A potentially important role for t cells and regulatory t cells in Langerhans cell histiocytosis

Publication date: Available online 18 June 2018
Source:Clinical Immunology
Author(s): Jenée M. Mitchell, Stuart P. Berzins, George Kannourakis
Langerhans cell histiocytosis is characterized by lesions containing inflammatory immune cells, including myeloid cells and T cells. Patient mortality remains unacceptably high and new treatment options are required. Several LCH studies have identified aberrant frequencies of T cell subsets with potential immune regulatory properties. High numbers of Foxp3⁺ regulatory T cells and gamma-delta T cells have been reported in patients with LCH, although, the cause of their presence or their significance is not yet clear. This review describes the current understanding of how LCH develops and progresses, focusing on the growing evidence that regulatory T cell subsets may be important and discussing the exciting potential for harnessing these cells to treat LCH using immune based therapies.



https://ift.tt/2I0XGTq

Zoonoses under our noses

Publication date: Available online 18 June 2018
Source:Microbes and Infection
Author(s): Alice R. Cross, Victoria M. Baldwin, Sumita Roy, Angela E. Essex-Lopresti, Joann L. Prior, Nicholas J. Harmer
One Health is an effective approach for the management of zoonotic disease in humans, animals and environments. Examples of the management of bacterial zoonoses in Europe and across the globe demonstrate that One Health approaches of international surveillance, information-sharing and appropriate intervention methods are required to successfully prevent and control disease outbreaks in both endemic and non-endemic regions. Additionally, a One Health approach enables effective preparation and response to bioterrorism threats.



https://ift.tt/2JXQUQ5

Utility of ultrasound of the lymph nodes in patients with high-risk cutaneous squamous cell carcinoma

Abstract

Background

Ultrasound (US) is a non-invasive, highly available and cheap examination of the lymph nodes of the neck. However, currently, there is no agreement of the standard use of US in the detection of metastatic lymph nodes in patients with high-risk cutaneous squamous cell carcinoma (cSCC). The aim of the study was to evaluate ultrasound in the diagnostics of lymph node metastases in cutaneous squamous cell carcinoma and in the light of different "high-risk" factors in cSCC to evaluate who would benefit from US.

Methods

We conducted a review ofliterature on squamous cell carcinoma of the head and neck (HNSCC) and US published in the year 2000 until September 2017. Nine studies and a total of 664 patients were included. The sensitivity, specificity, negative predictive value and accuracy for US were found in the included articles and a cumulative sum for the total cohort was calculated. Further, the results for US were compared to data from CT, PET CT and clinical examination.

Results

Sensitivity for US for the total cohort was 85.9, specificity was 96.3%, negative predictive value (NPV) was 93.1% and accuracy was 92.2%. We found significantly no difference when US was compared to CT and PET CT. CT had a sensitivity, specificity, NPV and accuracy at 82.8, 97.7, 90.9 and 92.32% respectively. Sensitivity, specificity, NPV and accuracy for PET CT were 87.4, 98.1, 95.2 and 95.2% respectively. In contrast, we found clinical examination to have the significantly lowest sensitivity, specificity, NPV and accuracy at 69.6, 80, 61.1 and 73.4%, respectively.

Conclusions

Ultrasound is found to have equal sensitivity, specificity and NPV as CT and PET CT. Further, US is proven significant better than clinical examination. Patients with one or two high-risk factors for metastases could very well benefit from US of neck. However, more studies on US are necessary and further, specific studies on cSCC should be performed in order to see if US of the neck in HNSCC patients is transferable to cSCC.

Level of evidence: Not ratable.

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Formation of a sensate forearm stump through neurovascular tissue transplantation

Abstract

The use of neurovascular flaps can help to maximize limb length and gain sensory re-innervation in amputees. We describe the case of a 19-year-old patient who underwent an innovative reconstructive approach aimed at preserving viable limb length with sensory regeneration by using innervated tissue transfer after traumatic upper extremity amputation below the elbow. The forearm length was maximized by means of two neurovascular free flaps that formed a robust, functional, and versatile stump. The mechanism of this reconstruction originated from the practice of placing a double-innervated anterolateral thigh flap over a myocutaneous flap for covering protruding forearm bone shafts. This form of vascularized tissue transplantation helps to minimize the risk of necrosis of radial and ulnar bone shafts. In this patient, an upper arm prosthesis would have been necessary if lower arm bone shafts had been shortened for primary wound closure. Therefore, the newly formed stump enabled the patient to wear a forearm prosthetic instead of a less functional upper arm device. In addition, neurovascular tissue transfer facilitates sensory re-innervation, improvement of the healing process and serving a protective function over the covered area. Through co-adaptation of free nerve endings, neuroma formation can also be prevented. To ensure long-term success, it is vital that the patient be in good mental and physical health, as well as demonstrate the capacity for long-term rehabilitation therapy prior to performing such reconstructions.

Level of Evidence: Level V, therapeutic study.

https://ift.tt/2tjmhO8

Clinical Development of HER3-targeting Monoclonal Antibodies: Perils and Progress

Publication date: Available online 18 June 2018
Source:Cancer Treatment Reviews
Author(s): Wolfgang Jacob, Ian James, Max Hasmann, Martin Weisser
The human epidermal growth factor receptor (HER) family consists of four transmembrane receptor tyrosine kinases: epidermal growth factor receptor (EGFR), HER2, HER3, and HER4. They are part of a complex signalling network and stimulate intracellular pathways regulating cell growth and differentiation. So far, monoclonal antibodies (mAbs) and small molecule tyrosine kinase inhibitors targeting EGFR and HER2 have been developed and approved. Recently, focus has turned to HER3 as it may play an important role in resistance to EGFR- and HER2-targeting therapies. HER3-targeting agents have been undergoing clinical evaluation for the last 10 years and currently thirteen mAbs are in phase 1 or 2 clinical studies. Single agent activity has proven to be limited, however, the tolerability was favourable. Thus, combinations of HER3-binding mAbs with other HER-targeting therapies or chemotherapies have been pursued in various solid tumor entities. Data indicate that the HER3-binding ligand heregulin may serve as a response prediction marker for HER3-targeting therapy. Within this review the current status of clinical development of HER3-targeting compounds is described.



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Clinical benefit of controversial first line systemic therapies for advanced stage ovarian cancer – ESMO-MCBS scores

Publication date: Available online 18 June 2018
Source:Cancer Treatment Reviews
Author(s): KE Broekman, M Jalving, H van Tinteren, C Sessa, AKL Reyners
BackgroundThe magnitude of clinical benefit scale (MCBS) was introduced by the European Society of Medical Oncology (ESMO) to quantify the clinical benefit of therapeutic regimens and to prioritise therapies. It distinguishes curative from palliative treatments and ranks their benefit based on overall survival (OS), progression free survival (PFS), quality of life (QoL) and toxicity. Objective of this study on the first line treatment of ovarian cancer was to evaluate the evidence for the current standard of care using the ESMO-MCBSv1.1 with an emphasis on controversial therapeutic options: intraperitoneal chemotherapy, dose-dense paclitaxel and bevacizumab.MethodsPhase III trials, published since 1992, investigating first line systemic treatment of Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage IIB-IV epithelial ovarian cancer were included. Since most studies included patients with FIGO stage IV disease or incomplete debulking, all treatments were judged to be palliative. Treatments were graded 5 to 1 on the ESMO-MCBSv1.1, where grades 5 and 4 represent a high level of clinical benefit.Results55 studies met the inclusion criteria. ESMO-MCBS scores were calculated for eleven studies that showed a statistically significant benefit of the experimental treatment. Intraperitoneal (ip) cisplatin scored a 4 and 3, but two other studies were negative and therefore not scored on the ESMO-MCBS. Dose-dense paclitaxel showed substantial clinical benefit in one study (score 4), but three studies were negative. Addition of bevacizumab also scored a 4 in one study subgroup including high-risk patients but a 2 in another trial with a larger study population.ConclusionBased on ESMO-MCBS scores, dose-dense paclitaxel and intraperitoneal chemotherapy cannot be recommended as standard treatment. Bevacizumab should be considered only in the high-risk population. The ESMO-MCBSv1.1. helps to summarise reported studies on controversial treatment regimens, and identifies their weaknesses.



