Publication date: Available online 28 June 2017
Source:Trends in Cognitive Sciences
Author(s): Esther Mondragón, Eduardo Alonso, Niklas Kokkola
Conditioning, how animals learn to associate two or more events, is one of the most influential paradigms in learning theory. It is nevertheless unclear how current models of associative learning can accommodate complex phenomena without ad hoc representational assumptions. We propose to embrace deep neural networks to negotiate this problem.
http://ift.tt/2soPSTM
Τετάρτη 28 Ιουνίου 2017
Associative Learning Should Go Deep
Bilateral Buccinator Myomucosal Flap Outcomes in Nonsyndromic Patients with Repaired Cleft Palate and Velopharyngeal Insufficiency
The purpose of this study was to assess speech outcomes and complication rate in nonsyndromic repaired cleft palate patients undergoing bilateral buccinator myomucosal flaps for velopharyngeal insufficiency management.
http://ift.tt/2u0gCvE
Cost analysis of microtia treatment in the Netherlands
Ear reconstruction for microtia is a challenging procedure. Although analyzing aesthetic outcome is crucial, there is a paucity of information with regard to financial aspects of microtia reconstruction. This study was conducted to analyze the costs associated with ear reconstruction with costal cartilage in patients with microtia.
http://ift.tt/2triS2d
“The Anatomy of the Medial Antebrachial Cutaneous Nerve and its Significance in Ulnar Nerve Surgery – an Anatomical Study”
During cubital tunnel surgery, the medial antebrachial cutaneous nerve (MACN) may be injured, causing painful scars, neuromas, hypaesthesia or hyperalgesia. As the literature on the anatomy of crossing branches in this area is contradictory, this study aimed to re-examine the anatomy of the MACN in this region.
http://ift.tt/2trxqPb
Clinical, histological and ultrasound follow-up of the breast reconstruction with one-stage muscle sparing “wrap” technique: a single-center experience
Prepectoral implant placement and complete coverage with porcine acellular matrix after mastectomy is a new concept in breast surgery presented in few cases in literature. The aim of this paper is to present our single center experience in one-stage breast reconstruction muscle sparing "wrap" technique by evaluating clinical and aesthetic outcomes, ultrasound and histological examination and patient quality of life.
http://ift.tt/2u0xh2l
The long-term impact of oncoplastic breast conserving surgery using Latissimus Dorsi miniflaps on mammographic surveillance and the detection of local recurrence
Latissimus Dorsi Miniflap is a breast-conserving volume replacement technique for reconstruction of large breast defects. While mammographic features of Mini Flap reconstruction have been described, little is known about the incidence, mode of presentation and size of local recurrence after this procedure. The aim of this study was to investigate the impact of Latissimus Dorsi Miniflap reconstruction on frequency, presentation and detection of local recurrence.
http://ift.tt/2trs1YD
Ratiometric co-delivery of multiple chemodrugs in a single nanocarrier
Publication date: 30 September 2017
Source:European Journal of Pharmaceutical Sciences, Volume 107
Author(s): Chao Chen, Ran Tao, Dan Ding, Deling Kong, Aiping Fan, Zheng Wang, Yanjun Zhao
Co-delivery of multiple anti-cancer drugs in a single nanoplatform has shown great promise in enhancing therapeutic efficacy and reducing adverse effects. However, the ratiometric dose control is pivotal, but often challenging in combinational nanomedicine. Here, we report the employment of cyclodextrin-bearing amphiphilic polymer conjugate micelles for ratiometric, non-covalent loading of three hydrophobic model drugs, curcumin (CUR), camptothecin (CPT), and doxorubicin (DOX) in one single nanocarrier. Each drug was physically encapsulated in the cyclodextrin-bearing polymer conjugate via guest-host complexation. All three drugs displayed a 1:1 complexation behavior with the cyclodextrin, which corresponded to a drug loading of 6.0±0.1% (CUR), 7.5±0.1% (CPT), and 9.0±0.1% (DOX) (w/w). The apparent association constant between the conjugate and drug was 2803.7±87.0 (CUR), 3699.4±123.3 (CPT), and 6760.9±176.3 (DOX), respectively. Ratiometric co-assembly of three types of drug-loaded conjugates produced mixed micelles in a dose- and ratio-controlled manner. The hydrodynamic diameter of co-assembled spherical micelles was ca. 150nm that was similar to the single-drug loaded micelles. The ratiometric co-delivery of three drugs via mixed micelles was demonstrated both in HepG2 cells in vitro and in a mice model in vivo compared to a mixture of free drugs, as evidenced by co-localization analysis. This work provides a facile way to realize ratiometric co-administration of multiple drugs.
Graphical abstract
http://ift.tt/2u0nmKg
Sprayable Carbopol hydrogel with soluble beta-1,3/1,6-glucan as an active ingredient for wound healing – Development and in-vivo evaluation
Publication date: 30 September 2017
Source:European Journal of Pharmaceutical Sciences, Volume 107
Author(s): Jostein Grip, Rolf Einar Engstad, Ingrid Skjæveland, Nataša Škalko-Basnet, Ann Mari Holsæter
Chronic wounds represent a significant health problem worldwide. There is a need for advanced- and cost-efficient wound healing products able to increase patient comfort and reduce the healing time. The aim of this study was to develop a sprayable hydrogel dressing with beta-glucan (βG) as the active ingredient, targeting future application in the treatment of both chronic and burn wounds. The βG was chosen as an active ingredient because of its promising wound healing capabilities, whereas Carbopol 971P NF (Carbopol) was chosen as the thickening agent in the formulation due to several attractive characteristics such as its low viscosity, low toxicity, high transparency and good ion tolerance. Four different hydrogel formulations were prepared with varying Carbopol concentrations. The higher Carbopol concentration, 0.5% (w/w), was used to prepare three formulations comprising the HighCP:NoβG, HighCP:LowβG and the HighCP:MediumβG formulation, respectively. Lower Carbopol concentration, 0.25% (w/w), was used to prepare the LowCP:HighβG formulation. The content of βG varied from 0.25% in the HighCP:LowβG, 0.5% in the HighCP:MediumβG and 1.0% (w/w) in the LowCP:HighβG formulation, respectively. The first part of the study focused on the rheological characterization of the hydrogels and the fluid affinity testing. All formulations were confirmed to be stable gels; the βG was shown to augment the gel strength by increasing the yield strength of the gel in a dose dependent manner. The stability of the formulations containing either Carbopol alone or in a combination with βG did not deteriorate over 26weeks, and the fluid donation and absorption study indicated a fluid donation profile, which favors healing of dry wounds. The in vivo efficacy of the formulations, evaluated in the modified diabetic male mice (db/db mice), showed that Carbopol alone was unable to induce improved healing and caused adverse reactions in some wounds. The inclusion of βG increased the epithelialization and wound contraction in the db/db mice when given at high βG:Carbopol ratio. The positive effect of βG was, however, not sufficient to counteract the adverse effect of Carbopol, thus a more suitable thickening agent should be investigated for further development of a sprayable wound care product.
Graphical abstract
http://ift.tt/2u0qOo2
Characterizing the time-course of antihypertensive activity and optimal dose range of fimasartan via mechanism-based population modeling
Publication date: 30 September 2017
Source:European Journal of Pharmaceutical Sciences, Volume 107
Author(s): Jürgen B. Bulitta, Soo Heui Paik, Yong Ha Chi, Tae Hwan Kim, Soyoung Shin, Cornelia B. Landersdorfer, Yuanyuan Jiao, Rajbharan Yadav, Beom Soo Shin
Fimasartan is a novel angiotensin II receptor blocker. Our aims were to characterize the time-course of the antihypertensive activity of fimasartan via a new population pharmacokinetic/pharmacodynamic model and to define its optimal dose range. We simultaneously modelled all fimasartan plasma concentrations and 24-h ambulatory blood pressure monitoring (ABPM) data from 39 patients with essential hypertension and 56 healthy volunteers. Patients received placebo, 20, 60, or 180mg fimasartan every 24h for 28days and healthy volunteers received placebo or 20 to 480mg as a single oral dose or as seven doses every 24h. External validation was performed using data on 560 patients from four phase II or III studies. One turnover model each was used to describe diastolic and systolic blood pressure. The input rates into these compartments followed a circadian rhythm and were inhibited by fimasartan. The average predicted (observed) diastolic blood pressure over 24-h in patients decreased by 10.1±7.5 (12.6±9.2; mean±SD)mmHg for 20mg, 14.2±7.0 (15.1±9.3) mmHg for 60mg, and 15.9±6.8 (11.5±9.9)mmHg for 180mg daily relative to placebo. The model explained the saturation of antihypertensive activity by counter-regulation at high fimasartan concentrations. Drug effect was maximal at approximately 23ng/mL fimasartan for diastolic and 12ng/mL for systolic blood pressure. The proposed mechanism-based population model characterized the circadian rhythm of ABPM data and the antihypertensive effect of fimasartan. After internal and external model validation, 30 to 60mg oral fimasartan given once daily was predicted as optimal dose range.
Graphical abstract
http://ift.tt/2u09csn
A novel chalcone derivative, LQFM064, induces breast cancer cells death via p53, p21, KIT and PDGFRA
Publication date: 30 September 2017
Source:European Journal of Pharmaceutical Sciences, Volume 107
Author(s): Bruna Lannuce Silva Cabral, Artur Christian Garcia da Silva, Renato Ivan de Ávila, Alane Pereira Cortez, Rangel Magalhães Luzin, Luciano Morais Lião, Eric de Souza Gil, Gérman Sanz, Boniek G. Vaz, José R. Sabino, Ricardo Menegatti, Marize Campos Valadares
This study shows the design, synthesis and antitumoral potential evaluation of a novel chalcone-like compound, (E)-3- (3, 5-di-ter-butyl-4-hydroxyphenyl)-1- (4-hydroxy-3-methoxyphenyl) prop-2-en-1-one [LQFM064) (4)], against human breast adenocarcinoma MCF7 cells. Some toxicological parameters were also investigated. LQFM064) (4) exhibited cytotoxic activity against MCF7 cells (IC50=21μM), in a concentration dependent-manner, and triggered significant changes in cell morphology and biochemical/molecular parameters, which are suggestive of an apoptosis inductor. LQFM064) (4) (21μM) induced cell cycle arrest at G0/G1 phase with increased p53 and p21 expressions. It was also shown that the compound (4) did not interfere directly in p53/MDM2 complexation of MCF7 cells. In these cells, externalization of phosphatidylserine, cytochrome c release, increased expression of caspases-7, −8 and −9, reduced mitochondrial membrane potential and ROS overgeneration were also detected following LQFM064 (4) treatment. Further analysis revealed the activation of both apoptotic pathways via modulation of the proteins involved in the extrinsic and intrinsic pathways with an increase in TNF-R1, Fas-L and Bax levels and a reduction in Bcl-2 expression. Furthermore, KIT proto-oncogene receptor tyrosine kinase, insulin-like growth factor (IGF1) and platelet-derived growth factor receptor A (PDGFRA) were downregulated, while glutathione S-transferase P1 (GSTP1) and interferon regulatory factor 5 (IRF5) expressions were increased by LQFM064 (4)-triggered cytotoxic effects in MCF7 cells. Moreover, it can be inferred that compound (4) has a moderate acute oral systemic toxicity hazard, since its estimated LD50 was 452.50mg/kg, which classifies it as UN GHS Category 4 (300mg/kg>LD50<2000mg/kg). Furthermore, LQFM064 (4) showed a reduced potential myelotoxicity (IC50=150μM for mouse bone marrow hematopoietic progenitors). In conclusion, LQFM064 (4) was capable of inducing breast cancer cells death via different cytotoxic pathways. Thus, it is a promising alternative for the treatment of neoplasias, especially in terms of the drug resistance development.
