Fibula free flaps are used widely in head and neck reconstruction, primarily for their versatility and contribution to aesthetic and functional outcomes. The literature suggests that early complications such as wound dehiscence and skin graft loss can occur in up to a third of patients. The healing of these donor sites can be prolonged, and in certain cases may require an operative intervention. A method to overcome this problem is described herein. In raising the skin paddle, a standard lateral approach to the fibula harvest is used.
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Τετάρτη 6 Απριλίου 2016
The fat–fascia paddle only with a composite fibula flap: marked reduction in donor site morbidity
Quality assessment of systematic reviews on alveolar socket preservation
The aim of this overview was to evaluate and compare the quality of systematic reviews, with or without meta-analysis, that have evaluated studies on techniques or biomaterials used for the preservation of alveolar sockets post tooth extraction in humans. An electronic search was conducted without date restrictions using the Medline/PubMed, Cochrane Library, and Web of Science databases up to April 2015. Eligibility criteria included systematic reviews, with or without meta-analysis, focused on the preservation of post-extraction alveolar sockets in humans.
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Effect of Modified Constraint-Induced Movement Therapy Combined with Auditory Feedback for Trunk Control on Upper Extremity in Subacute Stroke Patients with Moderate Impairment: Randomized Controlled Pilot Trial
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The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation
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Gender-Specific Association between Angiotensin II Type 2 Receptor −1332 A/G Gene Polymorphism and Advanced Carotid Atherosclerosis
The angiotensin II type 2 receptor (AT2R) −1332 A/G polymorphism has been denoted as functional and associated with certain cardiovascular disease phenotypes. However, there are no studies considering the association of this gene polymorphism with carotid atherosclerosis (CA) and cerebrovascular events. Therefore, the aim of our study was to investigate a possible association of the AT2R −1332 A/G polymorphism with the occurrence of carotid plaques (CPs) and history of cerebrovascular insult (CVI) in advanced CA.
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NAP SACC UK: protocol for a feasibility cluster randomised controlled trial in nurseries and at home to increase physical activity and healthy eating in children aged 2-4 years
Introduction
Systematic reviews have identified the lack of intervention studies with young children to prevent obesity. This feasibility study examines the feasibility and acceptability of adapting the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) intervention in the UK to inform a full-scale trial.
Methods and analysisA feasibility cluster randomised controlled trial in 12 nurseries in England, with 6 randomly assigned to the adapted NAP SACC UK intervention: nursery staff will receive training and support from an NAP SACC UK Partner to review the nursery environment (nutrition, physical activity, sedentary behaviours and oral health) and set goals for making changes. Parents will be invited to participate in a digital media-based home component to set goals for making changes in the home. As this is a feasibility study, the sample size was not based on a power calculation but will indicate the likely response rates and intracluster correlations. Measures will be assessed at baseline and 8–10 months later. We will estimate the recruitment rate of nurseries and children and adherence to the intervention and data. Nursery measurements will include the Environmental Policy Assessment and Observation score and the nursery staff's review of the nursery environment. Child measurements will include height and weight to calculate z-score body mass index (zBMI), accelerometer-determined minutes of moderate-to-vigorous physical activity per day and sedentary time, and diet using the Child and Diet Evaluation Tool. Questionnaires with nursery staff and parents will measure mediators. A process evaluation will assess fidelity of intervention delivery and views of participants.
Ethics and disseminationEthical approval for this study was given by Wales 3 NHS Research Ethics Committee. Findings will be made available through publication in peer-reviewed journals, at conferences and to participants via the University of Bristol website. Data will be available from the University of Bristol Research Data Repository.
Trial registration numberISRCTN16287377.
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What drives quality improvement in chronic kidney disease (CKD) in primary care: process evaluation of the Quality Improvement in Chronic Kidney Disease (QICKD) trial
Objectives
This study is a process evaluation of the Quality Improvement in Chronic Kidney Disease (QICKD) study, comparing audit-based education (ABE) and sending clinical guidelines and prompts (G&P) with usual practice, in improving systolic blood pressure control in primary care. This evaluation aimed to explore how far clinical staff in participating practices were aware of the intervention, and why change in practice might have taken place.
Setting4 primary care practices in England: 2 received ABE, and 2 G&P. We purposively selected 1 northern/southern/city and rural practice from each study arm (from a larger pool of 132 practices as part of the QICKD trial).
ParticipantsThe 4 study practices were purposively sampled, and focus groups conducted with staff from each. All staff members were invited to attend.
InterventionsFocus groups in each of 4 practices, at the mid-study point and at the end. 4 additional trial practices not originally selected for in-depth process evaluation took part in end of trial focus groups, to a total of 12 focus groups. These were recorded, transcribed and analysed using the framework approach.
Results5 themes emerged: (1) involvement in the study made participants more positive about the CKD register; (2) clinicians did not always explain to patients that they had CKD; (3) while practitioners improved their monitoring of CKD, many were sceptical that it improved care and were more motivated by pay-for-performance measures; (4) the impact of study interventions on practice was generally positive, particularly the interaction with specialists, included in ABE; (5) the study stimulated ideas for future clinical practice.
ConclusionsImproving quality in CKD is complex. Lack of awareness of clinical guidelines and scepticism about their validity are barriers to change. While pay-for-performance incentives are the main driver for change, quality improvement interventions can have a complementary influence.
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Identification of a glucose-mannose phosphotransferase system in Clostridium beijerinckii
Effective uptake of fermentable substrates is a fundamentally important aspect of any fermentation process. The solventogenic bacterium Clostridium beijerinckii is noted for its ability to ferment a wide range of carbohydrates, yet few of its sugar transport systems have been characterized. In common with other anaerobes, C. beijerinckii shows a marked dependence on the PEP-dependent phosphotransferase system (PTS) for sugar accumulation. In this study, the gene cbe0751 encoding the sugar-specific domains of a phosphotransferase belonging to the glucose family was cloned into an Escherichia coli strain lacking the ability to take up and phosphorylate glucose. Transformants gained ability to ferment glucose, and also mannose, and further analysis of a selected transformant demonstrated that it could take up and phosphorylate glucose, confirming that cbe0751 encodes a glucose PTS which also recognizes mannose as a substrate. RT-PCR analysis showed that cbe0751 was expressed in cultures grown on both substrates, but also to varying extents during growth on some other carbon sources. Although analogue inhibition studies suggested that Cbe0751 is not the only glucose PTS in C. beijerinckii, this system should nevertheless be regarded as a potential target for metabolic engineering to generate a strain showing improved sugar fermentation properties.
