Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Τετάρτη 11 Οκτωβρίου 2017
Radioactive and stable cesium isotope distributions and dynamics in Japanese cedar forests
Source:Journal of Environmental Radioactivity
Author(s): Vasyl Yoschenko, Tsugiko Takase, Thomas G. Hinton, Kenji Nanba, Yuichi Onda, Alexei Konoplev, Azusa Goto, Aya Yokoyama, Koji Keitoku
Dynamics of the Fukushima-derived radiocesium and distribution of the natural stable isotope 133Cs in Japanese cedar (Cryptomeria japonica D. Don) forest ecosystems were studied during 2014–2016. For the experimental site in Yamakiya, Fukushima Prefecture, we present the redistribution of radiocesium among ecosystem compartments during the entire observation period, while the results obtained at another two experimental site were used to demonstrate similarity of the main trends in the Japanese forest ecosystems. Our observations at the Yamakiya site revealed significant redistribution of radiocesium between the ecosystem compartments during 2014–2016. During this same period radionuclide inventories in the aboveground tree biomass were relatively stable, however, radiocesium in forest litter decreased from 20 ± 11% of the total deposition in 2014 to 4.6 ± 2.7% in 2016. Radiocesium in the soil profile accumulated in the 5-cm topsoil layers. In 2016, more than 80% of the total radionuclide deposition in the ecosystem resided in the 5-cm topsoil layer.The radiocesium distribution between the aboveground biomass compartments at Yamakiya during 2014–2016 was gradually approaching a quasi-equilibrium distribution with stable cesium. Strong correlations of radioactive and stable cesium isotope concentrations in all compartments of the ecosystem have not been reached yet. However, in some compartments the correlation is already strong. An increase of radiocesium concentrations in young foliage in 2016, compared to 2015, and an increase in 2015–2016 of the 137Cs/133Cs concentration ratio in the biomass compartments with strong correlations indicate an increase in root uptake of radiocesium from the soil profile. Mass balance of the radionuclide inventories, and accounting for radiocesium fluxes in litterfall, throughfall and stemflow, enabled a rough estimate of the annual radiocesium root uptake flux as 2 ± 1% of the total inventory in the ecosystem.
http://ift.tt/2ycgsq0
Cancer Immunotherapy Trials Underutilize Immune Response Monitoring
AbstractImmune‐related radiological and biomarker monitoring in cancer immunotherapy trials permits interrogation of efficacy and reasons for therapeutic failure. We report the results from a cross‐sectional analysis of response monitoring in 685 T‐cell checkpoint‐targeted cancer immunotherapy trials in solid malignancies, as registered on the U.S. National Institutes of Health trial registry by October 2016. Immune‐related radiological response criteria were registered for only 25% of clinical trials. Only 38% of trials registered an exploratory immunological biomarker, and registration of immunological biomarkers has decreased over the last 15 years. We suggest that increasing the utilization of immune‐related response monitoring across cancer immunotherapy trials will improve analysis of outcomes and facilitate translational efforts to extend the benefit of immunotherapy to a greater proportion of patients with cancer.
http://ift.tt/2ydChTN
A Comprehensive Review of Sequencing and Combination Strategies of Targeted Agents in Metastatic Colorectal Cancer
AbstractThe emergence of targeted therapies for the treatment of metastatic colorectal cancer (mCRC) has considerably improved survival, but has resulted in a dilemma of identifying the optimal sequence and combination of various agents in the mCRC treatment landscape. A number of cytotoxic agents, including irinotecan, oxaliplatin, 5‐fluorouracil, capecitabine, and TAS‐102, are available for treatment of mCRC. Additionally, whereas patients harboring rat sarcoma viral oncogene homolog (RAS)–wild type mCRC can be treated with the anti‐epidermal growth factor receptor antibodies cetuximab and panitumumab or antiangiogenic agents (bevacizumab, ziv‐aflibercept, and ramucirumab), patients with RAS‐mutant mCRC are limited to antiangiogenic agents as biologic options. Regorafenib, a multikinase inhibitor, can be used in both RAS subgroups. As such, the recommended sequence of therapies that should be received by each subgroup must also be considered separately. This review provides an overview of recent clinical data for approved and investigational targeted therapies that have been studied across different mCRC treatment lines and patient subgroups. It also examines emerging trends in the treatment landscape for mCRC, including treatment with immune checkpoint inhibitors and the utilization of genomic profiling.Implications for Practice.Currently, there are no established guidelines for optimal sequencing of cytotoxic or targeted agents in metastatic colorectal cancer (mCRC). This review provides a snapshot of the current mCRC treatment paradigm. We review the latest clinical data that support the utilization of several targeted agents alone or in combination with backbone chemotherapy across different lines of treatment and patient populations and highlight recommendations for their usage. Recent advances in the treatment landscape are also summarized, including genomic profiling and preliminary results with immune checkpoint inhibitors.
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Cost‐Effectiveness of Nivolumab in Recurrent Metastatic Head and Neck Squamous Cell Carcinoma
AbstractBackground.Treatment options for patients with platinum‐refractory, recurrent, metastatic head and neck squamous cell carcinoma (r/m HNSCC) are limited and prognosis is poor. The recent CheckMate 141 clinical trial demonstrated that nivolumab, an anti‐programmed cell death protein 1 monoclonal antibody, was efficacious in extending the median overall survival (OS) in this patient population compared with standard therapies. We conducted a cost‐effectiveness analysis to determine whether nivolumab is a cost‐effective treatment in this patient population and examined various subgroups to determine for which, if any, the treatment is more cost‐effective.Materials and Methods.We implemented a state transition model for HNSCC with a patient cohort who had tumor progression 6 months after the last dose of platinum‐containing chemotherapy and compared the cost‐effectiveness of nivolumab with docetaxel. Treatment effect estimates and adverse event rates were obtained from CheckMate 141. Costs, utilities, and other model inputs were gathered from published sources. We used a Canadian perspective, a 5‐year time horizon, and a 1.5% discount rate for the analysis.Results.Nivolumab extended mean OS by 4 months compared with docetaxel and resulted in fewer treatment‐related adverse events, producing an incremental effectiveness of 0.13 quality‐adjusted life years (QALY). The incremental cost of treatment with nivolumab was $18,823. At a willingness‐to‐pay threshold of $100,000/QALY, nivolumab was not a cost‐effective treatment option for r/m HNSCC, with an incremental cost‐effectiveness ratio of $144,744/QALY. Nivolumab would be cost‐effective if its price was reduced by 20%. Our subgroup analysis seemed to indicate that nivolumab might be cost‐effective for tumors with expression of programmed death‐ligand 1 >5%.Conclusion.We conclude that although nivolumab offers clinical benefit for the treatment of r/m HNSCC over current regimens, it is not cost‐effective based on its list price. We have also established a value‐based price estimate for nivolumab to be cost‐effective in this patient population. Further study is required to draw a definitive conclusion on biomarkers for cost‐effectiveness.Implications for Practice.In health care settings in which cost considerations are a constraint on choice of therapy, patient selection should be carefully considered to maintain efficiency in the system. Until a biomarker for response to therapy is identified for nivolumab, this medication is unlikely to be cost‐effective for most patients with recurrent, metastatic head and neck squamous cell carcinoma.
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Outcomes of a Specialized Interdisciplinary Approach for Patients with Cancer with Aberrant Opioid‐Related Behavior
AbstractBackground.Data on the development and outcomes of effective interventions to address aberrant opioid‐related behavior (AB) in patients with cancer are lacking. Our outpatient supportive care clinic developed and implemented a specialized interdisciplinary team approach to manage patients with AB. The purpose of this study was to report clinical outcomes of this novel intervention.Materials and Methods.The medical records of 30 consecutive patients with evidence of AB who received the intervention and a random control group of 70 patients without evidence of AB between January 1, 2015, and August 31, 2016, were reviewed.Results.At baseline, pain intensity (p = .002) and opioid dose (p = .001) were significantly higher among patients with AB. During the course of the study, the median number of ABs per month significantly decreased from three preintervention to 0.4 postintervention (p < .0001). The median morphine equivalent daily dose decreased from 165 mg/day at the first intervention visit to 112 mg/day at the last follow‐up (p = .018), although pain intensity did not significantly change (p = .984). "Request for opioid medication refills in the clinic earlier than the expected time" was the AB with the highest frequency prior to the intervention and the greatest improvement during the study period. Younger age (p < .0001) and higher Edmonton Symptom Assessment System anxiety score (p = .005) were independent predictors of the presence of AB.Conclusion.The intervention was associated with a reduction in the frequency of AB and opioid utilization among patients with cancer receiving chronic opioid therapy. More research is needed to further characterize the clinical effectiveness of this intervention.Implications for Practice.There are currently no well‐defined and evidence‐based strategies to manage cancer patients on chronic opioid therapy who demonstrate aberrant opioid‐related behavior. The findings of this study offer a promising starting point for the creation of a standardized strategy for clinicians and provides valuable information to guide their practice regarding these patients. The study results will also help clinicians to better understand the types and frequencies of the most common aberrant behaviors observed among patients with cancer who are receiving chronic opioid therapy. This will enhance the process of timely patient identification, management, or referral to the appropriate specialist teams.
