14, alcohol use remained comparable, while tobacco and cannabis use were higher in general population.Among ULIS students, low perceived health/life satisfaction, divorced/separated parents and high perceived academic demands were associated with tobacco use. Bullying, not liking school very much and attending schools outside a deprived area were associated with alcohol use. Having had sexual intercourse and not perceiving one's health as excellent were associated with cannabis use. Having dated was associated with using all three substances.



http://ift.tt/2nUZAyW

Personality dimensions and substance use in individuals with mild to borderline intellectual disabilities

Publication date: April 2017
Source:Research in Developmental Disabilities, Volume 63
Author(s): Evelien A.P. Poelen, Esmée P. Schijven, Roy Otten, Robert Didden
AimsThe aim of this study was to examine the role of the personality dimensions anxiety sensitivity, negative thinking, impulsivity and sensation seeking (as assessed by the revised version of the Substance Use Risk Profile Scale; SURPS) in substance use in individuals with mild to borderline intellectual disabilities (MBID).MethodWe tested the relationship between level of ID and SURPS personality dimensions and the relationship between SURPS personality dimensions and severity of alcohol and drug use. Participants were 118 persons (mean age 20.5 years) with a mean IQ of 71.1 admitted to care facilities for persons with MBID and severe behavioral problems.ResultsWe found no significant relationship between level of ID and the four personality dimensions. In addition, findings showed that individuals with lower levels of anxiety sensitivity, higher levels of negative thinking, impulsivity and sensation seeking showed more severe alcohol use. Individuals with higher levels of negative thinking and sensation seeking had more severe drug use.Conclusions and implicationsThe SURPS personality dimensions identify persons at increased risk for substance use disorders and might be useful in developing selective substance use interventions for individuals with MBID.



http://ift.tt/2n7RlMx

Substance use in individuals with mild to borderline intellectual disability: A comparison between self-report, collateral-report and biomarker analysis

Publication date: April 2017
Source:Research in Developmental Disabilities, Volume 63
Author(s): Joanneke E.L. VanDerNagel, Marion Kiewik, Marike van Dijk, Robert Didden, Hubert P.L.M. Korzilius, Job van der Palen, Jan K. Buitelaar, Donald R.A. Uges, Remco A. Koster, Cor A.J. de Jong
Background and aimsIndividuals with mild or borderline intellectual disability (MBID) are at risk of substance use (SU). At present, it is unclear which strategy is the best for assessing SU in individuals with MBID. This study compares three strategies, namely self-report, collateral-report, and biomarker analysis.Methods and proceduresIn a sample of 112 participants with MBID from six Dutch facilities providing care to individuals with intellectual disabilities, willingness to participate, SU rates, and agreement between the three strategies were explored. The Substance use and misuse in Intellectual Disability − Questionnaire (SumID-Q; self-report) assesses lifetime use, use in the previous month, and recent use of tobacco, alcohol, cannabis, and stimulants. The Substance use and misuse in Intellectual Disability − Collateral-report questionnaire (SumID-CR; collateral-report) assesses staff members' report of participants' SU over the same reference periods as the SumID-Q. Biomarkers for SU, such as cotinine (metabolite of nicotine), ethanol, tetrahydrocannabinol (THC), and its metabolite THCCOOH, benzoylecgonine (metabolite of cocaine), and amphetamines were assessed in urine, hair, and sweat patches.ResultsWillingness to provide biomarker samples was significantly lower compared to willingness to complete the SumID-Q (p<0.001). Most participants reported smoking, drinking alcohol, and using cannabis at least once in their lives, and about a fifth had ever used stimulants. Collateralreported lifetime use was significantly lower. However, self-reported past month and recent SU rates did not differ significantly from the rates from collateral-reports or biomarkers, with the exception of lower alcohol use rates found in biomarker analysis. The agreement between self-report and biomarker analysis was substantial (kappas 0.60–0.89), except for alcohol use (kappa 0.06). Disagreement between SumID-Q and biomarkers concerned mainly over-reporting of the SumID-Q. The agreement between SumID-CR and biomarker analysis was moderate to substantial (kappas 0.48 − 0.88), again with the exception of alcohol (kappa 0.02).Conclusions and implicationsIn this study, the three strategies that were used to assess SU in individuals with MBID differed significantly in participation rates, but not in SU rates. Several explanations for the better-than-expected performance of self- and collateral-reports are presented. We conclude that for individuals with MBID, self-report combined with collateralreport can be used to assess current SU, and this combination may contribute to collaborative, early intervention efforts to reduce SU and its related harms in this vulnerable group.



