A sensitive label-free immunosensor for detection α-Fetoprotein in whole blood based on anticoagulating magnetic nanoparticles

Publication date: 15 September 2017
Source:Biosensors and Bioelectronics, Volume 95
Author(s): Tingting Xu, Bo Chi, Fan Wu, Shangshang Ma, Shuyue Zhan, Meihui Yi, Hong Xu, Chun Mao
Accurate values of tumor markers in blood play an especially important role in the diagnosis of illness. Here, based on the combination of three techniques include anticoagulant technology, nanotechnology and biosensing technology, a sensitive label-free immunosensor with anti-biofouling electrode for detection α-Fetoprotein (AFP) in whole blood was developed by anticoagulating magnetic nanoparticles. The obtained products of Fe3O4-ɛ-PL-Hep nanoparticles were characterized by fourier transform infrared (FT-IR) spectra, transmission electron microscopy (TEM), ζ-potential and vibrating sample magnetometry (VSM). Moreover, the blood compatibility of anticoagulating magnetic nanoparticles was characterized by in vitro coagulation tests, hemolysis assay and whole blood adhesion tests. Combining the anticoagulant property of heparin (Hep) and the good magnetism of Fe3O4, the Fe3O4-ɛ-PL-Hep nanoparticles could improve not only the anti-biofouling property of the electrode surface when they contact with whole blood, but also the stability and reproducibility of the proposed immunosensor. Thus, the prepared anticoagulating magnetic nanoparticles modified immunosensor for the detection of AFP showed excellent electrochemical properties with a wide concentration range from 0.1 to 100ng/mL and a low detection limit of 0.072ng/mL. Furthermore, five blood samples were assayed using the developed immunosensor. The results showed satisfactory accuracy with low relative errors. It indicated that our developed immunoassay was competitive and could be potentially used for the detection of whole blood samples directly.



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Expression of long non-coding RNAs in autoimmunity and linkage to enhancer function and autoimmune disease risk genetic variants

Publication date: Available online 15 April 2017
Source:Journal of Autoimmunity
Author(s): T.M. Aune, P.S. Crooke, A.E. Patrick, J.T. Tossberg, N.J. Olsen, C.F. Spurlock
Genome-wide association studies have identified numerous genetic variants conferring autoimmune disease risk. Most of these genetic variants lie outside protein-coding genes hampering mechanistic explorations. Numerous mRNAs are also differentially expressed in autoimmune disease but their regulation is also unclear. The majority of the human genome is transcribed yet its biologic significance is incompletely understood. We performed whole genome RNA-sequencing [RNA-seq] to categorize expression of mRNAs, known and novel long non-coding RNAs [lncRNAs] in leukocytes from subjects with autoimmune disease and identified annotated and novel lncRNAs differentially expressed across multiple disorders. We found that loci transcribing novel lncRNAs were not randomly distributed across the genome but co-localized with leukocyte transcriptional enhancers, especially super-enhancers, and near genetic variants associated with autoimmune disease risk. We propose that alterations in enhancer function, including lncRNA expression, produced by genetics and environment, change cellular phenotypes contributing to disease risk and pathogenesis and represent attractive therapeutic targets.



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Editorial Board ((ofc))

Publication date: April 2017
Source:Acta Histochemica, Volume 119, Issue 3





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Hypothyroidism associated with parathyroid disorders

Publication date: Available online 15 April 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Giovanna Mantovani, Marta Elli Francesca, Sabrina Corbetta
Hypothyroidism may occur in association with congenital parathyroid disorders determining parathyroid hormone insufficiency, which is characterized by hypocalcemia and concomitant inappropriately low secretion of parathormone (PTH). The association is often due to loss of function of genes common to thyroid and parathyroid glands embryonic development. Hypothyroidism associated with hypoparathyroidism is generally mild and not associated with goiter; moreover, it is usually part of a multisystemic involvement not restricted to endocrine function as occurs in patients with 22q11 microdeletion/DiGeorge syndrome, the most frequent disorders. Hypothyroidism and hypoparathyroidism may also follow endocrine glands' damages due to autoimmunity or chronic iron overload in thalassemic disorders, both genetically determined conditions. Finally, besides PTH deficiency, hypocalcemia can be due to PTH resistance in pseudohypoparathyroidism; when hormone resistance is generalized, patients can suffer from hypothyroidism due to TSH resistance. In evaluating patients with hypothyroidism and hypocalcemia, physical examination and clinical history are essential to drive the diagnostic process, while routine genetic screening is not recommended.