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Development of patient decision support tools for motor neuron disease using stakeholder consultation: a study protocol
Introduction
Motor neuron disease (MND) is a terminal, progressive, multisystem disorder. Well-timed decisions are key to effective symptom management. To date, there are few published decision support tools, also known as decision aids, to guide patients in making ongoing choices for symptom management and quality of life. This protocol is to develop and validate decision support tools for patients and families to use in conjunction with health professionals in MND multidisciplinary care. The tools will inform patients and families of the benefits and risks of each option, as well as the consequences of accepting or declining treatment.
Methods and analysisThe study is being conducted from June 2015 to May 2016, using a modified Delphi process. A 2-stage, 7-step process will be used to develop the tools, based on existing literature and stakeholder feedback. The first stage will be to develop the decision support tools, while the second stage will be to validate both the tools and the process used to develop them. Participants will form expert panels, to provide feedback on which the development and validation of the tools will be based. Participants will be drawn from patients with MND, family carers and health professionals, support association workers, peak body representatives, and MND and patient decision-making researchers.
Ethics and disseminationEthical approval for the study has been granted by Macquarie University Human Research Ethics Committee (HREC), approval number 5201500658. Knowledge translation will be conducted via publications, seminar and conference presentations to patients and families, health professionals and researchers.
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Searching for the mechanisms of change: a protocol for a realist review of batterer treatment programmes
Introduction
Conflicting results reported by evaluations of typical batterer intervention programmes leave many judicial officials and policymakers uncertain about the best way to respond to domestic violence, and whether to recommend and fund these programmes. Traditional evaluations and systematic reviews tend to focus predominantly on whether the programmes 'worked' (eg, reduced recidivism) often at the exclusion of understanding for whom they may or may not have worked, under what circumstances, and why.
Methods and analysisWe are undertaking a realist review of the batterer treatment programme literature with the aim of addressing this gap. Keeping with the goals of realist review, our primary aims are to identify the theory that underlies these programmes, highlight the mechanisms that trigger changes in participant behaviour and finally explain why these programmes help some individuals reduce their use of violence and under what conditions they are effective or not effective. We begin by describing the process of perpetrator treatment, and by proposing an initial theoretical model of behaviour change that will be tested by our review. We then describe the criteria for inclusion of an evaluation into the review, the search strategy we will use to identify the studies, and the plan for data extraction and analysis.
Ethics and disseminationThe results of this review will be written up using the RAMESES Guidelines for Realist Synthesis, and disseminated through peer-reviewed publications aimed at the practitioner community as well as presented at community forums, and at violence against women conferences. Ethics approval was not needed.
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Gliding motility driven by individual cell-surface movements in a multicellular filamentous bacterium Chloroflexus aggregans
Chloroflexus aggregans is an unbranched multicellular filamentous bacterium having the ability of gliding motility. The filament moves straightforward at a constant rate, ~3 μm sec–1 on solid surface and occasionally reverses the moving direction. In this study, we successfully detected movements of glass beads on the cell-surface along long axis of the filament indicating that the cell-surface movement was the direct force for gliding. Microscopic analyses found that the cell-surface movements were confined to a cell of the filament, and each cell independently moved and reversed the direction. To understand how the cellular movements determine the moving direction of the filament, we proposed a discrete-time stochastic model; sum of the directions of the cellular movements determines the moving direction of the filament only when the filament pauses, and after moving, the filament keeps the same directional movement until all the cells pause and/or move in the opposite direction. Monte Carlo simulation of this model showed that reversal frequency of longer filaments was relatively fixed to be low, but the frequency of shorter filaments varied widely. This simulation result appropriately explained the experimental observations. This study proposed the relevant mechanism adequately describing the motility of the multicellular filament in C. aggregans.
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ATF3 provides protection from Staphylococcus aureus and Listeria monocytogenes infections
Activating transcription factor 3 (ATF3) is a stress-induced transcriptional regulator in eukaryote. The role of ATF3 in cancer has been well defined, but how ATF3 functions in bacterial infection is not well understood. Pneumococcal infection has been shown to induce ATF3 expression, which subsequently enhances cytokine production and provides protection from lethal Streptococcus pneumoniae infection, but the role of ATF3 in other Gram-positive (G+) infections remains unclear. Here, we report that infection with other G+ bacteria (Staphylococcus aureus and Listeria monocytogenes) and with G– bacteria (uropathogenic Escherichia coli) also significantly induced ATF3 expression. Moreover, the production of cytokines (tumor necrosis factor alpha [TNF]-α, interleukin [IL]-1β, IL-6 and interferon [IFN]-) was enhanced by ATF3 in S. aureus and L. monocytogenes infection, but decreased in uropathogenic E. coli (UPEC) infection. In addition, in S. aureus and L. monocytogenes infections, ATF3 WT mice cleared bacteria more efficiently and had higher survival rates than ATF3 knockout mice. However, in UPEC infection, no significant difference was found in survival rate. Taken together, these data suggest that ATF3 provides protection from S. aureus and L. monocytogenes infections; however, the role of ATF3 in UPEC infection is more complicated and should be further elucidated.
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Impact of continuous Medical Aid utilisation on healthcare utilisation: unique insight using the 2008-2012 Korean Welfare Panel Study (KOWEPS)
Objectives
Although there has been considerable discussion about the social safety net, few studies related to effect of duration of continuous receipt of Medical Aid on healthcare utilisation have been conducted. Therefore, we investigate whether the duration of receiving Medical Aid affected medical care utilisation.
SettingData were collected from the Korean Welfare Panel Study conducted from 2008 to 2012.
ParticipantsWe included 11 783 samples.
InterventionsEstimating changes in their healthcare utilisation during specific time intervals (1, 2 and ≥3 years) after they switched from National Health Insurance to Medical Aid.
Primary and secondary outcome measuresNumber of outpatient visits.
ResultsThe number of outpatient visits per year was 0.0.051-fold higher (p value: 0.434) among those who were Medical Aid beneficiaries for a continuous period of 1 year, 0.0.267-fold higher (p value: 0.000) among those who were beneficiaries for a continuous period of 2 years, and 0.0.562-fold higher (p value:<0.0001) among those who were beneficiaries for a continuous period of 3 years than it was among those who were beneficiaries of National Health Insurance.