http://ift.tt/2nUWCKN

Effects of prenatal exposure to WIFI signal (2.45GHz) on postnatal development and behavior in rat: Influence of maternal restraint

Publication date: 30 May 2017
Source:Behavioural Brain Research, Volume 326
Author(s): Haifa Othman, Mohamed Ammari, Mohsen Sakly, Hafedh Abdelmelek
The present study was carried out to investigate the potential combined influence of maternal restraint stress and 2.45GHz WiFi signal exposure on postnatal development and behavior in the offspring of exposed rats. 24 pregnant albino Wistar rats were randomly assigned to four groups: Control, WiFi-exposed, restrained and both WiFi-exposed and restrained groups. Each of WiFi exposure and restraint occurred 2h/day along gestation till parturition. The pups were evaluated for physical development and neuromotor maturation. Moreover, elevated plus maze test, open field activity and stationary beam test were also determined on postnatal days 28, 30 and 31, respectively. After behavioral tests, the rats were anesthetized and their brains were removed for biochemical analysis. Our main findings showed no detrimental effects on gestation progress and outcomes at delivery in all groups. Subsequently, WiFi and restraint, per se and mainly in concert altered physical development of pups with slight differences between genders. Behaviorally, the gestational WiFi irradiation, restraint and especially the associated treatment affected the neuromotor maturation mainly in male progeny. At adult age, we noticed anxiety, motor deficit and exploratory behavior impairment in male offspring co-exposed to WiFi radiation and restraint, and in female progeny subjected to three treatments. The biochemical investigation showed that, all three treatments produced global oxidative stress in brain of both sexes. As for serum biochemistry, phosphorus, magnesium, glucose, triglycerides and calcium levels were disrupted. Taken together, prenatal WiFi radiation and restraint, alone and combined, provoked several behavioral and biochemical impairments at both juvenile and adult age of the offspring.



http://ift.tt/2nXOCJo

Temporal changes in native-exotic richness correlations during early post-fire succession

Publication date: April 2017
Source:Acta Oecologica, Volume 80
Author(s): Qinfeng Guo
The relationship between native and exotic richness has mostly been studied with respect to space (i.e., positive at larger scales, but negative or more variable at smaller scales) and its temporal patterns have rarely been investigated. Although some studies have monitored the temporal trends of both native and exotic richness, how these two groups of species might be related to each other and how their relative proportions vary through time in a local community remains unclear. Re-analysis of early post-fire successional data for a California chaparral community shows that, in the same communities and at small spatial scales, the native-exotic correlations varied through time. Both exotic richness and exotic fraction (i.e., the proportion of exotic species in the flora) quickly increased and then gradually declined, during the initial stages of succession following fire disturbance. This result sheds new light on habitat invasibility and has implications for timing the implementation of effective management actions to prevent and/or mitigate species invasions.



http://ift.tt/2n7ISbX

Chronic hepatitis B: Immunological profile and current therapeutic vaccines in clinical trials

Publication date: Available online 25 March 2017
Source:Vaccine
Author(s): Yadira Lobaina, Marie-Louise Michel
More than 250million people worldwide are chronically infected with hepatitis B virus (CHB), and over half a million die each year due to CHB-associated liver complications such as cirrhosis and hepatocellular carcinoma. The translation of immunological knowledge about CHB into therapeutic strategies aiming to a sustainable hepatitis B virus (HBV) clearance has been challenging. In recent years, however, the understanding on the immune effectors required to overcome chronicity has notably increased thanks to preclinical and clinical research. Therapeutic vaccination may prove to be useful for treating CHB patients when coupled with current antiviral agents and other immunomodulatory strategies. This review summarizes current data and future perspectives on therapeutic vaccination. Other treatment alternatives that could be combined with vaccines for a complete cure from hepatitis B virus infection are also discussed.