Graphical abstract
http://ift.tt/2u0xhzs
Effect of humic acid on uranium(VI) retention and transport through quartz columns with varying pH and anion type
Source:Journal of Environmental Radioactivity, Volume 177
Author(s): Liang Du, Shicheng Li, Xiaolong Li, Ping Wang, Zhaoya Huang, Zhaoyi Tan, Chunli Liu, Jiali Liao, Ning Liu
Humic acid (HA)1 is ubiquitous in the environment and is an important factor in the migration behavior of U(VI) in the geological medium. The present work investigated the effect of HA on the migration behavior of U(VI) using quartz column experiments at different pH values and in the presence of various anions. The U(VI) adsorption characteristics and speciation were also studied to illuminate further the migration behavior of U(VI). Our results indicated that, at pH 6.0, HA slightly increased the migration velocity of U(VI) during the initial phase and reduced the quantity of eluted U(VI) because of the formation of HA-U(VI). The relative concentration (c/c0) of U(VI)was higher in the HA-U system at pH 8.0 than that at pH 5.0 because of the higher solubility of HA in basic solutions and the difference in charge of HA-U(VI). In the U-HA-anion system at pH 6.0, the breakthrough pore volumes (PVs2) of U(VI) in electrolytes containing Cl− and SO42− anions (PV = 8) are much higher than for solutions containing phosphate (PV = 3), while the HA migration behavior was not significantly affected by the type of anion. Thus, the fast migration of U(VI) under HA and phosphate was attributed to phosphate rather than HA. This result suggests that phosphate should be given more attention in predictions of U(VI) migration, especially in regions with high groundwater phosphate content.
http://ift.tt/2tnhMnj
Accuracy and Reliability of Intraoral Scanners: Are They the Better Option?
Abstract
Purpose of Review
The aim was to compare the accuracy of digital intraoral impressions with conventional impressions on the fabrication of different types of restorations. This study also compared the accuracy, reliability, and ease of use of different types of intraoral scanners available and correlated the results with the different scanning technologies.
Recent Findings
Digital impressions offer the same level of accuracy as conventional impressions regarding fabrication of crowns, fixed dental prostheses (FDPs), implant-supported crowns, and short-span FDPs with marginal gap values within the clinically acceptable range (<120 μm). However, for full-arch restorations, conventional impressions result in better accuracy.
Summary
Further enhancements needs to be undertaken regarding intraoral scanners to improve its accuracy regarding fabrication of full-arch restorations. Further in vivo studies evaluating the accuracy of intraoral digital impressions on the fabrication of a wider range of restorations such as inlays, veneers, and full-arch restoration need to be conducted.
http://ift.tt/2tqUBt7
A high sensitive visible light-driven photoelectrochemical aptasensor for shrimp allergen tropomyosin detection using graphitic carbon nitride-TiO2 nanocomposite
Publication date: 15 December 2017
Source:Biosensors and Bioelectronics, Volume 98
Author(s): Mahmoud Amouzadeh Tabrizi, Mojtaba Shamsipur, Reza Saber, Saeed Sarkar, Vahid Ebrahimi
Herein, for the first time a visible-light-driven photoelectrochemical (PEC) aptasensor for shrimp tropomyosin determination was fabricated by using graphitic carbon nitride (g-C3N4) and titanium dioxide (TiO2) as photoactive nanomaterials, ascorbic acid (AA) as electron donor and ruthenium (III) hexaammine (Ru(NH3)63+) as signal enhancer. The surface of an ITO electrode was first modified with g-C3N4, TiO2, and polyethyleneimine (PEI) and then the amine terminal aptamerTROP probe was attached to PEI by the use of glutaraldehyde (GA) as cross-linker. After that, Ru(NH3)63+ was adsorbed on aptamer to enhance the photocurrent signal. The principle of proposed PEC aptasensor is based on the formation of a selective complex between tropomyosin and immobilized aptamerTROP probe on the surface of ITO/g-C3N4-TiO2/PEI/aptamerTROP-Ru(NH3)6+3. After the incubation of tropomyosin with TROP aptamer probe, the photocurrent signal decreased due to releasing adsorbed Ru(NH3)63+ on aptamer and preventing AA from scavenging photogenerated holes to the photoactive modified electrode. Under the optimized conditions, the fabricated PEC aptasensor was used for the determination of shrimp tropomyosin in the concentration range of 1–400ngmL−1 with a limit of detection of 0.23ngmL−1. The proposed PEC aptasensor exhibited high selectivity, sensitivity, and good stability.
Graphical abstract
http://ift.tt/2tmQUEm
An ultrasensitive photoelectrochemical immunosensor for insulin detection based on BiOBr/Ag2S composite by in-situ growth method with high visible-light activity
Source:Biosensors and Bioelectronics, Volume 97
Author(s): Dawei Fan, Haoyuan Wang, Malik Saddam Khan, Chunzhu Bao, Huan Wang, Dan Wu, Qin Wei, Bin Du
A novel ultrasensitive label-free immunosensor based on BiOBr/Ag2S composite with high visible-light photoelectrochemical activity was prepared for the detection of insulin. After BiOBr was modified by thioglycolic acid, Ag2S nanoparticles were grown in-situ on the surface of BiOBr hierarchical microspheres to first form novel BiOBr/Ag2S composite. When ascorbic acid (AA) was used as an efficient electron donor for scavenging photo-generated holes, BiOBr/Ag2S composite material showed excellent photoelectrochemical activity. In order to immobilize insulin antibody, adhesive polydopamine (PDA) film formed by self-polymerization of dopamine was fabricated onto BiOBr/Ag2S modified electrode. Moreover, PDA film could further enhance the visible light absorption of BiOBr/Ag2S. When the solutions of 0.08molL−1AgNO3 and 0.1molL−1 AA were selected respectively during fabrication and detection process of this sensor, the best photocurrent singles were obtained. Under the optimum experimental condition, the specific binding between insulin and antibody resulted in a decrease in photocurrent intensity and the intensity decreased linearly with the logarithm of insulin concentration in the range of 0.001–20ngmL−1 with a detection limit of 0.2pgmL−1. The photoelectrochemical sensor ITO/BiOBr/Ag2S/PDA/anti-Insulin/BSA/Insulin revealed facile preparation, high sensitivity, and acceptable reproducibility, which may have practical applications in the biosensor, clinical diagnosis of cancers, photocatalysis, and other related fields.
http://ift.tt/2s3Bvop
Quantitative ratiometric phosphorescence hypoxia–sensing nanoprobes based on quantum dots/Ir(III) glycerol monoolein cubic-phase nanoparticles
Source:Biosensors and Bioelectronics, Volume 98
Author(s): Jiajun Liu, Youshen Wu, Yao Yu, Ke Li, Yuanyuan Ji, Daocheng Wu
A novel protocol is developed to prepare quantum dot (QD)/Ir(III) complex glycerol monoolein (GMO) cubic-phase nanoparticles (Qd/Ir GMCPNPs) as hypoxia nanoprobes, in which hypoxia probe Tris [1-phenylisoquinoline-C2, N] Iridium(III) [Ir(piq)3] and the reference QDs are separately loaded at hydrophilic and hydrophobic channels to avoid interference. Qd/Ir GMCPNPs were nearly spherical in shape, with an average size of 20–30nm. Their phosphorescence spectra showed that nanoprobes have a wide excited wave length range of 360–500nm, which is suitable for different types of measurement instruments. When the oxygen content decreased from 21% to 1%, the luminescent intensity ratio of Qd/Ir GMCPNPs in the solution and cells increased 4-fold and 2.8-fold, respectively, with an acceptable linear relationship. Particularly, extensive preliminary quantitative ratiometric oxygen sensing and long tumor imaging monitoring can be achieved with these nanoprobes.
http://ift.tt/2tmM5e9
Multiple amplified enzyme-free electrochemical immunosensor based on G-quadruplex/hemin functionalized mesoporous silica with redox-active intercalators for microcystin-LR detection
Source:Biosensors and Bioelectronics, Volume 98
Author(s): Cuifen Gan, Bingfeng Wang, Junying Huang, Aori Qileng, Zuyu He, Hongtao Lei, Weipeng Liu, Yingju Liu
A novel multiple amplified enzyme-free immunosensor was developed for competitive immunoassay of microcystin-LR (MC-LR). Classical electrochemical immunosensors usually employ enzymes as biocatalysts to afford amplified signals, but the proteolytic degradation and poor stability are still crucial problem. Herein, monodisperse core-shell mesoporous silica (SiO2@MSN)-functionalized DNAzyme concatamers were synthesized to load hemin and methylene blue (MB) as the mimic enzyme. Firstly, the surface of SiO2@MSN was conjugated with secondary antibody as the recognition of MC-LR antibody and with a DNA strand as the initiator. Two auxiliary DNA strands were then selected for the in-situ propagation to form a double-helix DNA through hybridization chain reaction (HCR), forming numerous DNAzymes (G-quadruplex/hemin) after the addition of hemin. Secondly, MB was inserted into the formed double-helix DNA, and also loaded in the brush-like structure of mesoporous SiO2@MSN. The molecular docking study showed that electrons can transfer more effectively with π-π stack of hemin/G-quadruplex and intercalation of MB/DNA, thus the catalytic ability of DNAzymes can be greatly improved. With the aid of MB, DNAzymes can catalyze the reduction of H2O2 to produce the electrochemical signal. This enzyme-free electrochemical immunosensor can successfully detect MC-LR in a range of 0.5ng/L and 25μg/L with a detection limit of 0.3ng/L. This stable, sensitive and selective nonenzymatic electrochemical immunoassay shows promise for applications in food and environmental monitoring.
http://ift.tt/2s4ey4q
Editorial Board
Source:Biosensors and Bioelectronics, Volume 97
http://ift.tt/2s3OhDx
Carbon nanostructures as immobilization platform for DNA: A review on current progress in electrochemical DNA sensors
Source:Biosensors and Bioelectronics, Volume 97
Author(s): P. Abdul Rasheed, N. Sandhyarani
Development of a sensitive, specific and cost-effective DNA detection method is motivated by increasing demand for the early stage diagnosis of genetic diseases. Recent developments in the design and fabrication of efficient sensor platforms based on nanostructures make the highly sensitive sensors which could indicate very low detection limit to the level of few molecules, a realistic possibility. Electrochemical detection methods are widely used in DNA diagnostics as it provide simple, accurate and inexpensive platform for DNA detection. In addition, the electrochemical DNA sensors provide direct electronic signal without the use of expensive signal transduction equipment and facilitates the immobilization of single stranded DNA (ssDNA) probe sequences on a wide variety of electrode substrates. It has been found that a range of nanomaterials such as metal nanoparticles (MNPs), carbon based nanomaterials, quantum dots (QDs), magnetic nanoparticles and polymeric NPs have been introduced in the sensor design to enhance the sensing performance of electrochemical DNA sensor. In this review, we discuss recent progress in the design and fabrication of efficient electrochemical genosensors based on carbon nanostructures such as carbon nanotubes, graphene, graphene oxide and nanodiamonds.