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Locally advanced gastro-oesophageal cancer: recent therapeutic advances and research directions

Publication date: Available online 18 June 2018
Source:Cancer Treatment Reviews
Author(s): Lorenzo Fornaro, Enrico Vasile, Giuseppe Aprile, Thorsten Oliver Goetze, Caterina Vivaldi, Alfredo Falcone, Salah-Eddin Al-Batran
Gastric (GC) and gastro-oesophageal (GOJC) adenocarcinomas are often considered as a single entity, even though differences exist in epidemiology, clinical presentation, molecular biology and treatment options. Locally advanced, resectable disease represents a particularly challenging scenario, as many critical issues need to be addressed. In both GC and GOJC among Western countries, systemic chemotherapy demonstrated the greatest benefit when administered before and after surgery and perioperative chemotherapy has been set as a standard in this setting. Nonetheless, multiple chemotherapy regimens have been tested and direct comparisons have been only recently presented. Adjuvant chemoradiotherapy is an option as well, but several trials have questioned its role when more effective combination regimens are used. With regards to GOJC, preoperative chemoradiotherapy is an alternative to perioperative chemotherapy, as it is associated with higher pathologic responses and a different toxicity profile: however, a definitive comparison with chemotherapy is ongoing. Herein, we review the current options for the treatment of resectable GC and GOJC and the main open questions in the management of these patients, trying to depict an update of the available algorithms for everyday practice. Moreover, we summarize the design and preliminary results of the randomized trials in progress that will hopefully give definitive answers to the most debated issues in the field.



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Medication-related osteonecrosis of the jaw: prevention, diagnosis and management in patients with cancer and bone metastases

Publication date: Available online 18 June 2018
Source:Cancer Treatment Reviews
Author(s): Sven Otto, Christoph Pautke, Tim Van den Wyngaert, Daniela Niepel, Morten Schiødt
Medication-related osteonecrosis of the jaw (MRONJ) is primarily an adverse side effect of denosumab or bisphosphonates (particularly when used at high doses to prevent skeletal-related events [SREs] in patients with cancer and bone metastases) or possibly anti-angiogenic cancer treatment. While the implementation of preventive measures over recent years has reduced the risk of MRONJ in patients with bone metastases due to cancer, it is imperative to balance the risk of MRONJ against the beneficial effects of treatment with denosumab or bisphosphonates on the skeletal health of patients. Despite growing awareness of MRONJ within the medical community, there is a lack of large-scale, prospective clinical studies in this rapidly evolving field. Discussing preventive measures with patients and implementing them, both before and during treatment with bisphosphonates or denosumab, is the best option to reduce the risk of MRONJ. In particular, avoiding bone trauma and preventing and treating dental infections before and during denosumab or bisphosphonate therapy is crucial to minimize the risk of MRONJ. If MRONJ develops, conservative (non-surgical) treatment can provide symptom relief, but achieving mucosal closure remains challenging. When management of symptoms and mucosal healing are the ultimate goals of therapy, or after failure of conservative treatment, a surgical approach may be beneficial. This critical review, based on a best-evidence review of currently available literature, provides clear practical guidelines to help to prevent, manage and treat MRONJ. Overall, a multidisciplinary, pragmatic approach to MRONJ should be adopted, prioritizing patient's quality of life and management of their skeletal malignant disease.



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The poor design of clinical trials of statins in oncology may explain their failure – lessons for drug repurposing

Publication date: Available online 18 June 2018
Source:Cancer Treatment Reviews
Author(s): Marwan I. Abdullah, Elizabeth de Wolf, Mohammed J. Jawad, Alan Richardson
Statins are widely used to treat hypercholesterolaemia. However, by inhibiting the production of mevalonate, they also reduce the production of several isoprenoids that are necessary for the function of small GTPase oncogenes such as Ras. As such, statins offer an attractive way to inhibit an "undruggable" target, suggesting that they may be usefully repurposed to treat cancer. However, despite numerous studies, there is still no consensus whether statins are useful in the oncology arena. Numerous preclinical studies have provided evidence justifying the evaluation of statins in cancer patients. Some retrospective studies of patients taking statins to control cholesterol have identified a reduced risk of cancer mortality. However, prospective clinical studies have mostly not been successful. We believe that this has occurred because many of the prospective clinical trials have been poorly designed. Many of these trials have failed to take into account some or all of the factors identified in preclinical studies that are likely to be necessary for statins to be efficacious. We suggest an improved trial design which takes these factors into account. Importantly, we suggest that the design of clinical trials of drugs which are being considered for repurposing should not assume it is appropriate to use them in the same way as they are used in their original indication. Rather, such trials deserve to be informed by preclinical studies that are comparable to those for any novel drug.



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Autopsy as a Source of Discovery in Cardiovascular Medicine: Then and Now.

Author: Thiene, Gaetano MD; Saffitz, Jeffrey E. MD, PhD

Page: 2683-2685

https://ift.tt/2K1l3l0

Autopsy 2018: Still Necessary, Even if Occasionally Not Sufficient.

Author: Goldman, Lee MD, MPH

Page: 2686-2688

https://ift.tt/2K20JMM

Prospective Countywide Surveillance and Autopsy Characterization of Sudden Cardiac Death: POST SCD Study.

Author: Tseng, Zian H. MD, MAS; Olgin, Jeffrey E. MD; Vittinghoff, Eric PhD; Ursell, Philip C. MD; Kim, Anthony S. MD, MAS; Sporer, Karl MD; Yeh, Clement MD; Colburn, Benjamin MD; Clark, Nina M. BS; Khan, Rana BA; Hart, Amy P. MD; Moffatt, Ellen MD

Page: 2689-2700

https://ift.tt/2K4sRlV

Cardiac and Noncardiac Causes of Apparent Sudden Arrhythmic Deaths: Shadows in a Spectrum.

Author: Myerburg, Robert J. MD

Page: 2701-2704

https://ift.tt/2JVD1BP

Importance of Variant Interpretation in Whole-Exome Molecular Autopsy: Population-Based Case Series.

Author: Shanks, Garrett W. BS *,; Tester, David J. BS *,; Ackerman, Jaeger P. BS; Simpson, Michael A. PhD; Behr, Elijah R. MD; White, Steven M. MD, PhD; Ackerman, Michael J. MD, PhD

Page: 2705-2715

https://ift.tt/2K68tRy

Primary Myocardial Fibrosis as an Alternative Phenotype Pathway of Inherited Cardiac Structural Disorders.

Author: Junttila, M. Juhani MD *,; Holmstrom, Lauri BM *,; Pylkas, Katri PhD; Mantere, Tuomo PhD; Kaikkonen, Kari MD; Porvari, Katja PhD; Kortelainen, Marja-Leena MD; Pakanen, Lasse MD; Kerkela, Risto MD; Myerburg, Robert J. MD; Huikuri, Heikki V. MD

Page: 2716-2726

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Bringing Autopsies Into the Molecular Genetic Era.

Author: Judge, Daniel P. MD; Brown, Emily E. MGC, CGC

Page: 2727-2729

https://ift.tt/2K45HMg

Cardiac Implantable Electronic Device Interrogation at Forensic Autopsy: An Underestimated Resource?.

Author: Lacour, Philipp MD *,; Buschmann, Claas MD *,; Storm, Christian MD; Nee, Jens MD; Parwani, Abdul Shokor MD; Huemer, Martin MD; Attanasio, Philipp MD; Boldt, Leif-Hendrik MD; Rauch, Geraldine PhD; Kucher, Andreas PhD; Pieske, Burkert MD; Haverkamp, Wilhelm MD; Blaschke, Florian MD

Page: 2730-2740

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Proteomic Architecture of Human Coronary and Aortic Atherosclerosis.

