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Δευτέρα 22 Ιανουαρίου 2018

Histological Changes in the Rat Femoral Artery Following the Use of the Empty-and-Refill Test

J reconstr Microsurg
DOI: 10.1055/s-0037-1621727

Background This study examines the effects of the empty-and-refill patency test on rat femoral arteries in the longer postoperative time period. Methods A simple arterial anastomosis was performed bilaterally on 20 rats. The empty-and-refill test was performed unilaterally in all rats, leaving the contralateral artery as an internal control. Rats were divided into two cohorts of 10 rats and survived for 48 hours and 2 weeks. Vessel patency was assessed prior to closing and immediately prior to sacrifice. The femoral arteries were harvested bilaterally and hematoxylin and eosin stains were performed. The femoral artery distal to the anastomosis in the region of the empty-and-refill test was histologically evaluated. Results All vessels were patent at the time of sacrifice. There was no statistical difference in the numeric scoring between the experimental and control vessels in the 48-hour cohort. Almost all vessels harvested at 48 hours showed endothelial cell loss distal to the anastomosis regardless of whether they underwent the empty-and-refill test. The only statistically significant difference in the 2-week cohort was an increase in adventitial smooth muscle proliferation in the experimental group. There were no other statistically significant results between the experimental and control groups at 2 weeks. An overall comparison of both cohorts revealed a statistically significant increase in endothelial cell number and intimal proliferation by 2 weeks postsurgery. Conclusion The empty-and-refill test does not compromise rat femoral artery anastomotic patency, nor does it produce histological damage either 48 hours or 2 weeks postsurgery.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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Impact of Duration of Perioperative Ischemia on Outcomes of Microsurgical Reconstructions

J reconstr Microsurg
DOI: 10.1055/s-0037-1621729

Background Free tissue transfers have become routine for a variety of reconstructive purposes. During the time of transfer, some period of ischemia time is unavoidable, causing structural and metabolic changes. This study aimed to evaluate whether length of intraoperative ischemia affects the outcomes of microsurgical reconstructions. Methods Within a 7-year period, 638 patients having undergone 690 microvascular free flap reconstructions fulfilled inclusion criteria for this study. The data were retrospectively screened for patients' demographics, intra- and perioperative details, flap survival, surgical complications, and outcomes. The cases were divided into two groups according to the length of intraoperative ischemia time, "< 60" versus "≥ 60 minutes." Results Both groups were comparable regarding the patient constellation, comorbidities, smoking status, and perioperative characteristics. Operative times were significantly longer in patients which had ischemia times of ≥ 60 minutes (p < 0.05). Also, during our 3-month follow-up period, a significantly higher rate of major and minor surgical complications, including total and partial flap losses, as well as higher revision rates occurred in the ≥ 60 minutes ischemia time group (p < 0.05). Conclusion In this study, prolonged ischemia time during free flap reconstructions was associated with higher rates of revision surgeries and complications rates.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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Clinical study to evaluate the performance of a noninvasive focused ultrasound device for thigh fat and circumference reduction compared to control

Summary

Background and objectives

An FDA-cleared focused ultrasound device (UltraShape, Syneron Candela®, Yokneam, Israel) for noninvasive abdominal fat reduction produces localized mechanical cellular membrane disruption in adipocytes. This study seeks to determine the safety and efficacy of this device for use on the thighs.

Study designs/Materials and methods

Fourteen women aged 33-60 were selected to receive 3 biweekly treatments to one thigh with the other thigh serving as an internal control. The subjects had a BMI range of 18-30 kg/m2 and a weight range of 54-83 kg. After the third treatment, patients were followed at 4, 8, and 16 weeks. Fat thickness was measured by both caliper and ultrasound. In addition, thigh circumference and the patient's weight were measured. Pain, edema, erythema, and adverse events as well as investigator and patient overall satisfaction were recorded at all visits.

Results

In comparison with the control, there was a statistically significant average reduction in fat thickness measured by calipers at all time points with a 22.20% (P = .0165) improvement in 16 weeks. By ultrasound, there was a 19.23% (4.03 mm P = .0051) reduction in fat thickness at 16 weeks with statistically significant improvement at the other follow-up visits. At 16 weeks, thigh circumference improved, on average, 2.8 cm (P = .0059) at the midline. 90.0% of the subjects were satisfied with the results at 16 weeks, and the investigator was 100% satisfied. No adverse events were reported; no edema was observed in any subject. All subjects experienced mild erythema. All reported zero pain on a 0-10 scale.

Conclusion

Focused ultrasound is safe, effective, and well tolerated to improve the circumference and fat thickness of the thighs without significant side effects. There were no significant adverse events. Investigators and subjects were highly satisfied with the results.



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Correction to: Rejuvenation Res 2015;18(5):422-436; DOI: 10.1089/rej.2014.1656

Rejuvenation Research , Vol. 0, No. 0.


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A Screening Tool Using Five Risk Factors Was Developed for Fall-Risk Prediction in Chinese Community-Dwelling Elderly Individuals

Rejuvenation Research , Vol. 0, No. 0.


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Challenges in the Eradication of Enterococcus faecalis and its Implications on Health

Abstract

Enterococcus faecalis is frequently found in infected root canals of teeth with persistent apical periodontitis.

Purpose

To review the challenges involved in the eradication of persistent Enterococcus faecalis infections and their impact on human health.

Recent Findings

In the root canal system, Enterococcus faecalis resides in biofilm communities that are able to resist a wide range of harsh conditions and treatments and persist for years. Various virulence and resistance factors provide Enterococcus faecalis capabilities in adherence, colonization, and biofilm formation, which is much more resistant to antibacterial agents than planktonic bacteria. These capabilities explain its persistence in root canal infections. To date, the available therapeutic tools to efficiently eradicate Enterococcus faecalis infections remain limited. Recently, in a model mimicking Enterococcus faecalis root canal infection, novel biofilm inhibitors and dispersing agents, such as D-Leucine, presented superior capability over sodium hypochlorite, the frequently used root-canal antibacterial irrigation solution, in the eradication of Enterococcus faecalis.

Summary

These recent studies present promising treatment regimens for Enterococcus faecalis persistent infections.



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Centers for Medicare and Medicaid Services' Decision to Reconsider Coverage Indications for ICDs: Where to Now?.

Author: Al-Khatib, Sana M. MD, MHS; Gillis, Anne M. MD; Curtis, Anne B. MD
Page: 317-319


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Routine Oxygen Supplementation in Acute Cardiovascular Disease: The End of a Paradigm?.

Author: Hofmann, Robin MD, PhD; James, Stefan K. MD, PhD
Page: 320-322


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Canagliflozin for Primary and Secondary Prevention of Cardiovascular Events: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study).

Author: Mahaffey, Kenneth W. MD; Neal, Bruce MB, ChB, PhD; Perkovic, Vlado MBBS, PhD; de Zeeuw, Dick MD, PhD; Fulcher, Greg MD; Erondu, Ngozi MD, PhD; Shaw, Wayne DSL; Fabbrini, Elisa MD, PhD; Sun, Tao PhD; Li, Qiang MBiostat, BPH, AStat; Desai, Mehul MD; Matthews, David R. DPhil, BM, BCh; On behalf of the CANVAS Program Collaborative Group
Page: 323-334


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Canagliflozin: Cui Bono?.

Author: Cavender, Matthew A. MD, MPH; Kosiborod, Mikhail MD
Page: 335-337


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Low-Density Lipoprotein Cholesterol Lowering With Evolocumab and Outcomes in Patients With Peripheral Artery Disease: Insights From the FOURIER Trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk).

Author: Bonaca, Marc P. MD, MPH; Nault, Patrice MD; Giugliano, Robert P. MD, SM; Keech, Anthony C. MD; Pineda, Armando Lira MD; Kanevsky, Estella MS; Kuder, Julia MA; Murphy, Sabina A. MPH; Jukema, J. Wouter MD, PhD; Lewis, Basil S. MD; Tokgozoglu, Lale MD; Somaratne, Ransi MD; Sever, Peter S. PhD; Pedersen, Terje R. MD; Sabatine, Marc S. MD, MPH
Page: 338-350


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Protecting Life and Limb in Peripheral Artery Disease.

Author: Creager, Mark A. MD
Page: 351-353


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ICare-ACS (Improving Care Processes for Patients With Suspected Acute Coronary Syndrome): A Study of Cross-System Implementation of a National Clinical Pathway.

Author: Than, Martin P. MBBS; Pickering, John W. PhD; Dryden, Jeremy M. MBChB; Lord, Sally J. MBBS; Aitken, S. Andrew MBChB; Aldous, Sally J. MBBS; Allan, Kate E. MBChB; Ardagh, Michael W. MBChB; Bonning, John W.N. MBChB; Callender, Rosie MBChB; Chapman, Laura R.E. MBBS; Christiansen, Jonathan P. MBChB; Cromhout, Andre P.J. MBChB; Cullen, Louise MBBS; Deely, Joanne M. PhD; Devlin, Gerard P. MBChB; Ferrier, Katherine A. MBChB; Florkowski, Christopher M. MBBS; Frampton, Christopher M.A. PhD; George, Peter M. MBBS; Hamilton, Gregory J. PhD; Jaffe, Allan S. MD; Kerr, Andrew J. MBChB; Larkin, G. Luke MD; Makower, Richard M. MBBS; Matthews, Timothy J.E. MBChB; Parsonage, William A. MBBS; Peacock, W. Frank MD; Peckler, Bradley F. MD; van Pelt, Niels C. MBChB; Poynton, Louise MBChB; Richards, A. Mark MBChB, PhD, DSc; Scott, Anthony G. MBChB; Simmonds, Mark B. MBChB; Smyth, David MBBS; Thomas, Oliver P. MBBS; To, Andrew C.Y. MBChB; Du Toit, Stephen A. MBChB; Troughton, Richard W. MBChB, PhD; Yates, Kim M. MBChB; On behalf of the ICare-ACS Implementation Group
Page: 354-363


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Transcatheter Interatrial Shunt Device for the Treatment of Heart Failure With Preserved Ejection Fraction (REDUCE LAP-HF I [Reduce Elevated Left Atrial Pressure in Patients With Heart Failure]): A Phase 2, Randomized, Sham-Controlled Trial.

