Automatic segmentation of liver tumors from multiphase contrast-enhanced CT images based on FCNs

Publication date: Available online 27 March 2017
Source:Artificial Intelligence in Medicine
Author(s): Changjian Sun, Shuxu Guo, Huimao Zhang, Jing Li, Meimei Chen, Shuzhi Ma, Lanyi Jin, Xiaoming Liu, Xueyan Li, Xiaohua Qian
This paper presents a novel, fully automatic approach based on a fully convolutional network (FCN) for segmenting liver tumors from CT images. Specifically, we designed a multi-channel fully convolutional network (MC-FCN) to segment liver tumors from multiphase contrast-enhanced CT images. Because each phase of contrast-enhanced data provides distinct information on pathological features, we trained one network for each phase of the CT images and fused their high-layer features together. The proposed approach was validated on CT images taken from two databases: 3Dircadb and JDRD. In the case of 3Dircadb, using the FCN, the mean ratios of the volumetric overlap error (VOE), relative volume difference (RVD), average symmetric surface distance (ASD), root mean square symmetric surface distance (RMSD) and maximum symmetric surface distance (MSSD) were 15.6±4.3%, 5.8±3.5%, 2.0±0.9%, 2.9±1.5mm, 7.1±6.2mm, respectively. For JDRD, using the MC-FCN, the mean ratios of VOE, RVD, ASD, RMSD, and MSSD were 8.1±4.5%, 1.7±1.0%, 1.5±0.7%, 2.0±1.2mm, 5.2±6.4mm, respectively. The test results demonstrate that the MC-FCN model provides greater accuracy and robustness than previous methods.



http://ift.tt/2nwC7D8

Protein fold recognition based on sparse representation based classification

Publication date: Available online 27 March 2017
Source:Artificial Intelligence in Medicine
Author(s): Ke Yan, Yong Xu, Xiaozhao Fang, Chunhou Zheng, Bin Liu
Knowledge of protein fold type is critical for determining the protein structure and function. Because of its importance, several computational methods for fold recognition have been proposed. Most of them are based on well-known machine learning techniques, such as Support Vector Machines (SVMs), Artificial Neural Network (ANN), etc. Although these machine learning methods play a role in stimulating the development of this important area, new techniques are still needed to further improve the predictive performance for fold recognition. Sparse Representation based Classification (SRC) has been widely used in image processing, and shows better performance than other related machine learning methods. In this study, we apply the SRC to solve the protein fold recognition problem. Experimental results on a widely used benchmark dataset show that the proposed method is able to improve the performance of some basic classifiers and three state-of-the-art methods to feature selection, including autocross-covariance (ACC) fold, D-D, and Bi-gram. Finally, we propose a novel computational predictor called MF-SRC for fold recognition by combining these three features into the framework of SRC to achieve further performance improvement. Compared with other computational methods in this field on DD dataset, EDD dataset and TG dataset, the proposed method achieves stable performance by reducing the influence of the noise in the dataset. It is anticipated that the proposed predictor may become a useful high throughput tool for large-scale fold recognition or at least, play a complementary role to the existing predictors in this regard.



http://ift.tt/2od3CQE

N-(aroyl)-N-(arylmethyloxy)-α-alanines: selective inhibitors of aldose reductase

Publication date: Available online 28 March 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Susanna Nencetti, Concettina La Motta, Armando Rossello, Stefania Sartini, Elisa Nuti, Lidia Ciccone, Elisabetta Orlandini
Aldose reductase (ALR2), a NADPH-dependent reductase, is the first and rate-limiting enzyme of the polyol pathway of glucose metabolism and is implicated in the pathogenesis of secondary diabetic complications. In the last decades, this enzyme has been targeted for inhibition but despite the numerous efforts made to identify potent and safe ALR2 inhibitors, many clinical candidates have been a failure. For this reason the research of new ALR2 inhibitors highly effective, selective and with suitable pharmacokinetic properties is still of great interest. In this paper some new N-(aroyl)-N-(arylmethyloxy)alanines have been synthesized and tested for their ability to inhibit ALR2. Some of the synthesized compounds exhibit IC50 in the low micromolar range and all have proved to be highly selective towards ALR2. The N-(aroyl)-N-(arylmethyloxy)-α-alanines are a promising starting point for the development of new ALR2 selective drugs with the aim of delaying the onset of diabetic complications.