ConclusionsOur results reflect an association between the number of consecutive years of receiving Medical Aid and number of outpatient visits. Since duration of dependence is correlated with reduced exit rates, limits on length of benefits should be considered to strengthen the incentive to return to work.
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Epidemiology of pertussis-related paediatric intensive care unit (ICU) admissions in Australia, 1997-2013: an observational study
Objective
To review the epidemiology of pertussis-related intensive care unit (ICU) admissions across Australia, over a 17-year period.
DesignRetrospective descriptive study.
SettingAustralian ICUs contributing data to the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry. The number of contributing ICUs increased over the study period, from 8 specialist paediatric ICUs in 1997 to 8 specialist paediatric and 13 general ICUs in 2013.
ParticipantsAll paediatric (<16 years) ICU admissions, coded as pertussis-related, between 1 January 1997 and 31 December 2013.
ResultsA total of 373 pertussis-coded ICU admissions were identified in the ANZPIC Registry over the study period. Of these cases, 52.8% occurred during the 4 years of the recent Australian epidemic (2009–2012). ICU admissions were most likely to occur in infants aged younger than 6 weeks (41.8%, n=156) and aged 6 weeks to 4 months (42.9%, n=160). The median length of stay for pertussis-related ICU admissions was 3.6 days, with 77.5% of cases staying in ICU for <7 days. Approximately half of all admissions (54.8%) required some form of respiratory support, with 32.7% requiring invasive respiratory support. Over the study period, 23 deaths were recorded (6.2% of pertussis-related ICU admissions), of which 20 (87.0%) were infants <4 months old.
ConclusionsPertussis-related ICU admissions occur primarily in infants too young to be fully protected from active immunisation. More needs to be done to protect these high-risk infants, such as maternal immunisation.
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Protective role of host aquaporin 6 against Hazara virus, a model for Crimean-Congo hemorrhagic fever virus infection
Crimean–Congo hemorrhagic fever virus (CCHFV) is an arthropod-borne pathogen that causes infectious disease with severe hemorrhagic manifestations in vascular system in humans. The proper function of the cells in the vascular system is critically regulated by aquaporins (AQP), water channels that facilitate fluxes of water and small solutes across membranes. With Hazara virus as a model for CCHFV, we investigated the effects of viruses on AQP6 and the impact of AQP6 on virus infectivity in host cells, using transiently expressed GFP-AQP6 cells, immunofluorescent assay for virus detection, epifluorescent imaging of living cells and confocal microscopy. In GFP-AQP6 expressing cells, Hazara virus reduced both the cellular and perinuclear AQP6 distribution and changed the cell area. Infection of human cell with CCHFV strain IbAR 10200 downregulated AQP6 expression at mRNA level. Interestingly, the overexpression of AQP6 in host cells decreased the infectivity of Hazara virus, speaking for a protective role of AQP6. We suggest the possibility for AQP6 being a novel player in the virus–host interactions, which may lead to less severe outcomes of an infection.
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Catalytic upgrading of butyric acid towards fine chemicals and biofuels
Fermentation-based production of butyric acid is robust and efficient. Modern catalytic technologies make it possible to convert butyric acid to important fine chemicals and biofuels. Here, current chemocatalytic and biocatalytic conversion methods are reviewed with a focus on upgrading butyric acid to 1-butanol or butyl-butyrate. Supported Ruthenium- and Platinum-based catalyst and lipase exhibit important activities which can pave the way for more sustainable process concepts for the production of green fuels and chemicals.
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Large-scale investment in green space as an intervention for physical activity, mental and cardiometabolic health: study protocol for a quasi-experimental evaluation of a natural experiment
Introduction
'Green spaces' such as public parks are regarded as determinants of health, but evidence from tends to be based on cross-sectional designs. This protocol describes a study that will evaluate a large-scale investment in approximately 5280 hectares of green space stretching 27 km north to south in Western Sydney, Australia.
Methods and analysisA Geographic Information System was used to identify 7272 participants in the 45 and Up Study baseline data (2006–2008) living within 5 km of the Western Sydney Parklands and some of the features that have been constructed since 2009, such as public access points, advertising billboards, walking and cycle tracks, BBQ stations, and children's playgrounds. These data were linked to information on a range of health and behavioural outcomes, with the second wave of data collection initiated by the Sax Institute in 2012 and expected to be completed by 2015. Multilevel models will be used to analyse potential change in physical activity, weight status, social contacts, mental and cardiometabolic health within a closed sample of residentially stable participants. Comparisons between persons with contrasting proximities to different areas of the Parklands will provide 'treatment' and 'control' groups within a 'quasi-experimental' study design. In line with expectations, baseline results prior to the enhancement of the Western Sydney Parklands indicated virtually no significant differences in the distribution of any of the outcomes with respect to proximity to green space preintervention.
Ethics and disseminationEthical approval was obtained for the 45 and Up Study from the University of New South Wales Human Research Ethics Committee. Ethics approval for this study was obtained from the University of Western Sydney Ethics Committee. Findings will be disseminated through partner organisations (the Western Sydney Parklands and the National Heart Foundation of Australia), as well as to policymakers in parallel with scientific papers and conference presentations.
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NAP SACC UK: protocol for a feasibility cluster randomised controlled trial in nurseries and at home to increase physical activity and healthy eating in children aged 2-4 years
Introduction
Systematic reviews have identified the lack of intervention studies with young children to prevent obesity. This feasibility study examines the feasibility and acceptability of adapting the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) intervention in the UK to inform a full-scale trial.
Methods and analysisA feasibility cluster randomised controlled trial in 12 nurseries in England, with 6 randomly assigned to the adapted NAP SACC UK intervention: nursery staff will receive training and support from an NAP SACC UK Partner to review the nursery environment (nutrition, physical activity, sedentary behaviours and oral health) and set goals for making changes. Parents will be invited to participate in a digital media-based home component to set goals for making changes in the home. As this is a feasibility study, the sample size was not based on a power calculation but will indicate the likely response rates and intracluster correlations. Measures will be assessed at baseline and 8–10 months later. We will estimate the recruitment rate of nurseries and children and adherence to the intervention and data. Nursery measurements will include the Environmental Policy Assessment and Observation score and the nursery staff's review of the nursery environment. Child measurements will include height and weight to calculate z-score body mass index (zBMI), accelerometer-determined minutes of moderate-to-vigorous physical activity per day and sedentary time, and diet using the Child and Diet Evaluation Tool. Questionnaires with nursery staff and parents will measure mediators. A process evaluation will assess fidelity of intervention delivery and views of participants.