Author: Feldman, Ted MD *,; Mauri, Laura MD, MSc *,; Kahwash, Rami MD; Litwin, Sheldon MD; Ricciardi, Mark J. MD; van der Harst, Pim MD, PhD; Penicka, Martin MD, PhD; Fail, Peter S. MD; Kaye, David M. MD, PhD; Petrie, Mark C. MB ChB; Basuray, Anupam MD; Hummel, Scott L. MD, MS; Forde-McLean, Rhondalyn MD, MHS; Nielsen, Christopher D. MD; Lilly, Scott MD, PhD; Massaro, Joseph M. PhD; Burkhoff, Daniel MD, PhD; Shah, Sanjiv J. MD; On behalf of the REDUCE LAP-HF I Investigators and Study Coordinators
Page: 364-375


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Impact of Regionalization of ST-Segment-Elevation Myocardial Infarction Care on Treatment Times and Outcomes for Emergency Medical Services-Transported Patients Presenting to Hospitals With Percutaneous Coronary Intervention: Mission: Lifeline Accelerator-2.

Author: Jollis, James G. MD; Al-Khalidi, Hussein R. PhD; Roettig, Mayme L. RN, MSN; Berger, Peter B. MD; Corbett, Claire C. MMS; Doerfler, Shannon M. PhD; Fordyce, Christopher B. MD, MHS, MSc; Henry, Timothy D. MD; Hollowell, Lori BSN; Magdon-Ismail, Zainab DrPH; Kochar, Ajar MD; McCarthy, James J. MD; Monk, Lisa RN, MSN; O'Brien, Peter MD; Rea, Thomas D. MD; Shavadia, Jay MD; Tamis-Holland, Jacqueline MD; Wilson, B. Hadley MD; Ziada, Khaled M. MD; Granger, Christopher B. MD
Page: 376-387


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Standardized Definition of Structural Valve Degeneration for Surgical and Transcatheter Bioprosthetic Aortic Valves.

Author: Dvir, Danny MD *,; Bourguignon, Thierry MD *,; Otto, Catherine M. MD; Hahn, Rebecca T. MD; Rosenhek, Raphael MD; Webb, John G. MD; Treede, Hendrik MD; Sarano, Maurice E. MD; Feldman, Ted MD; Wijeysundera, Harindra C. MD; Topilsky, Yan MD; Aupart, Michel MD; Reardon, Michael J. MD; Mackensen, G. Burkhard MD; Szeto, Wilson Y. MD; Kornowski, Ran MD; Gammie, James S. MD; Yoganathan, Ajit P. PhD; Arbel, Yaron MD; Borger, Michael A. MD; Simonato, Matheus; Reisman, Mark MD; Makkar, Raj R. MD; Abizaid, Alexandre MD; McCabe, James M. MD; Dahle, Gry MD; Aldea, Gabriel S. MD; Leipsic, Jonathon MD; Pibarot, Philippe PhD; Moat, Neil E. MD; Mack, Michael J. MD; Kappetein, A. Pieter MD; Leon, Martin B. MD; On behalf of VIVID (Valve in Valve International Data) Investigators
Page: 388-399


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From the Literature.

Author: Hampton, Tracy PhD
Page: 400-401


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Asymptomatic ST-Segment-Elevation ECG in Patient With Kidney Failure.

Author: Sotananusak, Thanyaluck MD; Meemook, Krissada MD
Page: 402-404


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Cardiovascular Outcomes and Safety of Empagliflozin in Patients With Type 2 Diabetes Mellitus and Peripheral Artery Disease: A Subanalysis of EMPA-REG OUTCOME.

Author: Verma, Subodh MD; Mazer, C. David MD; Al-Omran, Mohammed MD; Inzucchi, Silvio E. MD; Fitchett, David MD; Hehnke, Uwe Dipl Stat; George, Jyothis T. MD; Zinman, Bernard MD
Page: 405-407


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Burden of Catastrophic Health Expenditures for Acute Myocardial Infarction and Stroke Among Uninsured in the United States.

Author: Khera, Rohan MD *,; Hong, Jonathan C. MD, MHS *,; Saxena, Anshul PhD; Arrieta, Alejandro PhD; Virani, Salim S. MD, PhD; Blankstein, Ron MD; de Lemos, James A. MD; Krumholz, Harlan M. MD, SM; Nasir, Khurram MD, MPH
Page: 408-410


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Letter by Koutsampasopoulos et al Regarding Article, "Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction".

Author: Koutsampasopoulos, Konstantinos MD, MSc, PhD(c); Ouzouni, Christina PhD; Vogiatzis, Ioannis MD, MSc, PhD
Page: 411-412


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Letter by Jin-shan and Xue-bin Regarding Article, "Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction".

Author: Jin-shan, He MD; Xue-bin, Li MD
Page: 413


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Letter by Carbone et al Regarding Article, "Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction".

Author: Carbone, Salvatore MS; Canada, Justin M. MS, RCEP; Abbate, Antonio MD, PhD
Page: 414-415


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Response by Obokata and Borlaug to Letters Regarding Article, "Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction".

Author: Obokata, Masaru MD, PhD; Borlaug, Barry A. MD
Page: 416-417


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Editorial Board

Publication date: January 2018
Source:Cortex, Volume 98





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Visual feedback explains why propointing is better than antipointing in spatial neglect

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Publication date: January 2018
Source:Cortex, Volume 98
Author(s): Kathrin S. Utz, Constanze Hesse, Annika Hintz, Daniela Grüneberger, Hartwig Kulke, Inga Roth, Thomas Klos, Vaclav Kromichal, Arthur Melms, Wilfried Schupp, Detlef Kohl, Thomas Schenk
Rossit et al. (2011) showed that neglect patients perform normally in a propointing task but not in an antipointing task which requires pointing towards the mirrored position of a target. It is assumed that antipointing relies on information from the perceptual pathway of our visual brain. Therefore, this finding supports the notion that neglect is a disorder that primarily affects perceptual spatial representations within the brain leaving spatial maps used for visuomotor guidance intact. Alternatively, performance of patients might be compromised in both tasks, but only obviously so in tasks in which online corrections are made more difficult. It can be argued that online-corrections via visual feedback are less effective in antipointing because a direct comparison between hand and target is not possible in this condition. Secondly, it is also known that neglect patients have a pronounced egocentric bias which is assumed to be associated with a deviation of the perceived body midline. Since the midline is used to compute the end-position in the antipointing task this could also explain why patients are worse in antipointing. We investigated the influence of visual feedback on pro- and antipointing and the effect of providing a visual reference line for the antipointing task in right-brain damaged patients with neglect (n = 20), right-brain damaged patients without neglect (n = 23) and in a group of healthy participants (n = 22). The withdrawal of visual feedback had a stronger effect on propointing compared to antipointing. This effect was stronger in neglect patients than in patients without neglect or healthy controls. The introduction of a reference line reduced errors in antipointing performance, particularly in neglect patients with a strong egocentric bias. The results support our alternative account and challenge the hypothesis that the spatial disorder in neglect affects primarily perceptual maps within the visual system.



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Cover Figure

Publication date: January 2018
Source:Cortex, Volume 98





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Reachability judgement in optic ataxia: Effect of peripheral vision on hand and target perception in depth

Publication date: January 2018
Source:Cortex, Volume 98
Author(s): Angela Bartolo, Yves Rossetti, Patrice Revol, Christian Urquizar, Laure Pisella, Yann Coello
The concept of peripersonal space was first proposed by Rizzolatti, Scandolara, Matelli, and Gentilucci (1981), who introduced the term to highlight the close links between somatosensory and visual processing for stimuli close to the body and suggested that this near-body space could in fact be characterized as an action space (Rizzolatti, Fadiga, Fogassi, & Gallese, 1997). Supporting this idea, patients with right hemisphere lesions have been described as impaired in performing actions towards objects and in perceiving their location − but only when the objects were presented within arm's reach (Bartolo, Carlier, Hassaini, Martin, & Coello, 2014; Brain, 1941). Whether the deficit of optic ataxia patients in processing target locations for action has an effect on the representation of peripersonal space has never been explored. The present study highlights optic ataxia patients' specific difficulties in processing hand-to-target distances in a motor task and in a perceptual task requiring identification of what is reachable in the visual environment. The difficulties are especially evident when both the target and the hand are perceived in the visual periphery. Indeed, when patient I.G. was able to fixate the target, her reaching accuracy and her perception of reachable space both largely improved. Furthermore, the difficulties were enhanced when the hand and the target were both in the lower visual field (in a fixed-far condition vs a fixed-near condition). This novel up-down dimension of optic ataxia fits with the larger representation of the lower visual field in the posterior parietal cortex (Pitzalis et al., 2013; Previc, 1990).