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Peritoneal pre-conditioning reduces macrophage marker expression in collagen-containing engineered vascular grafts
Publication date: Available online 5 October 2017
Source:Acta Biomaterialia
Author(s): Mozhgan Shojaee, Kristin B. Wood, Lisa K. Moore, Chris A. Bashur
Engineered vascular grafts have shown promise as arteriovenous shunts, but they have not yet progressed to clinical trials for coronary arteries <4 mm in diameter such as the coronary arteries. Control over initial biomaterial properties and remodeling are necessary to generate viable grafts. In this study, we blended collagen with a synthetic material, poly(ε-caprolactone), to modulate the post-grafting inflammatory response while avoiding aneurysmal-like dilation and failure that can occur with pure collagen grafts. We also used pre-implantation in an "in vivo bioreactor" to recruit autologous cells and improve patency after grafting. Electrospun conduits were pre-implanted within rat peritoneal cavities and then grafted autologously into abdominal aortae. Conduit collagen percentages and pre-implantation were tested for their impact on graft remodeling and patency. Burst pressures >2000 mmHg, reproducible expansion with systole/diastole, and maintenance of mechanical integrity were observed. More importantly, peritoneal pre-implantation reduced overall lipid oxidation, intimal layer thickness, and expression of an M1 macrophage marker. The condition with the most collagen, 25%, exhibited the lowest expression of macrophage markers but also resulted in a thicker intimal layer. Overall, the 10% collagen/PCL with peritoneal pre-implantation condition appeared to exhibit the best combination of responses, and may result in improved clinical graft viability.Statement of SignificanceThis manuscript describes a rodent study to systematically determine the benefits of both pre-implantation in the peritoneal cavity and specific ratios of collagen on engineered vascular graft viability. We show that pre-implantation had a significant benefit, including decreasing the expression of macrophage markers and reducing lipid oxidation after grafting. This study is the first time that the benefits of peritoneal pre-implantation have been compared to an "off the shelf," directly grafted control condition. We also demonstrated the importance of specific collagen ratio on the response after grafting. Overall, we feel that this article will be of interest to the field and it has the potential to address a significant clinical need: a graft for coronary arteries <4 mm in diameter.
Graphical abstract
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Interactive effects of PAHs with different rings and As on their uptake, transportation, and localization in As hyperaccumulator
Abstract
In order to illuminate the mechanism of the interaction of polycyclic aromatic hydrocarbon (PAH) with different benzene rings and arsenic (As) in As hyperaccumulator, Pteris vittata L., the uptakes of PAHs were investigated using hydroponics simulation and localizations of PAHs in the plant were determined using two-photon laser scanning confocal microscopy (TPLSCM). The results showed that the total As concentration in different parts of P. vittata decreased in the presence of PAHs with increased numbers of benzene rings: 38.0–47.4% for benzo(a)pyrene (BaP, five rings), 20.5–35.9% for pyrene (PYR, four rings), and 13.7–16.6% for fluorine (FLU, three rings). BaP and PYR concentrations increased, while FLU concentration decreased in the presence of As. The results of TPLSCM revealed that PAHs distributed in epidermal cells of roots, xylem, and endothelial cells of rachis, epidermis, and stomatal cells of pinnae; however, the fluorescence intensity of BaP and PYR were higher than FLU significantly in plant. This study provided important basis to further research on interactive effects of PAHs and As in the P. vittata. These findings were important to understand the mechanisms of PAH and As translocation and distribution by P. vittata.
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In search of a comprehensible set of endpoints for the routine monitoring of neurotoxicity in vertebrates: sensory perception and nerve transmission in zebrafish ( Danio rerio ) embryos
Abstract
In order to develop a test battery based on a variety of neurological systems in fish, three sensory systems (vision, olfaction, and lateral line) as well as nerve transmission (acetylcholine esterase) were analyzed in zebrafish (Danio rerio) embryos with respect to their suitability as a model for the screening of neurotoxic trace substances in aquatic ecosystems. As a selection of known or putative neurotoxic compounds, amidotrizoic acid, caffeine, cypermethrin, dichlorvos, 2,4-dinitrotoluene, 2,4-dichlorophenol, 4-nonylphenol, perfluorooctanoic acid, and perfluorooctane sulfonic acid were tested in the fish embryo test (OECD test guideline 236) to determine EC10 values, which were then used as maximum test concentration in subsequent neurotoxicity tests. Whereas inhibition of acetylcholinesterase was investigated biochemically both in vivo and in vitro (ex vivo), the sensory organs were studied in vivo by means of fluorescence microscopy and histopathology in 72- or 96-h-old zebrafish embryos, which are not regarded as protected developmental stages in Europe and thus — at least de jure — represent alternative test methods. Various steps of optimization allowed this neurotoxicity battery to identify neurotoxic potentials for five out of the nine compounds: Cypermethrin and dichlorvos could be shown to specifically modulate acetylcholinesterase activity; dichlorvos, 2,4-dichlorophenol, 4-nonylphenol, and perfluorooctane sulfonic acid led to a degeneration of neuromasts, whereas both vision and olfaction proved quite resistant to concentrations ≤ EC10 of all of the model neurotoxicants tested. Comparison of neurotoxic effects on acetylcholinesterase activity following in vivo and in vitro (ex vivo) exposure to cypermethrin provided hints to a specific enzyme-modulating activity of pyrethroid compounds. Enhancement of the neuromast assay by applying a simultaneous double-staining procedure and implementing a 4-scale scoring system (Stengel et al. 2017) led to reduced variability of results and better statistical resolution and allowed to differentiate location-dependent effects in single neuromasts. Since acetylcholinesterase inhibition and neuromast degeneration can be analyzed in 72- and 96-h-old zebrafish embryos exposed to neurotoxicants according to the standard protocol of the fish embryo toxicity test (OECD TG 236), the fish embryo toxicity test can be enhanced to serve as a sensitive neurotoxicity screening test in non-protected stages of vertebrates.
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Fluoride containing bioactive glass composite for orthodontic adhesives – ion release properties
Source:Dental Materials
Author(s): N.A. Al-eesa, F.S.L. Wong, A. Johal, R.G. Hill
ObjectiveDental materials that release calcium, phosphate and fluoride ions could prevent demineralisation and/or enhance remineralisation of enamel. The objective was to develop a novel bioactive glass (BAG) resin and investigate pH changes and ion release in 3 immersion media.MethodsQuench melt derived BAG (35.25% SiO2, 6% Na2O, 43% CaO, 5.75% P2O5, and 10% CaF2) was incorporated into a resin (42.25% BisEMA, 55% TEGDMA, 0.25% DMAEM, 0.5% camphorquinone and 2% 4-Meta), with a filler load of 80% by weight. Ninety composite disks for each BAG loading of 80%, 60%, 50%, 40%, 20%, and 0% were made and each disk was immersed in 10ml of either tris buffer (TB), or artificial saliva at pH=7 (AS7) or pH=4 (AS4), n=30 for each solution. Three disks of each loading were taken from each of the solutions, at ten time points (6h–6months), for measurement of pH, fluoride, calcium and phosphate.ResultsThe BAG adhesive raised the pH in all the solutions, release Ca, PO4 and F ions especially in AS4. The rise in pH and the release of Ca and F are directly related to the BAG loading and the time of immersion. The pH and the ion releases were maintained and continued over 6months.SignificanceUnlike glass ionomer resins, favourable ions F, Ca and PO4 releases were maintained over a long time period especially in acidic condition for this novel BAG-resin composite. This indicates the resin has the potential to prevent formation and progression of early caries lesions.
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Impact of the heating/quenching process on the mechanical, optical and thermodynamic properties of polyetheretherketone (PEEK) films
Source:Dental Materials
Author(s): Lisa Bodden, Nina Lümkemann, Valerie Köhler, Marlis Eichberger, Bogna Stawarczyk
ObjectiveThe aim of this study was to investigate the impact of a heating/quenching process on the optical, mechanical and thermodynamic properties of filled (20%_4000) and unfilled PEEK films (0%_2000 and 0%_4000). Heating/quenching was performed to simulate thermoforming as possible method to process thermoplastic polymers for dental application.MethodsFor the investigation, films of different PEEK qualities (0%_2000, 0%_4000, 20%_4000) were produced using isostatic pressing (n=10/quality). From each PEEK film, round specimens (n=20/PEEK film) with a diameter of 34mm were cut and following parameters were determined: translucency (T%), Martens-Hardness (HM), indentation modulus (EIT), glass transition temperature (TG), melting temperature (TM) and enthalpy of fusion (ΔHf). Same specimens were exposed to heating/quenching using defined parameters. Afterwards, T%, HM, EIT, TG, TM and ΔHf were determined again. Data were analysed using Kolmogorov–Smirnov test, univariate ANOVA followed by post-hoc Scheffé test with partial eta squared (ηp2), Kruskal–Wallis and Mann Whitney U test. Level of significance was defined to 95%.ResultsMaterials showed significant differences for all investigated parameters in the initial state, except of TG (p=0.249). The heating/quenching process showed a significant increase on T% for the unfilled materials 0%_2000 and 0%_4000. HM and EIT decreased significantly through heating/quenching for all materials. Moreover, heating/quenching showed a reduction of TG for 0%_2000 and 20%_4000, while TM decreased for 0%_2000 and 0%_4000. ΔHf confirms different crystallinities of tested materials.SignificanceThe heating/quenching process showed a significant impact on all investigated parameters. The highest impact was found for mechanical properties resulting in decreased values of HM and EIT.
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Surface characteristics of dental implants: A review
Source:Dental Materials
Author(s): F. Rupp, L. Liang, J. Geis-Gerstorfer, L. Scheideler, F. Hüttig
ObjectivesDuring the last decades, several changes of paradigm have modified our view on how biomaterials' surface characteristics influence the bioresponse. After becoming aware of the role of a certain microroughness for improved cellular contact and osseointegration of dental titanium implants, the likewise important role of surface energy and wettability was increasingly strengthened. Very recently, synergistic effects of nanoscaled topographical features and hydrophilicity at the implant/bone interface have been reported.MethodsQuestions arise about which surface roughness and wetting data are capable to predict the bioresponse and, ultimately, the clinical performance. Current methods and approaches applied for topographical, wetting and surface energetic analyses are highlighted. Current knowledge of possible mechanisms explaining the influence of roughness and hydrophilicity at the biological interface is presented.ResultsMost marketed and experimental surfaces are based on commonly available additive or subtractive surface modifying methods such as blasting, etching or anodizing. Different height, spatial, hybrid and functional roughness parameters have been identified as possible candidates able to predict the outcome at hard and soft tissue interfaces. Likewise, hydrophilic implants have been proven to improve the initial blood contact, to support the wound healing and thereby accelerating the osseointegration.SignificanceThere is clear relevance for the influence of topographical and wetting characteristics on a macromolecular and cellular level at endosseous implant/biosystem interfaces. However, we are still far away from designing sophisticated implant surfaces with the best possible, selective functionality for each specific tissue or cavity interface. Firstly, because our knowledge of the respective surface related reactions is at best fragmentary. Secondly, because manufacturing of multi-scaled complex surfaces including distinct nanotopographies, wetting properties, and stable cleanliness is still a technical challenge and far away from being reproducibly transferred to implant surfaces.
