The role of the IFG and pSTS in syntactic prediction: evidence from a parametric study of hierarchical structure in fMRI

Publication date: Available online 18 December 2016
Source:Cortex
Author(s): William Matchin, Christopher Hammerly, Ellen Lau
Sentences encode hierarchical structural relations among words. Several neuroimaging experiments aiming to localize combinatory operations responsible for creating this structure during sentence comprehension have contrasted short, simple phrases and sentences to unstructured controls. Some of these experiments have revealed activation in the left inferior frontal gyrus (IFG) and posterior superior temporal sulcus (pSTS), associating these regions with basic syntactic combination. However, the wide variability of these effects across studies raises questions about this interpretation. In an fMRI experiment, we provide support for an alternative hypothesis: these regions underlie top-down syntactic predictions that facilitate sentence processing but are not necessary for building syntactic structure. We presented stimuli with three levels of structure: unstructured lists, two-word phrases, and simple, short sentences; and two levels of content: natural stimuli with real words and stimuli with open-class items replaced with pseudowords (jabberwocky). While both the phrase and sentence conditions engaged syntactic combination, our experiment only encouraged syntactic prediction in the sentence condition. We found increased activity for both natural and jabberwocky sentences in the left IFG (pars triangularis and pars orbitalis) and pSTS relative to unstructured word lists and two-word phrases, but we did not find any such effects for two-word phrases relative to unstructured word lists in these areas. Our results are most consistent with the hypothesis that increased activity in IFG and pSTS for basic contrasts of structure reflects syntactic prediction. The pars opercularis of the IFG showed a response profile consistent with verbal working memory. We found incremental effects of structure in the anterior temporal lobe (ATL), and increased activation only for sentences in the angular gyrus/temporal-parietal junction (AG/TPJ) – both regions showed these effects for stimuli with all real words. These findings support a role for the ATL in semantic combination and the AG/TPJ in thematic processing.



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Bimetal-organic frameworks/polymer core-shell nanofibers derived heteroatom-doped carbon materials as electrocatalysts for oxygen reduction reaction

Publication date: April 2017
Source:Carbon, Volume 114
Author(s): Qijian Niu, Junxia Guo, Binling Chen, Jun Nie, Xindong Guo, Guiping Ma
In this work, Zn-Co-ZIF-n(shell)/PAN(core) nanofibers were well-designed and prepared through bimetal zeolitic imidazolate frameworks (ZIFs) grown on the surface of 2-Methylimidazole/Polyacrylonitrile (MIM/PAN) electrospun nanofibers. After carbonization of Zn-Co-ZIF-n/PAN nanofibers (n was the molar ratio of Zn/Co before carbonization), the core layer was converted to nitrogen-doped carbon nanofibers (NCNFs) and the shell layer was converted to Zn/Co bimetal nanoparticles coated with graphitic carbon layer (Zn/Co@C). It was found that Zn/Co@C-NCNFs are featured with hierarchical network structure and high surface area. Further doped by nitrogen species and embedded by Zn/Co bimetal nanoparticles, it exhibited excellent electrocatalytic performance for oxygen reduction reaction (ORR), better than the reference samples. By further investigating the electrocatalytic performance, the optimized sample Zn/Co@C-NCNFs (0.50) derived from Zn-Co-ZIF-0.50/PAN at 800 °C carbonization exhibited excellent electrocatalytic activity (the onset and half-wave potentials were −0.099 V and −0.20 V vs. Ag/AgCl, respectively and nearly four electron selectivity (3.69)). Moreover, its methanol tolerance and duration stability was better than that of the commercial 20 wt% Pt/C. It provides an effective strategy to design non-precious metal electrocatalysts from the Zn-Co-ZIF-n/PAN nanofibers or other MOFs/polymer nanofibers for ORR in fuel cells.

Graphical abstract

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Metal homeostasis in infectious disease: recent advances in bacterial metallophores and the human metal-withholding response

Publication date: April 2017
Source:Current Opinion in Chemical Biology, Volume 37
Author(s): Wilma Neumann, Anmol Gulati, Elizabeth M Nolan
A tug-of-war between the mammalian host and bacterial pathogen for nutrients, including first-row transition metals (e.g. Mn, Fe, Zn), occurs during infection. Here we present recent advances about three metal-chelating metabolites that bacterial pathogens deploy when invading the host: staphylopine, staphyloferrin B, and enterobactin. These highlights provide new insights into the mechanisms of bacterial metal acquisition and regulation, as well as the contributions of host-defense proteins during the human innate immune response. The studies also underscore that the chemical composition of the microenvironment at an infection site can influence bacterial pathogenesis and the innate immune system.



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Distal Pb-Zn-Ag veins associated with the world-class Donggou porphyry Mo deposit, southern North China craton

Publication date: April 2017
Source:Ore Geology Reviews, Volume 82
Author(s): Zhan-Ke Li, Shi-Jian Bi, Jian-Wei Li, Wen Zhang, David R. Cooke, David Selby
The southern North China craton hosts numerous world-class porphyry Mo and Pb-Zn-Ag vein deposits. Whether or not the Pb-Zn-Ag veins are genetically associated with the porphyry Mo system remains contentious. Here we focus on the genetic relationships between the Sanyuangou Pb-Zn-Ag vein deposit and the world-class Donggou porphyry Mo deposit, and discuss the potential implications from the spatial and temporal relationships between porphyry and vein systems in the southern North China craton.At Sanyuangou, vein-hosted sulfide mineralization mainly comprises pyrite, sphalerite, and galena, with minor chalcopyrite, pyrrhotite, bornite, tetrahedrite, covellite, polybasite and argentite. The mineralization is hosted by a quartz diorite stock, which has a zircon U-Pb age of 1756±9Ma. However, sericite from alteration selvages of Pb-Zn-Ag sulfide mineralization yields a well-defined ⁴⁰Ar/³⁹Ar plateau age of 115.9±0.9Ma. Although nominally younger, the sericite ⁴⁰Ar/³⁹Ar age is similar to the age of the nearby Donggou porphyry Mo deposit (zircon U-Pb age of 117.8±0.9; molybdenite Re-Os ages of 117.5±0.8Ma and 116.4±0.6Ma). Pyrite from Donggou has elevated contents of Mo and Bi, whereas pyrite from Sanyuangou is enriched in Cu, Zn, Pb, Ag, Au, and As. This trace element pattern is consistent with metal zonation typically observed in porphyry related metallogenic systems. Pyrite grains from Sanyuangou have lead isotopes overlapping those from Donggou (17.273–17.495 vs. 17.328–17.517 for ²⁰⁶Pb/²⁰⁴Pb, 15.431–15.566 vs. 15.408–15.551 for ²⁰⁷Pb/²⁰⁴Pb, and 37.991–38.337 vs. 38.080–38.436 for ²⁰⁸Pb/²⁰⁴Pb). Collectively, the geological, geochronological, and geochemical data support a magmatic-hydrothermal origin for the Sanyuangou Pb-Zn-Ag deposit and confirm that the Pb-Zn-Ag veins and the Donggou Mo deposit form a porphyry-related magmatic-hydrothermal system.Given the widespread Pb-Zn-Ag veins and Mo mineralized porphyries in many districts of the southern North China craton, the model derived from this study has broad implications for further exploration of Mo and Pb-Zn-Ag resources in the area.

Graphical abstract

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Genesis of Luobuzhen Pb–Zn veins: Implications for porphyry Cu systems and exploration targeting at Luobuzhen-Dongshibu in western Gangdese belt, southern Tibet

Publication date: April 2017
Source:Ore Geology Reviews, Volume 82
Author(s): Xiang Sun, Youye Zheng, Miao Li, Haitao Ouyang, Qiangqiang Liu, Xinkui Jing, Guoping Sun, Qingjie Song
Porphyry systems are known to form in magmatic arc environment and commonly include porphyry Cu, epithermal Pb–Zn–Au–Ag, skarn polymetallic mineralization, etc. The systems are rarely reported in collisional zones, such as the Gangdese belt in southern Tibet where many postcollisional porphyry copper deposits occurred. In addition, other types of mineral systems are rarely present except porphyry copper mineralization in the Gangdese belt. In this study, we present Pb–Zn-bearing quartz veins at Luobuzhen in the western Gangdese belt. The Luobuzhen Pb–Zn veins cross-cut dacite of the Linzizong Group with zircon U–Pb age of 50.1±0.2Ma and monzogranite with zircon U–Pb age of 17.1±0.1Ma. Ore minerals include sphalerite, galena, chalcopyrite, and pyrite; gangue minerals are quartz with minor chlorite and sericite. Primary fluid inclusions of quartz are liquid-rich, aqueous, and two-phase inclusions. The homogenization temperatures of these primary inclusions are moderate to high (267–400°C), and salinities range from 8.9 to 18.4wt.% NaCl equiv. Quartz has δ¹⁸OSMOW values of 6.2–9.3‰, while sulfides have δ³⁴SV-CDT values of −5.1‰ to 0.1‰, ²⁰⁶Pb/²⁰⁴Pb of 18.722–18.849, ²⁰⁷Pb/²⁰⁴Pb of 15.640–15.785, and ²⁰⁸Pb/²⁰⁴Pb of 39.068–39.560. These data suggest that magmatic fluids with contribution from meteoric water, magmatic sulfur, and lead derived from upper crust and metasomatized mantle by Indian continental materials would be critical for the Luobuzhen base metal mineralization.The Dongshibu area, located at ∼2km east of the Luobuzhen, is characterized by high concentrations of Cu (up to 1450ppm) and Mo (up to 130ppm) of stream sediments, which is quite different from high concentrations in Pb, Zn, Ag, and Au shown in the Luobuzhen area. In addition, porphyry copper mineralization-related alteration and veins/veinlets occur in the Miocene monzogranite at Dongshibu. The monzogranite is characterized by high Sr/Y ratios, which are also shown on ore-forming intrusions in the Gangdese postcollisional porphyry copper deposits, and shows similar zircon Hf isotopes to the ore-related high Sr/Y intrusions from the Zhunuo porphyry copper deposit which is located ∼20km northeast of the Luobuzhen-Dongshibu. A comprehensive analysis allows us to infer that the base metal veins at Luobuzhen are components of a porphyry Cu system with porphyry Cu mineralization likely present at Dongshibu and epithermal Au–Ag veins possibly occurring at Luobuzhen, which are indicative of the existence of porphyry copper systems in collisional zones. The potential porphyry Cu mineralization and epithermal Au–Ag veins should be targeted in future exploration at Luobuzhen-Dongshibu.