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Multi-perspective comparisons and mitigation implications of SO 2 and NO x discharges from the industrial sector of China: a decomposition analysis

Abstract

This study is the first attempt to investigate the drivers of Chinese industrial SO2 and NOx emissions from both periodic and structural perspectives through a decomposition analysis using the logarithmic mean Divisia index (LMDI). The two pollutants' emissions were decomposed into output effects, structural effects, clean production effects, and pollution abatement effects. The results showed that China's industrial SO2 discharge increased by 1.14 Mt during 2003–2014, and the contributions from the four effects were 23.17, − 1.88, − 3.80, and − 16.36 Mt, respectively. Likewise, NOx discharge changed by − 3.44 Mt over 2011–2014, and the corresponding contributions from the four effects were 2.97, − 0.62, − 1.84, and − 3.95 Mt. Thus, the output effect was mainly responsible for the growth of the two discharges. The average annual contribution rates of SO2 and NOx from output were 14.33 and 5.97%, respectively, but pollution abatement technology presented the most obvious mitigating effects (− 10.11 and − 7.92%), followed by the mitigating effects of clean production technology (− 2.35 and − 3.7%), and the mitigation from the structural effect was the weakest (− 1.16 and − 1.25%, respectively), which meant pollutant reduction policies related to industrial structure adjustment should be a long-term measure for the two discharges. In addition, the sub-sectors of I20 (manufacture of raw chemical materials and chemical products), I24 (manufacture of non-metallic mineral products), and I26 (smelting and pressing of non-ferrous metals) were the major contributors to both discharges. Thus, these sub-sectors should be given priority consideration when designing mitigation-related measures. Last, some particular policy implications were recommended for reducing the two discharges, including that the government should seek a technological discharge reduction route.



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Phytoremediation of a petroleum-polluted soil by native plant species in Lorestan Province, Iran

Abstract

Petroleum hydrocarbons are potentially toxic for organisms due to the inherent properties, such as solubility, volatility, and biodegradability. The petroleum materials released from corroded old pipelines would pollute soils, shallow groundwater and air as a consequence, and threat the health of human and environment. Therefore, the removal of these compounds from environment is vital. The stability of these pollutants at the soil and their gradual accumulation over time would disrupt the normal function of the soil, such as reduced agricultural capability. In this research, the influence of two plant species (Bromus tectorum L. and Festuca arundinacea) with different amendments including arbuscular mycorrhizal fungi, alfalfa residues, and nutrient solution on the degradation rate of petroleum hydrocarbons in soil was studied. The results showed that the most effective treatment for petroleum remediation was related to B. tectorum L. plant when treated with mycorrhizal fungi and nutrient solution. The degradation rate during 40 days was about 83.27% when compared to the control. Arbuscular mycorrhizal associations are important in the restoration of degraded ecosystems because of the benefits to their symbiotic partners. This fungal phytotechnological mechanism is still in its infancy and there has been little research on aged-contaminated soils.



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Hippocampal GABAA antagonism reverses the novel object recognition deficit in sub-chronic phencyclidine-treated rats

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Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Nichole M. Neugebauer, Masanori Miyauchi, Tatsuya Sato, Jun Tadano, Hanife Akal, Hossein Ardehali, Herbert Y. Meltzer
BackgroundAbnormalities in prefrontal cortical and hippocampal GABAergic function are postulated to be major causes of the cognitive impairment associated with schizophrenia (CIAS). There are conflicting views on whether diminished or enhanced GABAergic activity contributes to the deficit in short-term novel object recognition (NOR) in the sub-chronic phencyclidine (scPCP) rodent model of CIAS. This study assessed the role of GABAA signaling in the medial prefrontal cortex (mPFC) and ventral hippocampus (vHPC) in NOR in saline (scSAL)- and scPCP-treated rats.MethodsThe effects of local administration of a GABAA agonist (muscimol) into the vHPC or mPFC and an antagonist (bicuculline) or a GABAA/benzodiazepine partial agonist (bretazenil) into the vHPC on NOR in scSAL and scPCP-treated rats were determined.ResultsIn scSAL-treated rats, injection of muscimol into the vHPC, but not mPFC, induced a deficit in NOR. The scPCP-induced NOR deficit was significantly reversed by intra-vHPC bicuculline, while intra-vHPC bretazenil produced a non-significant trend for reversal (p = .06). scPCP treatment increased mRNA expression of GABAA γ2 in PFC and GABAA α5 and GABAA β1 in the HPC. However, GABA concentration in the PFC or HPC was not altered.ConclusionsThese findings indicate that the scPCP-induced NOR deficit can be rescued by reducing GABAA receptor stimulation in vHPC, indicating that increased vHPC GABAA inhibition may contribute to the scPCP-induced NOR deficit in rats. These results also indicate that excessive GABAA receptor signalling in the vHPC has a deleterious effect on NOR in normal rats.



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Cognitive decline and increased hippocampal p-tau expression in mice with hearing loss

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Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): So Young Park, Min Jung Kim, Hong Lim Kim, Dong Kee Kim, Sang Won Yeo, Shi Nae Park
Hearing and cognition are commonly involved in both normal and pathological aging. Current clinical interest lies in whether peripheral hearing loss promotes cognitive decline. In our previous publication, the authors have shown a causal relationship between hearing and cognitive impairments in C57BL/6 mice. Here we extended the follow-up to 12 months to determine the long-term effects of hearing loss on cognition and to observe hippocampal p-tau and lipofuscin. One month old male mice were randomly allocated into two groups, the control (n = 12) and noise-induced hearing loss (NIHL) (n = 12). After baseline hearing and cognitive measurements, the mice in the NIHL group were exposed to 110 dB SPL white noise for 1 h every day for 20 consecutive days. Cognitive function was assessed by radial arm maze and novel object recognition tests. p-Tau was observed by the western blot, immunofluorescence, and immunogold staining. The mice in the NIHL group showed elevated auditory brainstem response thresholds and poorer performances in spatial working and recognition memories than the controls. They exhibited more p-tau and lipofuscin in the hippocampus. The cognitive impact of hearing loss varied with the types of memory. Working memory impairment was reversible, whereas recognition memory impairment was permanent. Our results provide behavioral and histopathological evidence for hearing-related cognitive decline. Early hearing loss is suggested to be one of the important determinants between normal and pathological cognitive aging.



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The monoamine-oxidase B inhibitor deprenyl increases selection of high-effort activity in rats tested on a progressive ratio/chow feeding choice procedure: Implications for treating motivational dysfunctions

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Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Samantha E. Yohn, Shanika Reynolds, Giuseppe Tripodi, Merce Correa, John D. Salamone
Motivated behaviors often are characterized by a high degree of behavioral activation and work output, and organisms frequently make effort-related decisions based upon cost/benefit analyses. Moreover, people with depression and other disorders frequently show effort-related motivational symptoms, such as anergia, psychomotor retardation, and fatigue. Tasks measuring effort-related choice are being used as animal models of these motivational symptoms. The present studies characterized the ability of the monoamine oxidase –B (MAO-B) inhibitor deprenyl (selegiline) to enhance selection of high-effort lever pressing in rats tested on a concurrent progressive ratio (PROG)/chow feeding choice task. Deprenyl is widely used as an antiparkinsonian drug, but it also has been shown to have antidepressant effects in humans, and to induce antidepressant-like effects in traditional rodent models of depression. Systemic administration of deprenyl (1.5–12.0 mg/kg IP) shifted choice behavior, significantly increasing markers of PROG lever pressing at a moderate dose (6.0 mg/kg), and decreasing chow intake at 6.0 and 12.0 mg/kg. Intracranial injections of deprenyl into nucleus accumbens (2.0 and 4.0 μg) also increased PROG lever pressing and decreased chow intake. Microdialysis studies showed that the dose of deprenyl that was effective at increasing PROG lever pressing (6.0 mg/kg) also significantly elevated extracellular dopamine in nucleus accumbens. Thus, similar to the well-known antidepressant bupropion, deprenyl is capable of increasing selection of high-effort PROG lever pressing at doses that increase extracellular dopamine in nucleus accumbens. These studies have implications for the potential use of MAO-B inhibitors as treatments for the motivational symptoms of depression and Parkinsonism.