Graphical abstract

http://ift.tt/2nIfmN9

Effect of 1,2,3-Triazole salts, non-classical bioisosteres of miltefosine, on Leishmania amazonensis.

Publication date: Available online 28 March 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Pedro H.F. Stroppa, Luciana M.R. Antinarelli, Arturene M.L. Carmo, Jacy Gameiro, Elaine S. Coimbra, Adilson D. da Silva
Here, we report the effect of new non-classical bioisoteres of miltefosine on Leishmania amazonensis. Fifteen compounds were synthesized and the compound dhmtAc, containing an acetate anion, a side chain of 10 carbon atoms linked to N-1 and a methyl group linked to N-3, showed high and selective biological activity against L. amazonensis. On the intracellular amastigotes, stages of the parasite related to human disease, the IC50 values were near or similar to the 1.0 μM (0.9, 0.8 and 1.0 μM on L. amazonensis-WT, and two transgenic L. amazonensis expressing GFP and RFP, respectively), being more active than miltefosine. Furthermore, dhmtAc did not show toxic effects on human erythrocytes and macrophages (CC50 = 115.9 μM) being more destructive to the intracellular parasites (selectivity index > 115). Promastigotes and intramacrophage amastigotes treated with dhmtAc showed low capacity for reversion of the effect of the compound. A study of the mechanism of action of this compound showed some features of metazoan apoptosis, including cell volume decreases, loss of mitochondrial membrane potential, ROS production, an increase in the intracellular lipid bodies, in situ labeling of DNA fragments by TUNEL labeling and phosphatidylserine exposure to the outerleaflet of the plasma membrane. In addition, the plasma membrane disruption, revealed by PI labeling, suggests cell death by necrosis. No increase in autophagic vacuoles formation in treated promastigotes was observed. Taken together, the data indicate that the bioisotere of miltefosine, dhmtAc, has promising antileishmanial activity that is mediated via apoptosis and necrosis.

Graphical abstract

http://ift.tt/2nIyWc1

STRUCTURE, GENETICS AND FUNCTION OF THE PULMONARY ASSOCIATED SURFACTANT PROTEINS A AND D: THE EXTRA-PULMONARY ROLE OF THESE C TYPE LECTINS

Publication date: Available online 27 March 2017
Source:Annals of Anatomy - Anatomischer Anzeiger
Author(s): Frederico Vieira, Johannes W. Kung, Faizah Bhatti
The collectins family encompasses several collagenous Ca²⁺-dependent defense lectins that are described as pathogen recognition molecules. They play an important role in both adaptive and innate immunity. Surfactant protein A and D are two of these proteins which were initially discovered in association with surfactant in the pulmonary system. The structure, immune and inflammatory functions, and genetic variations have been well described in relation to their roles, function and pathophysiology in the pulmonary system. Subsequently, these proteins have been discovered in a wide range of other organs and organ systems. The role of these proteins outside the pulmonary system is currently an active area of research. This review intends to provide a current overview of the genetics, structure and extra-pulmonary functions of the surfactant collectin proteins.



http://ift.tt/2nwzvoI

Exosomes and Exosomal microRNAs in Prostate Cancer Radiotherapy

Publication date: Available online 27 March 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Bijaya Malla, Kathrin Zaugg, Erik Vassella, Daniel M. Aebersold, Alan Dal Pra
Despite current risk stratification systems based on traditional clinico-pathological factors, many localized and locally advanced prostate cancers fail radical treatments (i.e. radical prostatectomy, radiotherapy with or without androgen deprivation therapy). Therefore, there is a pressing need for enhanced methods of disease stratification through novel prognostic and predictive tools that could reliably be applied in clinical practice. Exosomes are 50 nm – 150 nm small vesicles released by cancer cells that reflect genetic and non-genetic materials of parent cancer cells. Cancer cells might contain distinct sets of microRNA profiles, the expression of which might change due to stress such as radiation therapy. These alterations or distinctions in contents allow exosomes to be used as prognostic/predictive biomarkers as well as for monitoring of treatment response in cancer. Additionally, microRNAs have been shown to influence multiple processes in prostate tumorigenesis, including cell proliferation, induction of apoptosis, migration, oncogene inhibition, and radio-resistance. Thus, comparative exosomal microRNA profiling at different levels could help portray tumor aggressiveness and response to radiotherapy. Although technical challenges persist in exosome isolation and characterization, recent improvements in microRNA profiling have evolved towards in-depth analyses of the exosomal cargo and its functions. Herein, we review the role of exosomes and exosomal microRNAs in biological processes of prostate cancer progression and radiotherapy response with particular focus on the development of clinical assays for treatment personalization.