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Analysis and experimental evaluation of shunt active power filter for power quality improvement based on predictive direct power control
Abstract
This paper discusses the use of the concept of classical and predictive direct power control for shunt active power filter function. These strategies are used to improve the active power filter performance by compensation of the reactive power and the elimination of the harmonic currents drawn by non-linear loads. A theoretical analysis followed by a simulation using MATLAB/Simulink software for the studied techniques has been established. Moreover, two test benches have been carried out using the dSPACE card 1104 for the classic and predictive DPC control to evaluate the studied methods in real time. Obtained results are presented and compared in this paper to confirm the superiority of the predictive technique. To overcome the pollution problems caused by the consumption of fossil fuels, renewable energies are the alternatives recommended to ensure green energy. In the same context, the tested predictive filter can easily be supplied by a renewable energy source that will give its impact to enhance the power quality.
http://ift.tt/2yhGpUv
Effect of an alkaline environment on the engineering behavior of cement-stabilized/solidified Zn-contaminated soils
Abstract
Although the stabilization/solidification method has been widely used for remediation of heavy metal-contaminated soils in recent decades, the engineering behavior and mobility of heavy metal ions under alkaline groundwater conditions are still unclear. Therefore, the unconfined compressive strength test (UCS) combined with toxicity characteristic leaching procedure (TCLP) and general acid neutralization capacity (GANC) was used to investigate the effects of alkalinity (using NaOH to simulate alkalinity in the environment) on the mechanical and leaching characteristics of cement-solidified/stabilized (S/S) Zn-contaminated soils. Moreover, the microstructure was analyzed using the scanning electron microscope (SEM) technology. The results indicated that alkaline environment could accelerate the UCS development compared with specimens without soaking in NaOH solution,, regardless of whether the specimens contained Zn2+ or not. And the UCS varied obviously attributed to the variations of both NaOH concentration and soaking time. Except for the specimens soaked for 90 days, the leached Zn2+ concentrations were higher than that of without soaking. However, the leachability of Zn2+ in all the stabilized specimens is in the regulatory level. ANC results indicated that the Zn2+ leaching behavior can be divided into three stages related to the initial leachate pH. Moreover, SEM results proved that the alkaline environment could actually facilitate the cement hydration process. The results proved in the present paper could be useful in treating the heavy metal-contaminated soils involved in the solidification/stabilization technology under alkaline environment.
http://ift.tt/2xzIasD
Photoreduction of Cr(VI) in water using BiVO 4 -Fe 3 O 4 nano-photocatalyst under visible light irradiation
Abstract
The residuals of hexavalent chromium in the aquatic environment have raised much concern for water decontamination. In this study, BiVO4-Fe3O4 was synthesized using a solvothermal method and adopted as a photoreduction catalyst to removal of Cr(VI) in water under visible light irradiation. The physical and chemical properties of BiVO4-Fe3O4 were characterized by UV-vis-DRS, SEM, XRD, FTIR, and BET. The results demonstrated that the band gap for the obtained material is 1.74 eV with an average size of 15 nm and a specific surface area of 55.16 m2/g. A high photocatalytic performance was observed on the photoreduction of Cr(VI) and the removal efficiency was increased in the lower pH condition. The ascending catalyst dosages made the promotion effect, while the increase of Cr(VI) concentration contributed the inhibition for the reduction performance. The structural characteristics of the selected hole scavengers (ethanol, isopropanol, formic acid, citric acid, and oxalic acid) showed the various effects on the reactions due to the amounts of α-OH. For the optimal condition, 79.37% Cr(VI) was removed. Based on the excellent reusability of BiVO4-Fe3O4, this study demonstrated a potential method for the economic-friendly removal of high-valence metals with easier separation in the water.
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Pyrosequencing analysis of source water switch and sulfate-induced bacterial community transformation in simulated drinking water distribution pipes
Abstract
Inter-basin water transfer and source water switching will be increasingly launched due to significant population increase and the shortage of the local water resources in cities around the world. Source water switch may cause physiochemical and microbiological de-stabilization of pipe material, biofilms, and loose deposits in drinking water distribution system (DWDS). Great sulfate alteration during source water switch had been deemed as the main cause of a red water case that occurred in a northern China city. To ascertain the relationship between water quality changing and bacterial communities of biofilms in DWDS and possible bacteria risk in a red water case, water quality changing experiments in simulated DWDSs were conducted for approximately 2 years. Twenty-five corrosion scale samples and eight water samples collected from pipe harvest sites or during experimental periods were analyzed for their bacterial community composition by 454-pyrosequencing technology. Taxonomy results together with redundancy analysis (RDA) or canonical correspondence analysis (CCA) and hierarchical cluster analysis all indicated that bacterial community of samples with groundwater (GW) or surface water (SW) supply history and their variations under high sulfate water were rather different owing to different water source histories and the original pipe scale characteristics. Potential opportunistic pathogens: Burkholderia, Escherichia-Shigella, Mycobacterium, Serratia, Ralstonia, Novosphingobium, Flavobacterium, Sphingomonas, and Sphingopyxis were observed in scale or water samples.
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The addition of PRP to facial lipofilling: a double-blind placebo-controlled randomized trial.
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The lateral thigh perforator (LTP) flap for autologous breast reconstruction: A prospective analysis of 138 flaps.
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Complications and Patient-Reported Outcomes after Abdominal-Based Breast Reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study.
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Bony/Cartilaginous Mismatch: A radiologic investigation into the etiology of tension nose deformity.
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Outcomes After Phalloplasty: Do Transgender Patients and Multiple Urethral Procedures Carry a Higher Rate of Complication?.
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From Classical to Unusual: Report on 5 Cases of Transient Reactive Aquagenic Pseudokeratoderma and Review of the Literature.
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Tumour auto-contouring on 2d cine MRI for locally advanced lung cancer: A comparative study
Source:Radiotherapy and Oncology
Author(s): Martin F. Fast, Björn Eiben, Martin J. Menten, Andreas Wetscherek, David J. Hawkes, Jamie R. McClelland, Uwe Oelfke
Background and purposeRadiotherapy guidance based on magnetic resonance imaging (MRI) is currently becoming a clinical reality. Fast 2d cine MRI sequences are expected to increase the precision of radiation delivery by facilitating tumour delineation during treatment. This study compares four auto-contouring algorithms for the task of delineating the primary tumour in six locally advanced (LA) lung cancer patients.Material and methodsTwenty-two cine MRI sequences were acquired using either a balanced steady-state free precession or a spoiled gradient echo imaging technique. Contours derived by the auto-contouring algorithms were compared against manual reference contours. A selection of eight image data sets was also used to assess the inter-observer delineation uncertainty.ResultsAlgorithmically derived contours agreed well with the manual reference contours (median Dice similarity index: ⩾0.91). Multi-template matching and deformable image registration performed significantly better than feature-driven registration and the pulse-coupled neural network (PCNN). Neither MRI sequence nor image orientation was a conclusive predictor for algorithmic performance. Motion significantly degraded the performance of the PCNN. The inter-observer variability was of the same order of magnitude as the algorithmic performance.ConclusionAuto-contouring of tumours on cine MRI is feasible in LA lung cancer patients. Despite large variations in implementation complexity, the different algorithms all have relatively similar performance.
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Interim 18F-FDG-PET/CT during chemo-radiotherapy in the management of oesophageal cancer patients. A systematic review
Source:Radiotherapy and Oncology
Author(s): Marta Cremonesi, Cristina Garibaldi, Robert Timmerman, Mahila Ferrari, Sara Ronchi, Chiara Maria Grana, Laura Travaini, Laura Gilardi, Anna Starzyńska, Delia Ciardo, Roberto Orecchia, Barbara Alicja Jereczek-Fossa, Maria Cristina Leonardi
Oesophageal cancer is an aggressive disease. The possibility to early stratify patients as responsive and non-responsive with a non-invasive method is extremely appealing. The uptake of Fluorodeoxyglucose (18F-FDG) in tumours, provided by positron emission tomography (PET) images, has been proved to be useful to assess the initial staging of the disease, recurrence, and response to chemotherapy and chemo-radiotherapy (CRT). In the last years, efforts have been focused on the possibility to use ad interim 18F-FDG-PET/CT (PETint) to evaluate response during radiation therapy. However, controversial findings have been reported, although some relevant results would support its use for individual therapeutic decision.The present review assembles the comprehensive literature of the last decade to evaluate whether and in which cases PETint may offer predictive potential in oesophageal cancer. All the analysed studies (13 studies, 697 patients) denoted PETint as a challenging examination for early assessment of outcomes during CRT. In particular, 8 studies advocated the predictivity of PETint, whilst 5 did not find any correlation between the interim variation of PET parameters and the pathological complete response and/or the clinical outcome. The reasons that possibly have caused contradictions among the studies demand further research with prospective and uniform protocols and methods of analysis to assess the predictive and prognostic value of PETint in oesophageal cancer.