http://ift.tt/2tmVGle
Recent advances in transition-metal dichalcogenides based electrochemical biosensors: A review
Source:Biosensors and Bioelectronics, Volume 97
Author(s): Yi-Han Wang, Ke-Jing Huang, Xu Wu
Layered transition metal dichalcogenides (TMDCs) comprise a category of two-dimensional (2D) materials that offer exciting properties, including large surface area, metallic and semi-conducting electrical capabilities, and intercalatable morphologies. Biosensors employ biological molecules to recognize the target and utilize output elements which can translate the biorecognition event into electrical, optical or mass-sensitive signals to determine the quantities of the target. TMDCs nanomaterials have been widely applied in various electrochemical biosensors with high sensitivity and selectivity. The marriage of TMDCs and electrochemical biosensors has created many productive sensing strategies for applications in the areas of clinical diagnosis, environmental monitoring and food safety. In recent years, an increasing number of TMDCs-based electrochemical biosensors are reported, suggesting TMDCs offers new possibilities of improving the performance of electrochemical biosensors. This review summarizes recent advances in electrochemical biosensors based on TMDCs for detection of various inorganic and organic analytes in the last five years, including glucose, proteins, DNA, heavy metal, etc. In addition, we also point out the challenges and future perspectives related to the material design and development of TMDCs-based electrochemical biosensors.
http://ift.tt/2s3L86y
Dual signal amplification strategy of Au nanopaticles/ZnO nanorods hybridized reduced graphene nanosheet and multienzyme functionalized Au@ZnO composites for ultrasensitive electrochemical detection of tumor biomarker
Source:Biosensors and Bioelectronics, Volume 97
Author(s): Xian Fang, Junfeng Liu, Jing Wang, Hong Zhao, Hongxuan Ren, Zengxi Li
Herein, a dual signal amplification strategy was employed in fabricating ultrasensitive electrochemical immunosensor for alpha fetoprotein (AFP) detection, which was realized by utilizing of ZnO nanorods/Au nanopaticles hybridized reduced graphene nanosheet (Au/ZnO/RGO) and horseradish-peroxidase (HRP) bioconjugated detection antibody (Ab2) functionalized Au@ZnO (Ab2/HRP-Au@ZnO). During the fabrication of the immunosensor, a new kind of multiple-head surfactants CxN3 with different alkyl chain length played important roles such as acting as the surfactants of Au/ZnO/RGO and the reductant agents of Au@ZnO composite. Due to the good adsorption property and large surface area of Au/ZnO/RGO, plenty of the capture antibodies (Ab1) were immobilized on the electrode surface, and trace AFP was sensitively monitored. Furthermore, Ab2/HRP-Au@ZnO exhibited high affinity interaction with AFP through "sandwich" immunoreactions, along with the peroxidase-like catalytic activity of Au@ZnO, leading to a further enhancement in the sensitivity of the proposed immunosensor. The successful synthesis of the nanomaterials was characterized through a serious of techniques including Raman, XRD, FT-IR, SEM and UV–vis. Under the optimal conditions, two linear ranges of 0.02–10,000 and 10,000–100,000pgmL-1 AFP with a lower detection limit of 0.01pg mL-1 (S/N=3) was obtained. Especially, the proposed AFP immunosensor can be applied to detect human serum samples with satisfactory results, indicating a potential application in clinical monitoring of tumor biomarkers.
http://ift.tt/2tndJaO
Enzyme-less electrochemical displacement heterogeneous immunosensor for diclofenac detection
Publication date: 15 November 2017
Source:Biosensors and Bioelectronics, Volume 97
Author(s): T.T.K. Nguyen, T.T. Vu, G. Anquetin, H.V. Tran, S. Reisberg, V. Noël, G. Mattana, Q.V. Nguyen, Tran Dai Lam, M.C. Pham, B. Piro
We describe an electrochemical immunosensor based on functionalization of a working electrode by electrografting two functional diazonium salts. The first one is a molecular probe, diclofenac, coupled with an arylamine onto which a specific antibody is immobilized by affinity interactions; the second is a redox probe (a quinone) also coupled with an arylamine, able to transduce the hapten-antibody association into a change in electroactivity. The steric hindrance induced by the antibody leads to a current decrease upon binding of the antibody on the grafted molecular probe; conversely, when diclofenac is present in solution, a displacement equilibrium occurs between the target diffusing into the solution and the grafted probe. This leads to dissociation of the antibody from the electrode surface, event which is transduced into a current increase ("signal-on" detection). The detection limit is ca. 20 fM, corresponding to 6pgL−1 diclofenac, which is competitive compared to other label-free immunosensors. We demonstrate that the sensor is selective and is able to quantify diclofenac in tap water.
Graphical abstract
http://ift.tt/2s3Oh6v
A real-time-range potentiostat coupled to nano-Au-modified microband electrode array for high-speed stripping determination of human blood lead
Source:Biosensors and Bioelectronics, Volume 97
Author(s): Wen Zhang, Yiwei Xu, Xiaobo Zou, Ping Wang
A novel method of real-time-range measurement, characterized by pre-sampling forecast and balanced-range switching, is introduced in this study. According to this method, raw current signals in biosensing procedures may be measured and recorded with real-time-optimized instrumental settings. A low-cost and high-performance potentiostat is developed to validate the proposed method. The transient process of real-time-range measurement is investigated to optimize sampling interval and circuit parameters. Typical time consumption of a sampling cycle is less than 100μs, which makes high-speed and real-time-range measurement possible. The proposed method also brings excellent current resolution that is better than 0.8pA. It improves weak signals in stripping determinations, and is particularly suitable for biological samples. As-fabricated potentiostat, coupled to a nano-Au-modified microband electrode array, is adopted in high-speed stripping determinations towards human blood lead levels (HBLLs). Accuracy and precision of this method are validated with certified reference material (CRM). Obtained values (4.31 ± 0.18μgL−1) meet with certified levels of CRM (4.24 ± 0.11μgL−1). Coefficient of variation percent (CV %) is no more than 5.0% for intra- or inter-assay analyses. Finally, this method is utilized for human population based study. Two groups of data, from this method and inductively coupled plasma mass spectrometry (ICP-MS), are analyzed using a statistic tool of t-test, and no statistically significant difference is found.
http://ift.tt/2s46JvI
Aging and Confidence Judgments in Item Recognition.
Author: Voskuilen, Chelsea; Ratcliff, Roger; McKoon, Gail
DOI: 10.1037/xlm0000425
Publication Date: POST AUTHOR CORRECTIONS, 22 June 2017
http://ift.tt/2tmXR7N
Working Memory Capacity and the Antisaccade Task: A Microanalytic-Macroanalytic Investigation of Individual Differences in Goal Activation and Maintenance.
Author: Meier, Matt E.; Smeekens, Bridget A.; Silvia, Paul J.; Kwapil, Thomas R.; Kane, Michael J.
DOI: 10.1037/xlm0000431
Publication Date: POST AUTHOR CORRECTIONS, 22 June 2017
http://ift.tt/2uko9oz
Effect of orthognathic surgery on profile esthetics in Class II:1 malocclusions
Abstract
Objectives
To measure the effect of orthognathic surgery on Class II:1 profile silhouette esthetics and to identify pretreatment parameters and thresholds for consistent esthetic improvement.
Methods
Pre- and posttreatment black profile silhouettes of 20 patients with Class II:1 malocclusion who had received combined orthodontic/orthognathic treatment were evaluated retrospectively by 20 European orthodontists and laypeople each using a visual analogue scale (VAS). A variety of pretreatment skeletal and facial angles were measured cephalometrically and on the silhouette profiles. Descriptive statistics and Pearson's correlation coefficients were calculated.
Results
The population showed a mean VAS improvement of 12.6%. VAS changes were significantly and directly related to pretreatment ANB in all evaluator groups (r = 0.48–0.59), whereas the interrelation with the degree of pretreatment profile convexity angle was less clear and statistically significant for the orthodontic evaluators only (r = −0.34 to −0.51). The highest correlation coefficients in all evaluator groups were seen for the relationship with pretreatment VAS scores (r = −0.64 to −0.73).
Conclusion
The lower the pretreatment VAS score and the profile convexity angles or the larger the pretreatment ANB angles were, the more the VAS improved. Pretreatment thresholds for consistent improvements were as follows: VAS score < 20 mm, ANB > 8°, and profile angle ≤ 155°.
http://ift.tt/2tmNukG
Incidence and severity of gingival invaginations associated with early versus late initiation of orthodontic space closure after tooth extraction
Abstract
Objective
Gingival invaginations are a common side effect of orthodontic extraction–space closure. The timing of initiating the closure of an extraction space varies greatly in clinical practice. In this multicenter pilot and randomized controlled trial, we prospectively investigated whether initiating space closure in the early stage of wound healing would benefit the incidence and severity of invaginations developing in the extraction sites.
Methods
A total of 368 patients were screened for indications to extract at least one mandibular premolar. Those recruited were randomly assigned to one of two treatment arms: initiation of space closure either 2–4 weeks (arm A) or ≥12 weeks (arm B) after tooth extraction. Clinical data regarding treatment process and periodontal tissue response were recorded during and after space closure and analyzed by a specialized biometrics unit. The study was performed under continuous surveillance by an independent study control center.
Results
A total of 74 extraction sites were analyzed. Regarding the incidence of gingival invaginations, there were no significant intergroup differences [p = 0.13; group A comprising 37/44 (84.1%) and group B 29/30 (96.7%) invaginated sites]. The same was true based on either maxillary (p = 0.52) or mandibular (p = 0.21) sites only, and the severity of the invaginations did not differ between the treatment arms.
Conclusions
As to the incidence and severity of gingival invaginations, we did not notice any statistically significant differences between the two timeframes. Our data do, however, provide a basis to identify additional confounders and to improve the accuracy of case-load estimations for future trials.
http://ift.tt/2ukfFxC
Effects of combined orthodontic-orthognathic treatment for class II and III correction on posterior airway space
Abstract
Objectives
Comparison of treatment effects on the posterior airway space (PAS) in patients treated with combined orthodontic–orthognathic surgical treatment.
Methods
Pre- and postsurgical lateral cephalograms of 53 (34 females, 19 males) Caucasian patients were analyzed using a customized set of measurements. According to malocclusion (Class II or III) and surgical approach (either monognathic or bignathic), patients were allocated into four groups. PAS was assessed from cranial to caudal at six levels (P1–P6). Paired t tests were used for intragroup and t tests for independent samples for intergroup comparisons. Results were considered statistically significant at p < 0.05.
Results
In patients treated for Class II malocclusion, PAS retropalatally (P1 level) almost remained unchanged, whereas measurements at levels P2–P6 showed a mean increase ranging from approximately 2–5.5 mm. Significant changes were most pronounced in monognathic Class II patients (group 1) at levels P2–P4 with mean values ranging from approximately 3.7–5.5 mm. In patients treated for Class III malocclusion (groups 3 and 4), measurements at the P1 level almost remained unchanged in patients who underwent mandibular setback surgery (group 3), whereas the same measurements exhibited significant increase (>6 mm) in patients treated with bignathic surgery (group 4).