http://ift.tt/2nqWxfq

Dosimetric predictors of patient reported xerostomia and dysphagia with de-intensified chemoradiotherapy for HPV-associated oropharyngeal squamous cell carcinoma

Publication date: Available online 27 March 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Bhishamjit S. Chera, David Fried, Alex Price, Robert J. Amdur, William Mendenhall, Chiray Lu, Shiva Das, Nathan Sheets, Lawrence Marks, Panayiotis Mavroidis
Purpose/Objective(s): To estimate the association between different dose/volume metrics of the salivary glands and pharyngeal constrictors with patient reported severity of xerostomia/dysphagia in the setting of de-intensified chemoradiotherapy (CRT).Methods and MaterialsForty-five patients were treated on a phase II study assessing the efficacy of de-intensified CRT for favorable risk, HPV-associated oropharyngeal squamous cell carcinoma. Patients received 60 Gy intensity modulated radiotherapy with concurrent weekly cisplatin (30 mg/m²), and reported severity of their xerostomia/dysphagia (pre- and post-treatment) using the patient reported outcome version of the CTCAE (PRO-CTCAE). Individual patient dosimetric data of the contralateral parotid and submandibular glands and pharyngeal constrictors were correlated with changes in PRO-CTCAE severity. A change in severity (from baseline) of ≥ 2 was considered clinically meaningful. Associations between dose/volume metrics and patient outcomes were assessed with Receiver Operating Characteristic (ROC) curve and logistic regression model.ResultsSix months post CRT, patients reporting < 2 change in xerostomia severity (N=14) had an average Dmean = 22 ± 9 Gy to the sum of the contralateral glands (parotid+submandibular) compared to the patients reporting ≥ 2 change (N=21), who had an average Dmean = 34 ± 8 Gy. V15 to V55 for the combined contralateral glands showed the strongest association with xerostomia (AUC = 0.83-0.86). Based on the regression analysis, a 20% risk of toxicity was associated with V15 = 48%, V25 = 30% and Dmean = 21Gy. 6 months post CRT, patients reporting < 2 change in dysphagia severity (N=26) had an average V55 = 76±13 (%) to the superior pharyngeal constrictor compared to the patients reporting ≥ 2 change in severity (N=9), who had average V55 = 89±13 (%). V55 - V60 had the strongest association with dysphagia (AUC = 0.70-0.75). Based on the regression analysis, a 20% risk of toxicity was associated with V55 = 78%, V60 = 40%. The findings at 12 months were similar.ConclusionsFollowing de-intensified CRT, the rate of patient reported xerostomia/dysphagia appears to be associated with the V15 of the combined contralateral salivary glands and V55 to V60 of the superior pharyngeal constrictors.

Teaser

The association of different dose/volume metrics of the salivary glands and pharyngeal constrictors to patient reported xerostomia/dysphagia was performed for patients treated with a de-intensified chemoradiotherapy regimen. In the setting of de-intensified chemoradiotherapy, the rate of patient reported xerostomia/dysphagia appears to associated with the V15 of the combined contralateral parotid and submandibular glands (a more stringent metric than what has been used with conventional doses) and V55 to V60 of superior pharyngeal constrictors.


http://ift.tt/2o2eMdN

Low testosterone levels are related to oxidative stress, mitochondrial dysfunction and altered subclinical atherosclerotic markers in type 2 diabetic male patients