Graphical abstract

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NIPTL-Novo: Non-isobaric peptide termini labeling assisted peptide de novo sequencing

Publication date: 10 February 2017
Source:Journal of Proteomics, Volume 154
Author(s): Shen Zhang, Yichu Shan, Shurong Zhang, Zhigang Sui, Lihua Zhang, Zhen Liang, Yukui Zhang
A simple and effective de novo sequencing strategy assisted by non-isobaric peptide termini labeling, NIPTL-Novo, was established. The y-series ions and b-series ions of peptides can be clearly distinguished according to the different mass tags incorporated in N-terminus and C-terminus. This is helpful for improving the accuracy of peptide sequencing and increasing the sequencing speed. For the spectra commonly identified by both de novo sequencing and database searching software (Mascot or Maxquant), NIPTL-Novo gave identical result to more than 85% of these spectra. Furthermore, the quantitative profiling of the sample can be performed simultaneously along with de novo sequencing. Finally, this strategy can be applied to discover the peptides with potential mutation sites by combining with mass-defect based isotopic labeling.SignificanceThe aim of the research presented in this paper is to establish a simple but effective de novo sequencing strategy based on non-isobaric peptide termini labeling, named NIPTL-Novo. First, different mass tags incorporated in N-terminus and C-terminus generated by non-isobaric peptide termini labeling will help to distinguish both b and y ion series, which significantly simplify the MS/MS spectra and reduce the time consumption for de novo sequencing. Second, the isolation window of this strategy is just 4Da, much smaller than most existed labeling assisted de novo sequencing methods, which reduces the interferences caused by co-fragmentation ions. Third, the quantitative profiling of the sample can be performed simultaneously along with the de novo sequencing, and the quantitative accuracy is comparable to other chemical labeling methods. Finally, this strategy was expanded to the analysis of peptide mutation with combination of mass-defect based labeling, and two reliable mutated peptides were discovered.

Graphical abstract

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Development of highly reinforced acrylonitrile butadiene rubber composites via controlled loading of sol-gel titania

Publication date: 27 January 2017
Source:Polymer, Volume 109
Author(s): Chayan Das, Naresh D. Bansod, Bharat P. Kapgate, Uta Reuter, Gert Heinrich, Amit Das
Remarkable improvement in mechanical properties of acrylonitrile butadiene rubber (NBR) composites is achieved by incorporating nano-titania that is synthesised in solution of the raw rubber using titanium n-butoxide (TNB) as the titania precursor. This is achieved by designed and controlled incorporation of titania that resulted in very good dispersion of titania of nanometric dimension in rubber matrix and enhanced rubber-filler interaction. This sol-gel transformation is carried out under optimised reaction condition. Surface modification of titania by a silane coupling agent (bis-(3-triethoxysilylpropyl)-tetrasulfide, TESPT) causes further improvement in filler dispersion and composite properties when added in the reactive sol-gel system during in situ titania generation rather than it's external addition in the titania filled NBR during mixing and compounding. Thorough characterisation of the composites are done that encompasses a wide range of studies on thermal, morphological, mechanical, dielectric, dynamic mechanical, rheological and antifungal properties. The results are analysed on a comparative basis to investigate the effect of in situ incorporation and in situ surface modification of titania on the composite properties.

Graphical abstract

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Interlayer-expanded MoS2

Publication date: Available online 16 December 2016
Source:Materials Today
Author(s): Kowsalya Devi Rasamani, Farbod Alimohammadi, Yugang Sun
Motivated by the novel properties of two-dimensional materials, MoS2 has been extensively explored with discoveries surging in the recent years. Such impressive progress benefits from the success in synthesizing nanostructured MoS2 with precisely controlled parameters including edge density and crystalline phase. In this review, we focus on the synthesis of MoS2 with expanded interlayer spacing and their applications in energy storage, catalysis and environmental remediation, highlighting the importance of tuning interlayer spacing on improving performance of MoS2. The challenges faced in this emerging research area and perspective research directions are also discussed.



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IDD Newsletter November 2016

IDD NEWSLETTER – November 2015 (PDF File, 9.42 MB)
VOLUME 44 NUMBER 4 NOVEMBER 2016
IODINE GLOBAL NETWORK (formerly ICCIDD Global Network) is a nongovernmental organization dedicated to sustained optimal iodine
nutrition and the elimination of iodine deficiency throughout the world.

The post IDD Newsletter November 2016 appeared first on American Thyroid Association.

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MRI-guided breast vacuum biopsy: Localization of the lesion without contrast-agent application using diffusion-weighted imaging

Publication date: May 2017
Source:Magnetic Resonance Imaging, Volume 38
Author(s): Nicole Berger, Zsuzsanna Varga, Thomas Frauenfelder, Andreas Boss
ObjectiveIn magnetic resonance-guided breast vacuum biopsies, the contrast agent for targeting suspicious lesions can typically be applied only once during an intervention, due to the slow elimination of the gadolinium chelate from the extracellular fluid space. This study evaluated the feasibility of diffusion-weighted imaging (DWI) for lesion targeting in vacuum assisted magnetic resonance imaging (MRI) biopsies.ConclusionDWI may be used as an alternative to dynamic contrast-enhanced MRI with the advantage of reproducibility. However, the targeted lesion requires the characteristics of a mass-like lesion, substantial diffusion restriction, and a minimum size of approximately 1cm.



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The impact of spin coupling signal loss on fat content characterization in multi-echo acquisitions with different echo spacing

Publication date: May 2017
Source:Magnetic Resonance Imaging, Volume 38
Author(s): K. Nikiforaki, G.C. Manikis, T. Boursianis, K. Marias, A. Karantanas, T.G. Maris
PurposeThis study aimed to assess the effect of echo spacing in transverse magnetization (T2) signal decay of gel and fat (oil) samples. Additionally, we assess the feasibility of using spin coupling as a determinant of fat content.MethodsPhantoms of known T2 values, as well as vegetable oil phantoms, were scanned at 1.5T scanner with a multi echo FSE sequence of variable echo spacing above and below the empirical threshold of 20ms for echo train signal modulation (6.7, 13.6, 26.8, and 40ms). T2 values were calculated from monoexponential fitting of the data. Relative signal loss between the four acquisitions of different echo spacing was calculated.ResultsAgreement in the T2 values of water gel phantom was observed in all acquisitions as opposed to fat phantom (oil) samples. Relative differences in signal intensity between two successive sequences of different echo spacing on composite fat/water regions of interest was found to be linearly correlated to fat fraction of the ROI.ConclusionThe sample specific degree of signal loss that was observed between different fat samples (vegetable oils) can be attributed to the composition of each sample in J coupled fat components. Hence, spin coupling may be used as a determinant of fat content.



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Benefits of Centralized Scheduling in a Post- Acute Residential Rehabilitation Program for people with acquired brain lesions. A Pilot Study

Publication date: Available online 18 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Alec Vestri, Silvia Pizzighello, Sara Piccoli, Andrea Martinuzzi
ObjectiveTo verify if the use of a designated staff person to coordinate and schedule therapy services in a post acute residential rehabilitation program for people with acquired brain lesions results in a higher intensity treatment allowing the reaching of clinical outcome in a reduced length of stay. Cost saving and perceived satisfaction were explored.DesignThis nonrandomized retrospective study uses data collected relative to two different methods of scheduling: Self Planning in which each single team member makes appointments which are then displayed on a shared board, and Managed Planning in which appointments were made by a designated staff person.SettingThe study was conducted in a residential centre for people with post acute acquired brain lesions between 2009 and 2012.Participantsand main outcome measure: Patients of Managed Planning group (N=10) were balanced with patients of Self Planning group (N=10) on the basis of clinical and demographical characteristics. The sample of 20 patients was analysed using organizational measures (length of stay in rehabilitation, number of treatment hours and the total cost of rehabilitation), clinical outcome scales (Disability Rating Scale, Functional Independence Measure and Functioning and Barthel Index), perceived quality of treatment by patients (Questionnaire) and perceived satisfaction of team members (Job Descriptive Index).InterventionsNot applicableResultsAll patients improved on all clinical rating scales at the moment of discharge (all effect size are large). In the Managed Planning, number of treatment hours increased (Cohen's d = 2.15) resulting in reduced length of stay (Cohen's d = 0.95) and cost of rehabilitation (Cohen's d = 1.22); the quality of treatment perceived by the patients and their families increased while team member satisfaction did not change.ConclusionThe use of a designated staff person to manage therapy services improve efficiency and efficacy of a patient centered health care system. The proposed scheduling system results in a remarkable cost saving for the National Health System.



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Resilience and function in adults with physical disabilities: an observational study

Publication date: Available online 18 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Samuel L. Battalio, Arielle M. Silverman, Dawn M. Ehde, Dagmar Amtmann, Karlyn A. Edwards, Mark P. Jensen
ObjectiveTo determine if resilience is uniquely associated with functional outcomes (satisfaction with social roles, physical functioning, and quality of life) in individuals with physical disabilities, after controlling for measures of psychological health (depression and anxiety) and symptom severity (pain, fatigue, sleep disturbance). We also examined the potential moderating effect of gender, age, and diagnosis on the hypothesized associations between resilience and function.DesignCross-sectional survey study.SettingSurveys were mailed (81% response rate) to a community sample of 1949 individuals multiple sclerosis, muscular dystrophy, post poliomyelitis syndrome, or spinal cord injury. Participants were recruited through web or print advertisement (28%), a registry of previous research participants who indicated interest in future studies (21%), a departmental registry of individuals interested in research (19%), disability specific registries (18%), by word of mouth (10%), or other sources (3%).ParticipantsA convenience sample of community-dwelling adults aging with physical disabilities (N=1574) with a mean Connor-Davidson Resilience Scale (CD-RISC10) score of 29.InterventionsNot applicable.Main Outcome MeasuresPatient Reported Outcomes Measurement Information System (PROMIS) measures of Satisfaction with Social Roles and Activities and Physical Functioning, the World Health Organization's Older People's Quality of Life Questionnaire (OPQOL-brief), and the Connor-Davidson Resilience Scale (CD-RISC10).ResultsAfter controlling for age, age², gender, diagnosis, psychological health, and symptom severity, resilience was significantly and positively associated with satisfaction with social roles (β = .17, p < .001) and quality of life (β = .39, p < .001), but not physical function (β = .04, p > .05). For every 1 point increase in scores of resilience, there was an increase of .5 in the quality of life score and .2 in the satisfaction with social roles score. Gender also moderated the association between resilience and satisfaction with social roles, F(1, 1453) = 4.09, p = .043.ConclusionsThe findings extend past research, providing further evidence indicating that resilience plays a unique role in non-physical functional outcomes among individuals with physical disabilities.



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Percutaneous needle tenotomy for the treatment of muscle and tendon contractures in adults with brain damage: results and complications

Publication date: Available online 18 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Flavia Coroian, Claire Jourdan, Jérome Froger, Claire Anquetil, Olivier Choquet, Bertand Coulet, Isabelle Laffont
ObjectiveTo study the results and complications of percutaneous needle tenotomy (PNT) of superficial retracted tendons in brain damaged patients. Muscle and tendon contractures are common in this population and can lead to severe functional impairment. Care management is commonly based on open surgical tenotomy. PNT is a mini-invasive surgical procedure suspected to be safer among frail patients.DesignProspective observational studySettingUniversity Hospital Physical Medicine and Rehabilitation (PM&R) and Orthopedic Surgery Departments.ParticipantsThirty-eight patients with severe brain damage (60.7 years [24-93]; 21 women) requiring surgical management of contractures and eligible for PNT were enrolled between February 2015 and February 2016.InterventionsThe PNT gesture was performed by a PM&R physician trained by an orthopedic surgeon, under local or loco-regional anesthesia. Treated tendons varied among patients.Main Outcome MeasuresAll patients were evaluated at 1, 3 and 6 months to assess surgical outcomes (joint range of motion [ROM], pain, and functional improvement) while screening for complications.ResultsImprovements on ROM (37/38) and contractures-related pain (12/12) were satisfactory. Functional results were satisfactory (Goal Attainment Scale≥0) for most patients (37/38): nursing (12), putting shoes on (8), getting in bed or sitting on a chair (6), verticalization (7), transfers and gait (8), grip (2).Five patients had complications related to the surgical gesture: 2 cast-related complications, 2 hand hematoma and one cutaneous necrosis of the Achilles tendon in a patient with previous obliterative arteriopathy of the lower limbs.ConclusionPNT yields good results in the management of selected superficial muscle and tendon contractures. The complications rate is very low and this treatment can be an alternative to conventional surgery in frail neurological patients.