Ethics and disseminationEthical approval for this study was given by Wales 3 NHS Research Ethics Committee. Findings will be made available through publication in peer-reviewed journals, at conferences and to participants via the University of Bristol website. Data will be available from the University of Bristol Research Data Repository.
Trial registration numberISRCTN16287377.
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Topic Modeling of Chinese Language Beyond a Bag-of-Words
Source:Computer Speech & Language
Author(s): Zengchang Qin, Yonghui Cong, Tao Wan
The topic model is one of best known hierarchical Bayesian models for language modeling and document analysis. It has achieved a great success in text classification, in which a text is represented as a big of its words, disregarding grammar and even word order, that is referred to as the bag-of-words assumption. In this paper, we investigate topic modeling of the Chinese language, which has different morphology from alphabetical western languages like English. The Chinese characters, but not the Chinese words, are the basic structural units in Chinese. In previous empirical studies, it shows that the character-based topic model performs better than the word-based topic model. In this research, we propose the character-word topic model (CWTM) to consider the character-word relation in topic modeling. Two types of experiments are designed to test the performance of the new proposed model: topic extraction and text classification. By empirical studies, we demonstrate the superiority of the new proposed model comparing to both word and character based topic models.
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Information theoretic optimal vocal tract region selection from real time magnetic resonance images for broad phonetic class recognition
Source:Computer Speech & Language
Author(s): Abhay Prasad, Prasanta Kumar Ghosh
We propose an information theoretic region selection algorithm from the real time magnetic resonance imaging (rtMRI) video frames for a broad phonetic class recognition task. Representations derived from these optimal regions are used as the articulatory features for recognition. A set of connected and arbitrary shaped regions are selected such that the articulatory features computed from such regions provide maximal information about the broad phonetic classes. We also propose a tree-structured greedy region splitting algorithm to further segment these regions so that articulatory features from these split regions enhance the information about the phonetic classes. We find that some of the proposed articulatory features correlate well with the articulatory gestures from the Articulatory Phonology theory of speech production. Broad phonetic class recognition experiment using four rtMRI subjects reveals that the recognition accuracy with optimal split regions is, on average, higher than that using only acoustic features. Combining acoustic and articulatory features further reduces the error-rate by ∼8.25% (relative).
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A mixed-type intermesenteric trunk as a major contributor to the ascending, transverse, and descending colons: a case report
Abstract
Purpose
We present a case in which a mixed-type intermesenteric trunk was the major arterial supply for the ascending, transverse, and descending colons.
Methods
We dissected a cadaver of a man aged 74 years that was used for a routine abdominal dissection course of 2nd year medical students.
Results
We observed that a mixed-type intermesenteric trunk supplied the majority of the colon, originating from the inferior mesenteric artery. The vessel was non-tortuous and had a counter clockwise course. It gave branches that supply the marginal artery at the splenic and hepatic flexures and at the transverse colon and finally it anastomosed with the ileocolic artery at the ileocecal junction. Through the intermesenteric trunk, the inferior mesenteric artery supplied the descending, transverse, and ascending colons with contributions from the sigmoidal and ileocolic arteries.
Conclusions
The intermesenteric trunk is an important central connection between the superior and inferior mesenteric arteries. It probably is an embryologic remnant that constituted a longitudinal anastomosis between both mesenteric arteries.
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Targeted Imaging of Damaged Bone in Vivo with Gemstone Spectral Computed Tomography
ACS Nano
DOI: 10.1021/acsnano.5b07401
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School health services and its practice among public and private primary schools in Western Nigeria
Globally the number of children reaching school age is estimated to be 1.2 billion children (18 % of the world's population) and rising. This study was therefore designed to determine the school health service...
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Pre-diagnosis blood glucose and prognosis in women with breast cancer
Abstract
Background
The effect of moderately elevated blood glucose levels among non-diabetic subjects on cancer prognosis is not well described. The goal of this study was to examine the association of elevated random blood glucose (RBG) levels in non-diabetic breast cancer patients with overall survival (OS) and time to tumor recurrence (TTR).
Results
Forty-nine deaths and 32 recurrences occurred among 148 eligible study subjects during 855.44 person-years of follow-up, with median follow-up of 5.97 years. We observed that patients with elevated RBG levels experienced significantly shorter OS (hazard ratio [HR], 3.01; 95 % confidence interval [CI] (1.70–5.33); P < 0.001) and shorter TTR (HR, 2.08; CI (1.04–4.16); P = 0.04) as compared to patients with non-elevated RBG levels. After controlling for tumor grade, tumor stage, race, and BMI, elevated RBG continued to display high and statistically significant association with shorter OS (HR, 3.50; CI (1.87–6.54); P < 0.001). Adjustment for age, race, and BMI strengthened HR of RBG for TTR. The association of RGB with TTR lost its borderline statistical significance upon controlling for both tumor grade and stage.
Conclusions
The data suggest that elevated blood glucose is associated with poor prognosis of breast cancer patients. Given the potential clinical implication, these findings warrant further investigation.
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Update on the Massive Transfusion Guidelines on Hemorrhagic Shock: After the Wars
Abstract
Over the past decade, crystalloid- and red blood cell-dominated massive resuscitation practices have largely been replaced with high-ratio transfusion of plasma, platelets, and red blood cells (RBCs) in massively bleeding trauma patients. Literature from military and civilian experiences with massive transfusion (MT) was reviewed, beginning with military transfusion practices at the onset of the wars in Afghanistan and Iraq and continuing through to present day. Early and balanced resuscitation (1:1:1 ratio of plasma, platelets, and RBCs) is superior to crystalloid- or red blood cell-driven resuscitation. Military research from Afghanistan and Iraq stimulated civilian investigations into ratio-based MT. 1:1:1 resuscitation carries the most benefit for massively bleeding trauma patients. Thrombelastography-guided MT can be used to supplement empiric 1:1:1 therapy in order to detect and address specific coagulopathies. Future directions in MT research presently include resuscitation with fresh whole blood and pre-hospital plasma-based resuscitation.