Publication date: Available online 27 March 2017
Source:Free Radical Biology and Medicine
Author(s): Susana Rovira-Llopis, Celia Bañuls, Aranzazu M de Marañon, Noelia Diaz-Morales, Ana Jover, Sandra Garzon, Milagros Rocha, Victor M. Victor, Antonio Hernandez-Mijares
IntroductionLow testosterone levels in men are associated with type 2 diabetes and cardiovascular risk. However, the role of testosterone in mitochondrial function and leukocyte-endothelium interactions is unknown. Our aim was to evaluate the relationship between testosterone levels, metabolic parameters, oxidative stress, mitochondrial function, inflammation and leukocyte-endothelium interactions in type 2 diabetic patients.Materials and methodsThe study was performed in 280 male type 2 diabetic patients and 50 control subjects. Anthropometric and metabolic parameters, testosterone levels, reactive oxygen species (ROS) production, mitochondrial membrane potential, TNFα, adhesion molecules and leukocyte-endothelium cell interactions were evaluated.ResultsTestosterone levels were lower in diabetic patients. Total and mitochondrial ROS were increased and mitochondrial membrane potential, SOD and GSR expression levels were reduced in diabetic patients. TNFα, ICAM-1 and VCAM-1 levels, leukocyte rolling flux and adhesion were all enhanced in diabetic patients, while rolling velocity was reduced. Testosterone levels correlated negatively with glucose, HOMA-IR, HbA1c, triglycerides, nonHDL-c, ApoB, hs-CRP and AIP, and positively with HDL-c and ApoA1. The multivariable regression model showed that HDL-c, HOMA-IR and age were independently associated with testosterone. Furthermore, testosterone levels correlated positively with membrane potential and rolling velocity and negatively with ROS production, VCAM-1, rolling flux and adhesion.ConclusionsOur data highlight that low testosterone levels in diabetic men are related to impaired metabolic profile and mitochondrial function and enhanced inflammation and leukocyte-endothelium cell interaction, which leaves said patients at risk of cardiovascular events.

Graphical abstract

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Cigarette smoke extract induced exosome release is mediated by depletion of exofacial thiols and can be inhibited by thiol-antioxidants

Publication date: Available online 28 March 2017
Source:Free Radical Biology and Medicine
Author(s): Birke J. Benedikter, Charlotte Volgers, Pascalle H. van Eijck, Emiel F.M. Wouters, Paul H.M. Savelkoul, Niki L. Reynaert, Guido R.M.M. Haenen, Gernot G.U. Rohde, Antje R. Weseler, Frank R.M. Stassen
IntroductionAirway epithelial cells have been described to release extracellular vesicles (EVs) with pathological properties when exposed to cigarette smoke extract (CSE). As CSE causes oxidative stress, we investigated whether its oxidative components are responsible for inducing EV release and whether this could be prevented using the thiol antioxidants N-acetyl-L-cysteine (NAC) or glutathione (GSH).MethodsBEAS-2B cells were exposed for 24h to CSE, H2O2, acrolein, 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB), bacitracin, rutin or the anti-protein disulfide isomerase (PDI) antibody clone RL90; with or without NAC or GSH. EVs in media were measured using CD63⁺CD81⁺ bead-coupled flow cytometry or tunable resistive pulse sensing (TRPS). For characterization by Western Blotting, cryo-transmission electron microscopy and TRPS, EVs were isolated using ultracentrifugation. Glutathione disulfide and GSH in cells were assessed by a GSH reductase cycling assay, and exofacial thiols using Flow cytometry.ResultsCSE augmented the release of the EV subtype exosomes, which could be prevented by scavenging thiol-reactive components using NAC or GSH. Among thiol-reactive CSE components, H2O2 had no effect on exosome release, whereas acrolein imitated the NAC-reversible exosome induction. The exosome induction by CSE and acrolein was paralleled by depletion of cell surface thiols. Membrane impermeable thiol blocking agents, but not specific inhibitors of the exofacially located thiol-dependent enzyme PDI, stimulated exosome release.Summary/conclusionThiol-reactive compounds like acrolein account for CSE-induced exosome release by reacting with cell surface thiols. As acrolein is produced endogenously during inflammation, it may influence exosome release not only in smokers, but also in ex-smokers with chronic obstructive pulmonary disease. NAC and GSH prevent acrolein- and CSE-induced exosome release, which may contribute to the clinical benefits of NAC treatment.