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Myofascial Induction Effects on Neck-Shoulder Pain in Breast Cancer Survivors: Randomized, Single-Blind, Placebo-Controlled Cross-Over Design

Publication date: Available online 18 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Eduardo Castro-Martín, Lucía Ortiz-Comino, Tania Gallart-Aragón, Bernabé Esteban-Moreno, Manuel Arroyo-Morales, Noelia Galiano-Castillo
ObjectivesTo investigate the immediate effects of myofascial induction (MI) with placebo electrotherapy as control on perceived pain, cervical/shoulder range of motion (ROM) and mood state in breast cancer survivors (BCSs) with shoulder/arm morbidity. Our secondary objective was to examine the relationships between pain modifications and cervical/shoulder ROM on the side affected by breast cancer.DesignRandomized, single-blind, placebo-controlled cross-over study.SettingPhysical therapy laboratory.ParticipantsTwenty-one BCSs who had a diagnosis of stage I-IIIA breast cancer and had completed adjuvant therapy (except hormonal treatment).InterventionDuring each session, the BCSs received either an MI (fascial unwinding) intervention focused on the upper limb area following the Pilat approach or placebo pulsed shortwave therapy (control group). Each session lasted 30 minutes, and an adequate wash-out period of 4 weeks between sessions was established.Main Outcome MeasuresThe Visual Analogue Scale (VAS) for pain and anxiety, shoulder-cervical goniometry for ROM, the Profile of Mood States (POMS) for psychological distress and the Attitudes Towards Massage (ATOM) Scale were used.ResultsAn analysis of covariance (ANCOVA) revealed significant time x group interactions for VAS affected arm (P=0.031) but not for VAS cervical (P=0.332), VAS non-affected arm (P=0.698) or VAS anxiety (P=0.266). The ANCOVA also revealed significant interactions for affected shoulder flexion (P<0.001), abduction (P<0.001), external rotation (P=0.004) and internal rotation (P=0.001). Significant interactions for affected cervical rotation (P=0.022) and affected cervical lateral flexion (P=0.038) were also found. A significant negative correlation was found between changes in VAS affected arm and shoulder/arm internal rotation ROM (r=-0.46; P=0.03).ConclusionsA single MI session decreases pain intensity and improves neck-shoulder ROM to a greater degree than placebo electrotherapy for BCSs experiencing pain.



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Critical Review: CPAP and Weight Management of Obstructive Sleep Apnea Cardiovascular Co-morbidities

The cardiovascular co-morbidities of obstructive sleep apnea (OSA) are similar to those of obesity. Cardiovascular co-morbidities often are the cause of adverse outcomes in overweight/obese OSA patients. Continuous positive airway pressure (CPAP) therapy resolves the symptoms of OSA, but may, or may not lead to improvement of a given cardiovascular co-morbidity. The impact of CPAP on cardiovascular risk variables, adverse cardiovascular events in overweight/obese OSA patients has been evaluated primarily in prospective, uncontrolled cohort studies.

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Letter to the Editor regarding article by Miranda et.al

The article, "Improved healthcare economic outcomes after liposomal bupivacaine administration" provides a unique perspective on the use of long-acting analgesia in breast surgery and we wish to congratulate the authors [1]. Liposomes are microscopic structures consisting of a phospholipid bilayer encapsulating an aqueous core and confer specific drug release patterns including increased stability and longer duration of drug release [2]. There are increasing reports of liposomal formulations in postoperative analgesia with key advantages proposed as reducing opioid intake and shortening inpatient stay.

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Reply to Letter to the Editor Regarding Article by Miranda et al.

We thank the author for his insightful and well-thought comments on our article, "Improved healthcare economic outcomes after liposomal bupivacaine administration in first-stage breast reconstruction," and the current utilization of liposomal bupivacaine in general1. There have been many advances with the use liposomal bupivacaine for post-operative analgesia both within and outside of plastic surgery2. As mentioned in the letter by Layton, further understanding of the safety profile and efficacy in a novel therapeutic for post-operative analgesia is crucial for its widespread adoption.

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Commentary: The Outcome of the Second Fat Graft is Significantly Better than that of the First Fat Graft for Romberg Syndrome: A Study of Three-Dimensional Volumetric Analysis

The authors use Parry Romberg Syndrome as a model to demonstrate efficacy of serial fat grafting.1 The hallmarks Romberg Syndrome include subcutaneous adipose attrition likely secondary to underlying vascular compromise.2 Three-dimensional scanning photography is used to measure the retention of volume. The surface scans obtained prior to any fat grafting were compared to the scans obtained three months after each round of fat grafting. The authors deemed the volume of surface change per volume of adipose injected as the survival rate.

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Competing causes of death in the head and neck cancer population

Publication date: February 2017
Source:Oral Oncology, Volume 65
Author(s): Sean T. Massa, Nosayaba Osazuwa-Peters, Kara M. Christopher, Lauren D. Arnold, Mario Schootman, Ronald J. Walker, Mark A. Varvares
Purpose/objectivesThe increasing survivorship of head and neck squamous cell carcinoma (HNSCC) comes with a risk of death from other causes, known as competing causes. The demographics of HNSCC are also evolving with increasing incidence of Human Papillomavirus (HPV) associated tumors. This study describes competing causes of death for the HNSCC population compared to the general population and identifies associated risk factors.MethodsAdult patients with first mucosal HNSCC (2004–2011) were identified from the Surveillance, Epidemiology and End Result database. Competing causes of death were compared to reference populations using proportion of deaths and Standardized Mortality Ratios (SMR). A multivariable competing risk survival analysis yielded subdistribution hazard ratios (HR) for competing mortality.ResultsOf 64,598 HNSCC patients, 24,602 (38.1%) were deceased including 7142 deaths (29.0%) from competing causes. The most common were cardiovascular disease, lung cancer, and other cancers. All relative mortality rates were elevated, especially liver disease (SMR 38.7; 95% CI: 29.4–49.3), suicide (SMR 37.1; 95% CI: 26.1–48.6), and subsequent primary cancers (SMR 7.5; 95% CI: 6.78–8.32). Demographic and tumor factors independently increased risk of competing mortality, including age (HR per 5years 1.24; 95% CI: 1.22–1.25), sex (male HR 1.23; 95% CI: 1.16–1.32), race (Black HR 1.17; 95% CI: 1.09–1.26), insurance (uninsured HR 1.28; 95% CI: 1.09–1.50), and marital status (single HR 1.29; 95% CI: 1.21–1.37).ConclusionNearly one in three HNSCC patients died from competing causes. When developing long term survivorship regimens for HNSCC patients, clinicians should be familiar with this population's specific risks.



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Elevated plasma levels of copeptin linked to diabetic retinopathy in type 2 diabetes

Publication date: 15 February 2017
Source:Molecular and Cellular Endocrinology, Volume 442
Author(s): Qi Zhao, Xiao-Xuan Wu, Jun Zhou, Xiao Wang
BackgroundThe arginine vasopressin (AVP) system has been postulated to play a role in glucose homeostasis, insulin resistance, and diabetes mellitus in human and animal studies. The aim of this study was to evaluate the role of plasma copeptin in Chinese patients with type 2 diabetes mellitus (T2DM) with and without diabetic retinopathy (DR).MethodPlasma copeptin concentrations were determined in 281 patients with T2DM. At baseline, demographic and clinical information including presence of DR and vision-threatening DR (VTDR) was collected. The relationship between copeptin and DR or VTDR was investigated using logistic regression.ResultsT2DM participants with DR or VTDR had significantly higher plasma copeptin concentrations on admission (P < 0.0001). Receiver operating characteristics to predict DR and VDTR demonstrated areas under the curve for copeptin of 0.784 (95% confidence interval [CI] 0.724–0.844) and 0.834 (95% CI 0.781–0.904), respectively, which were superior to those for the homeostasis model assessment of insulin resistance (DR AUC 0.736, 95% CI 0.676–0.797; VTDR AUC 0.754, 95% CI 0.703–0.828; P < 0.01). Multivariate logistic regression analysis adjusted for common DR risk factors showed plasma copeptin concentrations ≥28.6 pmol/L (>3rd quartile) to be an independent marker of DR (OR 3.68, 95% CI 2.04–6.79; P < 0.0001) and VTDR (OR 4.32, 95% CI 2.12–8.14; P < 0.0001).ConclusionsWe found that increased plasma copeptin concentrations were an independent marker of DR and VDTR in Chinese patients with T2DM, suggesting a possible role of copeptin in the pathogenesis of DR complications.



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Phospholipid complex enriched micelles: A novel drug delivery approach for promoting the antidiabetic effect of repaglinide

Publication date: 1 March 2017
Source:European Journal of Pharmaceutical Sciences, Volume 99
Author(s): Ahmed Alaa Kassem, Sameh Hosam Abd El-Alim, Mona Basha, Abeer Salama
To enhance the oral antidiabetic effect of repaglinide (RG), a newly emerging approach, based on the combination of phospholipid complexation and micelle techniques, was employed. Repaglinide-phospholipid complex (RG-PLC) was prepared by the solvent-evaporation method then characterized using Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FT-IR) and X-ray powder diffraction (XPRD). The results revealed obvious disappearance of the characteristic peaks of the prepared RG-PLCs confirming the formation of drug-phospholipid complex. RG-PLC enriched micelles (RG-PLC-Ms) were prepared by the solvent-evaporation technique employing poloxamer 188 as surfactant. The prepared RG-PLC-Ms showed high drug encapsulation efficiencies (93.81–99.38%), with nanometric particle diameters (500.61–665.32nm) of monodisperse distribution and high stability (Zeta potential < −29.8mV). The in vitro release of RG from RG-PLC-Ms was pH-dependant according to the release media. A higher release pattern was reported in pH=1.2 compared to a more retarded release in pH=6.8 owing to two different kinetics of drug release. Oral antidiabetic effect of two optimized RG-PLC-M formulations was evaluated in an alloxan-induced diabetic rat model for 7-day treatment protocol. The two investigated formulations depicted normal blood glucose, serum malondialdehyde and insulin levels as well as an improved lipid profile, at the end of daily oral treatment, in contrast to RG marketed tablets implying enhanced antidiabetic effect of the drug. Hence, phospholipid-complex enriched micelles approach holds a promising potential for promoting the antidiabetic effect of RG.