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Sex differences in autonomic response and situational appraisal of a competitive situation in young adults

Publication date: Available online 16 April 2017
Source:Biological Psychology
Author(s): Diana Abad-Tortosa, Adrián Alacreu-Crespo, Raquel Costa, Alicia Salvador, Miguel Ángel Serrano
Competition is a social stressor capable of eliciting physiological responses modulated by the outcome. The main objective of this study was to analyze the psychophysiological changes associated with competition and its outcome in men and women, taking into account the role of situational appraisal. To this end, 112 young people (46 men and 66 women) participated in a laboratory task in a competitive or non-competitive condition, while Blood Pressure (BP), Heart Rate Variability (HRV), and Skin Conductance (SC) responses were measured. Our results indicate that competition elicits higher systolic blood pressure (SBP) than a non-competitive task; in addition, winners presented a greater R-R decrease from baseline to task, greater R-R Recovery, and lower frustration and external attribution than losers. Regarding sex, men perceived their opponent's capacity to be lower and their own capacity to be greater than women did, and they also showed higher R-R decreases and lower SC increases. In conclusion, we found a complex pattern of different psychophysiological responses to competition associated with outcome and sex in a laboratory competition. This result could be related to the use of more passive or active coping strategies.



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Chinese medicine Bu-Fei decoction attenuates epithelial-mesenchymal transition of non-small cell lung cancer via inhibition of transforming growth factor β1 signaling pathway in vitro and in vivo

Publication date: 23 May 2017
Source:Journal of Ethnopharmacology, Volume 204
Author(s): Xi-Ran He, Shu-Yan Han, Xiao-Hong Li, Wen-Xian Zheng, Li-Na Pang, Shan-Tong Jiang, Ping-Ping Li
Ethnopharmacological relevanceTraditional Chinese medicine Bu-Fei decoction (BFD) has been utilized to treat patients with Qi deficiency for decades, with the advantages of invigorating vital energy, clearing heat-toxin and moistening lung, etc. According to previous clinical experience and trials, BFD has been found to indeed improve life quality of lung cancer patients and prolong survival time. Nevertheless, little is known on its potential mechanisms so far. Being regarded as a pivotal cytokine in the tumor microenvironment, transforming growth factor β (TGF-β) stands out as a robust regulator of epithelial-mesenchymal transition (EMT), which is closely linked to tumor progression.Aim of the studyThe present study was designed to explore whether BFD antagonized EMT via blocking TGF-β1-induced signaling pathway, and then help contribute to create a relatively steady microenvironment for confining lung cancer.Materials and methodsThis experiment was performed in lung adenocarcinoma A549 cells both in vitro and in vivo. In detail, the influences mediated by TGF-β1 alone or in combination with different concentrations of BFD on migration were detected by wound healing and transwell assays, and the effects of BFD on cell viability were determined by cell counting kit-8 (CCK-8) assay. TGF-β1, EMT relevant proteins and genes were evaluated by western blotting, confocal microscopy, quantitative real-time polymerase chain reaction (qRT-PCR), immunohistochemistry (IHC) and enzyme-linked immuno sorbent assay (ELISA). Female BALB/C nude mice were subcutaneously implanted A549 cells and given BFD by gavage twice daily for 28 days. The tumor volume was monitored every 4 days to draw growth curve. The tumor weight, expression levels of EMT-related protein in tumor tissues and TGF-β1 serum level were evaluated, respectively.ResultsBFD only exerted minor effects on A549 cell proliferation and this was in accordance with the in vivo result, which showed that the tumor growth and weight were not be restrained by BFD administration. However, the data elucidated that BFD could dose-dependently suppress EMT induced by TGF-β1 in vitro via attenuating canonical Smad signaling pathway. In the A549 xenograft mouse model, BFD also inhibited protein markers that are associated with EMT and TGF-β1 secretion into serum.ConclusionsBased on these above data, the conclusion could be put forward that BFD probably attenuated TGF-β1 mediated EMT in A549 cells via decreasing canonical Smad signaling pathway both in vitro and in vivo, which may help restrain the malignant phenotype induced by TGF-β1 in A549 cells to some extent.

Graphical abstract

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Does exclusion of cancers registered only from death-certificate information diminish socio-demographic disparities in recorded survival?