Graphical abstract

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Activation-induced deoxycytidine deaminase: Structural basis favoring WRC hot motif specificities unique among APOBEC family members

Publication date: Available online 28 March 2017
Source:DNA Repair
Author(s): Phuong Pham, Samir A. Afif, Mayuko Shimoda, Kazuhiko Maeda, Nobuo Sakaguchi, Lars C. Pedersen, Myron F. Goodman




http://ift.tt/2nI657A

A novel small molecule compound possesses immunomodulatory properties on bone marrow-derived dendritic cells via TLR7 signaling pathway and alleviates the development of SLE

Publication date: June 2017
Source:International Immunopharmacology, Volume 47
Author(s): Sheng Gao, Linbo Yuan, Cunyu Li, Liping Han, Chunyan Hua
Dendritic cells (DCs) play an important role in the development and maintenance of immune tolerance. Activation of TLR7, which is expressed in DCs, is thought to contribute to the complex pathophysiology of systemic lupus erythematosus (SLE). In this study, we analyzed the in vitro and in vivo function of a novel small-molecule compound, FC-99, which was previously reported to have immunomodulatory functions. We found that FC-99 inhibited the expression of CD40 and inflammatory mediators (IL-6, IL-12, and CXCL-10), as well as R848-induced phosphorylation of IκB-α. We also present evidence that FC-99 is remarkably efficacious in the treatment of murine lupus. Interestingly, FC-99 affected the maturation and percentage of DCs in lupus-prone mice. Therefore, FC-99 may serve as a potential drug candidate for treatment of SLE.



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Platycodin D protects against cigarette smoke-induced lung inflammation in mice

Publication date: June 2017
Source:International Immunopharmacology, Volume 47
Author(s): Wei Gao, Ying Guo, Hongxia Yang
Cigarette smoke is the one of the major factors that leads to chronic obstructive pulmonary disease (COPD). Inflammation and oxidant stress have been known to play critical roles in the development of COPD. Platycodin D (PLD) has been reported to have anti-inflammatory and anti-oxidant effects. In this study, we aimed to investigate the protective effects of PLD on cigarette smoke (CS)-induced lung inflammation in mice. PLD was adminstrated i.p. to mice 2h before CS exposure daily for five consecutive days. The production of inflammatory cytokines TNF-α and IL-1β were measured by ELISA. The levels of malonaldehyde (MDA) and nitric oxide (NO) were also detected in this study. The expression of nuclear factor-erythroid 2–related factor 2 (Nrf2), heme oxygenase-1 (HO-1), NF-κB, and IκBα were detected by western blot analysis. The results showed that PLD significantly attenuated CS-induced lung pathological changes, inflammatory cells infiltration, as well as TNF-α and IL-1β production. CS-induced MDA and NO production were also inhibited by treatment of PLD. Western blot analysis showed that PLD significantly suppressed CS-induced NF-κB activation. In addition, PLD was found to increase the expression of Nrf2 and HO-1. Taken together, these results indicated that PLD protected against CS-induced lung inflammation by inhibiting inflammatory and oxidative response through activating Nrf2 signaling pathway. PLD might be an effective treatment for CS-induced lung inflammation.



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Response to the letter to editor “Cadmium exposure and urinary N-acetyl-β-D-glucosaminidase: a meta-analysis”

http://ift.tt/2ourIFR

Removal of sulfamethoxazole (SMX) and sulfapyridine (SPY) from aqueous solutions by biochars derived from anaerobically digested bagasse

Abstract

This study explored the sorption of sulfamethoxazole (SMX) and sulfapyridine (SPY) onto biochars produced from raw and anaerobically digested bagasse. Initial evaluation of six bagasse biochars showed that digested bagasse biochar prepared at 600 °C (DBG600) was the best adsorbent to remove SMX and SPY. Further laboratory batch sorption experiments showed that DBG600 adsorbed SMX and SPY from aqueous solution with maximum adsorption capacity of 54.38 and 8.60 mg g⁻¹, respectively. Solution pH showed strong effect on the sorption ability of DBG600 to the two antibiotics, and the sorption decreased with increasing of solution pH. Experimental and model results suggested that adsorption of SMX and SPY onto DBG600 might be controlled by the π–π interaction.