Graphical abstract

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Long-circulating polyhydroxybutyrate-co-hydroxyvalerate nanoparticles for tumor targeted docetaxel delivery: Formulation, optimization and in vitro characterization

Publication date: 1 March 2017
Source:European Journal of Pharmaceutical Sciences, Volume 99
Author(s): Harsh Vardhan, Pooja Mittal, Sandeep Kumar Reddy Adena, Brahmeshwar Mishra
In the present research an attempt was made to develop and optimize docetaxel-loaded polyhydroxybutyrate-co-hydroxyvalerate (PHBV) nanoparticles, using modified emulsification solvent evaporation technique and design of experiment (DOE) methodology. Formulation of docetaxel-loaded PHBV nanoparticles was conducted by factor screening studies with Plackett-Burman design (PBD) followed by Box-Behnken experimental design (BBD) to evaluate the effect of independent variables on responses. Five most important independent variables were screened out, which were obtained from failure mode effect analysis (FMEA) and factor screening studies. The effect of formulation parameters on selected responses was depicted by 2-D and 3-D response surface methodology (RSM). The final optimized batch was evaluated by various in vitro characterizations. The observed particle size, zeta potential and entrapment efficiency of optimized formulation was found to be 283±2.79nm, −17±2.64mV and 44±0.59% respectively. Morphological studies demonstrated the smooth and spherical shape of nanoparticles. In vitro drug release follows the Peppas-Korsmeyer model of drug release kinetics. Cytotoxicity study was assessed using MCF-7 for percentage inhibition of human breast cancer cell line. These results indicate that the PHBV Nanoparticles could be a promising drug delivery system for efficient prolong drug release.

Graphical abstract

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Large mammal biomass predicts the changing distribution of hunter-gatherer settlements in mid-late Holocene Alaska

Publication date: March 2017
Source:Journal of Anthropological Archaeology, Volume 45
Author(s): Andrew H. Tremayne, Bruce Winterhalder
This study provides an ecological explanation for the distribution of Arctic Small Tool tradition (ASTt) settlements in Alaska and the origin of their arctic maritime adaptation. Theoretically grounded in the ideal free distribution (IFD) model, which predicts that higher ranked habitats will be occupied first and most continuously, we contend that the location of large mammals was a major factor influencing human dispersal and settlement decisions in the arctic and subarctic ecosystems of Alaska. We rank habitat suitability based on historic mammal population densities from wildlife ecology reports across predefined ecological zones in Alaska; we multiply densities by average animal weights per species to determine suitability rankings. Coastal habitats in Alaska are higher ranked than adjacent tundra habitats, but the interior boreal forest may have been the highest ranked, considering technological constraints of hunting aquatic species. The ASTt migration into Alaska created population pressure that promoted the colonization of the unoccupied Arctic coast and development of the dual, terrestrial-maritime economy. When pan-Alaska human populations declined around 3200–2500years ago low ranked tundra ecoregions were abandoned. As human populations recovered Alaska coasts became the most densely populated habitats. The adaptive logic entailed in the IFD provides a consistent evolutionary interpretation for settlement patterns documented in this region.

Graphical abstract

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Microchoerus hookeri nov. sp., a new late Eocene European microchoerine (Omomyidae, Primates): New insights on the evolution of the genus Microchoerus

Publication date: January 2017
Source:Journal of Human Evolution, Volume 102
Author(s): Raef Minwer-Barakat, Judit Marigó, Joan Femenias-Gual, Loïc Costeur, Soledad De Esteban-Trivigno, Salvador Moyà-Solà
The study of Eocene primates is crucial for understanding the evolutionary steps undergone by the earliest members of our lineage and the relationships between extinct and extant taxa. Recently, the description of new material from Spain has improved knowledge of European Paleogene primates considerably, particularly regarding microchoerines. Here we describe the remains of Microchoerus from Sossís (late Eocene, Northern Spain), consisting of more than 120 specimens and representing the richest sample of Microchoerus from Spain. This primate was first documented in Sossís during the 1960s, on the basis of scarce specimens that were ascribed to Microchoerus erinaceus. However, the studied material clearly differs from M. erinaceus at its type locality, Hordle Cliff, and shows some characters that allow the erection of a new species, Microchoerus hookeri. This new species is characterized by its medium size, moderate enamel wrinkling, generally absent mesoconid and small hypoconulid in the M1 and M2, single paracone in the upper molars and premolars and, particularly, by the lack of mesostyle in most M¹ and M², a trait not observed in any other species of Microchoerus. Some specimens from Eclépens B (late Eocene, Switzerland), determined previously to be Microcherus aff. erinaceus, are also ascribed to M. hookeri. M. hookeri represents the first step of a lineage that differentiated from Necrolemur antiquus and, later, gave rise to several unnamed forms of Microchoerus, such as those from Euzet and Perrière, finally leading to M. erinaceus. This discovery sheds new light on the complex evolutionary scheme of Microchoerus, indicating that it is most probably a paraphyletic group. A detailed revision of the age of the localities containing remains of Microchoerus and the description of the still unpublished material from some European localities, are necessary to clarify the phylogenetic relationships among the members of this microchoerine group.



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Management of fish bone impaction in throat – Our experiences in a tertiary care hospital of eastern India

Publication date: Available online 18 December 2016
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): Santosh Kumar Swain, Santosh Kumar Pani, Mahesh Chandra Sahu
ObjectiveTo find out prevalence of accidental ingestion of fish bones and its management in a tertiary care hospital of eastern India.Materials & methodsThis is a prospective observational study. Three hundred thirty patients with complains of fish bone in throat who presented to the out patients department of Otorhinolaryngology and the emergency department of a Medical college between January 2008 to December 2015 were shortlisted for study. Followed by conventional examination, most were subjected to endoscopic examination and removal. The parameters analyzed were age and sex distribution, clinical presentation, duration of symptoms, location of impaction, conventional and endoscopic removal techniques.ResultAmong three hundred thirty patients, no foreign body was found in eighty patients. Patients in age group of 21–30years were affected mostly with almost equal sex distribution. Most patients presented with foreign body sensation in throat of short duration with precise finger point localization. Both conventional and endoscopic methods were employed with successful results but with definite advantage of endoscopic method.ConclusionFish bone in throat is a common occurrence in Otorhinolaryngological practice. Fish bone impaction is a common foreign body in the pharynx. Endoscopic removal is distinctly more helpful than the conventional ones.



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Commentary on “Patients with Small Abdominal Aortic Aneurysms are at Significant Risk of Cardiovascular Events and this Risk is not Addressed Sufficiently”

Publication date: Available online 18 December 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): J.-B. Ricco




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Commentary on “Tip Design of Hemodialysis Catheters Influences Thrombotic Events and Replacement Rate”

Publication date: Available online 18 December 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): X. Berard, S. Deglise




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Incidence of Stroke Following Thoracic Endovascular Aortic Repair for Descending Aortic Aneurysm: A Systematic Review of the Literature with Meta-analysis

Publication date: Available online 18 December 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): R.S. von Allmen, B. Gahl, J.T. Powell
ObjectiveStroke is an increasingly recognised complication following thoracic endovascular aortic repair (TEVAR). The aim of this study was to systematically synthesise the published data on perioperative stroke incidence during TEVAR for patients with descending thoracic aneurysmal disease and to assess the impact of left subclavian artery (LSA) coverage on stroke incidence.MethodsA systematic review of English and German articles on perioperative (in-hospital or 30 day) stroke incidence following TEVAR for descending aortic aneurysm was performed, including studies with ≥50 cases, using MEDLINE and EMBASE (2005–2015). The pooled prevalence of perioperative stroke with 95% CI was estimated using random effect analysis. Heterogeneity was examined using I² statistic.ResultsOf 215 studies identified, 10 were considered suitable for inclusion. The included studies enrolled a total of 2594 persons (61% male) between 1997 and 2014 with a mean weighted age of 71.8 (95% CI 71.1–73.6) years. The pooled prevalence for stroke was 4.1% (95% CI 2.9–5.5) with moderate heterogeneity between studies (I² = 49.8%, p = .04). Five studies reported stroke incidences stratified by the management of the LSA, that is uncovered versus covered and revascularised versus covered and not-revascularised. In cases where the LSA remained uncovered, the pooled stroke incidence was 3.2% (95% CI 1.0–6.5). There was, however, an indication that stroke incidence increased following LSA coverage, to 5.3% (95% CI 2.6–8.6) in those with a revascularisation and 8.0% (95% CI 4.1–12.9) in those without revascularisation.ConclusionStroke incidence is an important morbidity after TEVAR, and probably increases if the LSA is covered during the procedure, particularly in those without revascularisation.



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The impact of two fluoropolymer manufacturing facilities on downstream contamination of a river and drinking water resources with per- and polyfluoroalkyl substances

Abstract

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are emerging contaminants that have been detected in the environment, biota, and humans. Drinking water is a route of exposure for populations consuming water contaminated by PFAS discharges. This research study reports environmental measurement concentrations, mass flows, and the fate of dozens of PFASs in a river receiving effluents from two fluoropolymer manufacturing facilities. In addition to quantified levels of PFASs using LC- and GC-MS analytical methods, the total amount of unidentified PFASs and precursors was assessed using two complementary analytical methods, absorbable organic fluorine (AOF) determination and oxidative conversion of perfluoroalkyl carboxylic acid (PFCA) precursors. Several dozen samples were collected in the river (water and sediment) during four sampling campaigns. In addition, samples were collected in two well fields and from the outlet of the drinking water treatment plants after chlorination. We estimated that 4295 kg PFHxA, 1487 kg 6:2FTSA, 965 kg PFNA, 307 kg PFUnDA, and 14 kg PFOA were discharged in the river by the two facilities in 2013. High concentrations (up to 176 ng/g dw) of odd long-chain PFASs (PFUnDA and PFTrDA) were found in sediment samples. PFASs were detected in all 15 wells, with concentrations varying based on the location of the well in the field. Additionally, the presence of previously discharged PFASs was still measurable. Significant discrepancies between PFAS concentration profiles in the wells and in the river suggest an accumulation and transformation of PFCA precursors in the aquifer. Chlorination had no removal efficiency and no unidentified PFASs were detected in the treated water with either complementary analytical method. Although the total PFAS concentrations were high in the treated water, ranging from 86 to 169 ng/L, they did not exceed the currently available guideline values.

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Activated carbon adsorptive removal of azo dye and peroxydisulfate regeneration: from a batch study to continuous column operation

Abstract

The performance of activated carbon (AC) for the adsorption of Acid Orange 7 (AO7) was investigated in both batch and column studies. The optimal conditions for adsorption process in batch study were found to be a stirring speed of 500 rpm, AC dosage of 5 g/L, and initial AO7 concentration of 100 mg/L. The spent AC was then treated with peroxydisulfate (PDS), and the regenerated AC was used again to adsorb AO7. Both pseudo-first-order and pseudo-second-order rate models for adsorption kinetics were investigated, and the results showed that the latter model was more appropriate. The effects of regeneration time, PDS concentration, and stirring speed on AO7-spent AC regeneration were investigated in batch studies, and the optimal conditions were time 2 h, stirring speed 700 rpm, and PDS concentration 10 g/L. Under the same adsorption conditions, 89% AO7 could be decolorized by adsorption using regenerated AC. In the column studies, the effect of flow rate was investigated and the adsorption capacity was nearly the same when the flow rate rose from 7.9 to 11.4 mL/min, but it decreased significantly when the flow rate was increased to 15.2 mL/min. The performance of regenerated AC in the column was also investigated, and a slight increase in the adsorption capacity was observed in the second adsorption cycle. However, the adsorption capacity decreased to some extent in the third cycle due to the consumption of C-OH group on the AC surface during PDS regeneration.