Author: Herrington, David M. MD, MHS *,; Mao, Chunhong PhD; Parker, Sarah J. PhD; Fu, Zongming PhD; Yu, Guoqiang PhD; Chen, Lulu MS; Venkatraman, Vidya MS; Fu, Yi MS; Wang, Yizhi MS; Howard, Timothy D. PhD; Jun, Goo PhD; Zhao, Caroline F.; Liu, Yongmei PhD; Saylor, Georgia; Spivia, Weston R. MS; Athas, Grace B. PhD; Troxclair, Dana MD; Hixson, James E. PhD *,; Vander Heide, Richard S. MD, PhD, MBA *,; Wang, Yue PhD *,; Van Eyk, Jennifer E. PhD *,

Page: 2741-2756

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Correction to: Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury.

Author:

Page: e853

https://ift.tt/2I2vm2S

SPARTAN promotes genetic diversification of the immunoglobulin-variable gene locus in avian DT40 cells

Publication date: Available online 18 June 2018
Source:DNA Repair
Author(s): Arisa Nakazato, Kinumi Kajita, Masato Ooka, Remi Akagawa, Takuya Abe, Shunichi Takeda, Dana Branzei, Kouji Hirota
Prolonged replication arrest on damaged templates is a cause of fork collapse, potentially resulting in genome instability. Arrested replication is rescued by translesion DNA synthesis (TLS) and homologous recombination (HR)-mediated template switching. SPARTAN, a ubiquitin-PCNA-interacting regulator, regulates TLS via mechanisms incompletely understood. Here we show that SPARTAN promotes diversification of the chicken DT40 immunoglobulin-variable λ gene by facilitating TLS-mediated hypermutation and template switch-mediated gene-conversion, both induced by replication blocks at abasic sites. SPARTAN^-/- and SPARTAN^-/-/Polη^-/-/Polζ^-/- cells showed defective and similar decrease in hypermutation rates, as well as alterations in the mutation spectra, with decreased dG-to-dC transversions and increased dG-to-dA transitions. Strikingly, SPARTAN^-/- cells also showed reduced template switch-mediated gene-conversion at the immunoglobulin locus, while being proficient in HR-mediated double strand break repair, and sister chromatid recombination. Notably, SPARTAN's ubiquitin-binding zinc-finger 4 domain, but not the PCNA interacting peptide domain or its DNA-binding domain, was specifically required for the promotion of immunoglobulin gene-conversion, while all these three domains were shown to contribute similarly to TLS. In all, our results suggest that SPARTAN mediates TLS in concert with the Polη-Polζ pathway and that it facilitates HR-mediated template switching at a subset of stalled replication forks, potentially by interacting with unknown ubiquitinated proteins.



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Immune check-point in cervical cancer

Publication date: Available online 18 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): F. De Felice, C. Marchetti, I. Palaia, R. Ostuni, L. Muzii, V. Tombolini, P. Benedetti Panici
Despite different treatment strategies, locally advanced cervical cancer (CC) persists as one of the most incurable cancers among women worldwide. In fact, this setting of patients are at high risk of persistent and recurrent disease. In recent years, researches have investigated immune check-point inhibitors in hopes of determining improved response to therapy with prolongation of survival.We reviewed the published literature and conference proceedings and presented pivotal trials supporting immune check-point inhibitors use in the treatment of CC.



https://ift.tt/2JZisI3

The changing scenario of 1st line therapy in non-oncogene addicted NSCLCs in the era of immunotherapy

Publication date: Available online 18 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): A Russo, T Franchina, GRR Ricciardi, G Toscano, S Schifano, G Lo Certo, A Battaglia, E Pantò, M Scaffidi Fonti, V Adamo
During the last two decades front-line treatment of metastatic Non Small Cell Lung Cancer (NSCLC) has profoundly changed moving from the old "one size fits all" concept to a "histology-based" approach and then, for a small subgroup of patients to a "molecularly-selected" one. The development of immune checkpoint inhibitors and the unprecedented results reported in 2^nd/3^rd line prompted the evaluation of these novel therapeutic agents in chemotherapy-naïve patients either alone or in combination with platinum-based chemotherapy. Several randomized trials are evaluating the impact of immune-checkpoint inhibitors in 1^st line and some of them have yet produced preliminary evidence of efficacy. However, still a long way to go and several questions are still unanswered, including proper patients selection, optimal sequential/combinatorial use of these agents, appropriate treatment duration, and finally the identification of predictive biomarkers. The aim of this paper is to provide a comprehensive overview on the growing role of immune checkpoint inhibitors in the upfront treatment of advanced non-oncogene addicted NSCLC either as single agent or in combination with other agents.



https://ift.tt/2JVYaMh

Role of complement C5a and histones in septic cardiomyopathy

Publication date: Available online 18 June 2018
Source:Molecular Immunology
Author(s): Fatemeh Fattahi, Lynn M. Frydrych, Guowu Bian, Miriam Kalbitz, Todd J. Herron, Elizabeth A. Malan, Matthew J. Delano, Peter A. Ward
Polymicrobial sepsis (after cecal ligation and puncture, CLP) causes robust complement activation with release of C5a. Many adverse events develop thereafter and will be discussed in this review article. Activation of complement system results in generation of C5a which interacts with its receptors (C5aR1, C5aR2). This leads to a series of harmful events, some of which are connected to the cardiomyopathy of sepsis, resulting in defective action potentials in cardiomyocytes (CMs), activation of the NLRP3 inflammasome in CMs and the appearance of extracellular histones, likely arising from activated neutrophils which form neutrophil extracellular traps (NETs). These events are associated with activation of mitogen-activated protein kinases (MAPKs) in CMs. The ensuing release of histones results in defective action potentials in CMs and reduced levels of [Ca²⁺]i-regulatory enzymes including sarco/endoplasmic reticulum Ca²⁺-ATPase (SERCA2) and Na⁺/Ca²⁺ exchanger (NCX) as well as Na⁺/K⁺-ATPase in CMs. There is also evidence that CLP causes release of IL-1β via activation of the NLRP3 inflammasome in CMs of septic hearts or in CMs incubated in vitro with C5a. Many of these events occur after in vivo or in vitro contact of CMs with histones. Together, these data emphasize the role of complement (C5a) and C5a receptors (C5aR1, C5aR2), as well as extracellular histones in events that lead to cardiac dysfunction of sepsis (septic cardiomyopathy).



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Common and rare genetic variants of complement components in human disease

Publication date: Available online 18 June 2018
Source:Molecular Immunology
Author(s): Elena Goicoechea de Jorge, Alberto López Lera, Rafael Bayarri-Olmos, Hugo Yebenes, Margarita Lopez-Trascasa, Santiago Rodríguez de Córdoba
Genetic variability in the complement system and its association with disease has been known for more than 50 years, but only during the last decade have we begun to understand how this complement genetic variability contributes to the development of diseases. A number of reports have described important genotype-phenotype correlations that associate particular diseases with genetic variants altering specific aspects of the activation and regulation of the complement system. The detailed functional characterization of some of these genetic variants provided key insights into the pathogenic mechanisms underlying these pathologies, which is facilitating the design of specific anti-complement therapies. Importantly, these analyses have sometimes revealed unknown features of the complement proteins. As a whole, these advances have delineated the functional implications of genetic variability in the complement system, which supports the implementation of a precision medicine approach based on the complement genetic makeup of the patients. Here we provide an overview of rare complement variants and common polymorphisms associated with disease and discuss what we have learned from them.



https://ift.tt/2K2fRNt

Recovery of ilmenite mud as an additive in commercial Portland cements

Abstract

This work is focused on the manufacture of commercial cement using as additive ilmenite mud, a waste generated during TiO₂ pigment production. The cements were produced by adding different proportions of mud (2.5, 5 and 10 wt%) to ordinary Portland cement (OPC). The ilmenite mud and the ilmenite mud cements (IMCs) were characterised physico-chemically by X-ray fluorescence (XRF), inductively coupled plasma mass spectrometry (ICP-MS) and X-ray diffraction (XRD). Moreover, the technological properties of the IMCs were evaluated and compared with a reference material (OPC). Since waste from the TiO₂ industry is classified as a NORM (naturally occurring radioactive material), the concentrations of radionuclides were measured by high-resolution low-background gamma and alpha spectrometry techniques. Finally, the TCLP leaching test (Toxicity Characteristic Leaching Procedure, USEPA), the radiological index ("I") and the Ra equivalent concentration were also calculated to evaluate the environmental risks. As a final conclusion, it can be pointed out that the addition of ilmenite mud to OPC plays a beneficial role since it reduces the heat of hydration, the final setting time, the expansion and the linear retraction compared to standard OPC. The compression strength improves with the addition of up to 5 wt% mud. Moreover, the environmental impact of IMC2.5 and IMC5 can be considered negligible.