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Effects of ketamine on vocal impairment, gait changes, and anhedonia induced by bilateral 6-OHDA infusion into the substantia nigra pars compacta in rats: Therapeutic implications for Parkinson’s disease

Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Débora Dalla Vecchia, Luiz Kae Sales Kanazawa, Etiéli Wendler, Palloma de Almeida Soares Hocayen, Estevan Bruginski, Francinete Ramos Campos, Cristina Aparecida Jark Stern, Maria Aparecida Barbato Frazão Vital, Edmar Miyoshi, Markus Wöhr, Rainer K.W. Schwarting, Roberto Andreatini
Parkinson's disease is a chronic neurodegenerative disorder characterized by cardinal motor features, such as bradykinesia, but also vocal deficits (e.g. difficulties to articulate words and to keep the tone of voice) and depression. In the present study, rats with bilateral 6-hydroxydopamine lesion of the substantia nigra pars compacta were evaluated for changes in the emission of 50-kHz ultrasonic vocalizations, gait impairment (catwalk test), and depressive-like behaviour (sucrose preference test). Furthermore, we evaluated the effect of repeated treatment (28 days) with ketamine (5, 10, and 15 mg/kg, ip, once per week) or imipramine (15 mg/kg, ip, daily). The lesion had prominent effects on the production of 50-kHz ultrasonic vocalizations (reduced call numbers, call durations, total calling time, and increased latency to start calling), led to gait impairment (increased run duration and stand of right forelimb) and induced anhedonia (reduced sucrose preference). Also, significant correlations between gait changes, sucrose preference, and ultrasonic calling were found, yet, except for run duration and sucrose preference, these correlations were low indicating that these associations are weak. Importantly, ketamine and imipramine reversed lesion-induced anhedonia and improved gait impairments, but neither drug improved ultrasonic calling. In conclusion, the substantia nigra lesion with 6-hydroxydopamine induced subtle motor and non-motor manifestations, reflecting key features of the wide clinical spectrum of early Parkinson's disease. Furthermore, the present results suggest a potential efficacy of ketamine on depression and gait alterations in Parkinson's disease.

Graphical abstract

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Water treatment by new-generation graphene materials: hope for bright future

Abstract

Water is the most important and essential component of earth's ecosystem playing a vital role in the proper functioning of flora and fauna. But, our water resources are contaminating continuously. The whole world may be in great water scarcity after few decades. Graphene, a single-atom thick carbon nanosheet, and graphene nanomaterials have bright future in water treatment technologies due to their extraordinary properties. Only few papers describe the use of these materials in water treatment by adsorption, filtration, and photodegradation methods. This article presents a critical evaluation of the contribution of graphene nanomaterials in water treatment. Attempts have been made to discuss the future perspectives of these materials in water treatment. Besides, the efforts are made to discuss the nanotoxicity and hazards of graphene-based materials. The suggestions are given to explore the full potential of these materials along with precautions of nanotoxicity and its hazards. It was concluded that the future of graphene-based materials is quite bright.



http://ift.tt/2DznTdA

Neonicotinoids thiamethoxam and clothianidin adversely affect the colonisation of invertebrate populations in aquatic microcosms

Abstract

Surface waters are sometimes contaminated with neonicotinoids: a widespread, persistent, systemic class of insecticide with leaching potential. Previous ecotoxicological investigations of this chemical class in aquatic ecosystems have largely focused on the impacts of the neonicotinoid imidacloprid; few empirical, manipulative studies have investigated the effect on invertebrate abundances of two other neonicotinoids which are now more widely used: clothianidin and thiamethoxam. In this study, we employ a simple microcosm semi-field design, incorporating a one-off contamination event, to investigate the effect of these pesticides at field-realistic levels (ranging from 0 to 15 ppb) on invertebrate colonisation and survival in small ephemeral ponds. In line with previous research on neonicotinoid impacts on aquatic invertebrates, significant negative effects of both neonicotinoids were found. There were clear differences between the two chemicals, with thiamethoxam generally producing stronger negative effects than clothianidin. Populations of Chironomids (Diptera) and Ostracoda were negatively affected by both chemicals, while Culicidae appeared to be unaffected by clothianidin at the doses used. Our data demonstrate that field-realistic concentrations of neonicotinoids are likely to reduce populations of invertebrates found in ephemeral ponds, which may have knock on effects up the food chain. We highlight the importance of developing pesticide monitoring schemes for European surface waters.



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Altered HDL Remodeling and Functionality in Familial Hypercholesterolemia



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1-Year Outcomes of Patients Undergoing Primary Angioplasty for Myocardial Infarction Treated With Prasugrel Versus Ticagrelor

AbstractBackground

Early outcomes of patients in the PRAGUE-18 (Comparison of Prasugrel and Ticagrelor in the Treatment of Acute Myocardial Infarction) study did not find any significant differences between 2 potent P2Y12 inhibitors.

Objectives

The 1-year follow-up of the PRAGUE-18 study focused on: 1) a comparison of efficacy and safety between prasugrel and ticagrelor; and 2) the risk of major ischemic events related to an economically motivated post-discharge switch to clopidogrel.

Methods

A total of 1,230 patients with acute myocardial infarction (MI) treated with primary percutaneous coronary intervention were randomized to prasugrel or ticagrelor with an intended treatment duration of 12 months. The combined endpoint was cardiovascular death, MI, or stroke at 1 year. Because patients had to cover the costs of study medication after hospital discharge, some patients decided to switch to clopidogrel.

Results

The endpoint occurred in 6.6% of prasugrel patients and in 5.7% of ticagrelor patients (hazard ratio: 1.167; 95% confidence interval: 0.742 to 1.835; p = 0.503). No significant differences were found in: cardiovascular death (3.3% vs. 3.0%; p = 0.769), MI (3.0% vs. 2.5%; p = 0.611), stroke (1.1% vs. 0.7%; p = 0.423), all-cause death (4.7% vs. 4.2%; p = 0.654), definite stent thrombosis (1.1% vs. 1.5%; p = 0.535), all bleeding (10.9% vs. 11.1%; p = 0.999), and TIMI (Thrombolysis In Myocardial Infarction) major bleeding (0.9% vs. 0.7%; p = 0.754). The percentage of patients who switched to clopidogrel for economic reasons was 34.1% (n = 216) for prasugrel and 44.4% (n = 265) for ticagrelor (p = 0.003). Patients who were economically motivated to switch to clopidogrel had (compared with patients who continued the study medications) a lower risk of major cardiovascular events; however, they also had lower ischemic risk.

Conclusions

Prasugrel and ticagrelor are similarly effective during the first year after MI. Economically motivated early post-discharge switches to clopidogrel were not associated with an increased risk of ischemic events. (Comparison of Prasugrel and Ticagrelor in the Treatment of Acute Myocardial Infarction [PRAGUE-18]; NCT02808767)



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JACC Instructions for Authors



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Clash of Oral P2Y12 Receptor Inhibitors in Acute Coronary Syndromes



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Reply: Pregnancy-Associated Coronary Artery Dissection: A Therapeutic Dilemma



http://ift.tt/2Drkg6l

Biomarker-Guided Versus Guideline-Based Treatment of Patients With Heart Failure: Results From BIOSTAT-CHF

AbstractBackground

Heart failure guidelines recommend up-titration of angiotensin-converting enzyme (ACE) inhibitor/angiotensin receptor blockers (ARBs), beta-blockers, and mineralocorticoid receptor antagonists (MRAs) to doses used in randomized clinical trials, but these recommended doses are often not reached. Up-titration may, however, not be necessary in all patients.

Objectives

This study sought to establish the role of blood biomarkers to determine which patients should or should not be up-titrated.

Methods

Clinical outcomes of 2,516 patients with worsening heart failure from the BIOSTAT-CHF (BIOlogy Study to Tailored Treatment in Chronic Heart Failure) were compared between 3 theoretical treatment scenarios: scenario A, in which all patients are up-titrated to >50% of recommended doses; scenario B, in which patients are up-titrated according to a biomarker-based treatment selection model; and scenario C, in which no patient is up-titrated to >50% of recommended doses. The study conducted multivariable Cox regression using 161 biomarkers and their interaction with treatment, weighted for treatment-indication bias to estimate the expected number of deaths or heart failure hospitalizations at 24 months for all 3 scenarios.

Results

Estimated death or hospitalization rates in 1,802 patients with available (bio)markers were 16%, 16%, and 26%, respectively, in the ACE inhibitor/ARB up-titration scenarios A, B, and C. Similar rates for beta-blocker and MRA up-titration scenarios A, B, and C were 23%, 19%, and 24%, and 12%, 11%, and 24%, respectively. If up-titration was successful in all patients, an estimated 9.8, 1.3, and 12.3 events per 100 treated patients could be prevented at 24 months by ACE inhibitor/ARB, beta-blocker, and MRA therapy, respectively. Similar numbers were 9.9, 4.7, and 13.1 if up-titration treatment decision was based on a biomarker-based treatment selection model.

Conclusions

Up-titrating patients with heart failure based on biomarker values might have resulted in fewer deaths or hospitalizations compared with a hypothetical scenario in which all patients were successfully up-titrated.



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Prevalence of Cardiac Amyloidosis in Patients Referred for Transcatheter Aortic Valve Replacement



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Can Biomarker Panels Predict Response to Pharmacotherapy in Heart Failure?



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The Difficulty in Identifying Pregnancy-Associated Coronary Artery Dissection Using Nationwide Inpatient Databases



http://ift.tt/2Bn8DLW

Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends

AbstractBackground

Survival after in-hospital cardiac arrest (IHCA) is lower during nights and weekends (off-hours) compared with daytime during weekdays (on-hours). As overall IHCA survival has improved over time, it remains unknown whether survival differences between on-hours and off-hours have changed.

Objectives

This study sought to examine temporal trends in survival differences between on-hours and off-hours IHCA.

Methods

We identified 151,071 adults at 470 U.S. hospitals in the Get with the Guidelines–Resuscitation registry during 2000 to 2014. Using multivariable logistic regression with generalized estimating equations, we examined whether survival trends in IHCA differed during on-hours (Monday to Friday 7:00 am to 10:59 pm) versus off-hours (Monday to Friday 11:00 pm to 6:59 am, and Saturday to Sunday, all day).