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Thermal effects on development and adult longevity of endoparasitoid Chelonus murakatae Munakata (Hymenoptera: Braconidae)

Abstract

The effects of temperature on the development duration and longevity of adult of Chelonus murakatae were studied under five constant temperatures including 22.5, 25, 27.5, 30 and 32.5 ± 0.5 °C under laboratory conditions. It was observed that the development time was inversely proportional to the temperature within the range of 22.5 to 32.5 °C. The results indicated that the optimum temperature for development ranged from 25 to 30 °C. Thermal threshold was estimated by a linear model which was recorded as 15.5 and 18.5 °C for males and females, respectively. Number of degree days required to complete the development from egg to adult were 439.6 degree days in males and 336.8 degree days in females. Adult longevity also decreased with increase in temperature. This information can be used for optimizing mass culturing and field release for an efficient biological control of Chilo suppressalis in this specie.

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Re. “Fate of the Distal False Aneurysms Complicating Internal Carotid Artery Dissection: Systematic Review”

Publication date: Available online 18 December 2016
Source:European Journal of Vascular and Endovascular Surgery
Author(s): V.E.C. Pourier, G.J. de Borst




http://ift.tt/2gZqnGf

Change in thermal transitions and water uptakes of poly(l-lactic acid) blends upon hydrolytic degradation

Publication date: February 2017
Source:Data in Brief, Volume 10
Author(s): Hideko T. Oyama, Daisuke Tanishima, Shintaro Maekawa
This article reports experimental data related to the research article entitled "Poly(malic acid-co-l-lactide) as a Superb Degradation Accelerator for Poly(l-lactic acid) at Physiological Conditions" (H.T. Oyama, D. Tanishima, S. Maekawa, 2016) [1]. Hydrolytic degradation of poly(l-lactic acid) (PLLA) blends with poly(aspartic acid-co-l-lactide) (PAL) and poly(malic acid-co-l-lactide) (PML) oligomers was investigated in a phosphate buffer solution at 40°C. It was found in the differential scanning calorimetry measurements that upon hydrolysis the cold crystallization temperature (Tc) and the melting temperature (Tm) significantly shifted to lower temperature. Furthermore, the hydrolysis significantly promoted water sorption in both blends.



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Announcements

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1





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List of Reviewers 2016

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1





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Treatment of Second Ipsilateral Breast Tumor Event: A need for a new type of evidence for avoiding mastectomy

Publication date: Available online 18 December 2016
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Mark Trombetta, Jean-Michel Hannoun-Levi




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Inferior mesenteric artery lymph node metastasis in rectal cancer treated with neoadjuvant chemoradiotherapy: Incidence, prediction and prognostic impact

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1
Author(s): Y. Sun, P. Chi, H. Lin, X. Lu, Y. Huang, Z. Xu, S. Huang, X. Wang
AimTo assess the effect of neoadjuvant chemoradiotherapy (nCRT) on inferior mesenteric artery (IMA) nodal metastasis and identify predictors for IMA nodal metastasis in locally advanced rectal cancer (LARC) after nCRT.MethodPropensity score matching of 1167 patients with LARC was performed. Clinicopathological predictors and survival rates were analyzed using univariate and multivariate analyses.ResultsCompared to surgery alone, nCRT reduced the incidence of IMA nodal metastasis (before matching, 4.8% vs 9.1%, p = 0.004; after matching, 4.3% vs 10.1%, p = 0.002). Logistic regression analysis revealed that poorly differentiated (OR = 5.955, p < 0.001), tumors located above the peritoneal reflection (OR = 3.513, p = 0.005), and preoperative CEA levels ≧10 ng/ml (OR = 4.774, p = 0.005) were associated with IMA nodal metastasis. Time intervals to surgery ≧6 weeks were associated with fewer IMA nodal metastasis (OR = 0.274, p = 0.009).Over a median 40-month follow-up, the 3-year overall survival and disease-free survival rates were 63.0% and 43.1% in IMA-positive patients, respectively, which were significantly lower than the corresponding 89.0% and 82.4% rates in IMA-negative patients. Cox regression analysis revealed that IMA nodal metastasis was independently associated with unfavorable 3-year DFS.ConclusionnCRT reduced the incidence of IMA node metastasis. Tumors located above the peritoneal reflection, poorly differentiated, and higher preoperative CEA levels were associated with IMA nodal metastasis after nCRT. IMA lymph node dissection is beneficial to certain patients with IMA nodal metastases, and the oncologic benefit may be improved if IMA nodal metastasis can be predicted.



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Follow-up of colon cancer patients; causes of distress and need for supportive care

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1
Author(s): T. Wieldraaijer, L.A.M. Duineveld, K.M. van Asselt, A.A.W. van Geloven, W.A. Bemelman, H.C.P.M. van Weert, J. Wind
BackgroundColon cancer survivors experience physical and psychosocial problems that are currently not adequately addressed. This study investigated distress in patients after curative surgery for colon cancer and studied how this corresponds with the need for supportive care.MethodsProspective cohort of patients with stage I–III colon carcinoma, treated with curative intent, currently in follow-up at 6 different hospitals. A survey recorded symptoms, experienced problems, and (un)expressed needs. Satisfaction with supportive care was recorded.ResultsTwo hundred eighty four patients were included; 155 males and 129 females, with a mean age of 68 years (range 33–95), and a median follow-up of 7 months. 227 patients completed the survey.Patients experienced a median of 23 symptoms in the week before the survey, consisting of a median of 10 physical, 8 psychological and 4 social symptoms. About a third of these symptoms was felt to be a problem. Patients with physical problems seek supportive care in one in three cases, while patients with psychosocial problems only seek help in one in eight cases.Patients who recently finished treatment, finished adjuvant chemotherapy, or had a stoma, had more symptoms and needed more help in all domains.Patients most frequently consulted general practitioners (GPs) and surgeons, and were satisfied with the help they received.ConclusionColon cancer survivors experience many symptoms, but significantly fewer patients seek help for a psychosocial problem than for a physical problem. Consultations with supportive care are mainly with GPs or surgeons, and both healthcare providers are assessed as providing satisfying care.



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Comments on “intraoperative near-infrared fluorescence imaging using indocyanine green in colorectal carcinomatosis surgery: proof of concept”

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1
Author(s): G. Liberale, P. Bourgeois, V. Donckier




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Focused parathyroidectomy without intraoperative parathormone testing is safe after pre-operative localization with 18F-Fluorocholine PET/CT

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1
Author(s): M. Hocevar, L. Lezaic, S. Rep, K. Zaletel, T. Kocjan, M.J. Sever, J. Zgajnar, B. Peric
A focused surgical approach based on pre-operative localization replaced the classical four-gland exploration in patients with primary hyperparathyroidism (PHP). Sestamibi scanning and ultrasound are most often used localization modalities with reported sensitivity of 54–100% for identification of single gland disease.The aim of this study was to analyze the results of pre-operative localization with ¹⁸F-Fluorocholine PET/CT (FCh-PET) in patients with PHP.A retrospective review of 151 patients with PHP who underwent surgery after pre-operative localization with FCh-PET was performed. Only a focused parathyroidectomy without ioPTH testing had been done in patients with single adenoma on FCh-PET. Primary outcome was operative failure, defined as persistent PHP.According to pre-operative FCh-PET 126 (83,4%) patients had single adenoma, 22 (14,5%) multiglandular disease and the test was negative in only two patients. Intraoperative failure experienced 4/126 patients (3,3%) with single adenoma. Removed parathyroid glands were normal in three and hyperplastic in one patient with intraoperative failure. A limited bilateral neck exploration with ioPTH testing was used in 14/22 patients with double adenoma and a classical four-gland exploration without ioPTH testing was used in 8/22 patients with more than two pathological glands according to pre-operative FCh-PET. Intraoperative failure experienced 2/22 patients (9,1%). In two patients with negative FCh-PET a classical four-gland exploration without ioPTH testing was used and one experienced intraoperative failure.A preoperative localization with FCh-PET is a reliable test in patients with PHP. Patients with a single adenoma on FCh-PET can safely undergo a focused parathyroidectomy without ioPTH testing.



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Calendar

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1





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Symptoms, signs and radiologic findings in patients having reoperative surgery for malignant peritoneal mesothelioma

Publication date: January 2017
Source:European Journal of Surgical Oncology (EJSO), Volume 43, Issue 1
Author(s): M.D. Llanos, P.H. Sugarbaker
BackgroundA reasonable estimate is that 50% of patients treated with cytoreductive surgery (CRS) and perioperative chemotherapy for malignant peritoneal mesothelioma will recur. Recognition of this recurrence and knowledgeable selection for additional surgical intervention is important in improving survival of patients who progress.Material and methodsPatients treated for malignant peritoneal mesothelioma with CRS and perioperative chemotherapy were placed in follow-up for assessment of symptoms and signs and radiologic abnormalities by CT. The data were prospectively maintained and retrospectively reviewed.ResultsFrom a database of 130 patients with malignant peritoneal mesothelioma, 38 patients who had 50 reoperations with disease recurrence that was histologically confirmed were studied. The median time to first recurrence was 14 months with a range of 3–102. Considering 50 reoperative events the most common symptoms or signs were abdominal pain (40%) and abdominal distention (34%). The most common radiologic finding was a tumor mass (56%). Patients with an abdominal or pelvic mass had a reduced prognosis (p = 0.006) and patients with an absence of radiologic abnormalities had an improved survival (p = 0.047).ConclusionsIn patients having reoperative surgery, symptoms, signs and radiologic abnormalities associated with recurrent (progressive) malignant peritoneal mesothelioma are abdominal pain, abdominal distention, and a tumor mass. An abdominal or pelvic mass was associated with a reduced prognosis and an absence of radiologic abnormalities with an improved prognosis.

Teaser

Synopsis: Patients with malignant peritoneal mesothelioma who recur and go on to have a second or third operation were studied. The symptoms, signs and radiologic findings were correlated with survival following the reoperative surgery.


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Short term safety of oncoplastic breast conserving surgery for larger tumors

Publication date: Available online 18 December 2016
Source:European Journal of Surgical Oncology (EJSO)
Author(s): D.J. Wijgman, B. ten Wolde, N.R.A. van Groesen, M.E. Keemers-Gels, F.J.H. van den Wildenberg, L.J.A. Strobbe
BackgroundOncoplastic surgery (OPS) replaces lumpectomy as standard technique in breast conserving surgery (BCS). OPS has shown to give good cosmetic results, but is it as safe as standard lumpectomy? We conducted a retrospective cohort study to determine postoperative complications, resection margins and re-excision rates for OPS compared to standard lumpectomy.MethodsBased on data from the 'Netherlands Cancer Registry' and medical records we scored patient, treatment and follow-up related variables. All consecutive patients, with an initially breast conserving operation for primary breast cancer, performed between January 2010 and December 2014 in a dedicated breast center were eligible. Breast surgeons performed the operations. Invasive and in situ tumors were included. Postoperative complications within 30 days after surgery and the need for additional treatment were classified using the Clavien Dindo classification. Involved margin rates and subsequent re-excision were compared.ResultsWe included 828 women with 842 breast cancers, who had a standard lumpectomy (62.7%) or oncoplastic resection (37.3%). OPS was performed more often for larger tumors (17.5mm vs 13.6mm, p=0.002) and for tumors in the caudal half of the breast (33.1% vs 16.9%, p<0.001). There was no significant difference in postoperative complications. Positive surgical margins were similar (OPS 22.6%, lumpectomy 18.2%, p=0.119), as were re-excision rates (p=0.337).ConclusionOncoplastic breast surgery can be safely applied in larger tumors, resulting in comparable postoperative complications, resection margins and re-excision rates compared to standard lumpectomy.