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Declining Operative Experience for Junior-Level Residents: Is This an Unintended Consequence of Minimally Invasive Surgery?
Publication date: Available online 6 April 2016
Source:Journal of Surgical Education
Author(s): Matthew G. Mullen, Elise P. Salerno, Alex D. Michaels, Traci L. Hedrick, Min-Woong Sohn, Philip W. Smith, Bruce D. Schirmer, Charles M. Friel
IntroductionOur group has previously demonstrated an upward shift from junior to senior resident participation in common general surgery operations, traditionally performed by junior-level residents. The objective of this study was to evaluate if this trend would correct over time. We hypothesized that junior resident case volume would improve.MethodsA sample of essential laparoscopic and open general surgery procedures (appendectomy, inguinal herniorrhaphy, cholecystectomy, and partial colectomy) was chosen for analysis. The American College of Surgeons National Surgical Quality Improvement Program Participant Use Files were queried for these procedures between 2005 and 2012. Cases were stratified by participating resident post-graduate year with "junior resident" defined as post-graduate year1-3. Logistic regression was performed to determine change in junior resident participation for each type of procedure over time.ResultsA total of 185,335 cases were included in the study. For 3 of the operations we considered, the prevalence of laparoscopic surgery increased from 2005-2012 (all p < 0.001). Cholecystectomy was an exception, which showed an unchanged proportion of cases performed laparoscopically across the study period (p = 0.119). Junior resident participation decreased by 4.5%/y (p < 0.001) for laparoscopic procedures and by 6.2%/y (p < 0.001) for open procedures. The proportion of laparoscopic surgeries performed by junior-level residents decreased for appendectomy by 2.6%/y (p < 0.001) and cholecystectomy by 6.1%/y (p < 0.001), whereas it was unchanged for inguinal herniorrhaphy (p = 0.75) and increased for partial colectomy by 3.9%/y (p = 0.003). A decline in junior resident participation was seen for all open surgeries, with appendectomy decreasing by 9.4%/y (p < 0.001), cholecystectomy by 4.1%/y (p < 0.002), inguinal herniorrhaphy by 10%/y (p < 0.001) and partial colectomy by 2.9%/y (p < 0.004).ConclusionsAlong with the proliferation of laparoscopy for common general surgical procedures there has been a concomitant reduction in the participation of junior-level residents. As previously thought, familiarity with laparoscopy has not translated to redistribution of basic operations from senior to junior residents. This trend has significant implications for general surgery resident education.
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The Effectiveness of hCG and LHRH in Boys with Cryptorchidism: A Meta-Analysis of Randomized Controlled Trials
Horm Metab Res
DOI: 10.1055/s-0042-104059
To systematically review the efficacy of hCG and LHRH on testicular descent in boys with cryptorchidism, comprehensive search was performed to identify randomized controlled trials (RCTs) in PubMed, EMBASE, the Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI) up to March 2014. Outcomes included testicular complete descent rate (TCDR) and cure rate of patients. Study quality was evaluated using the Jadad scale. Meta-analysis was performed using Review Manager software. Finally, 13 studies were included. hCG and LHRH increased TCDR comparing with control group. The success rate of hCG and LHRH was 24 and 19%, respectively. Further, hCG and LHRH had significant effect on bilateral cryptorchidism, but not on unilateral cryptorchidism. All side effects were transitory and not severe, but if they have long-term harms were not clear. hCG and LHRH can effectively increase TCDR and there was no significant difference between them. However, the hormones cannot be recommended for everyone because of their low success rates and potential long-term harms. Further studies are needed to determine the efficacy of hormonal treatment for subtypes of cryptorchidism.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Effects of Vitamin D-K-Calcium Co-Supplementation on Endocrine, Inflammation, and Oxidative Stress Biomarkers in Vitamin D-Deficient Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Horm Metab Res
DOI: 10.1055/s-0042-104060
The current study was conducted to assess the effects of vitamin D-K-calcium co-supplementation on endocrine, inflammation, and oxidative stress biomarkers in vitamin D-deficient women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 60 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Participants were randomly allocated into 2 groups to intake either 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements (n=30), or placebo (n=30) twice a day for 8 weeks. Endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning and the end of the study. After 8 weeks of intervention, compared with the placebo, vitamin D-K-calcium co-supplementation resulted in a significant reduction in serum-free testosterone (− 2.1±1.6 vs.+0.1±1.0 pg/ml, p<0.001) and dehydroepiandrosterone sulfate (DHEAS) levels (− 0.8±1.0 vs.−0.1±0.5 μg/ml, p=0.006). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+ 75.7±126.1 vs.−80.4±242.8 mmol/l, p=0.005) and a significant difference in plasma malondialdehyde (MDA) concentrations (+ 0.03±0.6 vs.+1.4±2.4 μmol/l, p=0.005) was observed following the supplementation with vitamin D-K-calcium compared with the placebo. A trend toward a greater decrease in luteinizing hormone was observed in vitamin D-K-calcium co-supplement group compared to placebo group (− 7.0 vs.−1.2 IU/l, p=0.09). We did not find any significant effect of vitamin D-K-calcium co-supplementation on prolactin, follicle-stimulating hormone, 17-OH progesterone, inflammatory markers, and glutathione levels. Overall, vitamin D-K-calcium co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on serum DHEAS, free testosterone, plasma TAC, and MDA levels.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Effectiveness of hCG and LHRH in Boys with Cryptorchidism: A Meta-Analysis of Randomized Controlled Trials
Horm Metab Res
DOI: 10.1055/s-0042-104059
To systematically review the efficacy of hCG and LHRH on testicular descent in boys with cryptorchidism, comprehensive search was performed to identify randomized controlled trials (RCTs) in PubMed, EMBASE, the Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI) up to March 2014. Outcomes included testicular complete descent rate (TCDR) and cure rate of patients. Study quality was evaluated using the Jadad scale. Meta-analysis was performed using Review Manager software. Finally, 13 studies were included. hCG and LHRH increased TCDR comparing with control group. The success rate of hCG and LHRH was 24 and 19%, respectively. Further, hCG and LHRH had significant effect on bilateral cryptorchidism, but not on unilateral cryptorchidism. All side effects were transitory and not severe, but if they have long-term harms were not clear. hCG and LHRH can effectively increase TCDR and there was no significant difference between them. However, the hormones cannot be recommended for everyone because of their low success rates and potential long-term harms. Further studies are needed to determine the efficacy of hormonal treatment for subtypes of cryptorchidism.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Effects of Vitamin D-K-Calcium Co-Supplementation on Endocrine, Inflammation, and Oxidative Stress Biomarkers in Vitamin D-Deficient Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Horm Metab Res