Results

Among 151,071 participants, 79,091 (52.4%) had an IHCA during off-hours. Risk-adjusted survival improved over time in both groups (on-hours: 16.0% in 2000, 25.2% in 2014; off-hours: 11.9% in 2000, 21.9% in 2014; p for trend <0.001 for both). However, there was no significant change in the survival difference over time between on-hours and off-hours, either on an absolute (p = 0.75) or a relative scale (p = 0.059). Acute resuscitation survival improved significantly in both groups (on-hours: 56.1% in 2000, 71% in 2014; off-hours: 46.9% in 2000, 68.2% in 2014; p for trend <0.001 for both) and the difference between on-hours and off-hours narrowed over time (p = 0.02 absolute scale, p < 0.001 relative scale). In contrast, although post-resuscitation survival also improved over time in both groups (p for trend < 0.001 for both), the absolute and relative difference persisted.

Conclusions

Despite an overall improvement in survival, lower survival in IHCA during off-hours compared with on-hours persists.



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Should We Recommend Cardiac Rehabilitation in Patients With Spontaneous Coronary Artery Dissection?



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Is it Like Night and Day, or Weekend?



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A New Educational Framework to Improve Lifelong Learning for Cardiologists

Abstract

Lifelong learning is essential for the practicing cardiologist. Present lifelong learning mechanisms are stagnant and at risk for not meeting the needs of currently practicing cardiologists. With the increasing burden of cardiovascular disease, growing complexity of patient care, and ongoing pressures of nonclinical responsibilities, educational programming must evolve to meet the demands of the contemporary cardiovascular professional. A paradigm shift, replete with modern and practical educational tools, is needed in the lifelong learning armamentarium. Emerging evidence of novel educational strategies in graduate medical education supports the promise of broader application of these tools to different stages of professional life. In this commentary from the Fellows-in-Training Section Leadership Council, the authors propose 3 novel educational tools—personalized learning, adaptive learning, and the flipped classroom—to improve lifelong learning to meet the educational needs of fellows-in-training to practicing cardiologists alike.



http://ift.tt/2n2P5rB

Coronary Adventitial and Perivascular Adipose Tissue Inflammation in Patients With Vasospastic Angina

AbstractBackground

Recent studies suggested that perivascular components, such as perivascular adipose tissue (PVAT) and adventitial vasa vasorum (VV), play an important role as a source of various inflammatory mediators in cardiovascular disease.

Objectives

The authors tested their hypothesis that coronary artery spasm is associated with perivascular inflammation in patients with vasospastic angina (VSA) using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT).

Methods

This study prospectively examined 27 consecutive VSA patients with acetylcholine-induced diffuse spasm in the left anterior descending artery (LAD) and 13 subjects with suspected angina but without organic coronary lesions or coronary spasm. Using CT coronary angiography and electrocardiogram-gated 18F-FDG PET/CT, coronary PVAT volume and coronary perivascular FDG uptake in the LAD were examined. In addition, adventitial VV formation in the LAD was examined with optical coherence tomography, and Rho-kinase activity was measured in circulating leukocytes.

Results

Patient characteristics were comparable between the 2 groups. CT coronary angiography and ECG-gated 18F-FDG PET/CT showed that coronary PVAT volume and coronary perivascular FDG uptake significantly increased in the VSA group compared with the non-VSA group. Furthermore, optical coherence tomography showed that adventitial VV formation significantly increased in the VSA group compared with the non-VSA group, as did Rho-kinase activity. Importantly, during the follow-up period with medical treatment, both coronary perivascular FDG uptake and Rho-kinase activity significantly decreased in the VSA group.

Conclusions

These results provide the first evidence that coronary spasm is associated with inflammation of coronary adventitia and PVAT, where 18F-FDG PET/CT could be useful for disease activity assessment. (Morphological and Functional Change of Coronary Perivascular Adipose Tissue in Vasospastic Angina [ADIPO-VSA Trial]; UMIN000016675)



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Cardiac Resynchronization Therapy for End-Stage Hypertrophic Cardiomyopathy: The Need for Disease-Specific Criteria



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The Forgotten Vascular Layer in the Forgotten Coronary Disorder



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Pregnancy-Associated Spontaneous Coronary Artery Dissection: A Different Presentation Although Perhaps Not Such a Distinct Condition



http://ift.tt/2n5k9Y3

Transplantation of Human Embryonic Stem Cell-Derived Cardiovascular Progenitors for Severe Ischemic Left Ventricular Dysfunction

AbstractBackground

In addition to scalability, human embryonic stem cells (hESCs) have the unique advantage of allowing their directed differentiation toward lineage-specific cells.

Objectives

This study tested the feasibility of leveraging the properties of hESCs to generate clinical-grade cardiovascular progenitor cells and assessed their safety in patients with severe ischemic left ventricular dysfunction.

Methods

Six patients (median age 66.5 years [interquartile range (IQR): 60.5 to 74.7 years]; median left ventricular ejection fraction 26% [IQR: 22% to 32%]) received a median dose of 8.2 million (IQR: 5 to 10 million) hESC-derived cardiovascular progenitors embedded in a fibrin patch that was epicardially delivered during a coronary artery bypass procedure. The primary endpoint was safety at 1 year and focused on: 1) cardiac or off-target tumor, assessed by imaging (computed tomography and fluorine-18 fluorodeoxyglucose positron emission tomography scans); 2) arrhythmias, detected by serial interrogations of the cardioverter-defibrillators implanted in all patients; and 3) alloimmunization, assessed by the presence of donor-specific antibodies. Patients were followed up for a median of 18 months.

Results

The protocol generated a highly purified (median 97.5% [IQR: 95.5% to 98.7%]) population of cardiovascular progenitors. One patient died early post-operatively from treatment-unrelated comorbidities. All others had uneventful recoveries. No tumor was detected during follow-up, and none of the patients presented with arrhythmias. Three patients developed clinically silent alloimmunization. All patients were symptomatically improved with an increased systolic motion of the cell-treated segments. One patient died of heart failure after 22 months.

Conclusions

This trial demonstrates the technical feasibility of producing clinical-grade hESC-derived cardiovascular progenitors and supports their short- and medium-term safety, thereby setting the grounds for adequately powered efficacy studies. (Transplantation of Human Embryonic Stem Cell-derived Progenitors in Severe Heart Failure [ESCORT]; NCT02057900)



http://ift.tt/2Bj01WF

Pregnancy-Associated Coronary Artery Dissection: A Therapeutic Dilemma



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Trial of Embryonic Stem Cell-Derived Cardiac Progenitor Cells: An Encouraging Start



http://ift.tt/2BlADzj

Comparative study on the incision healing of the palatal mucosa by using Er:YAG laser or traditional scalpel in the SD rats

Abstract

The aim of this study was to compare the histology of wound healing following incisions with the scalpel or the Er:YAG laser in the palatal mucosa of SD rats. Two types of wounds were performed with the stainless steel scalpel or the Er:YAG laser in the palatal mucosa of SD rats, while the adjacent untreated palatal mucosa was chosen as control. Rats were sacrificed on day 1, day 3, day 7, and day 30 post-surgery. Biopsy samples from each wound were examined and the expression of IL-1ß and TGF-ß1 was determined by enzyme-linked immunosorbent assay (ELISA). The early postoperative incision of the scalpel group had obvious bleeding and swelling, while the laser wound mainly covered the surface of white pseudomembrane. The infiltration of neutrophils and lymphocytes in the stroma of the scalpel incision was more than that of the laser group. Compared to the laser group, 1 and 3 days after operation, the TGF-β1 content of the scalpel group were significantly increased (P = 0.032 and 0.019). Seven days after operation, the TGF-β1 content of two groups was decreased. TGF-β1 expression of control group was obviously increased (P > 0.05); 1, 3, and 7 days after operation, the traditional scalpel amount of IL-1β expression was significantly higher than that of control group (P = 0.000, 0.000, and 0.001). Postoperative day 1, IL-1β expression of laser group and control group had no significant difference (P = 0.572). Three days after operation, IL-1β expression of laser incision was increased and was significantly higher than that in control group (P = 0.032), however lower than the scalpel group (P = 0.03). Seven days after operation, the IL-1β expression of two groups had no significant difference (P = 0.333); however, the IL-1β expression of two groups were significantly higher than that of the control group (P = 0.02 and 0.001). Compared to the traditional scalpel, the incision of Er:YAG laser has smaller inflammation reaction, more pseudomembrane coverage, and minimal damage of the mucoperiosteal tissue.



http://ift.tt/2G5joFX

A grey DEMATEL-based approach for modeling enablers of green innovation in manufacturing organizations

Abstract

Incorporating green practices into the manufacturing process has gained momentum over the past few years and is a matter of great concern for both manufacturers as well as researchers. Regulatory pressures in developed countries have forced the organizations to adopt green practices; however, this issue still lacks attention in developing economies like India. There is an urgent need to identify enablers of green innovation for manufacturing organizations and also to identify prominent enablers among those. This study is an attempt to first identify enablers of green innovation and then establish a causal relationship among them to identify the enablers that can drive others. Grey DEMATEL (Decision Making Trial and Evaluation Laboratory) methodology is used for establishing the causal relationship among enablers. The novelty of this study lies in the fact that no study has been done in the past to identify the enablers of green innovation and then establishing the causal relationship among them. A total of 21 enablers of green innovation have been identified; research indicates developing green manufacturing capabilities, resources for green innovation, ease of getting loans from financial institutions, and environmental regulations as the most influential enablers of green innovation. Managerial and practical implications of the research are also presented to assist managers of the case company in adopting green innovation practices at their end.



http://ift.tt/2F2Fc3O

Does finance affect environmental degradation: evidence from One Belt and One Road Initiative region?