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Aesthetic and Functional Outcome after Breast Conserving Surgery – Comparison between Conventional and Oncoplastic Resection

Publication date: Available online 18 December 2016
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Kaisu Ojala, Tuomo J. Meretoja, Marjut H.K. Leidenius
BackgroundRecent studies implicate that oncoplastic breast cancer surgery provides better aesthetic outcome than conventional resection. Several factors have been associated with poor aesthetic outcome. This study aims to compare patient-reported aesthetic and functional outcome after conventional and oncoplastic resection and to evaluate prognostic factors for poor aesthetic outcome in a population-based setting.Methods637 patients having breast conserving treatment (BCT) due to unilateral primary breast cancer at a single hospital district during 2010 were included. Aesthetic and functional outcome were evaluated using two questionnaires three years after surgery.ResultsQuestionnaires were returned by 379 (59%) patients; 293 (77%) of these had conventional and 86 (23%) oncoplastic resection. Patients in oncoplastic resection group had larger tumour diameter (p<0.001), larger resection specimens (p<0.001), and more often multifocal tumours (p=0.032), node positive cancer (p=0.029) and lower quadrant tumour localization (p=0.007). Aesthetic outcome according to BCTOS questionnaire was good in 284 (75%) patients; 52 (61%) patients in the oncoplastic group and 230 patients (81%) in the conventional resection group, p<0.001. Larger tumour diameter (p=0.033), multifocality (p=0.022), weight of resection specimen (<0.001) and oncoplastic surgery (p<0.001) were predicting poor aesthetic outcome, when all patients were included. Tumour multifocality (p=0.013) remained predictor of poor aesthetic outcome in conventional resection group but not in oncoplastic resection group.ConclusionsPatient satisfaction to aesthetic outcome after BCT is high. Conventional resection provides good aesthetic outcome in appropriately selected patients. Oncoplastic resection enables BCT in patients with larger and multifocal tumours with favourable aesthetic outcome.



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Plasma concentrations of osteocalcin are associated with the timing of pubertal progress in boys

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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Influence of Social Media on the Dissemination of a Traditional Surgical Research Article

Publication date: Available online 16 December 2016
Source:Journal of Surgical Education
Author(s): EeeLN H. Buckarma, Cornelius A. Thiels, Becca L. Gas, Daniel Cabrera, Juliane Bingener-Casey, David R. Farley
ObjectiveMany institutions use social media to share research with the general public. However, the influence of social media on the dissemination of a surgical research article itself is unknown. Our objective was to determine whether a blog post highlighting the findings of a surgical research article would lead to increased dissemination of the article itself.DesignWe prospectively followed the online page views of an article that was published online in Surgery in May 2015 and published in print in August 2015. The authors subsequently released a blog post in October 2015 to promote the research. The number of article page views from the journal's website was obtained before and after the blog post, along with the page views from the blog post itself. Social media influence data were collected, including social activity in the form of mentions on social media sites, scholarly activity in online libraries, and scholarly commentary.ResultsThe article's online activity peaked in the first month after online publication (475 page views). Online activity plateaued by 4 months after publication, with 118 monthly page views, and a blog post was subsequently published. The blog post was viewed by 1566 readers, and readers spent a mean of 2.5 minutes on the page. When compared to the projected trend, the page views increased by 33% in the month after the blog post. The blog post resulted in a 9% increase in the social media influence score and a 5% absolute increase in total article page views.ConclusionsSocial media is an important tool for sharing surgical research. Our data suggest that social media can increase distribution of an article's message and also potentially increase dissemination of the article itself. We believe that authors should consider using social media to increase the dissemination of traditionally published articles.



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The First Trial—When Will We Examine the Effect of Duty Hours on Resident Burnout?

Publication date: Available online 18 December 2016
Source:Journal of Surgical Education
Author(s): Britney Corey




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Is insulin growth factor-1 the future for treating autism spectrum disorder and/or schizophrenia?

Publication date: Available online 18 December 2016
Source:Medical Hypotheses
Author(s): Rami Bou Khalil
To date, no curative psychopharmacologic treatment exists for the core symptoms of autism spectrum disorder (ASD) as well as for schizophrenia. Bumatenide is a specific antagonist of the first isoform of the Na-K-Cl cotransporter (NKCC1). It is usually used as a diuretic but may also promote a decrease in intraneuronal chloride ion concentration leading to hyperpolarization in neuronal membrane and subsequent decrease in neuronal hyperexcitability. This physiologic effect has been considered to be behind the relative efficacy of bumetanide in improving symptoms of ASD and, to a lesser extent, schizophrenia. However, insulin growth factor-1 (IGF-1) shows the same physiologic effect. In addition, it may improve brain network dysconnectivity which is known to be an important neurobiological feature in ASD and schizophrenia. IGF-1 has started to prove its efficacy in improving symptoms of children with Rett syndrome, a genetic disorder that shares several clinical similarities with ASD. IGF-1 may also improve oxytocin secretion through the enhancement of the transient potential receptor V2 channel function. Accordingly, IGF-1 should be studied as a potential treatment of ASD and other mental disorders characterized with brain dysconnectivity such as schizophrenia.



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Tourette Syndrome in the Context of Evolution and Behavioral Ecology

Publication date: Available online 18 December 2016
Source:Medical Hypotheses
Author(s): Jared Edward Reser
Tourette syndrome, and the closely related spectrum of tic disorders, are inherited neuropsychiatric conditions characterized by the presence of repetitive and stereotyped movements. Tics are elicited by either environmental experiences or internal signals that instruct the basal ganglia to initiate automatic or procedural movements. In most vertebrates the basal ganglia encode instructions for habitually used sequences of motor movements that are essential to survival. Tic disorders may represent evolved phenotypes with a lower threshold for basal ganglia-directed actions. This may have produced a susceptibility to extraneous tics, but also produced fast-acting tactical solutions to immediate physical problems. During periods of nonstop movement, continual foraging, and sustained vigilance, it may have been advantageous to allow subcortical motor commands to intrude into ongoing motor activities. It is clear that the engrams for individual motor responses held in the basal ganglia are selected by converging cortical and subcortical inputs. This form of convergent action selection results in the selection of the most contextually reinforced actions. Today people with Tourette's have tics that seem arbitrary and inappropriate; however, this may be due to the vast discrepancies in reinforcement between the ancestral environment and the modern one. In prehistoric environments, the motor behaviors of individuals with tic disorders may have been appropriate in environmental context, and had ecological relevance in survival and self-promotion.



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Vaccine coverage and adherence to EPI schedules in eight resource poor settings in the MAL-ED cohort study

Publication date: Available online 18 December 2016
Source:Vaccine
Author(s): Christel Hoest, Jessica C. Seidman, Gwenyth Lee, James A Platts-Mills, Asad Ali, Maribel Paredes Olortegui, Pascal Bessong, Ram Chandyo, Sudhir Babji, Venkata Raghava Mohan, Dinesh Mondal, Mustafa Mahfuz, Estomih R Mduma, Emanuel Nyathi, Claudia Abreu, Mark A. Miller, William Pan, Carl J. Mason, Stacey L. Knobler
BackgroundLaunched in 1974, the Expanded Program on Immunization (EPI) is estimated to prevent two-three million deaths annually from polio, diphtheria, tuberculosis, pertussis, measles, and tetanus. Additional lives could be saved through better understanding what influences adherence to the EPI schedule in specific settings.MethodsThe Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study followed cohorts in eight sites in South Asia, Africa, and South America and monitored vaccine receipt over the first two years of life for the children enrolled in the study. Vaccination histories were obtained monthly from vaccination cards, local clinic records and/or caregiver reports. Vaccination histories were compared against the prescribed EPI schedules for each country, and coverage rates were examined in relation to the timing of vaccination. The influence of socioeconomic factors on vaccine timing and coverage was also considered.ResultsCoverage rates for EPI vaccines varied between sites and by type of vaccine; overall, coverage was highest in the Nepal and Bangladesh sites and lowest in the Tanzania and Brazil sites. Bacillus Calmette-Guérin coverage was high across all sites, 87–100%, whereas measles vaccination rates ranged widely, 73–100%. Significant delays between the scheduled administration age and actual vaccination date were present in all sites, especially for measles vaccine where less than 40% were administered on schedule. A range of socioeconomic factors were significantly associated with vaccination status in study children but these results were largely site-specific.ConclusionsOur findings highlight the need to improve measles vaccination rates and reduce delayed vaccination to achieve EPI targets related to the establishment of herd immunity and reduction in disease transmission.



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Characterization of O-antigen delivered by Generalized Modules for Membrane Antigens (GMMA) vaccine candidates against nontyphoidal Salmonella

Publication date: Available online 18 December 2016
Source:Vaccine
Author(s): G. De Benedetto, R. Alfini, P. Cescutti, M. Caboni, L. Lanzilao, F. Necchi, A. Saul, C.A. MacLennan, S. Rondini, F. Micoli
Invasive nontyphoidal Salmonella disease (iNTS) is a leading cause of death and morbidity in Africa. The most common pathogens are Salmonella enterica serovars Typhimurium and Enteritidis. The O-antigen portion of their lipopolysaccharide is a target of protective immunity and vaccines targeting O-antigen are currently in development. Here we investigate the use of Generalized Modules for Membrane Antigens (GMMA) as delivery system for S. Typhimurium and S. Enteritidis O-antigen. Gram-negative bacteria naturally shed outer membrane in a blebbing process. By deletion of the tolR gene, the level of shedding was greatly enhanced. Further genetic modifications were introduced into the GMMA-producing strains in order to reduce reactogenicity, by detoxifying the lipid A moiety of lipopolysaccharide. We found that genetic mutations can impact on expression of O-antigen chains. All S. Enteritidis GMMA characterized had an O-antigen to protein w/w ratio higher than 0.6, while the ratio was 0.7 for S. Typhimurium ΔtolR GMMA, but decreased to less than 0.1 when further mutations for lipid A detoxification were introduced. Changes were also observed in O-antigen chain length and level and/or position of O-acetylation. When tested in mice, the GMMA induced high levels of anti-O-antigen-specific IgG functional antibodies, despite variation in density and O-antigen structural modifications.In conclusion, simplicity of manufacturing process and low costs of production, coupled with encouraging immunogenicity data, make GMMA an attractive strategy to further investigate for the development of a vaccine against iNTS.