http://ift.tt/2mMrYUl

The geochemical release feature of Tl in Tl-rich pyrite mine wastes: a long-term leaching test

Abstract

Identifying and revealing the geochemical behaviour of Tl during mine waste weathering are very important to assess the potential environmental impact of Thallium (Tl) from open mine-waste piles. Herein, two methods including the modified BCR sequential extraction and the long-term humidity cell tests (HCT) were employed to understand the Tl chemical fractions and to stimulate intense chemical weathering process, respectively. The results from BCR sequential extraction showed that the Tl concentration in the studied sample was 18.78 mg/kg, containing 1.878 mg/kg oxidisable, 0.282 mg/kg acid exchangeable and 1.596 mg/kg reducible Tl. The acid exchangeable fraction contributed to a particular potential risk to the aquatic marine life in the early stages and the Fe/Mn oxidisable fraction posed a potential risk being dissolved into solution at low pH (i.e. acidic conditions). The variations of Tl concentration in leachates were classified as two period as the pH values decrease. In the first period, the Tl concentrations decreased positively with pH value with poor correlation between pH value and SO₄²⁻ concentration in leachates. Drastic release of Tl was observed in the early period once the material was exposed to air and water, being ascribe to the acid exchangeable fraction bound to carbonate as dissolved by acid. During the second period, three increased peaks of Tl concentration (11.02, 16.03, 43.15 μg/L) and four increased peaks of SO₄²⁻ concentration (315, 390, 899.61 and 2670 mg/L) were observed. A good correlation (R ² = 0.8384) between the concentrations of Tl and SO₄²⁻ was observed, indicating the Tl was mainly released from the oxidation of sulphide.

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Study of Aerosol Gemcitabine in Patients With Solid Tumors and Pulmonary Metastases

Conditions:   Malignant Neoplasm of Bone and Articular Cartilage;   Malignant Neoplasms of Female Genital Organs;   Malignant Neoplasms of Independent (Primary) Multiple Sites;   Malignant Neoplasms of Lip Oral Cavity and Pharynx;   Malignant Neoplasm of Male Genital Organs;   Malignant Neoplasms of Mesothelial and Soft Tissue;   Malignant Neoplasm of Respiratory and Intrathoracic Organ Carcinoma;   Malignant Neoplasms of Thyroid and Other Endocrine Glands;   Malignant Neoplasms of Urinary Tract;   Melanoma and Other Malignant Neoplasms of Skin
Intervention:   Drug: Gemcitabine
Sponsors:   M.D. Anderson Cancer Center;   James B. and Lois R. Archer Charitable Foundation;   Gateway for Cancer Research
Not yet recruiting - verified March 2017

http://ift.tt/2nqUY0Q

Varicella seroepidemiology in United States air force recruits: A retrospective cohort study comparing immunogenicity of varicella vaccination and natural infection

Publication date: Available online 27 March 2017
Source:Vaccine
Author(s): Joshua R. Duncan, Catherine T. Witkop, Bryant J. Webber, Amy A. Costello
Background/ObjectivesInfection with varicella zoster virus (VZV) produces lifelong immunity, but duration of post-vaccination immunity has not been established. The purpose of this study is to determine if a difference exists in the long-term seropositivity of anti-VZV antibodies in a cohort of young adults who were vaccinated against varicella as compared to a similar cohort with a history of chickenpox disease, and to determine which variables best predict waning seropositivity following varicella vaccination.MethodsThis retrospective cohort study captures immunization and serology data from approximately 10,000 recruits who entered basic military training between January 1, 2008, and December 31, 2015, and who have childhood immunization records in the Air Force Aeromedical Services Information Management System. Varicella vaccine immunogenicity was determined relative to the immunogenicity of chickenpox disease, as measured by multiplex flow immunoassay. Among vaccine recipients, waning seroimmunity was modeled and adjusted for several important covariates.ResultsBasic military trainees who received varicella vaccine in childhood were 24% less likely to be seropositive to VZV than trainees who were exempt from vaccine due to a history of chickenpox disease. There was no significant difference in seropositivity between male and female trainees. The odds of a vaccinated trainee being seropositive to VZV decreased by 8% with each year elapsed since vaccination. Seroprevalence declined below estimated herd immunity thresholds in vaccinated trainees born after 1994, and in the cohort as a whole for trainees born after 1995.ConclusionDespite prior vaccination, seroimmunity in a large cohort of young adults unexposed to wild-type VZV failed to meet the estimated threshold for herd immunity. If vaccination in accordance with the current US VZV vaccination schedule is inadequate to maintain herd immunity, young adults not previously exposed to wild-type VZV may be at increased risk for varicella outbreaks.