Abstract

This paper explores the effects of finance on environmental degradation and investigates environmental Kuznets curve (EKC) of each country among 52 that participate in the One Belt and One Road Initiative (OBORI) using the latest long panel data span (1980–2016). We utilized panel long run econometric models (fully modified ordinary least square and dynamic ordinary least square) to explore the long-run estimates in full panel and country level. Moreover, the Dumitrescu and Hurlin (2012) causality test is applied to examine the short-run causalities among our considered variables. The empirical findings validate the EKC hypothesis; the long-run estimates point out that finance significantly enhances the environmental degradation (negatively in few cases). The short-run heterogeneous causality confirms the bi-directional causality between finance and environmental degradation. The empirical outcomes suggest that policymakers should consider the environmental degradation issue caused by financial development in the One Belt and One Road region.



http://ift.tt/2DAlq2w

Retinoic acid signalling is a candidate regulator of the expression of pituitary-specific transcription factor Prop1 in the developing rodent pituitary

Abstract

Development of the anterior pituitary proceeds via spatiotemporal patterning of transcription factors and signalling molecules. Among them, retinoic acid (RA) functions as an important signalling molecule for vertebrate organogenesis in many tissues. However, little is known regarding target genes in the developing pituitary. The present study aimed to clarify the relationship between endogenous RA signalling and mRNA expression of the pituitary-specific transcription factor Prop1 in the pituitary primordium of Rathke's pouch. Gene expression analysis and in situ hybridisation demonstrated that retinaldehyde dehydrogenases (Raldhs) and all types of RA receptors (Rars) are expressed at the level of transcription in the rat Rathke's pouch. Ex vivo organ culture using Rathke's pouch and in vitro reporter assay demonstrated that RA signalling increases the expression level of Prop1 via RARα. Moreover, a reporter assay using serial truncated constructs of the 5′-upstream region of mouse Prop1 revealed a predicted cis-regulatory element of RARα. This is the first report exhibiting a relationship between RA signalling and Prop1-expression during early pituitary development.

This article is protected by copyright. All rights reserved.



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3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study

Abstract

Objective

The aim of this study was to investigate differences between the virtually planned and clinically achieved implant positions in completely template-guided implantations as a function of the type of edentulous space, the residual natural dentition, and the surgical implementation.

Materials and methods

Fifty-six patient cases with a total of 122 implants were evaluated retrospectively. The implantations were completely template-based. The data of the planned implant positions were overlaid with the actual clinical implant positions, followed by measurements of the 3D deviations in terms of coronal (xc) and apical distance, height (xh), and angulation (ang) and statistical analysis.

Results

The mean xc was 1.2 mm (SD 0.7 mm); the mean xa was 1.8 mm (SD 0.9 mm), the mean xh was 0.8 mm (SD 0.7 mm); and the mean ang was 4.8° (SD 3.1). The type of edentulous space and the jaw (maxilla/mandible) had no significant effect on the results in terms of implant positions. The presence of an adjacent natural tooth at the time of implantation had a significant influence on xh (p = 0.04) and ang (p = 0.05). No significant differences were found regarding the surgical approach for any of the parameters examined.

Conclusion

The results of our study are in the same range as those of other studies. Template-guided implantation offers a high degree of accuracy even in the presence of different configurations of the residual dentition or different surgical approaches. A clinical benefit is therefore present, especially from a prosthetic point of view.

Clinical relevance

The clinically achievable accuracy can be described as sufficient for further prosthetic treatment, given the intrinsic and methodological tolerances, making prosthetic rehabilitation safe and predictable.



http://ift.tt/2G3YRlc

Assessment of the efficacy of a new complex antisensitive skin cream

Summary

Background

Sensitive skin is frequently complaint in dermatology consultation with cutaneous manifestations such as stinging, redness, dryness, and burning sensation that affect the quality of life. Its pathogenesis is mainly related to dysfunction of neurosensory, skin barrier, and also immune activity. The treatment is generally based on continuous and topical therapy by nonirritating complex.

Objective

To evaluate the antisensitive function of a new complex cream composed by Yunnan Portulaca oleracea extract, Prinsepia utilis oil, beta-glucan, and sodium hyaluronate extracted from mushroom.

Methods

A randomized double-blind and self-control study was conducted on 20 selected volunteers with sensitive skin. Subjects applied the test cream to 1 side of the face, and the control cream (tolerance-extreme cream) to the other side of the face, twice daily over 28 days. Evaluations were performed at baseline and at 28 days. Expert clinical grading of facial skin including dryness, roughness, desquamation, and erythema was assessed. Subject self-assessment questionnaires, digital photography and noninvasive bioinstrumentation of hydration, transepidermal water loss, lipid index, skin texture, and wettability were also included in the study.

Results

Products were well tolerated. For all parameters studied, no significant difference was observed between test and control creams. Results showed that test cream provided a statistically significant improvement in clinical grading scores for dryness, roughness, and erythema at 28 days compared to baseline. In addition, statistically significant improvement of skin hydration and texture parameters (eg, smoothness and roughness) was demonstrated. Volunteers' questionnaire revealed self-perceived benefits consistent with expert visual grading.

Conclusion

This study confirmed the effectiveness and tolerance of the new complex cream in subjects with sensitive skin. The test cream could serve as a daily care moisturizer for face.



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Editorial Board

Publication date: 20 February 2018
Source:Journal of Proteomics, Volume 173





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Phosphoproteomics unveils stable energy supply as key to flooding tolerance in Kandelia candel

Publication date: Available online 17 January 2018
Source:Journal of Proteomics
Author(s): Dezhuo Pan, Lingxia Wang, Fanglin Tan, Si Lu, Xiaojie Lv, Madiha Zaynab, Chi-Lien Cheng, Yakubu Saddeeq Abubakar, Shipin Chen, Wei Chen
The mangrove Kandelia candel (L.) Druce experiences daily flooding cycles. To explore the molecular mechanism underlying the physiological adaptation of K. candel to flooding, the potential role of protein phosphorylation in flooding responses was investigated by a large-scale quantitative phosphoproteomic analysis using isobaric tag for relative and absolute quantitation. Total 2141 unique phosphopeptides and 2603 non-redundant phosphorylation sites were identified from 1516 phosphoproteins in K. candel leaves. In addition to known phosphorylation motifs, three new motifs [GSP], [GxxSP] and [RSxS] were discovered. The phosphorylation levels of 96 differentially expressed phosphoproteins, including those involved in pyruvate metabolism and energy production, were identified in response to flooding. The physiological parameters and transcriptional levels relevant to flooding responses including photosynthesis, pyruvate metabolism, and ROS production were investigated and all were found to be robust under flooding conditions. The consistent results of the phosphoproteomic, physiological analyses and transcriptional levels reinforce each other to demonstrate that K. candel adapts to flooding through maintaining sufficient photosynthesis activities, achieving effective anaerobic respiration and increasing pentose phosphate pathway flux. Protein phosphorylation is likely to play a major role in the regulation of these pathways which together contribute to stable energy supply that enhances flooding tolerance in K. candel.Biological significanceFlooding stress is one of the major environmental stresses. The woody mangrove Kandelia candel experiences daily flooding cycles in its natural habitat. Protein phosphorylation is a crucial regulatory mechanism in plants' responses to both biotic and abiotic stresses. To analyze phosphorylation levels in critical enzymes involved in key metabolic pathways, we employed phosphoproteomic approach to dissect the adaptive mechanism of K. candel to flooding conditions. To our knowledge, this is the first large-scale quantitative phosphoproteomic analyses of K. candel's flooding responses. Multiplex iTRAQ-based quantitative proteomic and Nano-LC–MS/MS methods were used to construct the phosphorproteome. Our results indicate that K. candel is able to acquire stable energy supply under flooding by maintaining sufficient photosynthesis activities, enhancing effective anaerobic respiration and increasing pentose phosphate pathway (PPP) flux. The protein phosphorylation found in photosynthesis, anaerobic respiration and PPP is likely to play important roles in the flooding tolerance of K. candel.