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The scope for pneumococcal vaccines that do not prevent transmission
Source:Vaccine, Volume 35, Issue 45
Author(s): Stefan Flasche
The pneumococcal vaccine pipeline holds candidates developed with the aim to prevent the majority if not all pneumococcal disease. Herd protection is a critical component of the overall impact of current pneumococcal conjugate vaccines (PCVs) and is a prerequisite for disease elimination through an infant vaccination programme. We assessed the scope of a hypothetical pneumococcal vaccine candidate (HPVC) with high clinical efficacy against all pneumococci but that fails to induce such indirect protection. We found that, despite a lack of impact on unvaccinated individuals, HPVC use in infancy may offer similar or superior impact among young children if compared to current PCVs. Hence, it could provide a more affordable alternative to PCVs in particular in settings where most pneumococcal disease is concentrated in children.
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A randomized Phase III clinical trial to assess the efficacy of a bovine-human reassortant pentavalent rotavirus vaccine in Indian infants
Publication date: 27 October 2017
Source:Vaccine, Volume 35, Issue 45
Author(s): Prasad S. Kulkarni, Sajjad Desai, Tushar Tewari, Anand Kawade, Nidhi Goyal, Bishan Swarup Garg, Dinesh Kumar, Suman Kanungo, Veena Kamat, Gagandeep Kang, Ashish Bavdekar, Sudhir Babji, Sanjay Juvekar, Byomkesh Manna, Shanta Dutta, Rama Angurana, Deepika Dewan, Abhijeet Dharmadhikari, Jagdish K. Zade, Rajeev M. Dhere, Alan Fix, Maureen Power, Vidyasagar Uprety, Varsha Parulekar, Iksung Cho, Temsunaro R. Chandola, Vikash K. Kedia, Abhishek Raut, Jorge Flores
Rotavirus is the most common cause of moderate-to-severe infant diarrhoea in developing countries, resulting in enormous morbidity, mortality, and economic burden. A bovine-human reassortant pentavalent rotavirus vaccine (BRV-PV) targeting the globally most common strains was developed in India and tested in a randomized, double-blind, placebo-controlled end-point driven Phase III efficacy clinical trial implemented at six sites across India. Infants 6 to 8weeks of age were randomized (1:1) to receive three oral doses of BRV-PV or placebo at 6, 10, and 14weeks of age along with routine vaccines. Home visit surveillance was conducted to detect severe rotavirus gastroenteritis (SRVGE) and safety outcomes until the children reached two years of age. A total of 3749 infants received BRV-PV while 3751 received placebo. At the time of the primary end-point (when the minimum number of cases needed for analysis were accrued) the vaccine efficacy against SRVGE was 36% (95% CI 11.7, 53.6, p=0.0067) in the per protocol (PP) analysis, and 41.9% (95% CI 21.1, 57.3, p=0.0005) in the intent to treat (ITT) analysis. Vaccine efficacy over the entire follow-up period (until children reached two years of age) was 39.5% (95% CI 26.7, 50, p<0.0001) in the PP analysis and 38.8% (95% CI, 26.4, 49, p<0.0001) in the ITT analysis. Vaccine efficacy against the very severe rotavirus cases (VSRVGE, Vesikari score≥16) was 60.5% (95% CI 17.7, 81, p=0.0131) at the time of the primary analysis and 54.7% (95% CI 29.7, 70.8, p=0.0004) for the complete follow-period in the PP population. The incidence of solicited, unsolicited, and serious adverse events were similar in both the vaccine and placebo groups. Likewise, the number of intussusceptions and deaths were similar between both groups. Thus, BRV-PV is an effective, well tolerated and safe vaccine in Indian infants. (Trial registration: Clinical Trials.Gov [NCT 02133690] and Clinical Trial Registry of India [CTRI/2013/05/003667]).
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Update on the epidemiology of rotavirus in the Middle East and North Africa
Source:Vaccine, Volume 35, Issue 45
Author(s): Hassan Zaraket, Rana Charide, Khalil Kreidieh, Ghassan Dbaibo, Nada M. Melhem
Rotavirus (RV) is the leading cause of severe acute gastroenteritis (AGE) worldwide. Consequently, we conducted a systematic literature review on articles studying RV in the 25 countries of the MENA region during the past 15years (2000–2015). The methods and reporting were set according to the 2015 preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) and based on the elements from the international prospective register of systematic reviews (PROSPERO). Our literature search identified 169 studies meeting our predefined inclusion criteria. Studies reporting on RV were conducted in 19 out of the 24 countries of the MENA region. The largest number of studies was reported in Turkey (n=32), Iran (n=31), Saudi Arabia (n=19) and Egypt (n=17). The majority of studies reporting on RV gastroenteritis rates were clinical observational studies. In 115 studies out of 169, RV was reported among in-patients whereas 35 studies reported RV among outpatients. The predominantly reported RV genotype in the region was G1[P8] followed by G2[P4] and G9[P8]. The majority of studies (n=108) were conducted among children less than 5years of age whereas the remaining studies reported on AGE among other age groups and rarely adults. In MENA countries, RV infection was reported all year round with peaks described in cold as well as hot months. This systematic review provides a current update on the epidemiology of RV-associated gastroenteritis in countries of the MENA region and draws attention to the major gaps existing in the continuous monitoring of RV.
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A systematic review of factors affecting vaccine uptake in young children
Source:Vaccine, Volume 35, Issue 45
Author(s): Louise E. Smith, Richard Amlôt, John Weinman, Jenny Yiend, G. James Rubin
BackgroundMany parents make a conscious decision not to vaccinate their child. Multiple beliefs and perceptions surround this choice. If uptake of routine child vaccination is to increase, public health communications about vaccines must be informed by evidence on the factors affecting uptake.MethodWe conducted a systematic review to investigate psychological, social and contextual factors associated with uptake of routine vaccines in young children. Studies were included if they reported analyses of the association between psychological factors and uptake or included parents' self-reported reasons for or against vaccination.ResultsOur search identified 9110 citations after deduplication. Sixty-eight citations describing sixty-four studies were included in the review. The quality of the studies was mixed. There is strong evidence for an association between vaccination uptake and: not perceiving vaccines to cause adverse effects; general positive attitudes towards vaccination; positive vaccine recommendations; and perceiving fewer practical difficulties of vaccination. While there was good evidence for an association between vaccination and perceived susceptibility to the illness, evidence for an association between perceived severity of an illness and vaccination was weak. Other factors associated with vaccination include knowledge about the vaccine, social influences and trust in the healthcare profession. Having increased information about the vaccine was associated with vaccination, but the influence of different sources of information needs more research.ConclusionUnderstanding which factors are consistently associated with the decision to vaccinate one's child is important to identify messages which should be targeted by public health communications about routine child vaccinations.
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Vaccination strategies in pediatric inflammatory bowel disease
Source:Vaccine, Volume 35, Issue 45
Author(s): Valeria Dipasquale, Claudio Romano
The incidence of pediatric inflammatory bowel disease (IBD) is rising, as is the use of immunomodulatory and biological drugs. IBD patients are vulnerable to infections owing to disease-related immunological alterations and drug-induced systemic immunosuppression. Although many infections are vaccine-preventable, vaccination coverage in IBD patients is insufficient. Current guidelines recommend that children with IBD follow the same routine immunization schedule as healthy children, avoiding live vaccines during immunosuppressive therapy. Immunization status should be checked at diagnosis, and patients should be immunized with the vaccines they need. Some studies have demonstrated a suboptimal immune response to vaccinations in IBD patients, but responsible mechanisms are poorly understood. In this manuscript, we provide a broad review of available data about vaccine coverage rates, immunogenicity and safety of both killed and live attenuated vaccinations in the pediatric IBD population; furthermore, we provide comprehensive information regarding current guidelines for immunization of children with IBD and their household contacts. A comprehensive search of published literature using the PubMed (http:// http://ift.tt/LLinzW) database was carried out to identify all articles published in English from 1998 to March 2017, using the following key terms: "inflammatory bowel disease", "vaccination", "immunization", "immunogenicity", "safety" and "children".
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Editorial Board/Aims and Scope
Source:Vaccine, Volume 35, Issue 45
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Salmonella Enteritidis with double deletion in phoP fliC and a competitive exclusion culture elicit substantial additive protective effects against Salmonella exposure in newly hatched chicks
Source:Vaccine, Volume 35, Issue 45
Author(s): U. Methner, A. Berndt, M. Locke
A live Salmonella Enteritidis vaccine (SE147N ΔphoP fliC), able to express both a homologous intestinal colonisation-inhibition effect and a systemic invasion-inhibition effect, was tested for its potential to generate a postulated additive protective effect in case of combined application with a competitive exclusion (CE) culture against Salmonella exposure in very young chicks. Both, SE147N ΔphoP fliC and the CE culture alone were highly protective against systemic and intestinal colonisation of the challenge strain in case of moderate Salmonella exposure, consequently, additive protective effects in combined use could not be detected. However, in case of high Salmonella Enteritidis challenge with 106 cfu/bird at day 3 of life the combination of the ΔphoP fliC vaccine and the CE culture resulted in a protective effect much more pronounced than either of the single preparations and most substantial compared to untreated control birds. The term additive protective effects reflects the recognition that exclusion effects by gut flora cultures and inhibition effects by Salmonella vaccines are caused by different mechanisms.