DOI: 10.1055/s-0042-104060
The current study was conducted to assess the effects of vitamin D-K-calcium co-supplementation on endocrine, inflammation, and oxidative stress biomarkers in vitamin D-deficient women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 60 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Participants were randomly allocated into 2 groups to intake either 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements (n=30), or placebo (n=30) twice a day for 8 weeks. Endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning and the end of the study. After 8 weeks of intervention, compared with the placebo, vitamin D-K-calcium co-supplementation resulted in a significant reduction in serum-free testosterone (− 2.1±1.6 vs.+0.1±1.0 pg/ml, p<0.001) and dehydroepiandrosterone sulfate (DHEAS) levels (− 0.8±1.0 vs.−0.1±0.5 μg/ml, p=0.006). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+ 75.7±126.1 vs.−80.4±242.8 mmol/l, p=0.005) and a significant difference in plasma malondialdehyde (MDA) concentrations (+ 0.03±0.6 vs.+1.4±2.4 μmol/l, p=0.005) was observed following the supplementation with vitamin D-K-calcium compared with the placebo. A trend toward a greater decrease in luteinizing hormone was observed in vitamin D-K-calcium co-supplement group compared to placebo group (− 7.0 vs.−1.2 IU/l, p=0.09). We did not find any significant effect of vitamin D-K-calcium co-supplementation on prolactin, follicle-stimulating hormone, 17-OH progesterone, inflammatory markers, and glutathione levels. Overall, vitamin D-K-calcium co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on serum DHEAS, free testosterone, plasma TAC, and MDA levels.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Peripheral blood mononuclear cell gene expression testing and the heterogeneity of T-cell–mediated drug reaction with eosinophilia and systemic symptoms syndrome
Publication date: Available online 6 April 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Heather M. Schmitz, Theodore E. Kelbel, Faoud Ishmael
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Crotoxin: a novel allergen to occupational anaphylaxis
Publication date: Available online 6 April 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Leticia Gomes de Pontes, Nayara Rodrigues Vieira Cavassan, Camila Fernanda Zorzella Creste, Airton Lourenço Junior, Helen Andrade Arcuri, Rui Seabra Ferreira, Benedito Barraviera, Elaine Gagete, Lucilene Delazari dos Santos
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Topic Modeling of Chinese Language Beyond a Bag-of-Words
Source:Computer Speech & Language
Author(s): Zengchang Qin, Yonghui Cong, Tao Wan
The topic model is one of best known hierarchical Bayesian models for language modeling and document analysis. It has achieved a great success in text classification, in which a text is represented as a big of its words, disregarding grammar and even word order, that is referred to as the bag-of-words assumption. In this paper, we investigate topic modeling of the Chinese language, which has different morphology from alphabetical western languages like English. The Chinese characters, but not the Chinese words, are the basic structural units in Chinese. In previous empirical studies, it shows that the character-based topic model performs better than the word-based topic model. In this research, we propose the character-word topic model (CWTM) to consider the character-word relation in topic modeling. Two types of experiments are designed to test the performance of the new proposed model: topic extraction and text classification. By empirical studies, we demonstrate the superiority of the new proposed model comparing to both word and character based topic models.
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Information theoretic optimal vocal tract region selection from real time magnetic resonance images for broad phonetic class recognition
Source:Computer Speech & Language
Author(s): Abhay Prasad, Prasanta Kumar Ghosh
We propose an information theoretic region selection algorithm from the real time magnetic resonance imaging (rtMRI) video frames for a broad phonetic class recognition task. Representations derived from these optimal regions are used as the articulatory features for recognition. A set of connected and arbitrary shaped regions are selected such that the articulatory features computed from such regions provide maximal information about the broad phonetic classes. We also propose a tree-structured greedy region splitting algorithm to further segment these regions so that articulatory features from these split regions enhance the information about the phonetic classes. We find that some of the proposed articulatory features correlate well with the articulatory gestures from the Articulatory Phonology theory of speech production. Broad phonetic class recognition experiment using four rtMRI subjects reveals that the recognition accuracy with optimal split regions is, on average, higher than that using only acoustic features. Combining acoustic and articulatory features further reduces the error-rate by ∼8.25% (relative).
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A mixed-type intermesenteric trunk as a major contributor to the ascending, transverse, and descending colons: a case report
Abstract
Purpose
We present a case in which a mixed-type intermesenteric trunk was the major arterial supply for the ascending, transverse, and descending colons.
Methods
We dissected a cadaver of a man aged 74 years that was used for a routine abdominal dissection course of 2nd year medical students.
Results
We observed that a mixed-type intermesenteric trunk supplied the majority of the colon, originating from the inferior mesenteric artery. The vessel was non-tortuous and had a counter clockwise course. It gave branches that supply the marginal artery at the splenic and hepatic flexures and at the transverse colon and finally it anastomosed with the ileocolic artery at the ileocecal junction. Through the intermesenteric trunk, the inferior mesenteric artery supplied the descending, transverse, and ascending colons with contributions from the sigmoidal and ileocolic arteries.
Conclusions
The intermesenteric trunk is an important central connection between the superior and inferior mesenteric arteries. It probably is an embryologic remnant that constituted a longitudinal anastomosis between both mesenteric arteries.
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Targeted Imaging of Damaged Bone in Vivo with Gemstone Spectral Computed Tomography
ACS Nano
DOI: 10.1021/acsnano.5b07401
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School health services and its practice among public and private primary schools in Western Nigeria
Globally the number of children reaching school age is estimated to be 1.2 billion children (18 % of the world's population) and rising. This study was therefore designed to determine the school health service...
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Pre-diagnosis blood glucose and prognosis in women with breast cancer
Abstract
Background
The effect of moderately elevated blood glucose levels among non-diabetic subjects on cancer prognosis is not well described. The goal of this study was to examine the association of elevated random blood glucose (RBG) levels in non-diabetic breast cancer patients with overall survival (OS) and time to tumor recurrence (TTR).