Graphical abstract

image


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Assessment of the Agreement between Cerebral Hemodynamic Indices Quantified Using Dynamic Susceptibility Contrast and Dynamic Contrast-enhanced Perfusion Magnetic Resonance Imagings

Seyed Salman Zakariaee, Mohammad Ali Oghabian, Kavous Firouznia, Guive Sharifi, Farshid Arbabi, Farhad Samiei

Journal of Clinical Imaging Science 2018 8(1):2-2

Background: Brain tumor is one of the most common tumors. A successful treatment might be achieved with an early identification. Pathological investigation as the gold standard method for tumor identification has some limitations. Noninvasive assessment of tumor specifications may be possible using perfusion-weighted magnetic resonance imaging (MRI). Cerebral blood volume (CBV) and cerebral blood flow (CBF) could be calculated based on dynamic contrast-enhanced MRI (DCE-MRI) in addition to dynamic susceptibility contrast MRI (DSC-MRI) modality. Each category of the cerebral hemodynamic and permeability indices revealed the specific tumor characteristics and their collection could help for better identification of the tumor. Some mathematical methods were developed to determine both cerebral hemodynamic and permeability indices based on a single-dose DCE perfusion MRI. There are only a few studies available on the comparison of DSC- and DCE-derived cerebral hemodynamic indices such as CBF and CBV. Aim: The objective of the study was to validate first-pass perfusion parameters derived from T1-based DCE method in comparison to the routine T2*-based DSC protocol. Materials and Methods: Twenty-nine patients with brain tumor underwent DCE- and DSC-MRIs to evaluate the agreement between DSC- and DCE-derived cerebral hemodynamic parameters. Agreement between DSC- and DCE-derived cerebral hemodynamic indices was determined using the statistical method described by Bland and Altman. The reliability between DSC- and DCE-derived cerebral hemodynamic indices was measured using the intraclass correlation analysis. Results: The achieved magnitudes for DCE-derived CBV (gray matter [GM]: 5.01 ± 1.40 mL/100 g vs. white matter [WM]: 1.84 ± 0.74 mL/100 g) and DCE-derived CBF (GM: 60.53 ± 12.70 mL/100 g/min vs. WM: 32.00 ± 6.00 mL/100 g/min) were in good agreement with other studies. The intraclass correlation coefficients showed that the cerebral hemodynamic indices could accurately be estimated based on the DCE-MRI using a single-compartment model (>0.87), and DCE-derived cerebral hemodynamic indices are significantly similar to the magnitudes achieved based on the DSC-MRI (P < 0.001). Furthermore, an acceptable agreement was observed between DSC- and DCE-derived cerebral hemodynamic indices. Conclusion: Based on the measurement of the cerebral hemodynamic and blood–brain barrier permeability using DCE-MRI, a more comprehensive collection of the physiological parameters cloud be achieved for tumor evaluations.

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22q11 Deletion Syndrome with Vascular Anomalies

Pierre Maldjian, Alison Esteva Sanders

Journal of Clinical Imaging Science 2018 8(1):1-1

DiGeorge syndrome, also termed 22q11.2 deletion syndrome, represents a spectrum of disorders that include thymic aplasia/hypoplasia, parathyroid aplasia/hypoplasia, conotruncal vascular anomalies, and velocardiofacial (Shprintzen) syndrome. This case report describes a novel constellation of cardiovascular anomalies in a 31-year-old patient with 22q11.2 deletion confirmed by fluorescence in situ hybridization at the age of 24. CT angiogram of the thorax revealed a right aortic arch with mirror image branching and unilateral absence of the left pulmonary artery with collateral flow through left intercostal arteries and hypertrophied left bronchial artery. This particular cluster of vascular findings has not been previously described in the imaging literature in a patient with known 22q11.2 deletion.

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Book Review

Archive everything: mapping the everyday
Sebastian Gurciullo
Pages: 1-3 | DOI: 10.1080/01576895.2018.1407739


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Principles for embodied learning approaches
Marth Munro
Pages: 1-10 | DOI: 10.1080/10137548.2017.1404435


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Novel clinical and molecular findings in Spanish patients with nevoid basal cell carcinoma syndrome

Summary

Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin Syndrome, affects only 1 in 56 000 people. It is usually inherited from a parent with the condition and affects both males and females equally (autosomal dominant inheritance). People with NBCCS may show characteristic features such as extra fingers or toes, irregular ribs, an unusually shaped face and large head. Tumours sometimes develop, particularly jaw cysts and basal cell carcinomas (BCCs) of the skin from which the syndrome is named. NBCCS is caused by mistakes (mutations) in a gene called PTCH1 located on the long arm of chromosome 9. PTCH1 acts as a brake on a set of chemical processes in cells called the Hedgehog (HH)/GLI signalling pathway. In NBCCS, mutations inactivate PTCH1 allowing excessive Hedgehog signalling. This loss of control results in the abnormal bones and tumours. Within an affected family, people with the same genetic mutation can have very different abnormalities. This group from Spain studied 22 unrelated Spanish people with NBCCS to see if they could discern any relationship between specific clinical abnormalities and specific genetic mutations. BCCs were very common, occurring in 96% of patients with 43% having more than 50; 77% had jaw cysts. Two abnormalities had not previously been recognised in NBCCS: double uterus and a benign nerve tumour. They found 19 PTCH1 mutations that had not previously been reported. However, they could not find any pattern relating the type of mutation to the clinical abnormalities. Presumably other factors besides the PTCH1 mutation causes the clinical features.



http://ift.tt/2n0zJnr

British Association of Dermatologists’ guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018

Summary

Pruritus (or itch) is a common and distressing symptom of many skin diseases, systemic illnesses and psychological disorders. Itch is perhaps the commonest presenting symptom of skin disorders. In any two week period, 8 to 9% of the population suffer from significant pruritus. The focus of this guideline is not itchy rashes, but rather the situation where itch is present without rash. The guidelines also do not cover itch in children, in pregnancy, nor do they detail the science of the cause of itch. The study group consist mostly of dermatologists (skin specialists) from a number of hospitals in the U.K., but a number of other hospital doctors, a nurse and a general practitioner (GP) are also part of the team. There may be an underlying cause of pruritus, such as blood disorders, iron deficiency or excess, kidney problems, liver problems, cancer, infections, medications, behavioural factors, dry skin or any combination of these with old age. This can be significant in 20 to 30% of cases of itchy skin without rash. There remain a small number of individuals with itch and no apparent underlying cause or rash. It is always important to look for an underlying causative condition, as the most effective management of pruritus without rash depends on the treatment of any underlying disease. The management of itch appears to be very situation specific, even if the underlying cause cannot be treated. The management of true pruritus of unknown cause is different again.



http://ift.tt/2BiVlA0

Corrigenda



http://ift.tt/2mZz7i6

Advances in the diagnosis of pigmented skin lesions



http://ift.tt/2BkN5zj

通过电子皮镜观察到在后天性痣亚型中常见 BRAF 和 NRAS 突变,表现出组成型 MAPK 通路活化

Summary

大多数人的皮肤上都有几个褐斑,我们称之为黑素细胞痣或痣。痣对人体无害,但偶尔可能转化为潜在致死性肿瘤,也就是恶性黑色素瘤。在放大镜(电子皮镜)下,皮肤科专家通过外观确定了不同类型的痣。广义上:"球状"痣在早年出现,并且可能转化为黑色素瘤;"网状"痣在成年期出现,并且可能与未长痣部位出现的黑色素瘤有关;带"外围球状体"(PG) 的网状痣会生长,但非恶性。良性痣及癌性痣(恶性黑色素瘤)中都可能出现 BRAF 和 NRAS 基因突变(变异)。这些基因是在肿瘤形成中起重要作用的 MAPK 通路的成分。为说明这些基因的作用,这些来自澳大利亚的研究人员探讨了电子皮镜下外观与良性痣中的 NRAS 和 BRAF 突变之间的关系。他们通过电子皮镜检查了 27 人的 40 个后天性(非先天性)痣,然后去痣以进行分析。在显微镜下,研究人员观察到大多数网状痣中的细胞结构无序,但这种情况在球状痣以及 PG 痣中很少见。研究人员使用了一种能够检测单细胞突变的新型高灵敏度方法("微滴式数字 PCR"),他们发现大多数球状痣以及所有 PG 痣都出现 BRAF 突变,网状痣则出现 BRAF 或 NRAS 突变。研究人员得出结论,所有痣具有 MAPK 基因突变,证明 MAPK 通路在黑素细胞痣及黑色素瘤的形成中起基础性作用。



http://ift.tt/2mZV1Sr

A new era in holistic care: bridging the gap between dermatologists and oncologists for the treatment of malignant melanoma



http://ift.tt/2Bk780T

Morphological characteristics and human papillomavirus genotype predict the treatment response in cutaneous warts

Summary

Skin warts are highly prevalent in both children and adults. They are caused by a virus called 'human papilloma virus' (HPV). Only around half of skin warts disappear after treatment. This study was performed to predict the type of HPV in warts and more importantly, to predict which warts are likely to disappear after treatment. Therefore, features both of patients and their warts were studied. A new standard tool for warts (the CWARTS diagnostic tool) was used to score the appearance of the wart and 23 different virus types were tested. The treatments that were used were monochloroacetic acid, cryotherapy or a combination of cryotherapy and salicylic acid. In total, 311 warts of 159 patients were studied. Black dots in a wart suggested presence of HPV. If warts contained HPV2, HPV27 or HPV57 they responded less often to most treatments. However this did not apply to warts located on the hands or body if they were treated with cryotherapy. Warts that show callus or are deeper located on the skin were less responsive to cryotherapy. To summarize, the appearance of warts and the type of HPV they contain influence the chance of healing. Therefore, in the future it might be important for medics to take this into account when choosing a treatment option for common and plantar warts.