Publication date: June 2017
Source:Cancer Epidemiology, Volume 48
Author(s): Hanna E. Tervonen, David Roder, Stephen Morrell, Hui You, David C. Currow
BackgroundDeath Certificate Only (DCO) cancer cases are commonly excluded from survival analyses due to unknown survival time. This study examines whether socio-demographic factors are associated with DCO diagnosis, and the potential effects of excluding DCO cases on socio-demographic cancer survival disparities in NSW, Australia.MethodsNSW Cancer Registry data for cases diagnosed in 2000–2008 were used in this study. Logistic regression was used to estimate the odds of DCO registration by socio-demographic sub-group (socio-economic disadvantage, residential remoteness, country of birth, age at diagnosis). Cox proportional hazard regression was used to estimate the probability of death from cancer by socio-demographic subgroup when DCO cases were included and excluded from analyses.ResultsDCO cases consisted of 1.5% (n=4336) of all cases (n=299,651). DCO diagnosis was associated with living in socio-economically disadvantaged areas (most disadvantaged compared with least disadvantaged quintile: odds ratio OR 1.25, 95%CI 1.12–1.40), living in inner regional (OR 1.16, 95%CI 1.08–1.25) or remote areas (OR 1.48, 95%CI 1.01–2.19), having an unknown country of birth (OR 1.63, 95%CI 1.47–1.81) and older age. Including or excluding DCO cases had no significant impact on hazard ratios for cancer death by socio-economic disadvantage quintile or remoteness category, and only a minor impact on hazard ratios by age.ConclusionSocio-demographic factors were associated with DCO diagnosis in NSW. However, socio-demographic cancer survival disparities remained unchanged or varied only slightly irrespective of including/excluding DCO cases. Further research could examine the upper limits of DCO proportions that significantly alter estimated cancer survival differentials if DCOs are excluded.



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Liquid chromatography-high resolution mass spectrometric methods for the surveillance monitoring of cyanotoxins in freshwaters

Publication date: 1 August 2017
Source:Talanta, Volume 170
Author(s): Sara Bogialli, Claudio Bortolini, Iole Maria Di Gangi, Federica Nigro Di Gregorio, Luca Lucentini, Gabriella Favaro, Paolo Pastore
A comprehensive risk management on human exposure to cyanotoxins, whose production is actually unpredictable, is limited by reliable analytical tools for monitoring as many toxic algal metabolites as possible. Two analytical approaches based on a LC-QTOF system for target analysis and suspect screening of cyanotoxins in freshwater were presented. A database with 369 compounds belonging to cyanobacterial metabolites was developed and used for a retrospective data analysis based on high resolution mass spectrometry (HRMS). HRMS fragmentation of the suspect cyanotoxin precursor ions was subsequently performed for correctly identifying the specific variants. Alternatively, an automatic tandem HRMS analysis tailored for cyanotoxins was performed in a single chromatographic run, using the developed database as a preferred precursor ions list. Twenty-five extracts of surface and drinking waters contaminated by cyanobacteria were processed. The identification of seven uncommon microcystins (M(O)R, MC-FR, MSer⁷-YR, D-Asp³MSer⁷-LR, MSer⁷-LR, dmAdda-LR and dmAdda-YR) and 6 anabaenopeptins (A, B, F, MM850, MM864, oscyllamide Y) was reported. Several isobaric variants, fully separated by chromatography, were pointed out. The developed methods are proposed to be used by environmental and health agencies for strengthening the surveillance monitoring of cyanotoxins in water.

Graphical abstract

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Involvement of the nuclear progestin receptor in LH-induced expression of membrane type 2-matrix metalloproteinase required for follicle rupture during ovulation in the medaka, Oryzias latipes

Publication date: Available online 14 April 2017
Source:Molecular and Cellular Endocrinology
Author(s): Katsueki Ogiwara, Takayuki Takahashi
Hormonal regulation of the expression of Mmp15, a proteolytic enzyme indispensable for ovulation in the teleost medaka, was investigated. In an in vitro culture system using preovulatory follicles, Mmp15 expression and ovulation were induced in the presence of recombinant luteinizing hormone (rLh). Both rLh-induced Mmp15 expression and ovulation were 17α, 20β-dihydroxy-4-pregnen-3-one-dependent, suggesting the involvement of a nuclear progestin receptor (Pgr). In vitro follicle ovulation and Mmp15 expression were reduced by treatment with the Pgr antagonist RU-486. Like Pgr, the transcription factor CCAAT/enhancer-binding protein β (Cebpb) was induced by rLh. ChIP analyses indicated that Pgr and Cebpb bound to the mmp15 promoter region. These results indicate that the rLh-induced expression of Mmp15 is mediated by Pgr and Cebpb. A differential timing of expression of Pgr and Cebpb in the preovulatory follicles appears to explain the considerably long time-lag from the pgr gene activation to mmp15 gene expression.