http://ift.tt/2o6jFQ0

Moving the needle on nursing staff influenza vaccination in long-term care: Results of an evidence-based intervention

Publication date: Available online 25 March 2017
Source:Vaccine
Author(s): Cori L. Ofstead, Miriam R. Amelang, Harry P. Wetzler, Litjen Tan
PurposeInfluenza vaccination rates among healthcare providers (HCPs) in long-term care facilities (LTCFs) are commonly below the Healthy People 2020 goal of 90%. This study was conducted to develop and evaluate an intervention program designed to increase influenza uptake among HCPs in LTCFs.MethodsThis study was conducted in four Midwestern LTCFs. Baseline interviews, surveys, and administrative data analysis were performed following the 2013–2014 influenza season. Interventions implemented during the 2014–2015 season were based on the health belief and ecological models and included goal-setting worksheets, policy development, educational programs, kick-off events, incentives, a vaccination tracking roster, and facility-wide communication about vaccine uptake among HCPs. Outcomes were evaluated in 2015.ResultsAt baseline, 50% of 726 nursing staff employed during the 2013–2014 influenza season had documented receipt of influenza vaccine (Site A: 34%; Site B: 5%; Site C: 75%; Site D: 62%), and 31% of 347 survey respondents reported absenteeism due to respiratory illness. At follow-up, 85% of HCPs had documented receipt of influenza vaccine (p<0.01) and 19% of 323 survey respondents reported absenteeism due to respiratory illness (p<0.01). Vaccination rates among respondents' family members increased from 31% at baseline to 44% post-intervention (p<0.01). Reasons for declining vaccination did not change following exposure to educational programs, but HCPs were more likely to recommend vaccination to others after program implementation.ConclusionsVaccination rates among long-term care HCPs and their family members increased significantly and HCP absenteeism decreased after the implementation of multifaceted interventions based on an ecological model. The findings suggest that major increases in HCP vaccination can be achieved in LTCFs. More research is needed to evaluate the impact of increased HCP vaccination on the health and productivity of LTCF employees, their family members, and residents.



http://ift.tt/2nWR8Q1

Prevalence of factor H Binding Protein sub-variants among Neisseria meningitidis in China

Publication date: Available online 25 March 2017
Source:Vaccine
Author(s): Fenglin Shi, Aiyu Zhang, Bingqing Zhu, Yuan Gao, Li Xu, Yixing Li, Zundong Yin, Junhong Li, Na Xie, Zhujun Shao
ObjectiveTo study the prevalence of the fHbp genes in Neisseria meningitidis (N. meningitidis) isolates for further evaluation and development of serogroup B meningococcal vaccines in China.MethodsA panel of 1012 N. meningitidis strains was selected from the national culture collection from 1956 to 2016, according to the years of isolation, locations, and strain sources. These were tested by FHbp variant typing. Multi-locus sequence typing (MLST) was performed on 822 of these samples, including 242 strains from clinical strains and 580 carrier-derived strains. Analysis based on sequence types, serogroups, and FHbp variations were used to summarize the prevalence and characteristics of N. meningitidis.ResultsThere were 8 serogroups of N. meningitidis as well as a collection of nongroupable strains in this study. 1008 of 1012 N. meningitidis strains tested were positive for the fHbp gene. Serogroup A N. meningitidis (MenA) strains belonging to ST-1 and ST-5 clonal complexes harbored genes only encoding variant 1 (v1) FHbp. All MenW strains encoded v2 FHbp. 61.9% of clinical MenB strains were positive for v2 FHbp vs. 32.1% that were positive for v1. Among fHbp-positive carrier-derived MenB strains, v2 FHbp accounted for 90.8%. 79.7% of clinical MenC strains were positive for v1 FHbp and 20.3% were positive for v2 FHbp. Among carrier-derived MenC strains, v2 FHbp predominated. The number of major serogroups of N. meningitidis analyzed by MLST was 822, and the encoded FHbp showed CC- or ST-specific characteristics.ConclusionfHbp genes were detected in almost all N. meningitidis strains in this study. Therefore, it is possible that a vaccine against MenB or meningococci irrespective of serogroups, which includes FHbp, could be developed. Meningococcal vaccine development for China is a complex issue and these findings warrant further attention with respect to vaccine development.