Results
Forty-nine deaths and 32 recurrences occurred among 148 eligible study subjects during 855.44 person-years of follow-up, with median follow-up of 5.97 years. We observed that patients with elevated RBG levels experienced significantly shorter OS (hazard ratio [HR], 3.01; 95 % confidence interval [CI] (1.70–5.33); P < 0.001) and shorter TTR (HR, 2.08; CI (1.04–4.16); P = 0.04) as compared to patients with non-elevated RBG levels. After controlling for tumor grade, tumor stage, race, and BMI, elevated RBG continued to display high and statistically significant association with shorter OS (HR, 3.50; CI (1.87–6.54); P < 0.001). Adjustment for age, race, and BMI strengthened HR of RBG for TTR. The association of RGB with TTR lost its borderline statistical significance upon controlling for both tumor grade and stage.
Conclusions
The data suggest that elevated blood glucose is associated with poor prognosis of breast cancer patients. Given the potential clinical implication, these findings warrant further investigation.
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Update on the Massive Transfusion Guidelines on Hemorrhagic Shock: After the Wars
Abstract
Over the past decade, crystalloid- and red blood cell-dominated massive resuscitation practices have largely been replaced with high-ratio transfusion of plasma, platelets, and red blood cells (RBCs) in massively bleeding trauma patients. Literature from military and civilian experiences with massive transfusion (MT) was reviewed, beginning with military transfusion practices at the onset of the wars in Afghanistan and Iraq and continuing through to present day. Early and balanced resuscitation (1:1:1 ratio of plasma, platelets, and RBCs) is superior to crystalloid- or red blood cell-driven resuscitation. Military research from Afghanistan and Iraq stimulated civilian investigations into ratio-based MT. 1:1:1 resuscitation carries the most benefit for massively bleeding trauma patients. Thrombelastography-guided MT can be used to supplement empiric 1:1:1 therapy in order to detect and address specific coagulopathies. Future directions in MT research presently include resuscitation with fresh whole blood and pre-hospital plasma-based resuscitation.
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Declining Operative Experience for Junior-Level Residents: Is This an Unintended Consequence of Minimally Invasive Surgery?
Publication date: Available online 6 April 2016
Source:Journal of Surgical Education
Author(s): Matthew G. Mullen, Elise P. Salerno, Alex D. Michaels, Traci L. Hedrick, Min-Woong Sohn, Philip W. Smith, Bruce D. Schirmer, Charles M. Friel
IntroductionOur group has previously demonstrated an upward shift from junior to senior resident participation in common general surgery operations, traditionally performed by junior-level residents. The objective of this study was to evaluate if this trend would correct over time. We hypothesized that junior resident case volume would improve.MethodsA sample of essential laparoscopic and open general surgery procedures (appendectomy, inguinal herniorrhaphy, cholecystectomy, and partial colectomy) was chosen for analysis. The American College of Surgeons National Surgical Quality Improvement Program Participant Use Files were queried for these procedures between 2005 and 2012. Cases were stratified by participating resident post-graduate year with "junior resident" defined as post-graduate year1-3. Logistic regression was performed to determine change in junior resident participation for each type of procedure over time.ResultsA total of 185,335 cases were included in the study. For 3 of the operations we considered, the prevalence of laparoscopic surgery increased from 2005-2012 (all p < 0.001). Cholecystectomy was an exception, which showed an unchanged proportion of cases performed laparoscopically across the study period (p = 0.119). Junior resident participation decreased by 4.5%/y (p < 0.001) for laparoscopic procedures and by 6.2%/y (p < 0.001) for open procedures. The proportion of laparoscopic surgeries performed by junior-level residents decreased for appendectomy by 2.6%/y (p < 0.001) and cholecystectomy by 6.1%/y (p < 0.001), whereas it was unchanged for inguinal herniorrhaphy (p = 0.75) and increased for partial colectomy by 3.9%/y (p = 0.003). A decline in junior resident participation was seen for all open surgeries, with appendectomy decreasing by 9.4%/y (p < 0.001), cholecystectomy by 4.1%/y (p < 0.002), inguinal herniorrhaphy by 10%/y (p < 0.001) and partial colectomy by 2.9%/y (p < 0.004).ConclusionsAlong with the proliferation of laparoscopy for common general surgical procedures there has been a concomitant reduction in the participation of junior-level residents. As previously thought, familiarity with laparoscopy has not translated to redistribution of basic operations from senior to junior residents. This trend has significant implications for general surgery resident education.