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Evaluation of the chelating performance of biopolyelectrolyte green complexes (NIBPEGCs) for wastewater treatment from the metal finishing industry

Publication date: 5 August 2017
Source:Journal of Hazardous Materials, Volume 335
Author(s): Eduardo A. López-Maldonado, Oscar Gabriel Zavala García, Kevin Cruz Escobedo, Mercedes T. Oropeza-Guzman
In this paper nonstoichiometric interbiopolyelectrolyte green complexes (NIBPEGCs) were prepared using chitosan (Ch), alginate (AG) and poly(acrylic acid)(PAA). They are proposed as innovative formulations (polyelectrolytes and chelating agents) suitable for the elimination heavy metals contained in wastewater. This application may represent an integral solution for industries rejecting solid and aqueous metallic materials; however, it has not been previously reported. NIBPEGCs physicochemical performance was evaluated based on pH, particle size, surface charge, isoelectric point, dose, coagulation-flocculation kinetics and chemical affinity with seven metal ions. The experimental results showed that NIBPEGCs composed by AG/Ch and PAA/Chitosan have all the three complementary functions: chemical affinity, electrostatic interaction and particle entrapment anticipating more simple operation units to remove heavy metals. Complexes of AG/Ch (negative) were higher performance in removing heavy metals, with a dose window (150–180mg/L), lower dose of 410mg/L PAA/Ch (negative). Investigation of chelating performances of NIBPEGCs show that the efficiency of metal removal is: Ca˃Cr˃Cu˃Pb˃Ni˃Zn˃Cd. Transmittance vs time profiles, metals and zeta potential analysis showed that chelation capacity is the crucial factor to ensure metallic species removal, followed by physical entrapment of the metallic colloids. Integrating all presented results allow to sustain the development of excellent metals removal formulations.

Graphical abstract

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Synthesis, characterization and gas sensing properties of ZnO-decorated MWCNTs

Publication date: 15 August 2017
Source:Applied Surface Science, Volume 413
Author(s): Yong Jung Kwon, Ali Mirzaei, Sung Yong Kang, Myung Sik Choi, Jae Hoon Bang, Sang Sub Kim, Hyoun Woo Kim
In this work, ZnO-decorated multi-walled carbon nanotube (MWCNT) nanocomposites prepared using an in-situ method involving the thermal evaporation of Zn powders in the presence of MWCNTs. The gas sensing characteristics of the MWCNT/ZnO nanocomposites are studied, and results for the material characterizations for the synthesized nanocomposites confirm the formation of well-distributed ZnO nanoparticles onto MWCNTs, creating MWCNT/ZnO nanocomposites. The gas sensing properties of the MWCNT/ZnO nanocomposite gas sensor, such as response, cross-sensitivity, and response-recovery time, are investigated and compared with a bare MWCNT sensor. The decoration of ZnO nanoparticles greatly improves the gas sensing properties of bare MWCNTs. We discussed the possible mechanisms for the enhancement of sensing capabilities. The results suggest that decoration of n-type semiconducting oxide materials, such as ZnO in the form of nanoparticles, is a promising strategy for improvement of gas sensing properties of p-MWCNTs.