Conclusions
Bignathic surgery led to smaller changes of pharyngeal depth in Class II and III patients than monognathic surgery. Alterations of the PAS due to orthognathic surgery should be considered during orthodontic and presurgical treatment planning.
http://ift.tt/2tmL2dF
Electrochemical Carbon Based Nanosensors: A Promising Tool in Pharmaceutical and Biomedical Analysis
Publication date: Available online 28 June 2017
Source:Journal of Pharmaceutical and Biomedical Analysis
Author(s): Sevinc Kurbanoglu, Sibel A. Ozkan
Nanotechnology has become very popular in the sensor fields in recent times. It is thought that the utilization of such technologies, as well as the use of nanosized materials, could well have beneficial effects for the performance of sensors. Nano-sized materials have been shown to have a number of novel and interesting physical and chemical properties. Low-dimensional nanometer-sized materials and systems have defined a new research area in condensed-matter physics within past decades. Apart from the aforesaid categories of materials, there exist various materials of different types for fabricating nanosensors. Carbon is called as a unique element, due to its magnificent applications in many areas. Carbon is an astonishing element that can be found many forms including graphite, diamond, fullerenes, and graphene. This review provides an overview of some of the important and recent developments brought about by the application of carbon based nanostructures to nanotechnology for both chemical and biological sensor development and their application in pharmaceutical and biomedical area.
http://ift.tt/2sopMQB
Effect of orthognathic surgery on profile esthetics in Class II:1 malocclusions
Abstract
Objectives
To measure the effect of orthognathic surgery on Class II:1 profile silhouette esthetics and to identify pretreatment parameters and thresholds for consistent esthetic improvement.
Methods
Pre- and posttreatment black profile silhouettes of 20 patients with Class II:1 malocclusion who had received combined orthodontic/orthognathic treatment were evaluated retrospectively by 20 European orthodontists and laypeople each using a visual analogue scale (VAS). A variety of pretreatment skeletal and facial angles were measured cephalometrically and on the silhouette profiles. Descriptive statistics and Pearson's correlation coefficients were calculated.
Results
The population showed a mean VAS improvement of 12.6%. VAS changes were significantly and directly related to pretreatment ANB in all evaluator groups (r = 0.48–0.59), whereas the interrelation with the degree of pretreatment profile convexity angle was less clear and statistically significant for the orthodontic evaluators only (r = −0.34 to −0.51). The highest correlation coefficients in all evaluator groups were seen for the relationship with pretreatment VAS scores (r = −0.64 to −0.73).
Conclusion
The lower the pretreatment VAS score and the profile convexity angles or the larger the pretreatment ANB angles were, the more the VAS improved. Pretreatment thresholds for consistent improvements were as follows: VAS score < 20 mm, ANB > 8°, and profile angle ≤ 155°.
http://ift.tt/2tmNukG
Incidence and severity of gingival invaginations associated with early versus late initiation of orthodontic space closure after tooth extraction
Abstract
Objective
Gingival invaginations are a common side effect of orthodontic extraction–space closure. The timing of initiating the closure of an extraction space varies greatly in clinical practice. In this multicenter pilot and randomized controlled trial, we prospectively investigated whether initiating space closure in the early stage of wound healing would benefit the incidence and severity of invaginations developing in the extraction sites.
Methods
A total of 368 patients were screened for indications to extract at least one mandibular premolar. Those recruited were randomly assigned to one of two treatment arms: initiation of space closure either 2–4 weeks (arm A) or ≥12 weeks (arm B) after tooth extraction. Clinical data regarding treatment process and periodontal tissue response were recorded during and after space closure and analyzed by a specialized biometrics unit. The study was performed under continuous surveillance by an independent study control center.
Results
A total of 74 extraction sites were analyzed. Regarding the incidence of gingival invaginations, there were no significant intergroup differences [p = 0.13; group A comprising 37/44 (84.1%) and group B 29/30 (96.7%) invaginated sites]. The same was true based on either maxillary (p = 0.52) or mandibular (p = 0.21) sites only, and the severity of the invaginations did not differ between the treatment arms.
Conclusions
As to the incidence and severity of gingival invaginations, we did not notice any statistically significant differences between the two timeframes. Our data do, however, provide a basis to identify additional confounders and to improve the accuracy of case-load estimations for future trials.
http://ift.tt/2ukfFxC
Effects of combined orthodontic-orthognathic treatment for class II and III correction on posterior airway space
Abstract
Objectives
Comparison of treatment effects on the posterior airway space (PAS) in patients treated with combined orthodontic–orthognathic surgical treatment.
Methods
Pre- and postsurgical lateral cephalograms of 53 (34 females, 19 males) Caucasian patients were analyzed using a customized set of measurements. According to malocclusion (Class II or III) and surgical approach (either monognathic or bignathic), patients were allocated into four groups. PAS was assessed from cranial to caudal at six levels (P1–P6). Paired t tests were used for intragroup and t tests for independent samples for intergroup comparisons. Results were considered statistically significant at p < 0.05.
Results
In patients treated for Class II malocclusion, PAS retropalatally (P1 level) almost remained unchanged, whereas measurements at levels P2–P6 showed a mean increase ranging from approximately 2–5.5 mm. Significant changes were most pronounced in monognathic Class II patients (group 1) at levels P2–P4 with mean values ranging from approximately 3.7–5.5 mm. In patients treated for Class III malocclusion (groups 3 and 4), measurements at the P1 level almost remained unchanged in patients who underwent mandibular setback surgery (group 3), whereas the same measurements exhibited significant increase (>6 mm) in patients treated with bignathic surgery (group 4).
Conclusions
Bignathic surgery led to smaller changes of pharyngeal depth in Class II and III patients than monognathic surgery. Alterations of the PAS due to orthognathic surgery should be considered during orthodontic and presurgical treatment planning.
http://ift.tt/2tmL2dF
Evaluation of locked plate in the osteosynthesis of fractures in osteoporotic bones
Annals of African Medicine 2017 16(3):127-130
Background: The use of conventional dynamic compression plates (DCPs) in osteoporotic bones is associated with higher chances of implant failure. The advent and use of locking combi-plates have ensured a stable construct during osteosynthesis of fractures in osteoporotic bones. Objectives: The study aims to assess the outcome of use of locking combi-plates in the management of fractures in osteoporotic bones in our environment. Materials and Methods: Cases of patients with nonunion and localized osteoporosis from January 2014 to December 2014 that were managed with locked combi-plates were reviewed. Outcome was assessed by time to healing, stability of implant construct after 6 and 12 months. Results: There were 10 patients with mean age of 47.4 ± 12.63 years. There were 9 males and 1 female, and road traffic crashes were the mechanism of injury in 90% (n = 9) and gunshot injuries in 10% (n = 1). Atrophic nonunion was the most common indication for osteosynthesis with 80%, followed by fibrous nonunion with 10.0%. The humerus was the most common long bone involved with 50%. Locked broad DCP was used in 62.5%, and the duration between initial injury and surgery was 6 and 48 months, with an average of 17.5 months. The outcome was such that 90% healed after 12 months on follow-up while one case had the implant backing out and delay union at 6 months. Conclusion: The use of locked plate in the management of nonunion in the presence of osteoporosis ensures stable fixation construct and healing. Contexte: L'utilisation de plaques de compression dynamiques conventionnelles dans les os ostéoporotiques est associée à des chances plus élevées de défaillance de l'implant. L'avènement et l'utilisation de combi-plaques de verrouillage ont assuré une construction stable lors de l'ostéosyntheis de fractures dans les os ostéoporotiques. Objectifs: L'étude vise à évaluer le résultat de l'utilisation de combi-plaques de verrouillage dans la gestion des fractures dans les os ostéoporotiques dans notre environnement. Méthodologie: Les cas de patients atteints d'ostéoporose non syndiquée et localisée de janvier 2014 à décembre 2014 qui ont été gérés avec des combi-plaques verrouillées ont été examinés. Le résultat a été évalué par le temps de guérison, la stabilité de la construction d'implant après 6 et 12 mois. Résultats: il y avait 10 patients avec un âge moyen de 47,4 12,63. Il y avait 9 hommes et 1 accident de la route et de la route était le mécanisme de la blessure dans 90% (n = 9) et les blessures par balle dans 10% (n = 1). La non-union atrophique était l'indication la plus courante pour l'ostéosynthèse avec 80%, suivie d'une non-union fibreuse avec 10,0%. L'humérus était l'os le plus fréquent impliqué avec 50%. La plaque de compression dynamique bloquée (DCP) a été utilisée à 62,5% et la durée entre la blessure initiale et la chirurgie était de 6 et 48 mois avec une moyenne de 17,5 mois. Le résultat était tel que 90% ont été guéris après 12 mois de suivi, tandis que 1 cas avait l'implantation de l'implant et retardé l'union à 6 mois. Conclusion: L'utilisation de la plaque verrouillée dans la gestion de la non-union en présence d'ostéoporose assure une construction stable de fixation et une guérison.
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Primary hyperparathyroidism in pregnancy
Annals of African Medicine 2017 16(3):145-147
Primary hyperparathyroidism (PHT) is a frequent and asymptomatic pathology in 80% of patients, and a parathyroidal adenoma is found in the most case. However, rare cases might occur during pregnancy; and the literature reported up to 200 cases. We report three cases of PHT that occurred during the second and last third trimesters of pregnancy stage in patients aged 26, 42 and 32-year-old. Despite diagnosis limitations, since scintigraphy is prohibited in pregnancy, the patients were managed conservatively with good prognosis for both mothers and babies. L'hyperparathyroïdie primaire (HTP) est une maladie fréquente et asymptomatique chez 80% des patients. Un adénome parathyroïdien est retrouvé chez une grande majorité des cas. Cependant, l'apparition au cours de la grossesse est particulièrement rare et la littérature ne rapporte que 200 cas. Nous en rapportons 3 cas d'hyperparathyroïdie âgés de 26, 42 et 32 ans, survenue au cours du deuxième et troisième trimestre de la grossesse. Malgré les limites diagnostiques dues à l'interdiction de la scintigraphie au cours de la grossesse, la gestion avait été faite de façon très conservative de sorte à avoir le meilleur pronostic pour les patientes leurs fétus.
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Randomized controlled trials: Ethical and scientific issues in the choice of placebo or active control
Annals of African Medicine 2017 16(3):97-100
The use of control group in clinical trials has been universally acclaimed by researchers to effectively help discriminate between the actual effects of an intervention and those arising from other factors. However, the choice of the control that provided both scientific and ethical acceptability among researchers has been a source of intense debate. We conducted a literature search on the use of placebo and active controls in clinical trials and X-ray the arguments for and against both choices in randomized control trials and concluded by highlighting the scenarios where the use of placebo is justified.
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Low back pain in pregnant women attending antenatal clinic: The Aminu Kano teaching hospital experience
Annals of African Medicine 2017 16(3):136-140
Background: The profound physiologic effects of pregnancy affect the musculoskeletal system. Pregnant women are at increased risks of low back/pelvic girdle pains. Objective: To determine the incidence of low back/pelvic girdle pains among pregnant women. Materials and Methods: This was a cross-sectional study conducted from May 1 to June 30, 2016, among consenting pregnant women at Aminu Kano Teaching Hospital. Ethical approval was obtained from the Hospital Ethics Committee. Information was obtained in a questionnaire on consecutive pregnant women. Data obtained were analyzed using SPSS version 18 (SPSS Inc., Chicago, Illinois, USA, 2012). Fisher's exact test was used for categorical data, and P ≤ 0.05 was considered statistically significant. Results: A total of 309 pregnant women were recruited from May 1 to June 30, 2016. The mean age ± standard deviation was 28.4 ± 5.86 years. The incidence of low back pains (LBPs) and pelvic girdle pains among the pregnant women was 106 (34.3%) and 178 (57.6%), respectively. The pain was severe among 26 (9.2%) pregnant women, which warranted analgesic usage. Pain radiation was reported in >50% of cases. There was an incidental finding of urinary incontinence in 36 (12.6%) cases. Low back/pelvic girdle pain was not associated with body mass index (BMI) (P = 0.390). Conclusion: The incidence of LBPs and pelvic girdle pains was high and found to be 34.3% and 57.6%, respectively. Analgesics were used especially among those with severe pains. There was an incidental finding of urinary incontinence among pregnant women with complaints of low back/pelvic girdle pains. There was no statistically significant association between LBPs and maternal BMI.