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Epidemiology of hepatitis B infection in Finland: Implications for immunisation policy

Publication date: Available online 18 December 2016
Source:Vaccine
Author(s): Tanja Karvonen, Kari Auranen, Markku Kuusi, Tuija Leino
ObjectivesWe describe the current epidemiology of acute and chronic hepatitis B infections in Finland. We estimate the total incidence of chronic hepatitis B following from the current incidence of acute infections and the influx of chronic carriers of hepatitis B associated with net immigration. We evaluate the incidence of hepatitis B infections preventable by a universal vaccination programme among infants.MethodsWe analysed hepatitis B cases reported to the National Infectious Disease Register during 2004–2012 and used pre-developed methods to adjust for acute asymptomatic infections. We estimated the projected incidence of chronic infection by applying age-specific risks of chronic infection to the estimated incidence of acute infection. We estimated the influx of chronic carriers associated with immigration by utilising data on immigration during 2004–2012 and the WHO regional estimates of carriage prevalence.ResultsThe estimated incidence of acute hepatitis B infection in Finland, adjusted for asymptomatic infections, was 1.67 per 100,000 per year (95% Crl 1.43–1.94) which is 4.2-fold to the register-based incidence. The estimated lifetime risks of acute and chronic hepatitis B infections were 0.13% and 0.01%, respectively. We estimated that annually seven new chronic infections would result from infections acquired in Finland. These new chronic infections accounted for 1.2% of the total incidence of chronic infections. We estimated that eventually three chronic infections per year would be potentially preventable by a universal infant vaccination programme.ConclusionsPartly due to the fact that hepatitis B infections in neonates and in children are rare, a very limited number of chronic hepatitis B infections resulted from infection acquired within the country. A vast majority of chronic hepatitis B infections occurred among foreign-born persons and were therefore not preventable by a universal infant immunisation programme in Finland. Even with a targeted immunisation programme, the incidence of hepatitis B infection has remained low.



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Dendritic Spine Classification using Shape and Appearance Features based on Two-Photon Microscopy

Publication date: Available online 18 December 2016
Source:Journal of Neuroscience Methods
Author(s): Muhammad Usman Ghani, Fitsum Mesadi, Sümeyra Demir Kanık, Ali Özgür Argunşah, Anna Felicity Hobbiss, Inbal Israely, Devrim Ünay, Tolga Taşdizen, Müjdat Çetin
BackgroundNeuronal morphology and function are highly coupled. In particular, dendritic spine morphology is strongly governed by the incoming neuronal activity. The first step towards understanding the structure-function relationships is to classify spine shapes into the main spine types suggested in the literature. Due to the lack of reliable automated analysis tools, classification is mostly performed manually, which is a time-intensive task and prone to subjectivity.New MethodWe propose an automated method to classify dendritic spines using shape and appearance features based on challenging two-photon laser scanning microscopy (2PLSM) data. Disjunctive Normal Shape Models (DNSM) is a recently proposed parametric shape representation. We perform segmentation of spine images by applying DNSM and use the resulting representation as shape features. Furthermore, we use Histogram of Oriented Gradients (HOG) to extract appearance features. In this context, we propose a kernel density estimation (KDE) based framework for dendritic spine classification, which uses these shape and appearance features.ResultsOur shape and appearance features based approach combined with Neural Network (NN) correctly classifies 87.06% of spines on a dataset of 456 spines.Comparison with Existing MethodsOur proposed method outperforms standard morphological feature based approaches. Our KDE based framework also enables neuroscientists to analyze the separability of spine shape classes in the likelihood ratio space, which leads to further insights about nature of the spine shape analysis problem.ConclusionsResults validate that performance of our proposed approach is comparable to a human expert. It also enable neuroscientists to study shape statistics in the likelihood ratio space.



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Contribution of the HNE-Immunohistochemistry to Modern Pathological Concepts of Major Human Diseases

Publication date: Available online 18 December 2016
Source:Free Radical Biology and Medicine
Author(s): Kamelija Zarkovic, Antonia Jakovcevic, Neven Zarkovic
Excessive production of reactive oxygen species can induce peroxidation of the polyunsaturated fatty acids thus generating reactive aldehydes like 4-hydroxy-2-nonenal (HNE), denoted as "the second messenger of free radicals". Because HNE has high binding affinity for cysteine, histidine and lysine it forms relatively stable and hardly metabolized protein adducts. By changing structure and function of diverse structural and regulatory proteins, HNE achieves not only cytotoxic, but also regulatory functions in various pathophysiological processes. Numerous animal model studies and clinical trials confirmed HNE as one of the crucial factors in development and progression of many disorders, in particular of cancer, (neuro)degenerative, metabolic and inflammatory diseases.Since HNE has multiple biological effects and is in the living system usually bound to proteins and peptides, many research groups work on development of specific immunochemical methods targeting the HNE-histidine adducts as major bioactive marker of lipid peroxidation, following the research pathway initiated by Hermann Esterbauer, who discovered HNE in 60's. Such immunohistochemical studies did not only prove the high biomedical importance of HNE, but have also given new insights into major diseases of the modern man. Immunohistochemical studies have shown reversibility of formation of the HNE-protein adducts, as well as differential onset of the HNE-mediated lipid peroxidation between age- associated atherosclerosis and photoaging, revealing eventually selective anti-cancer effects of HNE produced by non-malignant cells in vicinity of cancer.This review summarizes some of the HNE-histidine immunohistochemistry findings we believe are of broad biomedical interest and could inspire new studies in the field.



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BAP1 immunohistochemistry has limited prognostic utility as a complement of CDKN2A (p16) fluorescence in situ hybridization in malignant pleural mesothelioma

Publication date: February 2017
Source:Human Pathology, Volume 60
Author(s): Stephanie M. McGregor, James McElherne, Agata Minor, Jennifer Keller-Ramey, Ryan Dunning, Aliya N. Husain, Wickii Vigneswaran, Carrie Fitzpatrick, Thomas Krausz
BRCA-associated protein 1 (BAP1) immunohistochemistry (IHC) and CDKN2A (p16) fluorescence in situ hybridization (FISH) have shown clinical utility in confirming the diagnosis of malignant pleural mesothelioma (MPM), but the role for using these 2 markers to guide clinical management is not yet clear. Although p16 loss is predictive of poor prognosis, there is controversy as to whether BAP1 loss is predictive of a more favorable prognosis; how these results interact with one another has not been explored. We performed CDKN2A FISH on a previously published tissue microarray on which we had performed BAP1 IHC, revealing combined BAP1/p16 status for 93 MPM cases. As expected, BAP1 IHC in combination with CDKN2A FISH resulted in high sensitivity (84%) and specificity (100%) for MPM, and p16 loss was an independent predictor of poor survival (hazard ratio, 2.2553; P = .0135). There was no association between BAP1 loss and p16 loss, as 26%, 28%, 30%, and 16% of overall cases demonstrated loss of BAP1 alone, loss of p16 alone, loss of both BAP1 and p16, or neither abnormality, respectively. Although multivariate analysis demonstrated that BAP1 IHC is not an independent predictor of prognosis, when viewed in combination with homozygous CDKN2A deletion, risk stratification was evident. More specifically, patients with CDKN2A disomy and loss of BAP1 expression had improved outcomes compared with those with CDKN2A disomy and retained BAP1 expression (hazard ratio, 0.2286; P = .0017), and this finding was notably evident among epithelioid cases. We conclude that BAP1 IHC provides prognostic information within the context of CDKN2A FISH that may have clinical utility beyond diagnosis.



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Modifying the One-Minute Preceptor Model for Use in the Emergency Department with a Critically Ill Patient

Publication date: Available online 16 December 2016
Source:The Journal of Emergency Medicine
Author(s): Kimberly Sokol




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Response

Publication date: Available online 16 December 2016
Source:The Journal of Emergency Medicine
Author(s): Susan E. Farrell, Sally Santen




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Tuberous sclerosis: Inside and outside

Publication date: Available online 16 December 2016
Source:Medical Journal Armed Forces India
Author(s): Manoj Gopinath, Deepak Vashisht, G.S. Madan




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Use of corticosteroids in acute respiratory distress syndrome: Perspective from an Indian intensive care unit

Publication date: Available online 16 December 2016
Source:Medical Journal Armed Forces India
Author(s): Naveen G.S. Chandra, Saraschandra Vallabhajosyula, Barkur A. Shastry, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula, Kavita Saravu
BackgroundAcute respiratory distress syndrome (ARDS) causes overwhelming inflammation, which serves as a potential target for corticosteroids. Despite extensive Western literature, there are no Indian studies evaluating steroids in ARDS.MethodsThis was a retrospective study at an Indian intensive care unit (ICU) on ARDS patients. Demographic, clinical, laboratory, and imaging parameters were collected. Patients were divided into cohorts based on steroid use, and some received high-dose (2mg/kg/day), whereas others received low-dose (1mg/kg/day) steroids. Primary outcomes were in-hospital mortality and secondary outcomes included need for and duration of invasive mechanical ventilation (IMV), IMV-free days, ICU length of stay (LOS), and total LOS. Two-tailed p<0.05 was considered statistically significant.ResultsDuring the 20-month period, 95 patients [median age 37 (30–47) years; 48 (50.5%) males] met our inclusion criteria. Steroid use was noted in 48 (50.5%) patients [11 (22.9%) low-dose and 37 (77.1%) high-dose]. Baseline characteristics of the cohorts, including ARDS severity indices, were comparable. Of these 95 patients, 70 (73.7%) had sepsis, but microbiological diagnosis was positive only in 17 (17.9%) patients. Steroid use did not significantly influence mortality [odds ratio (OR) 0.6 (0.3–1.4)] or need for IMV [OR 1.0 (0.4–2.6)]. There were no differences in outcomes of IMV-free days, ICU LOS, or total LOS. These outcomes were comparable between the high-dose and low-dose steroid users.ConclusionsSteroid use and comparison of low-dose vs. high-dose steroids did not influence outcomes associated with ARDS in the Indian population.



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Device-Associated Healthcare-Associated Infections (DA-HAI) and the caveat of multiresistance in a multidisciplinary intensive care unit

Publication date: Available online 16 December 2016
Source:Medical Journal Armed Forces India
Author(s): Inam Danish Khan, Atoshi Basu, Sheshadri Kiran, Shaleen Trivedi, Priyanka Pandit, Anupam Chattoraj
BackgroundDevice-Associated Healthcare-Associated Infections (DA-HAI), including Ventilator-Associated Pneumonia (VAP), Central-Line-Associated Blood Stream Infection (CLABSI), and Catheter-Related Urinary Tract Infection (CAUTI), are considered as principal contributors to healthcare hazard and threat to patient safety as they can cause prolonged hospital stay, sepsis, and mortality in the ICU. The study intends to characterize DA-HAI in a tertiary care multidisciplinary ICU of a teaching hospital in eastern India.MethodsThis prospective outcome-surveillance study was conducted among 2157 ICU patients of a 760-bedded teaching hospital in Eastern India. Clinical, laboratory and environmental surveillance, and screening of HCPs were conducted using the US Centers for Disease Control and Prevention (CDC)'s National Healthcare Safety Network (NHSN) definitions and methods.ResultsWith 8824 patient/bed/ICU days and 14,676 device days, pooled average device utilization ratio was 1.66, total episodes of DA-HAI were 114, and mean monthly rates of DA-HAI, VAP, CLABSI, and CAUTI were 4.75, 2, 1.4, and 1.25/1000 device days. Most common pathogens isolated from DA-HAI patients were Klebsiella pneumoniae (24.6%), Escherichia coli (21.9%), and Pseudomonas aeruginosa (20.2%). All Acinetobacter baumanii, >80% K. pneumoniae and E. coli, and >70% P. aeruginosa were susceptible only to colistin and tigecycline. One P. aeruginosa isolate was panresistant.ConclusionMean rates of VAP, CLABSI, and CAUTI were 14.4, 8.1, and 4.5 per 1000 device days, which are comparable with Indian and global ICUs. Patients and HCPs form important reservoirs of infection. Resolute conviction and sustained momentum in Infection Control Initiatives are an essential step toward patient safety.