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Describing heterogeneity of unmet needs among adults with a developmental disability: An examination of the 2012 Canadian Survey on Disability

Publication date: June 2017
Source:Research in Developmental Disabilities, Volume 65
Author(s): Jennifer Zwicker, Arezou Zaresani, J.C. Herb Emery
BackgroundAs a signatory to the UN Convention on the Rights of Persons with Disabilities, Canada has committed to protect the rights and dignity of persons with developmental disabilities (DD), which means that labour markets, education, and training opportunities should be inclusive and accessible.PurposeDescribe the unmet employment, education and daily needs of adults with DD, with a sub analysis of persons with autism spectrum disorder (ASD) and cerebral palsy (CP) in Canada, to inform efficient and equitable policy development.Methods and proceduresSecondary analysis of 2012 Canadian Survey on Disability was used to study a sample including working age (15–64 years old) individuals with self-reported DD, CP and ASD. Persons with DD reported on their met and unmet needs in term of activities of daily living, education and employment.Outcomes and resultsLabour force participation is the lowest for those with DD compared to any other disability. Individuals with CP and ASD report a high level of unmet needs that differ in terms of educational, vocational and daily living supports.Conclusions and implicationsImproving labour force participation to be inclusive and accessible requires policy that considers the range of unmet needs that exist for persons with DD.



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Corrigendum to “Caring for children with intellectual disabilities part 1: Experience with the population, pain-related beliefs, and care decisions” [Res. Dev. Disabil. 62 (2017) 197–208]

Publication date: Available online 14 April 2017
Source:Research in Developmental Disabilities
Author(s): Lara M. Genik, C. Meghan McMurtry, Lynn M. Breau




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Expression of coproporphyrinogen oxidase is associated with detection of upper gastrointestinal carcinomas by 5-aminolevulinic acid-mediated photodynamic diagnosis

Publication date: Available online 14 April 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Kumi Ogihara, Hajime Isomoto, Hiroki Kurumi, Tsutomu Kanda, Mikiko Hashisako, Kazuhiro Tabata, Hiroyuki Ishii, Ken Ohnita, Naoyuki Yamaguchi, Yuko Akazawa, Kayoko Matsushima, Fuminao Takeshima, Masaki Kunizaki, Shigekazu Hidaka, Atsushi Nanashima, Junya Fukuoka, Takeshi Nagayasu, Kazuhiko Nakao
Background5-Aminolevulinic acid is a precursor of photosensitizing protoporphyrin IX and has been applied for photodynamic diagnosis of brain and bladder tumors with few side effects. Although most upper gastrointestinal tumors can be detected during photodynamic diagnosis, some tumors containing signet-ring cells cannot be visualized. Here, we aimed to assess whether proteins involved in the absorbance, activation, and turnover of protoporphyrin IX altered the fluorescence signal in gastric cancer.MethodsAminolevulinic acid-mediated photodynamic diagnosis was performed in 23 lesions from 20 patients using an endoscope equipped with a blue laser light that caused red fluorescence emission of photosensitizing protoporphyrin IX. Red fluorescence signal and intensity was assessed during photodynamic diagnosis procedures. Lesions were resected by endoscopic and/or laparoscopic surgery, and specimens were immunostained and assessed for the expression of ATP-binding cassette sub-family G member 2, oligopeptide transporter-1, and coproporphyrinogen oxidase.ResultsPhotodynamic diagnosis was negative in four cases (17.4%). Three cases of photodynamic diagnosis-negative lesions were signet-ring cell carcinomas, and only one case was differentiated adenocarcinoma (intestinal type). Twenty intestinal type, photodynamic diagnosis-positive lesions showed high expression of coproporphyrinogen oxidase, whereas signet-ring cell carcinomas were all negative. Oligopeptide transporter-1 immunoreactivity was significantly higher in tumors of intestinal type. ATP-binding cassette sub-family G member 2 expression tended to be higher in luminal surface tumors than in intestinal type tumors.ConclusionAminolevulinic acid-mediated photodynamic diagnosis provided good detection of upper gastrointestinal tumors of intestinal type but not diffuse type tumors, such as signet-ring cell carcinomas, possibly owing to coproporphyrinogen oxidase expression.



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Comparing Originator Biologics and Biosimilars: A Review of the Relevant Issues