http://ift.tt/2n0aIc9

When to switch biologics: some answers, but lots of questions too



http://ift.tt/2Bkx1xn

Vitiligo and quality of life: the dark face of whiteness



http://ift.tt/2n0zGrL

受孕和妊娠期使用生物疗法:系统综述

Summary

生物疗法可以有效治疗银屑病,并且通常在育龄期女性中使用。监管部门表示,由于没有充分的研究评估在受孕或妊娠期使用生物制剂的安全性,因此建议在此期间禁用。但事实上,这实施起来很有挑战,因为临床上治疗银屑病需要持续进行。为评估受孕和/或者妊娠期使用生物疗法的安全性,该研究的作者(来自英国)对有关女性在受孕和/或妊娠期使用生物疗法治疗银屑病的相关研究进行了系统综述。作者确定了四项研究,共涉及 1,300 名在孕前 3 个月或孕期前 3 个月使用 TNFi 生物制剂的女性。这些研究表明具有不同炎症(不仅仅是银屑病)的女性在使用 TNFi 后容易出现药物特定的损害,而且其中三项研究表明先天畸形风险增加,一项研究表明早产风险增加。但是,风险很低且不确定是否因 TNFi 所致。作者得出结论,生物制剂对妊娠结局(特别是女性银屑病患者)的潜在影响尚缺乏充分研究,无法准确量化。有关在其他病例中的生物制剂使用数据十分有限。通常建议有生育能力的女性使用常规避孕,但在备孕的情况下,应视具体情况讨论继续或停止生物治疗的风险及好处。大规模研究是必需的,并且应考虑其他可能影响妊娠的因素,比如疾病活动性、其他疗法及母体人口统计特征。



http://ift.tt/2BjP47b

Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, double-blind, phase III NAVIGATE trial

Summary

Psoriasis is a chronic disease causing red and scaling skin lesions. Current treatments, especially biologics, which are either given by injection or intravenous infusion (IV), are very effective in the treatment of moderate to severe plaque psoriasis. However, most patients look to achieve clear skin, so there is room for improvement. One approved biologic, ustekinumab, blocks two of the body's internal proteins, interleukin (IL)-12 and IL-23. Blocking these proteins prevents signals that cause inflammation in psoriasis. While ustekinumab is effective in many patients, most will not achieve complete skin clearance. Because recent scientific evidence shows that IL-23 may be more important than IL-12 in causing psoriasis, guselkumab, a new treatment that specifically targets IL-23, but not IL-12, has been developed and was recently approved in the U.S. to treat moderate to severe psoriasis. In the NAVIGATE trial, 871 patients with moderate-to-severe plaque psoriasis received ustekinumab and if, after 16 weeks, patients were not clear or almost clear, they were randomly assigned to either continue ustekinumab or start treatment with guselkumab until week 44. From week 16 until week 40, the average number of visits (maximum = 4) at which patients were clear or almost clear was significantly greater in patients treated with guselkumab (1.5) than with ustekinumab (0.7). In addition, at week 28, twice the proportion of patients on guselkumab (31.1%) were clear or almost clear than on ustekinumab (14.3%). Infections were the most commonly reported adverse event among patients on either guselkumab or ustekinumab. The authors conclude that for patients who do not achieve clear or almost clear skin after ustekinumab treatment, switching to guselkumab could be an effective treatment strategy and did not raise safety concerns.



http://ift.tt/2n1InCe

Corrigenda



http://ift.tt/2mZPA55

Experiences of rosacea and its treatment: an interpretative phenomenological analysis

Summary

Rosacea is a skin disorder which causes flushing and redness of the face. Relatively few people with rosacea receive specialist dermatology treatment or psychological support. Despite this, individuals with rosacea can experience social anxiety, depression and embarrassment, and decreased quality of life. Whilst questionnaire based studies have been used to investigate the type of distress that people living with rosacea might experience, there are no studies that have sought to gain an in-depth understanding of the experiences of living with this visible skin condition. Therefore, this study used face-to-face interviews to learn about participants' complex, individual experience of life with rosacea. A qualitative approach called interpretative phenomenological analysis (IPA) was used to guide the interviews and analysis. This approach to research focuses on individual accounts and has been extensively used to investigate illness experience. In this study nine participants took part in detailed semi-structured interviews. Three overarching themes were gleamed from these interviews; self-consciousness, which focused on the fear of others assigning blame to participants for having caused their own symptoms; avoidance, concealment, and hiding emotions, referring to the coping strategies participants employed in response to rosacea; and inconsistencies in treatment, which focused on the need for medical professionals to assess the emotional wellbeing of patients with rosacea. The findings are consistent with qualitative findings from patients with other skin conditions that demonstrate that self-conscious emotions can be a significant part of the experience of life with a skin condition. Healthcare professionals need to take care to assess for the presence of such concerns in rosacea, and where unhelpful thoughts or beliefs are reported, patients may benefit from dermatology specific psychological support.



http://ift.tt/2Dx69Ak

Sustained Psoriasis Area and Severity Index, Dermatology Life Quality Index and EuroQol-5D response of biological treatment in psoriasis: 10 years of real-world data in the Swedish National Psoriasis Register

Summary

Patients with mild disease are usually treated with topical treatments, meaning applied to the skin, while patients with moderate to severe disease require systemic treatments (taken inside the body), which includes drugs called biologics. PsoReg is the Swedish national register established in 2006 to monitor the long term effectiveness and safety of biologics. PsoReg records patients' Psoriasis Area and Severity Index (PASI), which is a way of measuring how severe and widespread a patient's psoriasis is at a given time, allowing doctors to see if symptoms are worsending or improving. PsoReg also records patients' Health-Related Quality of Life (HRQoL), which takes into account how the disease is affecting their daily activities and emotional wellbeing. This study used data from 583 patients to see how switching to a biologic treatment, having not previously taken biologics, impacts on their PASI and HRQoL. PASI and HRQoL values were analysed at 3–5 months, 6–11 months, and at least once more after a year or more, up to 9 years after switch to biological treatment. The data showed significant improvement in these scores 3–5 months after the switch, and this improvement lasted the whole observation period. The results from this study may support clinicians in starting and continuing biological treatment for patients with disappointing results with other types of treatment.



http://ift.tt/2mZ4TuJ

What can we learn from psoriasis pharmacogenomics research?



http://ift.tt/2Dvx3bR

How breakthroughs in translational research have impacted treatment strategies for melanoma



http://ift.tt/2mZ4tVb

Scholar : Journal of Natural History, Volume 52, Issue 3-4, January - January 2018 is now available online on Taylor & Francis Online

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Taylor & Francis Online - The new journals and reference work platform for Taylor & Francis
The online platform for Taylor & Francis Online content

Journal of Natural History, Volume 52, Issue 3-4, January - January 2018 is now available online on Taylor & Francis Online.



This new issue contains the following articles:

Original Articles

Aquatic insects in the forest canopy: a new genus of moth flies (Diptera: Psychodidae) developing in slime on aerial roots
Gunnar Mikalsen Kvifte, Gregory R. Curler & Stephen A. Marshall
Pages: 137-153 | DOI: 10.1080/00222933.2017.1410590


Diversity of the subgenus Disparalona (Mixopleuroxus) Hudec, 2010 (Crustacea: Cladocera) in the New and Old World
Anna N. Neretina, Petr G. Garibian, Artem Y. Sinev & Alexey A. Kotov
Pages: 155-205 | DOI: 10.1080/00222933.2017.1411987


Article

Reproductive behaviour of the glass frog Hyalinobatrachium cappellei (Anura: Centrolenidae) in the Southern Amazon
Janaina da Costa de Noronha & Domingos de Jesus Rodrigues
Pages: 207-224 | DOI: 10.1080/00222933.2017.1414324


Original Articles

Comparison of breeding biology aspects of Fluvicola nengeta (Aves: Tyrannidae) between two nesting sites
Tatiane Lima da Silva, Rísia Brígida Gonçalves Cabral, Lucas de Assis Silva Andrade, Noemia Falcão Nogueira, Mariana de Souza Oliveira & Ildemar Ferreira
Pages: 225-235 | DOI: 10.1080/00222933.2017.1414897


Ecology and field biology of two dominant Camponotus ants (Hymenoptera: Formicidae) in the Brazilian savannah
Mariane U.V. Ronque, Vincent Fourcassié & Paulo S. Oliveira
Pages: 237-252 | DOI: 10.1080/00222933.2017.1420833


Book Review

Beaked Whales: A Complete Guide to their Biology and Conservation, by Richard Ellis and James G. Mead, Johns Hopkins University Press, Baltimore Maryland USA, 2017, £59.00, ISBN: 1421421828
Scott Wilson
Pages: 253-254 | DOI: 10.1080/00222933.2017.1419714


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Taylor & Francis, an Informa business.
Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.



The views of children and young people on the use of silk garments for the treatment of eczema: a nested qualitative study within the CLOTHing for the relief of Eczema Symptoms (CLOTHES) randomized controlled trial

Summary

This study reports on a trial from the U.K. to find out if specialised silk clothing improved eczema in children. Eczema is a common skin condition. It affects around one in five children and can cause sore and itchy skin, poor sleep and reduced quality of life. As part of this work the researchers wanted to find out what the children who wore the garments in the study thought of them. They invited 18 children aged between five and 15 years to take part, meeting in small groups and using stories and play to help the children tell the researchers about the garments. All the children and young people had high hopes that the garments would make their skin much better. They expected the garments to feel soft and smooth and were disappointed when they were not like this. They reported that they mostly wore them at night as it was embarrassing to wear them during the day. Some said that the garments were see through. Garments tended to go grey and start to fall apart when they had been worn and washed. A few children found that the garments made their skin more comfortable and helped them sleep better. They were disappointed that the miracle cure they hoped for did not happen. It is important and possible to involve children in studies like this so we can understand what they think about possible treatments for eczema.



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