http://ift.tt/2nwfr68

Measuring Patient-Reported Adverse Events in Oncology Practice Improves Quality of Life in Nasopharyngeal Carcinoma

Condition:   Nasopharyngeal Neoplasms
Interventions:   Other: adverse events using patient-reported outcomes version of common terminology criteria for adverse events (PRO-CTCAE) questionaire;   Other: do not report adverse events through patient-reported outcomes version of common terminology criteria for adverse events (PRO-CTCAE) questionaire
Sponsor:   Sun Yat-sen University
Not yet recruiting - verified March 2017

http://ift.tt/2nHRCca

Lower vaccine uptake amongst older individuals living alone: A systematic review and meta-analysis of social determinants of vaccine uptake

Publication date: Available online 27 March 2017
Source:Vaccine
Author(s): Anu Jain, A.J. van Hoek, Delia Boccia, Sara L. Thomas
IntroductionVaccination is a key intervention to reduce infectious disease mortality and morbidity amongst older individuals. Identifying social factors for vaccine uptake enables targeted interventions to reduce health inequalities.ObjectiveTo systematically appraise and quantify social factors associated with vaccine uptake amongst individuals aged ≥60years from Europe.MethodsWe searched Medline and Embase from inception to 24/02/2016. The association of vaccine uptake was examined for social factors relevant at an individual level, to provide insight into individuals' environment and enable development of targeted interventions by healthcare providers to deliver equitable healthcare. Factors included: living alone, marital status, education, income, vaccination costs, area-level deprivation, social class, urban versus rural residence, immigration status and religion. Between-study heterogeneity for each factor was identified using I²-statistics and Q-statistics, and investigated by stratification and meta-regression analysis. Meta-analysis was conducted, when appropriate, using fixed- or random-effects models.ResultsFrom 11,754 titles, 35 eligible studies were identified (uptake of: seasonal influenza vaccine (SIV) only (n=27) or including pneumococcal vaccine (PV) (n=5); herpes zoster vaccine (n=1); pandemic influenza vaccine (n=1); PV only (n=1)). Higher SIV uptake was reported for individuals not living alone (summary odds ratios (OR)=1.39 (95% confidence interval (CI): 1.16–1.68). Lower SIV uptake was observed in immigrants and in more deprived areas: summary OR=0.57 (95%CI: 0.47–0.68) and risk ratio=0.93 (95%CI: 0.92–0.94) respectively. Higher SIV uptake was associated with higher income (OR=1.26 (95%CI: 1.08–1.47)) and higher education (OR=1.05 (95%CI: 1–1.11)) in adequately adjusted studies. Between-study heterogeneity did not appear to result from variation in categorisation of social factors, but for education was partly explained by varying vaccination costs (meta-regression analysis p=<0.0001); individuals with higher education had higher vaccine uptake in countries without free vaccination.ConclusionsQuantification of associations between social factors and lower vaccine uptake, and notably living alone (an overlooked factor in vaccination programmes), should enable health professionals target specific social groups to tackle vaccine-related inequalities.



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Study Assessing the Effects of Chemotherapy in Advanced Esophagogastric Adenocarcinoma

Conditions:   Esophageal Neoplasms;   Stomach Neoplasms
Interventions:   Drug: Carboplatin;   Drug: Docetaxel;   Drug: Capecitabine;   Drug: Epirubicin;   Drug: Oxaliplatin
Sponsor:   Rigshospitalet, Denmark
Recruiting - verified March 2017

http://ift.tt/2nqRrQ4