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Flow cytometric detection of minimal residual disease in B-lineage acute lymphoblastic leukemia by using “MRD lite” panel

Publication date: Available online 16 December 2016
Source:Medical Journal Armed Forces India
Author(s): Tathagata Chatterjee, Venkatesan Somasundaram
BackgroundNormal B lymphoid precursors that express CD19, CD10, and/or CD34 are highly sensitive to corticosteroids and after two weeks of remission-induction therapy, they form less than 0.01% of the bone marrow population. More than 0.01% of such cells indicate minimal residual disease (MRD). MRD "lite" panel uses only three antibodies, namely CD19, CD10, and CD34 for MRD detection in cases of B-lineage acute lymphoblastic leukemia (B-ALL) expressing CD19, CD10, and/or CD34 by flow cytometry.MethodsFifteen cases of B-ALL were studied for MRD at Day 19 of remission-induction therapy by employing a simplified MRD detection protocol using a 3-color fluorochrome conjugated antibody panel (CD19, CD10, and CD34) on bone marrow aspirate samples.ResultsAll cases at diagnosis expressed CD19, CD10, and CD34. Of fifteen patients, five (33.33%) were MRD negative with less than 0.01% of mononuclear cells and remaining ten cases (66.66%) were MRD positive, with the level of 0.01% to less than 0.1% cells.ConclusionThe MRD assay used in this study is a simplified method for detecting MRD at Day 19 of remission-induction therapy for B-lineage ALL. This MRD assay is an effective and useful methodology in cases of B-ALL expressing CD19, CD10, and/or CD34 by flow cytometry.



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Ampelopsin attenuates lipopolysaccharide-induced inflammatory response through the inhibition of the NF-κB and JAK2/STAT3 signaling pathways in microglia

Publication date: March 2017
Source:International Immunopharmacology, Volume 44
Author(s): Leihua Weng, He Zhang, Xiaoxi Li, Hui Zhan, Fan Chen, Lijuan Han, Yun Xu, Xiang Cao
Increasing evidence suggests that microglia are a major cellular contributor to neuroinflammation. The present study investigated whether Ampelopsin (Amp), a type of flavanonol derivative from Ampelopsis grossedentata, may exert an anti-inflammatory effect on lipopolysaccharide (LPS)-induced BV2 and primary microglia cells. We found that pre-treatment of microglia cells with Amp before LPS with a non-cytotoxic concentration range decreased the production of nitric oxide (NO) and prostaglandin E2 (PGE2). Amp also suppressed the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) at the mRNA and protein levels. In addition, LPS-induced production of pro-inflammatory cytokines such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) was obviously reduced by Amp. Our mechanistic study indicated that Amp suppressed LPS-induced activation of the IκB/NF-κB inflammation pathway without affecting changes in the phosphorylation levels of mitogen-activated protein kinases (MAPKs) in BV2 cells. Further studies revealed that Amp markedly reduced the phosphorylation levels of JAK2-STAT3 and STAT3 nuclear translocation. Overall, our data suggest that Amp can suppress the LPS-induced inflammatory response of microglial cells, indicating that Amp has potential for the treatment of inflammation-mediated neurodegenerative diseases.



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Nutritionally relevant concentrations of resveratrol and hydroxytyrosol mitigate oxidative burst of human granulocytes and monocytes and the production of pro-inflammatory mediators in LPS-stimulated RAW 264.7 macrophages

Publication date: February 2017
Source:International Immunopharmacology, Volume 43
Author(s): Elisabetta Bigagli, Lorenzo Cinci, Sara Paccosi, Astrid Parenti, Mario D'Ambrosio, Cristina Luceri
The health benefits of bio-active phenolic compounds have been largely investigated in vitro at concentrations which exceed those reachable in vivo. We investigated and compared the anti-inflammatory effects of resveratrol, hydroxytyrosol and oleuropein at physiologically relevant concentrations by using in vitro models of inflammation.Human granulocytes and monocytes were stimulated with phorbol myristate acetate (PMA) and the ability of resveratrol, hydroxytyrosol and oleuropein to inhibit the oxidative burst and CD11b expression was measured. Nitric oxide (NO), prostaglandin E2 (PGE2) levels, COX-2, iNOS, TNFα, IL-1β and miR-146a expression and activation of the transcription factor Nrf2 were evaluated in macrophages RAW 264.7 stimulated with LPS (1μg/ml) for 18h, exposed to resveratrol, hydroxytyrosol and oleuropein (5 and 10μM). Synergistic effects were explored as well, together with the levels of PGE2, COX-2 and IL-1β expression in macrophages after 6h of LPS stimulation. PGE2 and COX-2 expression were also assessed on human monocytes.All the tested compounds inhibited granulocytes oxidative burst in a concentration dependent manner and CD11b expression was also significantly counteracted by resveratrol and hydroxytyrosol. The measurement of oxidative burst in human monocytes produced similar effects being resveratrol more active. Hydroxytyrosol and resveratrol inhibited the production of NO and PGE2 but did not reduce iNOS, TNFα or IL-1β gene expression in LPS-stimulated RAW 264.7 for 18h. Resveratrol slightly decreased COX-2 expression after 18h but not after 6h, but reduced PGE2 levels after 6h. Resveratrol and hydroxytyrosol 10μM induced NRf2 nuclear translocation and reduced miR-146a expression in LPS treated RAW 264.7.Overall, we reported an anti-inflammatory effect of resveratrol and hydroxytyrosol at low, nutritionally relevant concentrations, involving the inhibition of granulocytes and monocytes activation, the modulation of miR-146a expression and the activation of Nrf2. A regular dietary intake of resveratrol and hydroxytyrosol may be a useful complementary strategy to control inflammatory diseases.



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CD14++ CD16− monocytes are the main source of 11β-HSD type 1 after IL-4 stimulation

Publication date: February 2017
Source:International Immunopharmacology, Volume 43
Author(s): Vidya Kunnathully, Macarena Gomez-Lira, Giulio Bassi, Fabio Poli, Elisa Zoratti, Valentina La Verde, Luca Idolazzi, Davide Gatti, Ombretta Viapiana, Silvano Adami, Maurizio Rossini
The anti-inflammatory actions of IL-4 are well established through earlier findings. However, the exact mechanism it uses to downregulate the pro-inflammatory cytokine production through monocytes and macrophages is poorly understood. In this study, we examined the effect of IL-4 in the induction of 11β-HSD1 in the two main classes of monocytes, CD14⁺⁺ CD16⁻ (CD14) and CD14⁺ CD16⁺ (CD16). Peripheral Blood Mononuclear Cells (PBMCs) were isolated from 17 healthy donors and were sorted into CD14 and CD16 subpopulations using cell sorting. Effect of IL-4 on 11β-HSD1-enzyme activity was measured in sorted and unsorted monocytes using Homogeneous Time-Resolved Fluorescence (HTRF) and M1/M2 polarization analysis was performed by flow cytometry. Our results indicate that CD14 cells are the major source of 11β-HSD1 enzyme after IL-4 stimulation and that M2 phenotype is not a pre-requisite for its synthesis.



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Digital PCR assessment of MGMT promoter methylation coupled with reduced protein expression optimises prediction of response to alkylating agents in metastatic colorectal cancer patients

Publication date: January 2017
Source:European Journal of Cancer, Volume 71
Author(s): Andrea Sartore-Bianchi, Filippo Pietrantonio, Alessio Amatu, Massimo Milione, Andrea Cassingena, Silvia Ghezzi, Marta Caporale, Rosa Berenato, Chiara Falcomatà, Alessio Pellegrinelli, Alberto Bardelli, Michele Nichelatti, Federica Tosi, Filippo De Braud, Federica Di Nicolantonio, Ludovic Barault, Salvatore Siena
BackgroundO(6)-methylguanine-DNA-methyltransferase (MGMT) is a repair protein, and its deficiency makes tumours more susceptible to the cytotoxic effect of alkylating agents. Five clinical trials with temozolomide or dacarbazine have been performed in metastatic colorectal cancer (mCRC) with selection based on methyl-specific PCR (MSP) testing with modest results. We hypothesised that mitigated results are consequences of unspecific patient selection and that alternative methodologies for MGMT testing such as immunohistochemistry (IHC) and digital polymerase chain reaction (PCR) could enhance patient enrolment.Patients and methodsFormalin-fixed paraffin embedded archival tumour tissue samples from four phase II studies of temozolomide or dacarbazine in MGMT MSP-positive mCRCs were analysed by IHC for MGMT protein expression and by methyl-BEAMing (MB) for percentage of promoter methylation. Pooled data were then retrospectively analysed according to objective response rate, progression-free survival (PFS) and overall survival (OS).ResultsOne hundred and five patients were included in the study. Twelve had achieved partial response (PR) (11.4%), 24 stable disease (SD; 22.9%) and 69 progressive disease (PD; 65.7%). Patients with PR/SD had lower IHC scores and higher MB levels than those with PD. MGMT expression by IHC was negatively and MB levels positively associated with PFS (p < 0.001 and 0.004, respectively), but not with OS. By combining both assays, IHC low/MB high patients displayed an 87% reduction in the hazard of progression (p < 0.001) and a 77% in the hazard for death (p = 0.001).ConclusionIn mCRC selected for MGMT deficiency by MSP, IHC and MB testing improve clinical outcome to alkylating agents. Their combination could enhance patient selection in this setting.



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Calibration and response of an agarose gel based passive sampler to record short pulses of aquatic organic pollutants

Publication date: 1 April 2017
Source:Talanta, Volume 165
Author(s): Angel Belles, Claire Alary, Yann Aminot, James W. Readman, Christine Franke
A passive sampler inspired from previous devices was developed for the integrative sampling of a broad range of contaminants in the water column. Our primary objective was to improve the performance of the device to provide accurate and averaged pollutant water concentrations. For this purpose, an agarose diffusive gel was used as the boundary layer that drives the analyte uptake rate. Contrary to conventional passive samplers, the developed device does not require the sampling rates to be corrected for exposure conditions (e.g. hydrodynamic flow) because the diffusive gel boundary layer selected was sufficiently large to control the pollutant diffusion rate from the aqueous phase. The compounds diffusion coefficients in agarose gel and the gel thickness are the only required data to accurately calculate the time weighted averaged water concentration of pollutants. The performance of the developed sampler was evaluated in the laboratory under two contamination scenarios and in the field in 8 contrasting exposure sites for a selection of 16 emerging pollutants and pesticides. The results show that detection limits of this method are environmentally relevant and allow the determination of the averaged pollutant concentrations. Additionally, the ability of the device to sense very short contamination pulses (5–320min) was evaluated through a theoretical approach and laboratory tests. Results show that the device is suitable for sampling contamination pulses as short as 5min without deviation from the actual average concentrations of pollutants.

Graphical abstract

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