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Evaluation of neutrophil gelatinase-associated lipocalin and cystatin C as early markers of diabetic nephropathy
Annals of African Medicine 2017 16(3):101-106
Introduction: Diabetes mellitus (DM) is a major cause of concern because of its increasing prevalence rate and related microvascular as well as macrovascular complications, including kidney disease. Microalbuminuria has been accepted as the earliest marker for diabetic nephropathy; however, a large proportion of renal impairment occurs in nonalbuminuric state. We planned to investigate the serum and urinary levels of the tubular damage markers (neutrophil gelatinase-associated lipocalin [NGAL] and cystatin C [Cys C]) in patients of type 2 diabetes to detect early kidney injury. Materials and Methods: This cross-sectional hospital-based study included 180 patients with type 2 DM according to the American Diabetes Association criteria. Serum NGAL (S.NGAL) and urine NGAL (U.NGAL) and Cys C were measured in all study participants and investigated for correlation with microalbuminuria. Results: Our results showed that U.NGAL and S.NGAL levels were significantly high in patients with microalbuminuria as compared to normoalbuminuric controls. Serum Cys C was also higher in microalbuminuric patients than who had normoalbuminuria. A positive correlation of urinary albumin excretion with S.NGAL and U.NGAL was noted. U.NGAL also showed positive correlation with duration of diabetes, glycated hemoglobin, and dyslipidemia. Receiver operating characteristic curve analysis showed that the area under the curve for U.NGAL and S.NGAL were 1 and 0.8, respectively, which indicates that they are sensitive markers for early renal damage. Conclusion: Urinary biomarkers were significantly elevated in normoalbuminuric type 2 diabetic patients compared with nondiabetic controls and could be used as markers of nephropathy at a very early stage even before the development of microalbuminuria, the current gold standard for early diagnosis. Despite the promise of these new biomarkers, further large, multicenter prospective studies are still needed.
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Sonographic assessment of urolithiasis in university of Abuja teaching hospital, Nigeria
Annals of African Medicine 2017 16(3):95-96
http://ift.tt/2t2BfHy
Emerging trends of nosocomial pneumonia in intensive care unit of a tertiary care public teaching hospital in Western India
Annals of African Medicine 2017 16(3):107-113
Background: Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. Materials and Methods: It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months. We studied clinical profile and outcome of 120 adult patients who developed VAP/HAP during the study period. We also analyzed the causative organisms, antibiotic sensitivity, and resistance pattern in these patients. Results: Out of 120 patients, 29 patients were HAP and 91 patients were VAP. Mortality was 60% (72), and development of VAP and requirement of mechanical ventilation showed significant association with mortality (P < 0.00001). Most common organism causing HAP was Staphylococcus aureus (43.4%) and VAP was Klebsiella pneumoniae (49%). Maximum antibiotic sensitivity was found to piperacillin + tazobactam (58.8%), followed by imipenem (49.5%) and meropenem (41.8%), whereas maximum antibiotic resistance was found to cefepime (95.1%), followed by ceftazidime and amoxicillin (91.2%). Conclusion: Nosocomial pneumonia showed high incidence (17.44%) and mortality (60%). Common organisms identified were S. aureus and K. pneumoniae. Resistance was high for commonly used antibiotics and high antibiotic sensitivity for piperacillin + tazobactam and carbapenem. Contexte: La pneumonie nosocomiale pose un grand défi à un intensiviste. Des informations détaillées sur la pneumonie acquise dans les hôpitaux (HAP) et la pneumonie acquise par le ventilateur (VAP) sont essentielles pour la prévention et la gestion optimale, améliorant ainsi les soins de soins intensifs de qualité (UTI). Par conséquent, nous avons cherché à étudier la tendance actuelle de la pneumonie nosocomiale en UTI. Matériaux et méthodes: il s'agissait d'une étude de cohorte observationnelle prospective menée dans l'UCI d'un hôpital public d'enseignement tertiaire sur une période de 18 mois. Nous avons étudié le profil clinique et le résultat de 120 patients adultes qui ont développé le VAP / HAP pendant la période d'étude. Nous avons également analysé les organismes responsables, la sensibilité aux antibiotiques et le modèle de résistance chez ces patients. Résultats: Sur 120 patients, 29 patients étaient HAP et 91 patients étaient VAP. La mortalité était de 60% (72), et le développement du VAP et l'exigence de ventilation mécanique ont montré une association significative avec la mortalité (P < 0,00001). L'organisme le plus fréquent causant HAP était Staphylococcus aureus (43,4%) et VAP était Klebsiella pneumoniae (49%). Une sensibilité antibiotique maximale a été observée chez la pipéracilline + tazobactam (58,8%), suivie de l'imipénème (49,5%) et du méropénem (41,8%), alors que la résistance antibiotique maximale a été observée à cefépime (95,1%), suivie de ceftazidime et de l'amoxicilline (91,2%) . Conclusion: la pneumonie nosocomiale a montré une incidence élevée (17,44%) et la mortalité (60%). Les organismes communs identifiés étaient S. aureus et K. pneumoniae. La résistance était élevée pour les antibiotiques couramment utilisés et une forte sensibilité aux antibiotiques pour la pipéracilline + le tazobactam et le carbapénème.
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Cross-sectional, observational study of anterior segment parameters using anterior segment optical coherence tomography in North Indian Population
Annals of African Medicine 2017 16(3):131-135
Purpose: To study the anterior segment (AS) parameters using AS optical coherence tomography (AS-OCT) in the North Indian population. Methods: A hospital-based, observational, cross-sectional study was conducted over a period of 1 year. It included 251 normal individuals aged 20–70 years. Participants underwent imaging with AS-OCT.Ocular parameters included anterior chamber angle (ACA), iris cross-sectional area (ICSA), iris thickness (IT), and iris curvature (IC). The parameters were measured nasally and temporally for both sexes and different age groups. Results: The mean age of participants was 48.3 ± 13.9 years and 50.6% were men. The ACA decreased with age whereas ICSA, IT, and IC increased with age. The ACA (P = 0.0001nasally and temporally), ICSA (P = 0.011 nasally, P = 0.027 temporally), IT750 (P = 0.001 nasally, P = 0.011 temporally), IT1500 (P = 0.002 nasally, P = 0.002 temporally), and IC (P = 0.059 nasally, P = 0.128 temporally) underwent statistically significant changes with increasing age. No significant difference was seen in parameters of different sex. Conclusion: In this subset of the Indian population, the change in the AC parameters with age influences the AC dimensions predisposing the eye to glaucomatous conditions. These data are applicable clinically for the assessment and surgical management of patients requiring AS surgery. Objectif: Étudier les paramètres du segment antérieur (AS) en utilisant la tomodensitométrie optique AS (AS-OCT) dans la population du nord de l'Inde. Méthodes: Une étude axée sur l'hôpital, observationnelle et transversale a été menée sur une période de 1 an. Il comprenait 251 individus normaux âgés de 20 à 70 ans. Les participants ont subi une imagerie avec AS-OCT. Les paramètres oculaires comprenaient l'angle de la chambre antérieure (ACA), la surface transversale de l'iris (ICSA), l'épaisseur de l'iris (IT) et la courbure de l'iris (IC). Les paramètres ont été mesurés par voie nasale et temporelle pour les deux sexes et différents groupes d'âge. Résultats: l'âge moyen des participants était de 48,3 ± 13,9 ans et 50,6% des hommes. L'ACA a diminué avec l'âge alors que ICSA, IT et IC ont augmenté avec l'âge. L'ACA (P = 0,0001 par voie nasale et temporelle), ICSA (P = 0,011 nasale, P = 0,027 temporellement), IT750 (P = 0,001 par voie nasale, P = 0,011 temporellement), IT1500 (P = 0,002 par voie nasale, P = 0,002 temporellement) Et IC (P = 0,059 nasal, P = 0,128 temporellement) ont subi des changements statistiquement significatifs avec l'âge. Aucune différence significative n'a été observée dans les paramètres du sexe différent. Conclusion: Dans ce sous-ensemble de la population indienne, la variation des paramètres CA avec l'âge influence les dimensions AC prédisposant l'oeil aux conditions glaucomateuses. Ces données sont applicables cliniquement pour l'évaluation et la gestion chirurgicale des patients nécessitant une chirurgie AS.
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A profile of adverse effects of antihypertensive medicines in a tertiary care clinic in Nigeria
Annals of African Medicine 2017 16(3):114-119
Background: There has been a dearth of comprehensive data on the profile of adverse reactions to antihypertensive medicines in the Nigerian setting despite increased use. Objective: This study was aimed to characterize the adverse reactions experienced in the homogenously black African population. Methods: The study was carried out at the University of Benin Teaching Hospital, Benin City, Nigeria, in consenting eligible hypertensive patients ≥18 years. Adverse reactions were sought using patient's self-report and a medicine-induced symptom checklist. Results: A total of 514 patients (340 females) aged 22–97 years were studied. Thirteen percent, 27.6%, 26.7%, 22.0%, and 10.7% were on 1, 2, 3, 4, and ≥5 medicines, respectively, for control of their blood pressure with the frequency of adverse effects increasing proportionately up to four medicines. Adverse reactions to antihypertensive medicines were reported by a total of 93 (18.1%) patients. Diuretics – 27.9%, calcium channel blockers (CCBs) – 26.8%, and angiotensin-converting enzyme inhibitors (ACEIs) – 26.8% accounted for most of the adverse reactions seen, notably frequent micturition and headaches (CCB); excessive micturition and dizziness (diuretics); dry irritating cough (ACEI). Notable complaints for all patients using the checklist were increased frequency of micturition, reduction in libido, and headaches. The reactions resulted in the discontinuation and substitution of therapy in 49.5% of the patients. Conclusions: The characterization of these reactions in Nigerians requires further studies as frequent micturition reported is still a neglected complaint in antihypertensive therapy.
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Overview of extremity musculoskeletal neoplasms at the Ahmadu Bello University Teaching Hospital Zaria, Nigeria
Annals of African Medicine 2017 16(3):141-144
Background: The burden of managing patients with musculoskeletal neoplasms in the West African sub-region is quite significant. This is largely due to late presentation, delay in making diagnosis, and failure of obtaining consent to certain surgical procedures. Improvements in diagnosis and treatment over the years have however increased life and limb survival for many patients. This study was aimed at evaluating the clinicopathologic pattern of neoplasm as it affects the upper and lower limbs with a view to determining the most common types, the most involved sites of the body and the age at presentation of these tumors. Materials and Methods: A total of 65 patients with histologically confirmed neoplasm of the upper and lower limbs arising from bone, cartilage, skeletal muscle, synovium, and tendon sheath were retrospectively selected 7 years from January 2008 to 2015. Results: Forty-one (63.1%) patients were males, whereas 24 (36.9%) were females. Age range is between 5 and 75 years, average of 30.8 years. Lower limb involvement was recorded in 40 (61.5%) patients, with remaining 25 (38.5%) patients in upper limbs. 28 (43.1%) patients had benign lesion, whereas 37 (56.9%) were malignant. Giant cell tumor (GCT) was the most frequent benign tumor (50%) while osteogenic sarcomas top the list on the malignant variety (32.4%). The most commonly affected bones were tibia, carpal-metacarpal, and femur in that order. Conclusion: In our center, GCT and osteogenic sarcoma are the most frequently encountered benign and malignant musculoskeletal extremity neoplasms, respectively, with the tibial bone being most commonly affected.