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Whooping cough surveillance in France in pediatric private practice in 2006–2015
Source:Vaccine, Volume 35, Issue 45
Author(s): Nicole Guiso, Corinne Levy, Olivier Romain, Sophie Guillot, Andreas Werner, Marie Charlotte Rondeau, Stéphane Béchet, Robert Cohen
BackgroundIncreasing incidence of whooping cough (pertussis) has been reported in many countries, attributed to a switch from whole-cell pertussis-containing vaccine (wPV) to acellular PV (aPV) and circulation of the pertactin non-producing Bordetella pertussis. The present study aimed to estimate the duration of immunity conferred by PVs in children in France with data from an ongoing pediatric ambulatory surveillance of pertussis.MethodsA total of 64 pediatricians throughout France enrolled children with suspected pertussis. A standardized data form was used to collect data on age sex, vaccination status, brand of wPV or aPV and source of infection. Confirmed cases were positive on culture and/or real-time Polymerase Chain Reaction (for B.-non-classified or B. pertussis or B. parapertussis) and/or pertussis serology.ResultsBetween October 2006 and December 2015, 149 cases of confirmed Bordetella infections were reported, 86 infected with B. pertussis and 55 B. non-classified. Fifteen children (10.1%) were not vaccinated, and 26 (17.4%) were partially vaccinated. The mean age was greater for children who received 4 doses of wPV (11.3±2.2, p<0.001) or a combination of wPV and aPV (10.5±3.3, p<0.001) than only aPV (7.2±2.4years). The mean duration of cough before a visit to a pediatrician was longer for children with wPV or a combination of wPV and aPV than only aPV (23.8±10.1 and 25.0±25.6vs 13.6±10.0days).ConclusionDespite the use of a more sensitive diagnostic method and emergence of pertactin non producing B. pertussis, in France context, aPV-induced immunity still protects against pertussis; however, the mean duration of immunity is about 6 to 7years, compared to 9years for wPV vaccine, after the primary vaccination and one booster (3+1 doses).
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Personality and demographic correlates of New Zealanders’ confidence in the safety of childhood vaccinations
Source:Vaccine, Volume 35, Issue 45
Author(s): Carol H.J. Lee, Isabelle M. Duck, Chris G. Sibley
Despite extensive scientific evidence on the safety of standard vaccinations, some parents express skeptical attitudes towards the safety of childhood immunisations. This paper uses data from the 2013/14 New Zealand Attitudes and Values Study (NZAVS) survey (N=16,642) to explore the distribution, and demographic and personality correlates of New Zealanders' attitudes towards the safety of childhood vaccinations. Around two thirds (68.5%) of New Zealanders strongly agreed/were confident that "it is safe to vaccinate children following the standard New Zealand immunisation schedule," 26% were skeptical and 5.5% were strongly opposed. Multiple regression analysis indicated that people lower on Conscientiousness and Agreeableness but higher on Openness to Experience expressed lower confidence about vaccine safety. Having higher subjective health satisfaction, living rurally, being Māori, single, employed and not a parent were all associated with lower confidence, while a higher income and educational attainment were associated with greater confidence. Our findings suggest that the majority of New Zealand adults trust in the safety of scheduled childhood vaccinations, but about one third do express some degree of concern. This finding highlights the importance of improving public education about the safety and necessity of vaccinations.
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Parental perceptions of childhood seasonal influenza vaccination in Singapore: A cross-sectional survey
Source:Vaccine, Volume 35, Issue 45
Author(s): Mabel S.F. Low, Hweeyong Tan, Mikael Hartman, Clarence C. Tam, Cheehow Hoo, Jiaqing Lim, Simin Chiow, Simin Lee, Renzhi Thng, Mingzhe Cai, Yanru Tan, Jingzhan Lock
PurposeSeasonal influenza vaccination is recommended in children aged 6–59months, but little is known about child vaccination coverage and determinants in Asian settings. We report the results of a survey of knowledge, attitudes, practices, and determinants of child influenza vaccination in Singapore.MethodsIn December 2015-March 2016, we conducted a survey of 332 parents of children aged 6months to 5years attending pre-schools. We assessed child influenza vaccine coverage and parental knowledge, attitudes, and practices of child influenza vaccination. We used multivariable regression and structural equation models to identify factors associated with child influenza vaccination.ResultsKnowledge about influenza, perceived benefit of vaccination, and willingness to vaccinate were high. However, only 32% of children had ever received influenza vaccine, and only 15% in the past year. Factors independently associated with child influenza vaccination included: being recommended influenza vaccine by a child's doctor (prevalence ratio (PR)=2.47, 95% CI: 1.75–3.48); receiving influenza vaccine information from a private general practitioner (PR=1.47, 95% CI: 1.05–2.04); regularly receiving pre-travel influenza vaccine (PR=1.64, 95% CI: 1.19–2.25); higher willingness to vaccinate (PR=1.58, 95% CI:1.24–2.04 per unit increase in willingness score); and feeling well-informed about influenza vaccine (PR=1.44, 95% CI: 1.04–1.99). Parents who obtained influenza vaccine information from television were less likely to have vaccinated their child (PR=0.44, 95% CI: 0.23–0.85). Path analysis indicated that being recommended vaccination by a child's doctor increased willingness to vaccinate and self-efficacy (feeling well-informed about influenza vaccine). Median willingness-to-pay for a dose of influenza vaccine was SGD30 (interquartile range: SGD20-SGD50), and was higher in parents of vaccinated compared with unvaccinated children (SGD45vs SGD30, p=0.0012).ConclusionKnowledge and willingness to vaccinate was high in this parent population, but influenza vaccine uptake in children was low. Encouraging medical professionals to recommend vaccination of eligible children is key to improving uptake.
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Evaluation of T and B memory cell responses elicited by the pandemic H1N1 vaccine in HIV-infected and HIV-uninfected individuals
Source:Vaccine, Volume 35, Issue 45
Author(s): Peifang Sun, Nancy F. Crum-Cianflone, Gabriel Defang, Maya Williams, Anuradha Ganesan, Brian K. Agan, Tahaniyat Lalani, Timothy Whitman, Carolyn Brandt, Timothy H. Burgess
BackgroundThis study was to compare B and T memory cells elicited by a single dose monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009 H1N1) in HIV+ and HIV− groups, and to analyze the impact of the prior seasonal vaccines to the immunogenicity of this vaccine.MethodsBlood samples were collected before vaccination (day 0) and at days 28 and 180. Participants were categorized into HIV−/LAIV, HIV−/TIV and HIV+/TIV subgroups according to the trivalent live-attenuated or inactivated (LAIV or TIV) seasonal influenza vaccines they received previously. The IgG+ memory B cells (BMem) and IFNγ+ T cells were measured against antigens including the H1N1 vaccine, the hemagglutinin (HA) and neuraminidase (NA) proteins or peptide pools of the pandemic and the seasonal H1N1 strains, respectively.ResultsOverall BMem responses increased significantly at day 28 but returned to baseline by day 180 in all three subgroups. The average frequency of the H1N1-specific BMem at day 28 for the HIV−/LAIV, HIV−/TIV and HIV+/TIV groups was 2.14%, 1.26% and 1.67%, respectively, and the average fold change was 14.39, 3.81 and 3.93, respectively. The differences of BMem between HIV−/LAIV and the two TIV subgroups were significant. For the IFNγ response, the overall spot counts ranged widely between 0 and 958/106 PBMCs. The group average spot counts to H1N1 vaccine was 89, 102, and 30 at day 28 for HIV−/LAIV, HIV−/TIV and HIV+/TIV subgroups, respectively. The average increase of IFNγ response at day 28 vs day 0 in all three subgroups did not reach 2-fold.ConclusionParticipants with a prior LAIV seasonal vaccine, as compared to a TIV seasonal vaccine, responded significantly better to the monovalent H1N1 vaccine. Excluding LAIV participants, no difference was seen between the HIV+ and HIV− subject groups in terms of BMem. The BMem response declined at 6months.
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Evaluation of the innate immune responses to influenza and live-attenuated influenza vaccine infection in primary differentiated human nasal epithelial cells
Publication date: 27 October 2017
Source:Vaccine, Volume 35, Issue 45
Author(s): Adriana Forero, Katherine Fenstermacher, Nicholas Wohlgemuth, Andrew Nishida, Victoria Carter, Elise A. Smith, Xinxia Peng, Melissa Hayes, Doreen Francis, John Treanor, Juliet Morrison, Sabra L. Klein, Andrew Lane, Michael G. Katze, Andrew Pekosz
The host innate immune response to influenza virus is a key determinant of pathogenic outcomes and long-term protective immune responses against subsequent exposures. Here, we present a direct contrast of the host responses in primary differentiated human nasal epithelial cell (hNEC) cultures following infection with either a seasonal H3N2 influenza virus (WT) or the antigenically-matched live-attenuated vaccine (LAIV) strain. Comparison of the transcriptional profiles obtained 24 and 36h post-infection showed that the magnitude of gene expression was greater in LAIV infected relative to that observed in WT infected hNEC cultures. Functional enrichment analysis revealed that the antiviral and inflammatory responses were largely driven by type III IFN induction in both WT and LAIV infected cells. However, the enrichment of biological pathways involved in the recruitment of mononuclear leukocytes, antigen-presenting cells, and T lymphocytes was uniquely observed in LAIV infected cells. These observations were reflective of the host innate immune responses observed in individuals acutely infected with influenza viruses. These findings indicate that cell-intrinsic type III IFN-mediated innate immune responses in the nasal epithelium are not only crucial for viral clearance and attenuation, but may also play an important role in the induction of protective immune responses with live-attenuated vaccines.
Graphical abstract
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Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children
Source:Vaccine, Volume 35, Issue 45
Author(s): Lila J. Finney Rutten, Jennifer L. St. Sauver, Timothy J. Beebe, Patrick M. Wilson, Debra J. Jacobson, Chun Fan, Carmen Radecki Breitkopf, Susan T. Vadaparampil, Kathy L. MacLaughlin, Robert M. Jacobson
PurposeWe tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates.MethodsFrom October 2015 through January 2016, we conducted a survey of primary care clinicians (n=227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11–12years (n=14,406) with site-level vaccination rates.ResultsThe majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR)=1.05; 95% CI (1.01–1.09)] and completion (3 doses) [IRR=1.08; 95% CI (1.02–1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR=1.03; 95% CI (1.00–1.06)] and completion [IRR=1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR=1.05; CI (1.02,1.08)] and completion [IRR=1.05; 95% CI (1.01, 1.09)].ConclusionsConsistency and strength of HPV vaccination recommendation was associated with higher vaccination rates.