Publication date: Available online 15 April 2017
Source:Clinical Therapeutics
Author(s): Corrado Blandizzi, Pier Luigi Meroni, Giovanni Lapadula
PurposeWe provide a review of current knowledge on comparability between biosimilars and originator biologics in view of the continuous evolution occurring in this highly dynamic area.MethodsEnglish-language literature indexed in MEDLINE was explored, without time limits, to July 31, 2016, using the terms biosimilar, biotechnologic drug, biologic drug, monoclonal antibody, fusion protein, and anti–tumor necrosis factor. The reference lists of identified articles were examined carefully for additional pertinent publications.FindingsBiological medicines are much more structurally complex and extremely sensitive to manufacturing conditions and therefore more difficult to characterize and produce than small molecule drugs. Even minor changes in manufacturing may lead to significant variations of the cellular systems used for biological production, as well as to differences in the structure, stability, or other quality aspects of the end product, all of which have the potential to affect tolerability and/or efficacy and increase the risk of immune responses. Owing to these issues, specific regulatory guidance on biosimilars is continuously evolving, and there is some disagreement on which studies need to be implemented to approve a biosimilar. According to current literature, the following points on biosimilars deserve consideration: biosimilar development is characterized by global harmonization, although several not fully answered questions remain regarding extrapolation of indications, switching or interchangeability, and tolerability; in patients with rheumatic diseases, the tolerability and efficacy of biosimilars in clinical practice remain to be established; several medical and patient associations have published position papers on biosimilars requesting that safety, efficacy, and traceability be carefully considered; long-term postmarketing studies should be implemented to allow physicians to gain confidence in biosimilars.ImplicationsOn the basis of current knowledge, and taking into consideration both regulatory rules and medical society positions, it can be concluded that, although cost savings are highly desirable, the approval process for biosimilars needs to place tolerability and efficacy, supported by scientifically sound evidence, as the highest priority. Moreover, physicians must retain full authority regarding the decision about which biopharmaceutical to use for treating patients.



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The effect of focal cortical frontal and posterior lesions on recollection and familiarity in recognition memory

Publication date: Available online 15 April 2017
Source:Cortex
Author(s): Vess Stamenova, Fuqiang Gao, Sandra E. Black, Michael L. Schwartz, Natasha Kovacevic, Michael P. Alexander, Brian Levine
Recognition memory can be subdivided into two processes: recollection (a contextually rich memory) and familiarity (a sense that an item is old). The brain network supporting recognition encompasses frontal, parietal and medial temporal regions. Which specific regions within the frontal lobe are critical for recollection vs. familiarity, however, are unknown; past studies of focal lesion patients have yielded conflicting results. We examined patients with focal lesions confined to medial polar (MP), right dorsal frontal (RDF), right frontotemporal (RFT), left dorsal frontal (LDF), temporal, and parietal regions and matched controls. A series of words and their humorous definitions were presented either auditorily or visually to all participants. Recall, recognition, and source memory were tested at 30 min and 24 hr delay, along with "remember/know" judgements for recognized items. The MP, RDF, temporal and parietal groups were impaired on subjectively reported recollection; their intact recognition performance was supported by familiarity. None of the groups were impaired on cued recall, recognition familiarity or source memory. These findings suggest that the MP and RDF regions, along with parietal and temporal regions, are necessary for subjectively-reported recollection, while the LDF and right frontal ventral regions, as those affected in the RTF group, are not.



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Longitudinal changes in the fronto-striatal network are associated with executive dysfunction and behavioral dysregulation in Huntington’s disease: 30 months IMAGE-HD data

Publication date: Available online 15 April 2017
Source:Cortex
Author(s): Juan F. Domínguez D, Govinda Poudel, Julie C. Stout, Marcus Gray, Phyllis Chua, Beth Borowsky, Gary F. Egan, Nellie Georgiou-Karistianis
Neuropsychiatric disturbance−particularly executive dysfunction and behavioral dysregulation−is a common feature of Huntington's disease (HD), with implications for functional capacity and quality of life. No study to date has ascertained whether longitudinal change in brain activity is associated with neuropsychiatric deficits in HD. We used a set-response-shifting task together with functional magnetic resonance imaging to investigate 30-month longitudinal blood-oxygen level dependent (BOLD) signal changes in the fronto-striatal attentional control network in premanifest and symptomatic HD (pre-HD and symp-HD, respectively), relative to healthy control participants. We also assessed the extent to which changes in the BOLD signal over time were related to neuropsychiatric measures in the domains of executive dysfunction and behavioral dysregulation. Associations were also evaluated with clinical and disease severity. We found no longitudinal BOLD differences between pre-HD and controls over 30 months. In contrast, reduction in BOLD response over time was greater in symp-HD, relative to controls, in task-related areas (e.g., anterior cingulate cortex and striatum) and in regions from the default mode network (e.g., medial prefrontal cortex and posterior cingulate/precuneus). Moreover, when considered across both premanifest and symptomatic stages, longitudinal BOLD signal decline in the right dorsolateral prefrontal cortex and putamen was associated with executive dysfunction and behavioral dysregulation measures. In addition, longitudinal reduction in BOLD signal, in fronto-striatal and default mode networks, correlated with disease severity. These results suggest that longitudinal change in fronto-striatal and default mode networks may be useful in understanding the biological underpinnings of functional decline in HD. Such findings offer new avenues for targeted treatments in terms of minimizing psychiatric impairment and potentially maximizing cognitive function.