http://ift.tt/2o6q6CX

Cognitive testing to evaluate revisions to the Vaccine Adverse Event Reporting System (VAERS) reporting form

Publication date: Available online 25 March 2017
Source:Vaccine
Author(s): Tiffany A. Suragh, Elaine R. Miller, Beth F. Hibbs, Scott K. Winiecki, Craig Zinderman, Tom T. Shimabukuro
IntroductionThe Vaccine Adverse Event Reporting System (VAERS) is the spontaneous (passive) reporting system CDC and FDA use to monitor vaccine safety. We used cognitive testing to evaluate proposed revisions to the current VAERS form.MethodsWe conducted in-person cognitive interviews with 22 volunteers to evaluate proposed revisions in a prototype VAERS 2.0 form (new VAERS form). We analyzed data using thematic analysis.ResultsRepeating themes included preferences for: brevity, simplicity and clarity; features to minimize time requirements and facilitate ease of completion; logical ordering of questions by topic and importance; and visual cues like color-coded highlighting. Interviews identified instances of discordance between the intended meaning questions (from the perspective of CDC and FDA) and interpretation by volunteers.ConclusionsCognitive testing yielded useful information to guide further revisions of the VAERS form. Cognitive testing can be an effective tool for public health programs interested in developing surveys and reporting forms.



http://ift.tt/2nWTSx6

Quality assessment of delineation and dose planning of early breast cancer patients included in the randomized Skagen Trial 1

Publication date: Available online 25 March 2017
Source:Radiotherapy and Oncology
Author(s): Giulio Francolini, Mette S. Thomsen, Esben S. Yates, Carine Kirkove, Ingelise Jensen, Egil S. Blix, Claus Kamby, Mette H. Nielsen, Mechthild Krause, Martin Berg, Ingvil Mjaaland, Andreas Schreiber, Unn-miriam Kasti, Kristian Boye, Birgitte V. Offersen
Background and purposeTo report on a Quality assessment (QA) of Skagen Trial 1, exploring hypofractionation for breast cancer patients with indication for regional nodal radiotherapy.Material and methodsDeviations from protocol regarding target volume delineations and dose parameters (Dmin, Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS). Dice similarity scores (DSC) with original delineations were measured. Dose parameters measured in the two delineations were reported to assess their dosimetric outcome.ResultsAssessment included 88 plans from 12 centres in 4 countries. DSC showed high agreement in contouring, 99% and 96% of the patients had a complete delineation of target volumes and organs at risk. No deviations in the dosimetric outcome were found in 76% of the patients, 82% and 95% of the patients had successful coverage of breast/chestwall and CTVn_L2-4-interpectoral. Dosimetric outcomes of original delineation and GS were comparable.ConclusionsQA showed high protocol compliance and adequate dose coverage in most patients. Inter-observer variability in contouring was low. Dose parameters were in harmony with protocol regardless original or GS segmentation.



http://ift.tt/2mDGeyH

Dynamic conformal arc radiosurgery for arteriovenous malformations: Outcome and influence of clinical and dosimetrical data