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Investigating the candidacy of a capsular polysaccharide-based glycoconjugate as a vaccine to combat Haemophilus influenzae type a disease: A solution for an unmet public health need
Source:Vaccine, Volume 35, Issue 45
Author(s): Andrew D. Cox, Dean Williams, Chantelle Cairns, Frank St. Michael, Perry Fleming, Evgeny Vinogradov, Mélanie Arbour, Luke Masson, Wei Zou
After the introduction of the glycoconjugate vaccine based upon the capsular polysaccharide ofHaemophilus influenzaetype b in the mid 1980s there was a remarkable decrease in the number of invasive cases reported for this organism. Since the 1990s several groups have observed the emergence ofHaemophilus influenzaetype a (Hia), especially in indigenous communities in the northern regions of Canada and Alaska, to a stage where a solution is warranted to prevent further unnecessary deaths due to this pathogen. A glycoconjugate vaccine solution based upon the type a capsular polysaccharide (CPS) was investigated pre-clinically in an effort to illustrate the proof of concept for this approach. In this study we describe the growth of Hia and the isolation, purification and conjugation of the CPS to several carrier proteins. The resulting glycoconjugates were immunised in mice and rabbits provoking sera that facilitated bactericidal killing against all type a strains that we tested. This study has illustrated the pre-clinical proof of concept of a glycoconjugate vaccine based on the CPS of Hia asa solution to this emerging disease.
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Cost-effectiveness of a potential group B streptococcal vaccine for pregnant women in the United States
Source:Vaccine, Volume 35, Issue 45
Author(s): Sun-Young Kim, Chi Nguyen, Louise B. Russell, Sara Tomczyk, Fatimah Abdul-Hakeem, Stephanie J. Schrag, Jennifer R. Verani, Anushua Sinha
BackgroundIn the U.S., intrapartum antibiotic prophylaxis (IAP) for pregnant women colonized with group B streptococcus (GBS) has reduced GBS disease in the first week of life (early-onset/EOGBS). Nonetheless, GBS remains a leading cause of neonatal sepsis, including 1000 late-onset (LOGBS) cases annually. A maternal vaccine under development could prevent EOGBS and LOGBS.MethodsUsing a decision-analytic model, we compared the public health impact, costs, and cost-effectiveness of five strategies to prevent GBS disease in infants: (1) no prevention; (2) currently recommended screening/IAP; (3) maternal GBS immunization; (4) maternal immunization with IAP when indicated for unimmunized women; (5) maternal immunization plus screening/IAP for all women. We modeled a pentavalent vaccine covering serotypes 1a, 1b, II, III, and V, which cause almost all GBS disease.ResultsIn the base case, screening/IAP alone prevents 46% of EOGBS compared to no prevention, at a cost of $70,275 per quality-adjusted life-year (QALY) from a healthcare and $51,249/QALY from a societal perspective (2013 US$). At coverage rates typical of maternal vaccines in the U.S., a pentavalent vaccine alone would not prevent as much disease as screening/IAP until its efficacy approached 90%, but would cost less per QALY. At vaccine efficacy of ≥70%, maternal immunization together with IAP for unimmunized women would prevent more disease than screening/IAP, at a similar cost/QALY.ConclusionsGBS maternal immunization, with IAP as indicated for unvaccinated women, could be an attractive alternative to screening/IAP if a pentavalent vaccine is sufficiently effective. Coverage, typically low for maternal vaccines, is key to the vaccine's public health impact.
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Adjuvanting an inactivated influenza vaccine with conjugated R848 improves the level of antibody present at 6months in a nonhuman primate neonate model
Source:Vaccine, Volume 35, Issue 45
Author(s): Beth C. Holbrook, Ralph B. D'Agostino, S. Tyler Aycock, Matthew J. Jorgensen, Mallinath B. Hadimani, S. Bruce King, Martha A. Alexander-Miller
Generation of a potent antibody response that can be sustained over time is highly challenging in young infants. Our previous studies using a nursery-reared nonhuman primate model identified R848 conjugated to inactivated influenza virus as a highly immunogenic vaccine for neonates. Here we determined the effectiveness of this vaccine in mother-reared infants as well as its ability to promote improved responses at 6months compared to vaccination in the absence of R848. In agreement with our nursery study, R848 conjugated to influenza virus induced a higher antibody response in neonates compared to the non-adjuvanted vaccine. Further, the increase in the response relative to that induced by the non-adjuvanted vaccine was maintained at 6months suggesting the increased antibody secreting cells that resulted from inclusion of conjugated R848 production were capable of surviving long term. There was no significant difference in quality of antibody (i.e. neutralization or affinity), suggesting the beneficial effect of conjugated R848 during vaccination of neonates with inactivated influenza virus is likely manifest during the early generation of antibody secreting cells.
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Human innate responses and adjuvant activity of TLR ligands in vivo in mice reconstituted with a human immune system
Source:Vaccine, Volume 35, Issue 45
Author(s): Liang Cheng, Zheng Zhang, Guangming Li, Feng Li, Li Wang, Liguo Zhang, Sandra M. Zurawski, Gerard Zurawski, Yves Levy, Lishan Su
TLR ligands (TLR-Ls) represent a class of novel vaccine adjuvants. However, their immunologic effects in humans remain poorly defined in vivo. Using a humanized mouse model with a functional human immune system, we investigated how different TLR-Ls stimulated human innate immune response in vivo and their applications as vaccine adjuvants for enhancing human cellular immune response. We found that splenocytes from humanized mice showed identical responses to various TLR-Ls as human PBMCs in vitro. To our surprise, various TLR-Ls stimulated human cytokines and chemokines differently in vivo compared to that in vitro. For example, CpG-A was most efficient to induce IFN-α production in vitro. In contrast, CpG-B, R848 and Poly I:C stimulated much more IFN-α than CpG-A in vivo. Importantly, the human innate immune response to specific TLR-Ls in humanized mice was different from that reported in C57BL/6 mice, but similar to that reported in nonhuman primates. Furthermore, we found that different TLR-Ls distinctively activated and mobilized human plasmacytoid dendritic cells (pDCs), myeloid DCs (mDCs) and monocytes in different organs. Finally, we showed that, as adjuvants, CpG-B, R848 and Poly I:C can all enhance antigen specific CD4+ T cell response, while only R848 and Poly I:C induced CD8+ cytotoxic T cells response to a CD40-targeting HIV vaccine in humanized mice, correlated with their ability to activate human mDCs but not pDCs. We conclude that humanized mice serve as a highly relevant model to evaluate and rank the human immunologic effects of novel adjuvants in vivo prior to testing in humans.
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Value of an in-depth analysis of unpublished data on the safety of influenza vaccines in pregnant women
Source:Vaccine, Volume 35, Issue 45
Author(s): Neal A. Halsey, Tina Proveaux
BackgroundUnpublished data can sometimes provide valuable information on the safety of biologic products.MethodsWe assessed information potentially available from regulatory authorities, manufacturers, and public health agencies. We explored 4 recently established vaccine registries, reviewed package inserts from 99 influenza vaccines, and contacted vaccine manufacturers and regulatory agencies for data on influenza vaccine safety in pregnant women.ResultsThe vaccine registries did not have sufficient data to analyze and there are problems with the quality of the information. The majority of package inserts provided no product-specific safety information for pregnant women, especially in less developed countries. The majority of available data come from reports gathered from passive adverse event reporting systems in the general population and reports of women enrolled in clinical trials of influenza vaccines who became pregnant at various times before or after receiving influenza vaccine. The information was not collected in a systematic manner, there are inconsistencies in the follow up of pregnant women and the available information about pregnancy outcomes. Considerable resources would be needed to systematically identify all of the information, try to obtain missing follow up information, and conduct analyses. There would be substantial limitations to any attempt to conduct a systematic analysis.ConclusionsThe value of trying to analyze unpublished data on the safety of influenza vaccine in pregnancy is limited and would require considerable resources to thoroughly investigate. Expanding efforts to identify and review unpublished data regarding the safety of influenza vaccines in pregnancy is not likely to produce information of high scientific value or information that could not be identified from publications and other publically available data.
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Trends in pneumococcal meningitis hospitalizations following the introduction of the 13-valent pneumococcal conjugate vaccine in the United States
Source:Vaccine, Volume 35, Issue 45
Author(s): David M. Jacobs, Francine Yung, Emily Hart, Melanie N.H. Nguyen, Amy Shaver
BackgroundThe 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in 2010 in the U.S. and its impact on pneumococcal meningitis (PM) is unknown. We assessed the impact of PCV13 on PM hospitalization rates 4years after the vaccine was introduced.MethodsThis was a retrospective analysis of the National Inpatient Sample from 2008–2014. Patients with an ICD-9-CM code for PM (320.1) were identified and rates calculated using US Census data as the denominator. Data weights were used to derive national estimates. We examined three time periods: 2008–2009 (late post-PCV7), 2010 (transition year), and 2011–2014 (post-PCV13).ResultsDuring the study period, there were 10,493 hospitalizations due to PM in the U.S. Overall, PM incidence decreased from 0.62 to 0.38 cases per 100,000 over this time (39% decrease; P<0.01). Among children <2years, the average annualized PM rate decreased by 45% from 2.19 to 1.20 per 100,000 (P=0.10). Annual PM rates decreased in those aged 18–39years (0.25–0.15 cases per 100,000; P=0.02) and 40–64years (0.95–0.54 cases per 100,000; P=0.03). A total of 1016 deaths were due to PM, and the case fatality rate was variable over the study period (8.3%–11.2%; P=0.96).ConclusionFollowing the introduction of PCV13, hospitalization rates for PM decreased significantly with no subsequent improvements in case-fatality rate.