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Influence of response bias and internal/external source on lateral posterior parietal successful retrieval activity

Publication date: Available online 15 April 2017
Source:Cortex
Author(s): Danielle R. King, Michael B. Miller
In studies of recognition memory, regions of the lateral posterior parietal cortex exhibit greater activity (as indexed by the fMRI BOLD signal) during correct recognition of "old" (studied) items than correct rejection of "new" (unstudied) items. This effect appears to be source-sensitive, with greater activity associated with recognition of perceived than imagined events. Parietal successful retrieval activity also varies with response bias, or the tendency to be conservative about making "old" judgments. Here, we examined whether differences in response bias associated with recognition judgments of perceived and imagined events could account for source-based differences in LPPC activity. Participants perceived and imagined items in response to cue words and then at test, made recognition judgments in blocks that knowingly contained either a high or low proportion of old to new trials. While participants were indeed more conservative when making judgments about perceived than imagined events, the neuroimaging results demonstrated that response bias and source effects occurred in non-overlapping parietal regions. These findings suggest that source-based differences in LPPC activity cannot be explained by differences in response bias associated with recognizing perceived and imagined events.



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Hydroceles—Not Just For Men

Publication date: Available online 14 April 2017
Source:The Journal of Emergency Medicine
Author(s): Danielle Biggs, Amy Patwa, Steve Gohsler
BackgroundHydroceles develop in females through the canal of Nuck. This canal is formed when the processes vaginalis fails to obliterate during development. The canal of Nuck can lead to the formation of not only hydroceles, but hernias as well. Although physicians typically think of hydroceles occurring in males, on rare occasions, they do occur in females because of this defect. They are often mistaken for incarcerated hernias, making ultrasound an excellent tool to distinguish between them and guide further treatment.Case ReportWe report a rare case of a 46-year-old female with the chief complaint of a painful groin mass. A diagnosis of a hydrocele was made by point of care ultrasonography in the emergency department after being misdiagnosed by computed tomography scan on two previous occasions.Why Should an Emergency Physician Be Aware of This?Point of care ultrasound (POCUS) is a valuable tool for emergency physicians and can lead to quick diagnoses and appropriate management of the patient. Using ultrasound in conjunction with other imaging modalities can improve diagnostic accuracy. POCUS is portable and a powerful tool for immediate answers, and continues to prove its utility for clinical decision making.



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Initial Asthma Severity Assessment Tools as Predictors of Hospitalization

Publication date: Available online 14 April 2017
Source:The Journal of Emergency Medicine
Author(s): Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BackgroundAssessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department.ObjectiveOur aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations.Study DesignRetrospective study evaluating PAT, TL, and PS at presentation, and initial O2 sat of asthmatic children in the pediatric emergency department (PED). The primary outcome measure was the rate of hospitalization. Secondary outcomes were length of stay (LOS) in the PED and admission to the pediatric intensive care unit (PICU).ResultsPAT, TL, PS, and initial O2 sat were recorded in 14,953 asthmatic children. Multivariate analysis yielded the following results: Abnormal PAT and more severe TLs (I–II) were independent risk factors for hospitalization (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.4–1.8; OR 3.4, 95% CI 2.6–4.3, respectively) and longer LOS (OR 1.5, 95% CI 1.3–1.7; OR 2.6, 95% CI 2–3.3, respectively). PS > 3 showed a strong association with hospitalization (OR 8.1, 95% CI 7–9.4), PICU admission (OR 9.6, 95% CI 3–30.9) and longer LOS (OR 6.2, 95% CI 5.6–6.9). O2 sat < 94% was an independent predictor of admission (OR 5.2, 95% CI 4.6–5.9), PICU admission (OR 4.6, 95% CI 4.5–4.6), and longer LOS (OR 4.6, 95% CI 4.1–5.2).ConclusionsPAT, TL, PS, and initial O2 sat are good predictors of hospitalization in pediatric acute asthma exacerbations.



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