https://ift.tt/2liTshb

The effect of surgical weight loss on obstructive sleep apnoea: A systematic review and meta-analysis

This review aimed to examine the relationship between surgical weight loss and obstructive sleep apnoea (OSA) severity (i.e. apnoea-hypopnoea index [AHI]), and how this relationship is altered by the various respiratory events scoring (RES) criteria used to derive the AHI. A systematic search of the literature was performed up to December 2017. Before-and-after studies were considered due to a paucity of randomised controlled trials (RCTs) available to be reviewed in isolation. Primary outcomes included pre- and post-surgery AHI and body mass index (BMI).

https://ift.tt/2t8KCGS

Tolerability and Efficacy of Ipragliflozin in The Management of Inadequately Controlled Type 2 Diabetes mellitus: A Systematic Review and Meta-analysis

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0579-7860

Aim Ipragliflozin is a new antidiabetic agent that works through enhancing renal glucose excretion. We aim to synthesize evidence from published randomized controlled trials (RCTs) on the safety and efficacy of ipragliflozin in the management of type 2 diabetes mellitus (T2DM). Methods We searched PubMed, Scopus, Web of Science, and Cochrane Central register of clinical trials using relevant keywords. Records were screened for eligible studies and data were extracted and synthesized using Review Manager Version 5.3 for windows. Subgroup and sensitivity analyses were conducted. Results We included 13 RCTs (N=2535 patients) in the final analysis. The overall effect estimates favoured ipragliflozin 50mg monotherapy group over placebo in terms of: HbA1c (Standardized mean difference (SMD)=-1.20%, 95% Confidence interval (95% CI)=[-1.47, -0.93]; p<0.001), fasting plasma glucose (SMD=-1.30 mg/dL, 95% CI [−1.93, −0.67]; p<0.001), fasting serum insulin (SMD=−1.64 μU/mL, 95% CI [−2.70, −0.59]; p=0.002), and body weight (SMD=−0.85 kg, 95% CI [−1.19, −0.51]; p<0.001). Similarly, better glycemic control and significant body weight reduction compared to placebo were attained in ipragliflozin 50 mg combination with metformin, insulin with/without dipeptidyl peptidase-4 inhibitor, sulfonylurea, and pioglitazone. Ipragliflozin, either alone or in combination, exhibits acceptable safety profile. Conclusion The presented meta-analysis provides class one evidence that ipragliflozin is safe and effective in the management of T2DM either as monotherapy or an add-on.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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An investigation of the effects of capping on internal phosphorus release from sediments under rooted macrophytes ( Phragmites australis ) revegetation

Abstract

In eutrophic lake restorations, in situ capping is an often considered method to control sediment internal phosphorus (P) pollution for mitigating eutrophication status. Subsequent aquatic macrophyte revegetation can directly derive P from the sediment for growth. However, the effects of capping with clean soils on internal P release from sediments under rooted aquatic macrophyte revegetation are still unclear. In the present study, the influences of sediment P remobilization by P. australis revegetation on P inactivation by capping were investigated based on an entire growth simulation study. Our findings showed during the growth of P. australis, tests conducted on total phosphorous (TP), calcium-bound P (Ca-P), loosely bound P (loose-P), organic P (Org-P), and iron-adsorbed P (Fe-P) found significant changes (p < 0.001). Specifically, the mean contents of TP and Ca-P decreased by 291.1 and 224.2 mg kg⁻¹, respectively, while those of Fe-P increased from 26.4 to 124.8 mg kg⁻¹. In addition, sediment mobile-P contents increased coincidentally with the growth of P. australis during the whole course of experiment. Further analysis indicated calculated diffusion fluxes of soluble reactive phosphorus (SRP) generally increased with incubation time, although capping effectively induced the reduction of SRP concentration in pore water and its release to waters. Therefore, sediment P remobilization by P. australis revegetation was able to enhance P lability in lake sediments, with intermediate activation ability compared to other correlated water bodies. This phenomenon was most likely attributed to solubilization of sediment P by organic acids secreted from P. australis rhizosphere. Overall, sediment P remobilization by rooted macrophytes is unfavorable for capping to control internal P release to water column during eutrophic lake restorations.

https://ift.tt/2ymQNw8

Retrospective evaluation of fidaxomicin versus oral vancomycin for treatment of Clostridium difficile infections in allogeneic stem cell transplant

Publication date: Available online 18 June 2018
Source:Hematology/Oncology and Stem Cell Therapy
Author(s): Laura Prohaska, Zahra Mahmoudjafari, Leyla Shune, Anurag Singh, Tara Lin, Sunil Abhyankar, Siddhartha Ganguly, Dennis Grauer, Joseph McGuirk, Lisa Clough
Objective/backgroundClostridium difficile infection (CDI) is a potential complication during hematopoietic stem cell transplantation (HSCT), and no specific recommendations exist regarding treatment of CDI in allogeneic SCT patients. Use of metronidazole and oral vancomycin has been associated with clinical failure. Fidaxomicin has previously been found noninferior to the use of oral vancomycin for the treatment of CDI, and no studies have compared the use of oral vancomycin with fidaxomicin for the treatment of CDI in allogeneic SCT.MethodsThis retrospective chart review included 96 allogeneic SCT recipients who developed CDI within 100 days following transplantation. Participants were treated with oral vancomycin (n = 52) or fidaxomicin (n = 44). The primary outcome was clinical cure, defined as no need for further retreatment 2 days following completion of initial CDI treatment. Secondary outcomes were global cure, treatment failure, and recurrent disease.ResultsNo differences in clinical cure were observed between patients receiving oral vancomycin or fidaxomicin (75% vs. 75%, p = 1.00). Secondary outcomes were similar between oral vancomycin and fidaxomicin in regards to global cure (66% vs. 67%, p = .508), treatment failure (28% vs. 27%, p = .571), and recurrent disease (7% vs. 5%, p = .747). In a subanalysis of individuals that developed acute graft-versus-host disease following CDI, the difference in mean onset of acute graft-versus-host disease was 21.03 days in the oral vancomycin group versus 32.88 days in the fidaxomicin group (p = .0031).ConclusionThe findings of this study suggest that oral vancomycin and fidaxomicin are comparable options for CDI treatment in allogeneic SCT patients within 100 days following transplant.



https://ift.tt/2tpEfP5

A New Method for Mild Blepharoptosis Correction using Orbital Septum

Blepharoptosis greatly affects the eyelid appearance. Moderate to severe ptosis is easily distinguished. However, mild ptosis is often overlooked or easily missed. The normal upper eyelid is located in the middle horizontal line between the upper edge of the pupil and the upper edge of the cornea while the patient looks straight ahead; that is, the upper eyelid covers 1.5 to 2.0 mm of the cornea. Mild blepharoptosis is diagnosed when the upper eyelid covers the cornea over the normal level to the upper edge of the pupil; the upper eyelid falls about 1 to 2 mm.

https://ift.tt/2yk2cNp

Anatomical Variability of the Infra-mammary Fold and its Dynamics in Relation to Lejour Mammoplasty

The IMF is a defining element in the shape and structure of the female breast. 1 The anatomy and tissue components of the IMF have been a matter of controversy among plastic surgeons and anatomists. Some have attributed formation of the fold to a distinct ligament, 2,3 while others described a superficial fascial system. 4,5 Despite this controversy; most of the plastic surgeons settled on a thought that the preservation of the integrity of the IMF is an important goal in enhancing the aesthetic result in all breast surgeries.

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BAPRAS and BAAPS Scientific Meetings: Are we sticking our noses up at rhinoplasty?