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Effect of analgesia on the changes in respiratory parameters in blunt chest injury with multiple rib fractures
Annals of African Medicine 2017 16(3):120-126
Background: Blunt chest injury with multiple rib fractures can result in such complications as pneumonia, atelectasis, bronchiectasis, empyema thoracis, acute respiratory distress syndrome, and prolonged Intensive Care Unit and hospital stay, with its concomitant mortality. These may be prevented or reduced by good analgesic therapy which is the subject of this study. Methods: This was a prospective study of effects of analgesia on changes in pulmonary functions of patients with traumatic multiple rib fractures resulting from blunt chest injury. Results: There were 64 adult patients who were studied with multiple rib fractures caused by blunt chest trauma. Of these patients, 54 (84.4%) were male and 10 (15.6%) were female. Motorcycle (popularly known as "okada") and tricycle (popularly known as keke napep) accidents significantly accounted for the majority of the multiple rib fractures, that is, in 50 (78.1%) of the patients. Before analgesic administration, no patient had a normal respiratory rate, but at 1 h following the administration of analgesic, 21 (32.8%) of patients recorded normal respiratory rates and there was a significant reduction in the number (10.9% vs. 39.1%) of patients with respiratory rates >30 breaths/min. Before commencement of analgesic, no patient recorded up to 99% of oxygen saturation (SpO2) as measured by pulse oximeter, while 43.8% recorded SpO2of 96%. This improved after 1 h of administration of analgesics to SpO2of 100% in 18.8% of patients and 99% in 31.3% of patients and none recording SpO2of < 97% (P = 0.006). Before analgesia, no patient was able to achieve peak expiratory flow rate (PEFR) value >100% of predicted while only 9 (14.1%) patients were able to achieve a PEFR value in the range of 91%–100% of predicted value. One hour after analgesia, a total of 6 (9.4%) patients were able to achieve PEFR values >100% predicted, while 35 (54.7%) patients achieved PEFR values in the range of 91%–100% predicted. Conclusion: Adequate analgesia is capable of reversing the negative effects of chest pain of traumatic multiple rib fractures on pulmonary function parameters through improvement in respiratory mechanics.
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Atherogenic index of plasma for the assessment of cardiovascular risk factors
Annals of African Medicine 2017 16(3):148-148
http://ift.tt/2u038jM
Animal-derived natural products of Sowa Rigpa medicine: Their pharmacopoeial description, current utilization and zoological identification
Publication date: 31 July 2017
Source:Journal of Ethnopharmacology, Volume 207
Author(s): Karma Yeshi, Paolo Morisco, Phurpa Wangchuk
Ethnopharmacological relevanceThe Bhutanese Sowa Rigpa medicine (BSM) uses animal parts in the preparation of numerous polyingredient traditional remedies. Our study reports the taxonomical identification of medicinal animals and the description of traditional uses in English medical terminologies.Aim of the studyTo taxonomically identify the medicinal animals and their derived natural products used as a zootherapeutic agents in BSM.Materials and methodsFirst, the traditional textbooks were reviewed to generate a list of animal products described as ingredients. Second, animal parts that are currently used in Bhutan were identified. Third, the ethnopharmacological uses of each animal ingredients were translated into English medical terminologies by consulting Traditional Physicians, clinical assistants, pharmacognosists, and pharmacists in Bhutan. Fourth, the animal parts were taxonomically identified and their Latin names were confirmed by crosschecking them with online animal databases and relevant scientific literature.ResultsThe study found 73 natural products belonging to 29 categories derived from 45 medicinal animals (36 vertebrates and 9 invertebrates), comprising of 9 taxonomic categories and 30 zoological families. Out of 116 formulations currently produced, 87 of them contain one or more extracts and products obtained from 13 medicinal animals to treat more than 124 traditionally classified illnesses. Only five animal ingredients were found available in Bhutan and rest of the animal parts are being imported from India.ConclusionsOut of 73 natural products described in the traditional textbooks, only 13 of them (some omitted and few substituted by plants) are currently included in 87 formulations of BSM.
Graphical abstract
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Alterations in liver marker enzymes and recovery ability of cyprinids as indicators of aquatic pollution
Abstract
Information on the detection of pesticides in fresh water Lakes of Kashmir (Dal and Mansbal) through GC–MS technique is scarce, and also the recovery in biochemical parameters (AST, ALT and ALP) of fish after transferring them to clean media has not been reported yet. The water samples were collected from three sites and analyzed for their pesticide profile by dispersive liquid–liquid micro extraction (DLLME) followed by GC–MS. Influence of pesticides on liver marker enzymes of Cyprinus carpio and Carassius carassius was also investigated. The results obtained showed the presence of three main pesticides viz. chlorpyrifros, dimethoate and dichlorvos in waters of Dal Lake whereas no pesticide was detected in waters of Mansbal. The higher values for AST, ALT and ALP activities and decrease in protein content were obtained in the samples from the Dal Lake compared with those from Mansbal Lake (p < 0.05). These data when compared with the values found in C. carpio and C. carassius from both the Dal Lake and Mansbal Lake kept under laboratory conditions after 15, 30, 45 and 60 days of maintenance in clean media found that during depuration, all the enzyme activities came down significantly (p < 0.05) indicating the compensatory response by the fish against the pesticide stress. Therefore, these parameters could be used as indicators of pesticide pollution in aquatic organisms and were recommended for environmental monitoring for investigating the mechanism involved in the recovery pattern.
http://ift.tt/2t2KXda
Parasites and pollution: the effectiveness of tiny organisms in assessing the quality of aquatic ecosystems, with a focus on Africa
Abstract
The aquatic environment represents the final repository for many human-generated pollutants associated with anthropogenic activities. The quality of natural freshwater systems is easily disrupted by the introduction of pollutants from urban, industrial and agricultural processes. To assess the extent of chemical perturbation and associated environmental degradation, physico-chemical parameters have been monitored in conjunction with biota in numerous biological monitoring protocols. Most studies incorporating organisms into such approaches have focussed on fish and macroinvertebrates. More recently, interest in the ecology of parasites in relation to environmental monitoring has indicated that these organisms are sensitive towards the quality of the macroenvironment. Variable responses towards exposure to pollution have been identified at the population and component community level of a number of parasites. Furthermore, such responses have been found to differ with the type of pollutant and the lifestyle of the parasite. Generally, endoparasite infection levels have been shown to become elevated in relation to poorer water quality conditions, while ectoparasites are more sensitive, and exposure to contaminated environments resulted in a decline in ectoparasite infections. Furthermore, endoparasites have been found to be suitable accumulation indicators for monitoring levels of several trace elements and metals in the environment. The ability of these organisms to accumulate metals has further been observed to be of benefit to the host, resulting in decreased somatic metal levels in infected hosts. These trends have similarly been found for host–parasite models in African freshwater environments, but such analyses are comparatively sparse compared to other countries. Recently, studies on diplozoids from two freshwater systems have indicated that exposure to poorer water quality resulted in decreased infections. In the Vaal River, the poor water quality resulted in the extinction of the parasite from a site below the Vaal River Barrage. Laboratory exposures have further indicated that oncomiracidia of Paradiplozoon ichthyoxanthon are sensitive to exposure to dissolved aluminium. Overall, parasites from African freshwater and marine ecosystems have merit as effect and accumulation indicators; however, more research is required to detail the effects of exposure on sensitive biological processes within these organisms.
http://ift.tt/2sj8ZDi
Pediatric toxic polycystic thyroid
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
http://ift.tt/2s3qiUK
At Home Preresidency Preparation for General Surgery Internship: A Pilot Study
Publication date: Available online 27 June 2017
Source:Journal of Surgical Education
Author(s): T.K. Pandian, Eeeln H. Buckarma, Monali Mohan, Becca L. Gas, Nimesh D. Naik, Eduardo F. Abbott, Apram Jyot, Muhammad H. Zeb, Stephanie F. Heller, David R. Farley
ObjectiveTo create a novel "at-home" preresidency preparatory adjunct for medical students entering surgical residency.DesignPreparatory resources were mailed to match medical students before residency matriculation in 2015. This included "how-to" videos, low-cost models, and surgical instruments for 5 "stations" (arterial blood gas analysis, anatomy and imaging knowledge, knot tying ability, and suturing dexterity) of our program's biannual general surgery intern objective assessment activity (Surgical Olympics: total 13 stations, 10 points each). Scores from 2015 were compared with 2014 historical controls in a retrospective manner using the Student's t-test.SettingAcademic, tertiary care referral center with a large general surgery training program.ParticipantsPostgraduate year 1 general surgery trainees (interns) from the years 2014 and 2015.ResultsTwenty-six interns participated in the 2015 assessment and were compared to thirty-two 2014 interns. Overall mean scores were low, but higher (19.7 vs. 15.4, p = 0.04) in the 2015 class. The largest increase was noted in the anatomy knowledge station (mean = 5.0 vs. 1.9, p < 0.01). Scores in stations assessing technical competence were similar to controls. The number of perfect scores among the 5 stations was higher (10 vs. 5) in the 2015 group. Mean scores from the other 8 stations, for which no resources were mailed, showed no difference (29.3 vs. 28.3, p = 0.75).ConclusionsEnacting a simple, home-based curriculum for medical students before surgical residency, improved performance on early knowledge assessments.
http://ift.tt/2sjgjPD
A Multicenter Prospective Comparison of the Accreditation Council for Graduate Medical Education Milestones: Clinical Competency Committee vs. Resident Self-Assessment
Publication date: Available online 27 June 2017
Source:Journal of Surgical Education
Author(s): Ryan S. Watson, Andrew J. Borgert, Colette T. O׳Heron, Kara J. Kallies, Richard A. Sidwell, John D. Mellinger, Amit R. Joshi, Joseph M. Galante, Lowell W. Chambers, Jon B. Morris, Robert K. Josloff, Marc L. Melcher, George M. Fuhrman, Kyla P. Terhune, Lily Chang, Elizabeth M. Ferguson, Edward D. Auyang, Kevin R. Patel, Benjamin T. Jarman
ObjectiveThe Accreditation Council for Graduate Medical Education requires accredited residency programs to implement competency-based assessments of medical trainees based upon nationally established Milestones. Clinical competency committees (CCC) are required to prepare biannual reports using the Milestones and ensure reporting to the Accreditation Council for Graduate Medical Education. Previous research demonstrated a strong correlation between CCC and resident scores on the Milestones at 1 institution. We sought to evaluate a national sampling of general surgery residency programs and hypothesized that CCC and resident assessments are similar.DesignDetails regarding the makeup and process of each CCC were obtained. Major disparities were defined as an absolute mean difference of ≥0.5 on the 4-point scale. A negative assessment disparity indicated that the residents evaluated themselves at a lower level than did the CCC. Statistical analysis included Wilcoxon rank sum and Sign tests.SettingCCCs and categorical general surgery residents from 15 residency programs completed the Milestones document independently during the spring of 2016.ResultsOverall, 334 residents were included; 44 (13%) and 43 (13%) residents scored themselves ≥0.5 points higher and lower than the CCC, respectively. Female residents scored themselves a mean of 0.08 points lower, and male residents scored themselves a mean of 0.03 points higher than the CCC. Median assessment differences for postgraduate year (PGY) 1-5 were 0.03 (range: −0.94 to 1.28), −0.11 (range: −1.22 to 1.22), −0.08 (range: −1.28 to 0.81), 0.02 (range: −0.91 to 1.00), and −0.19 (range: −1.16 to 0.50), respectively. Residents in university vs. independent programs had higher rates of negative assessment differences in medical knowledge (15% vs. 6%; P = 0.015), patient care (17% vs. 5%; P = 0.002), professionalism (23% vs. 14%; P = 0.013), and system-based practice (18% vs. 9%; P = 0.031) competencies. Major assessment disparities by sex or PGY were similar among individual competencies.ConclusionsSurgery residents in this national cohort demonstrated self-awareness when compared to assessments by their respective CCCs. This was independent of program type, sex, or level of training. PGY 5 residents, female residents, and those from university programs consistently rated themselves lower than the CCC, but these were not major disparities and the significance of this is unclear.