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The Effectiveness of hCG and LHRH in Boys with Cryptorchidism: A Meta-Analysis of Randomized Controlled Trials
Horm Metab Res
DOI: 10.1055/s-0042-104059
To systematically review the efficacy of hCG and LHRH on testicular descent in boys with cryptorchidism, comprehensive search was performed to identify randomized controlled trials (RCTs) in PubMed, EMBASE, the Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI) up to March 2014. Outcomes included testicular complete descent rate (TCDR) and cure rate of patients. Study quality was evaluated using the Jadad scale. Meta-analysis was performed using Review Manager software. Finally, 13 studies were included. hCG and LHRH increased TCDR comparing with control group. The success rate of hCG and LHRH was 24 and 19%, respectively. Further, hCG and LHRH had significant effect on bilateral cryptorchidism, but not on unilateral cryptorchidism. All side effects were transitory and not severe, but if they have long-term harms were not clear. hCG and LHRH can effectively increase TCDR and there was no significant difference between them. However, the hormones cannot be recommended for everyone because of their low success rates and potential long-term harms. Further studies are needed to determine the efficacy of hormonal treatment for subtypes of cryptorchidism.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Effects of Vitamin D-K-Calcium Co-Supplementation on Endocrine, Inflammation, and Oxidative Stress Biomarkers in Vitamin D-Deficient Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Horm Metab Res
DOI: 10.1055/s-0042-104060
The current study was conducted to assess the effects of vitamin D-K-calcium co-supplementation on endocrine, inflammation, and oxidative stress biomarkers in vitamin D-deficient women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 60 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Participants were randomly allocated into 2 groups to intake either 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements (n=30), or placebo (n=30) twice a day for 8 weeks. Endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning and the end of the study. After 8 weeks of intervention, compared with the placebo, vitamin D-K-calcium co-supplementation resulted in a significant reduction in serum-free testosterone (− 2.1±1.6 vs.+0.1±1.0 pg/ml, p<0.001) and dehydroepiandrosterone sulfate (DHEAS) levels (− 0.8±1.0 vs.−0.1±0.5 μg/ml, p=0.006). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+ 75.7±126.1 vs.−80.4±242.8 mmol/l, p=0.005) and a significant difference in plasma malondialdehyde (MDA) concentrations (+ 0.03±0.6 vs.+1.4±2.4 μmol/l, p=0.005) was observed following the supplementation with vitamin D-K-calcium compared with the placebo. A trend toward a greater decrease in luteinizing hormone was observed in vitamin D-K-calcium co-supplement group compared to placebo group (− 7.0 vs.−1.2 IU/l, p=0.09). We did not find any significant effect of vitamin D-K-calcium co-supplementation on prolactin, follicle-stimulating hormone, 17-OH progesterone, inflammatory markers, and glutathione levels. Overall, vitamin D-K-calcium co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on serum DHEAS, free testosterone, plasma TAC, and MDA levels.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Effectiveness of hCG and LHRH in Boys with Cryptorchidism: A Meta-Analysis of Randomized Controlled Trials
Horm Metab Res
DOI: 10.1055/s-0042-104059
To systematically review the efficacy of hCG and LHRH on testicular descent in boys with cryptorchidism, comprehensive search was performed to identify randomized controlled trials (RCTs) in PubMed, EMBASE, the Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI) up to March 2014. Outcomes included testicular complete descent rate (TCDR) and cure rate of patients. Study quality was evaluated using the Jadad scale. Meta-analysis was performed using Review Manager software. Finally, 13 studies were included. hCG and LHRH increased TCDR comparing with control group. The success rate of hCG and LHRH was 24 and 19%, respectively. Further, hCG and LHRH had significant effect on bilateral cryptorchidism, but not on unilateral cryptorchidism. All side effects were transitory and not severe, but if they have long-term harms were not clear. hCG and LHRH can effectively increase TCDR and there was no significant difference between them. However, the hormones cannot be recommended for everyone because of their low success rates and potential long-term harms. Further studies are needed to determine the efficacy of hormonal treatment for subtypes of cryptorchidism.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Effects of Vitamin D-K-Calcium Co-Supplementation on Endocrine, Inflammation, and Oxidative Stress Biomarkers in Vitamin D-Deficient Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
Horm Metab Res
DOI: 10.1055/s-0042-104060
The current study was conducted to assess the effects of vitamin D-K-calcium co-supplementation on endocrine, inflammation, and oxidative stress biomarkers in vitamin D-deficient women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 60 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Participants were randomly allocated into 2 groups to intake either 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements (n=30), or placebo (n=30) twice a day for 8 weeks. Endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning and the end of the study. After 8 weeks of intervention, compared with the placebo, vitamin D-K-calcium co-supplementation resulted in a significant reduction in serum-free testosterone (− 2.1±1.6 vs.+0.1±1.0 pg/ml, p<0.001) and dehydroepiandrosterone sulfate (DHEAS) levels (− 0.8±1.0 vs.−0.1±0.5 μg/ml, p=0.006). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+ 75.7±126.1 vs.−80.4±242.8 mmol/l, p=0.005) and a significant difference in plasma malondialdehyde (MDA) concentrations (+ 0.03±0.6 vs.+1.4±2.4 μmol/l, p=0.005) was observed following the supplementation with vitamin D-K-calcium compared with the placebo. A trend toward a greater decrease in luteinizing hormone was observed in vitamin D-K-calcium co-supplement group compared to placebo group (− 7.0 vs.−1.2 IU/l, p=0.09). We did not find any significant effect of vitamin D-K-calcium co-supplementation on prolactin, follicle-stimulating hormone, 17-OH progesterone, inflammatory markers, and glutathione levels. Overall, vitamin D-K-calcium co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on serum DHEAS, free testosterone, plasma TAC, and MDA levels.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Eosinophilic esophagitis after desensitization to dust mites with sublingual immunotherapy
Publication date: Available online 6 April 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Johana Béné, Delphine Ley, Ramin Roboubi, Frédéric Gottrand, Sophie Gautier
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Peripheral blood mononuclear cell gene expression testing and the heterogeneity of T-cell–mediated drug reaction with eosinophilia and systemic symptoms syndrome
Publication date: Available online 6 April 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Heather M. Schmitz, Theodore E. Kelbel, Faoud Ishmael
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Crotoxin: a novel allergen to occupational anaphylaxis
Publication date: Available online 6 April 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Leticia Gomes de Pontes, Nayara Rodrigues Vieira Cavassan, Camila Fernanda Zorzella Creste, Airton Lourenço Junior, Helen Andrade Arcuri, Rui Seabra Ferreira, Benedito Barraviera, Elaine Gagete, Lucilene Delazari dos Santos
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A mixed-type intermesenteric trunk as a major contributor to the ascending, transverse, and descending colons: a case report
Abstract
Purpose
We present a case in which a mixed-type intermesenteric trunk was the major arterial supply for the ascending, transverse, and descending colons.
Methods
We dissected a cadaver of a man aged 74 years that was used for a routine abdominal dissection course of 2nd year medical students.
Results
We observed that a mixed-type intermesenteric trunk supplied the majority of the colon, originating from the inferior mesenteric artery. The vessel was non-tortuous and had a counter clockwise course. It gave branches that supply the marginal artery at the splenic and hepatic flexures and at the transverse colon and finally it anastomosed with the ileocolic artery at the ileocecal junction. Through the intermesenteric trunk, the inferior mesenteric artery supplied the descending, transverse, and ascending colons with contributions from the sigmoidal and ileocolic arteries.
Conclusions
The intermesenteric trunk is an important central connection between the superior and inferior mesenteric arteries. It probably is an embryologic remnant that constituted a longitudinal anastomosis between both mesenteric arteries.
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Targeted Imaging of Damaged Bone in Vivo with Gemstone Spectral Computed Tomography
School health services and its practice among public and private primary schools in Western Nigeria
Globally the number of children reaching school age is estimated to be 1.2 billion children (18 % of the world's population) and rising. This study was therefore designed to determine the school health service...
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