Dear Sir,

https://ift.tt/2yipG5k

The effects of DMARDs on the expression and function of P-gp, MRPs, BCRP in the treatment of autoimmune diseases

Publication date: September 2018
Source:Biomedicine & Pharmacotherapy, Volume 105
Author(s): Yi-jin Wu, Chun Wang, Wei Wei
The ATP-binding cassette (ABC) transporter family is a large class of ATP energy-dependent transmembrane proteins, and its primary function is to use the energy produced by ATP hydrolysis to transfer the substrate bound to the plasma membrane. This family is also closely related to multidrug resistance (MDR) in various diseases. Among the ABC transporter proteins, P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP) and breast cancer resistance protein (BCRP) are the main members associated with MDR. At present, the roles of these transporters in therapeutic failures have been extensively studied and reviewed in cancer; however, they have rarely been described in autoimmune diseases (AIDs). AID is a group of chronic inflammatory diseases of unknown aetiology. AID's basic feature is the production of a large number of autoantibodies, which leads to extensive damage to multiple systems and multiple organs. Disease-modifying anti-rheumatic drugs (DMARDs) are commonly used in the treatment of AID, but a considerable number of patients have no response or develop resistance to these drugs over time. This phenomenon may be related to the abnormal expression of the ABC transporter, which leads to a decrease in the amount of drug entering cells that produce MDR. This article reviews the effects of DMARDs on the expression and function of P-gp, MRPs, and BCRP and the related molecular mechanism in the treatment of AID.

Graphical abstract

https://ift.tt/2tkbuTA

Arsenic contamination, subsequent water toxicity, and associated public health risks in the lower Indus plain, Sindh province, Pakistan

Abstract

Arsenic (As) contamination in drinking water is a global public health risk. The present study highlighted the geological and anthropogenic causes of As contamination in groundwater (GW) and surface water (SW) and assessment of their potential health risks in Sindh province of Pakistan. Upon analyzing 720 GW and SW samples from 18 different sites, the estimates of As in groundwater and surface water was observed in the range of 0 to 125 and 0 to 35 μg/L with mean values of 46.8 and 15.43 μg/L respectively. Majority of the samples exceeded WHO permissible limit of As (10 μg/L) with higher concentration detected in groundwater samples compared to surface water. Moreover, both of these sample sources were found not potable based on physicochemical characteristics. The results of statistical analysis (correlation analysis, principal component analysis (PCA), and hierarchy cluster analysis (HCA)) indicate that natural mobilization of As in groundwater is believed to be enhanced by the pH-based reductive dissolution of iron hydroxide (FeOH) and competitive sorption of bicarbonate minerals in the presence of microorganisms along with evaporative enrichment while water logging, coal mining, and excessive use of pesticides are believed to be the anthropogenic causes of As enrichment. Furthermore, enormous health risk was associated with As in terms of chronic daily intake (CRI), hazard quotient (HQ), and cancer risk probability (CR) in GW and SW. Mean HQ values in GW were 4.47 mg/kg/day in adults and 3.89 mg/kg/day in children (standard HQ ≤ 1) and was 1.43 and 1.28 mg/kg/day in SW. Mean CR value in both GW and SW was found higher than the safe limit (10⁻⁶) having a mean of 2 × 10⁻³ in GW and 7 × 10⁻⁴ (mg/kg/day) in SW. These findings suggest that majority of the sampling sites carry serious public health risk due to high As values and hence demands exigent remedial and management measures.

https://ift.tt/2JYU3zk

Negative affect and past month binge eating may drive perceptions of loss of control

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): A.R. Bottera, A.M. Thiel, K.P. De Young
ObjectiveTo evaluate how subjective control over intake is influenced by objective aspects of consumption, negative affect, and recent binge eating.Method105 participants with or without current binge eating (BE) consumed a meal replacement shake following a 12-hour overnight fast in a 2 × 2 design: participants were instructed to either consume the entire shake (no control) or decide on their own how much to consume (affirmative control). They were allotted either 5 (fast) or 15 (slow) minutes to complete the task. Participants reported on subjective control and negative affect following consumption.ResultsCompared to the slow condition, participants in the fast condition reported higher negative affect after eating. Individuals without a history of BE reported lower subjective control in the no control compared to the affirmative control condition; however, this pattern was reversed among those with BE, such that individuals reported higher subjective control following consumption in the no control condition. In addition, subjective control was positively associated with negative affect in the no control condition whereas it was negatively associated with negative affect in the affirmative control condition.DiscussionEating rate influences affect, and subjective control over eating may be the result of an interaction of objective control with affect. Thus, distress may drive perceptions of control. This should be directly tested in future studies and has implications for how we understand BE.



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No effect of focused attention whilst eating on later snack food intake: Two laboratory experiments

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): Victoria Whitelock, Suzanne Higgs, Jeffrey M. Brunstrom, Jason C.G. Halford, Eric Robinson
Focusing attention on food during a meal has been shown to reduce later snack consumption. We report the results of two studies that aimed to replicate this effect and to elucidate the underlying mechanisms. We hypothesised that focused attention during a lunchtime meal would improve visual memory and/or memory for the satiating effects of the meal, and that this would reduce later food intake. In Study 1, participants (N = 108, 52.8% female, BMI M = 25.75 kg/m²) were randomly allocated to eat a fixed lunchtime meal while listening to instructions that encouraged them to pay attention to the sensory properties of the meal (focused attention condition), or to one of two control conditions. To determine whether the effect of focused attention on later food intake is influenced by meal satisfaction, in a second study, participants (N = 147, 100% female, BMI M = 25.15 kg/m²) were given either a satisfying or dissatisfying lunch. In both studies, after 3 h participants ate snack food ad libitum and completed assessments of their memory for the recent lunch. In both studies there was no effect of focused attention on later food intake. In Study 2, the effect of focused attention on later food intake was not moderated by meal satisfaction. In both studies focused attention did not improve memory for the lunch meal. The present studies failed to replicate the effect of focused attention on later food intake and this may be because focused attention did not improve memory for the lunchtime meal. Further research should examine the conditions under which attention during eating influences memory encoding and food intake.



https://ift.tt/2JY48MX

Transcatheter Tricuspid Valve Interventions: Landscape, Challenges, and Future Directions

Abstract

Tricuspid regurgitation is a common finding in patients with left-sided valvular or myocardial disease, often being a marker for late-stage chronic heart failure with a grim prognosis. However, isolated tricuspid valve surgery remains infrequent and is associated with the highest mortality among all valve procedures. Hence, a largely unmet clinical need exists for less invasive therapeutic options in these patients. In recent times, multiple percutaneous therapies have been developed for treating severe tricuspid regurgitation, including tricuspid valve repair and, more recently replacement, opening an entirely new venue for managing tricuspid regurgitation. The aim of this review is to provide an updated overview and a clinical perspective on novel transcatheter tricuspid valve therapies, highlighting potential challenges and future directions.

https://ift.tt/2JXSzp1

Critical Appraisal of the 2018 ACC Scientific Sessions Late-Breaking Trials From a Statistician's Perspective

Abstract

The late-breaking clinical trials presentations at the American College of Cardiology Scientific Sessions in March 2018 are an important contribution to the field of cardiology. This paper presents a constructive critical appraisal of 7 key studies: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), VEST (Vest Prevention of Early Sudden Death Trial), SECURE-PCI (Statins Evaluation in Coronary Procedures and Revascularization), TREAT (Ticagrelor in Patients with ST-Elevation Myocardial Infarction treated with Pharmacological Thrombolysis), POISE (PeriOperative ISchemic Evaluation), SMART-DATE (Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome), and CVD-REAL 2 (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors). For each study, our aim is to document and interpret the main findings, noting particularly when "positive spin" appears to occur, and to provide a balanced account of each study, paying attention to both constructive new findings and study limitations. These topical examples also provide useful general insights on what to look for when critiquing clinical trial presentations and publications.

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JACC Instructions for Authors

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Myocardial Edema and Prognosis in Amyloidosis

AbstractBackground

Prognosis in light-chain (AL) and transthyretin (ATTR) amyloidosis is influenced by cardiac involvement. ATTR amyloidosis has better prognosis than AL amyloidosis despite more amyloid infiltration, suggesting additional mechanisms of damage in AL amyloidosis.