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CHRONOVAC VOYAGEUR: A study of the immune response to yellow fever vaccine among infants previously immunized against measles
Publication date: 27 October 2017
Source:Vaccine, Volume 35, Issue 45
Author(s): Catherine Goujon, Marie-Lise Gougeon, Laura Tondeur, Béatrice Poirier, Valérie Seffer, Philippe Desprès, Paul-Henri Consigny, Muriel Vray
For administration of multiple live attenuated vaccines, the Advisory Committee on Immunization Practices recommends either simultaneous immunization or period of at least 28days between vaccines, due to a possible reduction in the immune response to either vaccine.The main objective of this study was to compare the immune response to measles (alone or combined with mumps and rubella) and yellow fever vaccines among infants aged 6–24months living in a yellow fever non-endemic country who had receivedmeasles and yellow fever vaccines before travelling to a yellow fever endemic area.Subjects and methods: A retrospective, multicenter case-control study was carried out in 7 travel clinics in the Paris area from February 1st 2011 to march 31, 2015. Cases were defined as infants immunized with the yellow fever vaccine and with the measles vaccine, either alone or in combination with mumps and rubella vaccine, with a period of 1–27days between each immunization. For each case, two controls were matched based on sex and age: a first control group (control 1) was defined as infants having received the measles vaccine and the yellow fever vaccine simultaneously; a second control group (control 2) was defined as infants who had a period of more than 27days between receiving the measles vaccine and yellow fever vaccine.The primary endpoint of the study was the percentage of infants with protective immunity against yellow fever, measured by the titer of neutralizing antibodies in a venous blood sample.Results: One hundred and thirty-one infants were included in the study (62 cases, 50 infants in control 1 and 19 infants in control 2). Of these, 127 (96%) were shown to have a protective titer of yellow fever antibodies. All 4 infants without a protective titer of yellow fever antibodies were part of control group 1.Discussion: The measles vaccine, alone or combined with mumps and rubella vaccines, appears to have no influence on humoral immune response to the yellow fever vaccine when administered between 1 and 27days. The absence of protective antibodies against yellow fever was observed only among infants who received both vaccines simultaneously.Conclusion: These results may support a revision of current vaccination recommendations concerning the administration of these two live attenuated vaccines either on the same day or at least 28days apart. Our findings show no statistically significant difference if the interval between both vaccines is more than 24 h, but the immune response seems to be reduced when the two vaccines are given at the same time.
http://ift.tt/2gaxJJe
Nano-material as an excellent catalyst for reducing a series of nitroanilines and dyes: triphosphonated ionic liquid- CuFe2O4-modified boron nitride
Publication date: March 2018
Source:Applied Catalysis B: Environmental, Volume 222
Author(s): Vasanthakumar Arumugam, Pavithra Sriram, Ta-Jen Yen, Gyanasivan Govindsamy Redhi, Robert Moonsamy Gengan
In this study a nanomaterial containing a novel tri-cationic phosphonate ionic liquid (TCPIL), copper ferrite magnetic nanoparticles (CuFe2O4 NP) and partially oxidized modified boron nitride nanosheet (BNONS) was synthesized, characterized and used as an efficient catalyst to reduce a series of nitro-anilines (NAs), and dyes. Three different ionic liquids (ILs) [DABCO]+[PDOL]−, [APIC]+[PDOL]− and [PYR]+[PDOL]− were synthesized separately, characterized and used to prepare a novel TCPIL {[DABCO, PYR, APIC-PDOL]+[ATMP]−}ionic liquid. Thereafter CuFe2O4 NPs and BNONS were used to synthesize the nanomaterial (TCPIL/CuFe2O4/BNONS): spectroscopic, microscopic and surface morphological studies were undertaken. The catalytic reduction of a series of NAs such as 2-nitroaniline (2-NA), 3-nitroaniline (3-NA), 4-nitroaniline (4-NA) and 4-nitro-2-phenylenediamine (4-NPDA) and dyes methylene blue (MB) and allura red (AR) in aqueous solution at ambient temperature were effective in all compounds tested: the order of reduction, based on reaction time, was 4-NPD>4-NA>3-NA>2-NA. Kinetic studies indicated either zero order or pseudofirst order. The rate constant, order of the reaction, activation energy and constant ratio were also calculated for each substrate. Furthermore kinetic studies at various temperatures showed that an increase in temperature speeded the reaction whilst by increasing the amount of catalyst the reaction occurred faster. In addition, the nanomaterial was easily recovered and re-used for more than seven times with negligible loss of its catalytic activity. Moreover, it is possible to make different nanomaterial by combining different d-block metals such Zn, Pd, Pt and Mn with BNONSs for potential applications in biomedical, sensors and catalytic fields.
Graphical abstract
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Food stories: Unraveling the mechanisms underlying healthful eating
Source:Appetite, Volume 120
Author(s): Emily Swan, Laura Bouwman, Noelle Aarts, Leah Rosen, Gerrit Jan Hiddink, Maria Koelen
The biomedical model of health (BMH) studies the causes and origins of disease. When applied to nutrition research, eating is studied as a behavior that supports physical health. However, the lack of attention the BMH pays to social and historical circumstances in which health behaviors are constructed has been widely addressed in literature. When people are studied without considering contextual influences, the relevance to everyday life is limited. As a result, how individuals actively deal with their context to manage healthful eating is poorly understood. This research applies a complementary model, salutogenic model of health (SMH), and uses life course research methodology to study a group of healthy eaters. The purpose of this research is to unravel how healthful eating develops in everyday life. Healthy eaters (n = 17) were identified and recruited from the NQplus research panel at Wageningen University, the Netherlands. Life course experiences were examined through narrative inquiry. Participants recalled and visually explored life experiences with food and health using timelines. Results indicate that healthful eating results from exposure to individual- and context-bounded factors during childhood and adulthood and involves specific mental and social capacities relevant to coping including amongst others, critical self-awareness; flexibility, craftiness, and fortitude. Through life-course learning moments, participants were able to develop proactive coping strategies which strengthened their sense of agency and helped them in overcoming stressors and challenges. Findings show that nutrition strategies should not only focus on strengthening food-specific factors like cooking skills and nutrition knowledge, but other factors like stress management, empowerment, and participation. Such factors support the development of adaptive skills and behaviors, enable individuals to deal with the demands of everyday life, and are building blocks for health promotion.
http://ift.tt/2yfeIeU
Different levels of visual perceptual skills are associated with specific modifications in functional connectivity and global efficiency
Publication date: Available online 5 October 2017
Source:International Journal of Psychophysiology
Author(s): Sabrina Danti, Giacomo Handjaras, Luca Cecchetti, Helen Beuzeron-Mangina, Pietro Pietrini, Emiliano Ricciardi
The disembedding ability (i.e., the ability to identify a simple masked figure within a complex one) depends on attentional mechanisms, executive functions and working memory. Recent cognitive models ascribed different levels of disembedding task performance to the efficiency of the subtended mental processes engaged during visuo-spatial perception.Here we aimed at assessing whether different levels of the disembedding ability were associated to the functional signatures of neural efficiency, defined as a specific modulation in response magnitude and functional connectivity strength in task-related areas. Consequently, brain activity evoked by a visual task involving the disembedding ability was acquired using functional magnetic resonance imaging (fMRI) in a sample of 23 right-handed healthy individuals. Brain activity was analyzed at different levels of information processing, from local responses to connectivity interactions between brain nodes, as far as to network topological properties.All different levels of information processing were significantly modulated by individual behavioral performance. Specifically, single voxel response magnitude, connectivity strength of the right intrahemispheric and interhemispheric edges, and graph measures (i.e., local and global efficiency) were negatively associated to behavioral performance. Altogether, these results indicate that efficiency during a disembedding task cannot be merely attributed to a reduced neural recruitment of task-specific regions, but can be better characterized as an enhanced functional hemispherical asymmetry.
http://ift.tt/2yhgb4j
Data of first de-novo transcriptome assembly of a non-model species, hawksbill sea turtle, Eretmochelys imbricate, nesting of the Colombian Caribean
Publication date: Available online 11 October 2017
Source:Data in Brief
Author(s): Javier Hernández-Fernández
The hawksbill sea turtle, Eretmochelys imbricata, is an endangered species of the Caribbean Colombian coast due to anthropic and natural factors that have decreased their population levels. Little is known about the genes that are involved in their immune system, sex determination, aging and others important functions. In this study, RNA sequencing was undertaken using Illumina sequencing technology. The first de-novo assembly of genes expressed in blood from this turtle was also performed. The raw FASTQ files were deposited in the NCBI SRA database with accession number SRX2653641. A total of 5.7Gb raw sequence data were obtained, corresponding to 47,555,108 raw reads. Trinity was used to perform a first de-novo assembly, and we were able to identify 47,586 transcripts of the female hawksbill turtle transcriptome with an N50 of 1100bp. The obtained transcriptome data will be useful for further studies of the physiology, biochemistry and evolution in this species.
http://ift.tt/2g2smYX
FTIR and GC-MS spectral datasets of wax from Pinus roxburghii Sarg. needles biomass
Source:Data in Brief
Author(s): Pallavi Dubey, Pradeep Sharma, Vineet Kumar
The study has been carried out to investigate the chemical composition and type of linkages present in wax obtained from Pinus roxburghii Sarg. needles biomass. The spectroscopic techniques viz. FT-IR and GC-MS were employed to obtain spectral datasets. The results were analysed to identify major structural components constituting wax in native state. The spectral recordings were carried out at three different stages which include native wax, hydrolysed fatty acids and their corresponding methyl esters. Further, mass fragmentation has been discussed to represent the observed m/z values obtained in electron impact spectrum of fatty acid methyl esters.