Publication date: Available online 25 March 2017
Source:Radiotherapy and Oncology
Author(s): Karen Clement-Colmou, Vincent Roualdes, Stéphane-André Martin, Stephanie Josset, Hubert Desal, Loïc Campion, François Thillays
PurposeTo assess efficacy, toxicity, and their predictive factors for dynamic conformal arc arteriovenous malformations (AVM) stereotactic radiosurgery.MethodData concerning 90 consecutive patients were retrospectively studied. Clinical, radiological, dosimetrical data and quality indexes were computed.ResultsAVM median volume was 1.06cc. Median prescribed dose was 22Gy. Total occlusion was obtained for 69% of patients. Post-radiosurgery annual hemorrhage rate was 2.2%. Predictive factor for total occlusion was delivered dose. Undesirable events occurred for 28% of patients. Predictive factors for adverse events were AVM revealing mode with seizure or headache, age≤28, AVM diameter≥3cm Spetzler–Martin score≥4, V12Gy≥2cc, large target volume and low homogeneity index (p<0.05). Brain parenchymal radiological reactions concerned 23% of patients, and their predictive factors were AVM revelation by seizure, deep localization, AVM diameter≥3cm, Spetzler–Martin score≥4, previous radiosurgery, numerous embolization, target volume, V12Gy and low homogeneity index (p<0.05).ConclusionOcclusion rate and toxicities are comparable to other series. Specific attention must be paid on pre-treatment clinical data, and target volume should be as small as possible, without reducing the delivered dose.



http://ift.tt/2n6nwMi

Three-dimensional-guided perineal-based interstitial brachytherapy in cervical cancer: A systematic review of technique, local control and toxicities

Publication date: Available online 25 March 2017
Source:Radiotherapy and Oncology
Author(s): Lucas C. Mendez, Yonatan Weiss, David D'Souza, Ananth Ravi, Lisa Barbera, Eric Leung
ObjectiveTo evaluate local control and toxicities of perineal-based interstitial brachytherapy (P-ISBT) in cervical cancers treated with three-dimensional (3D) image-based planning through a systematic review. The secondary objective of this review is to summarize the implant and dosimetric techniques in 3D P-ISBT.MethodsSystematic review of the literature using the PRISMA guideline was conducted through a search of Medline, EMBASE and Cochrane databases. This search resulted in 19 relevant manuscripts. Selected studies evaluated the role of perineal ISBT in cervical tumours treated using 3D planning. Eleven of nineteen manuscripts contained sufficient information for LC and toxicity calculations. Data were extracted by at least two investigators.ResultsA total of 672 cervical cancer patients were treated with P-ISBT and planned with 3D image-based planning. Clinical outcomes could be identified for 392 patients and 60% were staged IIIB or higher. Most patients received 45–50.4Gy EBRT to the pelvis followed by a P-ISBT boost with a range of dose between 28 and 48Gy EQD2Gy. Overall LC was 79% (310/392) with a median follow-up ranging from 14 to 55months. Almost half of the patients (48%) had a median follow-up ≥35months. Patients treated to a lower tumour EQD2Gy total dose had inferior LC. Procedure-related complications were rare (7 infections and 7 episodes of bleeding) and limited. Combined late gastro-intestinal, genitourinary and vaginal grade 3 and 4 toxicity was 12.1%.ConclusionPromising LC rates were found in patients with cervical cancers treated with perineal ISBT with 3D image-based planning. In this systematic review, 60% had stage IIIB disease or higher and yet a LC rate of 79% was found. LC seemed to correlate with the dose delivered to the tumour, while toxicity rates were similar to other cervical cancer series using 3D image-based brachytherapy. Perineal ISBT with 3D planning seems to be an effective and safe treatment for large advanced cervical tumours and may be a reasonable alternative to the increasingly more standard and modern intracavitary/interstitial (IC/IS) approaches such as the 'Vienna' applicator.



http://ift.tt/2mDv1Oz

G9a governs colon cancer stem cell phenotype and chemoradioresistance through PP2A-RPA axis-mediated DNA damage response