Objectives

The aim of the study was to assess the presence and prognostic significance of myocardial edema in patients with amyloidosis.

Methods

The study recruited 286 patients: 100 with systemic AL amyloidosis, 163 with cardiac ATTR amyloidosis, 12 with suspected cardiac ATTR amyloidosis (grade 1 on ^99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid), 11 asymptomatic individuals with amyloidogenic TTR gene mutations, and 30 healthy volunteers. All subjects underwent cardiovascular magnetic resonance with T1 and T2 mapping and 16 underwent endomyocardial biopsy.

Results

Myocardial T2 was increased in amyloidosis with the degree of elevation being highest in untreated AL patients (untreated AL amyloidosis 56.6 ± 5.1 ms; treated AL amyloidosis 53.6 ± 3.9 ms; ATTR amyloidosis 54.2 ± 4.1 ms; each p < 0.01 compared with control subjects: 48.9 ± 2.0 ms). Left ventricular (LV) mass and extracellular volume fraction were higher in ATTR amyloidosis compared with AL amyloidosis while LV ejection fraction was lower (p < 0.001). Histological evidence of edema was present in 87.5% of biopsy samples ranging from 5% to 40% myocardial involvement. Using Cox regression models, myocardial T2 predicted death in AL amyloidosis (hazard ratio: 1.48; 95% confidence interval: 1.20 to 1.82) and remained significant after adjusting for extracellular volume fraction and N-terminal pro–B-type natriuretic peptide (hazard ratio: 1.32; 95% confidence interval: 1.05 to 1.67).

Conclusions

Myocardial edema is present in cardiac amyloidosis by histology and cardiovascular magnetic resonance T2 mapping. T2 is higher in untreated AL amyloidosis compared with treated AL and ATTR amyloidosis, and is a predictor of prognosis in AL amyloidosis. This suggests mechanisms additional to amyloid infiltration contributing to mortality in amyloidosis.

https://ift.tt/2tk3zFS

Troponin Release and Reversible Left Ventricular Dysfunction After Transient Pressure Overload

AbstractBackground

The authors previously demonstrated that brief ischemia elicits cardiac troponin I (cTnI) release and myocyte apoptosis in the absence of necrosis. It remains uncertain whether other pathophysiological stresses can produce apoptosis and transient cTnI release without ischemia.

Objectives

This study sought to determine whether a transient increase in left ventricular (LV) preload elicits cTnI release in the absence of ischemia.

Methods

Propofol-anesthetized swine (N = 13) received intravenous phenylephrine (PE) (300 μg/min) for 1 h to increase left ventricular end-diastolic pressure (LVEDP) to ~30 mm Hg. Serial cTnI and echocardiographic function were assessed for 24 h, and myocardial tissue was analyzed for apoptosis and necrosis.

Results

PE infusion increased systolic blood pressure from 137 ± 14 mm Hg to 192 ± 11 mm Hg (mean ± SD; p < 0.001) and increased LVEDP from 17 ± 2 mm Hg to 30 ± 5 mm Hg (p < 0.001). Myocardial flow measurements demonstrated no evidence of ischemia. Hemodynamics normalized rapidly after PE, but LV ejection fraction remained depressed (32 ± 21% vs. 58 ± 7%; p < 0.01) with normalization after 24 h (51 ± 16%; p = 0.31). Baseline transcoronary cTnI release was low (16 ± 20 ng/l) but increased to 856 ± 956 ng/l (p = 0.01) 1 h after LVEDP elevation. Circulating cTnI rose above the 99th percentile within 30 min and remained elevated at 24 h (1,462 ± 1,691 ng/l). Pathological analysis demonstrated myocyte apoptosis at 3 h (31.3 ± 11.9 myocytes/cm² vs. 4.6 ± 3.7 myocytes/cm²; p < 0.01), that normalized after 24 h (6.2 ± 5.6 myocytes/cm²; p = 0.46) without histological necrosis.

Conclusions

Transient elevations of LVEDP lead to cTnI release, apoptosis, and reversible stretch-induced stunning in the absence of ischemia. Thus, preload-induced myocyte injury may explain many cTnI elevations seen in the absence of clinical signs or symptoms of myocardial ischemia.

https://ift.tt/2tk3EcE

Protocol-Driven CI-AKI Prevention in the Cath Lab

https://ift.tt/2JNJVx1

Correction

https://ift.tt/2MEAKN8

Angioscopic Evaluation of Spontaneously Ruptured Aortic Plaques

AbstractBackground

Spontaneous ruptured aortic plaques (SRAP), which might cause atheromatous embolization, are thought to be mainly iatrogenic and have not been observed directly.

Objectives

The purpose of this study was to clarify the incidence, types, and dimensions of SRAP using angioscopy.

Methods

In a cross-sectional study, 324 consecutive patients diagnosed with or suspected of having coronary artery disease were subjected to intra-aortic scans with nonobstructive angioscopy. Samples of SRAP were taken from the aorta. The dimensions of cholesterol crystals of atheromatous materials were measured with a polarizing microscope and compared with those of the ghost images of cholesterol crystals.

Results

SRAP were detected in 262 patients (80.9%); 120 of 262 patients had ruptured aortic plaques below the diaphragmatic level. Samples were successfully obtained from 96 patients. The detected numbers of atheromatous material, fibrin, macrophage, and calcification were 237 (49.1%), 244 (50.6%), 111 (23.0%), and 127 (26.3%) out of 482 samples, respectively. The median lengths and widths of the sampled plaques were 254 μm (interquartile range [IQR]: 100 to 685 μm) and 148 μm (IQR: 535 to 423.5 μm), respectively. The lengths and widths of the cholesterol crystals isolated from atheromatous materials were 40 μm (IQR: 32.7 to 53.7 μm), and 30 μm (IQR: 23 to 38 μm), respectively, compared with the respective dimensions of the ghost images of 86 μm (IQR: 53 to 119) and 13 μm (IQR: 7 to 18 μm). No embolic symptoms were observed within 24 h of general care via cardiac catheterization.

Conclusions

SRAP are commonly scattered, and their dimensions were smaller than previously recognized. (Detecting Ruptured Aortic Plaques by Nonobstructive Angioscopy; UMIN000029772)

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Unraveling the Mystery of Troponin Elevation in Heart Failure

https://ift.tt/2MAfdFC

Is Spontaneous Rupture of Aortic Plaques Truly More Common Than Believed?

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Cardiovascular Magnetic Resonance in Cardiac Amyloidosis: T1 Is Not Enough

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Correction

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Cardio-Oncology for GenNext: A Missing Piece of the Training Puzzle

https://ift.tt/2JVBfAU

Geriatric Cardiology: Two Decades of Progress and Strategy for the Future

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Additional Arterial Conduits in Coronary Artery Bypass Surgery: Finally Coming of Age

https://ift.tt/2MEBdPo

RESPONSE: A Call to Action for Established Cardio-Oncologists: Time to Train the Future

https://ift.tt/2MEB5iS

Noninvasive Assay for Donor Fraction of Cell-Free DNA in Pediatric Heart Transplant Recipients

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Aortic Stenosis, Left Ventricular Remodeling, and Renin-Angiotensin System Blockade

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Reply: Aortic Stenosis, Left Ventricular Remodeling, and Renin-Angiotensin System Blockade

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Revascularization Strategies in Patients With Acute MI and Cardiogenic Shock

https://ift.tt/2t90ZDt

Androgen Receptor and Ki67 Expression and Survival Outcomes in Non-small Cell Lung Cancer