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Design and Implementation of a Robotic Surgery Training Experience Logging System
Publication date: Available online 28 June 2017
Source:Journal of Surgical Education
Author(s): Kristin G. Baldea, Ryan Thorwarth, Petar Bajic, Marcus L. Quek, Gopal N. Gupta
PurposeResidents currently log robotic cases in the ACGME system as a "surgeon" if they performed any critical step of the procedure on the surgeon console. There is no standardization as to which steps or how much of the procedure should be performed by the resident. It was our objective to establish a tool for logging the true operative experience in robotic surgery to aid in assessing surgical competency as well as curriculum development.Materials and MethodsWe propose a tool to log surgical skill progression, experience, and feedback for robotic cases. A web-based robotic experience logging system (RoboLog) was developed with procedures deconstructed to their major steps. Trainees may request the supervising attending review their performance. RoboLog provides automated summary reports to both residents and attendings.ResultsRoboLog was successfully developed and piloted with a total of 310 cases logged over 1 year. A reporting structure was developed where residents could view statistics on several data points such as step-specific involvement and feedback from attending staff. Detailed data on resident experience were obtained. For instance, 82% of the 151 robotic prostatectomies were logged as "surgeon", yet urethral transection had <35% resident involvement.ConclusionsOur current system for logging robotic experience is lacking given the fact that resident involvement on the surgical console is variable. Widespread usage of a logging system with more insight into step-specific involvement is needed. RoboLog fills this need and can be used to track robotic training progress and aid in development of a standardized curriculum.
http://ift.tt/2tm5P1f
A Case of Keloids Complicated by Castleman’s Disease: Interleukin-6 as a Keloid Risk Factor
Summary: Keloids are a manifestation of a fibroproliferative scarring disorder of the skin and develop in response to dermal injury in patients with a susceptible background. Local, systemic, and genetic factors contribute to keloid susceptibility. These factors include tension on the edges of the wound, hormonal influences, and ethnicity, respectively. Castleman's disease is a rare lymphoproliferative disorder that is characterized by the unregulated overproduction of interleukin-6, which leads to systemic lymphadenopathy and constitutional inflammatory symptoms. This case report shows that the bilateral auricular keloids of an adult woman were greatly exacerbated by the onset of Castleman's disease. We present our multimodal management algorithm for auricular keloids, which involves core excision and radiation therapy and achieves excellent aesthetic outcomes. The current treatment pathway for auricular keloids and the possible relationship between interleukin-6 and keloid progression will be discussed.http://ift.tt/2snhkBm
Nonsteroidal anti-inflammatory drugs and the risk of anastomotic leakage after anterior resection for rectal cancer
Publication date: Available online 28 June 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Daniel Kverneng Hultberg, Eva Angenete, Marie-Louise Lydrup, Jörgen Rutegård, Peter Matthiessen, Martin Rutegård
BackgroundNonsteroidal anti-inflammatory drugs (NSAIDs) have been widely used in colorectal surgery due to their opioid-sparing effect. However, several studies have indicated an increased risk of anastomotic leakage following NSAID treatment, although conflicting results exist. The primary goal of this study was to further examine whether postoperative NSAIDs are independently associated with anastomotic leakage after anterior resection for rectal cancer.MethodsPatients who underwent anterior resection for rectal cancer during 2007-2013 in 15 different hospitals in three healthcare regions in Sweden were included in the study. Registry data and information from patient records were retrieved. The association between NSAID treatment (for at least two days in the first postoperative week) and symptomatic anastomotic leakage (within 90 days) was evaluated with multiple logistic regression, with adjustment for pertinent confounding factors.ResultsSome 1495 patients were included in the study. Of these, 27% received postoperative NSAIDs for at least two days in the first postoperative week. Symptomatic anastomotic leakage occurred in 11% and 14% in the NSAID and non-NSAID group, respectively. With adjustment for confounders, the odds ratio for leakage among patients who received NSAIDs compared with those who did not was 0.88 (95% CI 0.65-1.20). No differences were seen between non-selective and COX-2-selective NSAIDs.ConclusionPostoperative NSAID treatment does not seem to increase the risk of symptomatic anastomotic leakage after anterior resection for rectal cancer. NSAID use appears to be safe, but a well-powered randomized clinical trial is warranted.
http://ift.tt/2s3g2fo
Prognostic Significance of IgG4+ Plasma Cell Infiltrates Following Neoadjuvant Chemoradiation Therapy for Esophageal Adenocarcinoma
Publication date: Available online 28 June 2017
Source:Human Pathology
Author(s): Evgeny Yakirevich, Shaolei Lu, Danisha Allen, Shamlal Mangray, Jacqueline R Fanion, Kara A Lombardo, Howard Safran, Murray B Resnick
Lymphoplasmacytic infiltrates in esophageal adenocarcinoma (EAC) tissue following chemoradiotherapy (CRT) reflect alterations in the tumor immunoenvironment. The presence and role of plasma cells in this process are poorly understood. Our aim was to characterize the IgG4+ plasma cell population in EAC following CRT. Seventy-one esophagectomy specimens post CRT were compared to a surgery only group of 31 EACs. The distribution, density, and ratio of IgG4+ and IgG+ plasma cells were evaluated by immunohistochemistry and correlated with clinicopathologic features, treatment response, and survival. In the CRT group the presence of higher numbers of IgG4+ (≥ median of 94/high power field) and IgG+ (≥ median of 225/high power field) plasma cells and increased IgG4+/IgG+ ratio(≥ median of 41%) within ulcers was associated with complete or near complete treatment response (P=.0077, P=.0503, and P=.0063, respectively). Lower tumor grade, smaller tumor size, and higher levels of IgG4+ plasma cells in posttherapy ulcers significantly correlated with better overall survival (OS), while pretherapy clinical stage, posttherapy pathologic stage, smaller tumor size and lower tumor grade were associated with longer recurrence free survival (RFS). Multivariate analysis revealed that both posttherapy pathologic stage and high IgG4+ plasma cells in ulcers were independent predictors of OS (P=.05 and P=.01), whereas only posttherapy pathologic stage was associated with RFS (P<.01). This is the first study describing a dense IgG4+ plasma cell infiltrate in EAC following CRT. The presence of increased IgG4+ plasma cells may be a novel reliable factor to predict prognosis of EAC patients following CRT.
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EZH2 upregulation correlates with tumor invasiveness, proliferation, and angiogenesis in human pituitary adenomas
Publication date: Available online 28 June 2017
Source:Human Pathology
Author(s): Bin Liu, Bo Pang, Qirui Wang, Shengji Yang, Taihong Gao, Qian Ding, Huajie Liu, Yihang Yang, Haitao Fan, Rui Zhang, Tao Xin, Guangming Xu, Qi Pang
Enhancer of zeste homolog 2 (EZH2) is a critical component of the polycomb repressive complex 2 (PRC2), which epigenetically represses genes involved in tumorigenesis and is highly expressed in tumors. However, no studies have investigated EZH2 expression and its clinical significance in human pituitary adenomas (PAs). Therefore, we examined the expression pattern of EZH2 in PAs and studied the correlations between protein expression and invasiveness, proliferation, angiogenesis, hormone functioning, and some other factors. We measured EZH2 and MMP-14 protein and EZH2 mRNA expression in 62 samples of PAs by immunohistochemistry staining and quantitative real-time polymerase chain reaction (qRT-PCR) and correlated protein expression relative to clinicopathologic features. The immunopositive rate of EZH2 was 88.7% (55/62). The extent of expression was associated with invasiveness, microvessel density, and proliferation (Ki-67 index). Moreover, EZH2 expression correlated with MMP-14 expression. We did not find any correlation between EZH2 overexpression and hormone-secreting function or patient age or sex. The qRT-PCR analysis revealed that the amount of EZH2 mRNA was significantly higher in invasive than in noninvasive adenomas. This is the first report to describe EZH2 overexpression in human PAs, especially invasive adenomas. Thus, EZH2 is a potentially useful diagnostic marker and pharmacotherapeutic target for invasive PAs.
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Association of expression of the hedgehog signal with Merkel cell polyomavirus infection and prognosis of Merkel cell carcinoma
Publication date: Available online 28 June 2017
Source:Human Pathology
Author(s): Teruyuki Kuromi, Michiko Matsushita, Takeshi Iwasaki, Daisuke Nonaka, Satoshi Kuwamoto, Keiko Nagata, Masako Kato, Gen Akizuki, Yukisato Kitamura, Kazuhiko Hayashi
Merkel cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer that mostly occurs in the elderly. Merkel cell polyomavirus (MCPyV) is detected in approximately 80% of MCCs and is associated with carcinogenesis. Hedgehog signaling pathway plays a role in human embryogenesis and organogenesis. In addition, reactivation of this pathway later in life can cause tumors. Twenty-nineMCPyV-positive and 21 MCPyV-negative MCCs were immunohistochemically stained with primary antibodies for hedgehog signaling (SHH, IHH, PTCH1, SMO, GLI1, GLI2, and GLI3) and evaluated using H-score. Polymerase chain reaction and sequence analysis for SHH and GLI1 exons were also performed. Expression of SHH was higher in MCPyV-positive MCCs than in MCPyV-negative MCCs (P<.001). Higher expression of GLI1, MCPyV infection, male sex, and Japanese ethnicity were associated with better overall survival (P=.034, P=.001, P=.042, and P=.036, respectively). Higher expression of SHH and MCPyV infection were associated with improved MCC-specific survival (P=.037 and P=.002, respectively). The mutation analysis of prognosis-related GLI1 and SHH genes in our study revealed a low frequency of mutations in the 10 exons examined, except GLI1 exon 5 (18/22 cases), all having the same silent mutation of c.576G>A. Only 2 mutations with amino acid changes were detected in MCPyV-negative MCCs only: 1 missense mutation in GLI1 exon 4 and 1 nonsense mutation in SHH-3B. Expression of SHH and GLI1 may be useful prognostic markers of MCC because increased expression was associated with better prognosis. The high rate of c.576G>A silent mutation in GLI1 exon 5 was a feature of MCC.