http://ift.tt/2y9lMKH
Microarray analysis of subcutaneous adipose tissue from mature cows with divergent body weight gain after feed restriction and realimentation
Source:Data in Brief
Author(s): H.C. Cunningham, K.M. Cammack, K.E. Hales, H.C. Freetly, A.K. Lindholm-Perry
Body weight response to periods of feed restriction and realimentation is critical and relevant to the agricultural industry. The purpose of this study was to evaluate differentially expressed genes identified in subcutaneous adipose tissue collected from cows divergent in body weight (BW) gain after feed restriction and realimentation. We compared adipose samples from cows with greater gain based on average daily gain (ADG) during realimentation with samples from cows with lesser gain. Specifically, there were four comparisons including two comparing the high and low gain animals across each feeding period (feed restriction and realimentation) and two that compared differences in feed restriction and realimentation across high or low gain classifications. Using microarray analysis, we provide a set of differentially expressed genes identified between the high and low gain at both periods of nutrient restriction and realimentation. These data identify multiple differentially expressed genes between these two phenotypes across both nutritional environments.
http://ift.tt/2g2uG1U
Survival Disparity Following Abdominal Aortic Aneurysm Repair Highlights Inequality in Ethnic and Socio-economic Status
Publication date: Available online 10 October 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Manar Khashram, Suzanne Pitama, Jonathan A. Williman, Gregory T. Jones, Justin A. Roake
ObjectivesSocio-economic status (SES) and ethnicity have been reported as markers influencing the likelihood of increased mortality. The aim of this study was to investigate how SES and ethnicity impacted patient survival after abdominal aortic aneurysm (AAA) repair.MethodsConsecutive patients undergoing open and endovascular AAA repair during a 14.5 year period were identified. Ethnicity was defined as recorded on health records and SES (a score of 10, where 1 is least deprived and 10 being most deprived) and was linked to census data. Operative outcomes were reported at 30 days and a medium-term survival analysis used the Cox model to report adjusted hazard ratios (HR).ResultsA total of 6239 patients with a median age of 75 years and 78.7% males were included. The majority (5,654) were identified as New Zealand (NZ) Europeans, with 421 identified as NZ Maori, 97 identified as belonging to a Pacific ethnic group, and 67 identified as an Asian ethnic group. The median survival follow-up period was 5 years and after adjusting for confounders, those who identified as NZ Maori had the lowest survival compared with all other ethnic groups with a HR of 1.46 (95% CI 1.23–1.72). Living in areas of high social deprivation ≥ 7 was an independent predictor of short and medium-term overall mortality when compared with living in deprivation deciles 1 or 2.ConclusionsLow SES was identified as a marker of risk for all ethnic groups in relation to both reduced short and medium-term survival. However, regardless of SES, NZ Maori had worse overall medium-term survival following AAA repair than the other ethnic groups. Therefore it appears that both SES and being Maori were markers of increased exposure to risk that negatively impact upon survival after AAA repair. There is a need to ensure systemic processes support initiatives that reduce this inequality.
http://ift.tt/2g3psmE
Concurrent radiotherapy with temozolomide vs. concurrent radiotherapy with a cisplatinum-based polychemotherapy regimen
Abstract
Purpose
As the efficacy of all pediatric high-grade glioma (HGG) treatments is similar and still disappointing, it is essential to also investigate the toxicity of available treatments.
Methods
Prospectively recorded hematologic and nonhematologic toxicities of children treated with radiochemotherapy in the HIT GBM-C/D and HIT-HGG-2007 trials were compared. Children aged 3–18 years with histologically proven HGG (WHO grade III and IV tumors) or unequivocal radiologic diagnosis of diffuse intrinsic pontine glioma (DIPG) were included in these trials. The HIT-HGG-2007 protocol comprised concomitant radiochemotherapy with temozolomide, while cisplatinum/etoposide (PE) and PE plus ifosfamide (PEI) in combination with weekly vincristine injections were applied during radiochemotherapy in the HIT GBM-C/D protocol.
Results
Regular blood counts and information about cellular nadirs were available from 304 patients (leukocytes) and 306 patients (thrombocytes), respectively. Grade 3–4 leukopenia was much more frequent in the HIT GBM-C/D cohort (n = 88, 52%) vs. HIT-HGG-2007 (n = 13, 10%; P <0.001). Grade 3–4 thrombopenia was also more likely in the HIT GBM-C/D cohort (n = 21, 12% vs. n = 3,2%; P <0.001). Grade 3–4 leukopenia appeared more often in children aged 3–7 years (n = 38/85, 45%) than in children aged 8–12 years (n = 39/120, 33%) and 13–18 years (24/100, 24%; P =0.034). In addition, sickness was more frequent in the HIT GBM-C/D cohort (grade 1–2: 44%, grade 3–4: 6% vs. grade 1–2: 28%, grade 3–4: 1%; P <0.001).
Conclusion
Radiochemotherapy involving cisplatinum-based polychemotherapy is more toxic than radiotherapy in combination with temozolomide. Without evidence of differences in therapeutic efficacy, the treatment with lower toxicity, i. e., radiotherapy with temozolomide should be used.
http://ift.tt/2hAuabQ
Incidental skin malignancies in teledermatology and in-person cohorts in the Veterans Affairs Health System
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Vasken Keleshian, Alex G. Ortega-Loayza, Phillip Tarkington
http://ift.tt/2kI2gQ8
The doll hairline: A clue for the diagnosis of frontal fibrosing alopecia
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Nicolò Brandi, Michela Starace, Aurora Alessandrini, Francesca Bruni, Bianca Maria Piraccini
http://ift.tt/2ygVSE0
Table of Contents
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
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Prevalence of pediatric alopecia areata among 572,617 dermatology patients
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Chauncey C. Caldwell, Sami K. Saikaly, Robert P. Dellavalle, James A. Solomon
http://ift.tt/2kI2bMk
Information for Readers
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
http://ift.tt/2yX7f1E
A meta-analysis of nevus-associated melanoma: Prevalence and practical implications
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Riccardo Pampena, Athanassios Kyrgidis, Aimilios Lallas, Elvira Moscarella, Giuseppe Argenziano, Caterina Longo
The reported prevalence of nevus-associated melanoma varies substantially. We performed a systematic review and meta-analysis to determine the incidence and prevalence of this disease; we also performed subanalyses considering age, tumor thickness, and nevus-type classification. In 38 observational cohort and case–control studies, 29.1% of melanomas likely arose from a preexisting nevus and 70.9% de novo. Any given melanoma was 64% less likely to be nevus-associated than de novo (risk ratio 0.36, 95% confidence interval [CI] 0.29-0.44; P < .001; I2 = 99%); nevus-associated melanomas had a lower mean Breslow thickness than de novo melanomas (mean difference –0.39 mm; 95% CI –0.60 to –0.18; P = .0003; I2 = 66%). No significant differences were noted regarding the association of nevus-associated melanomas with nondysplastic nevi or dysplastic nevi (risk ratio 0.77, 95% CI 0.49-1.20; P = .24; I2 = 98%).
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JAAD Case Reports Article List
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
http://ift.tt/2zfegfi
Vancomycin and DRESS: A retrospective chart review of 32 cases in Los Angeles, California
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Barbara D. Lam, Melanie M. Miller, Adam V. Sutton, David Peng, Ashley B. Crew
http://ift.tt/2yghkcm
Journal Based CME Instructions and Information
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
http://ift.tt/2yXV6tl
The specimen that did not survive processing: Ethical considerations pertaining to open disclosure
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Nikki R. Adler, Catriona A. McLean, Douglas Gin
http://ift.tt/2kI26s0
Spectrum of orocutaneous disease associations
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Jeffrey D. Cizenski, Pablo Michel, Ian T. Watson, Jillian Frieder, Elizabeth G. Wilder, John M. Wright, M. Alan Menter
There are a number of diseases that manifest both on the skin and the oral mucosa, and therefore the importance for dermatologists in clinical practice to be aware of these associations is paramount. In the following continuing medical education series, we outline orocutaneous disease associations with both immunologic and inflammatory etiologies.
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Editorial Board
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
http://ift.tt/2yYw39B
CME examination
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
http://ift.tt/2yXSRGp
Atypical features and systemic associations in extensive cases of Grover disease: A systematic review
Publication date: November 2017
Source:Journal of the American Academy of Dermatology, Volume 77, Issue 5
Author(s): Madeleine Gantz, Daniel Butler, Matthew Goldberg, Jubin Ryu, Timothy McCalmont, Kanade Shinkai
BackgroundGrover disease is an acantholytic disorder that typically occurs on the trunk of older individuals, primarily white men, in association with heat and xerosis. Cases with extensive and/or atypical distributions have been reported.ObjectiveTo review the literature characterizing the population, morphology, associations, and disease course of extensive or atypical eruptions of Grover disease.MethodsA systematic literature review identified 50 articles with 69 cases.ResultsPatient age ranged from 14 to 83 years (mean age, 56 ± 15), with 71% of patients being male and 29% female. Areas of involvement included the trunk (90%), upper and lower extremities (63% and 61%, respectively), face/scalp (28%), neck (21%), groin (11%), buttocks (8%), and axillae (6%). The most common associations included a history of malignancy (61%), recent chemotherapy (38%), and recent transplant (20%).LimitationsExtensive cases with typical clinical morphology may not have been examined by biopsy or reported; thus, this review may have publication bias toward more severe or atypical presentations.ConclusionsGreater variability exists among patients affected by extensive or atypical Grover disease than among those with typical disease. Malignancy is a common association, and there may be a role for immunosuppression in the pathogenesis of extensive or atypical Grover disease.
http://ift.tt/2yXl0gV
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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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