Abstract

Lung cancer is the most common cause of cancer-related deaths worldwide with non-small cell lung cancer (NSCLC) making up most of these cases. Males have poorer overall survival compared to women following a lung cancer diagnosis. Many studies have focused on the effects of estrogen to explain higher survival rates among women, but few have looked at the effects of androgens. We describe the expression of the androgen receptor (AR) and Ki67 in lung cancer specimens in the Manitoba Tumor Bank (MTB) and correlate these factors with patient outcome. Using the MTB, we performed immunohistochemistry on lung cancer tissue to determine expression of the AR and Ki67. These were then correlated with patient outcome. Of the 136 cases, 55% were female and 55% were adenocarcinoma. AR expression was not independently associated with outcome. Ki67 was associated with a significantly higher hazard ratio for death and recurrence (HR 2.19, 95% CI 1.30–3.70; HR 1.92, 95% CI 1.07–3.46, respectively). AR expression modified the effect of Ki67 on outcome, such that when both were expressed, there was no association with recurrence or survival (HR 2.39, 95% CI 1.31–4.36 for AR− Ki67+ vs HR 1.54, 95% CI 0.44–5.37 for AR+ Ki67+). Ki67 was associated with poorer outcomes alone. AR status alone was not associated with outcome. Although the mechanism remains unclear, AR status seems to negate the association of a high Ki67 and poor outcome.

https://ift.tt/2JXt7Qn

Scholar : These new articles for Advances in Mental Health are available online

The online platform for Taylor & Francis Online content New for Advances in Mental Health and online now on Taylor & Francis Online: Original Articles 'Pets provide meaning and purpose': a qualitative study of pet ownership from the perspectives of people diagnosed with borderline personality disorder Maya Hayden-Evans, Ben Milbourn & Julie Netto Pages: 1-11 | DOI: 10.1080/18387357.2018.1485508 2018 Future Directions Forum JOIN US at the 2018 Future Directions Forum for Journal of Clinical Child & Adolescent Psychology - June 15-16, 2018 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. 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.

Scholar : These new articles for International Journal of Performance Arts and Digital Media are available online

The online platform for Taylor & Francis Online content New for International Journal of Performance Arts and Digital Media and online now on Taylor & Francis Online: Book Review New media dramaturgy: performance, media and new-materialism Sarah Sigal Pages: 1-2 | DOI: 10.1080/14794713.2018.1487550 Book Reviews Culture jamming: activism and the art of cultural resistance Arif Hussain Nadaf Pages: 1-3 | DOI: 10.1080/14794713.2018.1487536 RISE UP and join us at the American Alliance for Theatre & Education National Conference this summer – August 1-5 in Minneapolis! To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. 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 Optimal Dose of Sevoflurane Via Anaconda® in Post-operative Patient Underwent Head & Neck Surgery

Condition:   Patients Who Needs Sedation After Head & Neck Surgery
Interventions:   Procedure: Naso-tracheal group;   Procedure: tracheostomy group
Sponsor:   Yonsei University
Recruiting

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Postural Garment Versus Exercises for Women With Cervical Pain

Conditions:   Posture;   Cervical Pain
Interventions:   Other: Exercises;   Device: Posture garment
Sponsor:   University of Andorra
Recruiting

https://ift.tt/2M2pI3c

Flexible glassy grid structure for rapid degradation of azo dye

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): R. Li, X.J. Liu, H. Wang, Y. Wu, K.C. Chan, Z.P. Lu
Degradation of organic contaminants in industrial wastewaters has become a worldwide conundrum and attracted extensive attention. In this paper, we report a flexible grid structure with uniform mesh fabricated by plain weaving melt-extracted Fe80B20 glassy micro-wires, and the produced wire grid with a dosage of 0.3 g/L can completely degrade 0.2 g/L DB 15 azo dyes for <30 min at room temperature. The calculated degradation efficiency of the sample is approximately 4.3 min, 2.1 times faster than that of the Fe80B20 glassy ribbons and 28 times for commercial pure Fe powders. The enhanced degradation performance is primarily attributed to the uniform grid structure with high internal surface area in addition to the intrinsic activity of metallic glasses. Our findings not only provide high-performance candidate for degrading and filtering wastewater with organic pollutant simultaneously, but also promote the practical applications of metallic glasses as functional materials.

Graphical abstract

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Data on eye movements in people with glaucoma and peers with normal vision

Publication date: August 2018
Source:Data in Brief, Volume 19
Author(s): Daniel S. Asfaw, Pete R. Jones, Nicholas D. Smith, David P. Crabb
Eye movements of glaucoma patients have been shown to differ from age-similar control groups when performing everyday tasks, such as reading (Burton et al., 2012; Smith et al., 2014) [1,2], visual search (Smith et al., 2012) [3], face recognition (Glen et al., 2013) [4], driving, and viewing static images (Smith et al., 2012) [5]. Described here is the dataset from a recent publication in which we compared the eye-movements of 44 glaucoma patients and 32 age-similar controls, while they watched a series of short video clips taken from television programs (Crabb et al., 2018) [6]. Gaze was recorded at 1000 Hz using a remote eye-tracker. We also provide demographic information and results from a clinical examination of vision for each participant.



https://ift.tt/2lf6f3Z

Faculty commitment, effectiveness of job responsibilities and the moderating role of institutional support: A survey data set

Publication date: August 2018
Source:Data in Brief, Volume 19
Author(s): H.O. Falola, O.A. Oludayo, D.M. Akinnusi, A.O. Osibanjo, O.P. Salau
The main objective of this paper is to present the data set which depicts faculty commitment and effectiveness of job responsibilities in a changing world and the moderating role of the university׳s support system. The population of the study consisted all the 1912 Faculty members of six selected private universities in Southwest, Nigeria [5]. The sample size determination formula by [5] was adopted, resulting in the selection of 400 respondents to whom a structured questionnaire was administered accordingly. Only 343 copies of the questionnaire were valid and used for this data set. Structural equation modeling, which combines factor analysis and multiple regression, was used to present the structural relationship between dependent and independent variables. When the data is analysed, it will help to determine the degree of relationship and the strength of significance between the observed variables and the latent constructs.



https://ift.tt/2ykF6WJ

Survey data on Vietnamese retail investors׳ trading behavior and their psychological and behavioral patterns

Publication date: August 2018
Source:Data in Brief, Volume 19
Author(s): Thuy Chung Phan, Marc Oliver Rieger, Mei Wang
The data article describes self-assessments of 621 Vietnamese retail investors on their trading behavior, psychological attributes and socio-demographic characteristics. The dataset was obtained from a randomized survey of 3144 Vietnamese participants on financial attitudes and practice that has been used in Phan et al. [5]. A supplemental material data contains the full text, codes and numerical values of survey instruments. Discussion of theoretical frameworks and the development of hypothesis and measurement of survey variables are found in the associated research article [6].



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Scholar : These new articles for Alcheringa: An Australasian Journal of Palaeontology are available online

The online platform for Taylor & Francis Online content New for Alcheringa: An Australasian Journal of Palaeontology and online now on Taylor & Francis Online: Original Articles Foraminiferal biostratigraphy and facies analysis of the Permian Longge Formation in the Rongma Area, Tibet, China: implications for the palaeogeography of the South Qiangtang Block Zhong-Bao Wang, Jin-Han Gao, Gen-Hou Wang & Zhi-Hong Kang Pages: 1-18 | DOI: 10.1080/03115518.2018.1471735 Hoping to have your article read by anyone, anywhere and at any time? Find out more about publishing open access with Ecosystem Health and Sustainability. To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. 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.

Scholar : International Journal of Rail Transportation, Volume 6, Issue 3, August 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content International Journal of Rail Transportation, Volume 6, Issue 3, August 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Original Articles Evaluating the influence of ballast degradation on its shear behaviour Akbar Danesh, Massoud Palassi & Ali Asghar Mirghasemi Pages: 145-162 | DOI: 10.1080/23248378.2017.1411212 Simulation of train–bridge interaction under wind loads: a rigid-flexible coupling approach Xuhui He, Yongbin Gai & Teng Wu Pages: 163-182 | DOI: 10.1080/23248378.2017.1415170 Multi objective optimization of aerodynamic design of high speed railway windbreaks using Lattice Boltzmann Method and wind tunnel test results Masoud Mohebbi & Mohammad Ali Rezvani Pages: 183-201 | DOI: 10.1080/23248378.2018.1463873 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. 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.