Publication date: Available online 25 March 2017
Source:Radiotherapy and Oncology
Author(s): Chi-Wen Luo, Jaw-Yuan Wang, Wen-Chun Hung, Guang Peng, Ya-Li Tsai, Tsung-Ming Chang, Chee-Yin Chai, Chih-Hung Lin, Mei-Ren Pan
Background and purposeNeoadjuvant concurrent chemoradiotherapy (CCRT) is a standard treatment of locally advanced colon cancer cell (CRC). In order to maximize efficacy and minimize toxicity, new drugs have been developed and used in combination with CCRT. Recently, it has been shown that G9a plays a role in mediating phenotypes of cancer stem cells (CSCs). This study aimed to characterize G9a as a biomarker in predicting therapy response to prevent overtreatment and adverse effects in CRC patients.Experimental designThe primary tumors from 39 patients who received CCRT for rectal cancer were selected. In vivo tumor xenograft models for tumorigenic properties in immunodeficient mice were developed. In vitro stemness ability was performed by tumor-sphere assays, cell response to anti-cancer agents and stemness-related genes analysis.ResultsCells survived from radiation treatment, and displayed high levels of G9a. A significantly positive correlation was shown between G9a and CSCs marker CD133 in locally advanced rectal cancer patients with CCRT. Knockdown of G9a increased the sensitivity of cells to radiation treatment and sensitized cells to DNA damage agents through PP2A-RPA axis.ConclusionsOur study theorized that G9a might serve as a novel target in colon cancer, which offers exciting potential in prediction of response to preoperative chemoradiotherapy in patients with advanced CRC.



http://ift.tt/2n6rPXR

Patient safety in external beam radiotherapy, results of the ACCIRAD project: Current status of proactive risk assessment, reactive analysis of events, and reporting and learning systems in Europe

Publication date: Available online 25 March 2017
Source:Radiotherapy and Oncology
Author(s): Julian Malicki, Ritva Bly, Mireille Bulot, Jean-Luc Godet, Andreas Jahnen, Marco Krengli, Philippe Maingon, Carlos Prieto Martin, Kamila Przybylska, Agnieszka Skrobała, Marc Valero, Hannu Jarvinen
PurposeTo describe the current status of implementation of European directives for risk management in radiotherapy and to assess variability in risk management in the following areas: 1) in-country regulatory framework; 2) proactive risk assessment; (3) reactive analysis of events; and (4) reporting and learning systems.Material and MethodsThe original data were collected as part of the ACCIRAD project through two online surveys.ResultsRisk assessment criteria are closely associated with quality assurance programs. Only 9/32 responding countries (28%) with national regulations reported clear "requirements" for proactive risk assessment and/or reactive risk analysis, with wide variability in assessment methods. Reporting of adverse error events is mandatory in most (70%) but not all surveyed countries.ConclusionsMost European countries have taken steps to implement European directives designed to reduce the probability and magnitude of accidents in radiotherapy. Variability between countries is substantial in terms of legal frameworks, tools used to conduct proactive risk assessment and reactive analysis of events, and in the reporting and learning systems utilized. These findings underscore the need for greater harmonisation in common terminology, classification and reporting practices across Europe to improve patient safety and to enable more reliable inter-country comparisons.



http://ift.tt/2n6yGjO

Brain edema with clasmatodendrosis complicating ataxia telangiectasia

Publication date: Available online 25 March 2017
Source:Brain and Development
Author(s): Konomi Shimoda, Masakazu Mimaki, Shuhei Fujino, Masato Takeuchi, Rumi Hino, Hiroshi Uozaki, Masaharu Hayashi, Akira Oka, Masashi Mizuguchi
Ataxia-telangiectasia is a chronic progressive disorder affecting the nervous and immune systems, caused by a genetic defect in the ATM protein. Clasmatodendrosis, a distinct form of astroglial death, has rarely been reported in ataxia-telangiectasia. Neuropathology of our patient disclosed diffuse edema of the cerebral and cerebellar white matter with prominent clasmatodendrosis, implicating ATM in the regulation of astroglial cell death.



http://ift.tt/2nBeI47

Increased cortisol awakening response after completing the summer treatment program in children with ADHD