http://ift.tt/2s3bllD
Anesthetic agents, neurodevelopmental risk and the connection to bacterial infections
Source:Microbes and Infection
Author(s): Keith Fluegge, Kyle Fluegge
This short communication identifies a significant flaw in research investigating the neurodevelopmental consequences of general anesthesia exposure. We have identified that chronic environmental exposure to pervasive air pollutants that are also widely used as anesthetic agents, specifically nitrous oxide (N2O), may contribute to the rising prevalence of neurodevelopmental disorders. Consistent with the emerging link between microbes and psychiatric illness risk, this epidemiological analysis extends our prior conclusions by proposing that such exposures may alter host immunity so as to enhance vulnerability to certain pathogenic microbes that have been implicated in neurodevelopmental disorders, including Pseudomonas aeruginosa and Clostridium difficile.
http://ift.tt/2t2hfFa
The biological responses and metal phytoaccumulation of duckweed Spirodela polyrhiza to manganese and chromium
Abstract
The phytoaccumulation ability of duckweed Spirodela polyrhiza on manganese (Mn) and chromium (Cr) was assessed by exposing the plant to various concentrations of single or dual metals (5–70 mg L−1 Mn, 2–12 mg L−1 Cr(VI)) under laboratory conditions. The results showed that S. polyrhiza can tolerate Mn at high concentrations of up to 70 mg L−1, and its growth rate was barely affected by Mn. The effects of Cr on S. polyrhiza growth were dose-dependent, and the growth was completely inhibited in the presence of 12 mg L−1 Cr. Analysis of metal content in the plant biomass revealed a high accumulation of Mn (up to 15.75 mg per g of duckweed dry weight). The Cr bioaccumulation (from below detection limit to 2.85 mg Cr (11.84 mg Cr2O72−) per g of duckweed dry weight) increased with cultivation time and metal concentration in the medium. Further study with the concurrence of Mn and Cr showed increased toxicity to plant growth and photosynthesis. The metal accumulations in the dual metal treatments were also significantly decreased as compared to the single metal treatments. Nevertheless, the phytoaccumulation of these two metals in S. polyrhiza in the dual metal treatments were still comparable to or higher than in previous reports. Thus, it was concluded that duckweed S. polyrhiza has the potential to be used as a phytoremediator in aquatic environments for Mn and Cr removal.
http://ift.tt/2tZ7WG9
Predicting microalgae growth and phosphorus removal in cold region waste stabilization ponds using a stochastic modelling approach
Abstract
A stochastic ecological model with an integrated equilibrium temperature model was developed to predict microalgae growth and phosphorus removal in cold region waste stabilization ponds (WSPs). The model utilized a Monte Carlo simulation to account for parameter uncertainty. The equilibrium temperature model was parameterized using field data collected from two WSPs in Nunavut, Canada, from 2012 to 2014. The equilibrium temperature model provided good agreement with field data on a daily time step. The full model was run using historic (1956–2005) temperature and solar radiation data from five communities (Baker Lake, Cambridge Bay, Coral Harbour, Hall Beach, Resolute) in Nunavut, Canada. The communities represented a range of geographical locations and environmental conditions. Logistic regression on pooled model outputs showed that mean July temperature and mean treatment season temperature (June 1–September 15, ice-free period) provided the best predictors for microalgae growth. They had a predictive success rate of 93 and 88%, respectively. The modelled threshold (50% probability from the Monte Carlo simulation) for microalgae growth was 8.7 and 5.6 °C for the July temperature and mean treatment season temperature, respectively. The logistic regression was applied to each community (except Sanikiluaq) in Nunavut using historic climate data and a probability of microalgae growth was calculated. Based on the model results, soluble phosphorus concentrations consistent with secondary treatment could be achieved if WSP depth is less than 2 m. The model demonstrated a robust method to predict whether a microalgae bloom will occur under a range of model parameters.
http://ift.tt/2tpWxCe
Environmental Metabolic Footprinting (EMF) vs. half-life: a new and integrative proxy for the discrimination between control and pesticides exposed sediments in order to further characterise pesticides’ environmental impact
Abstract
Pesticides are regularly used for a variety of applications and are disseminated throughout the environment. These substances may have significant negative impacts. To date, the half-life, t1/2, was often used to study the fate of pesticides in environmental matrices (water, soil, sediment). However, this value gives limited information. First, it does not evaluate the formation of by-products, resulting in the need for additional experiments to be performed to evaluate biodegradation and biotransformation products. T1/2 also fails to consider the chemical's impact on biodiversity. Resilience time, a new and integrative proxy, was recently proposed as an alternative to t1/2, with the potential to evaluate all the post-application effects of the chemical on the environment. The 'Environmental Metabolic Footprinting' (EMF) approach, giving an idea of the resilience time, was used to evaluate the impact of botanicals on soil. The goal is to optimise the EMF to study the impact of a microbial insecticide, the Bacillus thuringiensis israelensis (Bti), on sediment. The difficulty of this work lies in the commercial solution of Bti that is really complex, and this complexity yields chromatograms that are extremely difficult to interpret; t1/2 cannot be used. No methodologies currently exist to monitor the impact of these compounds on the environment. We will test the EMF to determine if it is sensitive enough to tolerate such complex mixtures. A pure chemical insecticide, the α-cypermethrin, will be also studied. The article shows that the EMF is able to distinguish meta-metabolome differences between control and exposed (with Bti) sediments.
http://ift.tt/2tZ0Voz
Transformer oils as a potential source of environmental exposure to polychlorinated biphenyls (PCBs): an assessment in three central provinces of Iran
Abstract
Polychlorinated biphenyl (PCB) contamination of oils from all transformers of the national electrical grid in Tehran, Qom, and Alborz, three central provinces of Iran, was assessed. The concentration of PCBs in transformer oils was determined by gas chromatography. At the national level, the proportions of transformers with oil PCB contents of <5, 5–49, 50–499, 500–4999, and >5000 ppm were determined to be 85.7, 12.4, 1.6, 0.1, and 0.1%, respectively. About 0.5% of transformer oils (66,000 kg out of 13,342,000 kg) exhibited PCB levels higher than 50 ppm that based on the Stockholm Convention should be phased out before 2025. The contaminated oils contained 91.4% of detected PCBs (132 kg PCBs out of 144 kg PCBs) and were located in 1.9% of transformers (27 transformers out of 1449 transformers). Statistical analysis indicated that the year of manufacture and manufacturing company provided significant effects on PCB contamination (p value <0.001). PCB contamination of transformer oils in Tehran was higher than that of the other provinces that could be mainly caused by the older average year of manufacture. PCB levels higher than 499 ppm were also observed only in Tehran. This study provided valuable information for future studies on identification of PCB-contaminated transformers as well as planning and design of waste management facilities for PCB-contaminated oils at the national level.
http://ift.tt/2tpZpyD
Monitoring of organic pollutants in marine environment by semipermeable membrane devices and mussels: accumulation and biochemical responses
Abstract
This study involves the monitoring of organic pollutants using transplanted mussels (Mytilus galloprovincialis) as bioindicator organisms and semipermeable membrane devices (SPMDs) as passive samplers. Mussels and SPMDs were deployed to marinas, shipyards and shipbreaking yards on the coastal area of Turkey and retrieved after 60 days. Polycyclic aromatic hydrocarbons (PAH), polychlorinated biphenyls (PCB) and organochlorine pesticide (OCP) compounds were analysed with high-resolution GC-MS. Total PAH concentrations in SPMDs and mussels ranged from 200 to 4740 ng g sampler−1 and from 7.0 to 1130 ng g−1 in wet weight (ww). PCB and OCP concentrations in SPMDs changed between 0.04–200 and 4.0–26 ng g sampler−1, respectively. The highest PCB (190 ng g−1 ww) and OCP (200 ng g−1 ww) concentrations in mussels were measured at shipyard stations. A strong correlation was observed between the PAH and PCB concentrations in SPMDs and mussels. Enzyme assays (acetylcholinesterase, ethoxyresorufin-O-deethylase, glutathione S-transferase, glutathion reductase and carboxylesterase activities) were performed as biomarkers to reveal the effects of pollution on the mussels. There was no clear relationship found between the enzyme levels and the pollutant concentrations in mussels. Integrated biomarker responses were calculated to interpret the overall effect of pollutants.
http://ift.tt/2tZ2yma
Impacts of hydrologic variations on chemical weathering and solute sources in the Min River basin, Himalayan–Tibetan region
Abstract
Feedback between hydrologic variations and chemical weathering is thought to play a crucial role in modulating global carbon cycling. The mechanisms associated with the impacts of hydrologic variations on solute sources and chemical weathering were evaluated by examining the relationships between river discharge and hydrochemistry based on high-frequency sampling of the Min River, which originates in the Himalayan–Tibetan region. Fluid transit times and flow pathways vary with changes in discharge, thereby affecting various biogeochemical processes. Although shorter transit times occur during the high-flow season than during the low-flow season, concentrations of chemical weathering products exhibit chemostatic behaviour (less variation than changes in discharge) in response to increasing discharge due to hydrologic flushing of minerals, which increases the amount of reactive mineral surface area. The contributions of various sources to dissolved loads in the Min River were estimated using a forward model. The calculated annual carbonate and silicate weathering fluxes are 24.1 and 9.6 t/km2 year, respectively. Atmospheric contributions increase with increasing discharge, whereas the contributions of silicate weathering decrease with increasing discharge. Both the carbonate weathering flux (FCarb) and silicate weathering flux (FSil) are positively correlated with the discharge, indicating that temporal variations in chemical weathering fluxes in the Min River are highly affected by hydrologic variations. The slope of the relationship between FCarb and discharge is much greater than that between FSil and discharge due to the rapid dissolution of carbonate minerals, suggesting that carbonate weathering is more sensitive than silicate weathering to hydrologic variations. This study demonstrates that high-frequency sampling is necessary when investigating solute sources and chemical weathering processes in river basins influenced by a monsoon climate.
http://ift.tt/2tq52gu
Pollution-induced community tolerance in benthic macroinvertebrates of a mildly lead-contaminated lake
Abstract
Pollution-induced community tolerance (PICT) has been used to demonstrate effects of sediment contamination on microbes and meiofauna. Our study explored the potential to detect PICT in benthic macroinvertebrates of a lake with long-term mild lead (Pb) contamination. We collected macrobenthos from two areas in Caddo Lake, Texas, a control area (CO) with a mean sediment Pb level of 11 μg/g and Goose Prairie (GP) where sediment Pb levels averaged 74 μg/g. Upon return to the laboratory, we exposed macroinvertebrates to a lethal lead concentration and assessed 48-h mortality. Mortality of CO macrobenthos was significantly higher than that of GP macrobenthos, providing evidence that these communities differed in their tolerance to lead. A comparison of macrobenthos community composition between the areas showed that the GP macrobenthos lacked metal-sensitive taxa such as gastropods and amphipods (which were present at CO). Similarly, a higher proportion of the GP benthos belonged to metal-tolerant taxa such as isopods and chironomids. Thus, changes in community composition appeared to be at least partly responsible for differences in community tolerance. Our results showed that a sediment Pb concentration below effect-based sediment quality guidelines had a measurable impact on macrobenthos, thus demonstrating that results from single-species toxicity tests may underestimate impacts on communities. This study also confirms that the PICT approach with macroinvertebrates is a feasible and potentially powerful approach for detecting contaminant impacts.
http://ift.tt/2tYTyxj
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Summary Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an un...
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