Scholar : Classroom Discourse, Volume 9, Issue 2, July 2018 is now available online on Taylor & Francis Online

The online platform for Taylor & Francis Online content Classroom Discourse, Volume 9, Issue 2, July 2018 is now available online on Taylor & Francis Online. This new issue contains the following articles: Editorial Editorial Olcay Sert, Silvia Kunitz & Numa Markee Pages: 77-78 | DOI: 10.1080/19463014.2018.1486366 Review Article Positioning in classroom discourse studies: a state-of-the-art review Hayriye Kayi-Aydar & Elizabeth R. Miller Pages: 79-94 | DOI: 10.1080/19463014.2018.1450275 Articles Constructing students' deontic status by use of alternative recognitionals for student reference Mika Ishino & Yusuke Okada Pages: 95-111 | DOI: 10.1080/19463014.2017.1407947 Clarifications and carnival: Children's embodied investments in a literacy conversation Helle Pia Laursen & Kirsten L. Kolstrup Pages: 112-131 | DOI: 10.1080/19463014.2017.1392880 Managing participation in the adult ESL classroom: engagement and exit practices Elizabeth Reddington Pages: 132-149 | DOI: 10.1080/19463014.2018.1433051 Managed confrontation and the managed heart: gendered teacher talk through reported speech Robert Jean LeBlanc Pages: 150-165 | DOI: 10.1080/19463014.2018.1441728 Exploring the role of intertextuality in promoting young ELL children's poetry writing and learning: a discourse analytic approach Huili Hong Pages: 166-182 | DOI: 10.1080/19463014.2017.1351383 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. 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.

Comparative behavior between sunscreens based on free or encapsulated UV filters in term of skin penetration, retention and photo-stability

Publication date: 30 August 2018
Source:European Journal of Pharmaceutical Sciences, Volume 121
Author(s): Arianna C. Cozzi, Paola Perugini, Samuel Gourion-Arsiquaud
BackgroundThe growing incidence of photodamaging effects caused by UV radiation (e.g. sunburn, skin cancer) has increased the attention from health authorities which recommend the topical application of sunscreens to prevent these skin damages. The economic stakes for those companies involved in this international market are to develop new UV filters and innovative technologies to provide the most efficient, flexible and robust sunscreen products. Today the development of innovative and competitive sunscreen products is a complex formulation challenge. Indeed, the current sunscreens must protect against skin damages, while also being safe for the skin and being sensory and visually pleasant for the customers when applied on the skin. Organic UV filters, while proposing great advantages, also present the risk to penetrate the stratum corneum and diffuse into underlying structures with unknown consequences; moreover, their photo-stability are noted thorny outcomes in sunscreen development and subsequent performance. In recent years, the evaluation of the interaction between skin and sunscreen in terms of penetration after topical application has been considered from European authority but still its testing as their photo-stability assessment are not mandatory in most countries.ObjectiveThis study, based on in-vitro approaches, was performed to evaluate and compare the retention and the penetration of organic UV filters in free or encapsulated form inside the skin as well as their respective photo-stability.MethodsSunscreen formulation with a combination of Avobenzone and Octocrylene in "free form" and a formulation using the same UV filters but encapsulated in a sol-gel silica capsule, were analyzed and compared by FTIR Imaging Spectroscopy. Tape stripping method was used to investigate the penetration of these UV filters inside the stratum corneum. Their photo-stabilities were evaluated by spectroscopic measurements (FTIR, UV/Vis) and standard measurements were calculated: AUC (Area Under the Curve) and SPF (Sun Protection Factor).ResultWith traditional formulation, the organic UV filters penetrated significantly into the stratum corneum while the same UV filters combined with encapsulation technology remained on the skin surface. The encapsulation technology also improved significantly their stability.ConclusionEncapsulation technology is a promising strategy to improve the efficacy of sunscreen product using organic UV filters and to reduce safety problem. On the other hand, this study highlighted the pertinence of the FTIR Spectroscopy to test, compare and investigate sunscreen formulations.

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Application of hydroxypropyl methylcellulose as a protective agent against magnesium stearate induced crystallization of amorphous itraconazole

Publication date: 30 August 2018
Source:European Journal of Pharmaceutical Sciences, Volume 121
Author(s): B. Démuth, D.L. Galata, A. Balogh, E. Szabó, B. Nagy, A. Farkas, E. Hirsch, H. Pataki, T. Vigh, J. Mensch, G. Verreck, Z.K. Nagy, G. Marosi
Itraconazole is a fungicide drug which has low bioavailability due to its poor water solubility. Amorphous solid dispersion (ASD) is a tool that has the potential to greatly increase the dissolution rate and extent of compounds. In this work, the dissolution of tablets containing the ASD of itraconazole with either hydroxypropyl methylcellulose (HPMC) or vinylpyrrolidone-vinyl acetate copolymer (PVPVA) was compared in order to find a formulation which can prevent the drug from the precipitation caused by magnesium stearate. Formulations containing the PVPVA-based ASD with HPMC included in various forms could reach 90% dissolution in 2 h, while HPMC-based ASDs could release 100% of the drug. However, HPMC-based ASD had remarkably poor grindability and low bulk density, which limited its processability and applicability. The latter issue could be resolved by roller compacting the ASD, which significantly increases the bulk density and the flowability of the powder blends used for tableting. This roller compaction step might be a base for the industrial application of HPMC-based, electrospun ASDs.

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Technical note: Detailed characterization of a mist chamber for the collection of water-soluble organic gases

Publication date: September 2018
Source:Atmospheric Environment, Volume 188
Author(s): Christopher J. Hennigan, Marwa M.H. El-Sayed, Alma Hodzic
Mist chambers (MC) have been used for decades to sample water-soluble gases in atmospheric studies. Herein, we characterize the use of a mist chamber for the collection of oxygenated organic gases, with a focus on intermediate solubility compounds to better constrain the transition from low-to-high collection efficiency. The investigated compounds span a range in Henry's law constants (KH, 2.5 × 10¹ M atm⁻¹ to 4.1 × 10⁵ M atm⁻¹) and include moieties abundant in tropospheric gases (carboxylic acids, alcohols, and carbonyls). Under the configuration used here, the MC achieved greater than 90% collection efficiency for compounds with KH > 4.9 × 10² M atm⁻¹. This represents an improvement over prior MC characterizations, likely due to the increased number of intermediate solubility compounds investigated. We apply the MC collection efficiency to simulations of VOC photooxidation. The results indicate that the MC is likely to collect the majority of gas-phase oxidation products for ten different VOCs, with the highest collection efficiency (94%) predicted for the oxidation products of α-pinene under low-NOx conditions.



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Iron dissolution and speciation in atmospheric mineral dust: Metal-metal synergistic and antagonistic effects

Publication date: August 2018
Source:Atmospheric Environment, Volume 187
Author(s): Eshani Hettiarachchi, Richard L. Reynolds, Harland L. Goldstein, Bruce Moskowitz, Gayan Rubasinghege
Under acidic atmospheric conditions, iron leached from atmospheric mineral dust may influence the distribution of bioavailable iron at a global scale. However, the effects of non-Fe-containing minerals on iron dissolution remain unknown. This work describes metal-metal synergistic and antagonistic effects on iron dissolution that go beyond aggregation and ionic strength effects in mineral dust mixtures. In this study, we investigated iron mobilization by proton-promoted dissolution in natural mineral dust samples from the Kalahari Desert (SZ1) and Australian Red Dawn event (RO), along with one iron oxide proxy, hematite. The total iron dissolution in natural dust samples highly corresponds with the respective amount of Ti, rather than their particle sizes or Fe contents. The dust sample with high Ti content, SZ1, also showed a higher fraction of dissolved Fe(II), under dark conditions. These observations are in good agreement with the dissolution data for hematite artificially mixed with metal oxides. Total iron dissolution in hematite, mixed with TiO2, is 1.5- and 2-fold higher compared to that of just hematite under dark and light conditions, respectively. However, dissolution of hematite is suppressed when mixed with Al2O3 and CaO. Under dark conditions, furthermore, dissolved Fe(II) fraction is enhanced for hematite when mixed with TiO2 compared to that of other mixtures or hematite alone. Yet, dissolved Fe(II) is lower in hematite mixed with TiO2 under light conditions compared to that of hematite alone, suggesting photo-oxidation of Fe(II) by reactive oxygen species, such as OH radicals.

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