Publication date: Available online 24 March 2017
Source:Brain and Development
Author(s): Rumiko Okabe, Hisayoshi Okamura, Chiyomi Egami, Yasuhiro Tada, Chizuru Anai, Akiko Mukasa, Akiko Iemura, Shinichiro Nagamitsu, Junichi Furusho, Toyojiro Matsuishi, Yushiro Yamashita
ObjectiveLittle is known about the cortisol awakening response (CAR) in children with attention deficit hyperactivity disorder (ADHD). Here, we examined the CAR in children with ADHD and their mothers before, immediately after, and 4months after an intensive summer treatment program (STP).MethodsParticipants were 37 children aged 7–12years who completed the STP in 2009 and 2010, and their mothers. Daily saliva samples for cortisol measurement were collected twice daily at awakening and 30min afterwards at pre-STP, post-STP, and during a follow-up measurement period. ADHD symptom scores were evaluated by parents, and participants completed the Kid-KINDL^R QOL questionnaire.ResultsCAR was low in children with ADHD before the STP, and increased to the control range 4months after STP. Maternal CAR also tended to increase after STP. Changes in the CAR in children tended to correlate with an improved ADHD inattention scores (p=0.091), physical health (p=0.070), and school life subscales scores in the Kid-KINDL^R (p=0.079).ConclusionWe demonstrated that STP improved the behavior and QOL of children with ADHD. Our results indicate that STP could lead to improvements in HPA axis function, as reflected by increased CAR after STP.



http://ift.tt/2n4WyDC

Interictal Ripples Nested in Epileptiform Discharge Help to Identify the Epileptogenic Zone in Neocortical Epilepsy

Publication date: Available online 25 March 2017
Source:Clinical Neurophysiology
Author(s): Shuang Wang, Norman K. So, Bo Jin, Irene Z. Wang, Juan C. Bulacio, Rei Enatsu, Shenyi Dai, Zhong Chen, Jorge Gonzalez-Martinez, Imad M. Najm
ObjectiveThis study aimed to identify the subtype of interictal ripples that help delineate the epileptogenic zone in neocortical epilepsy.MethodsTotally 25 patients with focal neocortical epilepsy who had invasive electroencephalography (EEG) evaluation and subsequent surgery were included. They were followed up for at least 2 years. Interictal ripples (80–250 Hz) and fast ripples (250–500 Hz) during slow-wave sleep were identified. Neocortical ripples were defined as type I ripples when they were superimposed on epileptiform discharges, and as type II ripples when they occurred independently. Resection ratio was calculated to present the extent to which the cortical area showing an interictal event or the seizure onset zone (SOZ) was completely removed.ResultsFast ripples and types I and II ripples were found in 8, 19, and 21 patients, respectively. Only the higher resection ratio of interictal fast or type I ripples was correlated to the Engel 1a surgical outcome.ConclusionsType I ripples could assist in localizing the epileptogenic zone in neocortical epilepsy.SignificanceType I and fast ripples both may be pathological high-frequency oscillations.



http://ift.tt/2njHcgt

Infant Colonization with Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci Preceding Neonatal Intensive Care Unit Discharge.

Infant Colonization with Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci Preceding Neonatal Intensive Care Unit Discharge.

J Pediatric Infect Dis Soc. 2017 Mar 01;:

Authors: Clock SA, Jia H, Patel S, Ferng YH, Alba L, Whittier S, DeLaMora P, Tabibi S, Perlman J, Paul D, Zaoutis T, Larson E, Saiman L

Abstract
Rates of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) were determined for 1320 infants within 7 days of neonatal intensive care unit discharge. Overall, 4% and 1% of the infants were colonized with MRSA or VRE, respectively. Predictors identified in fixed-effects models were surgery during hospitalization (for MRSA colonization) and prolonged antimicrobial treatment (for VRE colonization).

PMID: 28339914 [PubMed - as supplied by publisher]

http://ift.tt/2noTgyy